Fibrocartilaginous mesenchymoma: a clinicopathological analysis of four cases / 中华病理学杂志

Objective: To investigate the clinical, radiological, histological and molecular features and the differential diagnosis of fibrocartilaginous mesenchymoma (FM). Methods: Four cases of FM diagnosed in the Department of Pathology, the Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine from 2020 to 2022 were analyzed. Related literature was also reviewed. Results: Case 1 was a 10-year-old girl with bone destruction in the sacrum and L5 articular processes revealed by CT scan. Case 2 was a 7-year-old girl with an aggressive lesion in her right distal ulna. Case 3 was an 11-year-old boy with a lesion in the metaphysis of his left proximal tibia. Case 4 was an 11-year-old boy with bone destruction in the distal portion of a radius. Microscopically, the four tumors all consisted of numerous spindle cells, hyaline cartilage nodules, and bone trabeculae. The hypocellular to moderately cellular spindle cell component contained elongated cells with slightly hyperchromatic, mildly atypical nuclei arranged in bundles or intersecting fascicles. Benign-appearing cartilaginous nodules of various sizes and shapes were scattered throughout the tumors. There were areas mimicking epiphyseal growth-plate characterized by chondrocytes arranged in parallel columns and areas of enchondral ossification. The stroma was rich in mucus in case 1. Mutation of GNAS and IDH1/IDH2 and amplification of MDM2 gene were not found in any of the three tested cases. Conclusions: FM is very rare and tends to affect young patients. It most frequently occurs in the metaphysis of long tubular bones, followed by the iliac-pubic bones and vertebrae. FM is characterized by a mixed population of spindle cells, hyaline cartilage nodules and trabeculae of bone, without specific immunophenotypes and molecular alternations. As a borderline, locally aggressive neoplasm, surgical removal with a wide margin is generally the treatment of choice for FM.

Research advances of photosensitizer in photodynamic therapy of glioblastoma / 药学学报

Glioblastoma is a malignant tumor in central nervous system, which has strong invasion, poor prognosis and short survival time. At present, the main treatment strategy of glioblastoma is surgical excision, supplemented by radiotherapy and chemotherapy. However, due to incomplete resection and high recurrence rate, it is urgent to find novel therapeutic method for glioblastoma. Photodynamic therapy, as a promising non-surgical treatment, provides a new strategy for postoperative adjuvant therapy of glioblastoma. This review summarizes the mechanism and clinical application of photodynamic therapy mediated by various photosensitizers in glioblastoma, in order to provide help for the treatment of glioblastoma.

Chinese Expert's Perspectives on Andrological Diseases Responding Specifically to Traditional Chinese Medicine / 中国实验方剂学杂志

In recent years， the incidence rate of andrological diseases has shown a significant growth trend. Considering the unavailability of a perfect theoretical system for andrology in traditional Chinese medicine （TCM） and the complex pathogenesis despite of the limited types of andrological diseases， it is necessary to improve the clinical efficacy of andrological diseases so as to satisfy the needs of patients. Therefore， the China Association of Chinese Medicine （CACM） organized the andrologists of TCM and western medicine and the outstanding young clinicians to discuss the andrological diseases responding specifically to TCM or integrated TCM and western medicine， such as chronic prostatitis， male infertility， benign prostatic hyperplasia， erectile dysfunction， and premature ejaculation， determine their diagnostic criteria in western medicine， and standardize the specifications for TCM diagnosis and treatment based on syndrome differentiation， thus formulating recognized and integrated diagnosis and treatment protocols. Apart from proposing suggestions on the treatment of such andrological diseases with TCM and western medicine， the experts have also figured out the andrological diseases responding specifically to TCM， the optimal intervention time of TCM and western medicine， and the suitable measures including surgery. The resulting consensus helps to better guide the formulation of accurate， personalized， and optimized treatment plans in clinical practice and improve the diagnosis and treatment effects of andrological diseases by giving full play to the advantages of TCM， which will in turn contribute to further innovation and development of TCM.

