Mechanisms of Chinese Medicine in Gastroesophageal Reflux Disease Treatment: Data Mining and Systematic Pharmacology Study / 中国结合医学杂志

OBJECTIVE@#To identify specific Chinese medicines (CMs) that may benefit patients with gastroesophageal reflux disease (GERD), and explore the action mechanism.@*METHODS@#Domestic and foreign literature on the treatment of GERD with CMs was searched and selected from China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and PubMed from October 1, 2011 to October 1, 2021. Data from all eligible articles were extracted to establish the database of CMs for GERD. Apriori algorithm of data mining techniques was used to analyze the rules of herbs selection and core Chinese medicine formulas were identified. A system pharmacology approach was used to explore the action mechanism of these medicines.@*RESULTS@#A total of 278 prescriptions for GERD were analyzed, including 192 CMs. Results of Apriori algorithm indicated that Evodiae Fructus and Coptidis Rhizoma were the highest confidence combination. A total of 32 active ingredients and 66 targets were screened for the treatment of GERD. Enrichment analysis showed that the mechanisms of action mainly involved pathways in cancer, fluid shear stress and atherosclerosis, advanced glycation end product (AGE), the receptor for AGE signaling pathway in diabetic complications, bladder cancer, and rheumatoid arthritis.@*CONCLUSION@#Evodiae Fructus and Coptidis Rhizoma are the core drugs in the treatment of GERD and the potential mechanism of action of these medicines includes potential target and pathways.

Transcriptomic analysis of the ΔPaLoc mutant of Clostridioides difficile and verification of its toxicity / 中华预防医学杂志

Objective: Comparative analyses of wild-type Clostridioides difficile 630 (Cd630) strain and pathogenicity locus (PaLoc) knockout mutant (ΔPaLoc) by using RNA-seq technology. Analysis of differential expression of Cd630 wild-type strain and ΔPaLoc mutant strain and measurement of its cellular virulence changes. Lay the foundation for the construction of an toxin-attenuated vaccine strain against Clostridioides difficile. Methods: Analysis of Cd630 and ΔPaLoc mutant strains using high-throughput sequencing (RNA-seq). Clustering differentially expressed genes and screening differentially expressed genes by DESeq software. Further analysis of differential genes using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment. Finally, cytotoxicity assays of ΔPaLoc and Cd630 strains were performed in the African monkey kidney epithelial cell (Vero) and the human colonic cell (Caco-2) lines. Results: The transcriptome data showed that the ΔPaLoc mutant toxin genes tcdA and tcdB were not transcribed. Compared to the wild-type strain, CD630_36010, CD630_020910,CD630_02080 and cel genes upregulated 17.92,11.40,8.93 and 7.55 fold, respectively. Whereas the hom2 (high serine dehydrogenase), the CD630_15810 (spore-forming protein), CD630_23230 (zinc-binding dehydrogenase) and CD630_23240 (galactitol 1-phosphate 5-dehydrogenase) genes were down-regulated by 0.06, 0.075, 0.133 and 0.183 fold, respectively. The GO and KEGG enrichment analyses showed that the differentially transcribed genes in ΔPaLoc were enriched in the density-sensing system, ABC transport system, two-component system, phosphotransferase (PTS) system, and sugar metabolism pathway, as well as vancomycin resistance-related pathways. Cytotoxicity assays showed that the ΔPaLoc mutant strain lost its virulence to Vero and Caco-2 cells compared to the wild-type Cd630 strain. Conclusion: Transcriptional sequencing analysis of the Cd630 and ΔPaLoc mutant strains showed that the toxin genes were not transcribed. Those other differential genes could provide a reference for further studies on the physiological and biochemical properties of the ΔPaLoc mutant strain. Cytotoxicity assays confirmed that the ΔPaLoc mutant lost virulence to Vero and Caco-2 cells, thus laying the foundation for constructing an toxin-attenuated vaccine strain against C. difficile.

