Clinical efficacy of surgical treatment of refractory hyperthyroidism in 56 patients / 中国基层医药

Methods:The clinical data and follow-up results of 56 patients with refractory hyperthyroidism who underwent laparoscopy or open surgery in Affiliated Nanhua Hospital of University of South China from January 2019 to August 2020 were retrospectively analyzed.Results:Among the 56 patients, there were 6 men and 50 women. Thirty-six (64.3%) patients underwent endoscopic surgery and twenty (35.7%) patients underwent open surgery. The operation time was (132.0 ± 32.0) minutes. Intraoperative blood loss was (32.4 ± 27.8) mL. Postoperative parathyroid hormone level was (27.8 ± 18.3) ng/L. Forty-nine (87.5%) patients showed benign pathology results after surgery. After surgery, 14 (25.0%) patients had hypothyroidism, including 7 (12.5%) patients with hyperthyroidism combined with thyroid cancer. There were no patients with permanent hypothyroidism or recurrent laryngeal nerve paralysis. All patients had a good prognosis and satisfactory surgical results.Conclusion:With the update of preoperative preparation methods for hyperthyroidism, the increasing maturity of thyroid surgery technology, and the use of new energy instruments and technologies, surgical treatment is undoubtedly a good treatment method for patients with refractory hyperthyroidism or a suspected malignant tumor.Objevtives:To investigate the indications and clinical efficacy of surgical treatment in patients with refractory hyperthyroidism.

Effect of Dimethyl Fumarate (DMF) on T-cell Acute Lymphoblastic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To explore the effect and possible mechanism of dimethyl fumarate (DMF) on T-cell acute lymphoblastic leukemia (T-ALL), and provide experimental and theoretical basis for the clinical treatment of T-ALL.@*METHODS@#Jurkat cells were treated with different concentrations of DMF for 24 hours, and then the proportion and absolute count of Ki67-positive Jurkat cells were analyzed by flow cytometry. Meanwhile, the protein levels of nuclear factor-erythroid 2-related factor 2 (Nrf2) and E3 ubiquitin ligase HACE1 in Jurkat cells treated with DMF for 24 hours were evaluated by Western blot. Nrf2 proteins were co-immunoprecipitated in Jurkat cells, and then HACE1 protein was assessed by Western blot. Plasmids of Flag-Nrf2 and different gradients of Flag-HACE1 were transfected into HEK293T cells, and the levels of Flag-Nrf2 were detected by Western blot after 48 hours.@*RESULTS@#DMF could significantly inhibit the proportion and absolute count of Ki67-positive Jurkat cells, and DMF inhibited the proliferation of Jurkat cells in a dose-dependent manner (r=0.9595, r=0.9054). DMF could significantly up-regulate the protein levels of Nrf2 and E3 ubiquitin ligase HACE1 in Jurkat cells (P<0.01, P<0.01). HACE1 physically interacted with Nrf2 in Jurkat cells. Overexpression of Flag-HACE1 significantly increased the protein level of Flag-Nrf2 in a dose-dependent manner (r=0.9771).@*CONCLUSION@#DMF inhibits the proliferation of T-cell acute lymphoblastic leukemia cell. The mechanism may be that, DMF significantly up-regulates the protein levels of Nrf2 and E3 ubiquitin ligase HACE1, and HACE1 interacts with Nrf2 and positively regulates Nrf2 protein level.

The success rate of His-Purkinje system pacing in patients with various sites of atrioventricular block / 中华心血管病杂志

