[Objective] To report a new technique that combines microfracture surgery under local anesthesia with injection of platelet-rich plasma (PRP) at the fracture site, so as to improve fracture healing rates. [Methods] Data from patients who visited our hospital from March 2020 to June 2023 and underwent the treatment for delayed union of limb fractures were retrospectively analyzed. Under local infiltrative anesthesia, with the assistance of a C-arm X-ray machine or ultrasound, percutaneous loosening was done at the fracture site and the medullary cavity, followed by cortical drilling around the fracture. The previously prepared PRP was then injected locally at the fracture site. Patients were followed up and their postoperative recovery was recorded. [Results] All patients were followed up, and the fracture healing rate was 94.12% (16/17), with an average healing duration of (5.88±2.50) months. None of the patients experienced any neural or vascular injuries, nor adverse events such as wound infections or osteomyelitis. Before the operation and at the last follow-up, the patients' pain visual analogue scores were (5.12±1.11) vs (0.71±1.21) respectively. The postoperative VAS scores showed a significant decrease compared to preoperative values (P<0.05). The excellent and good rate for limb function on the affected side was 88.24% (14/17) at the last follow-up, which was a significant increase from 0.00% before surgery (P<0.05). [Conclusion] The injection of PRP at the fracture site combined with microfracture surgery at the fracture site is minimally invasive, simple to perform, and well-accepted by patients. It has demonstrated some clinical efficacy in treating delayed fracture healing.

Diabetes have been shown to cause progressive neuronal injury with pain and numbness via advanced glycation end-products (AGEs)-induced neuronal cell apoptosis; however, the valuable drug targets for diabetic neuropathy have been poorly reported so far. In this study, we discovered a natural small-molecule schisandrol A (SolA) with significant protective effect against AGEs-induced neuronal cell apoptosis. ATP6V0D1, a major subunit of vacuolar-type ATPase (V-ATPase) in lysosome was identified as a crucial cellular target of SolA. Moreover, SolA allosterically mediated ATP6V0D1 conformation via targeting a unique cysteine 335 residue to activate V-ATPase-dependent lysosomal acidification. Interestingly, SolA-induced lysosome pH downregulation resulted in a mitochondrial-lysosomal crosstalk by selectively promoting mitochondrial BH3-only protein BIM degradation, thereby preserving mitochondrial homeostasis and neuronal cells survival. Collectively, our findings reveal ATP6V0D1 is a valuable pharmacological target for diabetes-associated neuronal injury via controlling lysosomal acidification, and also provide the first small-molecule template allosterically activating V-ATPase for preventing diabetic neuropathy.

Objective:To evaluate the effects of wearing N95 mask on the quality of chest compression and fatigue.Methods:A total of 80 participants from Zhongnan Hospital with basic life support (BLS) certification conferred by American Heart Association (AHA) within two years were enrolled. After reviewing the key points of cardiopulmonary resuscitation (CPR) and grasping the operation on the manikin, they were randomized (random number) into two groups: wearing surgical masks (SM group, n=40) and wearing N95 masks (N95 group, n=40) during CPR. Each participant performed a 2-minute chest compression-only CPR on the manikin. Participants' height, body weight, Borg scores and physiological parameters before and after CPR were recorded. The quality of chest compression (including compression depth, compression rate, adequate depth proportions, adequate rate proportions, hand position and complete chest recoil) were recorded by Laerdal QCPR ? software. Student's t test and Mann-Whitney test were used to compare the differences of chest compression quality indexes between the two groups. Results:Compared with the SM group, participants in the N95 group had significantly increased median of Borg scores after CPR (16 vs 14, P=0.027), and decreased quality of chest compression, including the decline in compression depth (mean 47 mm vs 52 mm, P=0.020), compression rate (107 times/min vs 118 times/min, P=0.004), complete chest recoil rate (89.8% vs 98.1%, P=0.046), adequate depth proportions (67.4% vs 89.6%, P<0.01) and adequate rate proportions (60.6% vs 74.8%, P<0.01). Conclusions:Wearing N95 masks during CPR decreases the quality of chest compression and aggravates rescuers’ fatigue. Therefore, it is necessary to exchange rescuers more frequently to ensure the quality of chest compression when wearing N95 masks.

