A new strategy for the management of ascites in liver cirrhosis:A long-term albumin treatment / 实用医学杂志

Ascites is the most frequent decompensating event of cirrhosis.At present,ascites recurs at a high rate due to lack of effective management strategy and is frequently complicated with spontaneous bacterial peritonitis,hepatorenal syndrome,and liver failure,which increase the fatality rate.Albumin treatment for hepatocirrhosic ascites has a long history,but it is limited as an acute or short-term treatment.In contrast,long-term albumin administration represents a completely different treatment paradigm.Results from several recent clinical studies indicate that long-term albumin treatment can be able to modify the disease courses of some decompensated cirrhosis when albumin is given at a sufficient dose for a sufficient time.In this review,we analyze the available data acquired from long-term albumin treatments,trying to establish a secure and effective management scheme involving maximal target popula-tion,albumin dose,administration time,and standards for albumin withdrawal,and thus provide references for the clinical practice.

Efficacy and safety analysis of a combination regimen with BCL-2 inhibitor in relapsed/refractory primary systemic light chain amyloidosis with t(11;14) from a single center / 中华内科杂志

Objective:To explore the efficacy and safety of BCL-2 inhibitor-based treatment in patients with relapsed/refractory t (11; 14) primary systemic light chain amyloidosis.Methods:This was a retrospective case series study. Ten patients with relapsed/refractory t(11;14) primary systemic light chain amyloidosis who had all received treatment with a combination regimen including the BCL-2 inhibitor venetoclax from January 2018 to November 2022 at the Hematology Department of Peking University People′s Hospital were included. Adverse events, and hematological and organ responses were evaluated.Results:The median age of the ten enrolled patients was 59 (range 41-78) years, and the male to female ratio was 8∶2. Except for one patient, a very good partial or better response was achieved in 8/9 patients and one patient obtained a partial response. The overall response rate was 100%. The median time to achieve a hematological response was 60 (range 24-236) days. At least one organ response was observed in 7/9 patients. With a median follow-up of 18 months, one patient experienced hematological progression and one patient died. Grade 3 adverse events included lymphocytopenia (3 cases), anemia (1 case), diarrhea (1 case), and appendicitis (1 case). One patient died of pulmonary fungal infection two months after completion of treatment, which was not excluded as being treatment related.Conclusion:A combination regimen including BCL-2 inhibitors in patients with relapsed/refractory t(11;14) primary systemic light chain amyloidosis is a potentially safe and effective treatment option that warrants further investigation.

Treatment of iliac fracture combined anterior dislocation of the sacroiliac joint by the "ladder reduction method" / 中华骨科杂志

Objective:To investigate the clinical effect of "ladder reduction method" in the treatment of iliac fracture combined anterior dislocation of sacroiliac joint.Methods:The retrospective analysis was performed on 10 cases of iliac fracture combined anterior sacroiliac joint dislocation admitted to the Affiliated Hospital of Yunnan University from February 2010 to January 2022, among which 5 cases were males and 5 cases were females, aged ranging from 22 to 52 years, with an average age of 38.8 years. All patients were injured in car accidents including 5 cases of C1.2, 3 cases of C2, and 2 cases of C3 fractures according to Tile classification. All patients were treated with the "ladder reduction method" with plate and screw fixation. In the first step, 1-2 Schanz pins were inserted into the iliac crest to control the ilium, and the Schanz pins were appropriately pulled laterally; in the second step, the periosteal stripper was used to pry the reduction between the sacrum and ilium; in the third step, for the patients who still could not be reduced, a 2.5 mm diameter Kirschner wire was placed on the sacrum close to the iliac crest, and a periosteal stripper was inserted between the sacrum and iliac crest, with its tip against the Kirkner wire, and the iliac crest as the fulcrum for pry pulling to separate the two. In the fourth step, the pry was maintained, and then another 2.5 mm diameter Kirschner wire was placed on the sacrum close to the internal margin of the iliac bone. The periosteal stripper was continued to pry between the sacrum and the iliac bone, and the operation was repeated. At the same time, the anterior dislocation of the sacroiliac joint was reduced with traction of the lower limb. Postoperatively, the quality of reduction was evaluated by the Matta score, and the degree of functional recovery after pelvic fracture was evaluated by the Majeed score.Results:Four patients completed the reduction through the first and second steps, and 6 cases of refractory sacroiliac joint anterior dislocation were successfully reduced through the first to fourth steps. The fracture reduction time of 6 patients with refractory anterior sacroiliac joint dislocation was 39.67±3.09 min (range, 35-44 min), with intraoperative blood loss of 300.00±141.42 ml (range, 150-600 ml); in the other 4 cases, the fracture reduction time was 36.75±4.38 min (range, 30-42 min), and the intraoperative blood loss was 225.00±44.30 ml (range, 200-300 ml). All 10 patients were followed up for 12.9±3.7 months (range, 9-20 months). The anterior and posterior pelvic ring fractures were healed in all patients, and the fracture healing time was 12.77±1.62 weeks (range, 10.71-15.28 weeks). At the last follow-up, Matta evaluation was excellent in 5 cases, good in 1 case, and excellent in the other 4 cases. The Majeed scores of 6 cases were 86.50±6.08 points (range, 74-92 points), of which 5 cases were excellent and 1 case was good. The other 4 cases were 81.5±9.39 scores (range, 71-94), of which 2 were excellent and 2 were good.Conclusion:The "ladder reduction method" is a safe, effective and easy-to-operate method for the treatment of iliac fracture combined anterior dislocation of the sacroiliac joint, especially for refractory anterior dislocation of the sacroiliac joint, which can still obtain satisfactory curative effects.