Objective: To evaluate the success rate of His-Purkinje system pacing (HPSP) in patients with various sites of atrioventricular block (AVB) and provide clinical evidence for the selection of HPSP in patients with AVB. Methods: This is a retrospective case analysis. 637 patients with AVB who underwent permanent cardiac pacemaker implantation and requiring high proportion of ventricular pacing from March 2016 to September 2021 in the Department of Cardiology, General Hospital of Northern Theater Command were enrolled. The site of AVB was determined by electrophysiological examination. His bundle pacing (HBP) was performed in the first 130 patients (20.4%) who were classified as the HBP group and HPSP included HBP and/or left bundle branch pacing (LBBP) was performed in later 507 patients (79.6%) and these patients were classified as the HPSP group. The basic clinical information such as age and sex of the two groups was compared, and the success rates of HBP or HPSP in patients with different sites of AVB and QRS intervals were analyzed. Results: The age of HBP group was (66.4±15.9) years with 75 males (57.7%). The age of HPSP group was (66.8±13.6) years with 288 (56.8%) males. Among 637 patients, 63.0% (401/637) had atrioventricular node block; 22.9% (146/637) had intra-His block; 14.1% (90/637) had distal or inferior His bundle block. Totally, the success rate of HPSP was higher than that of HBP [93.9% (476/507) vs. 86.9% (113/130), P<0.05]. In each group of patients with various AVB sites, the success rate of HPSP was higher than that of HBP respectively and both success rates of HBP and HPSP showed a declining trend with the distant AVB site. The success rate of HBP in patients with atrioventricular node block and intra-His block was higher than that in patients with distal or inferior His bundle block [95.2% (79/83) vs. 47.1% (8/17), P<0.001; 86.7% (26/30) vs. 47.1% (8/17), P=0.010]. The success rate of HPSP was higher than that of HBP in patients with distal or inferior His bundle block [87.7% (64/73) vs 47.1% (8/17), P=0.001]. In patients with QRS<120 ms, 94.9% (520/548) of AVB sites were in atrioventricular node or intra-His, and HBP had a similar high success rate with HPSP [95.6% (109/114) vs. 96.3% (418/434), P=0.943] in these patients. In patients with QRS ≥ 120 ms, 69.7% (62/89) of AVB sites were at distal or inferior His bundle, and the success rate of HBP was only 25.0% (4/16), while the success rate of HPSP was as high as 79.5% (58/73), P<0.001. Conclusions: In patients with QRS<120 ms and atrioventricular node block or intra-His block, success rates of HBP and HPSP are similarly high and HBP might be considered as the first choice. In patients with QRS ≥ 120 ms and AVB site at distal or inferior His bundle, the success rate of HPSP is higher than that of HBP, suggesting LBBP should be considered as the first-line treatment option.

Application and efficacy of the adjustment on left ventricular electrical delay and the distance between right and left ventricular pacing polar in optimizing the left ventricular pacing polar / 中华心血管病杂志

Objective: To investigate the application and efficacy of left ventricular (LV) electrical delay (LVED) and the distance of right ventricular(RV) pacing polar to LV(DRLV) in optimizing LV pacing polar. Methods: Heart failure (HF) patients who implanted cardiac resynchronization therapy (CRT) device with a LV quadripolar lead from January 2014 to January 2018 at General Hospital of Northern Theater Command were enrolled in the study. Measurements of LVED and DRLV of each polar of the lead were performed in patients with HF who underwent CRT with LV quadripolar lead. The principle in turn for polar selecting used for clinical LV pacing was the pacing polar: (1)without phrenic nerve stimulation(PNS); (2)with appropriate capture threshold; (3)not located in apical; (4)with maximal LVED; (5)with maximal DRLV. The LV pacing polar was selected for CRT according to the procedure. The distribution of target veins implanted with LV quadripolar lead were calculated. The percentage of biventricular pacing at 6-month follow-up was recorded. The following indexes were compared before and 6-month after surgery, including QRS duration, LV end-systolic volume(LVESV), LV ejection fraction(LVEF), LV end-diastolic dimension(LVEDD), 6 minute walking distance(6MWD), New York Heart Association(NYHA) class. The efficacy and echocardiographic efficacy of CRT was evaluated. Results: There were twenty-nine HF patients enrolled. The mean age of enrolled patients was(61.7±7.6)years old, nineteen (66%)of them were male. There were seventeen(59%) patients diagnosed as dilated cardiomyopathy and twelve(41%) patients as ischemic cardiomyopathy. All patients were successfully implanted with LV quadripolar lead into target veins, and all four pacing sites were also in target veins. Target veins were located in lateral veins in 15 patients (52%), anterior veins in 2 patients (7%), posterior veins in 11 patients (38%), and lateral branches of great cardiac veins in 1 patient (3%). After 6-month of follow-up, the percentage of biventricular pacing was greater than 95%.There were nineteen(66%) patients optimized LV pacing polar by the largest LVED and four (14%) patients by the DRLV. Of the 29 patients, 5(17%) patients used D1 as the pacing polar, 5(17%) patients used M2 as the pacing polar, 7(24%) patients used M3 as the pacing polar, and 12(41%) patients used P4 as the pacing polar. The pacing polars (D1, M2) of traditional bipolar lead were used in 10(34%) patients, and the LV quadripolar lead specific pacing polars (M3, P4) were used in 19(66%) patients.Compared to a LV quadripolar lead, the LV pacing polar (M3, P4) selected in 19(66%) patients were not achievable with the traditional LV bipolar lead (D1, M2). Preoperative QRS duration, LVESV, LVEF, LVEDD, 6MWD and NYHA class were (171±24)ms, (231±79)ml, (28±5)%, (74±11)mm, (294±103)m, (3.2±1.0)class and the postoperative 6-month were (130±12)ms, (158±73)ml, (36±10)%, (66±12)mm, (371±86)m, (1.9±0.5)class. These indexes were significantly improved after 6 months operation(P<0.001). 97% and 83% patients were responders of CRT as assessed by 6-month efficacy and echocardiographic efficacy. Conclusion: The maximal LVED and DRLV can be used to select LV pacing polar with a high rate of CRT response rate.

