The performance of digital chest radiographs in the detection and diagnosis of pulmonary nodules and the consistency among readers / 中华肿瘤杂志

Objective: To investigate the detection and diagnostic efficacy of chest radiographs for ≤30 mm pulmonary nodules and the factors affecting them, and to compare the level of consistency among readers. Methods: A total of 43 patients with asymptomatic pulmonary nodules who consulted in Cancer Hospital, Chinese Academy of Medical Sciences from 2012 to 2014 and had chest CT and X-ray chest radiographs during the same period were retrospectively selected, and one nodule ≤30 mm was visible on chest CT images in the whole group (total 43 nodules in the whole group). One senior radiologist with more than 20 years of experience in imaging diagnosis reviewed CT images and recording the size, morphology, location, and density of nodules was selected retrospectively. Six radiologists with different levels of experience (2 residents, 2 attending physicians and 2 associate chief physicians independently reviewed the chest images and recorded the time of review, nodule detection, and diagnostic opinion. The CT imaging characteristics of detected and undetected nodules on X images were compared, and the factors affecting the detection of nodules on X-ray images were analyzed. Detection sensitivity and diagnosis accuracy rate of 6 radiologists were calculated, and the level of consistency among them was compared to analyze the influence of radiologists' seniority and reading time on the diagnosis results. Results: The number of nodules detected by all 6 radiologists was 17, with a sensitivity of detection of 39.5%(17/43). The number of nodules detected by ≥5, ≥4, ≥3, ≥2, and ≥1 physicians was 20, 21, 23, 25, and 28 nodules, respectively, with detection sensitivities of 46.5%, 48.8%, 53.5%, 58.1%, and 65.1%, respectively. Reasons for false-negative result of detection on X-ray images included the size, location, density, and morphology of the nodule. The sensitivity of detecting ≤30 mm, ≤20 mm, ≤15 mm, and ≤10 mm nodules was 46.5%-58.1%, 45.9%-54.1%, 36.0%-44.0%, and 36.4% for the 6 radiologists, respectively; the diagnosis accuracy rate was 19.0%-85.0%, 16.7%-6.5%, 18.2%-80.0%, and 0%-75.0%, respectively. The consistency of nodule detection among 6 doctors was good (Kappa value: 0.629-0.907) and the consistency of diagnostic results among them was moderate or poor (Kappa value: 0.350-0.653). The higher the radiologist's seniority, the shorter the time required to read the images. The reading time and the seniority of the radiologists had no significant influence on the detection and diagnosis results (P>0.05). Conclusions: The ability of radiographs to detect lung nodules ≤30 mm is limited, and the ability to determine the nature of the nodules is not sufficient, and the increase in reading time and seniority of the radiologists will not improve the diagnostic accuracy. X-ray film exam alone is not suitable for lung cancer diagnosis.

Angelica sinensis polysaccharide promotes stress erythropoiesis in mice caused by 5-FU / 中国药理学通报

Aim To investigate the effects of angelica sinensis polysaccharide (ASP) antagonizing 5-fluorou-raeil (5-FU) on spleen stress erythropoiesis in mice and its related mechanism. Methods C57BL/6J mice aged 6-8 weeks were randomly divided into control group, ASP group, 5-FU group and ASP + 5-FU group. The mouse body weight during the modeling pe-riod was recorded, and peripheral blood routine and the number of mononuclear cells in the bone marrow of femur were measured. Histopathology of spleen was de-tected, also the index and cellularity of spleen were analyzed. BFU-E of spleen mononuclear cells was counted. The number of F4/80

Clinical value-oriented research paradigm about inheritance and innovation development of TCM dominant diseases / 中草药·英文版