A quantitative analysis method of multi-components with a single marker (QAMS) for simultaneous determination of six marker compounds (one from phenolic acids and five from phthalides) in Chuanxiong Rhizoma was established by applying HPLC and using butylidenephthalide as the internal reference substance. And also the feasibility and accuracy of the established method for quality evaluation and application of Chuanxiong Rhizoma were investigated and validated. The analysis was performed with the mobile phase consisting of acetonitrile - 0.2% aqueous formic acid. The flow rate was 1.0 mL . min-1 and the column temperature was maintained at 30 °C. The detection wavelengths were set at 252 nm (for ferulic acid, Z-ligustilide, and butylidenephthalide) and 266 nm (for senkyunolide I, senkyunolide A, and coniferyl ferulate), separately, and 20 µL was injected for analysis with gradient elution. The results showed that there were no significant differences observed between the HPLC-QAMS method and the external standard method (RSD <5%). The relative correction factors were credible (RSD < 5%) in changed chromatographic conditions. The established HPLC-QAMS method can be accurately used for simultaneously evaluating and controlling the quality of Chuanxiong Rhizoma with multi-components.

BACKGROUND: Diffusion tensor imaging is a common technique applied for clinical studies of the brain, but it is rarely used for the diagnosis or prognosis of spinal cord injury. OBJECTIVE: To establish a rat model of spinal cord injury using micrological techniques, and to evaluate spinal cord transection with diffusion tensor imaging technology, thus providing a good animal model for further intervention. METHODS: Twelve healthy Sprague-Dawley rats were applied to establish spinal cord injury models using precise microscopic techniques, and another six rats in the sham operated group served as controls. Spinal cord transection of experimental rats after modeling was observed using diffusion tensor imaging. Motor evoked potentials and somatosensory evoked potentials were used to detect electrical physiological changes of rats.Neurological function changes of rats were evaluated using slope experiments and Basso, Beattie and Bresnahan scores. RESULTS AND CONCLUSION: After experimental rats regained consciousness, their lower extremities exhibited complete paralysis, the tails cannot swing, accompanying urinary retention. Diffusion tensor imaging displayed the T10 segment of spinal cord was completely transected. Motor and sensory evoked potential waveform were not drawn compared than control group. At 1 day, 1 week, 2 weeks, 4 weeks after operation, the test angle of slope experiments was less than 30° and Basso, Beattie and Bresnahan score was less than 10 points; as the time prolonged, lower limb irritating reflections of some rats were visible, but no initiative functional activity was found, local spinal cord structure were severely damaged. Precise microscopic techniques can successfully establish spinal cord injury model in rats, and diffusion tension imaging clearly visualizes the complete transection of the T10 spinal cord.

Objective To explore the relationship of molecular biology characteristic and the treatment outcome,and influence factors of neoadjuvant chemotherapy (NAC) in inflammatory breast cancer (IBC).Methods The clinicopathological data of 103 IBC patients who were treated with NAC from January 2005 to June 2013 were analyzed retrospectively.Immunohistochemical method was used to detect the expression of estrogen receptor (ER),progesteron receptor (PR),human epidermal growth factor receptor 2 (HER-2) and E-cadherin.The treatment outcome were evaluated.Results In 103 IBC patients,ER negative was 48 patients,PR negative was 51 patients,HER-2 positive was 45 patients,E-cadherin positive was 66 patients.The effective rate of chemotherapy was 72.8％ (75/103).The effective rate of chemotherapy in taxane-based group was significantly higher than that in anthracycline-based group [80.6％ (50/62) vs.61.0％(25/41)],and there was significant difference (P ＜ 0.05).The effective rate of chemotherapy in ER,PR,E-cadherin negative patients was significantly higher than that in ER,PR,E-cadherin positive patients [83.3％ (40/48) vs.63.6％ (35/55),82.4％ (42/51) vs.63.5％ (33/52),83.8％ (31/37) vs.66.7％ (44/66)],and there was significant difference (P ＜ 0.05).The effective rate of chemotherapy in taxane-based group with E-cadherin positive patients was significantly higher than that in anthracycline-based group with E-cadherin positive patients [77.5％ (31/40) vs.50.0％ (13/26)] (P ＜0.05).No correlation existed between the expression of HER-2 and the treatment outcome of chemotherapy (P ＞ 0.05).Conclusion ER,PR and E-cadherin negative patients with IBC is chemosensitive to NAC.The positive expression of E-cadherin may be an important factor of chemotherapy resistance.For the patients with E-cadherin positive,taxane-based chemotherapy regimen can achieve a better effective rate.