Tapping at acupoints along meridian combined with thunder-fire moxibustion for upper-limb hemiplegia after stroke / 中国针灸

OBJECTIVE@#To observe the effect of tapping at acupoints along meridian combined with thunder-fire moxibustion on upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke.@*METHODS@#A total of 140 patients with upper-limb hemiplegia after stroke were randomly divided into a combination group (35 cases, 2 cases dropped off), an acupoint-tapping group (35 cases), a moxibustion group (35 cases, 2 cases dropped off) and a routine group (35 cases). The patients in the routine group were only treated with routine treatment and nursing. On the basis of the treatment in the routine group, the patients in the acupoint-tapping group were treated with tapping along the large intestine meridian of hand @*RESULTS@#Compared before treatment, body mass indexs of shoulder abduction, elbow extension, wrist flexion as well as BI scores in the four groups were significantly increased after treatment (@*CONCLUSION@#Tapping at acupoints along meridian combined with thunder-fire moxibustion could effectively improve the upper-limb muscle strength and activities of daily living in patients with upper-limb hemiplegia after stroke, and its effect is superior to simple tapping at acupoints along meridian or thunder-fire moxibustion.

Suprapubic lipectomy with a "Ω" incision for buried penis in obese adult men / 中华男科学杂志

Objective@#To investigate the application of suprapubic lipectomy with a "Ω" incision to removal of the prepubic fat pad for the management of buried penis in obese adult patients.@*METHODS@#We retrospectively analyzed the clinical data on 20 obese adult patients with buried penis treated by suprapubic lipectomy via a "Ω" incision between August 2016 and September 2019.@*RESULTS@#The operations were successfully completed in all the cases, with a mean operation time of 3.7 ± 0.6 hours and an average hospital stay of 8.3 ± 3.3 days. There were no such severe surgery-related complications as hematoma, urethral injury, or fat embolism in any of the cases. Fat liquefaction-related superficial wound infection developed in 1 patient postoperatively, which was cured by combined topical and systemic antibiotic therapy. A 3-month follow-up showed a 95% satisfaction of the patients with the postoperative appearance of the penis and suprapubic incision, but no complications such as ED, abnormal penile sensation, or penile retraction.@*CONCLUSIONS@#Suprapubic lipectomy with a "Ω" incision to remove the prepubic fat pad is an effective surgical approach to the management of buried penis in obese adult males, which is an anatomy-based surgical correction and has the advantages of slight injury, rapid recovery and few complications./.

Effect of Chaijie Yiganxian on Hepatic Fibrosis Induced by Thioacetamide in Rats / 中国实验方剂学杂志

Objective: To research the effect of traditional Chinese medicine compound Chaijie Yiganxian (CJYGX) on the hepatic fibrosis in rats and explore the mechanism. Method: Totally 60 SD rats were randomly divided into normal group, model group, positive group (Biejia Jianwan), and low, medium and high-dose CJYGX groups. Except for the normal group, the remaining five groups were involved in establishing the hepatic fibrosis model through the intraperitoneal injection of thioacetamide (TAA). Fourth weeks after modeling, the positive group was given Biejiajian pill (1 g·kg-1·d-1), and high, medium and low-dose CJYGX groups were given CJYGX(7.96, 3.98, 1.99 g·kg-1·d-1), respectively. The model group was given normal saline once a day for 5 weeks. 24 h after the last intragastric administration with chloral hydrate, the rats were anesthetized slightly. Serum and liver tissues were collected. The liver wet weight was weighed electronically, and the liver index was calculated. Liver function indexes[alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP)] and serum markers[laminin (LN), hyaluronidase (HA), Ⅳ collagen (CⅣ), procollagen Ⅲ (PCⅢ)] of hepatic fibrosis were detected by enzyme linked immunosorbent assay (ELISA). The degree of hepatic fibrosis by Masson stain, mRNA expressions of transforming growth factor-β1 (TGF-β1), Smad2, Smad3, Smad4, Smad7 were detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR), and protein expression levels of platelet derived growth factor (PDGF), TGF-β1 and α-smooth muscle actin (α-SMA) were detected by immunohistochemical or Western blot. Result: Compared with the blank group, the model group liver index was significantly increased; the contents of ALP, AST and ALT were significantly increased; the liver fibrosis indexes LN, HA, Ⅳ-C, PCⅢ and HYP were significantly increased; the degree of liver fibrosis was significantly increased in Masson tissue; the mRNA expressions of TGF-β1, Smad2, Smad3, Smad4 were significantly increased; and the Smad7 mRNA expression was significantly decreased. The protein expressions of TGF-β1, PDGF and α-SMA increased significantly (Pβ1, Smad2, Smad3, Smad4 and up-regulate mRNA expression of Smad7.Immunohistochemical and Western blot analysis show that, compared with model group, CJYGX could significantly reduce the protein expressions of TGF-β1, PDGF and α-SMA (PPConclusion: Traditional Chinese medicine compound CJYGX may protect TAA-induced hepatic fibrosis injury by interfering with TGF-β1/Smad signaling pathway.