Epidemiological and etiological characteristics of Vibrio parahaemolyticus strains causing foodborne disease outbreaks in Guangdong Province from 2017 to 2020 / 中华预防医学杂志

Objective: To study the epidemiological and pathogenic characteristics of Vibrio parahaemolyticus isolated from outbreaks cases in Guangdong Province, 2017-2020. Methods: Epidemiological characteristics of 87 outbreak events caused by Vibrio parahaemolyticus were analyzed. Strains were serotyped, and then analyzed by pulsed-field gel electrophoresis (PFGE). Results: The food-borne disease outbreak caused by Vibrio parahaemolyticus was found in 16 cities. 44.8% (39/87) and 37.9% (33/87) of the outbreaks occurred in hotels, restaurants and school canteens, respectively. Improper food processing and storage (40.2%, 35/87) and cross contamination caused by indiscriminate raw and cooked food (25.3%, 22/87) were the main causes of food-borne disease outbreaks of Vibrio parahaemolyticus. The main serotypes of patient derived strains were O3:K6 (87.5%) and O4:KUT (22.5%). The similarity value between O3:K6 type isolates was 65.5%-100.0%, and the PFGE pattern similarity value of O4:KUT type isolates was 66.5%-100.0%. Conclusion: Outbreaks caused by Vibrio parahaemolyticus are widely distributed in Guangdong province. It is necessary to strengthen the publicity and education on the correct handling of food in hotels, restaurants, schools, and unit canteens. O3:K6 and O4:KUT serotypes are the main serotypes of the outbreak. There is genetic diversity among the epidemic strains.

Identification and analysis of 2 Corynebacterium diphtheria strains in Guangdong Province / 中华预防医学杂志

Objective: To identify and analyze two strains of C. diphtheriae in Guangdong Province by combining whole genome sequencing with traditional detection methods. Methods: The C. diphtheriae was isolated from Guangzhou in 2010 and Zhuhai in 2020 respectively. Isolates were identified by API Coryne strips and MALDI-TOF-MS. Genomic DNA was sequenced by using Illumina. The assembly was performed for each strain using CLC software. J Species WS online tool was used for average nucleoside homology identification, then narKGHIJ and tox gene were detected by NCBI online analysis tool BLSATN. MEGA-X was used to build a wgSNP phylogenetic tree. Results: GD-Guangzhou-2010 was Belfanti and GD-Zuhai-2020 was Gravis. ANIb between GD-Guangzhou-2010 and C. belfantii was 99.61%. ANI between GD-Zhuhai-2020 and C. diphtheriae was 97.64%. BLASTN results showed that the nitrate reduction gene narKGHIJ and tox gene of GD-Guangzhou-2010 was negative, while GD-Zhuhai-2020 nitrate reduction gene narKGHIJ was positive. There were two obvious clades in wgSNP phylogenetic tree. The first clades included all Mitis and Gravis types strains as well as GD-Zhuhai-2020. The second clades contained all isolates of C.belfantii, C.diphtheriae subsp. lausannense and GD-guangzhou-2010. Conclusion: Two non-toxic C. diphtheriae strains are successfully isolated and identified. The phylogenetic tree suggests that GD-Guangzhou-2010 and GD-Zhuhai-2020 are located in two different evolutionary branches.

Reassessment of Echocardiography for Diagnosing Infectious Endocarditis / 中国循环杂志

Objective:To explore the value of echocardiography for diagnosing infectious endocarditis (IE).Methods:A total of 487 patients with cardiovascular implantable electronic devices (CIED) infection treated in our hospital from 2013-01 to 2015-06 were enrolled.Based on symptoms,blood culture and echocardiography,9 patients with suspected IE were further examined by 18F-FDG PET-CT to confirm their diagnosis and classification.Definitive therapy was conducted and the patients were followed-up for 1 year to confirm the diagnostic accuracy of echocardiography on CIED induced IE.Results:3 patients were preliminarily diagnosed for bacteremia since no vegetation was found by echocardiography,while IE was finally diagnosed by PET-CT.2 patients were preliminarily diagnosed for IE by echocardiography presented valvular vegetation,while PET-CT showed no evidence of vegetation;then one of them was diagnosed as bacteremia by positive blood culture and another was diagnosed as non-infection.4 patients were preliminarily diagnosed for IE by echocardiography indicated existing vegetation after CIED lead extraction,while PET-CT demonstrated no infection sign in heart chamber and the finally diagnosed was as "non-infectious fibrous residual tissue".According to final diagnosis,definitive therapies were performed to specific patients with at least 1 year follow-up study,no one had new and recurrent infection.Conclusion:Echocardiography had deficiency for diagnosing vegetation in heart chamber especially in suspicious IE patients after CIED lead extraction.It is necessary to make accurate diagnosis with other method for guiding appropriate therapy.

