股骨颈骨折内固定失败后行全髋关节置换术治疗的效果分析

目的分析探讨股骨颈骨折内固定失败后行全髋关节置换术(total hip arthroplasty,THA)治疗的临床疗效。方法回顾性分析2018年1月至2019年1月南阳市骨科医院关节科收治的股骨颈骨折内固定失败后行THA治疗的36例患者的病历资料,对比THA治疗前后髋关节Harris评分及简明健康状况调查量表(SF-36)评分变化情况,评估患者髋关节功能及生活质量。结果治疗后6个月患者髋关节Harris评分为(66.21±6.42)分,治疗后12个月为(88.45±7.19)分,均明显高于治疗前的(43.11±7.25)分(t=14.310、26.640,P均=0.000);治疗后12个月,患者简明健康状况调查量表(SF-36)中的躯体功能、躯体疼痛、生理职能、社会功能、精神健康、情感职能、精力、一般健康状况评分均明显高于治疗前(t=12.790、22.190、7.367、12.760、12.630、6.332、12.160、12.160,P均=0.000)。结论股骨颈骨折内固定失败后予以THA治疗,能够有效提高患者的髋关节功能及生活质量,临床应用价值较高。     

Depression in older patients with advanced colorectal cancer is closely connected with immunosuppressive acidic protein

Colorectal cancer (CRC) is one of the most common tumors. CRC patients are susceptible to suffering from depression. Whether the immune system of CRC patients with depression is impaired or stimulated is controversial. Possible reasons for this conflict are the involvement of confounding factors, such as the age of the patient, the stage of the CRC and the types of treatment in previous studies. To demonstrate clearly the relationship between depression and the immune system in the context of CRC, the present study included only older patients with advanced CRC who received only chemotherapy, and the study adopted immunosuppressive acidic protein (IAP) as an immune parameter for the first time. A total of 56 older patients with advanced CRC completed the Zung Self-Rating Depression Scale (SDS) and were divided into two groups according to SDS scores. The patients exhibiting depression were treated with fluoxetine until their symptoms remitted. The serum levels of IAP and the percentages of CD3-positive (CD3+), CD4+, CD8+ T lymphocytes and CD56+ natural killer (NK) cells and Neutrophil-lymphocyte ratio (NLR) were calculated at the time of enrollment and once the symptoms remitted. Correlation analyses revealed that the SDS score was positively associated with serum IAP levels but negatively associated with CD3 and CD4 levels. Among the depressed and non-depressed patients, serum IAP levels and the percentages of CD3 and CD4 cells were dramatically different. After the depression symptoms were treated, the IAP levels dramatically decreased, while the levels of CD3, CD4, CD8 and CD56 were unchanged. All of above suggested that IAP was closely correlated with depression and might be a relatively objective parameter for predicting depression.     

LipoxinA4 attenuates myocardial ischemia reperfusion injury via a mechanism related to downregulation of GRP-78 and caspase-12 in rats

This study aims to determine the effect of Lipoxin (LX)A₄ on myocardial ischemia reperfusion injury (MIRI) in rats and the related molecular mechanisms. Male SD rats were divided into six groups. The sham operation groups (groups C1, C2) were injected with 2 ml/kg normal saline before and after coronary artery threading, respectively. The MIRI group (groups I/R1, I/R2) were injected with normal saline before and after MIRI, respectively. The LXA₄ groups (groups LX1, LX2) were injected with LXA₄ before and after MIRI treatment, respectively. The hematoxylin–eosin staining and ultrastructural changes of cardiac muscle were observed. The serum levels of interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor (TNF) α and cardiac troponin I (cTnI) were measured before open-chest operation and at the end of the experiment. The mRNA and protein levels of GRP-78 and caspase-12 were determined in each group. The myocardial cell apoptosis, myeloperoxidase (MPO), superoxide dismutase (SOD), and malondialdehyde (MDA) contents were detected. The mRNA and protein levels of GRP-78 and caspase-12, the apoptosis, the serum IL-1β, IL-6, IL-10, TNF-α, and cTnI concentrations, MPO, SOD, MDA contents were significantly increased in groups I/R1, I/R2, LX1, and LX2 compared with those in groups C1 and C2 (P < 0.05). The mRNA and protein expression levels of GRP-78 and caspase-12 in groups LX1 and LX2 were lower than those in groups I/R1 and I/R2. Compared with group I/R1 and I/R2, the myocardial neutrophil infiltration and ultrastructure damage were significantly less in groups LX1 and LX2. GRP-78 and IL-10 are expressed both extracellularly and intracellularly, but are mainly expressed in the cytoplasms. In the absence of MIRI, LXA₄ has no detectable effect on GRP-78 and caspase-12 expression. Before and after MIRI, application of LXA₄ significantly inhibits neutrophil activation, and attenuates myocardial inflammatory injury and oxidative stress. LXA₄ downregulates the mRNA and protein expression of GRP-78 and caspase-12. LXA₄ could play a role in myocardial protection via a mechanism related to downregulation of GRP-78 and caspase-12, and inhibition of apoptosis.     

Vasodilatory Effect of a Novel Rho-Kinase Inhibitor,DL0805-2, on the rat Mesenteric Artery and its Potential Mechanisms

Purpose

In the present study, we investigated the vasodilatory effect of a novel scaffold Rho-kinase inhibitor, DL0805-2, on isolated rat arterial rings including mesenteric, ventral tail, and renal arteries. We also examined the potential mechanisms of its vasodilatory action using mesenteric artery rings.

Methods

A DMT multiwire myograph system was used to test the tension of isolated small arteries. Several drugs were employed to verify the underlying mechanisms.

