The effect of electro-acupuncture on motor function recovery in patients with acute cerebral infarction: a randomly controlled trial.

The aim of this study is to investigate the effect of electro-acupuncture treatment in acute phase of cerebral infarction on the motor functions. In this randomly controlled trial, 86 patients were allocated to two groups, the experimental group given clinical and electro-acupuncture treatments for a period of 4 weeks, and the control group given clinical treatment plus active and/or passive functional exercise. The result showed that the level of impairment and disability in both groups were improvement according to the Chinese Stroke Scale, Brunnstrom-Fugl-Meyer score, and Barthel Index throughout the study and 3 months after. The motor functions and the activities of daily living (ADL) were improved significantly in the electro-acupuncture group as compared with the control group (P < 0.05). Also, the results showed greater reduction of neurological deficit in the electro-acupuncture group than in the control group. CONCLUSION: Early acupuncture treatment for acute stroke patients may improve motor functions, and consequently the activities of daily living.     

Off-clamp Retroperitoneoscopic Tumour Evacuation for Sporadic Renal Angiomyolipomas with High RENAL Nephrometry Scores: A Novel Surgical Technique and Its Outcomes

BackgroundPartial nephrectomy or angioembolisation is commonly used for sporadic renal angiomyolipomas (RAMLs) with high RENAL scores, but there is a risk of reduced renal function, postoperative complications, and recurrence.ObjectiveTo describe a new technique for off-clamp laparoscopic evacuation of sporadic RAMLs with high RENAL scores that promotes maximal renal function maintenance and low postoperative complication and lesion recurrence rates.Design, setting, and participantsA retrospective cohort of patients undergoing off-clamp laparoscopic evacuation for sporadic RAMLs with RENAL scores ≥9 from January 2013 to June 2018 was included.Surgical procedureWe highlighted the curettage, suction, packing, and binding (CSPB) technique, a new off-clamp retroperitoneoscopic evacuation technique for sporadic RAMLs.MeasurementsDemographics, preoperative, intraoperative, and postoperative outcomes were assessed.Results and limitationsA total of 141 cases were included. The median (interquartile range [IQR]) tumour size was 7 (6.2–8.2) cm. The median (IQR) RENAL score was 10 (9–11). The median (IQR) operative time was 80 (65–125) min, with a median (IQR) estimated blood loss of 130 (90–362.5) ml. Conversion to neither open surgery nor standard laparoscopy occurred. The warm ischaemia time was zero for all cases. Postoperatively, 13 minor complications (Clavien grade 1) were recorded. No blood transfusions were reported. The glomerular filtration rate did not change significantly from preoperative period to 12-mo follow-up. Recurrence did not occur at the median follow-up period of 48 (36–60) mo. The retrospective design and lack of a control group are limitations of this study.ConclusionsOff-clamp retroperitoneoscopic tumour evacuation using the CSPB technique is feasible, safe, and effective for treating complex sporadic RAMLs.Patient summaryWe report a curettage, suction, packing, and binding technique for off-clamp retroperitoneoscopic evacuation of sporadic renal angiomyolipomas that leads to complete lesion clearance, excellent renal function preservation, and minimal perioperative complications.     

