Abstract:The Standardization of Diagnosis and Treatment for Hepatocellular Carcinoma issued by China in 2011 has effectively improved the comprehensive diagnosis and treatment of hepatocellular carcinoma (HCC). The new edition of Standardization of Diagnosis and Treatment for Hepatocellular Carcinoma published in 2017 firstly introduced the Oxford Centre for Evidence Based Medicine (OCEBM) grades of evidence, standardized the sampling method of HCC, and emphasized microvascular invasion (MVI) as an indicator of regular pathology report. The new guideline recommends modified Response Evaluation Criteria in Solid Tumor (mR ECIST) to assess anti-tumor efficiency. Moreover, the new guideline presents the Chinese staging system and treatment roadmap for HCC according to Chinese actual situation. This paper aimed to interpret the updates of the new guideline for reference by colleagues.

Abstract:Stem cell has been one of the focuses in current biomedical research. It has been well documented that there are various liver stem cells (LSCs) with different markers in liver, and they play important roles in liver regeneration. Moreover, some progresses have been made in autologous and allogeneic stem cells transplantation for the treatment of end-stage liver diseases. However, the origin and markers of LSCs have not been fully clarified, and the mechanism involved in LSCs proliferation and differentiation remains to be deeply studied. With the improvements of lineage tracing technique and stem cell isolation and culture system, it is believed that the origin of LSCs and their role in liver regeneration will be further clarified, and LSCs treatment for liver diseases will soon become a reality.

Abstract:To explore the influence of the hepatocyte-specific up-regulation of hepatocyte nuclear factor 1α (HNF1α) on mouse hepatic fibrosis induced by carbon tetrachloride (CCl₄). Methods Eighteen C57/B6 male mice were randomly divided into normal group, AAV8-TBG-Ctrl group and AAV8-TBG-HNF1α group, with 6 mice in each group. Mice in the AAV8-TBG-Ctrl and AAV8-TBG-HNF1α groups were intraperitoneally injected with CCl₄ to establish the hepatic fibrosis mouse model, and then the mice in the AAV8-TBG-HNF1α group were injected with AAV8-TBG-HNF1α carrying HNF1α gene under the control of the thyroid-binding globulin (TBG) promoter to specifically up-regulate expression of HNF1α in hepatocytes, while the mice in the AAV8-TBG-Ctrl group were injected with control vector AAV8-TBG. The expression of HNF1α was determined by immunohistochemistry and qPCR. The pathological changes and collagen deposition of liver tissues were detected by hematoxylin-eosin (H-E) staining and sirius red staining, respectively. Immunohistochemistry method was used to detect α-smooth muscle actin (α-SMA), and the expression of fibrosis related genes (typeⅠcollagen α1 chain[COL1A1], α-SMA), epithelial related genes (E-cadherin, Plakoglobin) and mesenchymal related genes (Vimentin, Slug and Twist1) in liver tissues were analyzed by qPCR. The cell proliferation and apoptosis in fibrotic livers were detected by immunohistochemistry and TdT-mediated dUTP Nick-End Labeling (TUNEL) method, respectively. Results Compared with the normal mice, CCl₄ promoted collagen deposition and the expression of α-SMA in livers, and the expression of HNF1α was significantly decreased (P<0.01) in the process of hepatic fibrosis. Compared with the AAV8-TBG-Ctrl group, the expression of COL1A1 and α-SMA in the fibrotic livers in the AAV8-TBG-HNF1α group was significantly decreased (P<0.01). There was no significant difference in the expression of E-cadherin, Vimentin or other Epithelial-mesenchymal transition related genes, or in the cell proliferation and apoptosis between the AAV8-TBG-Ctrl and AAV8-TBG-HNF1α groups (P>0.05). Conclusion Hepatocyte-specific up-regulation of HNF1α significantly improves CCl₄-induced liver fibrosis in mice.