Modern medicine has made remarkable achievements in safeguarding people's life and health, however, it is increasingly found that in the face of complex diseases, selective targeting of single target is often difficult to produce a comprehensive rehabilitation effect, and is prone to induce drug resistance, toxic side effects. Traditional Chinese medicine (TCM) has a long history of clinical application, and its clinical value in the treatment of complex diseases such as cardiovascular and cerebrovascular diseases, digestive diseases, skin diseases, rheumatism and immunity diseases, and adjuvant treatment of tumors has been proven to have obvious advantages. However, its modern research is relatively lagging behind, and in the face of the aging society and the characteristics of the modern disease spectrum, the traditional knowledge-driven research paradigm seems to be stuck in a bottleneck and difficult to make greater breakthroughs. Focusing on the key issues of TCM development in the new era, the clinical value-oriented strategy becomes to be a new research paradigm of TCM inheritance and innovation development, and dominant diseases would be the focus of the TCM inheritance and innovation development, which has been highly valued in recent years by the TCM academia and the relevant national management departments. Based on the clinical value, a series of policies are formulated for the selection and evaluation of the TCM dominant diseases (TCMDD), and exploratory researches about the clinical efficacy characteristics, the modern scientific connotation interpretation were carried out. The clinical value-oriented research paradigm of TCMDD inheritance and innovation development has been initially formed, which is characterized by strong policy support as the guarantee, systematic and standardized selection and evaluation methods as the driving force, scientific and effective research on internal mechanisms as the expansion, and effective clinical guidelines and principles as the transformation, which is of great value in promoting the high-quality development of the industries and undertaking of TCM. In this paper, the main policy support, selection and evaluation methods, therapeutic effect characterization, and modern scientific connotation research strategies of TCMDD in recent years have been comprehensively sorted out, with a view to providing the healthy and benign development of the research on TCMDD.

Pharmacodynamic advantages and characteristics of traditional Chinese medicine in prevention and treatment of ischemic stroke / 中草药·英文版

Ischemic stroke (IS) is a severe cerebrovascular disease with a high incidence, mortality, and disability rate. The first-line treatment for IS is the use of recombinant tissue plasminogen activator (r-tPA). Regrettably, numerous patients encounter delays in treatment due to the narrow therapeutic window and the associated risk of hemorrhage. Traditional Chinese medicine (TCM) has exhibited distinct advantages in preventing and treating IS. TCM enhances cerebral microcirculation, alleviates neurological disorders, regulates energy metabolism, mitigates inflammation, reduces oxidative stress injuries, and inhibits apoptosis, thereby mitigating brain damage and preventing IS recurrence. This article summarizes the etiology, pathogenesis, therapeutic strategies, and relationship with modern biology of IS from the perspective of TCM, describes the advantages of TCM in the treatment of IS, and further reviews the pharmacodynamic characteristics and advantages of TCM in the acute and recovery phases of IS as well as in post-stroke complications. Additionally, it offers valuable insights and references for the clinical application of TCM in IS prevention and treatment, as well as for the development of novel drugs.

Clinicopathological features of congenital hemangioma: a study of 40 cases / 中华病理学杂志

Objective: To investigate the clinical and pathologic features, diagnosis and differential diagnosis of congenital hemangioma (CH). Methods: Forty cases of CH were diagnosed from January 2017 to December 2020 in Henan Provincial People's Hospital. The clinical and pathological and immunohistochemical data were analyzed, with review of literature. Results: There were 24 male and 16 female patients. The lesions were located in the head, neck (11 cases), limbs (14 cases), and trunk (15 cases). The clinical manifestations were congenital painless plaques or masses, the larger ones protruded on the skin surface, mostly dusky purple or bright red, with surrounding white halos. Under low magnification, the tumor was lobular and well demarcated, composed of neo-microvascular lumen of different sizes. The vascular endothelial cells were cuboidal or hobnail in appearance, forming stellar drainage vessels within the lobules. Extra-medullary hematopoiesis was seen in one case of rapidly involuting CH; there were different number of tortuous and dilated vascular lumen between the lobular structures, and some non-involuting CH cases were vascular malformations, which were devoid of lobulated structures. Immunohistochemistry showed that endothelial cells were strongly positive for CD31, CD34 and ERG, while D2-40 and GLUT-1 were negative. Conclusions: CH is a benign congenital vascular tumor with characteristic lobulated growth and abnormal blood vessels in the stroma. Pathological diagnosis often needs to be differentiated from infantile hemangioma, pyogenic granuloma, kaposiform hemangioendothelioma and vascular malformation.

The value of myocardial work in detecting the reduction of left ventricular global systolic function in acute myocardial infarction patients with preserved ejection fraction / 中华心血管病杂志

