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Hepatocellular carcinoma （HCC） is a major cause of cancer-related death， and surgical resection remains an important method for radical treatment， but it is urgently needed to solve the problem of high postoperative recurrence rate. Neoadjuvant therapy can reduce the high recurrence rate after surgery， and there are little benefits from neoadjuvant therapy for HCC due to a lack of effective treatment methods in the past. At present， combination therapy based on immune checkpoint inhibitors has a relatively high response rate and has thus changed the treatment landscape for patients with advanced HCC. This urges investigators to reexamine the neoadjuvant treatment strategies for HCC， and it is expected that neoadjuvant therapy can provide new opportunities， reduce the postoperative recurrence rate， and improve the survival rate after treatment. This article discusses the current status and prospects of neoadjuvant therapy for HCC and related hot topics， so as to provide more ideas for exploring neoadjuvant therapy for HCC.
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@#[摘 要] 目的：构建中空硫化铜纳米酶脂质复合载体CuS@LIP并探讨其联合激光照射杀伤黑色素瘤B6-F10细胞的效果与机制。方法：构建（2,3-二油酰基-丙基）-三甲胺-丙烷（氯盐）（DOTAP）阳离子脂质体包被硫化铜纳米载体CuS@LIP，研究不同质量浓度的CuS与CuS@LIP在1 064 nm激光照射下的光热性能和热稳定性，通过H2O2与3,3',5,5'-四甲基联苯胺（TMB）催化活性检测体系检测CuS@LIP的类过氧化物活性；用系列质量浓度梯度的CuS、CuS@LIP在有/无激光条件下分别处理B16-F10细胞，CCK-8法检测细胞的存活率，Calcein-AM/PI染色法、Annexin Ⅴ-FITC/PI染色法结合流式细胞仪分别检测20 μg/mL CuS或CuS@LIP在激光照射或非激光照射条件下对B16-F10细胞活力和凋亡的影响。结果：成功制备的CuS@LIP的平均粒径为（178.23±6.46）nm，平均Zeta电位为（20.47±0.93）mV；在激光照射下，80 μg/mL CuS@LIP最高温度可达65.4 ℃，比单纯CuS的63.4 ℃更高；经3个激光开关周期测试，CuS@LIP终点温度基本保持不变；此外，CuS@LIP与CuS具有相同的类过氧化物酶催化活性。低于20 μg/mL的CuS@LIP在体外对B16-F10细胞的增殖活性没有明显影响（P>0.05），但联合激光照射后细胞存活率明显降低（29.76±3.60）% vs （87.95±8.18）%，P<0.000 1，细胞凋亡率显著升高[（19.34±4.41）% vs （13.36±0.86）%，P<0.01]。结论：制备的CuS@LIP具有符合设计要求的理化性质、良好的光热性能和优异的类过氧化物酶催化活性，其与激光照射联合后显示出更优异的杀伤B16-F10细胞的效果。
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@#Abstract: Objective To predict the potential distribution of talaromycosis marneffei (TSM) and analyze its driving factors, so as to provide evidence for the surveillance and prevention of this disease. Methods The data of all laboratory-confirmed, non-duplicating TSM published in the English and Chinese literature from the first case in January 1964 to December 2018 was collected. A Maxent ecology model using environmental variables, Rhizomys distribution and HIV/AIDS epidemic was developed to forecast ecological niche of TSM worldwide, as well as identify the driving factors. Results A total of 705 articles (477 in Chinese and 228 in English) were obtained during the study period. After excluding imported cases, a total of 100 foci information were included in the model. The area under the receiver operating characteristic (ROC) curve (AUC) of the model was 0.997 for the training set and 0.991 for the test set. Maxent model revealed that Rhizomys distribution, mean temperature of warmest quarter, precipitation of wettest month, HIV/AIDS epidemic and mean temperature of driest quarter were the top 5 important variables affecting TSM distribution. In addition to identifying traditional TSM endemic areas (South of the Yangtze River in China, Southeast Asian, North and Northeast India), other potential endemic areas were also identified, including parts of the North of the Yangtze River, Central America, West Coast of Africa, East Coast of South America, the Korean Peninsula and Japan. Conclusion Our finding has discovered hidden high-risk areas and provided insights about driving factors of TSM distribution, which will help inform surveillance strategies and improve the effectiveness of public health interventions against TM infections.