电针结合有氧运动对自然衰老大鼠骨骼肌IGF-I/Akt通路的作用

目的:探索低频电针结合有氧运动对增龄性骨骼肌萎缩的效应,以及IGF-I/Akt及其下游蛋白质合成相关通路信号蛋白的影响。方法:以自然衰老SD大鼠为研究对象,将6月龄雄性SD大鼠32只,体重400～450 g,饲养至大鼠12月龄,根据体重随机分为4组。对照组(YC,只抓取、固定、放回,不做其他干预),电针组(YA,电针干预),运动组(YE,运动干预),电针+运动组(YEA,电针结合运动干预),自SD大鼠12月龄开始持续干预至18月龄,实验结束时观察各组自然衰老大鼠:骨骼肌湿重/体重比;光学显微镜下比目鱼肌HE染色形态;Real-time qPCR法检测骨骼肌中IGF-I mRNA的表达水平;Western印迹法测定的大鼠腓肠肌中AKT、mTOR、p70S6K和p-p70S6K相关蛋白表达情况。结果:与YC组相比,YA组、YEA组皆明显增加18月龄大鼠腓肠肌湿重/体重比(P0.05);YEA组能明显增加比目鱼肌湿重/体重比,高于YC组和YA组(P0.05)。与YC组相比,各个干预组大鼠的腓肠肌IGF-I mRNA表达水平皆有上升趋势,其中YEA组IGF-I mRNA表达增加更为明显(P=0.051)。与YC组相比,电针组(YA)p-Akt,p-mTOR表达升高(P0.05),电针+运动组(YEA)p-Akt,p-mTOR,p-p70S6K表达也显示出升高趋势(P0.05)。结论:电针结合有氧运动可延缓18月龄自然衰老大鼠增龄性骨骼肌萎缩,其分子机制可能与通过激活IGF-I/Akt通路,促进蛋白合成有关。     

The role of low-grade infection in the pathogenesis of apparently aseptic tibial shaft nonunion

PurposeAim of this study was to determine the rate of low-grade infection in patients with primarily as aseptic categorized tibial shaft nonunion and lack of clinical signs of infection.MethodsIn a retrospective study between 2006 and 2013, all patients who underwent revision surgery for treatment of tibial shaft nonunion without clinical evidence of infection were assessed. Bacterial cultures harvested during nonunion revision, C-reactive protein (CRP) and/or white blood cell (WBC) values at hospital admission, outcome, and epidemiological data were analyzed.ResultsIn 88 patients with tibial shaft nonunion without any clinical signs of infection, bacterial samples remained negative in 51 patients. In 37 patients, microbiological diagnostic studies after long-term culturing demonstrated positive bacterial cultures whereas after short-term culturing for 2 days only 17 positive cultures were observed. In 12 cases a mixed culture with 2.3 different bacteria on average was detected. Among patients with negative bacterial cultures bone healing was achieved after 13.2 months. Nonunion with positive bacterial cultures required 19 (range 2-42) months until osseous healing (p = 0.009). Furthermore, nonunion with positive bacterial cultures require statistically more surgical revisions to achieve healing (2.9 ± 0.5 vs. 1.3 ± 0.1 additional procedure; (p = 0.003). Hematological studies carried out before surgical intervention did not demonstrate significant differences in CRP values (negative vs. positive cultures: 0.3 (range 0.3-2.8) mg/dl vs. 0.5 (range 0.3-5.7) mg/dl (p = 0.181) and in WBC values (negative vs. positive cultures: 7.4 (range 3.5-11.9) /nl vs. 7.3 (range 3.7-11.1) /nl (p = 0.723). Limitations of this study may include the varying amount of the at least four samples for microbiological diagnostics as well as the circumstance that for diagnosing low-grade infection swabs and tissue samples were included in this evaluation as being equivalent.ConclusionThe pathogenesis of nonunion may originate from low-grade infection even in patients without clinical signs of infection. In addition, nonunion with positive bacterial cultures require statistically more surgical revisions to achieve healing. Therefore, during any revision surgery, multiple bacterial samples are intended to be harvested for long-term culturing. Particularly, in tibial shaft nonunion following Gustilo-Anderson type III open fractures, low-grade infection should be suspected.Trial registration numberDRKS00014657.Date of registration04/26/2018 retrospectively registered     

黄芪甲苷抗肿瘤作用机制研究进展

黄芪甲苷是从黄芪Astragali Radix中提取得到的皂苷类化合物,是黄芪的主要有效成分之一,具有抗炎、抗氧化、免疫调节、调节代谢及抗肿瘤等药理作用,近年来在抗肿瘤领域备受关注。研究发现黄芪甲苷能抑制肿瘤细胞增殖,进一步抑制肺癌、结直肠癌、肝癌、宫颈癌、卵巢癌等癌症进展。其抗肿瘤作用机制主要有抑制肿瘤细胞增殖、促进肿瘤细胞凋亡、阻滞细胞周期进程、抑制肿瘤细胞侵袭等,此外还发现黄芪甲苷能在一定程度上增强抗肿瘤药物敏感性和提高机体免疫力。黄芪甲苷可通过多种途径发挥抗肿瘤作用,在抗肿瘤治疗领域有广阔的应用前景。对其抗肿瘤作用及机制进行综述,以期为临床的肿瘤治疗提供新的理论支持与借鉴。     