Suspected pathogen detection and epidemiological analysis of hand, foot and mouth disease in Minhang District of Shanghai from 2009 to 2016 / 复旦学报（医学版）

Objective To investigate the etiological agents of the outbreak of hand,foot and mouth disease (HFMD) in Minhang District of Shanghai from 2009 to 2016,and to provide evidence for the prevention and management policy of HFMD by collecting suspected HFMD samples for laboratory testing from HFMD sentinel hospitals,the Children's Hospitals of Fudan University and jurisdiction community health service centers.Methods Specimens including stools,throat swabs and anal swabs were collected from patients suspected of HFMD from surveillance hospitals,i.e.,Children's Hospital of Fudan University and jurisdiction community health service centers during 2009 and 2016.The specimens were detected by real-time RT-PCR with the five types of viruses including panenterovirus (EV),enterovirus 71 (EV71),Coxsackie virus A16 (CVA16),Coxsackie virus A6 (CVA6) and Coxsackie virus A10 (CVA10).The distribution characteristics of pathogens were analyzed.Results During 2009 and 2016 we collected 3 744 cases of HFMD,the positive detection rate of pan-enterovirus were 84.83％ (3 176 cases),including EV71 (64.45％) and CVA16 (15.77％),then were CVA6 (9.23％) and other EV (8.78％),and CVA10 was only 0.76％.The major etiological agent was EV71.The advantage of different years and different season strain presented dynamic change,mainly EV71 and CVA16 co-popular in 2009,mainly EV71 epidemic from 2010 to 2011,EV71 and CVA16 were co-popular again in 2012,and the priority was EV71,then EV71 and other EV were co-popular in 2013.After 2014,CVA6 gradually increased,mainly CVA6 was popular 2015 and 2016,especially in 2016,the proportion of CVA6 ranged as high as 40.55％.CVA10 showed sporadic distribution trend in very low proportion.From the difference of age and gender in HFMD cases,the males were more than the females (1.68 ∶ 1),and the incidence was the highest in children of 1-3 years old.The peak of incidence occured in April to July,then in September to November.Conclusions HFMD onset seasons mainly were summer and fall-and-winter in bimodal popular models.It happens in children under 5 years of age.The incidence was higher in male than in female.The advantage of different years and different season strains present dynamic change,and the prevalence has obvious age and season limit.

Pathogenic surveillance of viral diarrhea in Minhang District of Shanghai from 2014 to 2016 / 复旦学报（医学版）

Objective To investigate the epidemiological and pathogenic characteristics of viral diarrhea in Minhang District of Shanghai.Methods Random sampling on diarrhea was conducted in intestinal outpatient departments of 2 sentinel hospitals according to a certain sampling interval in Minhang District from 2014 to 2016.Real-time PCR was used to detect rotavirus (RV),norovirus (NV),adenovirus (AD),astrovirus (AstV) and sapovirus (SaV) in fecal samples.Results A total of 11 243 cases of diarrhea were monitored in 2 sentinel hospitals during 2014 and 2016,with 3 213,3 600 and 4 430 cases for each year,respectively.Out of 809 stool specimens,309 were tested positively,and the positive rate was 38.48％.All 5 pathogenic viruses were detected,mostly NV (207 cases,66.99％)followed by RV (77 cases,24.92％).Conclusions NV accounted for the majority of reported infection diarrhea cases in Minhang District of Shanghai from 2014 to 2016,with significant seasonal peaks.Tailored prevention and control measures should be carried out,particularly in risk seasons.