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@#[摘 要] 目的：构建负载二氧化锰（MnO2）纳米颗粒的可得然（Cur）复合水凝胶MnO2@Cur（简称MGel），研究其对黑色素瘤B16-F10细胞的杀伤效果。方法：采用热诱导法制备Cur水凝胶（Gel），物理负载MnO2构建MGel，表征其宏观和微观形貌，检测其机械性能、降解性能以及光热转换性能等理化性能，并研究其联合PTT对小鼠皮肤黑色素瘤B16-F10细胞的光热杀伤效果。结果：MGel具有优异的机械和可降解性能，抗拉伸强度达（127.97±3.60）kPa、抗压缩强度达（151.44±5.23）kPa，28 d降解率约58.17%。MGel负载MnO2纳米片（粒径约180 nm）获得优异的光热转换性能，负载1.0 mg/mL MnO2的MGel在1.0 W/cm2的808 nm NIR光照4 min后到达最高温度50 ℃。细胞毒性实验和Calcein-AM/PI荧光双染色实验表明，MGel联合PTT有效杀伤B16-F10黑色素瘤细胞，NIR光照使得MGel组细胞存活率降低至（4.68±0.66）%（P<0.000 1）。结论：MGel复合水凝胶具备优异的机械性能、可降解性能以及光热转换性能，其联合PTT能有效杀伤肿瘤细胞，可能成为一种有效治疗黑色素瘤的新手段。
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Objective: To analyze whether the upper airway of patients with catathrenia has obstructive manifestations using nasal resistance, craniofacial, and upper airway imaging methods, which could benefit the exploration of the etiology and treatment options. Methods: From August 2012 to September 2019, a total of 57 patients with catathrenia in the Department of Orthodontics at Peking University Hospital of Stomatology were included in the study, including 22 males and 35 females, aged (31.1±10.9) years, with a body mass index of (21.7±2.7) kg/m2. All the patients were diagnosed by full-night polysomnography at the Sleep Division, Peking University People's Hospital, of which 10 patients were combined with obstructive sleep apnea hypopnea syndrome (OSAHS). The median groaning index of patients was 4.8 (1.8, 13.0) events/h. Nasal resistance and cone-beam CT were conducted on the patients, and measurements were performed on the craniofacial structures, upper airway, and surrounding soft tissues, compared with non-snoring normal occlusion individuals' references published by the same research team (144 college students recruited at Peking University and 100 non-snoring young adults with normal occlusion recruited at six universities in Beijing). Results: The total nasal resistance of patients with catathrenia was (0.26±0.08) Pa·cm-3·s-1. The patients had overall well-developed mandibular hard tissues. However, the patients were found with increased FH/BaN (steep anterior cranial base plane), increased MP/FH (forward rotation of the mandible); increased U1/NA and L1/MP (proclined upper and lower incisors). The sagittal diameter of the velopharynx [(19.2±4.5) mm] was significantly larger than the normal reference (t=8.44, P<0.001), while the sagittal diameter at the hypopharynx [(17.4±6.4) mm] was statistically smaller than the normal reference (t=-2.79, P=0.006). Catarhrenia patients combined with OSAHS presented longer soft palate, tongue, and lower hyoid bone than those with primary catathrenia. Conclusions: In patients with catathrenia, the overall craniofacial characteristics are well-developed skeletal structures, lower nasal resistance, proclined upper and lower incisors, wide upper sagittal development of the upper airway and narrow hypopharynx. Groaning sounds might be related to the narrowing of the hypopharynx during sleep.
