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ObjectiveTo evaluate the efficacy and safety of 7 atypical antipsychotics combined with selective serotonin reuptake inhibitors（SSRIs） in the treatment of refractory obsessive-compulsive disorder by network Meta-analysis. MethodsRandomized controlled trials （RCTs） about atypical antipsychotics and SSRIs in the treatment of refractory obsessive-compulsive disorder were searched in CNKI， Wanfang Data， VIP， CBM， PubMed， Embase and Cochrane Library databases from inception to June 2020. Based on inclusion and exclusion criteria， the literature screening， date extraction and assessing risk of bias were performed by two researchers independently. Then all statistical analyses were performed using Stata 15.0 software. ResultsA total of 36 RCTs covering 7 atypical antipsychotics and 2 362 patients were included. Network Meta-analysis showed that the surface under the cumulative ranking （SUCAR） of total response rate was the largest in Olanzapine + SSRIs， followed by Paliperidone + SSRIs， Amisulpride + SSRIs， Risperidone + SSRIs， Quetiapine + SSRIs， Ziprasidone + SSRIs， Aripiprazole + SSRIs， SSRIs， and Placebo + SSRIs in turn. In terms of Hamilton Anxiety Scale （HAMA） score， the SUCAR was the largest in Amisulpride + SSRIs， followed by Aripiprazole + SSRIs， Quetiapine + SSRIs， Risperidone + SSRIs， and SSRIs in turn. In terms of Treatment Emergent Symptom Scale （TESS） score， the SUCAR was the largest in Amisulpride + SSRIs， followed by SSRIs， Paliperidone + SSRIs， Quetiapine + SSRIs， Ziprasidone + SSRIs， Risperidone + SSRIs， Aripiprazole + SSRIs， and Placebo + SSRIs in turn. ConclusionCompared with single application of SSRIs， its combination with atypical antipsychotics achieves better efficacy and higher safety in treating refractory obsessive-compulsive disorder， with Olanzapine+SSRIs being the most effective and Amisulpride+SSRIs the safest.
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OBJECTIVE: To investigate the effects of combined exposure to di(2-ethylhexyl) phthalate(DEHP) and bisphenol A(BPA) on glucose metabolism in female rats during gestational and lactation periods, and its possible mechanism. METHODS: Twenty-four specific pathogen free pregnant SD rats were randomly divided into control group, DEHP group, BPA group, and combined exposure group, with 6 rats in each group. From the 5 th day of gestation to the 21 st day after birth of the offspring, the rats in the DEHP group were treated with DEHP 600 mg/kg body weight(bw); rats in BPA group were treated with 80 mg/kg bw BPA, and rats in combined exposure group were treated with 600 mg/kg bw DEHP and 80 mg/kg bw BPA by intragastric perfusion, while the rats in the control group were given the same amount of corn oil, once per day. After exposure, maternal rats were sacrificed immediately. The levels of glucose metabolism related indicators in liver tissues and serum were examined, and the mRNA and protein expression of phosphatidylinositol 3-kinase(PI3 K)/protein kinase B(AKT) signaling pathway related factors in liver tissues were detected by real-time fluorescence quantitative polymerase chain reaction and Western blot. RESULTS: Except for the activity of phosphoenolpyruvate carboxykinase(PEPCK) in BPA group, the levels of liver glycogen and serum high density lipoprotein cholesterol(HDL-C) in rats of the 3 exposure groups decreased(P<0.05), while the activity of serum PEPCK and the level of low density lipoprotein cholesterol(LDL-C) increased(P<0.05) compared with rats in the control group. The levels of liver glycogen and serum HDL-C in the combined exposure group were lower than that in the BPA group(P<0.05), while the level of serum LDL-C were lower than that in DEHP group and BPA group(P<0.05). The levels of serum glycosylated serum protein, total cholesterol and triglyceride in the 4 groups were not statistically different when compared with each other(P>0.05). Except for the PI3 K protein in DEHP group, the mRNA and protein expression of PI3 K, AKT, and glucose transporter 4 in liver tissues of rats in the 3 exposure groups decreased(P<0.05), and the mRNA expression of forkhead box protein 1(Foxo1) decreased(P<0.05), but the protein expression of FOXO1 increased(P<0.05) compared with the control group. CONCLUSION: Exposure to DEHP or BPA during pregnancy and lactation can cause glucose metabolism disorders in rats. The combined exposure of DEHP and BPA has certain synergistic effect. This process may be achieved through the PI3 K/AKT signaling pathway.