女贞药用价值及其相关上市药品的研究进展

女贞Ligustrum lucidum是木犀科女贞属药用植物,其果实、叶、花等部位均可作为药用。女贞不同药用部位及单体成分具有多种功效,现已开发为多种制剂,既有中药单方制剂,也有以单体成分为主的化学药。大量研究表明,女贞相关药品被广泛用于治疗消化系统、免疫系统等疾病,且临床效果较好。通过对女贞不同药用部位的化学成分、临床应用及药理作用、女贞相关上市药品的工艺与质量、临床应用及基础研究进行综述,进而探讨女贞的潜在应用价值和开发前景,为女贞的综合开发与利用提供一定的参考。     

表面改性与致孔对干姜醇提物压片关键性能改善的研究

目的 以干姜Zingiberis Rhizoma醇提物为研究对象,研究表面改性、聚集与致孔相结合的共处理方式改善干姜醇提物的压片关键性能。方法 以共聚维酮（plasdone S-630,PVP/VA）和碳酸氢铵分别为改性剂和致孔剂,采用喷雾干燥共处理方法制备不同比例的干姜醇提物改性复合粉体,测定并比较各粉体的密度、流动性、粒径、孔隙率和压缩性等粉体学性质和抗张强度、屈服压、功和能等相关压片性质,并采用扫描电子显微镜（SEM）对各粒子表面形态进行表征。结果 仅加入共聚维酮或碳酸氢铵制备的复合粒子的孔隙率、抗张强度（TS）、有效功（Esp）和能（E2）均优于原粉粒子。此外,相比于碳酸氢铵或共聚维酮单独制备的复合粒子,碳酸氢铵-共聚维酮（7.0%、14.0%、21.0%）共喷雾制备的复合粒子所压制片剂的抗张强度进一步提升：分别为（1）3.8～9.7、4.0～12.5、4.2～13.7倍和（2）1.5～2.1、1.3～2.2、1.2～1.8倍。即同时加入共聚维酮和碳酸氢铵制备的多孔复合粒子使上述性质得到进一步改善。另外,崩解时间会随共聚维酮加入而有所延长（9～14 min）,碳酸氢铵的致孔作用...     

竹节参鲨烯环氧酶基因的克隆及生物信息学分析

目的 克隆竹节参Panax japonicus鲨烯环氧酶基因（squalene epoxidase,PjSE）的全长cDNA序列,进行生物信息学分析和原核表达。方法 设计特异性引物,从竹节参中克隆得到PjSE序列;以PjSE基因序列作为输入数据,利用多序列同源比对等生物信息学分析工具进行序列分析;构建重组原核表达载体pCold-PjSE,转化至大肠杆菌BL21(DE3)中进行蛋白诱导表达;采用实时荧光定量PCR技术分析该基因在竹节参不同组织中的相对表达量。结果 PjSE基因开放阅读框长度为1884 bp,编码627个氨基酸,PjSE蛋白相对分子质量为68 639.49,初步预测其具有跨膜结构域,可能定位在叶绿体上;聚丙烯凝胶电泳结果显示诱导表达蛋白的相对分子质量大小与预期结果一致;该基因在竹节参叶中表达量最高,须根次之,根中表达量最低。结论 PjSE基因的克隆、生信分析及原核表达研究,不仅有助于丰富竹节参中该类功能蛋白的种类和数量,完善竹节参皂苷类成分的生物合成途径,也为后期开展竹节参皂苷的异源合成提供了可供选择的关键基因元件。