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ObjectiveTo explore the mechanism of Xueniao capsule in the treatment of acute pyelonephritis （APN） by network pharmacology and experimental verification. MethodThe effect of Xueniao capsule on APN was investigated based on the APN model in rats. The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP）， Chemistryl Database， and SymMap were searched for the chemical components of Smilacis Chinae Rhizoma，Coicis Semen， and Trachycarpi Petiolus. The target information of the components was collected from PharmMapper and SwissTargetPrediction， and disease target information from Therapeutic Target Database （TTD）， DrugBank， DisGeNET， GeneCards， and Online Mendelian Inheritance in Man（OMIM）. The key genes of Xueniao capsule for APN underwent Gene Ontology（GO） and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analyses by Metascap. Real-time quantitative polymerase chain reaction （PCR） and Western blot were employed to verify the prediction results. ResultCompared with the blank group and the sham operation group， the model group showed an increased ratio of the left kidney to the right kidney and organ index（P<0.05， P<0.01），up-regulated white blood cells （WBC），neutrophils （NEUT），monocytes （MONO）， and lymphocytes （LY）（P<0.05， P<0.01）， and elevated levels of nuclear factor-κB（NF-κB）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α）（P<0.05， P<0.01）. Compared with the model group， the norfloxacin group， the low- and high-dose Xueniao capsule groups showed a decreased ratio of the left kidney to the right kidney and organ index（P<0.05， P<0.01）， dwindled levels of WBC， NEUT， MONO， and LY（P<0.05， P<0.01）， and reduced levels of NF-κB， IL-6， and TNF-α（P<0.05， P<0.01）. The medium-dose Xueniao capsule group showed a decreased ratio of the left kidney to the right kidney and organ index（P<0.05， P<0.01）， reduced levels of WBC， NEUT， MONO， and LY（P<0.05， P<0.01）， and dwindled levels of IL-6 and TNF-α（P<0.05， P<0.01）. Network pharmacological analysis revealed 17 active compounds from Smilacis Chinae Rhizoma， 18 active compounds from Coicis Semen， six active compounds from Trachycarpi Petiolus， and 39 key genes for the treatment of APN in Xueniao capsule. GO enrichment analysis demonstrated 704 biological processes， 22 cellular components， and 59 molecular functions. Sixty-two pathways were enriched in KEGG enrichment analysis. The experimental verification results showed that compared with the blank group， the model group showed increased mRNA expression of prostaglandin-endoperoxide synthase 2 （PTGS2）， mitogen-activated protein kinase 1 （MAPK1）/extracellular signal-regulated protein kinase 2 （ERK2），phosphoinositide 3 kinase （PI3K），protein kinase B2（Akt2），Janus kinase 2 （JAK2），and signal transducer and activator of transcription 3 （STAT3）and protein expression of PI3K， Akt2， JAK2， and STAT3 （P<0.05， P<0.01）. Compared with the model group， the low-dose Xueniao capsule group showed decreased mRNA expression of MAPK1， PI3K， JAK2， and STAT3 and protein expression of PI3K， JAK2， and STAT3 （P<0.05， P<0.01）. The medium-dose Xueniao capsule group showed decreased mRNA expression of MAPK1， PTGS2， PI3K， JAK2， and STAT3， and protein expression of PI3K， JAK2， and STAT3 （P<0.05， P<0.01）. The high-dose Xueniao capsule group showed reduced mRNA expression of PTGS2， MAPK1， PI3K， Akt2， JAK2， and STAT3 and protein expression of PI3K， Akt2， JAK2， and STAT3 （P<0.05， P<0.01）. ConclusionXueniao capsule has a certain curative effect on APN via multiple targets and multiple pathways. The mechanism may be related to the inhibition of the PI3K/Akt signaling pathway and the JAK2/STAT3 signaling pathway.
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With the ultra high performance liquid chromatography-quadruple-electrostatic field orbitrap high resolution mass spectrometry(UHPLC-Q Exactive Orbitrap-MS)-based metabonomics technology, this study aims to analyze the effect of Chaiqin Ningshen Granules(CNG) on endogenous metabolites in insomnia rats of liver depression syndrome and explore the sleep-improving mechanism of this prescription. Parachlorophenylalanine(PCPA, ip) and chronic stimulation were combined to induce insomnia of liver depression pattern in rats, and the effect of CNG on the macroscopic signs, hemorheology, and neurotransmitters in the hippocampus of insomnia rats of liver depression syndrome was observed. After the administration, rat hippocampus was collected for liquid chromatography-mass spectrometry(LC-MS) analysis of the metabolomics. Principal component analysis(PCA), partial least squares discriminant analysis(PLS-DA), and orthogonal partial least squares discriminant analysis(OPLS-DA) were employed for analyzing the metabolites in rat hippocampus and screening potential biomarkers. MetPA was used to yield the related metabolic pathways and metabolic networks. The results show that the drugs can significantly improve the mental state, liver depression, and blood stasis of rats, significantly increase the content of 5-hydroxytryptamine(5-HT) and gamma aminobutyric acid(GABA) in hippocampus(except low-dose CNG), and significantly reduce the content of glucose(Glu)(except low-dose CNG). Among them, estazolam and high-dose CNG had better effect than others. Metabolomics analysis yielded 27 potential biomarkers related to insomnia. MetPA analysis showed 4 metabolic pathways of estazolam in intervening insomnia and 3 metabolic pathways of high-dose CNG in intervening insomnia, involving purine metabolism, glycerophospholipid metabolism, histidine metabolism, and caffeine metabolism. CNG can alleviate insomnia by regulating endogenous differential metabolites and further related metabolic pathways. The result lays a basis for further elucidating the mechanism of CNG in improving sleep.
