A study on the conversion of prescribed dose for radiotherapy of logistic nanodosimetry model and microdosimetric kinetic model based on gamma analysis / 中华放射肿瘤学杂志

Objective:To validate the feasibility of the gamma analysis method in the study of prescription dose conversion between logistic nanodosimetry model (LNDM) and microdosimetric kinetic model (MKM) basing on the Chinese self-developed model LNDM by applying clinical experiences of National Institute of Radiological Science (NIRS).Methods:Physical dose distributions derived from the MKM- and LNDM-based carbon ion treatment plans were compared via the method of gamma analysis under the open-source treatment planning platform matRad. In this way, the prescribed dose conversion factor between the MKM- and LNDM-based treatment plans was obtained. Using water phantoms, the influence of geometric shape, size, depth of target volume (TV), prescribed dose and field setting on the conversion factor was investigated comprehensively. Moreover, preliminary verification of the acquired conversion factor was conducted on the C-shape model and a case of liver cancer patient.Results:The conversion factor depended on the field setting rather than the TV shape. Under the condition of single field, the conversion factor was positively correlated with the size and depth of TV, and the prescribed dose. Moreover, the conversion factor was successfully verified using the C-shape model and the patient with liver cancer, where the gamma passing rates (2%/2 mm) of the physical dose distribution generated by the MKM and LNDM treatment plans were 92.79% and 91.19%, respectively.Conclusions:The conversion factors (f=D LNDM/D MKM) obtained in this study might provide guidance for the prescribed dose setting during the carbon ion treatment planning based on the LNDM. Besides, the gamma analysis method could be used for the study of the prescribed dose conversion between different models.

Thoracic drainage with traditional chest tube versus central venous catheter after video-assisted thoracoscopic lobectomy: A randomized controlled study / 中国胸心血管外科临床杂志

@#Objective    To evaluate the effectiveness and safety of a central venous catheter for thoracic drainage after video-assisted thoracoscopic lobectomy compared with a conventional chest tube. Methods    This study collected 200 patients with lung cancer who underwent thoracoscopic lobectomy and systematic hilar and mediastinal lymph node dissection between January 2018 and September 2019 in our hospital. The patients were randomly divided into two groups, including a group A (left with 28F chest tubes postoperatively) and a group B (left with 12G central venous catheters postoperatively). Patients in both groups were left with 2 chest tubes after upper lobectomy and 1 chest tube after middle or lower lobectomy. Duration and total volume of drainage, length of hospital stay, maximum visual analogue scale score and so forth were compared between the two groups. Results    Finally, 151 patients were included for analysis. There were 73 patients in the group A, including 26 males and 47 females, with an average age of 55.38±9.95 years, and 78 patients in the group B, including 37 males and 41 females, with an average age of 59.86±10.18 years. No statistical  difference was found between the two groups in drainage volume on postoperative day 2, and proportion of prolonged air leaks, hemothorax, chylothorax or drain reinsertion (all P>0.05). There was a statistical difference in drainage volume on postoperative day 1 [200.0 (120.0, 280.0) mL vs. 57.5 (10.0, 157.5) mL, P=0.000], postoperative day 3 [155.0 (100.0, 210.0) mL vs. 150.0 (80.0, 215.0) mL, P=0.023], total volume of drainage [890.0 (597.5, 1 530.0) mL vs. 512.5 (302.5, 786.3) mL, P=0.000], maximum pain score (2.29±0.72 points vs. 2.09±0.51 points, P=0.013) and length of hospital stay [7 (7, 9) d vs. 5 (4, 7) d, P=0.000]. Conclusion    Compared with conventional chest tubes, central venous catheters for chest drainage in patients with lung cancer after thoracoscopic lobectomy shortens the length of hospital stay and reduces postoperative pain.

Identification and Expression Analysis of PP2C Gene Family Members in Cannabis sativa / 中国实验方剂学杂志