Discussion of development and validation of dissolution methods for solid oral dosage forms / 药学学报

It is generally assumed that study of in vitro dissolution can reveal the in vivo behavior and bioavailability of a drug. The dissolution test indisputably plays a vital role in the research and development of pharmaceutical preparations as well as routine quality control of approved drugs. In order to develop an ideal dissolution method, the physicochemical properties of drug and the characteristics of its dosage form should be considered, and a proper dissolution condition be established to simulate the in vivo dissolution behavior of drugs. The new dissolution method should have the required characteristics of accuracy and durability, but also could distinguish pharmaceutic preparations with different quality. In recent years, there have been more and more reports on the establishment and verification of dissolution methods for oral solid dosage forms. However, there is very few review articles on the topic. According to the latest guidelines by domestic and foreign drug organizations, this review paper is prepared to summarize the most important skills and progress in the development of dissolution methods for oral solid preparations. The aim is to provide a reference for the development and validation of new dissolution methods.

Results of thin-layer cytology and biopsy and the risk factors for residual and/or recurrence after loop elec-trosurgical excision procedure for cervical intraepithelial neoplastic lesions / 医学研究生学报

Objective The loop electrosurgical excision procedure (LEEP) is a major option for the treatment of cervical in-traepithelial neoplastic (CIN) lesions,but reports are rarely seen on the consistency of the result of post-LEEP pathology with that of preoperative biopsy as well as on the postoperative pathological upgrading of related factors. This study analyzes the consistency of the result of preoperative biopsy with that of post-LEEP pathology for CIN lesions and the risk factors for residual and/or recurrence after LEEP. Methods A retrospective study was conducted on 1 089 patients with CIN lesions treated by LEEP in our hospital from May 2014 to A-pril 2017. All the patients underwent liquid-based thin-layer cytology (TCT) and vaginoscopic biopsy preoperatively,followed by analysis of the results of TCT,the consistency of the result of preoperative bi-opsy with that of post-LEEP pathology,and the risk factors for residu- al and/or recurrence after LEEP. Results Preoperative biopsy showed 447 cases of low-grade squamous intraepithelial lesion (LSIL),among which TCT revealed 85 cases negative for intraepithelial lesion and malignancy (NILM),with a false negative rate of LSIL of 19.0%. Of the 645 cases of high-grade squamous intraepithelial lesion (HSIL) revealed by preoperative biopsy,TCT manifes-ted 95 cases of NILM,with a false negative rate of HSIL of 14.7%,which was significantly lower than that of LSIL (P<0.05). Preop-erative biopsy showed 447 cases of LSIL,among which post-LEEP pathology manifested 316 cases of LSIL (70.69%) and 51 cases of HSIL (11.4%). Of the 635 cases of HSIL revealed by preoperative biopsy,post-LEEP pathology exhibited 4 cases (0.63%) of inva-sive cervical cancer (ICC). Multivariate analysis showed the risk factors for pathological upgrading after LEEP were sexual partners >2 (OR=0.139,95% CI: 0.034-0.561) and LSIL in TCT (OR=0.111,95% CI: 0.040-0.310) (P<0.05) and those for postopera-tive recurrence included positive incision margin (OR=2.970,95% CI: 1.010-8.733) and persistent human papilloma virus (HPV) infection (OR=5.446,95% CI: 3.109-9.540). Preoperative HPV16 infection was correlated with lesion residual and/or recurrence after LEEP (P<0.05). Conclusion LEEP can significantly improve the diagnosis rate of HSIL in low-grade CIN patients with high risk factors. The risk factors for lesion residual and/or recurrence after LEEP include HPV16 infection,lesion involvement of the inci-sion margin,and persistent HPV infection.

