ObjectiveTo systematically evaluate the potential effectiveness of JinHuang powder in the treatment of diabetic foot ulcers (DFUs). MethodsDatabases including PubMed, The Cochrane Library, Web of Science, CBM, WanFang data, VIP and CNKI were electronically searched from their inception to December 2013, to identify randomized controlled trials (RCTs) about JinHuang powder for DFUs. Two reviewers screened literature according to the inclusion and exclusion criteria, extracted data and assessed the methodological quality of included studies, and then meta-analysis was performed by using RevMan 5.1 software. ResultsA total of 3 RCTs involving 198 patients were included. The results of meta-analysis showed that:the JinHuang powder group were superior to the control group in total effective rate (RR=1.25, 95%CI 1.10 to 1.41, P=0.00) and the wound healing time (SMD=-3.32, 95%CI -5.69 to -0.96, P=0.00). ConclusionCurrent evidence suggests that the JinHuang powder is an effective therapeutic method for DFUs. Because of the limitations of quantity and quality of the eligible studies, large sample size studies are needed to validate the conclusion.
Objective Endoplasmic reticulum stress (ERS) mediated apoptosis is one of the eukaryotic cellularapoptotic pathways, to investigate the potential role of ERS during myocardium apoptosis in rats with severe burninjury. Methods Sixty-four 7-week-old male Wistar rats, weighing 200-220 g, were randomly divided into 2 groups. Thirtypercentage of total body surface area full-thickness thermal injury was produced in 32 rats of burn group, while sham burn wasproduced in 32 rats of control group. The heart tissues were harvested from 8 rats in each group at 1, 4, 7, and 14 days after burnto observe the changes of myocardium ultrastructure with transmission electron microscope (TEM). Myocardium apoptosis wasdetected with TUNEL assay. The expressions of glucose regulated protein 78 (GRP 78), C/EBP-homologous protein (CHOP),and cleaved Caspase 12 in different pathways of ERS were analysed with Western blot. Results All rats survived during theexperiment. Apoptotic changes of cardiomyocytes were observed in burn group, and the apoptosis index in burn group wassignificantly higher than that in control group at each time point (P lt; 0.05), and it reached peak at 7 days after burn injury(P lt; 0.05). The expressions of myocardial GRP 78, CHOP, and cleaved Caspase 12 showed persistent elevation in burn group.The expressions of GRP 78 and cleaved Caspase 12 in burn group were significantly higher than those in control group at eachtime point (P lt; 0.05), while the expression of CHOP was higher than that in control group at the other time points (P lt; 0.05)except 1st day after burn injury. Conclusion ERS and CHOP, Caspase 12 mediated apoptotic pathway are activated inmyocardium after severe burn injury, and this may be one pathway of myocardium apoptosis.
ObjectiveTo systematically review the prevalence of osteoarthritis in Chinese aged 40 and above from January 2000 to December 2019.MethodsPubMed, ScienceDirect, Wiley Online Library, The Cochrane Library, CBM, VIP, CNKI and WanFang Data databases were electronically searched to collect cross-sectional studies on osteoarthritis in Chinese aged 40 and above from January 1st, 2000 to December 31st, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using R 3.5.2 software.ResultsA total of 29 cross-sectional studies with a total sample of 60 711 cases and 19 707 patients were included. The results of meta-analysis showed that, the crude prevalence of osteoarthritis in Chinese aged 40 and over was 38.46% (95%CI 24.31% to 46.22%). Subgroup analysis results showed that the prevalence of lumbar osteoarthritis was the highest (24.79%, 95%CI 13.28% to 27.37%), followed by knee osteoarthritis prevalence (20.50%, 95%CI 14.51% to 27.23%) which increased with age. The prevalence of knee osteoarthritis in females (25.14%, 95%CI 19.54% to 31.19%) was higher than that in males (18.99%, 95%CI 13.86% to 24.71%). The prevalence of knee and lumbar osteoarthritis in rural areas was higher than that in urban areas. The prevalence of knee osteoarthritis in western China (23.59%, 95%CI 18.34% to 30.35%) was higher than that in eastern China (18.36%, 95%CI 12.43% to 27.92%) and central China (15.54%, 95%CI 11.22% to 21.53%). The prevalence of lumbar osteoarthritis in western China (31.17%, 95%CI 19.21% to 50.60%) was higher than that in eastern China (24.38%, 95%CI 16.26% to 36.54%). The incidence of cervical osteoarthritis in the eastern China (20.49%, 95%CI 13.90% to 30.21%) was higher than that in the western China (12.32% 95%CI 8.09% to 18.75%). The prevalence of hand osteoarthritis in western China (6.85%, 95%CI 2.71% to 8.13%) was higher than that in eastern China (2.7%, 95%CI 1.33% to 5.48%).ConclusionsCurrent evidence shows that the prevalence of osteoarthritis in Chinese aged 40 and above is high, and the prevalence of lumbar osteoarthritis is the highest, and the prevalence in western China is higher than that in eastern and central China, followed by knee osteoarthritis, in which the prevalence in females, rural areas, and western China is high. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusion.
