Value of serum YKL-40 in the diagnosis of anti-MDA5-positive patients with dermatomyositis complicated with severe pulmonary injury / 北京大学学报(医学版)

OBJECTIVE@#To investigate the value of serum and bronchoalveolar lavage fluid (BALF) chitinase-3-like-1 protein (YKL-40) in the diagnosis of anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis (DM) patients complicated with serious pulmonary injury, including rapidly progressive interstitial lung disease (RP-ILD) and pulmonary infection.@*METHODS@#Anti-MDA5 antibodies positive patients with DM who were hospitalized in the Department of Rheumatology of China-Japan Friendship Hospital from 2013 to 2018 were involved in this study. Demographic information, clinical, laboratory and imaging data were retrospectively collected. ELISA was used to detect the serum and BALF levels of YKL-40. The receiver operating characteristic (ROC) curve was drawn, and the area under ROC curve (AUC) was used to evaluate the diagnostic value of serum YKL-40 for pulmonary injury.Interstitial lung disease (ILD) was confirmed by chest high-resolution CT (HRCT). RP-ILD was defined as progressive respiratory symptoms such as dyspnea and hypoxemia within 3 months, and/or deterioration of interstitial changes or appearace of new pulmonary interstitial lesions on chest HRCT. Pulmonary infection was considered as positive pathogens detected in qualified sputum, blood, bronchoalveolar lavage fluid or lung biopsy specimens.@*RESULTS@#A total of 168 anti-MDA5-positive DM patients including 108 females and 60 males were enrolled in the study. Of these patients, 154 had ILD, and 66(39.3%) of them presented RP-ILD. Seventy patients with pulmonary infection were confirmed by etiology. In the patients with RP-ILD, 39 (59.1%) of them were complicated with pulmonary infection. While only 31 cases(30.4%) had pulmonary infection in the non-RP-ILD patients. The incidence of pulmonary infection in the patients with RP-ILD was significantly higher than that of those with non-RP-ILD (P < 0.001). The serum YKL-40 levels in the RP-ILD patients with pulmonary infection were the highest compared with RP-ILD without pulmonary infection, non-RP-ILD with pulmonary infection and non-RP-ILD without pulmonary infection groups among all the patients [83 (42-142) vs. 42 (21-91) vs. 43 (24-79) vs. 38 (22-69), P < 0.01].The sensitivity, specificity and AUC of serum YKL-40 in the diagnosis of RP-ILD complicated with pulmonary infection were 75%, 67%, and 0.72, respectively. The AUC of diagnosed of anti-MDA5 positive DM patients complicated with RP-ILD and pulmonary infection was higher than that of patients complicated with only RP-ILD and only pulmonary infection (0.72 vs. 0.54 and 0.55, Z=2.10 and 2.11, P < 0.05).@*CONCLUSION@#The prognosis of anti-MDA5-positive DM patients with RP-ILD and pulmonary infection were poor. Serum YKL-40 level can be used as a helpful tool for the diagnosis of coexistence of these conditions in the patients.

Evaluation of Compatibility Proportion and Antidepressant Mechanism of Bupleuri Radix-Scutellariae Radix Based on Uniform Design / 中国实验方剂学杂志

Objective:To optimize proportion of couplet medicine of Bupleuri Radix and Scutellariae Radix in the treatment of anti-depression, and to explore the possible antidepressant mechanism of this couplet medicine. Method:The dosages of Bupleuri Radix and Scutellariae Radix in the 2015 edition of Chinese Pharmacopoeia were taken.According to U7(72) uniform design table, Bupleuri Radix and Scutellariae Radix were carried out into 7 groups.The chronic unpredictable mild depression model mice were induced by intragastric administration of decoction of this couplet medicine and the antidepressant effect was observed by the behavior tests, which included sucrose preference test, tail suspension test, forced swimming test and open field test(crossing scores).The regression equations were established by selecting the effective indexes.The experiments of retest were taken to check the results and the possible antidepressant mechanism was primarily investigated by measuring the phosphorylation level of cyclic adenosine monophosphate(cAMP)-response element binding protein(CREB) and expression of brain-derived neurotrophic factor(BDNF). Result:Compared with the blank group, sucrose preference rate of the model group was significantly decreased(PPPPPPPPPPPPPPConclusion:Compatibility of Bupleuri Radix and Scutellariae Radix can ameliorate depressive-like behavior of model mice, and the best antidepressant compatibility proportion of Bupleuri Radix and Scutellariae Radix is 1:1, the optimal amounts of them are about 5 g.The antidepressant effect may relate to promoting phosphorylation level of CREB and the expression of BDNF in the hippocampus.