The role of signaling crosstalk of microglia in hippocampus on progression of ageing and Alzheimer's disease / 药物分析学报

Based on single-cell sequencing of the hippocampi of 5x familiar Alzheimer's disease(5x FAD)and wild type mice at 2-,12-,and 24-month of age,we found an increased percentage of microglia in aging and Alzheimer's disease(AD)mice.Blood brain barrier injury may also have contributed to this increase.Immune regulation by microglia plays a major role in the progression of aging and AD,according to the functions of 41 intersecting differentially expressed genes in microglia.Signaling crosstalk between C-C motif chemokine ligand(CCL)and major histocompatibility complex-1 bridges intercellular communi-cation in the hippocampus during aging and AD.The amyloid precursor protein(APP)and colony stimulating factor(CSF)signals drive 5x FAD to deviate from aging track to AD occurrence among intercellular communication in hippocampus.Microglia are involved in the progression of aging and AD can be divided into 10 functional types.The strength of the interaction among microglial subtypes weakened with aging,and the CCL and CSF signaling pathways were the fundamental bridge of communication among microglial subtypes.

Influences of gymnastics on body composition and cardiopulmonary function of athletes / Influências da ginástica na composição corporal e na função cardiopulmonar de atletas / Influencias de la gimnasia en la composición corporal y en la función cardiopulmonar de atletas

