Effects of 0.01% atropine on ocular biometrics in myopic adolescents / 中华实验眼科杂志

Objective:To observe the effects of 0.01% atropine eye drops on ocular biometrics in myopic adolescents.Methods:A prospective cohort study was conducted.Two hundred and nineteen myopic adolescents who visited the First Affiliated Hospital of Zhengzhou University from June 2016 to June 2017 and completed the 1-year follow-up on time were enrolled.The 219 adolescents were divided into a 0.01% atropine+ single-vision spectacles (SV) group (119 cases) wearing single-vision spectacles with one drop of atropine eye drop applied to both eyes once nightly, and a simple SV group (100 cases) wearing SV only.Axial length (AL), corneal power and anterior chamber depth were measured with the IOLMaster.Lens power was calculated using the Bennett-Rabbetts formula.Intraocular pressure was measured by non-contact tonometry.Spherical equivalent (SE) was examined by cycloplegic autorefraction.Total astigmatism and corneal astigmatism were calculated by vector decomposition.The right eye data were analyzed to compare the ocular biometrics changes between the two groups, and multiple linear regression analysis was used to evaluate the influencing factors.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of First Affiliated Hospital of Zhengzhou University (No.2016-35). Written informed consent was obtained from guardians before any medical examination.Results:The SE change and AL elongation 12 months after treatment in 0.01% atropine+ SV group were (-0.47±0.45) D and (0.37±0.22) mm, respectively, which were significantly lower than (-0.70±0.60)D and (0.46±0.35)mm in simple SV group ( t=5.523, 9.651; both at P<0.001). There were significant differences in SE and AL between before and after treatment in both groups (SE: Fgroup=1.556, P=0.015; Ftime=12.538, P=0.002; AL: Fgroup=3.425, P=0.021; Ftime=18.235, P=0.008). The SE and AL at 4, 8 and 12 months after treatment were all increased in comparison with before treatment in both groups, showing statistically significant differences (all at P<0.001). The SE and AL at 8 and 12 months after treatment in 0.01% atropine+ SV group were smaller than in simple SV group, and the differences were statistically significant (all at P<0.001). At 8 and 12 months after treatment, total astigmatism and the anterior chamber depth were increased and the lens power was decreased in comparison with before treatment in both groups, and the differences were statistically significant (all at P<0.05). There was no significant difference in corneal astigmatism, corneal power and intraocular pressure at different time points before and after treatment between the two groups (all at P>0.05). In the multiple linear regression analysis, an equation of Δmyopic SE=-0.012-2.685×ΔAL-1.002×Δcorneal astigmatism-0.656×Δlens power+ 0.477×Δtotal astigmatism+ 0.363×Δanterior chamber depth-0.060×age+ 0.011×sex was used, showing the change of SE was mainly caused by the change of AL ( β=-2.685), then corneal power, lens power, total astigmatism and anterior chamber depth. Conclusions:In adolescents, 0.01% atropine eye drops can effectively retard myopia progression and axial elongation, showing no effect on astigmatism, corneal power, lens power, anterior chamber depth and intraocular pressure.The controlling effect of 0.01% atropine eye drops in the development of myopia is mainly achieved by reducing axial elongation.

Construction of intervention program for physical and mental adjustment for primary caregivers of cancer patients based on network cognitive behavior therapy / 中国实用护理杂志

Objective:Based on cognitive behavioral therapy, to construct a physical and mental adjustment intervention plan for the main caregiver of cancer patients through the network platform.Methods:Through evidence-based literature published from July 2012 to July 2022 screening and evaluation, combined with qualitative interviews for 10 primary caregivers of cancer patients, the intervention plan for physical and mental adjustment of the main caregivers of cancer patients was preliminarily formulated. After consultation with Delphi experts (15 cases) through two rounds, the intervention plan was finally determined.Results:In the two rounds of expert letter inquiries, 15 questionnaires were distributed and 15 valid questionnaires were recovered. The effective recovery rate was 100.00% and the expert authority coefficient were 0.89 and 0.90 in the two rounds of expert letter inquiries respectively, the Kendall harmony coefficients were 0.279 and 0.323 respectively, and the differences were all statistically significant ( P<0.01). The intervention plan for physical and mental adjustment ofthe main caregivers of cancer patients included 5 first-level indicators (basic knowledge, symptom education, home care knowledge, relaxation training, social support), 27 second-level indicatorsand 54 third-level indicators. Conclusions:The method of the psychosomatic regulation intervention program is scientific and practical, which can be initially applied to the psychological adjustment of the main caregivers of cancer patients, so as to provide a reference for improving their negative emotions.

Advances of Congenital Alopecia/Hypotrichosis in Genetics Research / 罕见病研究

Congenital alopecia/hypotrichosis is a rare group of monogenic genetic hair disorders characterized by congenital limited or diffuse hair loss and scarcity, without any effective treatment. Genetic testing to identify the causative gene mutation is the gold standard for confirming the diagnosis of this group of disorders. Because of the heterogeneity in clinical features and genetic pattern of this group of diseases, it is very easy to misdiagnose and mistreat them as diffuse baldness or androgenic alopecia and other acquired alopecia, so clinicians should improve their understanding of this group of diseases. With the continuous development of molecular biology techniques in recent years, a variety of causative genes for congenital alopecia/hypotrichosis have been identified so far, and the pathogenesis of some of these genes and their corresponding subtypes have been clarified. In this paper, we reviewed the clinical manifestations and genetic research progress of non-syndromic congenital alopecia/ hypotrichosis, in order to facilitate clinicians' comprehensive understanding of these rare hair diseases and improve clinical diagnosis and treatment.