Abstract:To study the expression of microRNA-544 (miR-544) in hepatocelluar carcinoma (HCC) tissues and its effect on proliferation, apoptosis, colony formation and sphere-forming potential of HCC cells, so as to explore the role of miR-544 in carcinogenesis and development of HCC. Methods Quantitative real-time PCR was used to detect the expressions of miR-544 in liver tissues from rats treated with diethylnitrosamine (DEN), in HCC and adjacent non-tumor tissues from patients, and in HCC spheres after sphere-forming culture. After HCC cell line Hep3B being transfected with miR-544 mimic or miR-544 inhibitor, cell counting kit-8 (CCK-8) was used to detect the proliferation of the HCC cells, colony-formation assay was used to observe the colony-formation ability of the HCC cells, and flow cytometry was used to analyze the cell apoptosis of HCC cells with propidium iodide staining. The sphere-formation assay was performed to determine the sphere-forming potential of HCC cells transfected with miR-544 mimic. Results MiR-544 expression was significantly down-regulated in the HCC tissues of DEN-treated rats (versus the control rats without modelling, P<0.05) and HCC tissues of patients (versus adjacent non-tumor tissues, P<0.01). Overexpression of miR-544 significantly inhibited proliferation (P<0.05, P<0.01) and colony-formation potential (P<0.05) of HCC cells, and also significantly promoted the apoptosis of HCC cells at 72 h (P<0.01). While inhibition of miR-544 in HCC cells significantly promoted the cell proliferation (P<0.01) and colony-formation potential (P<0.05). MiR-544 expression was significantly down-regulated in sphere-forming HCC cells during enrichment culture of liver cancer stem cells (P<0.05), and overexpression of miR-544 inhibited the sphere-formation of HCC cells (P<0.05). Conclusion MiR-544 expression is reduced in HCC tissues and can inhibit the malignant biological behaviors of HCC cells, indicating its inhibitory roles in the development and progression of HCC.

Abstract:Objective To establish a luciferase reporter gene system for detecting the activity of hepatocyte nuclear factor 4α (HNF4α), so as to screen the small molecule compounds regulating the activity of HNF4α. Methods HNF4α was purified by affinity chromatography. The direct interaction of DNA fragment or small molecule compounds to the HNF4α was determined by protein thermal shift assay. The constructing recombinant plasmid pGL3-NINJ1-3p or pGL3-NINJ1-9p, which contained three copies or nine copies of the HNF4α response element in the Ninjurin 1 (NINJ1) promoter, was transfected into hepatoma carcinoma cells. The transcriptional activity of HNF4α was detected by dual-luciferase reporter gene assay. The expressions of HNF4α and its down-stream genes were analyzed in hepatoma carcinoma cells treated with small molecular compound luteolin or alverine by real-time quantitative PCR. The changes of HNF4α transcriptional activity of cells treated with luteolin or alverine were estimated by luciferase reporter gene assay. Results Protein thermal shift confirmed that the HNF4α response element in NINJ1 promoter bound to HNF4α protein. In the hepatoma carcinoma cells with overexpression of HNF4α, both pGL3-NINJ1-3p and pGL3-NINJ1-9p could detect the alteration of the transcriptional activity of HNF4α, and pGL3-NINJ1-9p was more sensitive than pGL3-NINJ1-3p (P<0.01). Luteolin and alverine, both directly interacting with HNF4α, down-regulated and up-regulated the expression of HNF4α target genes, respectively. Moreover, pGL3-NINJ1-9p could validate the effect of luteolin or alverine on the transcriptional activity of HNF4α. Conclusion We successfully establish a detection system for HNF4α activity in hepatoma carcinoma cells by the reporter gene vector pGL3-NINJ1-9p. This system is a tool for screening small molecule compounds that regulate HNF4α activity.

Abstract:Covert hepatic encephalopathy (CHE) is defined as presence of neuropsychological and/or neurophysiological abnormalities in cirrhotic patients without disorientation or asterixis. The West-Haven criteria are most often used to grade hepatic encephalopathy (HE), with scores ranging from 0 to 4. In 2011, the minimal (grade 0) and grade 1 hepatic encephalopathy were collectively referred to as CHE by SONIC classification. It is difficult for clinicians to diagnose CHE because its clinical manifestation is not obvious. So far, there is no consensus on CHE treatment. Here we have reviewed the articles regarding the diagnoses and treatment of CHE, hoping to provide guidance for the clinicians in clinical practice.