ABSTRACT Introduction: Aerobics is a recreational, ornamental, rhythmic, and expressive sport. It is widely used in physical education in colleges and universities because it is also believed that this sport benefits the cardiopulmonary function and the body composition of the practitioners. Objective: Study the influences of aerobic gymnastics on body composition and cardiopulmonary function in its practitioners. Methods: 40 college students volunteered for the research sample. The living conditions and learning level of the subjects were the same. The students were divided into two groups for research. There was no significant difference between the groups comparing the volunteers' age, height, and weight. The high-load group performed exercises with a maximum heart rate of 220, while the low-load group performed the same protocol under a maximum heart rate of 195 beats per minute. The intervention took place over 40 and 60 minutes of exercise, respectively, for eight weeks. The POLAR monitor was used to check the kinematic performance of the athletes. The data were processed statistically. Results: Aerobic gymnastics influenced the body composition of college students with significant differences in bust circumference, waist, hip, thigh, and skinfold thickness (P<0.05). The athletes' heart rate, pulmonary ventilation, and diastolic pressure increased significantly after aerobic gymnastics. The study showed that the resting heart rate of the volunteers decreased significantly after exercise, and their lung function returned to normal (P<0.05). Conclusion: Aerobic exercise can improve the body composition, physiology, and cardiopulmonary function of its practitioners, and its greater encouragement in colleges and universities is recommended. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A ginástica aeróbica é um esporte recreativo, ornamental, rítmico e expressivo. É amplamente utilizado na educação física em faculdades e universidades pois também se acredita que esse esporte beneficie a função cardiopulmonar e a composição corporal dos praticantes. Objetivo: Estudar as influências da ginástica aeróbica sobre a composição corporal e sobre a função cardiopulmonar em seus praticantes. Métodos: 40 estudantes universitários foram voluntários para a amostra de pesquisa. As condições de vida e nível de aprendizagem das disciplinas foram as mesmas. Os estudantes foram divididos em dois grupos para pesquisa. Não houve diferença significativa entre os grupos na comparação da idade, altura e peso dos voluntários. O grupo de alta carga efetuou exercícios com um ritmo cardíaco máximo de 220 enquanto o grupo de baixa carga executou o mesmo protocolo sob ritmo cardíaco máximo de 195 batimentos por minuto. A intervenção deu-se em 40 e 60 minutos de exercício, respectivamente, durante oito semanas. O monitor POLAR foi usado para verificar o desempenho cinemático dos atletas. Os dados foram processados estatisticamente. Resultados: A ginástica aeróbica influenciou a composição corporal dos estudantes universitários com diferenças significativas na circunferência de busto, cintura, quadril, coxa e espessura de prega cutânea (P<0,05). A frequência cardíaca, a ventilação pulmonar e a pressão diastólica dos atletas aumentaram significativamente logo após a ginástica aeróbica. O estudo mostrou que a frequência cardíaca em repouso dos voluntários diminuiu significativamente após o exercício, e sua função pulmonar voltou ao normal (P<0,05). Conclusão: O exercício aeróbico aperfeiçoou a composição corporal, a fisiologia e a função cardiopulmonar de seus praticantes sendo recomendado o seu maior incentivo nas faculdades e universidades. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La gimnasia aeróbica es un deporte recreativo, ornamental, rítmico y expresivo. Se utiliza mucho en la educación física en colegios y universidades porque también se cree que este deporte beneficia la función cardiopulmonar y la composición corporal de los practicantes. Objetivo: Estudiar las influencias de la gimnasia aeróbica sobre la composición corporal y sobre la función cardiopulmonar en sus practicantes. Métodos: 40 estudiantes universitarios se ofrecieron como voluntarios para la muestra de la investigación. Las condiciones de vida y el nivel de aprendizaje de los sujetos eran los mismos. Los estudiantes se dividieron en dos grupos para la investigación. No hubo diferencias significativas entre los grupos al comparar la edad, la altura y el peso de los voluntarios. El grupo de alta carga realizó los ejercicios con una frecuencia cardíaca máxima de 220, mientras que el grupo de baja carga realizó el mismo protocolo con una frecuencia cardíaca máxima de 195 pulsaciones por minuto. La intervención tuvo lugar durante 40 y 60 minutos de ejercicio, respectivamente, durante ocho semanas. El monitor POLAR se utilizó para verificar el rendimiento cinemático de los atletas. Los datos se procesaron estadísticamente. Resultados: La gimnasia aeróbica influyó en la composición corporal de los estudiantes universitarios con diferencias significativas en la circunferencia del busto, la cintura, la cadera, el muslo y el grosor de los pliegues cutáneos (P<0,05). La frecuencia cardíaca, la ventilación pulmonar y la presión diastólica de los atletas aumentaron significativamente inmediatamente después de la gimnasia aeróbica. El estudio mostró que la frecuencia cardíaca en reposo de los voluntarios disminuyó significativamente después del ejercicio, y su función pulmonar volvió a ser normal (P<0,05). Conclusión: El ejercicio aeróbico puede mejorar la composición corporal, la fisiología y la función cardiopulmonar de sus practicantes siendo recomendable su mayor fomento en colegios y universidades. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

A single-center retrospective analysis of 100 consecutive cases treated with lenalidomide/bortezomib/dexamethasone in newly diagnosed multiple myeloma / 中华内科杂志

Objective:To investigate the efficacy and safety of lenalidomide combined with bortezomib and dexamethasone (RVD) in patients with newly diagnosed multiple myeloma (NDMM).Methods:A total of 100 consecutive NDMM patients treated with RVD from August 2016 to September 2020 at Peking University People′s Hospital were retrospectively analyzed, including response, drug toxicity, follow-up and survival, and subgroup analysis.Results:The median follow-up time was 19.5 (2.0-57.0) months. For patients undergoing autologous stem cell transplantation (ASCT) after RVD regimen, the objective response rate (ORR)/complete response+stringent complete response (CR+sCR)/≥very good partial response (VGPR) rates were 100%, 73.3% (33/45), 95.6% (43/45) respectively. For 54 patients not receiving transplantation, the ORR/CR+sCR/≥VGPR rates were 79.6% (43/54), 18.5% (10/54), 51.9% (28/54) respectively. As to the survival analysis, 2-year progression free survival (PFS) rates were 84.5% and 70.9% in transplant and non-transplant patients respectively ( P=0.102). Two-year overall survival (OS) rates were 100% and 80.8% in transplant and non-transplant patients respectively ( P=0.003). The common hematologic adverse events (AEs) were thrombocytopenia (33%) and neutropenia (25%). Abnormal liver function (43%) and peripheral neuropathy (24%) were recognized more as non-hematologic AEs. Conclusion:RVD as front-line regimen has high efficient response rate and acceptable safety in Chinese NDMM patients.