Clinical and pathological characteristics of immune mediated necrotizing myopathy / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinical and pathological features of immune-mediated necrotic myopathies (IMNM) with different myositis-specific antibodies (MSAs).@*METHODS@#In the study, 104 IMNM patients who met any of the following three criteria were selected from idiopathic inflammatory myopathy patients who had MSAs results and underwent muscle biopsy from 2008 to 2018 in China-Japan Friendship Hospital: (1) Anti-signal recognition particle (SRP) antibody positive; (2) Anti-3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) antibody positive; (3) MSAs negative and consistent with the pathological diagnostic criteria of IMNM defined by the European Neuromuscular Centre in 2004. The clinical, laboratory and muscle pathological information of the IMNM patients were retrospectively collected and compared in anti-SRP, anti-HMGCR and MSAs negative groups.@*RESULTS@#Of 104 IMNM patients, 47 patients (45.2%) were positive for anti-SRP antibody, 23 (22.1%) were positive for anti-HMGCR antibody, and 34 (32.7%) were negative for MSAs. The common symptoms of IMNM patients were muscle weakness (92.3%), elevated serum creatine kinase level (92.3%), dysphagia (33.7%) and interstitial lung diseases (ILD) (49.5%). The anti-HMGCR-positive patients were more frequent to have "V" sign (30.4% vs. 4.3% and 5.9%, P<0.01) as compared with the anti-SRP-positive and MSAs-negative patients. The incidence of ILD in the anti-SRP-positive patients was higher than that in the anti-HMGCR-positive and MSAs negative patients (64.4% vs. 34.8% and 29.0%, P<0.01). The prevalence of the patients combined with other connective tissue diseases in MSAs-negative IMNM was higher than that in the other two groups (32.4% vs. 8.5% and 4.3%, P<0.01). 93.3% of the anti-SRP-positive patients were found with antinuclear antibody positivity, higher than those of the anti-HMGCR-positive and MSAs-negative patients (93.3% vs. 36.4% and 58.8%, P<0.001). The common pathological features of IMNM were muscle fibre necrosis (94.2%), regeneration (67.3%) and phagocytosis (65.4%), overexpression of major histocompatibility complex1 on sarcolemma (78.8%), infiltration of CD4+ T cells (81.7%) and CD68+ macrophage (79.8%) and expression of membrane attack complex (MAC) (77.8%). The endomysial infiltration of CD4+ T cells and CD68+ macrophage and MAC expression on sarcolemma in the MSAs-negative group were more common than that in the anti-SRP and anti-HMGCR groups (88.2% vs. 57.4% and 60.9%, 91.2% vs. 59.1% and 38.1%, 76.5% vs. 45.5% and 42.9%, respectively, P<0.01).@*CONCLUSION@#There is heterogeneity in anti-SRP-positive, anti-HMGCR-positive or MSAs-negative patients. The detection of MSAs and performing of muscle biopsy are useful for distinguishing different types of IMNM.

Generality and specificity of cognitive control: research logics and debates / 生理学报

As a high-level cognitive function of actively regulating human behaviors, cognitive control plays essential roles in conflict processing, working memory, decision making and so on. However, it is still under debate whether a universal cognitive control mechanism underlies the processing of various conflicts. Many existing theories tend to hold that cognitive control is domain-general; however, this view has been challenged by recent empirical studies. The logics of studying generality/specificity mainly include transferability, parallel comparison, correlation and resources competition, etc. Current empirical findings support that cognitive control is domain-general, domain-specific or both, respectively. To tackle this controversy, future studies about cognitive control can be performed from the perspectives of life-span development, the dynamic brain network, combination of multiple logics, causal relationship from brain injury, computational modeling, cognitive flexibility and functional connectivity.