Mechanism of Gegen Qinlian Decoction in improving glucose metabolism in vitro and in vivo by alleviating hepatic endoplasmic reticulum stress / 中国中药杂志

This study investigated the mechanism of Gegen Qinlian Decoction(GQD) in improving glucose metabolism in vitro and in vivo by alleviating endoplasmic reticulum stress(ERS). Molecular docking was used to predict the binding affinity between the main effective plasma components of GQD and ERS-related targets. Liver tissue samples were obtained from normal rats, high-fat-induced diabetic rats, rats treated with metformin, and rats treated with GQD. RNA and protein were extracted. qPCR was used to measure the mRNA expression of ERS marker glucose-regulated protein 78(GRP78), and unfolded protein response(UPR) genes inositol requiring enzyme 1(Ire1), activating transcription factor 6(Atf6), Atf4, C/EBP-homologous protein(Chop), and caspase-12. Western blot was used to detect the protein expression of GRP78, IRE1, protein kinase R-like ER kinase(PERK), ATF6, X-box binding protein 1(XBP1), ATF4, CHOP, caspase-12, caspase-9, and caspase-3. The calcium ion content in liver tissues was determined by the colorimetric assay. The ERS-HepG2 cell model was established in vitro by inducing with tunicamycin for 6 hours, and 2.5%, 5%, and 10% GQD-containing serum were administered for 9 hours. The glucose oxidase method was used to measure extracellular glucose levels, flow cytometry to detect cell apoptosis, glycogen staining to measure cellular glycogen content, and immunofluorescence to detect the expression of GRP78. The intracellular calcium ion content was measured by the colorimetric assay. Whereas Western blot was used to detect GRP78 and ERS-induced IRE1, PERK, ATF6, and eukaryotic translation initiation factor 2α(eIF2α) phosphorylation. Additionally, the phosphorylation levels of insulin receptor substrate 1(IRS1), phosphatidylinositol 3-kinase regulatory subunit p85(PI3Kp85), and protein kinase B(Akt), which were involved in the insulin signaling pathway, were also measured. In addition, the phosphorylation levels of c-Jun N-terminal kinases(JNKs), which were involved in both the ERS and insulin signaling pathways, were measured by Western blot. Molecular docking results showed that GRP78, IRE1, PERK, ATF4, and various compounds such as baicalein, berberine, daidzein, jateorhizine, liquiritin, palmatine, puerarin and wogonoside had strong binding affinities, indicating that GQD might interfere with ERS-induced UPR. In vivo results showed that GQD down-regulated the mRNA transcription of Ire1, Atf6, Atf4, Grp78, caspase-12, and Chop in diabetic rats, and down-regulated GRP78, IRE1, PERK, as well as ERS-induced apoptotic factors ATF4 and CHOP, caspase-12, caspase-9, and caspase-3, while up-regulating XBP1 to enhance adaptive UPR. In addition, GQD increased the calcium ion content in liver tissues, which facilitated correct protein folding. In vitro results showed that GQD increased glucose consumption in ERS-induced HepG2 cells without significantly affecting cell viability, increased liver glycogen synthesis, down-regulated ATF6 and p-eIF2α(Ser51), and down-regulated IRE1, PERK, and GRP78, as well as p-IRS1(Ser312) and p-JNKs(Thr183/Tyr185), while up-regulating p-PI3Kp85(Tyr607) and p-Akt(Ser473). These findings suggested that GQD alleviates excessive ERS in the liver, reduces insulin resistance, and improves hepatic glucose metabolism in vivo and in vitro.

Effects of 0.01% atropine eye drops on the prevention of myopia onset among schoolchildren: a randomized, double-blind, controlled trial / 中华实验眼科杂志

Objective:To observe the safety and efficacy of 0.01% atropine eye drops in the prevention of myopia onset in schoolchildren.Methods:A randomized double-blind controlled study was conducted.Sixty Chinese Han children (60 eyes) with binocular spherical equivalent (SE) between + 0.50 D and -0.75 D (pre-myopia) by cycloplegic autorefraction treated in The First Affiliated Hospital of Zhengzhou University were enrolled from July to October 2020.Aged 6-12 years old, the children were divided into 0.01% atropine group and control group according to a random number table, with 30 cases (30 eyes) in each group.The children were given one drop of 0.01% atropine or placebo eye drops in both eyes once a night.The SE, axial length (AL), accommodative amplitude and pupil diameter were compared before and after 3-month, 6-month of treatment between the two groups.Discomforts were recorded.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of The First Affiliated Hospital of Zhengzhou University (No.2020-KY-286). Written informed consent was obtained from guardian of each subject.Results:After treatment, 26 and 25 subjects completed the 6-month follow-up in 0.01% atropine group and control group, respectively, among which 3 subjects in 0.01% atropine group accounting for 11.5% and 9 in control group accounting for 36.0% developed myopia, showing a statistically significant difference ( χ2=4.238, P=0.040). There were significant differences in the overall comparison of SE and AL at different time points between before and after treatment ( Ftime=10.981, 81.854; both at P<0.001). At 3 and 6 months after treatment, there were significant increases in the SE and AL of control group and AL of 0.01% atropine group compared with respective baseline values (all at P<0.05). There was no significant difference in SE at 3 and 6 months after treatment compared with baseline SE in 0.01% atropine group (both at P>0.05). At 6 months after treatment, the change in SE in 0.01% atropine group was (-0.15±0.26)D, which was significantly less than (-0.34±0.35)D in control group, and the change in AL in 0.01% atropine group was (0.17±0.11)mm, Which was significantly shorter than (0.28±0.14)mm in control group, with significant differences between them ( t=2.207, P=0.032; t=3.127, P=0.003). There were significant differences in pupil diameter at different time points between before and after treatment ( Ftime=2.263, P=0.032). At 3 and 6 months after treatment, the pupil diameter was increased in comparison with baseline in 0.01% atropine group (both at P<0.05). There were significant differences in accommodative amplitude at different time points between before and after treatment in the two groups ( Fgroup=0.882, P=0.042; Ftime=0.337, P=0.033). The accommodative amplitude at 3 and 6 months after treatment were decreased in comparison with baseline in 0.01% atropine group and control group at corresponding time points (all at P<0.05). Within a month after treatment, photophobia in bright sunlight occurred in 5 cases in 0.01% atropine group, accounting for 16.7%(5/30), and 2 cases in control group, accounting for 6.7%(2/30), showing no significant difference ( χ2=0.647, P=0.421). No near-vision blur and other uncomfortable symptoms was found in the two groups. Conclusions:After 6-month application of 0.01% atropine eye drops, the prevalence of myopia in pre-myopia schoolchildren decreases and the changing rate of SE and AL slows down.The accommodative amplitude is slightly reduced and pupil diameter is slightly increased, with no obvious effects on study and life.