Anti-inflammatory effect, plasma effective components and therapeutic targets of Huanglian Jiedu Decoction on ulcerative colitis mice / 中国中药杂志

This paper was to investigate the effect of Huanglian Jiedu Decoction(HLJD) on ulcerative colitis(UC) in mice, and determine the effective components in plasma, and virtually screen its therapeutic target, and predict its mechanism. Sixty Balb/c mice were randomly divided into blank group, model group, mesalazine treatment group(0.3 g·kg~(-1)), and HLJD treatment groups(24.66, 12.33, 6.17 g·kg~(-1)). Excepted for the blank group, all the mice in HLJD and mesalazine treatment groups were gavage administration. All mice freely drank 2.5% DSS solution for seven days to induce UC. The disease activity index(DAI) was detected each day. At the end of the experiment, HE staining was used to observe the pathological changes in colon. The content of IL-1β, IL-6 and TNF-α in colon were determined by ELISA. The effective components in plasma were determined by UPLC-Q-TOF-MS. The reverse docking in PharmMapper was used to screen the component targets. The disease targets of UC were collected by searching TTD, OMIM and GeneCards databases. The intersection of the component targets and disease targets was selected as the therapeutic targets. Then the therapeutic targets were imported into the STRING for GO and KEGG enrichment analysis. Discovery Studio was used to simulate the docking between the components and the targets. RESULTS:: showed that the DAI in the model group increased significantly(P<0.05), and the number of inflammatory cells and infiltration degree increased significantly compared with the blank group. The DAI in HLJD treatment group was significantly reduced(P<0.05), and the number and infiltration degree of inflammatory cells were reduced compared with the model group. The ELISA results showed that the levels of IL-1β, IL-6 and TNF-α were increased significantly in the model group(P<0.01) compared with the blank group, and significantly down regulated in the HLJD treatment group(P<0.05) compared with the model group. After UPLC-Q-TOF-MS analyse, ten components were identified. The network pharmacology analysis showed that the action targets were significantly enriched in 129 of biological processes, such as response to organic substance, chemical and oxygen-containing compound, etc., as well as 16 of signal pathways, such as IL-17, TNF and hepatitis B signal pathways, were enriched too. The results of molecular docking showed that limonin, palmatine and berberine could bind to CASP3 and MMP9 by hydrogen bond. In conclusion, HLJD could alleviate the colonic mucosal inflammatory infiltration and mucosal damage in UC mice. The mechanism may be related to the anti-inflammatory effect on UC mice by reducing the levels of IL-1β, IL-6 and TNF-α in colon through limonin, palmatine and berberine regulating IL-17 signal pathway and TNF signal pathway via CASP3 and MMP9 meditated.

A longitudinal study of transcriptional profiling of carbon-ions exposure on the lung / 中华放射肿瘤学杂志

Objective:To investigate the expression changes at the transcriptional level in normal lung tissues of mice after exposure to heavy ion radiation for different durations at different doses, aiming to provide evidence for exploring sensitive genes of heavy ion radiation, heavy ion radiation effect and the damage mechanism.Methods:Experiments on the temporal kinetics: the whole thorax of mice was irradiated with 14.5Gy carbon-ions and the total RNA of lung tissue was extracted at 3days, 7days, 3 weeks and 24 weeks. In dose-dependent experiment, the total RNA of lung tissue was extracted at 1 week after irradiated with a growing thoracic dose of 0, 7.5, 10.5, 12.5, 14.5, 17.5 and 20Gy. Protein-to-protein interaction (PPI) analysis and gene-ontology biological process enrichment analysis were performed on significant differentially expressed genes (DEGs).Results:A clearly differential expression patterns were observed at 3-day (acute stage), 1-week (subacute stage), 3-week (inflammatory stage) and 24-week (fibrosis stage) following 14.5Gy carbon-ions irradiation. Among those, the 3-day time point was found to be the mostly different from the other time points, whereas the 7-day time point had the highest uniformity with the other time points. Cellular apoptosis was the main type of cell death in normal lung tissues following carbon-ions exposure. The interactive genes of Phlda3, GDF15, Mgmt and Bax were identified as the radiosensitive genes, and Phlda3 was the center ( R=0.76, P<0.001). Conclusion:The findings in this study provide transcriptional insights into the biological mechanism underlying normal lung tissue toxicity induced by carbon-ions.