ObjectiveThe type 2C protein phosphatases （PP2C） are involved in numerous plant signal transduction pathways. They mainly participate in plant stress response and regulate second metabolites biosynthesis via negatively regulating MAPK signaling pathway. Herein，we were to identify and analyze PP2C （CsPP2C） gene family from hemp genome，in hope of providing comprehensive insights for studying CsPP2C function during the development of hemp. MethodMolecular Evolutionary Genetics Analysis （MAGA）-X was used to construct phylogenetic tree. Expert Protein Analysis System （ExPASy），WoLF PSORT，Multiple EM for Motif Elicitation （MEME），Batch Conserved Domain Search （Batch-CD-Search），PlantCare，and TBtools were used，respectively，to predict CsPP2C physicochemical properties，subcellular localization，conserved motifs，protein structure，cis-element in promoter and collinearity with Arabidopsis PP2C. Cannabis sativa transcriptome and Real-time polymerase chain reaction（Real-time PCR） were used to analyze and verify gene expressions，respectively. ResultFifty-two CsPP2C with conserved domains were identified from the entire genome of hemp，encoding proteins ranging from 244 to 1 089 aa in length and with molecular weights ranging from 26.76 to 122.53 kDa. Those genes were mainly distributed in the nucleus，cytoplasm and chloroplast. The 47 CsPP2C were divided into 10 subfamilies，and the remaining 5 were not clustered. Seven pairs of homologous genes between hemp and Arabidopsis thaliana were identified according to collinear analysis. The light-responsive elements and abscisic acid elements are most abundant in the prediction. The gene expression heat map showed varied expression pattern of CsPP2C in different tissues. Real-time PCR results of three CsPP2C were consistent with transcriptome data. Moreover，alternative splicing analysis showed that some CsPP2C had alternative-splicing genes during evolution. ConclusionWe predicted and analyzed CsPP2C gene family in genomic scale and showed that CsPP2C are involved in many biological processes，whereby provides foundation for CsPP2C functional study.

Identification and Expression Analysis of PP2C Gene Family Members in Cannabis sativa / 中国实验方剂学杂志

ObjectiveThe type 2C protein phosphatases （PP2C） are involved in numerous plant signal transduction pathways. They mainly participate in plant stress response and regulate second metabolites biosynthesis via negatively regulating MAPK signaling pathway. Herein，we were to identify and analyze PP2C （CsPP2C） gene family from hemp genome，in hope of providing comprehensive insights for studying CsPP2C function during the development of hemp. MethodMolecular Evolutionary Genetics Analysis （MAGA）-X was used to construct phylogenetic tree. Expert Protein Analysis System （ExPASy），WoLF PSORT，Multiple EM for Motif Elicitation （MEME），Batch Conserved Domain Search （Batch-CD-Search），PlantCare，and TBtools were used，respectively，to predict CsPP2C physicochemical properties，subcellular localization，conserved motifs，protein structure，cis-element in promoter and collinearity with Arabidopsis PP2C. Cannabis sativa transcriptome and Real-time polymerase chain reaction（Real-time PCR） were used to analyze and verify gene expressions，respectively. ResultFifty-two CsPP2C with conserved domains were identified from the entire genome of hemp，encoding proteins ranging from 244 to 1 089 aa in length and with molecular weights ranging from 26.76 to 122.53 kDa. Those genes were mainly distributed in the nucleus，cytoplasm and chloroplast. The 47 CsPP2C were divided into 10 subfamilies，and the remaining 5 were not clustered. Seven pairs of homologous genes between hemp and Arabidopsis thaliana were identified according to collinear analysis. The light-responsive elements and abscisic acid elements are most abundant in the prediction. The gene expression heat map showed varied expression pattern of CsPP2C in different tissues. Real-time PCR results of three CsPP2C were consistent with transcriptome data. Moreover，alternative splicing analysis showed that some CsPP2C had alternative-splicing genes during evolution. ConclusionWe predicted and analyzed CsPP2C gene family in genomic scale and showed that CsPP2C are involved in many biological processes，whereby provides foundation for CsPP2C functional study.

Analysis of the correlation between body mass index and coronary flow reserve in patients with chest pain and no obstructive coronary artery disease / 中华内分泌代谢杂志

Objective:To explore the correlation between body mass index(BMI)and coronary flow reserve(CFR)in patients with chest pain and no obstructive coronary artery disease(NOCA).Methods:This study was a single-center retrospective cross-sectional study. Sixty-six patients with chest pain and NOCA on coronary angiography who underwent PET/CT quantitative myocardial blood flow measurements at TEDA International Cardiovascular Hospital were retrospectively analyzed from August 2018 to October 2019. Pearson correlation analysis and linear regression analysis were used to explore the correlation between BMI and CFR. Patients were divided into 2 groups according to CFR: coronary microvascular dysfunction(CMD)group(CFR<2.5)and control group(CFR≥2.5). Logistic regression analysis was applied to analyze the association of BMI with CMD.Results:The proportions of female, obesity, and overweight plus obesity in CMD group were higher than those in control group( P<0.05). The levels of BMI and low density lipoprotein-cholesterol(LDL-C)were higher in CMD group compared with control group( P<0.05). Pearson correlation analysis showed that CFR was linearly correlated with BMI( r=-0.45, P<0.01), which still existed after adjusted by confounding factors using linear regression model( r=-0.371, P<0.01). Logistic regression analysis showed that BMI was dependently associated with CMD after adjusted by gender, age, hypertension, diabetic mellitus, and LDL-C. The OR value of CMD was 4.46(95% CI 1.47-13.55, P<0.01)with BMI increased by 5 kg/m 2. Conclusion:In patients with chest pain and NOCA, higher BMI is an independent risk factor of CMD.