Objective: To investigate the diagnosis value of myocardial work (MW) in evaluating left ventricular global systolic function among acute myocardial infarction (AMI) patients with preserved ejection fraction (LVEF). Methods: This study was a diagnostic trial in a prospective case-control design. AMI patients with preserved LVEF were enrolled as AMI(LVEF>50%) group and age and sex-matched healthy individuals undergoing healthy checkup in our hospital were collected as control group. Two-dimensional dynamic images, including standard apical two-chamber, long-axis and four-chamber views in 3 consecutive cardiac cycles were acquired. General clinical data, routine echocardiography and myocardial work parameters were obtained from all subjects. The indices were compared between the two groups. Intra-observer and inter-observer repeatability of myocardial work parameters were evaluated by intra-group correlation coefficient (ICC). Receiver operator characteristic (ROC) curve was used to determine the diagnostic value of global constructive work (GCW), global wasted work (GWW), global work efficiency (GWE) and global work index (GWI) on the reduction of left ventricular global systolic function in AMI(LVEF>50%) group. Results: There were 30 patients in AMI(LVEF>50%) group, the age was (67.3±9.7)years, and 14 cases were female(46.7%). Thirty participants were included in the control group, the age was (68.1±8.6)years, and 12 cases were female (40.0%). Compared with the control group, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), interventricular septum thickness (IVSD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), peak early diastolic velocity of mitral orifice/tissue Doppler velocity of posterior mitral annulus (E/e), left ventricular mass (LVM), left ventricular mass index (LVMI) were significantly higher, while E and e values were significantly lower in AMI (LVEF>50%) group (all P<0.05). Compared with the control group, GCW ((1 145.9±440.1)mmHg% (1 mmHg=0.133 kPa) vs. (1 425.7±355.4)mmHg%), GWE ((80.9±9.5)% vs. (87.3±5.5)%), GWI ((1 001.3±416.2)mmHg% vs. (1 247.6±341.7)mmHg%) and the absolute value of long axis integral strain (GLS) ((8.5±3.4)% vs. (11.4±3.7)%) were significantly lower, while peak strain dispersion(PSD)((101.3±66.4)ms vs. (74.7±31.9)ms) was significantly higher in AMI(LVEF>50%) group (P all<0 05). There was no significant difference in GWW((177.2±71.1)mmHg% vs. (155.7±64.6)mmHg%) between the two groups (P>0.05). The reproducibility of GCW, GWW, GWE and GWI within and between observers were satisfactory (all ICC>0.75). ROC curve analysis showed that all four parameters, GCW, GWW, GWE, and GWI, could be used for the diagnosis of reduced left ventricular systolic function in patients with AMI (LVEF>50%), and their areas under the ROC curve were 0.896,0.929,0.808,0.862. Conclusion: Myocardial work assessment is valuable on diagnosing left ventricular global systolic function reduction in AMI patients with preserved LVEF.

Role of Foxo6 in insulin resistance of vascular endothelial cells induced by high glucose and high fat and its interaction with NF-κB pathway / 中国药理学通报

Aim To investigate the expression of Foxos in human umbilical vein endothelial cells(HUVECs)with insulin resistance(IR)induced by high glucose and high fat(HG/HF)stress and its significance.Methods First, the IR model of endothelial cells was established by HG /HF stress.The differential expression of Foxos gene in normal(Ctrl )group and HG /HF group was observed, and the subtypes with the most significant changes in Foxos were screened out, such as Foxo6.Next, Foxo6 was silenced to observe its role in endothelial cell with IR.Finally, whether the mechanism of Foxo6-mediated IR was related to the interaction of NF-κB signaling was investigated.Results The expression increase of Foxo6 was the most significant among Foxos under the IR condition induced by HG/HF.Using a small RNA interference and plasmid transfection technique, we found that the silence effect of the siRNA3 fragments targeting Foxo6 was the most significant among the siRNAs.Moreover, the further study showed that silencing the Foxo6 gene could significantly reverse the endothelial IR induced by HG/HF, and the mechanism of the reversal effect was related to the interaction between the Foxo6 and NF-κB signal.Conclusions Foxo6 mediates the endothelial cell IR induced by the HG /HF stress.The underlying mechanism is that Foxo6 can interact with NF-κBp65 and activate NF-κB signaling pathway.Silencing Foxo6 can improve the IR of vascular endothelial cells induced by HG /HF stress.