Keyhole Approach Endoscopic Surgery versus Stereotactic Aspiration plus Urokinase in Treating Basal Ganglia Hypertensive Intracerebral Hemorrhage / 中国医学科学院学报

To compare the short-and long-term effect of two minimal invasive surgical therapies including keyhole approach endoscopic surgery(KAES)and stereotactic aspiration plus urokinase(SAU)in treating basal ganglia hypertensive intracerebral hemorrhage(hICH). The clinical data of 117 hICH patients(63 received KAES and 54 received SAU)were retrospectively analyzed.The operation time,blood loss during surgery,and drainage time were compared between two groups.The residual hematoma volume,hematoma clearance rate(HCR),Glasgow coma scale(GCS)score,and National Institute of Health Stroke Scale(NIHSS)score were recorded at baseline and in the ultra-early stage,early stage,and sub-early stage after surgery.The 30-day mortality and serious adverse events were assessed and the 6-month modified Rankin scale(mRS)score was rated. Baseline data showed no significant difference between these two groups.Compared with the SAU group,the KAES group had significantly longer operation time,more intraoperative blood loss,and shorter drainage time(all 0.05).In the ultra-early and early stage,the GCS and NIHSS scores showed no significant differences between two groups(all >0.05),whereas in the sub-early stage,the NIHSS score was better in the SAU group(=0.034).The 30-day mortality and incidences of serious adverse events showed no significant difference(all >0.05).The good recovery(mRS≤3)at 6-months follow-up showed no significant difference between the two groups(=0.413). Both KAES and SAU are safe and effective in treating basal ganglia hICH.In the ultra-early stage after surgery,KAES achieves better residual hematoma volume and HCR,and patients undergoing SAU quickly catch up.The short-and long-term effectiveness of SAU is comparable or even superior to KAES.

Role of hippocampal ApoE in age factors-induced effect on long-term cognitive function in mice undergoing multiple exposure to sevoflurane anesthesia: gene knockout method / 中华麻醉学杂志

Objective:To evaluate the role of hippocampal ApoE in age factors-induced effect on long-term cognitive function in mice undergoing multiple exposure to sevoflurane anesthesia using the gene knockout method.Methods:Seventy-two juvenile (6 days old, weighing 3-5 g) and adult (60 days old, weighing 20-25 g) wild-type (WT) C57BL/6J mice and 56 ApoE gene knockout (ApoE-KO) C57BL/6J mice were studied.WT mice were divided into 4 groups ( n=18 each) using a random number table method: juvenile control group (P6+ C group), juvenile sevoflurane group (P6+ S group), adult control group (P60+ C group) and adult sevoflurane group (P60+ S group). ApoE-KO mice were randomly divided into 4 groups ( n=14 each) according to a random number table method: juvenile control group (P6+ C group), juvenile sevoflurane group (P6+ S group), adult control group (P60+ C group) and adult sevoflurane group (P60+ S group). Mice inhaled 3% sevoflurane in 60% O 2 for 2 h every day for 3 consecutive days in sevoflurane group, while mice were placed in the same environment and inhaled 60% O 2 for 2 h every day for 3 consecutive days in control group.Four mice were selected at the end of sevoflurane anesthesia (8 or 62 days after birth) for determination of IL-1β, IL-6 and TNF-α contents in hippocampus by enzyme-linked immunosorbent assay.Four mice in each group of WT mice were randomly selected to detect the expression of full-length ApoE and ApoE fragments in hippocampus by Western blot.The remaining 10 mice in each group of WT mice received standardized feeding, and contextual fear conditioning test was performed at 22 days after sevoflurane anesthesia (30 or 84 days after birth). Results:WT mice Compared with P6+ C group, IL-1β, IL-6 and TNF-α contents were significantly increased, the expression of full-length ApoE and ApoE fragments was up-regulated, and the standstill time was shortened in P6+ S group ( P <0.05), and no significant change was found in the parameters mentioned above in P60+ C and P60+ S groups ( P>0.05). ApoE-KO mice Compared with P6+ C and P6+ S groups, no significant change was found in IL-1β, IL-6 and TNF-α contents or standstill time in P60+ C group and P60+ S group ( P>0.05). Conclusion:The mechanism of age influencing the long-term cognitive dysfunction is related to up-regulating ApoE expression in hippocampus and inducing neuroinflammatory response in mice undergoing multiple exposure to sevoflurane anesthesia.