Analysis of quantitative parameters measured with PET/CT and relative risk factors in female patients with coronary microvascular diseases / 中华核医学与分子影像杂志

Objective:To diagnose female coronary microvascular diseases (CMVD) without obstructive coronary artery disease through coronary flow reserve (CFR) measured with PET/CT imaging, and further analyze its related risk factors of quantitative parameters and clinical characteristics.Methods:From September 2017 to August 2019, a total of 75 female patients (age: 25-77 years) with clinically suspected CMVD from TEDA International Cardiovascular Hospital were retrospectively analyzed. All patients had negative results of coronary angiography (CAG) or coronary CT angiography (CCTA) and underwent 13N-NH 3·H 2O PET/CT dynamic quantitative imaging. Left ventricle (LV) coronary flow reserve (LV-CFR) value of 2.5 for critical value was divided into CMVD group and non-CMVD group. Clinical characteristics and quantitative parameters including rest LV-myocardial blood flow (MBF) and stress LV-MBF were respectively analyzed and compared between groups. Independent-sample t test, Mann-Whitney U test and Pearson correlation analysis were used to analyze the data. Results:Of 75 patients, 51 cases (68%) were diagnosed with CMVD and 24 cases (32%) with non-CMVD. Body mass index (BMI) of the CMVD group was higher than that of the non-CMVD group ((26.93±3.52) vs (23.83±3.42) kg/m 2, t=3.63, P=0.001), and LV-CFR was negatively correlated with BMI ( r=-0.341, P=0.003). The LV-CFR of the overweight group (BMI≥24 kg/m 2) was lower than that of non-overweight group (BMI<24 kg/m 2) (2.18±0.47 vs 2.54±0.55, t=-2.89, P=0.005). The rest LV-MBF in the CMVD group (0.74(0.65, 0.84) ml·min -1·g -1) was higher than that in the non-CMVD group (0.66(0.58, 0.75) ml·min -1·g -1; U=417.5, P=0.027), and the stress LV-MBF and LV-CFR was lower than that in the non-CMVD group ((1.53±0.35) vs (1.96±0.45) ml·min -1·g -1, 2.07(1.71, 2.34) vs 2.86(2.61, 2.95); t=-4.54, U=0, both P<0.001). In the hypertensive group, the CMVD sub-group had higher rest LV-MBF than the non-CMVD sub-group ((0.77±0.16) vs (0.65±0.13) ml·min -1·g -1; t=2.26, P<0.05), but lower stress LV-MBF ((1.49±0.34) vs (1.85±0.40) ml·min -1·g -1; t=-3.07, P<0.05) and LV-CFR(1.99(1.64, 2.23) vs 2.85(2.55, 2.95); U=0, P<0.05] than the non-CMVD sub-group. In the non-hypertensive group, stress LV-MBF and LV-CFR of the CMVD sub-group were lower than those of the non-CMVD sub-group (1.53(1.36, 1.97) vs 1.94(1.76, 2.16) ml·min -1·g -1, 2.35(1.94, 2.43) vs 2.87(2.65, 3.09); U values: 43.5 and 0, both P<0.05). LV-CFR of CMVD subgroup in hypertensive group was lower than that of CMVD subgroup in non-hypertensive group ( U=164.0, P=0.028). Conclusions:BMI is negatively correlated with LV-CFR in CMVD. The decrease of stress LV-MBF and the increase of rest LV-MBF in CMVD lead to the decrease of LV-CFR. Hypertension is one of the important influence factors for MBF and CFR.

Diagnostic value of blood flow reserve measurement with 13 N-NH3 ·H2 O PET/ CT imaging in pa-tients with coronary microvascular disease / 中华核医学与分子影像杂志