BACKGROUND:Previous studies have demonstrated that cell transplantation has neuroprotective effect on intracerebral hemorrhage,and some researches have indicated that transplantation of bone marrow stromal cells(BMSCs)can promote neural function recovery after cerebral infarction.OBJECTIVE:To explore whether transplantation of BMSCs-modified by gtial cell line-dedved neurotrophic factor gene(GDNF)gene provides a better therapeutic effect than native BMSCs after stroke.METHODS:Totally 36 SD rats were induced intracerabral hemorrhage models by injecting autologous arterial blood,and then divided into 3 groups(n=6).each group was assigned into 2 sub-groups Rabbits in each group were stereotaxically grafted with 20 μL GDNF/BMSCs,BMSCs or saline respectively.The rats were executed at 1 and 2 weeks after operation,and immunohistochemistry was used to observe the expressions of synaptophysin(Syn)and growth associated protein-43(GAP-43)in the margin of the hemorrhagic focus.RESULTS AND CONCLUSlON:Compared with the BMSCs and control groups.both Syn-immunoreactive and GAP-43-immunoreactive products were significantly increased in the GDNF/BMSCs group(P＜0.05).Present results demonstrate that transplantation of GDNF gene-modified BMSCs provides better neuroprotection than native BMSCs delivery for stroke.

Objective To investigate the effects of radiosensitivity enhancement and inhibition of migration ability of human lung adenocarcinoma cells by celecoxib,a selective cyclooxygenase (COX)-2 inhibitor.Methods Human lung adenocarcinoma cells of the line A549 were cultured and then inoculated into six-well plates and randomly divided into 4 groups:control group,celecoxib group administered with celecoxib at the subtoxic doses 30 and 50 μmol/L,irradiated group exposed to 0,1,2,4,6,or 8 Gy by linear accelerator,and combined treatment (celecoxib + irradiation) group.The radiosensitizing effect of celecoxib was assessed by clonogenic cell survival test.The migration ability of the A549 cells was measured by scratch-wound test and the content of metalloproteinase-2 (MMP-2) in culture supernatant was detected with ELISA.Results The sensitization enhancement ratio of the celexib group was increased dosedependently.The values of D0 ,Dq,SF2 and D0.01 of the celecoxib + irradiation group were all significantly lower than those of the irradiated group.Scratch-wound test showed that the no-scratch area of the celecoxib + irradiation group and celecoxib group were all significantly wider than those of the mere irradiation and control groups and there was a dose-dependent manner,and the no-scratch area of the celecoxib + irradiation group was wlider than that of the celecoxib group.ELISA showed that the MMP-2 levels in the supernatant of the celecoxib group and celecoxib + irradiation group were respectively significantly lower than those of the control group and mere irradiated group (t = 3.78,5.79、3.15,P ＜ 0.05),however,there was not significant difference between the mere irradiation and control groups (t = 2.73,2.38,P ＞ 0.05).Conclusions Celecoxib enhances concentration-dependently the radiosensitivity of human lung carcinoma cell and inhibits the secretion of MMP-2 of the carcinoma cells,thus inhibiting their migration ability.