Application of failure mode and effect analysis mode in maintenance of PICC catheter in children with leukemia undergoing chemotherapy / 中国实用护理杂志

Objective:To analyze failure mode and effect analysis (FMEA) management model on the risk and satisfaction of PICC catheterization in children with leukemia undergoing chemotherapy.Methods:Totally 100 children with PICC catheterized leukemia were admitted to our hospital from June 2015 to December 2018, and their FMEA were managed. Find out the possible failure content and potential risk factors during PICC tube placement operation and maintenance, and calculate the risk value (RPN) according to the formula. Based on RPN values, specific prevention and treatment strategies were formulated and follow-up observation was monitored.Results:After the failure mode and effect analysis, the RPN scores of misevaluation, nonstandard operation, uncooperative children and insufficient preparation for use were (619.5 ± 11.7), (859.3 ± 18.7), (248.6 ± 20.6), (597.4 ± 8.4) points respectively, while those before the intervention were (1 347.5 ± 27.8), (1 127.4 ± 34.7), (427.3 ± 41.9) points, the difference was statistically significant ( t values were 9.563-14.279, P < 0.05). After the failure mode and effect analysis, the RPN scores of drug factor, child factor, ineffective sealing, infusion interruption, inadequate propaganda and maintenance were (598.4 ± 17.4), (537.2 ± 12.1), (407.3 ± 12.1), (178.4 ± 12.1), (8.4 ± 12.1) points, respectively. Before the intervention, the scores were (986.4 ± 30.7), (685.7 ± 17.8), (527.4 ± 23.6), (359.2 ± 29.4) and (148.3 ± 26.5) points, respectively. The differences were statistically significant ( t values were 11.092-19.634, P < 0.05). Conclusion:Failure mode and effect analysis applied to children with leukemia PICC pipeline placement and maintenance can improve the effectiveness of pipeline management and reduce the occurrence of pipeline maintenance risk events.

Comparative transcriptomic analysis of vascular endothelial cells after hypoxia/re-oxygenation induction based on microarray technology / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#To provide comprehensive data to understand mechanisms of vascular endothelial cell (VEC) response to hypoxia/re-oxygenation.@*METHODS@#Human umbilical vein endothelial cells (HUVECs) were employed to construct hypoxia/re-oxygenation-induced VEC transcriptome profiling. Cells incubated under 5% O2, 5% CO2, and 90% N2 for 3 h followed by 95% air and 5% CO2 for 1 h were used in the hypoxia/re-oxygenation group. Those incubated only under 95% air and 5% CO2 were used in the normoxia control group.@*RESULTS@#By using a well-established microarray chip consisting of 58 339 probes, the study identified 372 differentially expressed genes. While part of the genes are known to be VEC hypoxia/re-oxygenation-related, serving as a good control, a large number of genes related to VEC hypoxia/re-oxygenation were identified for the first time. Through bioinformatic analysis of these genes, we identified that multiple pathways were involved in the reaction. Subsequently, we applied real-time polymerase chain reaction (PCR) and western blot techniques to validate the microarray data. It was found that the expression of apoptosis-related proteins, like pleckstrin homology-like domain family A member 1 (PHLDA1), was also consistently up-regulated in the hypoxia/re-oxygenation group. STRING analysis found that significantly differentially expressed genes SLC38A3, SLC5A5, Lnc-SLC36A4-1, and Lnc-PLEKHJ1-1 may have physical or/and functional protein-protein interactions with PHLDA1.@*CONCLUSIONS@#The data from this study have built a foundation to develop many hypotheses to further explore the hypoxia/re-oxygenation mechanisms, an area with great clinical significance for multiple diseases.

Use of Tripterygium wilfordii Hook F for immune-mediated inflammatory diseases: progress and future prospects / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Tripterygium wilfordii Hook F has significant anti-inflammatory and immunosuppressive properties and is widely used for treating autoimmune and inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus, and kidney disease, especially in traditional Chinese medicine. The mechanisms underlying its effects may be diverse but they remain unclear, and its toxicity and side effects limit its wider clinical application. This review summarizes the clinical application of Tripterygium wilfordii Hook F in recent years, as well as the results of studies into its mechanisms and toxicity, to provide a reference for its future clinical application.