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Animals , Rats , Biomarkers , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal/pharmacology , Estazolam , Hippocampus/metabolism , Metabolomics/methods , Sleep , Sleep Initiation and Maintenance Disorders/drug therapyABSTRACT
Objective:To investigate the biomechanical characteristics and clinical outcomes of arthroscopic superior capsular reconstruction for massive irreparable rotator cuff tears (MIRCT) using the long head of biceps tendon (LHBT) with tenotomizing its distally or not (the "Chinese way" ).Methods:Eight fresh-frozen cadaveric shoulders were used to create a MIRCT model by detaching the footprints of the supraspinatus and infraspinatus tendons on the greater tuberosity. LHBT autograft was transferred and securely fixed onto the footprint of supraspinatus tendon for superior capsular reconstruction. Further, all cadaveric specimens were assigned to the tenotomy group or reservation group (4 cadaveric specimens in each group) according to whether the distal part of LHBT was tentomized or not. Biomechanical tests were conducted to observe the stiffness, ultimate load of fixed LHBT and to measure the length between LHBT tear site and its insertion on the superior labrum. A total of 41 patients with MIRCT who underwent arthroscopic superior capsular reconstruction using LHBT autograft between July 2016 and December 2018 were enrolled in the study. There were 17 males and 24 females, aged from 46 to 76 years (62.6±7.3 years). All patients were assigned to the tenotomy group (23 cases) or reservation group (18 cases) according to whether the distal part of LHBT was tentomized or not. The visual analogue scale (VAS), University of California, Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score and Fudan University Shoulder Score (FUSS) were used to evaluate the clinical outcomes. The range of motion (ROM) of shoulder was recorded before and after operation. Magnetic resonance imaging was used to assess the structural integrity of reconstructed tissue at 12 months after operation (refers to the failure of the transposed LHBT, which may be accompanied by a retear of partial repaired supraspinatus tendon).Results:Biomechanical research showed that the stiffness, ultimate load of fixed LHBT and the length between LHBT tear site and its insertion on the superior labrum in the reservation group (54.0±6.6 N/mm, 141.8±15.9 N, 93.3±12.4 mm, respectively) were significantly higher than those in the tenotomy group (25.7±4.2 N/mm, 80.8±8.0 N, 47.4±2.0 mm, respectively) ( P<0.05). All patients were followed up for 12-18 months (14.5±1.8 months) without significant complications and adverse reactions. No matter the distal part of LHBT was tentomized or not, the ROM and clinical scores (VAS score, UCLA score, Constant-Murley score, ASES score and FUSS) of patients improved significantly at 1 year follow-up than that before operation ( P<0.05). However, there were no significant differences between the reservation group and tenotomy group in terms of postoperative ROM [flexion, abduction, external rotation at side, internal rotation (vertebral level) were 144.3°±15.5° vs. 148.0°±10.3°, 145.1°±14.1° vs. 142.3°±11.2°, 67.3°±14.4° vs. 62.7°±11.7°, 8.3±2.1 vs. 7.8±2.5, respectively], VAS scores (2.3±1.6 vs.1.5±1.2), functional scores (Constant-Murley score, UCLA score, ASES score and FUSS were 88.2±11.4 vs. 85.6±9.6, 29.3±2.8 vs. 31.4±3.5, 86.8±11.8 vs. 82.6±9.2, 92.1±10.1 vs. 88.3±8.2, respectively) and structural failures (35.2% vs. 30.0%, P>0.05). Conclusion:Arthroscopic superior capsular reconstruction using LHBT with reserving its distal part could achieve higher mechanics strength. However, the short-term follow-up showed that tenotomizing the distal part of LHBT exerted no obvious influence on postoperative function and structural integrity.