BACKGROUND: Stimulating cerebellar fastigial nucleus can regulate, dilate blood vessels and greatly increase local blood flow. However, if its mechanism is to improve the function of vascular endothelium is still uncertain.OBJECTIVE: To study the effects of stimulating cerebellar fastigial nucleus by electricity to vascular relaxation of transient ischemic attack(TIA) patients which is induced by blood flow and explore its protective mechanism to blood vessels of TIA patients.DESIGN: Randomized case control study to patients based on diagnosis SETTING: Department of general diseases, rehabilitation room and ultrasound department of a university hospital.PARTICIPANTS: Forty-four TIA patients(＞ 60 years old) admitted into Department of General Diseases of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology during February 2001 to October 2002 were selected after excluding cerebral hemorrhage or cerebral infarction, atrium fibrillation and other arrhythmia or heart failure and blood system diseases. They were randomly divided into treatmentgroup(22 cases)and control group(22 cases) which were conducted stimulating fastigial nucleus + routine treatment and only routine treatment respectively.METHODS: High resolution ultrasound technique and brachial artery congestion method were used to test the internal diameter change rate of brachial artery in TIA patients before and after treatment.MAIN OUTCOME MEASURES: The internal diameter change rate of brachial artery of TIA pat ients.RESULTS: The internal diameter change rate of brachial artery was (4.59 ± 3.32) % and ( 10. 34 ± 3.13 ) % respectively before and after conducting electric stimulus to fastigial nucleus with significant difference ( t = 5.91, P ＜ 0.01 ). There was significant difference on internal diameter change rate between treatment group and control group( t =5.41, P ＜ 0.01 )while there was no difference in control group before and after treatment [(4.68±3.20) %,(5.10±3.29) %](t=1.72, P＞ 0.05).CONCLUSION: Conducting electric stimulating to fatigial nucleus can greatly improve the reactively vascular congestive function of brachial artery internal diameter and it can improve the vascular endothelial functions of TIA patients.

BACKGROUNDEndostar™ (rh-endostatin, YH-16) is a new recombinant human endostatin developed by Medgenn Bioengineering Co. Ltd., Yantai, Shandong, P.R.China. Pre-clinical study indicated that YH-16 could inhibit tumor endothelial cell proliferation, angiogenesis and tumor growth. Phase I and phase II studies revealed that YH-16 was effective as single agent with good tolerance in clinical use.The current study was to compare the response rate , median ti me to progression (TTP) ,clinical benefit andsafety in patients with advanced non-small cell lung cancer ( NSCLC) , who were treated with YH-16 plus vi-norelbine and cisplatin (NP) or placebo plus NP.

METHODSFour hundred and ninety-three histologically or cy-tologically confirmed stage IIIB and IV NSCLC patients , withlife expectancy > 3 months and ECOG perform-ance status 0-2 , were enrolledin a randomized ,double-blind ,placebo-controlled , multicenter trial ,either trialgroup : NP plus YH-16 (vinorelbine 25 mg/m² on day 1 and day 5 ,cisplatin 30mg/m² on days 2 to 4 , YH-167.5mg/m² on days 1 to 14) or control group : NP plus placebo (vinorelbine 25 mg/m² on day 1 and day 5 ,cis-platin 30 mg/m² on days 2 to 4 ,0.9% sodium-chloride 3 .75 ml on days 1 to 14) every 3 weeks for 2-6 cycles .The trial endpoints included response rate ,clinical benefit rate ,time to progression,quality of life and safety .

RESULTSOf 486 assessable patients , overall response rate was 35.4% in trial group and 19.5% in controlgroup (P=0 .0003) . The median TTP was 6 .3 months and 3 .6 months for trial group and control group respectively (P < 0 .001) . The clinical benefit rate was 73 .3 %in trial group and 64.0% in control group (P=0 .035) .In untreated patients of trial group and control group ,the response rate was 40 .0% and 23.9%(P=0 .003) ,the clinical benefit rate was 76 .5 % and 65 .0 % (P=0 .023) ,the median TTP was 6 .6 and 3 .7months (P=0 .0000) ,respectively .In pretreated patients of trial group and control group ,the response ratewas 23.9% and 8.5%(P=0 .034) ,the clinical benefit rate was 65.2% and 61.7%(P=0 .68) ,the median TTP was 5 .7 and 3 .2 months (P=0 .0002) ,respectively . The relief rate of clinical symptoms in trial groupwas higher than that of those in control group ,but no significance existed (P > 0 .05) . The score of quality oflife in trial group was significantly higher than that in control group (P=0 .0155) after treatment . There were no significant differences in incidence of hematologic and non-hematologic toxicity , moderate and severe sideeffects betweentrial group and control group .

CONCLUSIONSThe addition of YH-16 to NP regimen results in significantly and clinically meaningful improvement in response rate , median time to tumor progression,and clinical benefit rate compared with NP alone in advanced NSCLC patients . YH-16 in combination with chemotherapy shows a synergic activity and a favorable toxic profile in advanced cancer patients .