The clinical application of plasmacytoma variant translocation gene 1 in the diagnosis of rheumatoid arthritis / 中华风湿病学杂志

Objective:To explore the clinical application and diagnosis of the long non-coding RNA plasmacytoma variant translocation gene 1 (PVT1) in plasma for rheumatoid arthritis (RA).Methods:One hundred and nineteen healthy individuals were designed as healthy control (HC), 158 patients with RA, 50 patients with systemic lupus erythematosus (SLE) and 50 patients with primary Sj?gren′s syndrome (pSS) were collected from Xuzhou Central Hospital. The plasma PVT1 of HC, RA, SLE and pSS patients and were determined by real time polymerase chain reaction (qRT-PCR). The t test of two independent-samples and One-Way analysis of variance (ANOVA) were used to compare the levels of plasma PVT1 in HC, RA, SLE and pSS patients. The correlation between PVT1 and RF, IL-6 and anti-CCP of RA patients were analyzed by Spearman's rank correlation test. Receiver operating characteristic (ROC) curves were used to identify the diagnostic performance of plasma PVT1 for RA. Results:Compared to HC [(1.32±1.22)], SLE [(1.15±0.83)] and pSS patients [(1.46±0.88)], the plasma PVT1 relative expression [(3.71±2.68)] were significantly increased in RA patients ( t=8.36, P<0.01; t=6.83, P<0.01; t=5.98, P<0.01). The PVT1 had a strong positive correlation with RF, IL-6 and anti-CCP( r=0.41, P<0.01; r=0.38, P<0.01; r=0.40, P<0.01). The area under curve (AUC) of plasma of PVT1 of RA was 0.79[95% CI(0.72, 0.85); P<0.01]. At the optimal cut-off of 1.97, the diagnostic sensitivity and specificity were 68.27% and 86.45%, and in this point provided better diagnostic accuracy. When combination PVT1 with RF, the AUC was 0.88[95% CI(0.83, 0.93); P<0.01], the sensitivity and specificity were 80.22% and 82.73%. Conclusion:Plasma PVT1 has potential diagnostic value for RA, which may become a new biomarker for the diagnosis for RA patients.

Compatibility Rules of Prescriptions Containing Forsythiae Fructus in Dictionary of Traditional Chinese Medicine Prescriptions and Anti-inflammatory Mechanism： An Exploration Based on Data Mining and Network Pharmacology / 中国实验方剂学杂志