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OBJECTIVE@#To observe the analgesic effect of auricular point sticking therapy during the perioperative stage in the patients with partial lung resection.@*METHODS@#A total of 92 patients with partial lung resection were randomized into an auricular point group (31 cases, 1 case dropped off), the sham-auricular point group (30 cases) and a medication group (31 cases, 1 case dropped off). The routine medication for analgesia was provided in all of the three groups. In the auricular point group, 1 day before operation, the auricular point sticking therapy was applied at shenmen (TF@*RESULTS@#In 8, 16, 24, 48 h and 72 h after operation, VAS scores in the auricular point group were lower than those in the sham-auricular point group and the medication group separately (@*CONCLUSION@#Auricular point sticking therapy relieves perioperative pain, shortens analgesic time, releases anxious and depressive emotions and reduces postoperative adverse reaction in the patients with partial lung resection. The analgesic mechanism is probably related to the increase of plasma concentration of β-endorphin.
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Humans , Acupuncture Points , Acupuncture, Ear , Lung , Pain , Pain ManagementABSTRACT
Objective:To explore the application and effect of mixed teaching based on Blackboard network teaching platform in basic chemistry teaching.Methods:The study included in 240 undergraduate students majoring in clinical medicine of Batch 2018 as the research subjects, and they were divided into the experimental group and the control group, with 120 students in each group. The control group was taught by the traditional teaching mode, and the experimental group was taught by mixed teaching method based on the Blackboard network teaching platform. A unified test was conducted for both groups of students. At the end of the course, a questionnaire survey was conducted among the students in the experimental group. SPSS 13.0 was used to process the data and independent sample t-test was performed. Results:The overall scores of the experimental group [(76.45 ± 2.62) points] were higher than those of the control group [(65.38 ± 3.09) points], with statistical significance ( t = 19.472, P < 0.001). The experimental group's satisfaction with the mixed teaching method was more than 75%. Conclusion:The mixed teaching method based on Blackboard network teaching platform is helpful to improve the quality and effect of basic chemistry teaching, and improve students' autonomous learning ability.
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BACKGROUND@#Reverse intertrochanteric fractures are usually initially treated with closed reduction. However, sometimes these fractures are not amenable to closed reduction and require open reduction. To date, few studies have been conducted on predictors of and reduction techniques for irreducible reverse intertrochanteric fractures. Therefore, this study aimed to summarize the displacement patterns of irreducible reverse intertrochanteric fractures and corresponding reduction techniques, and explore predictors of irreducibility.@*METHODS@#We reviewed 1174 cases of trochanteric fractures treated in our hospital from January 2006 to October 2018, 113 of which were reverse intertrochanteric fractures. An irreducible fracture was determined according to intra-operative fluoroscopy imaging after closed manipulation. Fractures were assessed for displacement patterns, radiographic features of irreducibility, and reduction techniques. Logistic regression analysis was performed on potential predictors for irreducibility, including gender, age, body mass index, AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification, and radiographic features.@*RESULTS@#Seventy-six irreducible fractures were identified, accounting for 67% of reverse intertrochanteric fractures. Six patterns of fracture displacement after closed manipulation were identified; the most common pattern was medial displacement and posterior sagging of the femoral shaft relative to the head-neck fragment. Multivariate logistic regression analysis identified three predictors of irreducibility: a medially displaced femoral shaft relative to the head-neck fragment on the anteroposterior (AP) view (odds ratio [OR], 8.00; 95% confidence interval [CI], 3.04-21.04; P < 0.001), a displaced lesser trochanter (OR, 3.61; 95% CI, 1.35-9.61; P = 0.010), and a displaced lateral femoral wall (OR, 2.92; 95% CI, 1.02-8.34; P = 0.046).@*CONCLUSIONS@#A high proportion of reverse intertrochanteric fractures are not amenable to closed reduction. Six patterns of fracture displacement after closed manipulation were identified. Different reduction techniques are required for different displacement patterns. Predictors of irreducibility include a medially displaced femoral shaft relative to the head-neck fragment on the AP view, a displaced lesser trochanter, and a displaced lateral femoral wall. These patients warrant special consideration in terms of recognition and management.