Abstract:Protein tyrosine phosphorylation is ubiquitously found in eukaryotic cells, and it is a fundamental regulatory mechanism to be involved in the regulation of cell proliferation, apoptosis, differentiation and migration. Dysregulation of protein tyrosine phosphorylation can influence various liver diseases, such as liver inflammation, liver fibrosis and liver cancer. The src-homology 2 domain-containing protein tyrosine phosphatase 1 (SHP-1), a nonreceptor type protein tyrosine phosphatase, is a key regulator of maintaining protein tyrosine phosphorylation level in vivo. Recently, great progress in the research of SHP-1 in liver diseases has been made, and this review summed up the advances of SHP-1 in liver diseases.

Abstract:Objective To compare the positive surgical margins of the cases by a single surgeon using open versus robot-assisted radical prostatectomy. Methods We chose one surgeon's 387 eligible cases with prostatic cancer, of whom 81 underwent open radical prostatectomy and 306 underwent robot-assisted radical prostatectomy in Department of Urology of Changhai Hospital of Second Military Medical University from Jan. 2009 to May 2017. A positive surgical margin was defined as the presence of tumor cells at the inked surface of the resected specimen. We collected all patients' data from the prostate cancer follow-up database, including age, pre-operative level of prostate specific antigen (PSA), post-operative pathological Gleason score, pathological T staging, and upper and lower margins status. We used propensity score matching to match the data of two groups to ensure the consistency and finally analyzed the difference of positive surgical margins between the two matched groups. Multivariate logistic regression analysis was used to identify the independent influencing factors of positive surgical margins. Results We successfully matched 81 pairs of cases by propensity score matching using age, pre-operative level of PSA, post-operative pathologic Gleason score and pathological T staging as prediction variables. The positive rates of upper, lower and total surgical margins showed no significant differences between open and robot-assisted radical prostatectomy (upper:22.2%[18/81] vs 18.5%[15/81]; lower:29.6%[24/81] vs 30.9%[25/81]; total:38.3%[31/81] vs 38.3%[31/81]). Multivariate logistic regression analysis showed that pre-operative level of PSA (P=0.011) and pathological T stage (P=0.000) were independent influencing factors of positive surgical margin. Conclusion Robot-assisted and open radical prostatectomies show a similar integrity in radical prostatectomy.

Abstract:Objective To explore the effects of invariant natural killer T (iNKT) cell activation on inflammation and severity of early sepsis. Methods Healthy C57BL/6 male mice were randomly divided into 3 groups:sham group, cecal ligation and puncture (CLP)-induced sepsis model group (CLP group) and CLP-induced sepsis model plus treatment with anti-CD1d blocking antibody group (anti-CD1d group). Flow cytometry was used to determine the frequencies of the iNKT cells in the peripheral blood, spleen and thymus of mice after 24 h of CLP operation. Meanwhile, the ELISA assay was used to detect the serum levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-6, interferon-γ (IFN-γ) and IL-4. The correlation of iNKT cells and cytokine was analyzed. The bacterial colonies in peripheral blood and peritoneal lavage fluid were determined. The 10-day survival rates of mice after CLP operation were observed. Twenty patients with confirmed sepsis and 20 healthy volunteers aging 18-70 years were selected. The frequency of peripheral blood iNKT cells and serum cytokine levels of all patients and healthy volunteers were detected. Correlations of iNKT cells and cytokines, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) scores in septic patients were analyzed. Results Compared with the sham group, the mice in the CLP group showed significantly more iNKT cells, significantly higher levels of TNF-α, IL-6, IFN-γ and IL-4 (P<0.05, P<0.01), and significantly higher levels of bacterial colonies in peripheral blood and peritoneal lavage fluid (P<0.01). The mice in the CLP group all died within 7 days after operation. In the mice of the anti-CD1d group, iNKT cell proportions in peripheral blood, spleen and thymus, the serum levels of TNF-α, IL-6, IFN-γ and IL-4 in peripheral blood, and the bacterial burden in the abdominal cavity were decreased compared with the CLP group (P<0.05, P<0.01). Four mice in anti-CD1d group survived at 10 days of post-operation. Compared with healthy volunteers, septic patients displayed significantly higher frequency of iNKT cells and significantly higher levels of TNF-α, IL-6, IFN-γ and IL-4 (P<0.05, P<0.01). Moreover, there was a positive correlation between frequency of iNKT cells with serum IFN-γ and IL-4 and the score of APACHE Ⅱ (P<0.05). Conclusion Increase of peripheral blood iNKT cells in early sepsis is associated with the severity and prognoses of sepsis, which suggests iNKT cells may play an important role in the inflammation of sepsis.