Daratumumab for the treatment of primary systemic amyloidosis: a multicenter retrospective analysis / 中华内科杂志

Objective:To analyze the efficacy and safety of Daratumumab for the treatment of primary AL light chain systemic amyloidosis.Methods:Twenty one patients who were diagnosed as primary AL light chain systemic amyloidosis and treated with Daratumumab from 7 centers were retrospectively analyzed. Daratumumab was administrated as first line therapy in seven patients and 14 patients with relapsed settings. Hematological response, safety and survival were analyzed.Results:All 7 patients achieved very good partial response (VGPR) or better with first-line application of daratumumab. Three patients died, and the other four achieved organ remission. Among 14 relapsed patients, 2 patients had a difference of free light chain (dFLC) less than 20 mg/L before treatment, and 9 with a dFLC of more than 50 mg/L. All patients reached partial response (PR) or better, including 4 patients with complete response (CR), 3 with VGPR and 2 with PR. The response rate was 100% in 3 patients with dFLC 20-50 mg/L at baseline. The organ remission rate was 50% in patients with heart involvement and 58.3% in patients with kidney impairment. The overall median follow-up period was 5.3 months, and 11 months in surviving patients. One patient died of severe infection and disseminated intravascular coagulation (DIC) with stable amyloidosis. One patient switched to other regimens because dFLC elevated but did not fulfill progressive disease after 2 year application. As to safety, no grade 3/4 infusion reaction developed, and grade 1 infusion reaction occurred in 3 cases during the first infusion. Lymphocytopenia was seen in 75% patients including grade 3 or more in 30% patients.Conclusion:Daratumumab is effective to eliminate serum free light chain in both newly diagnosed and relapsed patients with systemic amyloidosis.

The efficacy and safety of daratumumab in relapsed and refractory multiple myeloma / 中华内科杂志

Objective:To investigate the efficacy and safety of daratumumab in relapsed and refractory multiple myeloma (RRMM).Methods:The efficacy and adverse events (AEs) of daratumumab based regimens were retrospectively analyzed in 37 patients with RRMM from Peking University People′s Hospital, Beijing Hospital and Fu Xing Hospital affiliated to Capital Medical University in China. The deadline for inclusion was December, 2019.Results:Among the 37 patients, 35 patients were available for response evaluation. The overall response rate (ORR) was 68.6%, which was better in patients receiving 16 mg/kg daratumumab than in those with fixed doses of 800 mg daratumumab [ORR: 78.3%(18/23) vs. 40.0%(4/10)]. The percentage of infusion related reactions of daratumumab was 27.0%(10/37). The most common hematological AEs were lymphocytopenia and thrombocytopenia, with the incidences of grade 3 or more severe 59.5%(22/37) and 43.2%(16/37) respectively. Pulmonary infections(37.8%, 14/37) were the most common non-hematological AEs. One patient with positive hepatitis B surface antigen (HBsAg) and two patients dependent on dialysis were safely treated with daratumumab.Conclusion:Daratumumab is highly effective in relapsed and refractory multiple myeloma. Adverse reactions are mild and well tolerable.

The clinical characteristics of patients with primary plasma cell leukemia and the efficacy of novel agents and hematopoietic stem cell transplantation / 中华内科杂志