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Background@#Reverse intertrochanteric fractures are usually initially treated with closed reduction. However, sometimes these fractures are not amenable to closed reduction and require open reduction. To date, few studies have been conducted on predictors of and reduction techniques for irreducible reverse intertrochanteric fractures. Therefore, this study aimed to summarize the displacement patterns of irreducible reverse intertrochanteric fractures and corresponding reduction techniques, and explore predictors of irreducibility.@*Methods@#We reviewed 1174 cases of trochanteric fractures treated in our hospital from January 2006 to October 2018, 113 of which were reverse intertrochanteric fractures. An irreducible fracture was determined according to intra-operative fluoroscopy imaging after closed manipulation. Fractures were assessed for displacement patterns, radiographic features of irreducibility, and reduction techniques. Logistic regression analysis was performed on potential predictors for irreducibility, including gender, age, body mass index, AO Foundation/Orthopaedic Trauma Association (AO/OTA) classification, and radiographic features.@*Results@#Seventy-six irreducible fractures were identified, accounting for 67% of reverse intertrochanteric fractures. Six patterns of fracture displacement after closed manipulation were identified; the most common pattern was medial displacement and posterior sagging of the femoral shaft relative to the head-neck fragment. Multivariate logistic regression analysis identified three predictors of irreducibility: a medially displaced femoral shaft relative to the head-neck fragment on the anteroposterior (AP) view (odds ratio [OR], 8.00; 95% confidence interval [CI], 3.04-21.04; P < 0.001), a displaced lesser trochanter (OR, 3.61; 95% CI, 1.35-9.61; P = 0.010), and a displaced lateral femoral wall (OR, 2.92; 95% CI, 1.02-8.34; P = 0.046).@*Conclusions@#A high proportion of reverse intertrochanteric fractures are not amenable to closed reduction. Six patterns of fracture displacement after closed manipulation were identified. Different reduction techniques are required for different displacement patterns. Predictors of irreducibility include a medially displaced femoral shaft relative to the head-neck fragment on the AP view, a displaced lesser trochanter, and a displaced lateral femoral wall. These patients warrant special consideration in terms of recognition and management.
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Objective:The effect of processing on promoting digestion of Crataegi Fructus was investigated by the method of serum metabonomics based on 1H-NMR and the analysis of traditional biochemical indexes. Method:The dyspepsia model was induced by high protein and calorie diet. The small intestine propulsive rate in mice and the hormone level in rat gastrointestinal tract were used as pharmacodynamic indexes. After administration of Crataegi Fructus, fried and charred Crataegi Fructus, the changes of serum metabolites were analyzed by 1H-NMR technique combined with multivariate statistical analysis, so as to compare the therapeutic effects of each processed products on rats with dyspepsia model. Result:Each processed products group of Crataegi Fructus could improve the ability of intestinal propulsion and gastric emptying, especially in charred Crataegi Fructus group, caused by dyspepsia. The serum metabonomics proved that there were significant metabolic differences between the model group and the blank group. A total of 13 biomarkers related to dyspepsia, covering 3-hydroxybutyric acid, glycerophosphoryl choline (GPC), N-acetylglycoprotein, O-acetylglycoprotein, trimethylamine oxide (TMAO), alanine, acetic acid, glutamic acid, glutamine, creatine, leucine, lactic acid and glucose, were screened on the grounds of VIP value of S-plot, single factor ANOVA and area under receiver operating characteristic curve (ROC curve) (AUC). The metabolite composition of each administration group was the same except that the callback tendency of O-acetylglycoprotein, glutamine and GPC in charred Crataegi Fructus group was closer to that in the blank group. Conclusion:There are differences in the effect of promoting digestion to eliminate stagnation among processed products of Crataegi Fructus, charred Crataegi Fructus is more effective in improving dyspepsia, which may play a role in regulating gastrointestinal motility and energy metabolism.
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Serum pharmacochemistry of traditional Chinese medicine(TCM) is a new subject based on the identification of migrating components in serum after oral administration of TCM.After more than 20 years of development,serum pharmacochemistry of TCM has been widely recognized and applied by researchers.Based on the references related with the serum pharmacochemistry from these years,the research summarized the methods of serum pharmacochemistry of TCM,for example,selection of experimental animals,preparation of gastric irrigation,design of drug administration scheme,method and time of adoption blood,pretreatment of serum containing drug,as well as analysis of serum sample.In addition,the paper will emphatically introduce the application of serum pharmacochemistryof TCM,which includes clarifying the substance basis of Chinese medicine,establishing the quality standard of TCM,and clarifying the compatibility of compound Chinese medicine.At the same time,we will through some existing problems to look forward to the future of serum pharmacochemistryof TCM,so that people can have a comprehensive understanding of serum pharmacochemistryof TCM,hoping to lay a foundation for the further application of this method in TCM research.