Effects of integrin metalloproteinases on osteogenic differentiation / 北京大学学报(医学版)

OBJECTIVE@#To study the effects of disintegrin and metalloproteinase (ADAM) 9, 15 and 17 on the osteogenic differentiation of bone marrow mesenchymal stem cells (BMMSCs).@*METHODS@#BMMSCs of ADAM9, ADAM15, ADAM17 conditional knockout mice and wild type mice (WT) were induced and cultured. Alkaline phosphatase (ALP) activity was measured by colorimetry, early osteogenic transcription factors Runx and Osterix were detected by Real-time PCR, and mineral formation was analyzed by alizarin red staining.@*RESULTS@#ALP activity was lower in ADAM9 group (8.08±0.34), ADAM15 group (6.46±3.40), ADAM17 group (9.30±2.30) than that in WT group (9.44±2.50), but there was no significant difference (P>0.05). Stimulated with bone morphogenetic protein 2(BMP2),there was significant difference (P<0.05) between ADAM9 group (14.22±3.25), ADAM15 group (10.14±2.40) and WT group (20.89±3.40), and ADAM 17 group (23.56±2.50) was higher than WT group (20.89±3.40), but no significant difference (P>0.05). Similarly, cultured by osteogenic induction medium (OST), compared with WT group (12.97±1.30), ADAM9 group (9.63±1.00) and ADAM15 group (7.75±1.30) were lower, ADAM17 group (20.09±1.68) was higher, and the difference was statistically significant (P<0.05). Using stimulated culture by BMP2 and OST combined, ADAM9 group (15.75±1.30), ADAM 15 group (12.43±1.30) were less than WT group (26.15 ±1.50), while ADAM17 group (29.55±2.10) was higher than WT group were statistically significant (P<0.05). The expression of Runx2 in ADAM9 group (2.02±0.24), ADAM15 group (3.09±0.19), ADAM17 group (3.89±0.91) had no significant difference compared with WT (2.02±0.21) group (P>0.05). ADAM9 group stimulated by BMP2 (7.00±0.23), ADAM15 group (6.04±0.23) were lower than WT group (12.6±0.23), ADAM17 group (18.52±1.39) was higher than WT group (12.6±0.23), and the difference was statistically significant (P<0.05). In non-stimulating culture, there was no significant difference in Osterix expression between ADAM9 group (9.60±3.87), ADAM17 group (12.40±3.00) and WT group (10.9±1.10, P>0.05), but in ADAM15 group (6.50±1.51) it was slightly lower than that in WT group (P<0.05). After BMP2 stimulation, ADAM9 group (39.20±3.23) and ADAM15 group (20.50±4.80) were less than WT group (60.30±5.93), while ADAM17 group (80.20±3.30) was higher than WT group (P<0.05). Alizarin red staining showed no obvious orange-red mass in the non-induction group. Local calcified nodules could be seen in the BMP2, OST, OST + BMP2 induction culture conditions in all the experimental groups, but there was no significant difference in quantitative analysis (P>0.05).@*CONCLUSION@#ADAM9, 15, 17 took part in the osteogenic differentiation of BMMSCs, and provided new targets for its regulation.

Femoral revision of the hip: reason, type and different techniques / 中国组织工程研究

BACKGROUND: Total hip arthroplasty has been widely used in clinical practice, and achieved good clinical efficacy. However, with the yearly increased number of patients receiving primary arthroplasty, the number of revision hip arthroplasty patients has increased. However, hip arthroplasty is one of the most difficult hip surgery, and it is challenging. OBJECTIVE: To review the causes of femoral revision of the hip arthroplasty, the classification of the femoral bone defect, and the type of prosthesis available in the clinical revision, and the clinical effect of the different prosthesis, so as to provide reference for femoral revision. METHODS: CNKI, Web of Science, and PubMed were searched for the literatures published between January 1975 and August 2017 with the key words of "Revision total hip arthroplasty, Femur revision, Cemented femoral revision, Cemenless femoral revision Reoperation, Porous-coated stems, Modular, tapered stem, Wagner SL revision Stem". RESULTS AND CONCLUSION: (1) A total of 1 041 articles were retrieved. After reading the abstract, unrelated and repeated studies were excluded. Finally, 109 studies were included. Of them, there were 106 English studies and 3 Chinese studies. Femoral revision was analyzed and summarized. (2) Femoral revision of the hip is still the future challenges facing the joint surgeon. We continue to strive to overcome the direction. Although the current material science and surgical technology are now rapidly developed, only the analysis of the reasons for the revision of the femoral side, identifying the femoral side bone defect classification, mastering the treatment of different defects and the application of the principle of prosthesis type, making reasonable femoral revision program is the key to success according to the patient's age and activity.