Study of mechanism of bone marrow perivascular niche injured by 5-fluorouracil / 中国药理学通报

Aim To investigate the injury of 5-fluorouracil(5-FU)to perivascular hematopoietic niche via isolating mouse bone marrow perivascular mesenchymal progenitor cells in vitro and its related mechanism. Methods The perivascular mesenchymal progenitor cells were isolated from femurs and tibias of C57BL/6J mice with type Ⅱ collagenase and cultured in vitro. Agarose gel electrophoresis was used to detect specific niche genes expression. The viable cells were counted by Trypan blue; the cellular proliferation was detected by CCK-8; the apoptosis was detected by Annexin V/PI double staining, and the cell senescence was detected by β-galactosidase staining. The levels of malondialdehyde(MDA)and superoxide dismutase(SOD)were detected by enzymatic assay. Osteogenic and adipogenic differentiation potential of cells were detected by osteogenic and adipogenic differentiation experiment and osteogenic related genes qRT-PCR assay. The mRNA expression of hematopoietic growth factors was detected by qRT-PCR. Hematopoietic cells were co-cultured with perivascular mesenchymal progenitor cells, and the adhesion molecules and signal molecules between stromal cells and hematopoietic cells were detected, also hematopoietic cell activity, redox indicators and β-galactosidase specific cell senescence were detected. Results 5-FU caused simultaneous apoptosis and senescence of perivascular mesenchymal progenitor cells, inhibited cell proliferation, induced oxidative stress, led to osteogenic/adipogenic differentiation imbalance, and down-regulated the transcription of hematopoietic factors SCF, CXCL12, and G-CSF. For the interaction between stromal cells and hematopoietic cells, the binding effects of VLA-4/VCAM-1, ICAM-1/LFA1 were weakened and TPO/MPL and ANG-1/Tie-2 signals were impaired, leading to oxidative stress of hematopoietic cells and cell senescence. Conclusions 5-FU induces oxidative damage of perivascular mesenchymal progenitor cells and indirectly induces premature senescence of hematopoietic cells.

Network Meta-analysis of Chinese patent medicine in treatment of unstable angina pectoris / 中国中药杂志

Network Meta-analysis was used to compare the efficacy and safety of Chinese patent medicines in the treatment of unstable angina pectoris. PubMed, Cochrane Library, CNKI, Wanfang, VIP and other databases were retrieved by computers from the establishment of the databases to June 2020. Randomized controlled trials(RCTs) of Chinese patent medicines for the treatment of unstable angina pectoris were collected. Two investigators independently screened out the literatures, and extracted data according to the inclusion and exclusion criteria. The quality of the included RCTs was evaluated according to the bias risk assessment tool recommended by the Cochrane System Reviewer Manual, and the Stata 13.0 software was used for data analysis and mapping. Through screening, 28 eligible studies were finally included, with the sample size of 2 885 cases, involving 8 Chinese patent medicines. The results of the network Meta-analysis showed that in terms of total effective rate for angina symptom improvement, the order was as follows: Shenshao Capsules > Naoxintong Capsules > Ginkgo Ketone Ester Dripping Pills > Compound Danshen Dripping Pills > Ginkgo Leaf Tablets > Shexiang Baoxin Pills > Tongxinluo Capsules > Yindan Xinnaotong Soft Capsules; in terms of total effective rate for ECG curative effect, the order was as follows: Ginkgo Ketone Ester Dripping Pills>Compound Danshen Dripping Pills > Tongxinluo Capsules > Shenshao Capsules > Shexiang Baoxin Pills > Yindan Xinnaotong Soft Capsules; in terms of hypersensitivity-C-reactive protein curative effect, the order was as follows: Tongxinluo Capsules > Shenshao Capsules > Ginkgo Leaf Tablets>Compound Danshen Dropping Pills> Shexiang Baoxin Pills > Naoxintong Capsules > Yindan Xinnaotong Soft Capsules > Ginkgo Ketone Ester Dropping Pills. Chinese patent medicine combined with conventional therapy can improve the clinical efficacy of unstable angina pectoris. Due to the differences in the quantity and quality of the included studies, the order results of Chinese patent medicines need to be further verified.

Time series observation on microstructure development of mandibular bone under different occlusal force in rats / 实用口腔医学杂志

Objective: To study the microstructure development of mandibular bone in rats on timing sequence and under different occlusal force. Methods: 63 male SD rats aged 23 days were randomly divided into three groups (n = 7): Baseline group, soft-diet (SD) group and hard-diet (HD) group. 7 rats were killed at week 0, 2, 4, 6 and 8 respectively after feeding the food with different hardness.Micro-CT was used to reconstruct and analysis microstructure of the region of interest in mandible of the rats. Results: Compared with HD group, bone volume/total volume (BV/TV) and trabecular thickness (Tb. Th) decreased significantly after 4 th week (P ＜ 0. 05), the bone surface/bone volume (BS/BV) and trabecular separation (Tb. Sp) increased significantly during the 4 th to the 6 th week (P ＜0. 05) . Conclusion: In the process of mandibular development in rats, reduction of occlusal force may lead to reduction of bone mass, and the changes of microstructure are closely related to the time of intervention.