Results

DL0805-2 (10^?7–10^?4 M) inhibited KCl (60 mM)-induced vasoconstriction in three types of small artery rings (pEC₅₀: 5.84?±?0.03, 5.39?±?0.03, and 5.67?±?0.02 for mesenteric, renal, and ventral tail artery rings, respectively). Pre-incubation with DL0805-2 (1, 3, or 10 μM) attenuated KCl (10–60 mM) and angiotensin II (AngII; 10^?6 M)-induced vasoconstriction in mesenteric artery rings. The relaxant effect on the rat mesenteric artery was partially endothelium-dependent (pEC₅₀: 6.02?±?0.05 for endothelium-intact and 5.72?±?0.06 for endothelium-denuded). The influx and release of Ca²⁺ were inhibited by DL0805-2. In addition, the increased phosphorylation levels of myosin light chain (MLC) and myosin-binding subunit of myosin phosphatase (MYPT1) induced by AngII were blocked by DL0805-2. However, DL0805-2 had little effect on K⁺ channels.

Conclusions

The present results demonstrate that DL0805-2 has a vasorelaxant effect on isolated rat small arteries and may exert its action through the endothelium, Ca²⁺ channels, and the Rho/ROCK pathway.     

Hemoglobin A1c as a marker for identifying diabetes and cardiovascular risk factors: the China Health and Nutrition Survey 2009

Hemoglobin A_1c (HbA_1c) has been recommended as an optional method for diagnosing diabetes. The impact of HbA_1c on the diagnosis of diabetes has not been evaluated in China, a country with the greatest number of people with diabetes in the world. Hence, we aim to examine how well HbA_1c performs as compared with fasting plasma glucose (FPG) for diagnosing diabetes in Chinese population. We conducted a cross-sectional analysis of 7,641 Chinese men and women aged ≥18 years using data from the China Health and Nutrition Survey 2009 in which FPG and standardized HbA_1c were measured. HbA_1c was measured with high-performance liquid chromatography system. Diabetes is defined as having FPG ≥7 mmol/l or HbA_1c ≥6.5 %. Overall, 5.0 and 5.8 % had undiagnosed diabetes by FPG ≥7 mmol/l and HbA_1c ≥6.5 %, respectively. Overlap between HbA_1c- and FPG-based diagnosis of diabetes was limited (n = 214, 34.9 %). Similar trends were noted in both genders, all age groups, urban/rural settings, regions, body mass index (BMI) categories, waist circumference (WC) groups, and blood pressure status. Solely HbA_1c-defined individuals exhibited higher levels of BMI, WC, total cholesterol, and hypersensitive C-reactive protein and lower levels of homeostasis model assessment of insulin resistance. We note limited overlap between FPG- and HbA_1c-based diagnosis of diabetes. The limited overlap between FPG- and HbA_1c-based diagnosis of diabetes persisted in each evaluated subgroup. HbA_1c criterion for the diagnosis of diabetes identifies individuals with a worse cardiovascular risk profile compared with FPG.     

Magnetic resonance imaging and risk factors for progression of lacunar infarct lesions in Chinese patients

Neuroradiology - The proportion of acute symptomatic lacunar infarction lesions that undergo cavitation and the factors influencing cavity formation are yet unclear, particularly in the Chinese...     

江苏省乳腺X射线摄影频度调查及乳腺癌风险评估

目的 调查估算江苏省乳腺X射线摄影的频度,进而估算乳腺摄影对江苏省女性人口的剂量负担,并评估乳腺摄影对江苏省各年龄组女性人口诱发乳腺癌的风险。方法 采用分层随机抽样调查的方法,通过调查30台乳腺摄影设备年检查人数和受检者年龄分布,估算全省乳腺摄影的频度,并计算乳腺摄影对女性人口的剂量负担。使用美国科学院电离辐射生物效应报告BEIR-Ⅶ中的超额归因风险（EAR）模型估算乳腺摄影检查对3个年龄组诱发乳腺癌的风险。结果 江苏省乳腺摄影检查的频度为3.77次/千人口;乳腺摄影对江苏省女性人口剂量负担为0.02 mGy/人。每次乳腺摄影检查对0~15岁组、16~40岁和>40岁3个年龄组的乳腺癌终生归因风险（LAR）分别为138/10万人、14.7/10万人和1.0/10万人。结论 乳腺摄影对人群乳腺癌诱发风险较小,但低年龄组的风险较大,提示针对低年龄乳腺摄影检查仍应慎重。     

Effects of acid and phosphate on arsenic solidification in a phosphogypsum-based cement backfill process

Phosphogypsum (PG) produced during phosphoric acid production contains significant amounts of arsenic and can potentially cause adverse environmental and health effects. Cement backfill technology is an effective management technique that is used to store PG to prevent such problems. The goal of this paper is to study the influencing factors and mechanism of arsenic stabilization in a PG-based cement backfill process. First, a leaching toxicity test was conducted, which showed that the arsenic concentration in PG batches ranged from 129.1 μg L⁻¹ to 407.1 μg L⁻¹, which were all far above the standard limit (10 μg L⁻¹) set by GB/T 14848-93. In addition, the arsenic content was higher in samples with larger PG particles. Secondly, hydrogen and phosphate ions were added to the backfill to investigate how they influenced arsenic solidification, and the results indicated that phosphate ions, rather than hydrogen ions, delayed the arsenic solidification process. This suggests that controlling the soluble phosphate in PG will help reduce arsenic pollution during backfilling. A toxicity leaching test was carried out after backfill samples were cured for 28 d. All arsenic concentrations were below the standard limit, indicating that the cement backfill technology ensured the long-term solidification and stabilization of arsenic.

Phosphogypsum (PG) produced during phosphoric acid production contains significant amounts of arsenic and can potentially cause adverse environmental and health effects.