Systematic review and meta-analysis of the efficacy and safety of immunosuppressive pulse therapy in the treatment of paraquat poisoning / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Paraquat (PQ), a highly effective herbicide, is widely used worldwide. PQ poisoning can cause multiple organ failure, in which the lung is the primary target organ. After PQ poisoning, the patient mortality rate is as high as 90%, and there is currently no specific antidote. The main clinical treatment is the use of glucocorticoids and cyclophosphamide for pulse therapy, but its effectiveness and safety are still uncertain. We investigated the effectiveness and safety of immunosuppressive pulse therapy with glucocorticoids and cyclophosphamide to evaluate the treatment value in patients with acute PQ poisoning. This meta-analysis, combined with seven trials that enrolled a total of 426 patients, showed that immunosuppressive pulse therapy with glucocorticoids and cyclophosphamide for PQ poisoning significantly reduced mortality of the study group (59.3%, 134/226) compared with the control group (81.0%, 162/200). There was no significant difference of hepatitis or renal failure between the control and study groups, indicating that immunosuppressive pulse therapy was relatively safe. Several patients were reported to have leukopenia and returned to normal after 1-2 weeks without any abnormalities. Two cases of non-fatal sepsis were reported and considered to be a side effect of the immunosuppressive pulse therapy. Thus, immunosuppressive pulse therapy can efficiently reduce the mortality of PQ poisoning and it is relatively safe.

Changes of serum miR-375 and blood target genes in patients with allergic rhinitis before and after treatment and its significance / 中南大学学报(医学版)

To explore the changes of serum miR-375 and its target genes in patients with allergic rhinitis (AR) before and after treatment and its significance.
 Methods: A total of 120 AR patients treated in Wuhan Fourth Hospital were selected as an observation group (AR group), and 120 healthy volunteers served as a control group. Real-time quantitative polymerase chain reaction was used to detect the expression changes of miR-375 and its predicted target genes, such as 3-phosphoinositide-dependent protein kinase-1 (PDK1), protein kinase B (AKT1), Janus kinase 2 (JAK2), and signal transducer and activator of transcription 3 (STAT3), as well as inflammatory factors, such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), and interleukin-13 (IL-13) in the AR group before and after treatment. According to the relative expression levels of miR-375 and target genes, the AR patients were also subdivided into a high expression group and a low expression group for comparative analysis.
 Results: Before treatment, the level of miR-375 in the serum in the AR group was higher than that in the control group (P<0.01); the expressions of PDK1, AKT1, JAK2 and STAT3 in the plasma in the AR group were lower than those in the control group (all P<0.01); the plasma levels of TNF-α, IL-6, IL-10, and IL-13 in the AR group were higher than those in the control group (all P<0.05). After treatment, compared with the control group, the level of miR-375 in the serum was down-regulated (P<0.01), while the levels of target genes (PDK1, AKT1, JAK2 and STAT3) were up-regulated (all P<0.05), and the levels of TNF-α, IL-6, IL-10, and IL-13 were down-regulated in the AR group (all P<0.05). The total effective rate, total nasal symptom score (TNSS), symptom improvement time, and incidence of adverse reactions in the AR groups with high expression of miR-375 and low expression of target genes before treatment were better than those in the correspending groups with low expression of miR-375 and high expression of target genes (all P<0.05).
 Conclusion: MiR-375 might be a potential predictor of treatment response for AR patient, which might be related to the plasma levels of its target genes and inflammatory factors.

Systematic review and meta-analysis of the efficacy and safety of immunosuppressive pulse therapy in the treatment of paraquat poisoning / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Paraquat (PQ), a highly effective herbicide, is widely used worldwide. PQ poisoning can cause multiple organ failure, in which the lung is the primary target organ. After PQ poisoning, the patient mortality rate is as high as 90%, and there is currently no specific antidote. The main clinical treatment is the use of glucocorticoids and cyclophosphamide for pulse therapy, but its effectiveness and safety are still uncertain. We investigated the effectiveness and safety of immunosuppressive pulse therapy with glucocorticoids and cyclophosphamide to evaluate the treatment value in patients with acute PQ poisoning. This meta-analysis, combined with seven trials that enrolled a total of 426 patients, showed that immunosuppressive pulse therapy with glucocorticoids and cyclophosphamide for PQ poisoning significantly reduced mortality of the study group (59.3%, 134/226) compared with the control group (81.0%, 162/200). There was no significant difference of hepatitis or renal failure between the control and study groups, indicating that immunosuppressive pulse therapy was relatively safe. Several patients were reported to have leukopenia and returned to normal after 1–2 weeks without any abnormalities. Two cases of non-fatal sepsis were reported and considered to be a side effect of the immunosuppressive pulse therapy. Thus, immunosuppressive pulse therapy can efficiently reduce the mortality of PQ poisoning and it is relatively safe.