Influenza surveillance in Minhang District of Shanghai from 2013 to 2016 / 复旦学报（医学版）

Objective To understand the epidemic characteristics of influenza in Minhang District of Shanghai during 2013-2016,so as to provide scientific basis for the prevention and control of influenza.Methods Surveillance data of influenza like illness (ILI) cases from the national influenza network and data of pathogen detection during 2013-2016 in Minhang District were selected to analyze the epidemic characteristics of influenza.Results The number of influenza like illness (ILI) was 37 738 from 2013 to 2016,which accounted for 0.90％ of the outpatients in monthly average.Meanwhile,4 094 samples were collected,among which 857 samples were virus positive.The total isolation rate was 20.93％.In 2013,the dominant strain was mainly seasonal influenza A (H3N2).Dominant strains of 2014 were influenza B (Yamagata) and seasonal influenza A (H3N2).In 2015,dominant strain was seasonal influenza A (H3N2) of summer peak,but the dominant strains of winter-spring peak were new type influenza H1N1 (H1N1 pdm09) and influenza B (Victoria) from December 2015 to April 2016.The dominant strain of winter peak in 2016 was seasonal influenza A (H3N2) popular.Spearman correlation analysis showed positive rate between ILI visiting rate (ILI％) and influenza virus (rs =0.460,P＜0.05).Conclusions The epidemic peaks of of influenza were winter-spring and summer in Minhang District,advantages strains were interaction pandemic with certain regulation.The characteristics of ILI visiting rate was coincident with influenza virus activity.

Reassessment of Echocardiography for Diagnosing Infectious Endocarditis / 中国循环杂志

Objective:To explore the value of echocardiography for diagnosing infectious endocarditis (IE).Methods:A total of 487 patients with cardiovascular implantable electronic devices (CIED) infection treated in our hospital from 2013-01 to 2015-06 were enrolled.Based on symptoms,blood culture and echocardiography,9 patients with suspected IE were further examined by 18F-FDG PET-CT to confirm their diagnosis and classification.Definitive therapy was conducted and the patients were followed-up for 1 year to confirm the diagnostic accuracy of echocardiography on CIED induced IE.Results:3 patients were preliminarily diagnosed for bacteremia since no vegetation was found by echocardiography,while IE was finally diagnosed by PET-CT.2 patients were preliminarily diagnosed for IE by echocardiography presented valvular vegetation,while PET-CT showed no evidence of vegetation;then one of them was diagnosed as bacteremia by positive blood culture and another was diagnosed as non-infection.4 patients were preliminarily diagnosed for IE by echocardiography indicated existing vegetation after CIED lead extraction,while PET-CT demonstrated no infection sign in heart chamber and the finally diagnosed was as "non-infectious fibrous residual tissue".According to final diagnosis,definitive therapies were performed to specific patients with at least 1 year follow-up study,no one had new and recurrent infection.Conclusion:Echocardiography had deficiency for diagnosing vegetation in heart chamber especially in suspicious IE patients after CIED lead extraction.It is necessary to make accurate diagnosis with other method for guiding appropriate therapy.

Suspected pathogen detection and epidemiological analysis of hand, foot and mouth disease in Minhang District of Shanghai from 2009 to 2016 / 复旦学报（医学版）