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OBJECTIVE: To investigate the effect of bisphenol A exposure on the expression of DNA methyltransferase(Dnmt) gene in mouse Leydig cell line TM3 cells. METHODS: TM3 cells were randomly divided into 0, 20, 50, 125 and 300 μmol/L dose group(0 μmol/L dose group was the control group). Cells were treated with various concentration of bisphenol A solution for 24 hours.The viability of TM3 cells was determined by CCK-8 method, and the mRNA expression of Dnmt1, Dnmt3 a and Dnmt3 b was detected by real-time fluorescence quantitative polymerase chain reaction. RESULTS:The viability of TM3 cells decreased with the increasing doses of bisphenol A(P<0.01). The relative mRNA expression of Dnmt1 in TM3 cells decreased with the increase of doses of bisphenol A(P<0.01).The relative mRNA expression of Dnmt3 b in TM3 cells in the 20, 50, 125, 300 μmol/L dose group was lower than that in the control group(P<0.05).There was no statistical significant difference in the relative mRNA expression of Dnmt3 a in TM3 cells in these 5 groups(P>0.05). CONCLUSION: Bisphenol exposure is cytotoxic to TM3 cells. This toxic effect may be related to changes in Dnmt mRNA expression.
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Objective To investigate the clinical and CT features of basal cell adenomas (BCA)of parotid gland,and to improve the understanding of the disease.Methods Clinical and CT data of 1 8 patients with BCA of parotid gland confirmed by surgery and pathology were collected.The characteristics of age,sex,clinical symptom,lesion site,number,size,shape,density and CT dualGphase enhancement of the lesions were retrospectively analyzed.Results (1)Age and sex of onset:1 2 cases(6 6.6 7%)of age stage from 30 to 5 9,5 cases (27.78%)of the elder over 60,1 case of the younger below 29,5 cases (27.78%)for males,1 3cases (72.22%)for females,the incidence ratio of male to female being 1 ︰ 2.5.(2)Clinical manifestations:there were sporadic masses in the parotid region,3 cases were accompanied by mild pain and all patients had no facial nerve symptoms.(3)Location site,number,size:23 lesions in 18 cases, of which 15 cases (83.3%)were single and 3 cases (16.7%)had multiple lesions on one side.17 lesions (73.9%)were located in superficial lobe, and 6 lesions (26.1%)were located in the deep lobe;(4)Shape and cross section diameter:the shape of the tumor was round or ellipse with wellG defined margin,13 cases (56.5%)of the round shape,10 cases (43.5%)of the ellipse;the maximum cross section diameter was (2.49±1.3 8)cm,the superficial lobe group was (2.05 ±1.02)cm,and the deep lobe group was (3.73 ±1.59)cm.The difference between the two groups on the maximum cross section diameter was significant (P＜ 0.05).(5)Density:the density of most lesions was heterogeneous.17 lesions were accompanied by central or peripheral cystic degeneration of varying degrees,of which 10 lesions with cystic regions ＞ 50% and 2 lesions with maximum transverse diameter ＜ 0.8 cm.(6)CT dualGphase enhancement:19 lesions showed obvious homogeneous or heterogeneous enhancement on the arterial phase,and persistent enhancement on the venous phase.4 lesions showed progressive heterogeneous enhancement,and the enhancement degree of venous phase was even higher than that of arterial phase.Conclusion The BCA of the parotid gland aremainly occuring in middleGaged and older women,displaying regular shape of lesions,developing to cystic degeneration easily and presenting＂fastGelevation and sustained enhancement＂or progressive enhancement patterns in the dualGphase enhanced scans.These characteristics are helpful to make a diagnosis preoperatively.