Forecast on the Flowing of Medical Direct Expenses on Patients' Distribution in China from 2016 to 2020 / 中国卫生经济

Objective:To forecast the reduce of medical direct expenses of China from 2016 to 2020,under the circumstances that some outpatients and inpatients of tertiary hospitals and secondary hospitals could be distributed to primary medical institutions.Methods:According to the number of outpatients,number of inpatients,medical expenses of outpatients per visit,and medical expenses of inpatients per visit in the first grade,second grade and third grade public hospitals from 2006 to 2015,the corresponding visit numbers and costs from 2016 to 2020 were forecasted based on liner regression model.The percentages of transferable patients out of all patients in different levels of institutions could be equal to 10％,20％ and 30％.The direct medical expense could be saved after the distribution were calculated.Results:If the trend of health service utilization from 2016 to 2020 were equal to the sample,the third grade hospitals would keep the fast increasing of outpatient expenses and patients.8％,16％ and 24％ of the total expenses would be saved if 10％,20％ and 30％ patients in third and second were led to the second and first grade medical institutions.Conclusion:It needed to slowdown the increasing trend of medical expenses,lead patients visit hospitals reasonably,strengthen the construction capacity of second grade medical and health institutions,meanwhile,the medical and health service system construction should adjust the distribution ratio.

Forecast on the Flowing of Medical Direct Expenses on Patients' Distribution in China from 2016 to 2020 / 中国卫生经济

Objective:To forecast the reduce of medical direct expenses of China from 2016 to 2020,under the circumstances that some outpatients and inpatients of tertiary hospitals and secondary hospitals could be distributed to primary medical institutions.Methods:According to the number of outpatients,number of inpatients,medical expenses of outpatients per visit,and medical expenses of inpatients per visit in the first grade,second grade and third grade public hospitals from 2006 to 2015,the corresponding visit numbers and costs from 2016 to 2020 were forecasted based on liner regression model.The percentages of transferable patients out of all patients in different levels of institutions could be equal to 10％,20％ and 30％.The direct medical expense could be saved after the distribution were calculated.Results:If the trend of health service utilization from 2016 to 2020 were equal to the sample,the third grade hospitals would keep the fast increasing of outpatient expenses and patients.8％,16％ and 24％ of the total expenses would be saved if 10％,20％ and 30％ patients in third and second were led to the second and first grade medical institutions.Conclusion:It needed to slowdown the increasing trend of medical expenses,lead patients visit hospitals reasonably,strengthen the construction capacity of second grade medical and health institutions,meanwhile,the medical and health service system construction should adjust the distribution ratio.

Effects of different medications with tadalafil on erectile dysfunction in males with primary sexual failure / 中华男科学杂志

Objective@#To evaluate the effects of three different medications with tadalafil on erectile dysfunction (ED) in young men with primary sexual failure.@*METHODS@#This study included 76 male ED patients aged 21－35 years who had primary sexual failure but normal nocturnal penile tumescence and rigidity and failed to respond to psychotherapy. We randomly assigned them to receive oral tadalafil once daily, on demand, or once-daily + on-demand. After 2－3 months of treatment, we evaluated the effects based on the scores of the patients in the five domains of the International Index of Erectile Function (IIEF-5).@*RESULTS@#After medication, all the patients showed significantly increased scores in the four domains of IIEF-5, namely, erectile function, orgasmic function, intercourse satisfaction, and overall satisfaction. The on-demand group achieved even higher scores in erectile and orgasmic functions but a lower score in sexual desire than the once-daily group. However, the patients in the once-daily + on-demand group exhibited more significant improvement than those in the other two in all the five domains.@*CONCLUSIONS@#Once-daily + on-demand medication with tadalafil can significantly enhance the therapeutic effect on psychogenic ED in young men with primary sexual failure.