Objective To investigate the etiological agents of the outbreak of hand,foot and mouth disease (HFMD) in Minhang District of Shanghai from 2009 to 2016,and to provide evidence for the prevention and management policy of HFMD by collecting suspected HFMD samples for laboratory testing from HFMD sentinel hospitals,the Children's Hospitals of Fudan University and jurisdiction community health service centers.Methods Specimens including stools,throat swabs and anal swabs were collected from patients suspected of HFMD from surveillance hospitals,i.e.,Children's Hospital of Fudan University and jurisdiction community health service centers during 2009 and 2016.The specimens were detected by real-time RT-PCR with the five types of viruses including panenterovirus (EV),enterovirus 71 (EV71),Coxsackie virus A16 (CVA16),Coxsackie virus A6 (CVA6) and Coxsackie virus A10 (CVA10).The distribution characteristics of pathogens were analyzed.Results During 2009 and 2016 we collected 3 744 cases of HFMD,the positive detection rate of pan-enterovirus were 84.83％ (3 176 cases),including EV71 (64.45％) and CVA16 (15.77％),then were CVA6 (9.23％) and other EV (8.78％),and CVA10 was only 0.76％.The major etiological agent was EV71.The advantage of different years and different season strain presented dynamic change,mainly EV71 and CVA16 co-popular in 2009,mainly EV71 epidemic from 2010 to 2011,EV71 and CVA16 were co-popular again in 2012,and the priority was EV71,then EV71 and other EV were co-popular in 2013.After 2014,CVA6 gradually increased,mainly CVA6 was popular 2015 and 2016,especially in 2016,the proportion of CVA6 ranged as high as 40.55％.CVA10 showed sporadic distribution trend in very low proportion.From the difference of age and gender in HFMD cases,the males were more than the females (1.68 ∶ 1),and the incidence was the highest in children of 1-3 years old.The peak of incidence occured in April to July,then in September to November.Conclusions HFMD onset seasons mainly were summer and fall-and-winter in bimodal popular models.It happens in children under 5 years of age.The incidence was higher in male than in female.The advantage of different years and different season strains present dynamic change,and the prevalence has obvious age and season limit.

Pathogenic surveillance of viral diarrhea in Minhang District of Shanghai from 2014 to 2016 / 复旦学报（医学版）

Objective To investigate the epidemiological and pathogenic characteristics of viral diarrhea in Minhang District of Shanghai.Methods Random sampling on diarrhea was conducted in intestinal outpatient departments of 2 sentinel hospitals according to a certain sampling interval in Minhang District from 2014 to 2016.Real-time PCR was used to detect rotavirus (RV),norovirus (NV),adenovirus (AD),astrovirus (AstV) and sapovirus (SaV) in fecal samples.Results A total of 11 243 cases of diarrhea were monitored in 2 sentinel hospitals during 2014 and 2016,with 3 213,3 600 and 4 430 cases for each year,respectively.Out of 809 stool specimens,309 were tested positively,and the positive rate was 38.48％.All 5 pathogenic viruses were detected,mostly NV (207 cases,66.99％)followed by RV (77 cases,24.92％).Conclusions NV accounted for the majority of reported infection diarrhea cases in Minhang District of Shanghai from 2014 to 2016,with significant seasonal peaks.Tailored prevention and control measures should be carried out,particularly in risk seasons.

Influenza surveillance in Minhang District of Shanghai from 2013 to 2016 / 复旦学报（医学版）

Objective To understand the epidemic characteristics of influenza in Minhang District of Shanghai during 2013-2016,so as to provide scientific basis for the prevention and control of influenza.Methods Surveillance data of influenza like illness (ILI) cases from the national influenza network and data of pathogen detection during 2013-2016 in Minhang District were selected to analyze the epidemic characteristics of influenza.Results The number of influenza like illness (ILI) was 37 738 from 2013 to 2016,which accounted for 0.90％ of the outpatients in monthly average.Meanwhile,4 094 samples were collected,among which 857 samples were virus positive.The total isolation rate was 20.93％.In 2013,the dominant strain was mainly seasonal influenza A (H3N2).Dominant strains of 2014 were influenza B (Yamagata) and seasonal influenza A (H3N2).In 2015,dominant strain was seasonal influenza A (H3N2) of summer peak,but the dominant strains of winter-spring peak were new type influenza H1N1 (H1N1 pdm09) and influenza B (Victoria) from December 2015 to April 2016.The dominant strain of winter peak in 2016 was seasonal influenza A (H3N2) popular.Spearman correlation analysis showed positive rate between ILI visiting rate (ILI％) and influenza virus (rs =0.460,P＜0.05).Conclusions The epidemic peaks of of influenza were winter-spring and summer in Minhang District,advantages strains were interaction pandemic with certain regulation.The characteristics of ILI visiting rate was coincident with influenza virus activity.