Abstract:Objective To explore the effects of microRNA-484 (miR-484) on hepatic stellate cells (HSCs), the key cell in the occurrence and development of liver fibrosis, and to investigate the functions. Methods On the basis of our previous microarray analysis results, we transfected HSC-T6 cell lines with miR-484 inhibitor to intervene the expression of miR-484 in vitro. The expressions of mRNA and proteins related to liver fibrosis and apoptosis were detected by qPCR and Western blotting, respectively. The cell apoptosis with Annexin Ⅴ-FITC/PI double staining was determined by flow cytometry. Results Compared with the control group, the mRNA and protein expression of miR-484-targeted gene Fis1 and proapoptotic factor caspase-3 were both significantly up-regulated (P<0.05), and apoptosis inhibitory factor Bcl-2 was significantly down-regulated (P<0.05) in the HSC-T6 cells transfected with miR-484 inhibitor; the apoptosis rate of HSC-T6 cells was significantly increased ([32.81±3.21]% vs[57.54±6.76]%, P<0.05), and α-smooth muscle actin and collagen type Ⅰ were both significantly down-regulated (P<0.05) in the HSC-T6 cells transfected with miR-484 inhibitor. Conclusion MiR-484 promotes the occurrence and progress of liver fibrosis through inhibiting the apoptosis and promoting the activation of HSCs by targeting Fis1.

Abstract:Objective To measure the circumferential cortical thickness of anterior entrance and anterior half of lower cervical pedicles on computed tomography (CT) images, providing a reference for accurate anterior cervical pedicle screws. Methods CT scanning was performed in 10 normal lower cervical vertebrae from fresh cadavers, and the coronal and sagittal reconstructed images were obtained. The images were then opened in AutoCAD-2007 software to perform quantitative measurement (accuracy was 0.1 mm) using the "dimaligned function" of dimension menu, and measurement parameters included the thicknesses of superior, medial, inferior and lateral cortex of anterior entrance of pedicle (SAE, MAE, IAE and LAE, respectively), and thicknesses of superior, medial, inferior and lateral cortex of anterior half of pedicle (SPA, MPA, IPA and LPA, respectively). Results Average thicknesses of SAE, MAE, IAE, LAE, SPA, MPA, IPA, and LPA at left and right side from C₃ to C₇ were (1.9±0.6) and (1.9±0.5) mm, (1.9±0.7) and (1.9±0.4) mm, (2.4±0.6) and (2.4±0.5) mm, (0.9±0.5) and (0.9±0.6) mm, (2.3±0.9) and (2.3±0.7) mm, (2.1±0.5) and (2.1±0.6) mm, (2.2±0.8) and (2.2±0.7) mm, and (1.0±0.7) and (1.0±0.6) mm, respectively. There was no significant difference in same measurement parameter between left and right sides at same cervical level (P>0.05). Single factor random block analysis of variance found LAE and LPA were significantly thinner than the other 6 parameters of the same side of same cervical vertebra (all P<0.01), while LAE and LPA were not significantly different (P>0.05). Conclusion LAE and LPA are the thinnest among the 8 measurement parameters from C₃ to C₇, which suggests LAE and LPA have the weakest resistance to exotic force if resistance strength to exotic force is parallel to cortex thickness. We should avoid locating close to LAE when finding anterior entrance or close to LPA when inserting anterior cervical pedicle screws.