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Objective To evaluate the short-term efficacy of combination of 125 I seed brachytherapy and cetuximab in postoperation recurrent rectum cancer.Methods From July 2014 to June 2018,at Affiliated Hospital of Shandong Academy of Medical Sciences,57 patients with postoperation recurrent rectal cancer were recruited.According to therapy the patients were divided into two groups:the radiotherapy group (30 cases) treated with radioactive 125I seeds alone and the combination treatment group (27 cases) treated with combination of radioactive 125I seeds and cetuximab.The tumor size,pain relief and adverse reactions were observed in both groups.Chi-square test were performed for statistical analysis.Results After treatment for six months,the total efficacy rate and local control rate of combination treatment group were 54.2％ (13/24) and 87.5％ (21/24),respectively;and which were higher than those of radiotherapy group (17.9％,5/28 and 39.3％,11/28),and the differences were statistically significant (x2 =15.01 and 2.55,both P ＜ 0.05).At one month after treatment,the pain relief rate of radiotherapy group and combination treatment group was 70.0％ (21/30) and 85.2％ (23/27),respectively,and there was no statistically significant difference between the two groups (P ＞ 0.05).After treatment for six months,the rates of adverse reactions of radiotherapy group and combination treatment group were 46.7 ％ (14/30) and 63.0％ (17/27),respectively,there was no statistically significant difference between the two groups (P ＞ 0.05).The symptoms of patients with radiation injury significantly improved after symptomatic treatment.Conclusion The short-term efficacy of combination of 125 I seed brachytherapy and cetuximab is better than that of 125 I seed brachytherapy alone in patients with postoperation recurrent rectum cancer.
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Nosocomial infection (NI) is one of the most significant complications arising after open heart surgery,and leads to increased mortality,hospitalization time and health resource allocation.This study investigated the morbidity,mortality,and independent risk factors associated with NI following open heart surgery.We retrospectively surveyed the records of 1606 consecutive cardiovascular surgical patients to identify those that developed NI.The NI selection criteria were based on the Centers for Disease Control and Prevention (CDC) guidelines.The term NI encompasses surgical site infection (SSI),central venous catheter-related infection (CVCRI),urinary tract infection (UTI),respiratory tract infection and pneumonia (RTIP),as well as other types of infections.Of 1606 cardiovascular surgery patients,125 developed NI (7.8％,125/1606).The rates of NI following surgery for congenital malformation,valve replacement,and coronary artery bypass graft were 2.6％ (15/587),5.5％ (26/473) and 13.6％ (32/236),respectively.The NI rate following surgical repair of aortic aneurysm or dissection was 16.8％ (52/310).Increased risk of NI was detected for patients with a prior preoperative stay ≥3 days (OR=2.11,95％ CI=1.39-3.20),diabetes (OR=2.00,95％=CI 1.26-3.20),length of surgery ≥6 h (OR=2.26,95％ CI=1.47-3.47),or postoperative cerebrovascular accident (OR=4.08,95％ CI=1.79-9.29).Greater attention should be paid toward compliance with ventilator and catheter regulations in order to decrease NI morbidity and mortality following cardiovascular procedures.
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Nosocomial infection (NI) is one of the most significant complications arising after open heart surgery,and leads to increased mortality,hospitalization time and health resource allocation.This study investigated the morbidity,mortality,and independent risk factors associated with NI following open heart surgery.We retrospectively surveyed the records of 1606 consecutive cardiovascular surgical patients to identify those that developed NI.The NI selection criteria were based on the Centers for Disease Control and Prevention (CDC) guidelines.The term NI encompasses surgical site infection (SSI),central venous catheter-related infection (CVCRI),urinary tract infection (UTI),respiratory tract infection and pneumonia (RTIP),as well as other types of infections.Of 1606 cardiovascular surgery patients,125 developed NI (7.8％,125/1606).The rates of NI following surgery for congenital malformation,valve replacement,and coronary artery bypass graft were 2.6％ (15/587),5.5％ (26/473) and 13.6％ (32/236),respectively.The NI rate following surgical repair of aortic aneurysm or dissection was 16.8％ (52/310).Increased risk of NI was detected for patients with a prior preoperative stay ≥3 days (OR=2.11,95％ CI=1.39-3.20),diabetes (OR=2.00,95％=CI 1.26-3.20),length of surgery ≥6 h (OR=2.26,95％ CI=1.47-3.47),or postoperative cerebrovascular accident (OR=4.08,95％ CI=1.79-9.29).Greater attention should be paid toward compliance with ventilator and catheter regulations in order to decrease NI morbidity and mortality following cardiovascular procedures.