Rapid identification for Mycobacterium fortuitum with RNA isothermal transcription-mediated amplification and real-time detection assay / 中国人兽共患病学报

The aim of the study is to establish and evaluate a RNA isothermal transcription-mediated amplification and realtime detection assay (RIARD-MF) for the identification of Mycobacterium fortuitum in clinical isolates.RNA probes and specific primers of reverse transcription and amplification for T7 promoter were designed based on the sequence of M.fortuitum 16S rRNA.The isothermal successive cycles of amplification were performed for real-time detection by using T7 RNA polymerase at 42 ℃.Five non-mycobacterium strains,20 Mycobacterium strains and 259 clinical strains were detected by the established assay to evaluate the specificity and sensitivity,and the results were compared with those of PCR sequencing.In the test of 5 non-mycobacterium strains and 20 Mycobacterium strains,only M.fortuitum was positive,and the remaining 24 strains of bacteria were negative,which was consistent with PCR gene sequencing.The sensitivity and specificity of RIARD-MF reached 60 CFU/mL and 100％.In the test of 259 strains of clinical isolates,5 strains were identified to be M.fortuitum,the remaining 254 strains were not identified to be M.Fortuitum,which was also consistent with PCR gene sequencing.Both the specificity and sensitivity reached up to 100％ in the detection of clinical isolates.It suggested that the RIAR-DMF established in this study is a specific,sensitive,accurate and rapid method for the identification of M.Fortuitum and it may be hopeful for rapid identification of M.fortuitum in clinical isolates.

Rapid identification for Mycobacterium fortuitum with RNA isothermal transcription-mediated amplification and real-time detection assay / 中国人兽共患病学报

The aim of the study is to establish and evaluate a RNA isothermal transcription-mediated amplification and realtime detection assay (RIARD-MF) for the identification of Mycobacterium fortuitum in clinical isolates.RNA probes and specific primers of reverse transcription and amplification for T7 promoter were designed based on the sequence of M.fortuitum 16S rRNA.The isothermal successive cycles of amplification were performed for real-time detection by using T7 RNA polymerase at 42 ℃.Five non-mycobacterium strains,20 Mycobacterium strains and 259 clinical strains were detected by the established assay to evaluate the specificity and sensitivity,and the results were compared with those of PCR sequencing.In the test of 5 non-mycobacterium strains and 20 Mycobacterium strains,only M.fortuitum was positive,and the remaining 24 strains of bacteria were negative,which was consistent with PCR gene sequencing.The sensitivity and specificity of RIARD-MF reached 60 CFU/mL and 100％.In the test of 259 strains of clinical isolates,5 strains were identified to be M.fortuitum,the remaining 254 strains were not identified to be M.Fortuitum,which was also consistent with PCR gene sequencing.Both the specificity and sensitivity reached up to 100％ in the detection of clinical isolates.It suggested that the RIAR-DMF established in this study is a specific,sensitive,accurate and rapid method for the identification of M.Fortuitum and it may be hopeful for rapid identification of M.fortuitum in clinical isolates.