Study on Policies of Non-public Hospitals Based on Content Analysis Method / 中国医院管理

To encourage the development of non-public hospitals is an important content and direction of the Chinese healthcare reform.In the study,policies of non-public hospitals are systematically collected and classified,stages and common key words analysis are developed,policies text is compared by using content analysis method,and the policy recommendations are finally put forward.

Correlations between Vessel Changes and the Histopathologic Subtypes of Lung Adenocarcinoma with Pure Ground-glass Nodule on Computed Tomography / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the correlations between vessel changes and the histopathologic subtypes of lung adenocarcinoma with pure ground-glass nodule (pGGN) on computed tomography (CT).</p><p><b>METHODS</b>Totally 107 patients (116 lesions) with lung adenocarcinomas with pGGN who had undergone curative resection were included. Vessel changes included vascular convergence and/or vessel dilation or distortion within the pGGN. According to the vessel appearances within the pGGN, all patients were categorized into two groups: no change group and change group. Pearson chi-square test was used to analyze the relationships between vessel changes and histopathologic subtypes. Mann-Whitney rank test and t-test were used to identify the relationship of vessels changes with pGGN density and diameter.</p><p><b>RESULTS</b>Among these 116 pGGNs, there were 21 without vessel changes and 4 with vessel changes in 25 preinvasive lesions; 14 without vessel changes and 15 with vessel changes in 29 minimally invasive adenocacinomas; 16 without vessel changes and 46 with vessel changes in 62 invasive lung adenocarcinomas. There were statistically significant differences of vessel changes (P=0.000) among histopathologic subtypes. The lesion diameter was significantly different between these two groups (P=0.000), while the lesion density showed no significant difference (P=0.826).</p><p><b>CONCLUSION</b>Vessel changes may indicate the invasiveness of lung adenocarcinoma with pGGNs and are related with the lesion diameter.</p>

Value of Baseline Clinical and CT Characteristics for Predicting the Progression of Persistent Pure Ground-glass Nodule 10 mm or Less in Diameter / 中国医学科学院学报

Objective To explore the risk factors of the progression of persistent pure ground-glass nodule (pGGN) and make the risk stratification for pGGN 10 mm or less in diameter. Methods From June 2008 to April 2015,100 patients (108 lesions) with persistent pGGN≤10 mm in diameter were included in this study. Patients were followed up at least 1 year using thin-section computed tomography (CT). Patients' baseline clinical data and CT characteristics of pGGN were compared between progression group (size increased or/and solid component appeared) and non-progression group. Cox regression analysis was used to assess the relationship between clinical data,CT characteristics of pGGN,and lesion progression. The risk indices of lesion progression were calculated according to the results of Cox regression analysis and the relative factors of lung adenocarcinoma in previous studies. Logistic regression analysis was used to assess the relationship between risk indices and lesion progression. The optimal cutoff value was decided on receiver operating characteristic curve of risk indices and verified for predicting lesion progression. Results Fifteen of 108 lesions showed progression. The mean follow-up duration was (1016.36±486.00) days. There were statistically significant differences of lesion size,air bronchogram,and vessel changes between progression group and non-progression group (P=0.040,P=0.003,P=0.030,respectively).Lesion density (CT value≥-542.5 HU) and air bronchogram were the risk factors of lesion progression (P=0.003,P=0.021,respectively). The optimal cutoff value of total risk indices on predicting lesion progression was 4.25,with the sensitivity of 46.7%,specificity of 89.2%,and consistency of 83.3%. Conclusions CT value ≥-542.5 HU of pGGN and air bronchogram within lesion may predict lesion progression in persistent pGGN 10 mm or less in diameter. A risk index of less than 4.25 often suggests small probability of disease progression and thus a longer follow-up interval is recommended.