Connotation of "precision novelty assessment of literature" and its empirical analysis / 中华医学图书情报杂志

After the concept of"precision novelty assessment of literature" was proposed by integrating"precision"into novelty assessment of literature, the connotation of"precision novelty assessment of literature" was elaborated, including full communication with the trustee, working out comprehensive strategies for "precision novelty assess-ment of literature", writing accurate and complete retrieval process of"precision novelty assessment of literature", appropriate and objective report of "precision novelty assessment of literature". Empirical analysis was then con-ducted by elaborating the concept of"precision novelty assessment of literature" in order to enrich the theory for the novelty assessment of scientific literature and further improve its practical level.

Connotation of "precision novelty assessment of literature" and its empirical analysis / 中华医学图书情报杂志

After the concept of"precision novelty assessment of literature" was proposed by integrating"precision"into novelty assessment of literature, the connotation of"precision novelty assessment of literature" was elaborated, including full communication with the trustee, working out comprehensive strategies for "precision novelty assess-ment of literature", writing accurate and complete retrieval process of"precision novelty assessment of literature", appropriate and objective report of "precision novelty assessment of literature". Empirical analysis was then con-ducted by elaborating the concept of"precision novelty assessment of literature" in order to enrich the theory for the novelty assessment of scientific literature and further improve its practical level.

Analysis on the Countermeasures and the Investigation of the Current Situation of Medical Students'Humanistic Quality / 医学信息学杂志

The paper analyzes the current problems of medical students'humanistic quality and the causes,points out the necessity of strengthening the humanistic quality of medical students,and puts forward the countermeasures to be taken by libraries of medical colleges in the humanistic quality education for college students,including strengthening the construction of medical humanistic resources,doing well of medical humanistic reading guide and entrance education for new students,and strengthening reading promotion activities,etc.

Chemical constituents from Scutellaria barbata / 中草药

Objective: To investigate the constituents in the aerial parts of Scutellaria barbata. Methods: The isolation and purification of the compounds were performed by AB-8 macroporous adsorption resin, silica gel, polyamide and Sephadex LH-20 column chromatography, and their structures were determined on physicochemical characters and spectroscopic data. Results: Fourteen compounds were separated and elucidated as hispidulin-7-O-β-D-methylgluzcuronide (1), apigenin (2), scutellarin (3), scutellarein (4), luteolin (5), scutellarein-7-O-β-D-glucuronide methyl ester (6), isoscutellarein-8-O-β-D-glucuronide-6″-methyl ester (7), apigenin-7-O-β-D-glucuronide-6″-methyl ester (8), 4'-hydroxywogonin (9), 4',5-dihydroxy-3',5',6,7-tetramethoxyflavone (10), isoscutellarein (11), 6-hydroxyluteolin (12), 5-hydroxy-6,7,3',4'-tetramethoxyflavone (13), salvigenin (14). Conclusion: Compound 7 is isolated from Lamiaceae for the first time, compounds 1 and 13 are for the first time isolated from the genus Scutellaria, and compounds 6 and 12 are for the first time obtained from S. barbata.

The effective parts of liangxue tongyu prescription on cooling-blood and activating-blood and analysis of chemical constituents by HPLC-MS and GC-MS / 药学学报

In order to clarify material basis of effective parts of liangxue tongyu prescription, blood-heat and blood-stasis rat model induced by dry yeast was established. The changes of rectal temperature, blood viscosity and plasma viscosity were used to evaluate the cooling-blood and activating-blood effects of liangxue tongyu prescription and its parts. Compared with the model group, the extract from liangxue tongyu prescription, its volatile oil and n-butanol part could significantly reduce rectal temperature (P<0.01), and also reduce blood viscosity and plasma viscosity to various degrees (P<0.01 or P<0.05). So volatile oil and n-butanol part were primarily identified as effective parts of liangxue tongyu prescription. By using GC-MS with normalization method of area to analyze volatile oil of liangxue tongyu prescription, 70 compounds were identified, accounting for about 92.54%, mainly as β-asarone, paeonol, α-asarone and shyobunone. 42 compounds such as peony glycosides, tannins, and iridoid glycosides were identified by HPLC-MS techniques and standard comparison. The study determined the effective parts of liangxue tongyu prescription and clarified the chemical composition providing the foundation for further studies on material basis of liangxue tongyu prescription.