Effect of Qingfei Quyu Decoction in Prevention of Radiation Pneumonitis Induced by Concurrent Chemoradiotherapy for Esophageal Carcinoma Patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To assess the effect of Qingfei Quyu Decoction (QQD) in preventing radiation pneumonitis in esophageal carcinoma patients by concurrent using it with chemoradiotherapy.</p><p><b>METHODS</b>A total of 120 patients with mid-late stage esophageal carcinoma were randomly assigned to the treatment group (60 cases) and the control group (60 cases). All patients received concurrent radiochemotherapy. Patients in the treatment group additionally took QQD, one dose per day for 8 successive weeks. The incidence of radiation pneunonitis was compared between the two groups. The improvement rates of short-term benefit rate, Karnofsky performance scale (KPS), and body weight (BW) improvement rate were calculated between the two groups. The 1-and 2-year overall survival rates were compared between the two groups.</p><p><b>RESULTS</b>The incidence of radiation pneunonitis was 8.93% (15/56) in the treatment group and 18.64% (11/59) in the control group (P < 0.05). The short-term benefit rate was 92.86% (52/56) in the treatment group and 69.49% (41/59) in the control group (P < 0.05). Besides, the KPS and BW improvement rate were higher in the treatment group [89.29% (50/56) and 83.05% (49/59) ] than in the control group [80.36% (45/56) and 66.10% (39/59)] (P < 0.05). The 1-and 2-year overall survival rate were 66.07% and 35.71% in the treatment group, higher than those of the control group (61.02% and 30.51%; P > 0.05).</p><p><b>CONCLUSION</b>Concurrent using QQD with chemoradiotherapy for treating esophageal carcinoma patients could lower the incidence of radiation pneumonitis, attenuate the degree of radiation induced lung injury, improve clinical benefit rate, and elevate their QOL.</p>

Concurrent control study of involved field intensity modulated radiotherapy in patients with esophageal carcinoma / 实用医学杂志

Objective To explore the treatment effect and failure patterns associated with different clinical target volume on patients with esophageal carcinoma treated with 5-filed intensity modulated radiotherapy (IMRT), and to determine whether involved field irradiation (IFI) is practicable in these patients. Methods A total of 88 patients with esophageal carcinoma between January 2012 to June 2014 underwent IMRT in our hospital, were divided into IFI group and elective nodal irradiation(ENI) group according to the CTV range for a concurrent control study. Results One-year and two-year survival rate in IFI group and ENI group were 75.0%, 45.5% and 70.5%, 43.2% respectively (P > 0.05). Local failure rate in IFI and ENI groups was 27.3% and 22.7% respectively, distant metastasis failure rates 22.7% and 18.2% respectively and regional failure rate outside the radiation field 11.4% and 4.5%, which showed no statistical difference (P > 0.05). Subgroup analysis indicated failure outside the radiation field tended to increase for primary lesion located in the up thoracic or clinical stageⅠ in IFI group. The volume dose histogram of lung V5, V20, V30 and mean lung dose of ENI group were greater than that of IFI group, while V5 of lung and the mean lung dose had statistical difference. Conclusions The survival rate and local control rate have no significant differencein IFI group and ENI group, so IFI is feasible for some esophageal carcinoma, but it should be cautious to choose IFI for those primary lesion located in the up thoracic or clinical stageⅠ.

Analysis and outlook on teaching status of Molecular Pharmacognosy / 中国中药杂志

The teaching status of Molecular Pharmacognosy in 28 institutions in China was investigated by questionnaire and the survey data was analyzed by SPSS. Research contents included course beginning years, majors, class hours, characteristics of the course, teaching ways, the theory and practice contents, evaluation modes, selection of teaching material, teaching achievements, teachers and so on for undergraduates and graduates. Research results showed that with 20 years' development, Molecular Pharmacognosy had been offered for both undergraduate and graduate students in at least 20 colleges and universities and Molecular Pharmacognosy education in China showed good development momentum. At the same time, to promote the development of Molecular Pharmacognosy further, investment for it should be increased and practical teaching condition should be improved.

Differentiating Benign from Malignant Bone Tumors Using Fluid-Fluid Level Features on Magnetic Resonance Imaging