Comparison Study of Polysomnographic Features in Multiple System Atrophy-cerebellar Types Combined with and without Rapid Eye Movement Sleep Behavior Disorder / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The brain stem is found to be impaired in multiple system atrophy-cerebellar types (MSA-C). Rapid eye movement (REM) sleep behavior disorder (RBD) is reported as a marker of progressive brain stem dysfunction. Few systematic studies about the sleep disturbances in MSA-C patients combined with or without RBD were reported. This study aimed to explore the polysomnographic (PSG) features of sleep disturbances between MSA-C patients with and without RBD.</p><p><b>METHODS</b>Totally, 46 MSA-C patients (23 with RBD, and 23 without RBD) were enrolled in this study. All patients underwent a structured interview for their demographic data, history of sleep pattern, and movement disorders; and then, overnight video-PSG was performed in each patient. All the records were evaluated by specialists at the Sleep Medicine Clinic for RBD and the Movement Disorder Clinic for MSA-C. The Student's t-test, Mann-Whitney U-test for continuous variables, and the Chi-square test for categorical variables were used in this study.</p><p><b>RESULTS</b>MSA-C patients with RBD had younger visiting age (52.6 ± 7.4 vs. 56.7 ± 6.0 years, P = 0.046) and shorter duration of the disease (12.0 [12.0, 24.0] vs. 24.0 [14.0, 36.0] months, P = 0.009) than MSA-C patients without RBD. MSA-C with RBD had shorter REM sleep latency (111.7 ± 48.2 vs. 157.0 ± 68.8 min, P = 0.042), higher percentage of REM sleep (14.9% ±4.0% vs. 10.0% ± 3.2%, P = 0.019), and lower Stage I (9.5% ±7.2% vs. 15.9% ±8.0%, P = 0.027) than MSA-C without RBD. Moreover, MSA-C patients with RBD had more decreased sleep efficiency (52.4% ±12.6% vs. 65.8% ±15.9%, P = 0.029) than that without RBD.</p><p><b>CONCLUSIONS</b>In addition to the RBD, MSA-C patients with RBD had other more severe sleep disturbances than those without RBD. The sleep disorders of MSA patients might be associated with the progress of the disease.</p>

Anti-A/B Antibody Titers in Group O Healthy Donors in Hainan Province Area / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To detect the IgM anti-A (B) and IgG anti-A (B) antibody titers of group O healthy donors in Hainan province area, to understand the distribution of O-type blood donor IgM and IgG antibody titers and to analyze the relationship between antibody titers, so as to provide experimental evidences for the safety and feasibility of urgent transfusion of uncrossmatched group O RBCs.</p><p><b>METHODS</b>Group O whole blood sample was collected from 80 volunteers blood donors. IgM antibody titrations was performed using the immediate spin (IS) tube, and IgG antibody titration were performed using the column agglutination technique with anti-human globulin (AHG). Using two-way ANOVA, paired t-test and correlation analysis, the different types of antibodies were compared.</p><p><b>RESULTS</b>The IgM antibody titers distributed in 4-1 024, IgG antibody titer distributed in 2-2 048. Anti-A antibody titers of IgG were significantly higher than that of IgM anti-B, IgG anti-B and IgM anti-A titers (P < 0.05). There was a positive correlation bewteen IgM anti-A and anti-B, IgM anti-B and IgG anti-B, IgG anti-A and anti-B (P < 0.05).</p><p><b>CONCLUSION</b>Group O blood donors have high antibody titers in Hainan province area, type O RBC suspensions should be first screened through screening the anti-A titer of IgG, so that can significantly improve the pass rate of O-type universal blood and reduce testing costs.</p>

Correlations between pathologic subtypes/immunohistochemical implication and CT characteristics of lung adenocarcinoma ≤ 1 cm with ground-glass opacity / 中国医学科学院学报