Abstract:Objective To explore a method for establishment of tethered cord syndrome model with neural axial stretch in pig. Methods Eighteen adult pigs were randomized into three groups. Sham group:L_1-5 spinal cords were exposed; control group:L_1-5 bilateral pedicle screws were placed after exposure of L_1-5 spinal cords; and experiment group:L_1-5 spinal cords were exposed, then bilateral pedicle screws were placed, and finally L_1-5 intervertebral spaces were extended axially, with six in each group. At different time points, the pigs in the three groups were subjected to X-ray, hindlimb behaviors, urodynamics, somatosensory evoked potential, laser speckle imaging for blood flow and histopathology examination, and the examination results were compared and analyzed. Results In the sham group and control group, there was no obvious change in L_1-5 intervertebral space height, hindlimb motor nerve function scores, urodynamics, somatosensory evoked potentials or laser speckle imaging for blood flow before and after operation; and the spinal cord and nerve structure were normal or nearly normal in the histopathology. In the experiment group, compared with before distraction, L_1-5 intervertebral height after distraction was significantly increased, hindlimb motor nerve function score was significantly decreased, latency of P-wave of sematosensory evoked potential was significantly extended and the amplitude was significantly decreased, and blood flow on the surface of spinal cord was significantly reduced (P<0.05). We observed low compliance bladder, detrusor-sphincter dyssynergia, varying degrees of neuronal necrosis in the spinal cord, vacuolar degeneration and granular degeneration in the cytoplasm, tissue edema, sparse cell structure, and partial perineurium injury in nerve root after extension of L_1-5 intervertebral height. Conclusion The spinal cord and nerve root injury model can be established by loosening posterior column structure and extending intervertebral space, and this model can be used to simulate the clinical tethered cord syndrome patients with sensory and motor dysfunction in the lower extremities, and sphincter dysfunction, which lays a foundation for studying the pathological mechanism and exploring the surgical treatment of tethered cord syndrome.

Abstract:Objective To evaluate the diagnostic value of targeted 1 024 ultra high-resolution CT scanning for the pulmonary nodules under 8 mm in diameter and its effect on follow-up protocols. Methods A total of 67 pulmonary nodules with a mean diameter of (5.97±1.34) mm in 57 patients undergoing targeted scans at Department of Radiology, Shanghai Pulmonary Hospital, Tongji University between July 2015 and August 2016 were analyzed prospectively. Two of 32 nodules with surgical resection were benign, 9 were atypical adenomatous hyperplasia (AAH), 14 were adenocarcinoma in situ (AIS), and 7 were minimally invasive adenocarcinoma (MIA). Sixteen nodules were considered to be malignant but not resected and 19 nodules were considered as benign lesions or required follow-up. The 67 pulmonary nodules were examined by conventional CT scan and targeted 1 024 ultra high-resolution CT scan. Three radiologists with 3-10 years of experience in imaging evaluated the image quality, type of nodules, diagnostic confidence using a 5-point score and gave the diagnosis result and treatment method. The film-reading results were analyzed using SPSS software. Results The images obtained by the targeted 1 024 ultra high-resolution CT scan were significantly superior to that of conventional CT in showing the margin of nodules, internal component, lobulation sign and other aspects (P<0.05). There were significant differences in judging the pure ground-glass opacity (GGO) nodules and mixed GGO nodules between the two kinds of CT images (P<0.05). The diagnostic accuracy of targeted 1 024 ultra high-resolution CT scan was significantly increased versus the conventional CT scan (P<0.05), and the same was true for the diagnostic confidence (P<0.05). The treatment methods given by the two kinds of CT images were significantly different (P<0.05), which was reflected by the decreasing number of follow-up cases and increasing numbers of surgical cases and no follow-up cases. Conclusion The targeted 1 024 ultra high-resolution CT scan can provide a better image quality for pulmonary nodules below 8 mm in diameter. For patients with pulmonary nodules which are difficult to diagnose or with insufficient confidence, further examination should be performed using a targeted 1 024 ultra high-resolution scan.