Clinicopathological features of congential intestinal solitary fibromatosis: 2 cases report and literature review / 临床与实验病理学杂志

Purpose To study the clinicopathological features of congenital solitary intestinal fibromatosis (SIF).Methods Clinical,radiological and pathological features of 2 cases of SIF were analyzed along with a literature review.Results Two cases of SIF with one girl and one boy.Both presented with vomiting and abdominal distention at the birth day.A plain abdominal radiograph revealed small bowl obstruction and pneumoperitoneum.Jejunum atresia and perforation were detected at surgery.Microscopically,spindle tumor cells diffusely infiltrated in the whole intestinal wall,tumor cells were monomorphic with bland looking and rare mitosis was reviewed.Immunohistochemically,vimentin was positive while muscular markers as SMA,desmin and Myogenin were all negative.And S-100,CD117,CD34,ALK and β-catenin were not expressed.ETV6 split gene was not detected in one of the patients by FISH.Two patients of SIF had no tumor recurrence with follow-up till now.Conclusion Congenital SIF is a rare and unique intestinal tumor in neonate,and it should be differentiated from congenital fibrosarcoma and myofibroma.SIF appears a very good prognosis after segmental resection.

Finite element stress analysis of weakened root of maxillary central incisors restored with titanium post-core and fiber post-core systems / 西安交通大学学报(医学版)

Objective To analyze the stress distribution of the weakened root dentine restored with titanium post-core crown and fiber post-core crown by finite element method.Methods The sample was scanned by Inveon Micro-CT technology from incised margin to root apex at 21 μm interval to obtain transverse data of DICOM format.The three-dimensional finite element model was created by rebuilding the morphology of maxillary central incisor with Inveon Research Workplace as well as Mimics,Geomagic and Catia software.The model was meshed and loaded to analyze the stress distribution on the weakened dentine of root by finite element method.Results The maximum stress,shearing stress and equivalent stress of the root restored with fiber post-core crown were 60%less than the stresses of the root restored with titanium post-core crown in the experiment.The stress on various parts of the root restored with titanium post-core crown was higher than that of the root restored with fiber post-core crown.Furthermore,the stress concentration occurred mainly on the labial interface of the upper 1/3 of root. Especially when the root was restored with titanium post-core crown,the stress value reached 37 .73 MPa,which was 1.9 times that of fiber post-core crown.Conclusion The finite element analysis indicates that the fiber post-core crown is better than titanium post-core crown in avoiding stress concentration and root fracture in the restoration of weakened root of maxillary central incisors.

In vitro study of dentin hypersensitivity treated with Nd:YAG laser / 西安交通大学学报(医学版)

ABSTRACT:Objective To observe the structural changes of dentin irradiated with Nd:YAG laser under dif-ferent parameters and the changes of calcium-phosphorus ration,and evaluate the optimal parameters of Nd:YAG laser in treating dentin hypersensitivity (DH).Methods The model of dentin hypersensitivity was established by acid etching method.Samples were irradiated with Nd:YAG laser under different parameters.The morphological alterations of the dentin surfaces and Ca-P ratio were examined with scanning electron microscopy (SEM)combined with energy dispersive X-ray microanalysis.Results Compared with those in the control group,dentinal tubules could be blocked partially or totally with no cracks in A-C (30 mj,5 Hz),(30 mj,10 Hz)and (50 mj,5 Hz)groups. Dentinal tubules could be entirely blocked but with cracks in D (50 mj,10 Hz)and E (80 mj,5 Hz)groups.Dentin was carbonized in F (80 mj,10 Hz)group.Compared with that in the control group,Ca-P ratio was decreased sig-nificantly (P <0.05).Conclusion The suitable energy parameter of Nd:YAG laser in treating dentin hypersensi-tivity is (30 mj,10 Hz)and (50 mj,5 Hz).