ABSTRACT
Longgu is the fossil of ancient mammals which was used as a common kind of mineral medicine. Longgu is always used to treat neurological diseases. Currently, the quality standard of Longgu is incomplete. Moreover, because of the non-renewable nature of the resource and the increase of national protection of fossils, the clinical application of Longgu is facing a series of problems. As the discovery of the ingredient and the development of forging technology researchers launched to search the substitutes of Longgu. The article summarizes the usage and the study of Longgu, in order that we can discuss the modern usage and substitutability of Longgu.
ABSTRACT
Objective To explore the feasibility, safety and preliminary efficacy of radioactive gastric tube of 125Ⅰ seeds in the treatment of advanced esophageal carcinoma. Methods For 10 cases with advanced esophageal carcinoma, the tumor target area was outlined in the TPS system according to preoperative CT images. Prescription dose was 60 Gy with 125Ⅰ seed radioactivity of 2. 22 × 107 Bq. Accordingly, the 125Ⅰ seeds number and the appropriate gastric tube was decided. Then, depending on the location of the tumor and certain rules, 125Ⅰ seeds were fixed in the tube wall to make the radioactive 125Ⅰ seeds gastric tube. Under the C-arm X-ray fluoroscopy, the radioactive 125Ⅰ seeds gastric tubes were placed into esophageal carcinoma site of the patients. Results The radioactive 125Ⅰ seeds gastric tubes of 10 patients were successfully placed, without esophageal perforation, bleeding complications and so on. In one month after operation, all patients with dysphagia′s Stooler classification score were 2 -3 level,of which one case died of other basic diseases in three months after operation, and six cases achieved 0 -1 level while the other three cases achieved 1 -2 level in four months after operation. There were no cases of postoperative chest pain, bleeding, pneumonia and other related complications. Conclusions The radioactive 125Ⅰ seeds gastric tube could not only help to solve nutrition problems, but also the intracavitary brachytherapy inhibit the growth of tumor, which is safe and feasible in clinical use. It can be used as a palliative treatment for patients with advanced esophageal carcinoma.
ABSTRACT
Objective To study the dosimetry distribution of 125Ⅰ seed chains with different radians in different curvatures of bile ducts. Methods The outlines were drawn on the papers, which are the seed chain models with different radians. Radians formula (radian length=2πr × angle/360) was used to calculate the corresponding 0°, 30°, 60°, 90°, 120°, 150° and 180° models with a radian length at 45 mm, for the total length of seed chain model was 45 mm, and the seeds, had no interval or linear arrangements. The image was transmitted to the Brachytherapy planning system for seeds implantation( TPS) to simulate the seed chains with different radians. Using TPS to delineate the tumor target area, of which the activity was set as 1. 85 × 107 Bq, and the prescription dose was 60 Gy. It was prescribed to simulate the bile duct ( diameter at 8 mm) . TPS were used to calculate the D90 and V100 of the simulated bile duct with the diameter at 8 mm, and explore dosimetry of the points at the centripetal and centrifugal sides with 5 mm vertical distance which from two endpoints and center of seed chains with different radians. Results When the radian of seed chain was 30°, the D90and the V100 were the highest (the D90 was 132 Gy; the V100 was 100%). While the radian was 60°, the D90 and the V100 were the lowest (the D90 was 45 Gy, the V100 was 68%). As the radian was 30°, the highest dose was in the center ( dose in the centripetal side was 165 Gy, and centrifugal side dose was 142 Gy) . The center has the lowest dose as the radian up to 180°(dose in the centripetal side was 90 Gy, and centrifugal side dose was 50 Gy) . Among all radians, dose in the centripetal side was always higher than centrifugal side in the center. Between two endpoints, dose in the centrifugal side was higher than centripetal. Conclusions Distribution of seed chain dosage also changed along with the change of radian. When the radian of seed chain was 30°, the D90 and the V100 were the highest. The centripetal dose was higher than that of the centrifugal side.