Objective:To analyze the compatibility rules of prescriptions containing Forsythiae Fructus based on data mining and explore the anti-inflammatory mechanism of Forsythiae Fructus based on network pharmacology，so as to provide reference for the rational clinical application of Forsythiae Fructus and the development of health foods and new Chinese medicines. Method:The prescriptions containing Forsythiae Fructus in the<italic> Dictionary of Traditional Chinese Medicine Prescriptions</italic> were collected，based on which a clinical prescription database was constructed. The Chinese herbs combined with Forsythiae Fructus and the corresponding indications were subjected to frequency statistics，association rule analysis，and complex network analysis using SPSS Statistics 26，IBM SPSS Modeler 18.0，and Gephi 9.2. The active components and targets of Forsythiae Fructus for anti-inflammation were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP），BATMAN-TCM，and SEA，and the targets related to anti-inflammation from GeneCards，Online Mendelian Inheritance in Man （OMIM），CTD，and GenCLiP3. Following the analysis of protein-protein interactions （PPI） with STRING，a PPI network was constructed. The enrichment analysis was performed using Metascape，and the active component-anti-inflammation target-signaling pathway network of Forsythiae Fructus was constructed by Cytoscape 3.8.2. Result:According to the inclusion and exclusion criteria，2 245 prescriptions containing Forsythiae Fructus were harvested，involving 512 Chinese herbs，with a total usage frequency of 27 314. The Chinese herbs that were most frequently combined with Forsythiae Fructus （>800 times） were Glycyrrhizae Radix et Rhizoma （1 483 times），Scutellariae Radix （964 times），and Angelicae Sinensis Radix （842 times）. Hence，the herbal pairs "Forsythiae Fructus-Scutellariae Radix" and "Forsythiae Fructus-Angelicae Sinensis Radix" were further explored. The prescriptions containing Forsythiae Fructus could be utilized for the treatment of 29 kinds of diseases，and three representative disease categories including "carbuncle，gangrene，sores and ulcers"，"ophthalmic diseases and syndromes" and "epidemic diseases" are selected for data mining. There were 19 association rules obtained with "Forsythiae Fructus-Glycyrrhizae Radix et Rhizoma-Lonicerae Japonicae Flos-Angelicae Sinensis Radix" as the core herb combination for "carbuncle，gangrene，sores and ulcers". The clustering analysis revealed one multi-herb clustering group，four herbal pairs，and single herb Lonicerae Japonicae Flos，the complex network analysis four herbal modules，and the factor analysis six common factors. There were 23 association rules obtained with "Forsythiae Fructus-Glycyrrhizae Radix et Rhizoma-Scutellariae Radix-Angelicae Sinensis Radix" as the core herb combination for "ophthalmic diseases and syndromes". The clustering analysis revealed two multi-herb clustering groups and four herbal pairs，the complex network analysis four herbal modules，and the factor analysis five common factors. There were 28 association rules obtained with "Forsythiae Fructus-Glycyrrhizae Radix et Rhizoma-Menthae Haplocalycis Herba-Lonicerae Japonicae Flos" as the core herb combination for "epidemic diseases". The clustering analysis revealed three multi-herb clustering groups，one herbal pair，and two single herbs Forsythiae Fructus and Glycyrrhizae Radix et Rhizoma，the complex network analysis four herbal modules，and the factor analysis five common factors. As demonstrated by network pharmacology-based analysis，the core anti-inflammation components of Forsythiae Fructus were quercetin，luteolin，and kaempferol，and the core targets were phosphoinositide-3-kinase regulatory subunit 1 （PIK3R1），protein kinase B 1 （Akt1），and epidermal growth factor receptor（EGFR）. The biological pathways were mainly concentrated in proteoglycans in cancer，pathways in cancer，and PI3K/Akt signaling pathway，with such functions as inhibition of transcription factors，regulation of enzyme activity，and inflammation-related gene expression involved. Conclusion:This study employed a variety of data mining techniques to objectively，intuitively，and scientifically uncover the compatibility rules of Forsythiae Fructus in the treatment of high-frequency diseases. It has been found that Forsythiae Fructus is often combined with heat-clearing herbs，tonifying herbs，exterior-releasing herbs，and blood-activating and stasis-resolving herbs for diverse diseases and syndromes. Under the premise of clearing heat and removing toxin，reinforcing healthy Qi and dredging stagnation are also emphasized. According to the degree of internal heat exuberance，the heat-clearing herbs with different merits are combined. This study has revealed the unique advantages of Forsythiae Fructus in the treatment of specific diseases and syndromes as well as its multi-component，multi-target，and multi-pathway mechanisms in anti-inflammation，breaking through the limitations in modern clinical and experimental research of Forsythiae Fructus. These findings are of great significance for guiding the rational clinical application of Forsythiae Fructus and the development of health foods and new Chinese medicines，thus better accelerating the development of Chinese medicine health industry.

Differentiation of hypovascular pancreatic neuroendocrine tumors and mass-forming pancreatitis by enhanced CT / 医学研究生学报

ObjectiveTo explore the value of MSCT for differentiating the hypovascular pancreatic neuroendocrine tumors (Hypo-PNETs) from mass-forming pancreatitis.Methods21 patients with histological-confirmed MPFs and 19 patients with Hypo-PNETs who underwent preoperative dynamic contrast-enhanced CT were included. The CT images were analyzed including tumor size,density, border, CT values in each phase, dilatation of pancreatic duct and bile duct and metastases. The clinical data included age, sex and clinical symptoms.ResultsMFPs often occurred in male patient compared with Hypo-PNETs (85.7% vs 52.6%, P<0.05), and the difference is statistically significant; Metastases only occurred in Hypo-PNETs (P<0.05), and the difference is drastically significant. The well-defined margin often occurred in Hypo-PNETs (52.4% vs 47.6%, P=0.032). Solid tumor more happened in MFPs(95.2% vs 47.4%, P＜0.05). The CT values in the portal of MFPs were higher than Hypo-PNETs(P<0.05). The combined features showed accepted diagnostic performance for differentiating Hypo-PNETs from MFPs (89.5% of sensitivity and 95.2% of specificity).ConclusionMFPs often occurred in male patient, and CT values of portal phase, density, border and metastases may be valuable for differentiating Hypo-PNETs from MFPs.

A meta-analysis of Gegen-Qinlian decoction for ulcerative colitis / 国际中医中药杂志

Objective To systematically evaluate the effectiveness and safety of Gegen-Qinlian decoction in treating ulcerative colitis.Methods We searched Cochrane Library, PubMed, CNKI, VIP, CBM and Wanfang online Data bases June, 2017. All of the randomized controlled trials(RCTs) of Gegen-Qinlian decoction compared with sulfasalazine in treating for ulcerative colitis were searched. The quality of RCTs meeting inclusion criteria was evaluated and the data were extracted; meta-analyses were performed with RevMan 5.3 software, and then the GRADE system was used to rate the level of evidence and strength of recommendation.Results Totally 5 RCTs were included into the study. The group treated withGegen-Qinlian decoction or combined with sulfasalazine was superior to the control group in total effective rate (RR=1.18, 95％ CI(1.06-1.30),P=0.002). There were no significant differences between the two groups in clinical symptom curative effect [RR=1.09, 95％CI (0.72-1.64), P=0.69], adverse reactions [RR=0.11, 95％ CI (0.01-1.92),P=0.13], Symptom curative effect [RR=1.33, 95％CI (0.95-1.88),P=0.10], mucosal lesions curative effect [RR=1.33, 95％CI(0.95-1.88), P=0.10]. Based on the GRADE system, the level of total effective rate and adverse reactions evidence was Grade C, and the strength of recommendation was 2. the level of the rest of the evidence was Grade D.Conclusions Compared with sulfasalazine,Gegen-Qinliandecoction or combined with sulfasalazine can be used as a treatment option.