Objective To evaluate the diagnostic value of coronary flow reserve (CFR) on 13 N-NH3 ·H2 O PET/ CT imaging for patients with suspected coronary microvascular disease (CMVD). Meth-ods From September 2017 to September 2018, 54 clinical suspected CMVD patients (22 males, 32 fe-males; age: 25-77 years) in TEDA International Cardiovascular Hospital were retrospectively analyzed. All patients underwent 13N-NH3·H2O PET/ CT imaging to measure left ventricle CFR (LV-CFR), and were divided into CMVD group (LV-CFR<2.5) and non-CMVD group (LV-CFR≥2.5). Semi-quantitative parameters of PET/ CT myocardial perfusion imaging (MPI), including summed stress score (SSS), summed rest score (SRS), summed difference score (SDS) and transient ischemic dilation (TID), as well as left ventricular function parameters, such as rest and stress imaging left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) were compared between two groups. Besides, rest and stress LV-myocardial blood flow (MBF) and CFR distribution of the CMVD group in the region of three coro-nary arteries was also analyzed and compared. Independent-sample t test, Mann-Whitney U test and Pearson cor-relation analysis were used to analyze the data. Results Rest LV-MBF of CMVD group was higher than that of non-CMVD group ((0.74±0.16) vs (0. 63±0.09) ml·g-1 ·min-1 ) and stress LV-MBF was lower ((1.52± 0. 36) vs (1.89±0.22) ml·g-1 ·min-1; t values: 2.925, -4.503, both P<0.05). There was no signifi-cant difference between the two groups in other semi-quantitative parameters ( t values: from - 1. 430 to 1. 400, U values: 286.0-338.5, all P>0.05). Positive correlations were found in CFR among left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) (r values: 0.798-0.836, all P<0.01). Conclusion CFR measured with PET/ CT imaging is better than semi-quantitative parameters in MPI, which provides noninvasive and objective diagnosis and evaluation information for patients without ob-vious epicardial coronary artery stenosis and suspected with CMVD.

Diagnostic value of blood flow reserve measurement with 13N-NH3·H2O PET/CT imaging in patients with coronary microvascular disease / 中华核医学与分子影像杂志

Objective@#To evaluate the diagnostic value of coronary flow reserve (CFR) on 13N-NH3·H2O PET/CT imaging for patients with suspected coronary microvascular disease (CMVD).@*Methods@#From September 2017 to September 2018, 54 clinical suspected CMVD patients (22 males, 32 females; age: 25-77 years) in TEDA International Cardiovascular Hospital were retrospectively analyzed. All patients underwent 13N-NH3·H2O PET/CT imaging to measure left ventricle CFR (LV-CFR), and were divided into CMVD group (LV-CFR<2.5) and non-CMVD group (LV-CFR≥2.5). Semi-quantitative parameters of PET/CT myocardial perfusion imaging (MPI), including summed stress score (SSS), summed rest score (SRS), summed difference score (SDS) and transient ischemic dilation (TID), as well as left ventricular function parameters, such as rest and stress imaging left ventricular ejection fraction (LVEF), end-diastolic volume (EDV), and end-systolic volume (ESV) were compared between two groups. Besides, rest and stress LV-myocardial blood flow (MBF) and CFR distribution of the CMVD group in the region of three coronary arteries was also analyzed and compared. Independent-sample t test, Mann-Whitney U test and Pearson correlation analysis were used to analyze the data.@*Results@#Rest LV-MBF of CMVD group was higher than that of non-CMVD group ((0.74±0.16) vs (0.63±0.09) ml·g-1·min-1) and stress LV-MBF was lower ((1.52±0.36) vs (1.89±0.22) ml·g-1·min-1; t values: 2.925, -4.503, both P<0.05). There was no significant difference between the two groups in other semi-quantitative parameters (t values: from -1.430 to 1.400, U values: 286.0-338.5, all P>0.05). Positive correlations were found in CFR among left anterior descending (LAD), left circumflex (LCX) and right coronary artery (RCA) (r values: 0.798-0.836, all P<0.01).@*Conclusion@#CFR measured with PET/CT imaging is better than semi-quantitative parameters in MPI, which provides noninvasive and objective diagnosis and evaluation information for patients without obvious epicardial coronary artery stenosis and suspected with CMVD.

Urban PM2.5 in Guangzhou induces apoptosis of PC-12 cells / 实用医学杂志

Objective To investigate the toxicity of urban PM2.5 in Guangzhou on PC-12 cells.Methods PM2.5 was collected in Guangzhou city.PC-12 cells were cultured in vitro and divided into several groups,including the control group,PM2.5 groups with different concentrations and NAC pretreated group (pretreaed with 10 μmol/mL NAC followed with 100 μg/mL PM2.5 exposure).Cells were incubated with indicated stimulator for 24 h,then cell viability was checked with cell counting Kit-8 assay,the level of intracellular ROS was labeled using H2DCFDA fluorescence probe,cell apoptosis was measured by the flow cytometry and the expression of apoptosis-related proteins,including Cytochrome C,Caspase 9,Caspase 3 and PARP,were detected by Western Blot assay.Results PM2.5 has a strong toxicity on PC-12 cells when its concentration is over 25 μg/mL.After exposure for 24 h,the cell viability was markedly decreased.The results of flow cytometry and Western blot assay showed that PM2.5 enhanced the apoptosis of PC-12 cells with the upregulatios of Cytochrome C,Caspase 9,Caspase 3 and PARP.Pretreatment with NAC could significantly diminish PM2.5-induced PC-12 cell toxicity,decreased ROS generation and apoptosis of PC-12 cells,with the down regulations of apoptosis-related proteins.Conclusion PM2.5 can cause apoptosis of PC-12 cells by inducing oxidative stress,upregulating the Cytochrome C expression and activating Caspase9/3,which may be one of the mechanisms underlying PM2.5-induced neurotoxicity.