OBJECTIVE: To analyze different fluid-fluid level features between benign and malignant bone tumors on magnetic resonance imaging (MRI). MATERIALS AND METHODS: This study was approved by the hospital ethics committee. We retrospectively analyzed 47 patients diagnosed with benign (n = 29) or malignant (n = 18) bone tumors demonstrated by biopsy/surgical resection and who showed the intratumoral fluid-fluid level on pre-surgical MRI. The maximum length of the largest fluid-fluid level and the ratio of the maximum length of the largest fluid-fluid level to the maximum length of a bone tumor in the sagittal plane were investigated for use in distinguishing benign from malignant tumors using the Mann-Whitney U-test and a receiver operating characteristic (ROC) analysis. Fluid-fluid level was categorized by quantity (multiple vs. single fluid-fluid level) and by T1-weighted image signal pattern (high/low, low/high, and undifferentiated), and the findings were compared between the benign and malignant groups using the chi2 test. RESULTS: The ratio of the maximum length of the largest fluid-fluid level to the maximum length of bone tumors in the sagittal plane that allowed statistically significant differentiation between benign and malignant bone tumors had an area under the ROC curve of 0.758 (95% confidence interval, 0.616-0.899). A cutoff value of 41.5% (higher value suggests a benign tumor) had sensitivity of 73% and specificity of 83%. CONCLUSION: The ratio of the maximum length of the largest fluid-fluid level to the maximum length of a bone tumor in the sagittal plane may be useful to differentiate benign from malignant bone tumors.

The effects of gastric bypass procedures on blood glucose, gastric inhibitory polypeptide and glucagon-like peptide-1 of normal glucose tolerance dogs / 中华外科杂志

<p><b>OBJECTIVE</b>To observe postoperative glucose tolerance, gastric inhibitory polypeptide (GIP) , and glucogan-like peptide-1 (GLP-1) in normal glucose level dogs after undergoing gastric bypass procedures, and to explore the mechanism of gastric bypass procedures to treat type 2 diabetes.</p><p><b>METHODS</b>The 6 dogs with normal glucose tolerance had undergone gastric bypass procedures, and measure preoperative and postoperative oral and intravenous glucose tolerance (at time points 1, 2, and 4 weeks) through changes in blood glucose, insulin, gastric inhibitory polypeptide (GIP), glucagon-like peptide-1 (GLP-1), and measure preoperative and postoperative week 4 pancreatic tissue morphology.</p><p><b>RESULTS</b>Second weeks after operation, the fasting blood sugar was (3.58 ± 0.33) mmol/L, and significantly lower than preoperative (t = 3.571, P < 0.05). The GLP-1 level before oral glucose tolerance test (OGTT) and 30 minutes after OGTT were (0.90 ± 0.21) and (0.91 ± 0.19) pmol/L respectively, and significantly higher than preoperative (t value were -3.660 and -2.971, P < 0.05). GLP-1 levels began to decrease in the second week after surgery. After 4 weeks, the index recovered to the preoperative level. Four weeks after surgery when compared with preoperative, islet morphology, islet number (6.8 ± 0.8 and 7.1 ± 0.8 respectively) and islet cells (16.7 ± 2.5 and 16.3 ± 3.1 respectively) did not change significantly (P > 0.05).</p><p><b>CONCLUSION</b>Gastric bypass procedures could be briefly affect normal glucose tolerance in dogs' blood glucose, insulin and diabetes-related gastrointestinal hormones.</p>

High-dose chemotherapy/autologous stem cell transplantation for nasopharyngeal T cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the role of high-dose chemotherapy (HCT)/autologous stem cell transplantation (ASCT) for nasopharyngeal T cell lymphomas.</p><p><b>METHODS</b>A retrospective review of 51 patients who underwent HCT/ASCT between January 1995 and January 2007.</p><p><b>RESULTS</b>Of the 51 patients who underwent ASCT, no treatment-related death was seen; sixteen patients relapsed after transplant, two patients are still alive through salvage chemotherapy 91 months and 56 months after relapse, the other fourteen patients died in tumor progression. 1-year, 3-year and 5-year overall survival (OS) rates were 98.0%, 84.0% and 72.0%, respectively. 1-year, 3-year and 5-year progression-free survival (PFS) rates were 90.2%, 78.4%and 66.7%, respectively. Univariate analysis showed that clinical stage, B symptom and IPI were prognostic factors for patients with nasopharyngeal T cell lymphomas, the P value being 0.041, 0.036 and 0.031, respectively.</p><p><b>CONCLUSION</b>High-dose therapy/autologous stem cell transplantation can improve cure rate and prolong survival time significantly in patients with nasopharyngeal T cell lymphomas.</p>