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OBJECTIVE: To investigate the mechanism of calcium ion(Ca~(2+))/calcineurin(CaN) signaling pathway in bisphenol A(BPA)-induced interleukin-6(IL-6) secretion in macrophages. METHODS: Raw 264.7 cells in logarithmic growth phase were divided into control group, activator group, BPA low-, medium-and high-dose groups and inhibitor group. The cells in control group were treated with 0.10% dimethyl sulfoxide. The activator group was treated with lipopolysaccharide at mass concentration of 2 mg/L. The 3 BPA groups were treated with BPA at final concentrations of 1, 10, or 100 μmol/L. Two sets of verapamil or tacrolimus(FK506) groups were given verapamil at the final concentration of 10 or 30 μmol/L; or final concentration of FK506 at 250 or 500 nmol/L. Then the cells were treated with final concentration of 100 μmol/L BPA. The cells were collected at 4, 12, and 24 hours. The mRNA expression of IL-6 and CaN at 4 and 12 hours were detected by real-time fluorescence quantitative polymerase chain reaction. The relative expression of IL-6 and CaN protein was detected at 24 hours by enzyme-linked immunosorbent assay, and the intracellular Ca~(2+) level was detected at 4 hours using a single-tube multi-function detector. RESULTS: At 12 hours, the mRNA expression of IL-6 in the 100 μmol/L BPA group was higher than that in control group, activator group and the 1 and 10 μmol/L BPA groups(P<0.05), and higher than that in the 10 and 30 μmol/L verapamil groups, and in the 250 and 500 nmol/L FK506 groups(P<0.05). The mRNA expression of CaN in the 100 μmol/L BPA group was higher than that in control group, activator group and 1 and 10 μmol/L BPA groups(P<0.05), and higher than in 10 and 30 μmol/L verapamil groups(P<0.05). The relative expression of IL-6 protein in the 100 μmol/L BPA group was higher than that in control group, activator group and 1 and 10 μmol/L BPA groups(P<0.05). The relative expression of CaN protein in 100 μmol/L BPA group and 10 and 30 μmol/L verapamil groups were higher than that in control group and activator group(P<0.05). The relative expression of CaN protein in the 10 and 30 μmol/L verapamil groups were lower than that in the 100 μmol/L BPA group(P<0.05). The intracellular Ca~(2+) level in the 100 μmol/L BPA group was higher than that in control group and activator group(P<0.05). The intracellular Ca~(2+) level in the 10 μmol/L verapamil group was lower than that in the 100 μmol/L BPA group(P<0.05). CONCLUSION: BPA might promote the secretion of IL-6 through Ca~(2+)/CaN signaling pathway in macrophages.