Effects ofYiqi Shuxin Pills on Coronary Flow Reserve of Patients with Acute Coronary Syndrome in Coronary Angiography / 中国中医药信息杂志

Objective To observe the effects ofYiqi Shuxin Pills on the coronary flow reserve (CFR) of patients with acute coronary syndrome (ACS) in the coronary angiography (CAG); To discuss its relevant mechanism of action.Methods Totally 101 patients with ACS were divided into control group (49 cases) and treatment group (52 cases). Patients in the treatment group were treated with western therapy andYiqi Shuxin Pills, while patients in the control group were treated with western therapy only. After treated for 6 months, CAG was reviewed to compare the CFR in both groups before and after the treatment. The blood-stasis syndrome and qi-deficiency syndrome scores and the level of NO, ET-1, hs-CRP, sVCAM-1, P-selectin in blood of both groups before and after the treatment were observed.Results The blood-stasis syndrome and qi-deficiency syndrome scores in the treatment group were significantly lower than those in the control group (P<0.01); The levels of ET-1, hs-CRP, sVCAM-1, P-selectin were obviously reduced and NO obviously increased in treatment group than those of control group (P<0.05). The CFR in the treatment group was significantly better than that of control group, with statistical significance (P<0.05). ConclusionYiqi Shuxin Pills can improve the state of blood-stasis syndrome and qi-deficiency syndrome, improve vascular endothelial function, relieve inflammatory reaction, lower the expression of platelet, stabilize atherosclerotic plaque of coronary artery, and then improve the CFR of ACS patients in CAG.

Impact of transfection with recombinant adenovirus vector-mediated Klotho gene on myocardial remodeling in a rat model of heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To assess the impact of transfection with recombinant adenovirus vector-mediated Klotho gene on myocardial remodeling in a rat model of heart failure (HF) by intraperitoneal injection of isoproterenol.</p><p><b>METHODS</b>Rats were divided into 5 groups by table of exponential random numbers: normal control group, HF group, saline-control HF group, recombinant adenovirus vector transfection group (Ad.EGFP group, 2 × 10¹⁰ pfu, 0.5 ml/rat), pDC316-CMV-EGFP-rKlotho transfection group (Ad.Klotho group, n=5 each). Left ventricular ejection fraction (LVEF) was obtained by echocardiography, hemodynamic parameters obtained by multi-channel physiological recorder, myocardial tissue underwent pathohistological examination. Additionally, the green fluorescin expression was observed on frozen heart section. Myocardial fibrosis correlated gene expression including Klotho gene, collagen I and III was detected by real time-PCR. Moreover, plasma levels of B-type natriuretic peptide (BNP) were measured with ELISA.</p><p><b>RESULTS</b>Compared to saline control HF group, LVEF, LVSP and ±dp/dtmax were significantly increased, myocardial fibrosis and myocardial remodeling were significantly attenuated in the Ad. Klotho group and there was green fluorescin distribution in myocardial tissues of Ad. Klotho group. Klotho expression was down-regulated and collagen I and III expression was upregulated in HF rats compared to normal control group (all P<0.05) and these changes could be significantly reversed in Ad. Klotho group (all P<0.05). Plasma BNP level was also significantly lower in Ad. Klotho group than in HF group (P<0.05).</p><p><b>CONCLUSIONS</b>Klotho gene transfection could improve cardiac function and attenuate cardiac remodeling and reducing myocardial fibrosis.</p>

Clinical Study of Coronary Artery Lesion in Patients with Angina Pectoris Using Virtual Histology Intravascular Ultrasound / 中国医学影像学杂志

Purpose To observe the characteristics of coronary artery lesion in patients with unstable angina pectoris (UAP) and stable angina pectoris (SAP) using virtual histology intravascular ultrasound (IVUS-VH).Materials and Methods A total of 199 patients with angina pectoris were enrolled and divided into SAP group (101 cases) and UAP group (98 cases) according to clinical symptoms, ECG and myocardial enzyme level. All the patients underwent coronary angiography to determine the criminals vessels, grayscale intravascular ultrasound was used to measure and compare the external elastic membrane area (EEMA), lumen cross-sectional area (lumen CSA), plaque area (PA), plaque burden (PB), remodeling index (RI), plaque eccentricity index (EI) of the criminals vessels. IVUS-VH method was used to measure and compare the area and percentage of calcified tissue,fibrous tissue, lipid tissue and necrotic tissue in the plague components of the criminals vessels between the two groups.Results There was no significant difference (t=1.392,-0.345, 1.921, 0.378 and 0.857,P>0.05) of EEMA, lumen CSA, PA, EI and RI measured at the location with smallest lumen area between the two groups. Necrotic core area and percentage of lesion composition in UAP group was significantly higher than that in SAP group (t=2.361,P0.05) between the two groups on the area of fiber, lipid and calcification. On the distribution of plaque components, fibrous plaque area percentage of UAP group was lower than that in SAP group (t=-2.418, P0.05) between the two groups on lipid and calcification area.Conclusion Necrotic core area and percentage of plaque composition in the UAP group is larger than the other group. Criminals lesions are more unstable and more easily to be complicated with acute cardiovascular events.