Experiences of Professor Zhou Zhong-ying in diagnosing and treating rheumatoid arthritis by data mining / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To summarize Professor ZHOU Zhong-ying's academic ideas and clinical experiences in diagnosing and treating rheumatoid arthritis (RA).</p><p><b>METHODS</b>Totally 153 clinical case reports were recruited. Data mining techniques like frequencies, factor analysis, and association analysis were used in order to find out laws of syndrome, pathogenesis, treatment methods, formulae and medication.</p><p><b>RESULTS</b>By statistical analyses, we found 14 main symptoms, 76 commonly used clinical drugs, 8 core prescriptions for RA, and the correlation between main pathogeneses and related drugs.</p><p><b>CONCLUSION</b>Results analyzed and summarized from mining his experiences in RA treatment were in line with clinical practice.</p>

Effects of mechanical stimulus on mesenchymal stem cells differentiation toward cardiomyocytes.

Background: Mesenchymal stem cells (MSCs) known to be sensitive to mechanical stimulus. This type of stimulus plays a role in cellular differentiation, so that it might affect MSCs differentiation toward cardiomyocytes. Objectives: Investigate the effect of mechanical stimulus on MSCs differentiation toward cardiomyocytes. Methods: The adipose tissue-derived MSCs were induced to differentiate with 5-azacytidine, and stimulated by one Hz mechanical stretching up to 8%. After 10 days, the cell’s cardiac markers and cardiogenesis-related genes were detected by immumohistochemistrical staining and reverse transcriptase-polymerase chain reaction, and the cell’s ATPase activity was detected. Results: The cyclic mechanical stretching enhanced the expression of cardiogenesis-related genes and cardiac markers, and stimulated the activity of Na+-K+-ATPase and Ca2+-ATPase in the MSCs treated with 5-azacytidine. Without 5-azacytidine pre-treatment, cyclic mechanical stretch alone has little effect. Conclusion: Mechanical stretch combined with 5-azacytidine treatment could accelerate MSCs differentiation toward cardiomyocytes.

Expression of proteasome immunosubunit in labial glands of patients with primary Sjogren's syndrome / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the expression of proteasome immunosubunit low molecular weight polypeptide (LMP)2 and LMP7 in labial glands of patients with primary Sjogren's syndrome patients, and thus explore their role in the diagnosis, differential diagnosis and pathogenesis of primary Sjogren's syndrome (pSS).</p><p><b>METHODS</b>Labial specimens were collected from 40 patients with pSS, 15 patients with connective tissue diseases other than pSS, and 9 healthy controls. The expressions of LMP2 and LMP7 in labial specimens were determined using immunohistochemical approaches and analyzed using semi-quantitative methods. The positive rate of acinar was calculated. After the square arcsine transformation of data, the differences of the positive rate in acinar between LMP2 and LMP7 were compared among three groups. Spearman's rank correlation coefficient was used for analyzing the correlation of clinical manifestations with LMP2 and LMP7 expressions.</p><p><b>RESULTS</b>The expressions of LMP2 and LMP7 within the acinar and ductal epithelial cells were confirmed. Although the LMP2 expression in labial specimens was not significantly different among three groups(P=0.369), the expression of LMP7 was significantly higher in pSS patients compared with patients with connective tissue disease and healthy controls (P<0.01). Only in pSS group, LMP7 was found to be with higher positive rate in acinar than LMP2 (P<0.01). No significant correlation was found between LMP2/LMP7 and clinical manifestations (P>0.05).</p><p><b>CONCLUSION</b>In patients with pSS, the expression of LMP7 (but not LMP2) is up-regulated in labial gland, indicating these two proteins have different genetic regulation mechanisms.</p>