<p><b>OBJECTIVE</b>To discuss the correlation of pathologic subtypes and immunohistochemical implication with CT features of lung adenocarcinoma 1 cm or less in diameter with focal ground-glass opacity (fGGO).</p><p><b>METHODS</b>CT appearances of 59 patients who underwent curative resection of lung adenocarcinoma ≤ 1 cm with fGGO were analyzed in terms of lesion location, size, density, shape (round, oval, polygonal, irregular), margin (smooth, lobular, spiculated, lobular and spiculated), bubble-like sign, air bronchogram, pleural tag, and tumor-lung interface. Histopathologic subtypes were classified according to International Association for the Study of Lung Cancer/ American Thoracic Society/European Respiratory Society classification of lung adenocarcinoma. Common molecular markers in immunohistochemical study included human epidermal growth factor receptor (HER)-1,HER-2,Ki-67, vascular endothelial growth factor (VEGF) and DNA topoisomerase 2Α.Patients' age and lesions' size and density were compared with pathologic subtypes using analysis of variance or nonparametric Wilcoxon tests. Patients' gender, lesion location, shape and margin, bubble-like sign, air bronchogram, pleural tag, and tumor-lung interface were compared with histopathologic subtypes and immunohistochemical implication using ψ² test or Fisher's exact test.</p><p><b>RESULTS</b>The patients' gender, age, lesion location, shape, air bronchogram, pleural tag, and tumor-lung interface were not significantly different among different histopathologic subtypes (P=0.194, 0.126, 0.609, 0.678, 0.091, 0.374, and 0.339, respectively), whereas the lesion size,density,bubble-like sign, and margin showed significant differences (P=0.028, 0.002, 0.003, 0.046, respectively). The expression of Ki-67 significantly differed among nodules with different shapes(P=0.015). Statistically significant difference also existed between tumor-lung interface and HER-1 expression (P=0.019) and between bubble sign and HER-2 expression (P=0.049).</p><p><b>CONCLUSIONS</b>Of lung adenocarcinoma ≤ 1 cm with fGGO,bubble-like sign occurs more frequently in invasive pulmonary adenocarcinoma and less frequently in atypical adenomatous hyperplasia. In addition, preinvasive lesions (atypical adenomatous hyperplasia and adenocarcinoma in situ) more frequently demonstrates smooth margin,while invasive lesions (minimally invasive adenocarcinoma and invasive pulmonary adenocarcinoma) more frequently demonstrates lobular and spiculated margin. Some CT features are associated with immunohistochemical implication of lung adenocarcinoma ≤ 1 cm with fGGO.</p>

Efficacy observation on navel-warming therapy combined with western medication for yang-deficiency tympanites / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of navel-warming therapy on clinical efficacy in patients with yang-deficiency tympanites based on regular treatment of western medication.</p><p><b>METHODS</b>One hundred and twenty cases of yang-deficiency tympanites were randomly divided into a navel-warming therapy group and a western medication group, sixty cases in each one. The regular treatment of western medicine was applied in the western medication group, including oral administration of antiviral drug and diuretics as well as intravenous drip of hepatic protector. Based on western medicine treatment, the navel-warming therapy was applied in the navel-warming group. A medical cake was laid on Shenque (CV 8), and then a medical cylinder was placed above the medical cake and ignited. The treatment was given once daily. One month was considered as a treatment session in both groups and totally one session was required. The TCM symptom score, B-ultrasound ascites and temporary use of diuretics before and after treatment were observed in both groups; also the efficacy was evaluated.</p><p><b>RESULTS</b>The total effective rate was 81.7% (49/60) in the navel-warming therapy group, which was superior to 56.7% (34/60) in the western medication group (P < 0.05). After the treatment, the TCM symptom score and ascites were improved in both groups (all P < 0.05), which was more significant in the navel-warming therapy group (all P < 0.05). The temporary use of diuretics was statistically different between the two groups (P < 0.05), indicating the navel-warming therapy group could obviously reduce or stop the use of diuretics.</p><p><b>CONCLUSION</b>Based on regular treatment of western medication, the navel-warming therapy could significantly improve therapeutic efficacy, effectively relieve clinical symptoms and ease ascites.</p>

Cardioprotective effect of erythropoietin on sepsis-induced myocardial injury in rats / 世界急诊医学杂志（英文）