Comparing the clinical effect of single incision laparoscopic right hemicolectomy and laparotomy right hemicolectomy / 中国医师进修杂志

Objective To study the feasibility and clinical effect of trans umbilical single incision laparoscopic right hemicolectomy for right hemicolon carcinoma.Methods The clinical data of 35 patients with right hemicolon carcinoma were retrospectively analyzed,the 15 cases were received the trans umbilical single incision laparoscopic right hemicolectomy (single incision group) and 20 cases were received laparotomy right hemicolectomy (laparotomy group).The clinical indexes were compared between the 2 groups.Results The length of incision,intraoperative bleeding volume,passage of gas by anus time,feeding time,hospitalized time in single incision group were significantly better than those in laparotomy group [(5.5 ± 0.6) cm vs.(17.6 ± 2.2) cm,(84.0 ± 31.1) ml vs.(155.5 ± 43.1) ml,(2.00 ± 0.76) d vs.(3.75 ± 0.63) d,(5.3 ± 0.6) d vs.(6.5 ± 0.6) d,(9.3 ± 1.4) d vs.(13.5 ± 1.5) d],the operation time in single incision group was significantly longer than that in laparotomy group [(238.4 ± 19.3) min vs.(165.3 ± 25.8) min],there were statistical differences (P ＜ 0.05).There was no statistical difference in number of incision lymph node between the 2 groups (P ＞ 0.05).Postoperative complication in single incision group occurred in 2 cases,postoperative complication in laparotomy group occurred in 3 cases,there was no statistical difference (P ＞0.05).The follow-up time was 1-55 months,the median follow-up time was 28 months,local recurrence and distant metastasis were found in 2 cases in single incision group,and 4 cases was found in laparotomy group,there was no statistical difference (P ＞ 0.05).Conclusions Single incision laparoscopic right hemicolectomy for right hemicolon carcinoma is safe and feasible,which has the advantages of minimal trauma,aesthetic outlook,less bleeding,quick recovery and short hospitalization time,etc.It can be developed in the hospital which has some basis of laparoscopic surgery.

Effect of Shanzha Xiaozhi Capslue on Stability of Atherosclerosis Plaques in Patients with Metabolic Syndrome and Carotid Atherosclerosis / 中国中医药信息杂志

Objective To investigate the effect of Shanzha Xiaozhi Capslue on stability of atherosclerosis plaques in patient with metabolic syndrome (MS) and carotid atherosclerosis (CAS). Methods Totally 106 patients with MS and CAS were randomly divided into 2 groups with 55 cases in the treatment group and 51 cases in the control group. The control group improved the way of life and control of relevant risk factors, while the treatment group was treated with Shanzha Xiaozhi Capslue additionally for 6 months. The occurrence of major adverse cardiovascular and cerebrovascular events of the two groups was compared. The intima-media thickness, plaques grade of carotid artery and the changes of Hs-CRP, Hcy, insulin resistance were measured before and after the treatment. Results After treatment, the occurrence of major adverse cardiovascular and cerebrovascular events in the treatment group reduced significantly compared with the control group (P=0.047). The intima-media thickness and plaques grade of carotid artery in the treatment group decreased significantly compared with the control group (P<0.05), and the serum levels of Hs-CRP, Hcy, insulin resistance were decreased significantly compared with the control group (P<0.01). Conclusion Shanzha Xiaozhi Capslue can decrease the intima-media thickness and plaques score of carotid artery, stabilize atherosclerotic plaque, thus reduce the occurrence of major adverse cardiovascular and cerebrovascular events of patients with MS and CAS.