Abstract:Objective To compare the advantages and disadvantages between high performance liquid chromatography (HPLC)-ultraviolet (UV, HPLC-UV), HPLC-fluorescence detector (FLD, HPLC-FLD) and HPLC-mass spectrometry (MS, HPLC-MS) for determination of the monoamine neurotransmitters (MNs) in brain tissues of mice, and to determine the content of MNs in brain tissues of vascular depression mice using the optimal method. Methods We used the UV, FLD and MS detectors to establish different methods for determination of dopamine (DA), norepinephrine (NE) and 5-hydroxytryptamine (5-HT) in brain tissues. Then the methods was verified with methodology. The HPLC-FLD was applied for the content determination of DA, NE and 5-HT in different brain tissues of vascular depression mice. Results It was observed that the limits of quantification for HPLC-UV, HPLC-FLD and HPLC-MS were DA 103.5 ng/mL, NE 107.5 ng/mL and 5-HT 93.6 ng/mL; 10.35 ng/mL, 10.75 ng/mL and 9.36 ng/mL; and 10.35 ng/mL, 32.25 ng/mL and 9.36 ng/mL, respectively. Both HPLC-FLD and HPLC-MS for DA and 5-HT were superior to HPLC-UV. HPLC-FLD for NE was superior to HPLC-MS. Compared with HPLC-UV and HPLC-FLD, HPLC-MS showed remarkable matrix effects. HPLC-FLD determination results showed that content of DA was the lowest in hippocampus, 5-HT was the lowest in cerebral cortex, and NE did not differ in different brain tissues of vascular depression mice. Conclusion Compared with HPLC-UV and HPLC-MS, HPLC-FLD can more effectively determine the contents of MNs (DA, NE and 5-HT). DA and 5-HT can be used as the diagnostic markers of the vascular depression diseases.

Abstract:Objective To explore the intestinal absorption-promoting effect of volatile oils of Shichangpu, benzoin and storax on Rhodamine-123 (Rho-123) and its mechanisms. Methods Rat in vitro everted gut sac (EGS) model was made. The EGS was filled with 1.0 mL K-R solution, and suspended in 45.0 mL 37℃ K-R solution with or without 60 μg/mL volatile oils of Shichangpu, benzoin or storax. After incubation for 30 min, Rho-123 was added in the experimental solution outside the EGS. Rho-123 content in the EGS was determined by high-performance liquid chromatography-fluorescence detector. The human colon carcinoma cell lines Caco-2 were cultured in DMEM and incubated with 80 μg/mL volatile oils of Shichangpu, benzoin or storax for 48 h. P-glycoprotein (P-gp) expression in Caco-2 cells was assessed using flow cytometry, and P-gp gene MDR1 mRNA expression was determined by qPCR. Results The volatile oils of Shichangpu, benzoin and storax each significantly increased the absorption rate constant and apparent permeability coefficient of Rho-123 in rat jejunum and ileum (P<0.01), reduced P-gp expression and MDR1 mRNA level in Caco-2 cells (the decreased rates of P-gp expression were 53.15%, 55.10% and 61.86%, and of MDR1 mRNA levels were 55.41%, 16.24% and 38.46%, P<0.01). Conclusion Inhibiting the protein and MDR1 mRNA expressions of P-gp may be one of the main mechanisms of volatile oils of Shichangpu, benzoin and storax in promoting Rho-123 intestinal absorption.

Abstract:A new type of direct oral anticoagulants (DOACs) was approved for the prevention of thrombotic stroke in patients with nonvalvular atrial fibrillation and for treatment of venous thrombosis (VTE)/pulmonary infarction (PE) in 2010. Compared with the traditional oral anticoagulant vitamin K antagonist (VKA), DOACs have similar anticoagulant effect, better safety, easier administration and less intracranial hemorrhage, but it may increase the risk of gastrointestinal bleeding. As the half-life of DOACs is short, most gastrointestinal bleeding caused by DOACs does not require special treatment, but in rare situations, such as life-threatening bleeding or emergency surgery, DOACs reversal agent was needed to resist the anticoagulation of DOAC. In this review, we summarized the current status of DOACs, incidence of DOACs associated gastrointestinal bleeding, related prophylaxis and DOACs-specific reversal agents.