Objective To introduce the myocutaneous flap in blepharoplasty and summarize its clinical efficacy. Methods Between January 2013 and March 2016, 1 560 patients underwent blepharoplasty with myocutaneous flap. Of them, 158 patients were followed up over 6 months and included in the study. There were 18 males and 140 females with the average age of 23.4 years (range, 18-35 years). The unilateral side was involved in 13 cases and bilateral sides in 145 cases. The patients had narrow double eyelid, shallow double eyelid, single eyelid, bloated upper eyelid, and upper eyelid skin relaxation. During operation, the tissue between the orbicular muscle of eye and the tarsus was trimmed layer by layer; the orbicularis oculi muscle, capillary network, and the front fascia of tarsus were retained, and the full-thickness skin, muscle, and the front fascia of tarsus were sutured by anatomical apposition. Results Incision healed at stage I. All patients were followed up 6 months to 2 years (mean, 8.3 months). During follow-up period, shallow or extinctive double-eyelid line was observed in 9 cases (12 eyes), and satisfactory results were achieved after trimming front fascia of tarsus and suturing. Good clinical results were obtained in the other patients, who had natural and coherent double eyelid without obvious scar or depression at resection margin. Conclusion Myocutaneous flap for blepharoplasty has many advantages of fast recovery, little wound, light swelling, permanent effects, and good appearance.
ObjectiveTo summarize the possible roles and relevant mechanisms of solute carrier family 3 member A2 (SLC3A2) gene in hepatocellular carcinoma (HCC), and explore its clinical application prospects and value in the diagnosis, treatment, and prognosis of patients with HCC. MethodThe literature on reseaches of the SLC3A2 gene and its association with HCC both domestically and internationally in recent years was reviewed and summarized. ResultsNotably, the SLC3A2 exhibited obviously elevated expression in the HCC tissue as compared with the normal liver tissue. It mainly affected the disease progression of HCC by regulating the intracellular and extracellular amino acids transport, inhibiting the ferroptosis of cells, activating the mechanistic target of rapamycin complex signaling pathways and integrin signaling pathway, and played an important role in the diagnosis, treatment, and prognosis of patients with HCC. ConclusionFrom the results of literature review collected, SLC3A2 might be closely associated with the migration, invasion, proliferation, and apoptosis of HCC cell, and it is expected to serve as an indicator for evaluating survival and prognosis of patients with HCC, and become one of the effective treatment targets for HCC in future.