Effects of glycemic control on refraction in diabetic patients / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the effects of glycemic control on refraction in diabetic patients. METHODS: Twenty newly diagnosed diabetic patients were included in this study. The random blood glucose, HbA1c levels, fasting C-peptide and postprandial 2h C-peptide were measured before treatment. The patients with random blood glucose higher than 12.0mmol/L and HbA1c level higher than 10.0% were selected. Refraction, intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length, and axial length were measured on admission and at the end of week 1, 2, 3 and 4 during glycemic control.RESULTS: A transient hyperopic change occurred in all the patients receiving glycemic control. The maximum hyperopic change was 1.60D (range 0.50±3.20D). Recovery of the previous refraction occurred between two and four weeks after insulin treatment. There was a positive correlation between the maximum hyperopic changes and the HbA1c levels on admission (r=0.84, P<0.05). There was a positive correlation between the maximum hyperopic changes and the daily rate of blood glucose reduction over the first 7 days of the treatment (r=0.53, P<0.05). During transient hyperopia, no significant changes were observed in the intraocular pressure, radius of the anterior corneal curvature, depth of the anterior chamber, lens thickness, vitreous length and axial length.CONCLUSION: Transient hyperopic changes occur after glycemic control in diabetic patients with severe hyperglycemia. The degrees of transient hyperopia are highly dependent on HbA1c levels before treatment and the rate of reduction of the blood glucose level.

Efficacy and toxicity analysis of XELOX and FOLFOX4 regimens as adjuvant chemotherapy for stage III colorectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare the efficacy and toxicity of capecitabine plus oxaliplatin (XELOX) versus 5-fluorouracil/leucovorin (5-Fu/LV) plus oxaliplatin (FOLFOX4) regimens as adjuvant chemotherapy for stage III colorectal cancer.</p><p><b>METHODS</b>The clinicopathological data of 118 patients with stage III colorectal cancer were studied retrospectively. The patients were assigned to receive either FOLFOX4 regimen (n = 76) or XELOX regimen (n = 42). 3-year disease-free survival (DFS) and adverse events as end points were compared between the two groups.</p><p><b>RESULTS</b>The number of patients that failed to finish 8 cycles was higher in FOLFOX4 group (28 vs. 8, P = 0.044). There was no significant difference for 3-year DFS and all grades adverse events between the two groups. However, the FOLFOX4 group showed more grade 3/4 neutropenia (31.6% vs. 14.3%, P = 0.039) and central venous catheter-associated complication (11.8% vs. 4.8%, P = 0.205), while XELOX showed more grade 3/4 thrombocytopenia (19.0% vs. 6.6%, P = 0.038) and hand-foot syndrome (11.9% vs. 1.3%, P = 0.012).</p><p><b>CONCLUSION</b>The results of this analysis indicate that XELOX and FOLFOX4 regimens have very similar efficacy as an adjuvant chemotherapy for stage III colon cancer, but XELOX may be safer than FOLFOX4.</p>

Prognosis comparison in middle and later stage severe hepatitis B patients treat with plasma exchange or unified medicine therapy / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To observe the influence on the prognosis of the patients with severe hepatitis B in middle and later stage treated with plasma exchange or unified medicine therapy, and search the therapy methods on the middle and later stage severe hepatitis B.</p><p><b>METHODS</b>To observe the liver function, complications and prognosis of the patients treated with plasma exchange on the basis of unified medicine therapy. To compare with that of the corresponding period patients with unified medicine therapy and analysis the clinical data with statistics methods.</p><p><b>RESULTS</b>36 cases of the plasma exchange group, 18 cases survived and 18 cases died. 32 cases of the unified medicine therapy group, 13 cases survived and 19 cases died. The survival rates between the two groups patients does not appear statistics difference;liver function index (ALT, AST, SB, ALB, TC, ChE) and PT also appear the same results in statistics.</p><p><b>CONCLUSIONS</b>Compare with unified medicine therapy, plasma exchange on the basis of the unified medicine therapy does not appear to improve survival rate of the patients with the middle and later stage severe hepatitis B. The prognosis of these patients determined by the liver failure extent itself.</p>

