人工膝关节在运动性损伤中的应用

目的：评价人工膝关节置换及其在运动性损伤中的应用前景。 方法：以 “人工膝关节，置换，运动性损伤，膝关节损伤为中文关键词；以:“artificial knee joint，arthroplasty, sports injury, knee joint injury” 为英文关键词，采用计算机检索1993-01/2009-10相关文章。纳入与有关膝关节运动性损伤及人工膝关节置换相关的文章；排除重复研究或Meta分析类文章。以39篇文献为主重点进行了讨论膝关节运性损伤的生物力学特征及人工膝关节的发展与在运动损伤中的应用。 结果：运动性膝关节损伤的性质主要为擦伤、挫伤、骨折、脱位、撕裂、劳损，严重的关节损伤、骨折、骨裂等损伤要经过手术治疗才能得到康复，必要时需要接受人工关节置换。人工关节置换能够出去痛灶、疼痛，恢复关节的活动功能，并能有效地调整肢体的长度，人工关节置换具有疗效的确切性和可预期性，但也存在如假体松动、磨损或折断等并发症。置换人工膝关节时首先考虑的问题是假体的材料，需要耐用且无排斥反应。 结论：人工膝关节近年来发展迅速，解决了很多患者的关节疾病问题，随着材料学及生物学的发展，在采用材料特别是对假体的个性化设计方面还有很大提升空间。人工膝关节置换能够应用于某些严重的运动性膝关节损伤患者。     

Effect of urinary albumin creatinine ratio on type 2 diabetic retinopathy and is cut-off value for early diabetic retinopathy diagnosis

ObjectiveTo evaluate the effect of Urinary albumin creatinine ratio (UACR) on diabetic retinopathy (DR) in People with Type 2 diabetes (T2D) and the cut-off value of UACR for predicting DR using receiver operating characteristic curve (ROC).MethodsA prospective cohort study of 2490 people with T2D was conducted with follow-up ranging from 3 to 10 years, with a mean follow-up of 7 years. Dilated fundus examination and urine examination were performed annually. Medical history and clinical data were collected and analyzed. Linear mixed effect models with unstructured variance-covariance were carried out to longitudinally assess the influence of UACR and other factors on DR, and ROC curve was drawn to evaluate the value of UACR in early diagnosis of DR.ResultsLinear Mixed-effect models revealed that UACR was positively correlated with the development of DR (β = 0.001, 95 %CI: 1.023–1.241, P < 0.001). The area under the ROC curve for UACR was 0.634 (95 %CI: 0.605–0.664, P < 0.001), cut-off value for early diagnosis of DR was 27.81 mg/g, the sensitivity was 0.586, and the specificity was 0.632.ConclusionUACR can predict the occurrence of DR in people with T2D, so it can be considered as a preliminary indicator of DR.     

Predictive value of a novel sub-item mortality risk score derived from the Norfolk Quality of Life in Diabetic Neuropathy questionnaire in Romanian participants with diabetes mellitus

AimsTo evaluate whether the Norfolk Quality of Life in Diabetic Neuropathy (QOL-DN) questionnaire and the novel Norfolk Mortality Risk Score (NMRS), comprising Norfolk QOL-DN items, can identify 4-year mortality risk in individuals with diabetes.MethodsOf 21,756 adults completing Norfolk QOL-DN in 2012, two groups of surviving and deceased patients were identified in 2016: Group 1, from a county capital and Group 2, from six small cities. NMRS was calculated in Group 1 using the 2012 scores of Norfolk QOL-DN items that discriminate between deceased and surviving participants (p < 0.05) and was subsequently applied to Group 2.Results763 participants were included (Group 1: 481 [450 surviving, 31 deceased]; Group 2: 282 [218 surviving, 64 deceased]). Total Norfolk QOL-DN score was significantly higher (worse) in deceased participants than in survivors in both groups (p ≤ 0.008). Optimal cut-off for the 25-item NMRS was 11.5 in Group 1. Individuals in Groups 1 and 2 with NMRS≥ 11.5 in 2012 had a 4-year mortality risk ratio of 4.24 (95 % confidence interval [CI]: 1.65–10.84) and 2.33 (95 % CI: 1.33–4.07), respectively, corresponding to 8 and 16 additional deaths/100 persons/4 years (p = 0.001).ConclusionNorfolk QOL-DN and NMRS can identify individuals with diabetes at risk of 4-year mortality.     