Effect of ulinastatin on isoflurane-induced neuronal apoptosis in the hippocampus of rats / 南方医科大学学报

OBJECTIVE@#To investigate the effect of ulinastatin pretreatment on isoflurane-induced mitochondria-dependent neuronal apoptosis in the hippocampus of rats.@*METHODS@#Thirty-six male SD rats were randomly assigned into control group, isoflurane group and ulinastatin group. In the latter two groups, the rats were subjected to acute exposure to 0.75% isoflurane for 6 h and pretreated with 50 000 U/kg of ulinastatin before isoflurane exposure, respectively. After the treatments, apoptosis of the hippocampal neurons was detected using TUNEL assay, and the mitochondrial membrane potential (△ ψm) was measured using JC-1 mitochondrial membrane potential kit; cytochrome C release and caspase-3 activity were examined with Western blotting, and intracellular reactive oxygen species (ROS) was detected using the fluorescent probe H2DCFDA.@*RESULTS@#Compared with those in the control group, the rats with acute exposure to isoflurane showed markedly increased TUNEL-positive cells in the hippocampus ( < 0.05), which were obviously reduced by ulinastatin pretreatment ( < 0.05). The △ψm of the hippocampal neurons was significantly reduced after isoflurane exposure ( < 0.05), and was partly recovered by ulinastatin pretreatment ( < 0.05). Acute exposure to isoflurane resulted in obviously increased cellular ROS, cytochrome C release and caspase-3 activity in the hippocampal neurons ( < 0.05), and these changes were significantly inhibited by ulinastatin pretreatment ( < 0.05).@*CONCLUSIONS@#Ulinastatin pretreatment provides neuroprotection against isoflurane-induced apoptosis of the hippocampal neurons in rats possibly by inhibiting mitochondria-dependent apoptosis pathway.

The clinical significance of lnc-DC in plasma for the diagnosis of primary Sj(o)gren's syndrome / 中华检验医学杂志

Objective To explore the long non-coding RNA that ineract within dentridic cell (lnc-DC) in plasma as a novel bio-marker for primary Sj(o)grens syndrome (pSS).Methods Case-control study.One hundred and thirty-nine patients of pSS,50 patients of systemic lupus erythematosus(SLE) and 50 patients of rheumatoid arthritis(RA) were collected from Xuzhou Central Hospital from January 2017 to January 2018,and 78 healthy individuals were designed as healthy control.The plasma lnc-DC of pSS,SLE and RA patients and healthy control(HC)was determined by real time polymerase chain reaction (RT-PCR).The plasma levels of anti-SSA(anti-Sj(o)gren's syndrome type A) and anti-SSB(anti-Sj(o)gren's syndrome type B) were tested by ELISA.The correlation between lnc-DC and dry mouth,dry eyes,ESR,β2-microglobulin,anti-SSA and anti-SSB of pSS patients were analyzed by Spearman's rank correlation test.Receiver operating characteristic (ROC) curves were used to identify the diagnostic performance of plasma lnc-DC for pSS.Results Compared to healthy control (3.38 ± 0.44),the lnc-DC relative expression (6.82 ± 0.51) was significantly increased in pSS patients (t=4.78,P＜0.01).The lnc-DC had a strong positive correlation with dry mouth (r=0.81,P＜0.01),dry eyes(r=0.75,P＜0.01),ESR(r=0.73,P＜0.01),β2-microglobulin(r=0.63,P＜0.01),anti-SSA(r=0.45,P＜0.01)and anti-SSB(r=0.53,P＜0.01).The area under curve (AUC) of plasma of lnc-DC was 0.81,(95％ CI:0.71-0.90).When combination lnc-DC with anti-SSA and anti-SSB,the AUC is 0.86 (95％CI:0.78-0.94).At the optimal cut-off of 5.1,the diagnostic sensitivity and specificity were 0.73(95％CI:0.60-0.84) and 0.82 (0.66-0.92).And in this point may provided better diagnostic accuracy.Meanwhile,compared with SLE and RA patients,the plasma level of lnc-DC were higher,ROC curves of lnc-DC in pSS patients can distinguish pSS from other autoimmune disease such as SLE and RA.Conclusions Plasma lnc-DC can provide additional diagnostic information beyond other clinican characteristics such as dry mouth,dry eyes,ESR,β2-microglobulin,anti-SSA and anti-SSB.It can be used as a novel bio-marker for pSS patients,and also have significant values in diagnosis of pSS.