Abstract:As negative immune regulatory molecules, the inhibitory co-stimulatory molecules programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) play important roles in the adaptive cellular immunity. PD-L1 expressed in tumor cells is involved in regulating T cell activation and differentiation and inhibiting the anti-tumor immune activity of T cell through specific binding with the receptor molecule PD-1 on T cells. Currently, a variety of agents targeting the immune checkpoints of PD-1/PD-L1 have been used in clinic, which have exhibited long-lasting effect in treatment for different types of tumors. In this review, we summed up the molecular structure, expression features, factors influencing upregulation of PD-1/PD-L1, and their roles in promoting tumor growth and escaping from immune system and tumor immunotherapy.

Abstract:The research and establishment of combat injury coding are important in accurate judgment of war wound, medical documents recording, health resource allocation, medical decision supporting and health service informatization. Mass casualties with complicated injuries, numerous mechanisms and severe wound infection in combat field are not found in civilian trauma, so civilian injury coding is not applicable to combat injury data. In this paper, we reviewed the development of foreign civilian injury coding systems and American military combat coding system, and explored its reference role for Chinese military combat coding research.

Abstract:Objective To determine the contents of the hesperidin and liquiritin in Bailong Jieyu granule with high-performance liquid chromatography (HPLC). Methods HPLC was performed with octadecylsilane chemically bonded silica as filler using the Agilent SB-ZOBAX C₁₈ Column (250 mm×4.6 mm, 5 μm). Hesperidin was detected with the mobile phase consisting of acetonitrile and 0.1% of phosphoric acid solution (22:78), with column temperature being 30℃, the detection wavelength being 283 nm, and the injection volume being 10 μL. Liquiritin was determined with acetonitrile-0.1% of phosphoric acid solution (18:82) as mobile phase, with column temperature being 30℃, the detection wavelength being 276 nm, and the injection volume being 10 μL. Results Accuracy, repeatability and stability of HPLC for determination of hesperidin and liquiritin were in line with the relevant requirements. The linear relationship of hesperidin was good within the range of 35.64-178.20 μg/mL (r=0.999 8), with the average recovery rate being 99.30%, and relative standard deviation (RSD) being 1.0% (n=9). The good linear range of liquiritin was 13.55-216.80 μg/mL (r=0.999 9), with the average recovery rate being 98.60% and RSD being 1.5% (n=9). Conclusion HPLC method was fast, simple, stable and reliable, and it can be used for the quality control of Bailong Jieyu granule.

Abstract:Objective To determine the relationship between circulating sclerostin levels and serum bone metabolism markers, bone mineral density (BMD) in postmenopausal women with or without fracture after falling, and to explore whether sclerostin can serve as a new biomarker to predict fragility fracture. Methods In this cross sectional and prospective study, 50 premenopausal women (group A), 50 postmenopausal women with femoral neck fracture after falling (group B) and 50 postmenopausal women without femoral neck fracture after falling (group C) were included. Observation items included serum sclerostin, bone metabolism markers and BMD. Results There were significant differences in bone metabolism markers (including C-terminal telopeptides of type Ⅰ collagen[CTXⅠ], C-terminal telopeptides of type Ⅱ collagen[CTXⅡ], bone alkaline phosphatase[b-ALP], procollagen type 1 N-propeptide[P1NP], receptor activator of NF-κB[RANK] and receptor activator of NF-κB ligand[RANKL]) among three groups (P<0.05, P<0.01). The protein levels of sclerostin (P<0.05, P<0.01) and osteocalcin (P<0.01) in the group B and C were significantly higher than that in the group A, but there was no statistical difference between the group B and C. There were significant differences in BMD at the site of lumbar spine (from L₁ to L₄), total hip, trochanter or femoral neck among three groups (P<0.01), and the BMD in the group B was significantly lower than those in the group A and C (P<0.01). There were significant negative correlations between serum sclerostin level and mean femoral neck BMD (r=-0.228, P=0.004), mean trochanter BMD (r=-0.199, P=0.002) and mean total hip BMD (r=-0.273, P<0.001). Conclusion There is no statistical difference in serum sclerostin between postmenopausal women with and without femoral neck fracture after falling, suggesting that serum sclerostin levels may not be used to predict the potential risks of fraglity fracture in postmenopausal women.

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