Expression of p-PPARγ in the aging thoracic aorta of spontaneously hypertensive rat and inhibitory effect of rosiglitazone

Objective: To investigate the expression of phosphorylated peroxisome proliferators-activated receptor γ (p-PPARγ) in the aging thoracic aorta of spontaneously hypertensive rat (SHR) and the inhibitory effect of rosiglitazone on the phosphorylation of PPARγ. Methods: 16, 32 and 64 week-old Wistar-Kyoto rats (WKY) and SHR were randomly and respectively divided into WKY, SHR and SHR+rosiglitazone group (9 in each group). The rats in SHR+rosiglitazone group were treated with rosiglitazone (5 mg/kg, intragastrically) for 56 d, whereas normal saline was applied in WKY and SHR groups. Systolic blood pressure (SBP) of rats was measured by tail cuff method. Histopathological damage of thoracic aorta was analyzed using Hematoxylin-Eosin (HE) staining. Immunohistochemical staining and western blot were performed to test the level of p-PPARγ protein in the thoracic aorta arising from each group. Results: The SBP in 16, 32 and 64 week-old SHR were significantly higher as compared with those in matched WKY rats (P < 0.05, respectively). HE staining showed increased content of smooth muscle cell, wrinkled lining endothelium and increased thickness of internal elastic lamina in the thoracic aorta of SHR. Immunohistochemical staining and western blot indicated that the levels of p-PPARγ in the thoracic aorta arising from SHR were obviously higher than those in the thoracic aorta arising from WKY rats (P < 0.05, respectively). Importantly, the high SBP, histopathological abnormalities of the thoracic aorta and elevated p-PPARγ expression were prominently abrogated by rosiglitazone treatment in SHR (P < 0.05, respectively). Furthermore, the SBP, histopathological abnormalities of the thoracic aorta and p-PPARγ expression were positively correlated with age in SHR (P < 0.05, respectively). Conclusions: The PPARγ phosphorylation was observed in the thoracic aorta of SHR and its expression was increased by the increase of age. Furthermore, rosiglitazone inhibited the PPARγ phosphorylation and suppressed vascular aging in SHR.

Combined detection of antinuclear antibody and antinuclear antibody spectrum and its clinical significance in systemic lupus erythematosus / 国际检验医学杂志

Objective To explore the diagnostic value and clinical significance of the combined detection of antinuclear antibody (ANA) and anti-nuclear antibody spectrum (ANAs) in systemic lupus erythematosus (SLE) .Methods 110 patients with SLE ,88 patients with other autoimmune diseases (AID) and 50 individuals with healthy physical examination were selected and detected se-rum ANA by using indirect immunofluorescence (IIF);the Western blot was adopted to detect the 15 items of ANAs .Results A-mong 110 cases of SLE ,the positive rates of serum ANA ,anti-ribonucleoprotein /Smith antibody (nRNP/Sm) ,anti-Smith antibody (Sm) ,anti-Sjogren′s syndrome A antibody (SSA) ,anti-Ro-52 antibody (Ro-52) ,anti-Sjogren′s syndrome B antibody (SSB) ,anti-scleroderma 70 antibody (Scl-70) ,anti-PM-Scl antibody (PM-Scl) ,anti-cytoplasmic group acyl-tRNA antibody (J0-1) ,anti-centro-mere antibodies (CENP B) ,anti-proliferative protein antibody (PCNA ) ,anti-double stranded DNA antibody (ds-DNA ) ,anti-nu-cleosome antibody (AnuA) ,anti-histone antibody (AHA) ,anti-ribosomal P protein antibody (ARPA) and anti-mitochondrial anti-body M2 subtype (AMA M2) were 98 .2% ,59 .1 % ,39 .1 % ,71 .8 % ,68 .2 % ,21 .8 % ,2 .7 % ,3 .6 % ,0 .9% ,9 .1% ,5 .5% , 44 .5% ,38 .2 % ,27 .3 % ,38 .2% and 15 .5% respectively ,the positive rate of above 16 kinds of autoantibody in the orther AID were64.8% ,14.8% ,0% ,37.5% ,42.0% ,11.4% ,9.1% ,0% ,5.7% ,9.1% ,1.1% ,2.3% ,1.1% ,1.1% ,5.7% and2.3% respec-tively ;ANA had the highest diagnostic sensitivity (98 .2% ) and low specificity (35 .2% ) for SLE ,the antibodies with higher speci-ficity in diagnosing SLE were anti-Sm antibody (100 .0% ) ,anti-ds-DNA antibody (97 .7% ) ,anti-AnuA antibody (99 .0% ) ,anti-AHA antibody (99 .0% ) ,anti-ARPA antibody (94 .3% ) and anti-PCNA antibody (98 .9% ) and the disease control group (50 .9% ) .In detecting ANA karyotype by IIF ,the maximum was nuclear particle type (43 .5% ) and the disease control group (50 .9% ) ,no statistically significant difference was found between them (P>0 .05) ,part of the ANA-negative patients have positive ANAs .Conclusion Multiple autoantibodies can be detected in the serum of the SLE patients .The combined detection of ANA and ANAs has important clinical significance for diagnosing and differentially diagnosing SLE .