Efficacy and safety assessment of neoadjuvant paclitaxel and trastuzumab in Chinese women with Her-2 positive operable breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To assess the efficacy and safety of neoadjuvant 3-weekly paclitaxel plus trastuzumab (TH) in Chinese women with Her-2 overexpressing operable breast cancer.</p><p><b>METHODS</b>This is a single center open-label phase II clinical trial. The included patients underwent 4 cycles of neoadjuvant 3-weekly TH before surgery. The primary endpoint was pathologic complete response rate (pCR rate) and the secondary endpoint was overall response rate (OR rate). Patients were also stratified according to hormone receptor status, and pCR rate and OR rate were compared between subgroups. Adverse events were graded according to CTCAE v3.0.</p><p><b>RESULTS</b>There were 40 eligible patients entering this study with median age of 49 years. All patients completed 4 cycles of neoadjuvant treatment. pCR rate was 52.5% and OR rate was 87.5%. The differences of pCR and OR rates between subgroups were of no statistical significance. No cardiac toxicity event severer than grade 2 was recorded.</p><p><b>CONCLUSION</b>3-weekly TH regimen has satisfactory pCR rate and OR rate in Chinese patients with Her-2 overexpressing operable breast cancer and reliable safety.</p>

A meta-analysis of neoadjuvant chemotherapy combined with trastuzumab for HER2-positive breast cancers / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of neoadjuvant chemotherapy combined with trastuzumab for HER2 positive breast cancers.</p><p><b>METHODS</b>PubMed online database, ASCO abstract database, SABCS abstract database, ESMO abstract database and CBMdisc database were searched for literatures related to trastuzumab in neoadjuvant chemotherapy for breast cancers. A meta-analysis was performed for retrieved literatures meeting the inclusion criteria.</p><p><b>RESULTS</b>Three clinical trials were included. Meta-analysis showed that compared to chemotherapy only, regimens combined with trastuzumab could significantly improved the pCR rate of HER2-positive breast cancers (RR=1.65, 95% CI 1.28-2.13, P<0.0001) without increasing the frequencies of cardiac toxicity (RR=1.16, 95% CI 0.82-1.64, P=0.41).</p><p><b>CONCLUSION</b>In neoadjuvant chemotherapy for HER2-positive breast cancers, chemotherapy combined with trastuzumab is superior to exclusive chemotherapy.</p>

Randomized and controlled clinical study of modified prescriptions of Simiao Pill in the treatment of acute gouty arthritis / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the compatibility of a modified prescription of Simiao Pill in the treatment of acute gouty arthritis and to verify the clinical efficacy and safety of the drug through a clinical trial.</p><p><b>METHODS</b>A randomized and controlled clinical trial was designed based on clinical epidemiological principles. A total of 107 patients with acute gouty arthritis were enrolled and randomly assigned to four groups. The first group (Group I) included 27 patients taking gout prescription I; the second group (Group II) included 27 patients taking gout prescription II; the third group (Group III) included 28 patients taking gout prescription III; and the fourth group (control group) included 25 patients taking indomethacin and Benzobromarone as a control group. The duration of the treatment in all 4 groups was two weeks. After the treatment, the index of blood uric acid, blood leukocyte count, score of clinical symptoms, etc. were observed and measured.</p><p><b>RESULTS</b>The total clinical effective rate of the three different modified prescriptions of the Simiao Pill was above 96%, significantly superior to that of the control group (68%, P<0.05). In terms of the improvement of main symptoms, the scores of four symptoms in all TCM treatment and control groups decreased after treatment, with statistically significant differences (P<0.05). Moreover, the scores markedly fell more so in the three Chinese herb groups than in the control group, and especially in Group III (P<0.05). There was a statistically significant difference in blood uric acid values before and after the treatment in the same group but no significant inter-group difference was seen.</p><p><b>CONCLUSION</b>The modified prescriptions, based on the clinical research, clinical experience and traditional Chinese medicine theory, did show a better effect than Western medicine in this clinical study. Moreover, the prescriptions were precise, with the herbs inexpensive and readily available. The patients had good compliance with less adverse reactions noted. The modified prescription has a favorable prospect for future development and is worthy of further blind trials with larger samples.</p>