Objective:To analyze the immunophenotype and cytogenetic characteristics of primary plasma cell leukemia (pPCL), and to evaluate the efficacy of bortezomib and hematopoietic stem cell transplantation as main treatment.Methods:A retrospective cohort study was conducted including 42 pPCL patients admitted to Peking University People′s Hospital from January 1998 to March 2019. All patients were followed up until December 31, 2019. The immunophenotype and cytogenetic characteristics were compared with historical data of multiple myeloma (MM). Thirty-nine patients were divided into bortezomib-based group (29 cases) and non-bortezomib group (10 cases). All patients were also divided into hematopoietic stem cell transplantation (HSCT) group (15 cases) and non-HSCT group (24 cases).Chi-square test was used for efficacy comparison, and Kaplan-Meier method was used for univariate prognostic analysis. Cox proportional hazards model was used for multi-variant analysis.Results:pPCL accounted for 2.6% of the total patients with plasma cell diseases during the same period. There were 22 males and 20 females, with a median age of 50 (30—77) years old at diagnosis. In immunophenotype analysis, tumor cells in pPCL patients also expressed CD38, CD138, CD45, which was similar as patients with MM. However the expression of CXCR4 were more frequently seen in pPCL(73.1% vs. 34.7%, P= 0.000), while intensity of CD9 and CD200 was lower (40.7% vs. 62.5%, P =0.028, 33.3% vs. 58.0%, P=0.021).Overall response rate of bortezomib-based therapy was superior to non-bortezomib therapy (69.0% vs.50.0%). The median survival was 18.2 (0.2—95.7)months, and the 1-and 2-year survival rates were 61.9% and 37.4%, respectively. Multivariate prognostic analysis suggested that age ( P= 0.027) and efficacy( P= 0.035)were significantly correlated with survival.HSCT resulted in superior survival compared with chemotherapy alone(26.8 vs. 8.1 months, P=0.021). Conclusions:Immunophenotypes and cytogenetic abnormalities in patients with pPCL are different from those with multiple myeloma. Bortezomib based regimens improve response rate and survival of pPCL. Hematopoietic stem cell transplantation also predicts survival benefits.

Two cases report of heavy- and light-amyloidosis and literature review / 中华肾脏病杂志

Objective:To investigate the clinical manifestation, diagnosis and prognosis of heavy- and light-amyloidosis (AHL).Methods:The clinical data of two patients with AHL in Peking University People's Hospital and 21 cases of reported literature were reviewed to clarify the clinical and prognostic characteristics of AHL.Results:Compared with light-amyloidosis, most AHL patients were male, with high positive rate of blood and urine immunofixation electrophoresis and complete immunoglobulin. The manifestations of the kidneys were proteinuria, mainly composed of albumin, nephrotic syndrome and microscopic haematuria. The pathology of renal biopsy showed that Congo red staining positive substances were deposited in many sites (mesangial area, capillary wall, arteriole and renal interstitium), and immunofluorescence showed that monoclonal heavy chain with light chain (the type was consistent with the hematuria M protein) were clumpy deposition, which was consistent with amyloid deposition site. Heart involvement was rare, and the proportion of plasma cells in bone marrow was high.Conclusion:AHL is rare and its clinical manifestations of AHL are different from those of light-amyloidosis. The prognosis needs to be further observed.

Dose-response relationship of radiation-induced pulmonary fibrosis in mouse models based on CT-derived parameters / 中华放射肿瘤学杂志

Objective To investigate the radiation induced pulmonary fibrosis with a dose-response mouse model, based on the CT image changes of pulmonary fibrosis.Methods Female C57BL6 mice aged 8-10 weeks were randomly divided into 20 Gy or escalated doses of X-ray whole thoracic irradiation ( WTI) groups. CT scan was performed at different time points before and after radiation. The average lung density and lung volume changes were obtained by three-dimensional segmentation algorithm. After gene chip and pathological validation, the parameters of CT scan were subject to the establishment of logistic regression model. Results At the endpoint of 24 weeks post-irradiation, the lung density in the 20 Gy irradiation group was (-289.81± 12.06) HU, significantly increased compared with (-377.97± 6.24) HU in the control group ( P<0.001) . The lung volume was ( 0.66±0.01) cm3 in the control group, significantly larger than ( 0.44±0.03) cm3 in the irradiated mice ( P<0.001) . The results of quantitative imaging analysis were in accordance with the findings of HE and Mason staining, which were positively correlated with the fibrosis-related biomarkers at the transcriptional level ( all R2=0.75, all P<0.001) . The ED50 for increased lung density was found to be ( 13.64± 0.14) Gy ( R2=0.99, P<0.001) and ( 16.17± 4.36) Gy ( R2=0.89, P<0.001) for decreased lung volume according to the logistic regression model. Conclusions Quantitative CT measurement of lung density and volume are reliable imaging parameters to evaluate the degree of radiation-induced pulmonary fibrosis in mouse models. The dose-response mouse models with pulmonary fibrosis changes can provide experimental basis for comparative analysis of high-dose hypofractioned irradiation-and half-lung irradiation-induced pulmonary fibrosis.