Imaging diagnosis of 52 cases of sclerosing pneumocytoma / 医学研究生学报

Objective Sclerosing pneumocytoma (SP) is a rare benign tumor of the lung. This study investigates the CT and PET/CT features of 52 patients with sclerosing pneumocytoma (SP), summarizes their imaging features and provide reference for improving the accuracy of SP imaging diagnosis.Methods The clinical and imaging data of 52 patients with SP confirmed by operation and pathology in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine and the First Affiliated Hospital of Nanjing Medical University from January 2010 to March 2018 were analyzed retrospectively，and the imaging features of the disease were analyzed and summarized. Among 52 SP patients, 46 were female and 6 were male, with an average of 50.7±12.6 years old.Results ①Morphological characteristics: all were round or round-shaped solitary nodules or masses in the lung. The average diameter of the tumor was 22.2±15.4 mm. 39 lesions had smooth edges and 13 had shallow edge lobulation sign; ②Predilection sites: 33 of the cases were closely attached to or adjacent to the pleura, and there was no preponderant distribution of the lobe; ③Density: The density of the lesion was homogeneous. 8 cases had coarse calcifications at the edges or in the lesions; ④Enhancement features: 26 cases showed moderate to marked enhancement, only 6 cases were mild enhancement; ⑤Features around the tumor: "vascular adhering sign" in 21 cases, "tail sign" in 7 cases, "air crescent sign " in 5 cases, "localized emphysema" in 4 cases, "halo sign" in 11 cases, "bird egg-bird nest sign" in 5 cases, 4 cases of secondary bronchiectasis; ⑥Associated tumors: 3 cases of invasive lung adenocarcinoma, 3 cases of lung adenocarcinoma in situ, 2 cases of pulmonary atypical adenomatous hyperplasia, 1 case of pulmonary tiny inflammatory nodule; 2 cases of esophageal cancer associated, 1 case of invasive thymoma, 1 case of large mature ovarian cystic teratoma; ⑦PET/CT characteristics: 18F-FDG standard uptake value in tumor increased to different degrees, the average of SUV max value was 4.4±3.2.Conclusion The innovation of this research: SP is shown as solitary circular or circular-shaped blood-rich nodules in the lung, often under the pleura, especially the mediastinal pleura and lobar pleura. There is no lobar distribution advantage; SP calcification is uncommon, among which the calcification at the margin of the tumor was more common. "Air crescent sign", " Halo sign" and " Bird egg-bird nest sign" have high diagnostic value for SP.

Effect of bone marrow mesenchymal stem cells transplantation on immune in-flammatory response in experimental ischemic cerebral infarction in rats / 中国免疫学杂志

Objective:To investigate the effect of bone marrow mesenchymal stem cell transplantation on immunoinflammatory response in experimental cerebral infarction rats,and to provide a method for the treatment of cerebral infarction.Methods:①Experimental rat model of ischemic cerebral infarction was established.Sixty SD rats in the lab from March 2015 to May 2017 were selected to complete the ischemic cerebral infarction model established by modified Zea-longa suture method.②Acquisition and culture of stem cells.In addition,5 rats were used to wash the bone marrow cavity with DMEM medium to collect bone marrow cells and the rat bone marrow mesenchymal stem cells could be isolated and prepared by adherent method.③Treatment of model rats.After successful modeling,60 rats were randomly divided into model group,control group and experimental group.After modeling,the model group only performed vascular ligation and did not insert the line plug;the control group injected equal volume of PBS at the lesion site;the experi-mental group injected 10 μl of third-generation bone marrow mesenchymal stem cells at the lesion site and measured the immune levels of the three groups of rats.To evaluate the effect of bone marrow mesenchymal stem cells in experimental rats with ischemic cerebral in-farction.Results:①In the inverted microscope,the volume of the first generation of MSCs became polygonal or fusiform on the third day,and the cells started to aggregate.The third generation of cells proliferated rapidly and arranged in a certain direction with swirling growth,and had multiple layers,the boundaries are unclear;②Fluorescence microscopy showed that:99% of cells obtained by fluorescence labeling,the obtained cells were bone marrow mesenchymal stem cells;③Control group and model group 1 month after treatment,there was no significant difference in neurological score between 2 months and 3 months(P>0.05).Neurological scores at 1, 2 and 3 months after treatment in the observation group were lower than those in the control group and the model group(P<0.05);④The levels of IL-6 and IFN-γ in the observation group were higher than those in the control group at 3 months after treatment(P<0.05).The levels of IL-10 and TGF-β in the observation group at 3 months after treatment were lower than those in the control group(P<0.05).⑤The percentage of CD4+CD25+Tregs in CD4+T cells at 1 month,2 months and 3 months after treatment in observation group was higher than that in control group and model group(P<0.05).Conclusion:Transplantation of bone marrow mesenchymal stem cells can help regulate rat immunity,reduce the level of inflammatory cytokines and promote the early recovery of neurological function.

Association between Magnetic Resonance Imaging Findings of the Pelvic Floor and de novo Stress Urinary Incontinence after Vaginal Delivery

OBJECTIVE: The study aimed to evaluate the contributions of levator ani muscle (LAM) injury, vesical neck movement, urethral length and mobility, and urethral sphincter dysfunction observed on magnetic resonance imaging (MRI) towards stress urinary incontinence (SUI) after vaginal delivery. MATERIALS AND METHODS: Fifty primiparous women after 6 months of delivery (15 with SUI and 35 without) and 35 nulliparous as continent controls underwent MRI at rest and Valsalva maneuver. A published levator ani scoring system was used to characterize morphological changes of LAM. The severity of the injury was divided into three categories as none, minor, and major. A series of common parameters including levator plate angle, iliococcygeal angle, and levator hiatus were used to describe the functional conditions of LAM. Urethral mobility was defined based on the rotation of the urethra between Valsalva and rest status. Vesical neck movement was evaluated by its distance to the pubococcygeal line. Urethral sphincter dysfunction was defined as the widening of the proximal urethra and/or funneling at the urethrovesical junction during Valsalva. RESULTS: Primiparous incontinent (PI) women had additional major levator ani defects (33.3% vs. 17.1%) while less minor defects (0.7% vs. 31.4%) than primiparous continent (PC) women. Vesical neck downward movement in PI women was more obvious than PC women (28.5 mm vs. 24.2 mm, p = 0.006). Urethral mobility was more active in primiparous women than in nulliparous continent controls (57.4 vs. 52.4), whereas no difference was observed on urethral mobility in the primiparous group (p = 0.25). Urethral sphincter dysfunction and funneling were present in 80% of PI women versus 22.9% in PC women (p < 0.001). CONCLUSION: The MRI findings revealed that de novo SUI was associated with major LAM injury, vesical neck downward movement as well as urethral sphincter dysfunction. Vesical neck funneling on sagittal images can be treated as a valuable predictor for SUI. The intervention for the PI should focus on the elevation of vesical neck, rehabilitation of LAM as well as recovery of the urethral sphincter muscle.