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OBJECTIVE: To observe the hepatic injury induced by combined exposure to diethylhexyl phthalate( DEHP) and bisphenol A( BPA) in rats and explore the mechanism of oxidative stress. METHODS: Thirty-two specific pathogen free healthy male SD rats were randomly divided into control group,DEHP(750 mg/kg body weight) group,BPA(100 mg/kg body weight) group and combined exposure group,with 8 rats in each group. The rats were gavaged once per day,7 days per week,for 6 weeks. The changes of liver organ coefficient and histopathology were observed. The activities of superoxide dismutase( SOD), glutathione peroxidase( GSH-Px) and the levels of hydrogen peroxide( H2 O2),malondialdehyde( MDA) were detected by spectrophotometry. The relative mRNA expression of antioxidant gene nuclear factor erythroid-2 related factor 2( Nrf2),heme oxygenase-1( HO-1),glutamate cysteine ligase catalytic subunit( Gclc),thioredoxin reductase( Txnrd),superoxide dismutase 3( Sod3) and glutathione peroxidase 1( Gpx1) in liver tissue were examined by real-time fluorescent quantitative polymerase chain reaction. RESULTS: The body weight of DEHP exposure group was lower than that of control group from the beginning of the 2 nd week( P < 0. 05),and the body weight of combined exposure group was lower than control group from the beginning of the 3 rd week( P < 0. 05). The liver mass and organ coefficients in DEHP group and combined exposure group were significantly higher than that of control group( P <0. 05). The results of pathology examination showed that there was necrosis of liver cells in DEHP group,vacuolar degeneration in cytoplasm of BPA group,and severe inflammatory cell infiltration in combined exposure group. The activity of SOD and GSH-Px of each exposure group was reduced( P < 0. 05),the H2 O2 level of each exposure group was increased(P < 0. 05),meanwhile the MDA level in the liver tissue of the BPA group and the combined exposure group increased compared with the control group( P < 0. 05). The relative mRNA expression of Nrf2,HO-1 and Gpx1 in each exposure group were decreased( P < 0. 05),the relative mRNA expression of Gclc,Txnrd and Sod3 in DEHP group and mixed exposure group were decreased compared with the control group( P < 0. 05). The relative mRNA expression of Nrf2,HO-1,Gclc,Txnrd and Sod3 in combined exposure group were decreased compared with the BPA group( P < 0. 05).CONCLUSION: Under the conditions of this study,DEHP and BPA alone or in combination could cause hepatic injury. The combined effect was greater than single effect. The effect of DEHP was greater than that of BPA. The liver injury induced by DEHP and BPA was related to Nrf2 signaling pathway.
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Objective To investigate CT and MRI features of giant cell tumor of the skull.Methods CT and MRI features of 5 patients with giant cell tumor of the skull with histopathologically confirmed were analyzed retrospectively.Plain CT scanning was performed in all 5 patients.Plain MRI,contrast-enhanced MRI and HRCT scanning with facial nerve and auditory ossicle chain computer reconstruction were performed in 3 patients with giant cell tumor of temporal bone.Results Tumor occured unilateral in all cases,4 cases on the right side,1 case on the left side.CT scan showed a wide range of expanding destruction without sclerotic border,residual bone septum and bone cladding, On MRI, tumor signal variable;tumor appeared hypo-isointense on T1WI and heterogeneous hyperintense with hypointense rim on T2WI.CE-MRI: solid part of tumor show heterogeneous enhancement.Conclusion CT features of giant cell tumors of the skull was wide range of expanding destruction, residual bone septum and bone cladding.On T2WI, low signal in the rim of tumor was the disease characteristic imaging finding;Auditory ossicle chain and facial nerve CPR reconstruction made prepare for preoperative evaluation of otosteon and facial nerve,to provide more accurate image information for clinical treatment strategies.
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Objective To investigate the efficiency and application value of CT-guided percutaneous puncture biopsy in the diagnosis of lung disease.Methods The clinical and imaging data of 60 patients with CT-guided percutaneous lung biopsy were analyzed retrospectively.Results Among all the 60 patients, 57 had finally to be proved by pathological diagnosis, including 47 primary lung cancer (21 squamous cell carcinoma, 18 adenocarcinoma, 3 small cell lung cancer and 5 bronchioloalveolar carcinoma), 7 metastatic lung cancer and 3 tuberculosis.In addition, 3 cases were chronic inflammation and did not make a definite diagnosis, in which 2 were proved to be caseous pneumonia and 1 was proved to be fungus infection by postoperative pathology.The successful rate of punctures,the diagnostic accuracy and the total complications rate of lung puncture biopsy in 60 cases was 100%, 95.0% and 21.7% [11.7% pneumothorax (7/60), 8.3% hemoptysis (5/60) and 1.7% needle bleeding(1/60)].Conclusion CT-guided percutaneous puncture biopsy is a safe, accurate and significant clinical method in the diagnosis and differential diagnosis of lung lesions.