Effect of electroacupuncture at different acupoints on follicle development and related factors in serum and ovary tissues of PCOS rats / 针刺研究

OBJECTIVE: To observe the effect of electroacupuncture (EA) at different acupoints on follicle development, expression of gonadotropins and their receptors and anti-Müllerian hormone(AMH), inhibin B(INHB) in polycystic ovarian syndrome (PCOS) rats, so as to explore its mechanisms underlying improvement of PCOS. METHODS: Sixty female SD rats were randomized into six groups: control, model, Zusanli(ST36), Sanyinjiao(SP6), Guanyuan(CV4) and combination (ST36+SP6+CV4, n=10 rats/group). The PCOS model was established by gavage of Letrozole solution (1.0 mg/kg) once daily for 21 consecutive days. Rats of the control group were given 1% Carboxymethyl Cellulose (CMC, 1 mg/kg). EA (2 Hz) was applied to ST36, SP6, or/and CV4 for 20 min, once daily for 14 consecutive days. The number of follicles was counted, and the ovarian structure and follicular development were observed under light microscope after H.E. stain, and the contents of serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), AMH, and INHB were assayed by enzyme-linked immunosorbent assay, and the ratio of LH/FSH was calcula-ted. The immunoactivity of LH receptor (LHR) and FSH receptor (FSHR) proteins was detected by immunohistochemistry. RESULTS: After modeling, the number of follicles at the growth stage, contents of serum LH, AMH and INHB, and ratio of LH/FSH were significantly increased, and serum FSH level and FSHR, LHR immunoactivity were remarkably decreased in the model group relevant to the control group (P0.05). CONCLUSION: EA of CV4, SP6, ST36 and ST36+CV4+SP6 can reduce the number of follicles at the growth stage and regulate the expression levels of gonadotropins in PCOS rats. The effects of EA of CV4 and ST36 are evidently better than those of EA of SP6 in up-regulating serum FSH content and in down-regulating LH/FSH ratio, and serum AMH and INHB levels, and EA of SP6 is evidently superior to EA of CV4 down-regulating LH level, but without synergistic effect among the 3 acupoints.

Effect of Electroacupuncture at Different Acupoints on Steroid Hormones and Ovarian Androgen Receptor Expression in Polycystic Ovary Syndrome Rats / 针刺研究

OBJECTIVE: To observe the effect of electroacupuncture (EA) at different acupoints on hyperandrogenism and ovarian androgen receptor (AR) expression in rats with polycystic ovary syndrome (PCOS), so as to explore its mechanisms underlying improvement of PCOS. METHODS: Sixty female SD rats were randomly divided into control, model, Zusanli (ST 36), Sanyinjiao (SP 6), Guanyuan (CV 4) and comprehensive groups (10 rats/group). The PCOS model was established by giving (gavage) the animals with Letrozole solution (1.0 mg/kg), once daily for 21 consecutive days. EA stimulation was applied to ST 36, SP 6, or CV 4 respectively, once daily for 14 days. The comprehensive group was treated by EA treatment of the abovementioned three acupoints in the meantime. Before and after the treatment, the body mass and the ovary weight were measured. The morphological structure of the ovary was observed under microscope after H．E. staining. The levels of serum hormone and sex hormone binding globulin (SHBG) were assayed by ELISA. Free androgen index (FAI) was calculated and the expression of AR in the ovary was detected by immunohistochemistry. RESULTS: After modeling, the body mass, ovary weight, serum testosterone (T) and FAI levels and the expression of AR protein in late ovarian follicles were significantly increased (P<0.01, P<0.05), and serum estradiol (E2) and SHBG contents were significantly decreased relevant to the control group (P<0.01). Following EA intervention and compared with the model group, the body weight of each EA group was significantly reduced (P<0.05), the ovarian pathological changes were improved, and serum T and FAI levels were significantly decreased (P<0.01), and serum E2 and SHBG contents significantly increased in the ST 36, CV 4 and comprehensive groups (P<0.01, P<0.05). The ovary weight of only CV 4 group was significantly lower than that of the model group (P<0.01). The expression of AR protein in late follicles of both CV 4 and SP 6 groups was markedly decreased (P<0.05, P<0.01). CONCLUSION: EA at ST 36, SP 6, and CV 4 all can improve the hyperandrogenism and ovarian polycystic morphological changes of PCOS rats, while different acupoints have different functional characteristics.