CT findings of rare pulmonary neuroendocrine carcinoma / 医学研究生学报

Objective Typical carcinoma(TC), atypical carcinoma(AC) and large cellul neuroendocrine carcinoma (LC-NEC) are rare pulmonary neuroendocrine tumor (PNET) possessing different pathological features , biological behaviors and clinical prognosis .The paper aimed to investigate the characteristic CT findings of rare pulmonary neuroendocrine carcinoma in comparison with pathological diagnosis . Methods A retrospective analysis was conducted on clinical data , CT findings and pathological results of 22 patients admitted in the Affiliated Hospital of Nanjing University of TCM from 2010 to 2016, followed by statistical analysis . Results Among the 22 cases, there were 9 females and 13 males, 12 cases of central type and 10 cases of peripheral type , 7 cases with calcifi-cations, 10 cases with focal necrosis , 6 cases with combined bronchial obstruction sign , 5 cases with lymph node metastasis , and 1 case with distant metastasis.TC was presented with younger onset age , while AC and LCNEC with older onset age (P=0.003).TC ten-ded to be central type (P=0.044), mainly charaterized by bronchial lumen nodules (P=0.005) with smooth edges (P=0.000) and often accompanied with obstructive pneumonia and atelectasis ( P=0.019) without pleural involvement .AC mostly belonged to central type , charaterized by multilobulated soft tissue masses , elongated or"iceberg"in typical ones , with rare obstruction signs and no obvi-ous pleural involvement.LCNEC was mostly peripheral, with lobulated lesion margin (P=0.000), no obvious obstruction signs, and frequent pleura involvement ( P=0.000 ) . Conclusion Rare pulmonary neuroendocrine tumors have certain characteristic clinical features and CT findings .TC has the youngest onset age , mainly characterized by bronchial lumen nodules with smooth edges and often accompanied with obstruction signs , while LCNEC has the oldest on-set age and tends to be peripheral , mostly without obstruction signs and with frequent pleura involvement .

Clinical value of 68Ga-PSMA-11 PET/CT in the diagnosis of castration-resistant prostate cancer / 中华核医学与分子影像杂志

Objective To assess the role of 68Ga-N,N'-bis (2-hydroxy-5-(carboxyethyl) benzyl) ethylenediamine-N,N'-diacetic acid(HBED-CC)-(Ahx) Lys-CO-Glu(PSMA-11) PET/CT on the detection of metastatic lesions from castration-resistant prostate cancer (CRPC).Methods Sixteen patients with CRPC who underwent 68Ga-PSMA-11 PET/CT between January 2015 and November 2015 were recruited in this study.Mean age of patients was (72±9) years.The PSA levels were 4-12 356 μg/L,Gleason score was 7-10.PET/CT was performed at 1 h postinjection of 68Ga-PSMA-11.Patient-based analysis and lesionbased analysis were performed.ROI analysis was used to calculate the tumor uptake (SUVmax).Final diagnosis was based on histopathology and results of other imaging examinations(99Tcm-MDP imaging,MRI).x2 test was used to compare the diagnostic efficiencies of PET and CT.Results No adverse effects were observed in patients.68Ga-PSMA-11 PET/CT showed moderate physiologic uptake in salivary glands and proximal small intestine,with predominant tracer clearance by the kidneys.All patients were positive on 68Ga-PSMA-11 PET/CT.Bone metastasis was found in 16 patients,liver metastasis in 2 patients (5 lesions),and lymph node metastasis in 4 patients (26 lesions).The SUVmax of liver,lymph node and bone metastases were 15.06±2.77,7.54±5.20,19.01± 16.96,respectively.The diagnostic sensitivity,specificity and accuracy on bone metastasis with 68Ga-PSMA-11 PET and CT were 96.30％(52/54) vs 61.11％(33/54),3/3 vs 1/3,96.49％ (55/57) vs 59.65％ (34/57).The sensitivities and accuracies of the two modalities were significantly different(x2=19.943,22.593,both P＜0.01).Conclusions 68Ga-PSMA-11 PET/CT could precisely detect both primary and metastatic lesions of CRPC,suggesting that it is of great value for the clinical management and treatment.

Feasibility study of MR T2-mapping for evaluating birth-related levator ani muscle injury / 实用放射学杂志

Objective To investigate MR T2-mapping in evaluating birth-related levator ani muscle injury.Methods 25 primiparas at 6 weeks after first vaginal delivery as primiparous group and 12 nulliparous volunteers as control group were prospectively studied. All the subjects underwent pelvic MRI including T2-mapping,mDIXON-T2 WI sequences.Levator ani muscle were divided into two subgroups:levator ani muscle injury group and non-injury group according to if there were edema,avulsion,or rupture in each levator ani muscle subdivisions[puborectal muscle(PRM);iliococcygeal muscle(ICM)],which were showed on mDIXON-T2 WI images.Two radiologists evaluated T2 values of PRM,ICM and observed artificial color images respectively.The consistency between two observers for T2 values of PRM,ICM were evaluated using the intraclass correlation coefficient (ICC ),the difference of T2 values in each levator ani muscle subdivisions among control group,non-injury group and muscle injury group were analyzed using ANOVA .Results There were 26 PRM injury cases and 24 non-injury cases in primiparous group on mDIXON-T2 WI images,and no ICM injured cases in our study.Inter-rater reliability for T2 values between two observers were good(ICC >0.75).T2 values in PRM injury group,non-injury group and control group were(62.78±1.23)ms,(49.75±3.17)ms,(49.96±4.37)ms respectively and the difference was significant. There were significant difference between PRM injury group and non-injury group,control group respectively(P =0.000,P =0.000). The T2 values of ICM in PRM injury group,non-injury group and control group were(70.80±6.50)ms,(62.41±7.32)ms,(62.78±6.91)ms and there were significant difference(P =0.000),meanwhile the difference between PRM injury group and non-injury group,control group were significant respectively(P =0.000,P =0.000).The color gradation of PRM in PRM injury group were mixed with blue, green,and yellow,and tone were lightened on T2-mapping artificial color images;ICM color gradation were uneven with green and yellow, a d tone were higher than those of control group and non-injurygroup.Conclusion T2-mapping can quantitatively assess birth-related levator ani muscle injury and T2-mapping artificial color images show the range and degree of levator ani muscle injury visually.It is hopeful to find micro lesions that T2 WI images are difficult to find.