The effect of Shanzha Xiaozhi capsule on intima-media thickness and plaques score of carotid artery in patients with non-acute phase coronary heart disease / 中国中西医结合急救杂志

Objective To investigate the effect of Shanzha Xiaozhi capslue on intima-media thickness(IMT) and plaques score of carotid artery in patients with non-acute phase coronary heart disease and traditional Chinese medicine(TCM)syndrome of phlegm and blood stasis. Methods A prospective study was conducted to carry out a research on 102 patients with non-acute phase coronary heart disease and TCM syndrome of phlegm and blood stasis. They were randomly divided into two groups:a control group(50 cases)treated with conventional western medicine alone and a observation group(52 cases)which was treated by both conventional western medicine and Shanzha Xiaozhi capslue(the main TCM ingredients:Shanzha,Dahuang)0.7 g,3 times a day,the therapeutic course being 6 months in both groups. The cardiocerebral vascular incidences of the two groups were observed,in the mean time,the carotid artery IMT and plagues score were registered,the scores of phlegm stagnation syndrome and blood-stasis syndrome were measured,adverse reaction was observed and compared in both groups before and after treatment. Results After treatment,the occurrence of major adverse acute cardiovascular and cerebrovascular events in observation group were reduced significantly compared with those in the control group(5.77%vs. 20.00%,P<0.05). The IMT and plaques score of carotid artery and the scores of phlegm stagnation syndrome and blood-stasis syndrome were all decreased obviously compared to those before treatment,and the effect was more remarkable in the treatment group〔IMT of carotid artery(mm):0.80±0.13 vs. 0.95±0.12,the plaques score:1.35±0.65 vs. 1.75±0.88, phlegm syndrome score:20.98±6.42 vs. 35.55±9.22,blood-stasis syndrome score:23.23±5.12 vs. 28.95±6.38, P<0.05 or P<0.01〕. Abdominal pain appeared in 2 patients of observation group without other adverse reactions. Conclusion Shanzha Xiaozhi capsule can stabilize atherosclerotic plaque and reduce the occurrence of acute adverse cardiocerebral vascular events in patients with non-acute phase coronary heart disease and phlegm and blood stasis syndrome possibly by removing phlegm and blood stasis to decrease the IMT and plaques score of carotid artery.

Value of trauma and injury severity score in predicting mortality of trauma patients in different rank hospitals / 中华创伤杂志

ObjectiveTo evaluate the trauma care effect and the value of trauma and injury severity score (TRISS) in prediction of the mortality by using TRISS to calculate the survival probability of trauma patients in five hospitals from Zhejiang province in 2009.MethodsA retrospective study was done on trauma patients (study group) firstly admitted to Emergency Department of five hospitals from Zhejiang province in 2009.The relevant information was collected,including demographic data,trauma types and injury causes.The TRISS score was obtained through calculating injury severity score (ISS) and revised trauma score (RTS) on admission into emergency department.With the major trauma outcome study (MTOS) as control group,M value,standardized Ws value and 95％ confidence interval (CI) were calculated to compare actual survival rate and anticipation survival rate.ResultsA total of 2 193 patients at mean age of 44.39 years were enrolled in the study,including 1 661 male patients (75.74％).Traffic accident injury was the most common,followed by fall injury.The mortality rate according to TRISS was 13.22％,but the actual mortality rate was 9.75％.For all the patients,M =0.80 indicated that the injury severity of the study group was significantly different from that of the control group.At the same time,Ws =2.15,95％ CI for Ws:1.54-2.77 showed that the actual survival rate of the study group was significantly higher than that of the control group.Besides,the survival rate of trauma patients in the affiliated hospitals and three hospitals at class A grade was significantly higher fian that of the control group,but there was no significant difference between three hospitals at class B grade and control group. ConclusionsTRISS overestimates the mortality of the study group,which is probably associated with the rapid development of traumatology and the old coefficients of TRISS.Setting up local trauma database and renewing coefficients of TRISS may improve the ability of TRISS in predicting mortality of the trauma patients.

Different effects of isoflurane and sevoflurane on expression of Caspase-3 and microtubule associated protein 1B of cortical neurons in neonatal SD rats / 中华行为医学与脑科学杂志

Objective To investigate the effects of isoflurane and sevoflurane at the same dose on expression of Caspase-3 of primary somatosensory cortex (SI) and expression of micmmbule associated protein 1B (MAP1B)in cortical neuronsin neonatal SD rats.Methods Fifty-five neonatal SD rats at postnatal day 7 (eleven rats each litter,altogether 5 litters)were assigned randomly into control group(C group),isoflurane group (I group)and sevoflursne group(S group)in average.The rats in I group,S group or C group were exposed to 1.1% isoflurane or 1.8% sevoflurane (equivalent to 0.5MAC)or air 4h.The brain of neonatal rats were perfused and embedded by paraffin,Caspase-3 positive expression in the SI cortex of brain was detected by immunohistochemistry staining.Besides,the fresh cortex was dissected at O h in C group and at 2h,4h in I group and S group,microtubule associated protein 1 B expression was detected by West blot staining.Results Caspase-3 positive cells in the SI cortex were increased by 561.23%in I group(t=4.45,P<0.01)and 194.46% in S group(t=5.17,P<0.01)when compared with C group,and increased by 124.45% in I group(P<0.05)when compared with S group.The MAP1B protein was increased by 557.15%at 2h(t=16.54 P<0.01)and 475.21% at 4h(t=32.97,P<0.01)in I group while increased by 693.11%at 2h(t=9.45,P<0.001)and 268.15% at 4h(t=2.79,P=0.049) in S group when compared with C group.In S group,MAP1B protein at 4h reduced by 53.65%(P<0.01) when compared with that at 2h.Conclusion 0.5 MAC isoflurane can induce more apoptosis in the cortex in the neonatal rats'brain at postnatal day 7 than sevoflurane.They can both significantly promote the expression of MAP1B in the cortex to start the self-reparation.