Expression of lymphoid enhance factor 1 in chronic myeloid leukemia and its clinical significance / 白血病·淋巴瘤

Objective To analyze the mRNA expression level of lymphoid enhance factor 1 (LEF-1), and to investigate its clinical significance in bone marrow mononuclear cells of patients with chronic myeloid leukemia chronic-phase (CML-CP) after initial diagnosis and chemotherapy, and to analyze its clinical significance. Methods The real-time fluorescence quantitative polymerase chain reaction was used to measure the expression level of LEF-1 gene in 38 CML-CP patients after initial diagnosis and chemotherapy and 20 persons without blood system diseases and neoplastic diseases as normal control. The difference of LEF-1 expression level between the patients and healthy control was compared, and the effect of imatinib on the main molecular response (MMR) was analyzed. Results The expression of LEF-1 mRNA in 38 newly diagnosed patients [0.00214 (0.00020 - 0.02120)] was significantly higher than that in normal controls [0.00101 (0.00009 - 0.00233)] (U= 163.0, P 0.05). The level of LEF-1 mRNA expression of non-MMR group was also higher than that of the normal control group (U= 14.0, P<0.01). The rate of acquiring MMR was significantly higher in high LEF-1 mRNA expression group [84.2 %(16/19)] than that in low expression group [47.4%(9/19)] (χ2=4.209, P<0.01). The time of acquiring MMR was significantly shorter in the high LEF-1 mRNA expression group [(10.0 ± 4.5) months] than that in the low expression group [(14.6 ± 3.8) months] (t= 2.705, P< 0.01). Conclusions LEF-1 may be involved in the occurrence and development of CML, and reflects the tumor burden. It may be one of the indicators to predict the efficacy of imatinib.

Regularities in Application of Acupoints in Acupuncture Treatment for Ovulatory Disorder Infertility / 上海针灸杂志

Objective To explore the regularities in clinical application of acupoints in acupuncture treatment for ovulatory disorder infertility and provide guidance for clinical treatment of this disease.Methods China National Knowledge Infrastructure, Wanfang Database, VIP Chinese Scientific Journal Database and China Biomedical Literature Database were searched to retrieve clinical literature on acupuncture treatment for ovulatory disorder infertility published from 1996 to 2015 and analyze the application frequency of main acupoints statistically, acupoint meridian tropism and regions, and regularities in acupoint selection.Results A total of 98 articles were included, involvng 58 main acupoints, 608 frequencies of using main acupoints and 11 meridians to which the main acupoints were related. The four most frequently used acupoints were Guanyuan, Sanyinjiao, Zigong and Zhongji. The meridians of which the main acupoints were used at the first five highest frequencies were in order the Ren meridian, the spleen meridian, the stomach meridian, the bladder meridian and the kidney meridian.Conclusions Guanyuan, Sanyinjiao, Zigong and Zhongji are the most frequently used acupoints in modern acupuncture treatment for ovulatory disorder infertility. The principles of acupoint selection are based on visceral and meridional syndrome differentiations. Acupoint selection along the meridian and local acupoint selection are the main methods and acupoint selection according the experience is an auxiliary method.

Effect of intensive atorvastatin therapy on B7-H4 in peripheral blood monocytes of patients with unstable angina undergoing percutaneous coronary intervention / 实用医学杂志

Objective To investigate the intensive atorvastatin therapy on B7-H4 in peripheral blood monocytes of patients with unstable angina PCI undergoing percutaneous coronary intervention. Methods 80 patients with unstable angina were randomized to pretreatment with intensive dose (80 mg/day ,n = 40) and conventional dose(20 mg/day,n=40)of atorvastatin. Peripheral blood were subsequently obtained prior to PCI,and 18 ~ 24 h after PCI. Peripheral blood serum level of IL-4,IL-10 and IFN-γ were quantified using enzyme-linked immunosorbent assays. Fluorescence-based quantitative real-time PCR was used to measure levels of periph-eral blood monocytes B7-H4 mRNA. Results Levels of IL-10 ,sB7-H4 and B7-H4 mRNA increased in patients of both groups after PCI. The increase in intensive dose group is more significant (P < 0.05). IL-4 and IFN-γ decreased in patients of both groups after PCI. The decrease in intensive dose group is more significant (P <0.05). Conclusion Intensive dose atorvastatin treatment improve post-PCI immune inflammation in patients with unstable angina,possibly by promoting the expression of B7-H4 in peripheral blood monocytes.