Feasibility study of MR T2-mapping for evaluating birth-related levator ani muscle injury / 实用放射学杂志

Objective To investigate MR T2-mapping in evaluating birth-related levator ani muscle injury.Methods 25 primiparas at 6 weeks after first vaginal delivery as primiparous group and 12 nulliparous volunteers as control group were prospectively studied. All the subjects underwent pelvic MRI including T2-mapping,mDIXON-T2 WI sequences.Levator ani muscle were divided into two subgroups:levator ani muscle injury group and non-injury group according to if there were edema,avulsion,or rupture in each levator ani muscle subdivisions[puborectal muscle(PRM);iliococcygeal muscle(ICM)],which were showed on mDIXON-T2 WI images.Two radiologists evaluated T2 values of PRM,ICM and observed artificial color images respectively.The consistency between two observers for T2 values of PRM,ICM were evaluated using the intraclass correlation coefficient (ICC ),the difference of T2 values in each levator ani muscle subdivisions among control group,non-injury group and muscle injury group were analyzed using ANOVA .Results There were 26 PRM injury cases and 24 non-injury cases in primiparous group on mDIXON-T2 WI images,and no ICM injured cases in our study.Inter-rater reliability for T2 values between two observers were good(ICC >0.75).T2 values in PRM injury group,non-injury group and control group were(62.78±1.23)ms,(49.75±3.17)ms,(49.96±4.37)ms respectively and the difference was significant. There were significant difference between PRM injury group and non-injury group,control group respectively(P =0.000,P =0.000). The T2 values of ICM in PRM injury group,non-injury group and control group were(70.80±6.50)ms,(62.41±7.32)ms,(62.78±6.91)ms and there were significant difference(P =0.000),meanwhile the difference between PRM injury group and non-injury group,control group were significant respectively(P =0.000,P =0.000).The color gradation of PRM in PRM injury group were mixed with blue, green,and yellow,and tone were lightened on T2-mapping artificial color images;ICM color gradation were uneven with green and yellow, a d tone were higher than those of control group and non-injurygroup.Conclusion T2-mapping can quantitatively assess birth-related levator ani muscle injury and T2-mapping artificial color images show the range and degree of levator ani muscle injury visually.It is hopeful to find micro lesions that T2 WI images are difficult to find.

Research progress on nucleoside drugs combination used in clinic against chronic hepatitis B / 药物评价研究

Hepatitis B is a serious hazard to human health.This paper describes the current clinical use of several nucleoside antiviral drugs combination,and introduces the candidate drugs which are able to effectively inhibit the hepatitis B virus replication in vivo and in vitro in two years,which provides reference for the research and development of new anti-HBV drugs.

Clinical value of 68Ga-PSMA-11 PET/CT in the diagnosis of castration-resistant prostate cancer / 中华核医学与分子影像杂志

Objective To assess the role of 68Ga-N,N′-bis(2-hydroxy-5-(carboxyethyl)benzyl) ethylenediamine-N,N′-diacetic acid(HBED-CC)-(Ahx)Lys-CO-Glu(PSMA-11) PET/CT on the detection of metastatic lesions from castration-resistant prostate cancer (CRPC).Methods Sixteen patients with CRPC who underwent 68Ga-PSMA-11 PET/CT between January 2015 and November 2015 were recruited in this study.Mean age of patients was (72±9) years.The PSA levels were 4-12 356 μg/L, Gleason score was 7-10.PET/CT was performed at 1 h postinjection of 68Ga-PSMA-11.Patient-based analysis and lesion-based analysis were performed.ROI analysis was used to calculate the tumor uptake (SUVmax).Final diagnosis was based on histopathology and results of other imaging examinations(99Tcm-MDP imaging, MRI).χ2 test was used to compare the diagnostic efficiencies of PET and CT.Results No adverse effects were observed in patients.68Ga-PSMA-11 PET/CT showed moderate physiologic uptake in salivary glands and proximal small intestine, with predominant tracer clearance by the kidneys.All patients were positive on 68Ga-PSMA-11 PET/CT.Bone metastasis was found in 16 patients, liver metastasis in 2 patients (5 lesions), and lymph node metastasis in 4 patients (26 lesions).The SUVmax of liver, lymph node and bone metastases were 15.06±2.77, 7.54±5.20, 19.01±16.96, respectively.The diagnostic sensitivity, specificity and accuracy on bone metastasis with 68Ga-PSMA-11 PET and CT were 96.30%(52/54) vs 61.11%(33/54), 3/3 vs 1/3, 96.49%(55/57) vs 59.65%(34/57).The sensitivities and accuracies of the two modalities were significantly different(χ2=19.943, 22.593, both P<0.01).Conclusions 68Ga-PSMA-11 PET/CT could precisely detect both primary and metastatic lesions of CRPC, suggesting that it is of great value for the clinical management and treatment.