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Objective To investigate the correlation between mammographic findings and different molecular subtypes of breast cancer.Methods Totally 84 patients with breast cancer proved pathologically who underwent digital mammography examination before operation were enrolled.All cases were examined by immunohistochemical staining,the expression levels of estrogen receptor(ER),progesterone receptor (PR)and human epidermal growth factor receptor-2(HER-2)in tumor cells were analyzed.They were classified into four molecular subtypes:Luminal A,Luminal B,HER-2 + and Basal-like tumors according to their expression levels.The correlation between mammographic findings and different molecular subtypes of breast cancer were analyzed.Results Among the 84 cases of breast cancer,there were significant differences between mass shadow and mass shape in the four subtypes of tumors(P<0.05).Luminal A,Luminal B breast cancer showed more irregular edge of the tumor;HER-2 + breast cancer with more malignant calcifications,of which simple calcifications of breast cancer were more;Basal-like breast cancer with regular shape,clear border shadow,rarely accompanied by malignant calcifications.Conclusion Mammographic features of breast cancer can predict its molecular subtypes to some extent,which can provide objective basis for the selection of clinical preoperative treatment protocols.
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Objective To analyse the changes of cerebral cortical thickness and explore the connectivity of cortical thickness and the clinical syndrome of concomitant strabismus using high-resolution magnetic resonance imaging.Methods Participants were 26 children with primary strabismus and 28 healthy children strictly matched for sex, age, education and socioeconomic level.By using Freesurfer software, the whole-brain-based analysis was perfomrmed to compare the cortical thickness between the two groups.Results Compared with the healthy control group the children with strabismus were found that the cerebral cortex became thinner, including these brain regions related with stereovision,advanced visual-attention,attention and executive control function,as well as brain areas in insula and cingulate circuit.Conclusion Concomitant strabismus in children are not only caused by pathological changes of extraocular muscles,but anatomical changes of the central nervous system, especially the brain areas involved in the advanced visual processing related with visual-motor and visual-attention, and the advanced cognitive brain regions associated with attention and executive control, as well as the anatomical changes in insula and cingulate cortex circuit, which can explain the clinical syndrome of children with concomitant strabismus.
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Objective To investigate the correlation between X-ray calcification and expression of human epidermal growth factor receptor-2 (HER-2) in breast cancer.Methods Totally 84 patients with breast cancer proved pathologically who underwent digital mammography examination before operation were collected,and HER-2 of surgical specimens were detected by immunohistochemical staining after operation.The correlation between X-ray calcification and HER-2 expression was analyzed.Results The positive expression rate and the negative expression rate of HER-2 were equal in X-ray calcified group.The negative expression rate of HER-2 was higher in the non calcified group (61.54 ％).There were no differences between the calcification type,calcification number and HER-2 expression (P＞0.05).The positive expression rate of HER-2 in calcification range ≥2 cm group was significantly higher than that in calcification range ＜2 cm group (P＜0.05).The positive expression rate of HER-2 in calcification distribution ≥2 quadrants was significantly higher than that in one quadrant group (P ＜0.01).The negative expression rate of HER-2 in cluster-like calcification was higher(61.11 ％) than that in other calcifications.Conclusion There is a certain correlation between X-ray calcification and HER-2 expression in breast cancer,which can provide a clinical reference for surgical approach and prognosis evaluation of breast cancer.
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Objective To investigate the alterations of interhemispheric resting-state functional connectivity in patients with chro-nic primary trigeminal neuralgia (CPTN).Methods Twenty patients with CPTN and 20 age-,gender-,and education-matched healthy subjects underwent a resting-state functional magnetic resonance imaging (rs-fMRI)scanning.The voxel-mirrored homo-topic connectivity(VMHC)approach and statistic analysis were used to investigate the interhemispheric coordination of the whole brain.Results Compared with healthy controls,decreased VMHC was found in patients with CPTN,including medial and lateral or-bitofrontal cortex,and premotor (P <0.05,GRF corrected).Conclusion Our results suggest that decreased VMHC in brain regions indicate the aberrant perceptual and affective processing of CPTN,and limited complex movements function.