Nasal surgery and upper airway radiofrequency ablation in patients with obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the efficacy and related factors of nasal surgery combined with upper air way radiofrequency ablation(RFA) for treatment of obstructive sleep apnea hypopnea syndrome (OSAHS) with chronic nasal blockage.@*METHOD@#One hundred and three mild or moderate OSAHS patients with chronic nasal blockage were recruited, all cases had nasal surgery and upper airway RFA. All patients were evaluated by body mass index (BMI), Epworth sleep scale (ESS), snoring scale, and nocturnal polysomnography (PSG). Eighty-nine patients were reevaluated at least 6 months after surgery with the preoperative methods.@*RESULT@#After operation, the apnea and hypopnea index (AHI) decreased from (18.67 +/- 9.48)/h to (9.22 +/- 7.18)/h; the lowest artery oxygen saturation (LSaO2) increased from (0.83 +/- 0.08) to (0.92 +/- 0.06); the Epworth sleep scale(ESS) decreased from (8.74 +/- 5.67) to (5.12 +/- 3.74); the snoring scale decreased from (7.16 +/- 2.85) to (3.56 +/- 2.26), the percentage of time with oxyhemoglobin saturation below 0.90 (CT90) decreased from (18.64 +/- 12.98) to (10.73 +/- 8.29). All of the differences were obvious (P<0.01). Success was defined as a postoperative apnea-hypopnea in dex < 10 events per hour and at least 50% less than the preoperative value. The surgical success rate was 75.3% (67/89). No major perioperative complications occurred.@*CONCLUSION@#Our findings suggest that nasal surgery combined with upper airway RFA can improve snoring and disease-specific quality of life in patients with anatomic na sal obstruction with mild or moderate OSAHS.

Preliminary implementation and effect of clinical pathways for chronic Keshan disease in endemic areas / 中国地方病学杂志

Objective This present study explores and evaluates the effect of preliminary implementation in the clinical therapy programs for patients with chronic Keshan disease (CKD) in the disease seriously-affected endemic areas.Methods In 2010,seventy-six CKD patients with heart failure were chosen from Huangling and Xunyi Counties in Shaanxi Province,where incidences of CKD were high.Besides taking sodium selenite,all patients were given treatment with fixed prescription,which included angiotensin-converting enzyme inhibitor (captopril),β-blocker (propranolol),diuretics (hydrochlorothiazide,spironolactone) and cardiac (digoxin) for 4 months.The changes before and after treatment were analyzed,which included the changes of heart function by the United States of America New York Heart Association(NYHA) fractionation,cardiothoracic ratio,electrocardiogram,left ventricular ejection fraction(EF) and fractional shortening(FS).The therapeutic effect was subsequently evaluated.Results Seventy-four cases of the seventy-six CKD patients completed the treatment observation.The improvement rate of heart function was 81.1％ (60/74) after treatment.The elimination rates of ectopic rhythm,conduction block and ST-T changes were 37.5％ (9/24),2.7％ (1/36) and 26.9％ (7/26),respectively.The cardiothoracic ratios of heart function NYHA Ⅱ,Ⅲ and Ⅳ were 0.504 ± 0.051,0.572 ± 0.054 and 0.632 ± 0.063 before treatment.After treatment,the cardiothoracic ratios were 0.486 ± 0.048,0.538 ± 0.046 and 0.607 ± 0.048,which were reduced in all groups (t =2.643,6.641,3.005,all P ＜ 0.05),while the D-value of cardiothoracic ratio changes before and after treatment was not significantly different(F =3.005,P ＞ 0.05).Both the mild reduction group(35％≤EF ＜ 50％) and the moderate-severe group(EF ＜ 35％) EF were (43.62 ± 4.58)％,(27.57 ± 3.69)％ before treatment and were (48.21 ± 10.01)％,(36.57 ± 6.60)％ after treatment,EF were increased in the two groups,while the changes before and after treatment were significantly different(t =-2.911,-3.334,all P＜ 0.05).The EF D-value of the two groups was (4.59 ± 8.48)％ before treatment and was (9.00 ± 7.14)％ after treatment,which were not significantly different(P ＞ 0.05).FS was higher compared with pre-treatment in FS reduction group(FS ＜ 25％) and the changes before and after treatment[(19.75 ± 2.88)％,(21.92 ± 5.67)％] were significantly different(t =-2.297,P ＜ 0.05).Conclusions This study shows that the feasibility of clinical treatment of patients with CKD is very promising.The treatment of fixed prescription is effective.