BACKGROUND:Sepsis-induced myocardial injury is one of the major predictors of morbidity and mortality of sepsis. The cytoprotective function of erythropoietin (EPO) has been discovered and extensively studied. However, the cardioprotective effects of EPO on sepsis-induced myocardial injury in the rat sepsis model has not been reported.METHODS:The rat models of sepsis were produced by cecal ligation and perforation (CLP) surgery. Rats were randomly (random number) assigned to one of three groups (n=8 for each group):sham group, CLP group and EPO group (1000 IU/kg erythropoietin). Arterial blood was withdrawn at 3, 6, 12, and 24 hours after CLP. cTnI, BNP, CK-MB, LDH, AST, TNF-α, IL-6, IL-10, and CRP were tested by the ELISA assay. Changes of hemodynamic parameters were recorded at 3, 6, 12, 24 hours after the surgery. Histological diagnosis was made by hematoxylin and eosin. Flow cytometry was performed to examine cell apoptosis, myocardium mitochondrial inner membrane potential, and NF-κB (p65). Survival rate at 7 days after CLP was recorded.RESULTS:In the CLP group, myocardial enzyme index and inflammatory index increased at 3, 6, 12 and 24 hours after CLP compared with the sham group, and EPO significantly blocked the increase. Compared with the CLP group, EPO significantly improved LVSP, LV +dp/dtmax, LV -dp/dtmin, and decreased LVEDP at different time. EPO blocked the reduction of mitochondrial transmembrane potential, suppressed the cardiomyocyte apoptosis, inhibited the activation of NF-κB, and reduced the production of proinflmmatory cytokines. No difference in the survival rate at 7 days was observed between the CLP group and the EPO group.CONCLUSION:Exogenous EPO has cardioprotective effects on sepsis-induced myocardial injury.

Serological characteristics and transfusion efficacy evaluation in 61 cases of autoimmune hemolytic anemia / 中国实验血液学杂志

This study was aimed to analyze the serological characteristics, efficacy and safety of incompatible RBC transfusion in patients with autoimmune hemolytic anemia (AIHA). The patients with idiopathic or secondary AIHA were analyzed retrospectively, then the serological characteristics and the incidence of adverse transfusion reactions were investigated, and the efficacy and safety of incompatible RBC transfusion were evaluated according to the different autoantibody type and infused different RBC components. The results showed that out of 61 cases of AIHA, 21 cases were idiopathic, and 40 cases were secondary. 8 cases (13.1%) had IgM cold autoantibody, 50 cases (82.0%) had IgG warm autoantibody, and 3 cases (4.9%) had IgM and IgG autoantibodies simultaneously. There were 18 cases (29.5%) combined with alloantibodies. After the exclusion of alloantibodies interference, 113 incompatible RBC transfusions were performed for 36 patients with AIHA, total efficiency rate, total partial efficiency rate and total inefficiency rate were 56.6%, 15.1% and 28.3%, respectively. Incompatible RBC transfusions were divided into non-washed RBC group and washed RBC group. The efficiency rate, partial efficiency rate and inefficiency rate in non-washed RBC group were 57.6%, 13.0% and 29.4%, respectively. The efficiency rate, partial efficiency rate and inefficiency rate in washed RBC group were 53.6%, 21.4% and 25.0%, respectively. There was no significant difference of transfusion efficacy (P > 0.05) in two groups. Incompatible RBC transfusions were also divided into IgM cold autoantibody group and IgG warm autoantibody group. The efficiency rate, partial efficiency rate and inefficiency rate in IgM cold autoantibody group were 46.2%, 30.8% and 29.4%, respectively. The efficiency rate, partial efficiency rate and inefficiency rate in IgG warm autoantibody group were 56.7%, 13.4% and 29.9%, respectively. There was no significant difference of transfusion efficacy (P > 0.05 ) in two groups. Hemolytic transfusion reaction was not observed in all incompatible RBC transfusions. It is concluded that the same ABO type of non-washed RBC transfusion and O type washed RBC transfusion are all relatively safe for the AIHA patients with severe anemia after the exclusion of alloantibodies interference. There is no significant difference of transfusion efficacy in two groups. The same ABO type of non-washed RBC transfusion is more convenient and efficient than washed RBC transfusion, and excessive use of type O RBCs can also be avoided.