Evaluation of renal function parameters in acute kidney injury patients secondary to liver cirrhosis / 临床检验杂志

Objective To investigate the clinical application of measurements of neutrophil gelatinase associated lipocalin in serum (sN-GAL) and urine(uNGAL),cystatin C(CysC) and serum creatinine(sCr) in diagnosis of acute kidney injury(AKI) patients secondary to liver cirrhosis (LC).Methods A total of 260 liver cirrhosis patients without AKI (LC group),207 liver cirrhosis patients with AKI (AKI group)and 106 healthy controls(HC group)were included in the study.The levels of sNGAL,uNGAL,serum creatinine(sCr) and cystatin C (CysC) were determined,respectively.The estimated glomerular filtration rate (eGFR) were calculated base on sCr and CysC,named as c-aGFR and CysC-eGFR.The differences and correlation of each observed parameters among the various groups were statistically analyzed,and the effectiveness of these parameters as biomarkers for predicting the development of AKI in these patients with liver cirrhosis were assessed.Results Compared with LC group and healthy control group,the levels of sNGAL,uNGAL,sCr and CysC in AKI group were significantly increased(all P ＜0.01),while the levels of c-aGFR and CysC-eGFR were significantly decreased(all P ＜ 0.01).Along with the progression of AKI stages,the levels of sNGAL,uNGAL,sCr and CysC in the patients were increasing(all P ＜ 0.01),while the levels of c-aGFR and CysC-eGFR were decreasing(all P ＜0.01).Correlation analysis showed that the levels of sNGAL,uNGAL and CysC were positively correlated with sCr(r =0.662,0.672,0.726,all P ＜0.01)and negatively correlated with c-aGFR(r =-0.639,-0.661,-0.732,all P ＜ 0.01).On the contrary,CysC was negatively correlated with sCr (r =-0.711,P ＜ 0.01)and positively correlated with c-aGFR (r =0.736,P ＜ 0.01).ROC curve analysis showed that the area under the curve (AUC) of uNGAL was maximum (0.995) which were significantly higher than that of sNGAL,sCr,c-aGFR,CysC and CysCeGFR(all P ＜ 0.01).The AUC of sNGAL did not present marked difference with that of sCr and CysC (P ＞ 0.05),but-was barely higher than that of c-aGFR and CysC-eGFR (P ＜ 0.05).The diagnostic effectiveness of uNGAL was maximum (0.962),followed by sNGAL(0.920).Conclusion For diagnosis of the development of AKI in the patients with liver cirrhosis,NGAL may be more reliable marker than sCr and CysC,and the detection of uNGAL could be more effective than sNGAL for the diagnosis.

A study on the characteristics and influencing factors of heterosexual intercourse among MSM population / 预防医学

Objective To explore the heterosexual intercourse characteristics and its influencing factors among MSM population. Methods Voluntary counseling/testing and questionnaire survey were carried out at the bathhouses where MSM usually assemble. Results Among 342 MSM surveyed,52. 05% were married. 76 people( 22. 22%) were completely homosexual,while 266 people(77. 78%)were bisexual. 24(31. 57%)MSM who answered″ totally gay″ in self-assessment of sex orientation were married,significantly lower than those answered bisexual(57. 89%)(p<0. 05). 197 of participants had sex with women ,and 123 MSM had sex with women during the last six months,49 MSM of which used condoms at each heterosexual activity. MSM who were married or bisexual were easy to have heterosexual intercourse. Among the MSM surveyed,the HIV and syphilis infection rates were 11. 40% and 16. 67% respectively. There was no significant difference between the use of condoms and infection( both p>0. 05). In the recent six months,there was no significant difference in the use of condoms between infected( 43. 34%)and non-infected persons( 43. 34%)( p >0. 05). Conclusion Among MSM population,the prevalence of heterosexual intercourse is high,while condom use rate is relatively low. It is necessary to strengthen the behavioral intervention and promote condom use.

Research of the relationship between FIB with ACS and severity of the ACS / 实用医学杂志

Objective Serum FIB has been established as a predictor of cardiovascular events. The aim of this study was to investigate the relationship of FIB with acute coronary syndrome (ACS) and severity of the ACS. Methods A total of 692 patients with ACS who underwent a definite diagnosis were selected. Ninety-nine patients without coronary heart disease severed as control group. Detail information were recorded in age, gender, history of alcoholic, smoking, hypertension. All patients were detected in FIB and some other biochemical indicators levels. Use the correlation analysis to find the relationship of FIB with grace scoring. Results With the increase of Grace risk level and coronary artery lesions and myocardial ischemia,the levels of FIB were significantly increased (P < 0.05).The correlation analysis showed that Grace scores had a positive correlation with FIB in ACS patients. The logistic regression analysis showed the FIB was the most prominent predictors for ACS. The areas under the ROC curve of FIB were 0.87 which suggested that FIB had a higher predictive value of ACS. Conclusion The levels of serum FIB is closely related to criticality of ACS. For the ACS patients,higher levels of FIB indicated higher Grace scores. FIB level may have important clinical value in early risk stratification evaluation of prognosis and treatment options.