Intracerebroventricular administrations of angiotensin IV (Ang IV) ameliorate cognitive disorder in diabetic rats

Cognitive impairment is a common complication of diabetes. Hippocampus plays an important role in cognitive function. In hyperglycemia, synaptophysin, a crucial synaptic vesicle membrane protein in hippocampus neuron is found to be down-regulated. Recent evidences have shown that angiotensin IV can facilitate memory acquisition and recovery. However, whether it can also improve cognitive functions of diabetic rats with cognitive disorder, and the possible mechanisms are uncertain. Hence, the objectives of this study. Forty fi ve Sprague Dawley male rats were randomly divided into three groups: Control, diabetic group and diabetes with angiotensin IV treatment group. The cognitive functions, mainly learning and memory of the rats were evaluated using Morris water maze task. The synapses ultrastructure, relative mRNA concentrations and protein expression levels of synaptophysin in hippocampus CA1 area were estimated using transmission electron microscope, RT-PCR, immunohistochemistry and western blotting, respectively. Our study showed that in the diabetic rats with angiotensin IV treatment, the cognitive impairment as measured by Morris water maze task improved, the ultrastructure of synapses in hippocampus reversed, the relative mRNA concentrations and protein levels of synaptophysin in hippocampus signifi cantly increased, when compared with diabetic rats. We conclude that angiotensin IV plays an important role in improving cognitive function of diabetic rats. The possible mechanisms are up-regulating the expression of synaptophysin and normalizing the ultrastructure of synapses in hippocampus.

Association of depression with glycosylated hemoglobin, lipid metabolism and coping style in patients with type 2 diabetes mellitus / 第二军医大学学报

Objective To investigate the association of depression with glycosylated hemoglobin, lipid metabolism and coping style in patients with type 2 diabetes mellitus (DM). Methods A total of 73 patients with type 2 DM were divided into depression group (n=31) and non-depression group (n = 42) according to the results of Zung Self-Rating Depression Scale. The anxiety statuses were evaluated by Zung Self-Rating Anxiety Scale (SAS). The coping style was assessed by Medical Coping Modes Questionnaire (MCMQ). Moreover, the blood HbAlc, triglycerides (TG), total cholesterol (TO, high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were also compared between the two groups. Results The SAS standard score and MCMQ score of resignation in the depression group were significantly higher than those in the non-depression group (P<0. 01). The MCMQ score of confronce and avoidance, blood HbAlc, TG, TC, HDL-C, and LDL-C were not significantly different between the 2 groups. Conclusion It is suggested that type 2 DM patients with resignation coping style are more liable to have depression.

Effects of alpha-linolenic acid on inflammation and oxidative stress in the diabetic rats / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the effects of alpha-linolenic acid (ALA) on inflammation and oxidative stress in the diabetic rats.</p><p><b>METHODS</b>An experimental type 2 diabetes mellitus model was induced by feeding male SD rats with diet of high fat for 4 weeks and then injected them intraperitoneally with streptozocin (STZ) at 30 mg/kg. Then the animals were randomly divided into three groups (n = 10): control group, diabetic group and ALA group. Four weeks later, tumor necrosis factor (TNF)-a, soluble P-selectin (sP-selectin), soluble intercellular adhesion molecule-1 (sICAM-1), nitric oxide (NO) production, malondialdehyde (MDA), superoxide dismutase (SOD) and catalase (CAT) in the serum were determined.</p><p><b>RESULTS</b>Inflammatory agents including TNF-alpha, sP-selectin and sICAM-1 increased in diabetic rats to compare with control group. Treatment with ALA significantly decreased TNF-alpha, sP-selectin and slCAM-1 to compare with diabetic group. Furthermore, compared with control group, serum MDA production increased whereas NO production, SOD and CAT activities decreased in diabetic rats. Treatment with ALA reduced MDA production, increased NO production, promoted SOD and CAT activities compared with diabetic group.</p><p><b>CONCLUSION</b>These results indicate that diet rich in ALA exerted the anti-inflammatory and anti-oxidative effects in diabetic rats, which may be beneficial to the prevention and treatment of diabetes.</p>