Efficacy of neuroendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage / 国际外科学杂志

Objective To investigate the efficacy of neuroendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage.Methods From August 2014 to August 2017,91 spontaneous thalamic hemorrhage ruptured into ventricles patients in Affiliated Hospital of the Yangzhou University were enrolled,who were underwent surgical treatment in this retrospective study.The patients were divided into the study group(n =41) and control group(n =50) based on different methods of treatment.The patients in the study group were given with remove visible intraventricular hematoma by neuroendoscopy,followed by External Ventricular Drainage (EVD) combined with urokinase fibrinolysis.The patients in control group were given with EVD combined with urokinase fibrinolysis.The time of postoperative drainage,ICU stay,duration of onset of fever,the number of intracranial infections,and the proportion of Glasgow outcome scale (GOS) (1 to 5) at 6 months postsurgery were compared between two groups.Measurement data were expressed as (Mean ± SD),and t test was used for measurement data.The count data were analyzed by x2 test or nonparametric rank sum test.Results The time of postoperative drainage,the number of intracranial infections,ICU stay in study group were (6.19 ± 1.1) d,5 cases,(2.8 ± 1.6) d,the indexes in control group were (7.06 ± 1.3) d,15 cases,(5.2 ± 2.0) d.The time of postoperative drainage,ICU stay,the number of intracranial infections were superior to those of the control group,and the difference was statistically significant.The proportion of GOS (1 to 5) at 6 months after surgery was 5 cases (12.2％),5 cases (12.2％),10 cases (24.4％),14 cases (34.1％),7 cases (17.1％) in study group,the indexes in control group were 10 cases(20.0％),13 cases (26.0％),11 cases(22.0％),10 cases(20.0％),6 cases(12.0％).The 6-month postoperative GOS of the study group were superior to those of the control group,and the difference was statistically significant (P ＜ 0.05).Conclusion Neruendoscopy combined with urokinase in the treatment of spontaneous intraventricular hemorrhage can reduce the time of postoperative drainage and the incidence of intracranial infection,shorten the time of ICU stay and improve the functional prognosis of the patients.

Therapeutic effects of number of BCD (bortezomib, cyclophosphamide, dexametha-sone) chemotherapy courses on newly diagnosed multiple myeloma / 中国肿瘤临床

Objective: To analyze the treatment effect of the number of bortezomib, cyclophosphamide, and dexamethasone (BCD) chemotherapy courses for newly diagnosed multiple myeloma. Methods: We retrospectively analyzed data of patients with newly diagnosed multiple myeloma from January 2014 to July 2016 in Peking University People's Hospital. All 70 patients received two or more courses of BCD chemotherapy. Patients with extramedullary disease or amyloidosis were excluded. Patients completed their follow-up, and the treatment effects were studied in those who only received two, four, and six chemotherapy courses. Results: Among the 70 patients, the ratio of male to female was 36 :34, the median age of disease onset was 58.4 y (range: 33-81 y), and the number of patients with ISS stagesⅠ,Ⅱ, and Ⅲ was 16, 18, and 36, respectively. The number of patients who received two, four, and six chemotherapy courses was 14, 20, and 36, respectively. The percentages of complete remission, equal or more than very good partial remission, equal or more than partial remission for patients who received two courses were 14.28%, 42.86%, and 71.42%, those for four courses were 30.00%, 60.00%, 80.00%, and those for six courses were 38.89%, 75.00%, 83.33%, respectively. During the median 15.37 (range: 2-32) months follow up, the estimated progression free survival (PFS) was 21.96 months (95% CI: 19.26-24.70). No statistically significant difference for PFS was observed among the three groups (P=0.700). Conclusions: For the BCD chemotherapy regimen, the maximum therapeutic effect occurred after four or more courses. As the number of induction courses after four chemotherapies increased, the depth of disease relief increased but overall remission did not show substantial improvement. Therefore, four or more BCD chemotherapies can be used for the first line of induction therapy.