Risk factors for nosocomial infection in trauma patients during intensive care unit stay / 中华急诊医学杂志

Objective To determine risk factors in nosocomial infection of trauma patients during intensive care unit stay. Methods A retrospective study was carried out. A total of 1103 trauma patients admitted to the intensive care unit of five tertiary hospitals in Zhejiang Province in 2009 were reviewed. Demographic data, injury severity score and other variables related to the trauma services were collected. Univariate and multivariate analysis were processed to identify the independent risk factors of nosocomial infection in trauma patients during stay in intensive care unit. Results Overall, 171 patients( 15.5% )developed nosocomial infection during ICU stay. Of 1103 patients, 157 patients (14.2% ) died, and the 59 fatal patients were from infection group. The mortality rate in infection group was 34.7% , which was significantly higher than that in non - infection group (10.5% ). The independent risk factors of nosocomial infection in all the patients determined by using multivariate analysis included central venous monitoring, mechanical ventilation, age ≥65, the length of ICU stay > 14 days and injury severity score ≥ 16. For the severe trauma patients, central venous monitoring, mechanical ventilation, the length of ICU stay > 14 days were independent risk factors of nonsocomial infection. Conclusions The severity of injury, age, the length of ICU stay and invasive procedures were related to the nosocomial infection. To standardize the invasive procedures and to reduce the length of ICU stay may decrease the infection rate of trauma patients.

An analysis of the risk factors in the mortality of casualties: data from eight hospitals in Zhejiang province / 中华急诊医学杂志

Objective To explore risk factors in the mortality of casualties and to find a way to improve trauma emergency service. Method The possible factors likely related to the mortality of casualties were taken into account based on each stage of trauma emergency so as to find the independent risk factors by using univariate and multivariate analyses. Results A total of 3 659 casualties were enrolled in this study.Of them, 226 casualties died and the mortality rate was 6.18%. Following factors were related to mortality after univariate analysis: age, cause of trauma, injury severity score, Glasgow come scale come on the scene, professional emergency treatment on the scene, intubation in the ambulance, debridement and hemostasis in the ambulance, low blood pressure at admission, closed drainage of pleural cavity, emergency operation, CVP monitoring in ICU and mechanical ventilation in ICU. After multivariate analysis, six factors were independently related to the mortality of casualties as follows: Glasgow coma scale, injury severity score, mechanical ventilation, blood pressure at admission, age and professional emergency treatment on the scene. Conclusions It has a great significance to investigate the risk factors of mortality for casualties. Severity of trauma and age were independently associated with the outcomes of trauma. Besides, improving prehospital care and stabilizing the trauma patients in early phase can further decrease the mortality.

The effects of sodium phenylbutyrate(SPB)on the expression of p21 and survivine genes on human tongue squamous cancer cell line Tca8113 / 中国药理学通报

Aim To investigate the effects of sodium phenylbutyrate on cell proliferation,apoptosis and its expression of p21 and survivin genes in human tongue squamous cancer Tca8113 cell line.Methods The cellular proliferation inhibitory ratio was evaluated by MTT assay and the apoptosis and cell cycle of the Tca8113 cell line was detected by FCM.The expression of p21 and survivin genes was analyzed with Western blot and RT-PCR.Results Sodium phenylbutyrate could inhibit the Tca8113 cells proliferation,promote cell apoptosis and arrest the cells at G_1/G_0 phase.The expression of p21 gene in Tca8113 cell line treated by sodium phenylbutyrate was increased,and one of survivin gene was decreased.Conclusions Sodium phenylbutyrate induces up-regulation of p21 gene and down-regulation of survivin gene,which inhibits Tca8113 cell proliferation and induces its apoptosis and arrests the cells at G_1/G_0 phase.And the increase of p21 mRNA expression is negatively correlated with the decrease of survivin mRNA expression(r_s=-0.548,P<0.01),and so is its protein expression(r_s=-0.514,P<0.01).