Bio-inspired microcapsule for targeted antithrombotic drug delivery

Thrombosis or embolism is the leading cause of death and long-term adult disability worldwide. To reduce the risk of thrombosis and hemorrhaging in patients, a facile and versatile method was developed to fabricate microcapsules for targeted antithrombotic drug delivery. The microcapsules were prepared via oxidative polymerization of dopamine on polystyrene microspheres, followed by immobilization of fibrinogen onto the surface of poly(dopamine) layers. Subsequently, microcapsules were obtained by removing the cores with THF. Nattokinase was loaded into the microcapsules via diffusion. The loading amount was approximately 0.05 mg g⁻¹ at 37 °C, and the loading efficiency was nearly 75%, based on the initial concentration of nattokinase in PBS. The release of nattokinase was a gradual process at 37 °C, and the activity of the targeted activated platelets was highly efficient. The antithrombotic activity of the nattokinase microcapsules was evidenced by the sharp dissolution of fibrin clots and the blood clotting time indexes. A gradual release mechanism of platelet-inspired microcapsules used for targeted antithrombotic therapy was proposed. This strategy for targeted antithrombotic drug delivery, which lowers the demand dose and minimizes side effects while maximizing drug efficacy, provides a potential new way to treat life-threatening diseases caused by vascular disruption.

NK-loaded hollow microcapsules were fabricated and assessed as a potential antithrombosis therapy.     

Structural characterization and anti-inflammatory effect in hepatocytes of a galactoglucan from Antrodia camphorata mycelium

The galactoglucan ACP2 was isolated from cultured Antrodia camphorata mycelium through anion-exchange column chromatography and Sephadex G-100 chromatography and shown to exhibit hepatoprotective function in L02 cells. Based on monosaccharide composition analysis, ACP2 was mainly composed of glucose, galactose, and 6-deoxyglucose in a molar ratio of 5 : 2 : 1. The average molecular weight of ACP2 was 1.93 × 10⁴ Da. The primary structure of ACP2 was elucidated with Fourier-transform infrared spectroscopy, gas chromatography-mass spectrometry, and nuclear magnetic resonance spectroscopy. The results indicated the following composition: →6)-linked-β-d-Galp-(1→, →6)-linked-α-d-Glcp-(1→, →3)-linked-α-d-Glcp-(1→, and →2,4)-linked-β-d-Glcp-(1→, with terminal 6-deoxy-α-d-Glcp and α-d-Glcp. ACP2 alleviated lipopolysaccharide-induced hepatocyte inflammation by down-regulating the expressions of COX-2, IL-1β, TNF-α and IL-6. The decreased expressions of TLR4, MyD88, NF-κB, and phosphorylated p38 in ACP2-treated L02 cells indicated that ACP2 might ameliorate inflammation through the TLR4 and p38/NF-κB signaling pathways.

A previously undescribed polysaccharide ACP2 was isolated from Antrodia camphorata mycelium. ACP2 ameliorated hepatocyte inflammation through TLR4 and p38/NF-κB signal pathway.     

药品清洁验证中残留物检测的分析方法选择

药品生产企业在每道工序完成后,需要对生产设备进行清洁,对残留物进行检测,而检测方法的选择一直是困扰企业的一个难题。本文对残留物进行简单分类,给出了一些通用的选择方法,同时结合实际情况,灵活选择。     

Profiling and quantification of isoflavone-C-glycosides impurities in puerarin injection by liquid chromatography coupled to ESI-ion trap mass spectrometry

An HPLC/DAD/MSⁿ method was established for the qualitative and quantitative analysis of the impurities in puerarin injection (PI), a widely used drug in China. The analytical HPLC was performed on an Agela RP-C18 column using 0.1% aqueous formic acid (v:v) and methanol as mobile phase. A total of nine impurities were detected and eight of them were identified as isoflavone-C-glycosides basing on their UV spectra and MSⁿ spectra and comparing with the literature data. An HPLC method for the assay of two common impurities in the commercial PI samples, i.e., neopuerarin A and neopuerarin B, was then established. The validation of the method, including sensitivity, linearity, precision, accuracy, was carried out. The calibration curves showed good linearity of R² > 0.9999 and LOQ (S/N = 10) were less than 3.73 ng. The precision was evaluated by intra- and inter-day assays and R.S.D. values were less than 0.94%. The average recovery rates were 97.0% and 99.5%, respectively, with R.S.D. less than 1.38%. The contents of neopuerarin A and neopuerarin B in various commercial brands of PI samples varied over the range of 0.30–1.16% and 0.42–1.66%, respectively. This is the first report on the impurities in PI.