Upper Gastrointestinal Complications and Cardiovascular/Gastrointestinal Risk Calculator in Patients with Myocardial Infarction Treated with Aspirin / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Aspirin is widely used for the prevention of cardiovascular and cerebrovascular diseases for the past few years. However, much attention has been paid to the adverse effects associated with aspirin such as gastrointestinal bleeding. How to weigh the benefits and hazards? The current study aimed to assess the feasibility of a cardiovascular/gastrointestinal risk calculator, AsaRiskCalculator, in predicting gastrointestinal events in Chinese patients with myocardial infarction (MI), determining unique risk factor(s) for gastrointestinal events to be considered in the calculator.</p><p><b>METHODS</b>The MI patients who visited Shapingba District People's Hospital between January 2012 and January 2016 were retrospectively reviewed. Based on gastroscopic data, the patients were divided into two groups: gastrointestinal and nongastrointestinal groups. Demographic and clinical data of the patients were then retrieved for statistical analysis. Univariate and multiple logistic regression analyses were used to identify independent risk factors for gastrointestinal events. The receiver operating characteristic (ROC) curves were used to assess the predictive value of AsaRiskCalculator for gastrointestinal events.</p><p><b>RESULTS</b>A total of 400 MI patients meeting the eligibility criteria were analyzed, including 94 and 306 in the gastrointestinal and nongastrointestinal groups, respectively. The data showed that age, male gender, predicted gastrointestinal events, and Helicobacter pylori (HP) infection were positively correlated with gastrointestinal events. In multiple logistic regression analysis, predicted gastrointestinal events and HP infection were identified as risk factors for actual gastrointestinal events. HP infection was highly predictive in Chinese patients; the ROC curve indicated an area under the curve of 0.822 (95% confidence interval: 0.774-0.870). The best diagnostic cutoff point of predicted gastrointestinal events was 68.0‰, yielding sensitivity and specificity of 60.6% and 93.1%, respectively, for predicting gastrointestinal events in Chinese patients with MI.</p><p><b>CONCLUSIONS</b>AsaRiskCalculator had a predictive value for gastrointestinal events in Chinese patients with MI. HP infection seemed to be an independent risk factor for gastrointestinal events caused by long-term aspirin treatment in Chinese patients with MI, and it should be included in the risk calculator adapted for Chinese patients.</p>

Synchronous imaging control system for two modes of cone beam X-ray luminescence CT and CT / 医疗卫生装备

Objective To design and implement a synchronous imaging control system for two modes of cone beam X-ray luminescence CT (CB-XLCT) and CT to provide a software control platform for small animal in vivo imaging.Methods The software control platform was developed with the existing CB-XLCT/CT system,Microsoft Visual Studio 2010 platform,multi thread programming technology and dynamic link library so as to realize synchronous acquisition of two-mode data.The performances of the system imaging were evaluated by designing phantom experiments combined with sparse-view CT reconstruction algorithm.Results The phantom experiments results showed that synchronous imaging control had the acquisition time decreased by 79％ when compared with non-synchronous imaging,and the requirements were met for imaging quality.Conchusion Synchronous imaging control of CB-XLCT/CT facilitates in vivo researches for small animals.

Synchronous imaging control system for two modes of cone beam X-ray luminescence CT and CT / 医疗卫生装备

Objective To design and implement a synchronous imaging control system for two modes of cone beam X-ray luminescence CT (CB-XLCT) and CT to provide a software control platform for small animal in vivo imaging.Methods The software control platform was developed with the existing CB-XLCT/CT system,Microsoft Visual Studio 2010 platform,multi thread programming technology and dynamic link library so as to realize synchronous acquisition of two-mode data.The performances of the system imaging were evaluated by designing phantom experiments combined with sparse-view CT reconstruction algorithm.Results The phantom experiments results showed that synchronous imaging control had the acquisition time decreased by 79％ when compared with non-synchronous imaging,and the requirements were met for imaging quality.Conchusion Synchronous imaging control of CB-XLCT/CT facilitates in vivo researches for small animals.

Research progress of RNF180 value to the diagnosis of gastric cancer / 中国综合临床

RNF180 is a novel membrane-bound E3 ubiquitin ligase that participates in cell development,proliferation and apoptosis.It is a tumor suppressor gene that inhibits cell proliferation and induces apoptosis and may inhibit gastric cancer cell lymph node metastasis.The study found that RNF180 gene methylation and gastric cancer is closely related to the occurrence and development.Therefore,RNF180 gene methylation is expected as a tumor marker of gastric cancer for early diagnosis and prognosis of gastric cancer.In this paper,RNF180 on the diagnosis of gastric cancer research progress made a review.

Advances in Study on SEPT9 Gene Methylation in Diagnosis of Colorectal Cancer / 胃肠病学

Colorectal cancer (CRC) is one of the most common gastrointestinal malignancies with poor prognosis and high mortality.SEPT9 gene is a tumor suppressor gene and plays an important role in the end of cell division.Studies have shown that methylation of SEPT9 gene could be used in the early diagnosis of CRC.This article reviewed the advances in study on SEPT9 gene methylation in the screening and diagnosis of CRC.