ObjectiveTo investigate the application of autologous keratinocyte suspension transplantation in skin reconstruction. MethodsForty adult Sprague Dawley rats (weighing, 210-230 g) were randomly divided into 4 groups (n=10): high density keratinocyte suspension transplantation (1×106 cells/cm2) group (group A), middle density (1×105 cells/cm2) group (group B), low density (1×104 cells/cm2) group (group C), and control group (group D). Skin samples were harvested from the rats in groups A, B, C for the isolation of keratinocytes. The model of anti-contracture of full thickness skin wound was made in rats and autologous keratinocyte suspension was transplanted into the wound. The wound was covered by the allogeneic skin (allogeneic skin derived from Wistar rats). The survival of rats was observed after operation. The survival of allogeneic skin was observed at 7, 14, and 21 days after operation, and wound healing rate was calculated after allogeneic skin dropped off. Histological staining and immunohistochemical staining were carried out at 21 days after operation. ResultsAll the rats survived to the end of the experiment. The allograft skins survived in all groups, dried and dropped off. The epithelium sheet could be seen in groups A and B at 21 days, a few very thin epithelium in group C, and no epithelization in group D. The wound healing rate of groups A (62.9%±9.6%) and B (64.2%±9.1%) were significantly higher than that of groups C (38.5%±5.7%) and D (22.7%±5.5%) (P<0.05), and significant difference was found between groups C and D (P<0.05), but there was no significant difference between groups A and B (P>0.05). The results of histological observation showed that squamous epithelial cells were observed in groups A, B, and C, but not in group D; obvious layers of epidermis were observed in groups A and B, thin epidermis and inflammatory cell infiltration in group C, and granulation tissue in group D. The immunohistochemistry staining showed that the expressions of collagen type IV and collagen type VII in groups A, B, and C; the percentage of collagen type IV and collagen type VII positive cells in groups A and B were significantly higher than that of group C (P<0.05), but there was no significant difference between groups A and B (P>0.05). The expressions of collagen type IV and collagen type VII in group D were negative. ConclusionThe repair of full thickness skin wound with graft of autologous keratinocyte suspension can achieve reconstruction of the skin. The appropriate density of keratinocyte suspension for wound healing is 1×105 cells/cm2.
ObjectiveTo explore the effectiveness of the zygomatic spindle-shaped osteotomy and internal push of titanium screw anchor for prominent malar. MethodBetween July 2011 and January 2015, 58 patients with prominent malar underwent zygomatic spindle-shaped osteotomy and internal push of titanium screw anchor. There were 3 males and 55 females, aged 18-33 years (mean, 23 years). They had congenital bilateral prominent malar. Preoperative anteroposterior, lateral, supine position, 45°oblique photographs of the face were taken, three-dimensional CT reconstruction of face was performed. Simple prominent malar was observed in 30 cases, and prominent malar and zygomatic arch in 28 cases; zygomatic bone and zygomatic arch were symmetrical in 51 cases, and asymmetrical in 7 cases. ResultsAll patients obtained stage I incision healing after operation, without infection or hematoma. Numbness of the upper lip occurred in 2 cases, limitation of mouth opening in 1 case, and nasolabial fold deepening in 1 case, which recovered spontaneously after 3 months. Fifty-eight cases were followed up 6-12 months (mean, 10 months). Zygomatic narrow spacing was 10.6-13.9 mm (mean, 11.2 mm). No ptosis of facial soft tissue, zygomatic step, facial nerve injury, raising eyebrow, dysfunction of eyes closure, or temporomandibular joint disorder syndrome occurred. Good bone healing was obtained, zygomatic facial sensation had no obvious abnormality, all patients were satisfied with the improvement of appearance. ConclusionsZygomatic spindle-shaped osteotomy and internal push titanium screw anchor can effectively reduce the cheekbones, and maintain the natural curve of zygomatic body and zygomatic arch. Because of simple operation, less complications, and excellent results, it is an ideal plasty.
Postoperative gastrointestinal disorder (POGD) is a common complication after surgery under anesthesia. Strategies in combination with traditional Chinese medicine and Western medicine have shown some distinct effects but standardized clinical practice guidelines are not available. Thus, a multidisciplinary expert team from various professional bodies including the Perioperative and Anesthesia Professional Committees of the Chinese Association of Integrative Medicine (CAIM), jointly with Gansu Province Clinical Research Center of Integrative Anesthesiology/Anesthesia and Pain Medical Center of Gansu Provincial Hospital of Traditional Chinese Medicine and WHO Collaborating Center for Guideline Implementation and Knowledge Translation/Chinese Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Center /Gansu Provincial Center for Medical Guideline Industry Technology/Evidence-based Medicine Center of Lanzhou University was established to develop evidence-based guidelines. Clinical questions (7 background and 12 clinical questions) were identified through literature reviews and expert consensus meetings. Based on systematic reviews/meta-analyses, evidence quality was analyzed and the advantages and disadvantages of interventional measures were weighed with input from patients’ preferences. Finally, 20 recommendations were developed through the Delphi-based consensus meetings. These recommendations include disease definitions, etiologies, pathogenesis, syndrome differentiation, diagnosis, and perioperative prevention and treatment.