Temporal and spatial stability of the EM/PM molecular subtypes in adult diffuse glioma / 医学前沿

Detailed characterizations of genomic alterations have not identified subtype-specific vulnerabilities in adult gliomas. Mapping gliomas into developmental programs may uncover new vulnerabilities that are not strictly related to genomic alterations. After identifying conserved gene modules co-expressed with EGFR or PDGFRA (EM or PM), we recently proposed an EM/PM classification scheme for adult gliomas in a histological subtype- and grade-independent manner. By using cohorts of bulk samples, paired primary and recurrent samples, multi-region samples from the same glioma, single-cell RNA-seq samples, and clinical samples, we here demonstrate the temporal and spatial stability of the EM and PM subtypes. The EM and PM subtypes, which progress in a subtype-specific mode, are robustly maintained in paired longitudinal samples. Elevated activities of cell proliferation, genomic instability and microenvironment, rather than subtype switching, mark recurrent gliomas. Within individual gliomas, the EM/PM subtype was preserved across regions and single cells. Malignant cells in the EM and PM gliomas were correlated to neural stem cell and oligodendrocyte progenitor cell compartment, respectively. Thus, while genetic makeup may change during progression and/or within different tumor areas, adult gliomas evolve within a neurodevelopmental framework of the EM and PM molecular subtypes. The dysregulated developmental pathways embedded in these molecular subtypes may contain subtype-specific vulnerabilities.

Diagnostic efficacy of prostate cancer using targeted biopsy with 6-core systematic biopsy for patients with PI-RADS 5 / 北京大学学报(医学版)

OBJECTIVE@#To investigate the diagnostic efficacy of targeted biopsy (TBx), systematic biopsy (SBx), TBx+6-core SBx in prostate cancer (PCa) / clinically significant prostate cancer (cs-PCa) for patients with prostate imaging reporting and data system (PI-RADS) score of 5, and thereby to explore an optimal sampling scheme.@*METHODS@#The data of 585 patients who underwent multiparametric magnetic resonance imaging (mpMRI) with at least one lesion of PI-RADS score 5 at Peking University First Hospital from January 2019 to June 2022 were retrospectively analyzed. All patients underwent mpMRI / transrectal ultrasound (TRUS) cognitive guided biopsy (TBx+SBx). With the pathological results of combined biopsy as the gold standard, we compared the diagnostic efficacy of TBx only, SBx only, and TBx+6-core SBx for PCa/csPCa. The patients were grouped according to mpMRI T-stage (cT2, cT3, cT4) and the detection rates of different biopsy schemes for PCa/csPCa were compared using Cochran's Q and McNemar tests.@*RESULTS@#Among 585 patients with a PI-RADS score of 5, 560 (95.7%) were positive and 25(4.3%) were negative via TBx+SBx. After stratified according to mpMRI T-stage, 233 patients (39.8%) were found in cT2 stage, 214 patients (36.6%) in cT3 stage, and 138 patients (23.6%) in cT4 stage. There was no statistically significant difference in the detection rate of PCa/csPCa between TBx+6-core SBx and TBx+SBx (all P>0.999). Also, there was no statistically significant difference in the detection rate of PCa/csPCa between TBx and TBx+SBx in the cT2, cT3, and cT4 subgroups (PCa: P=0.203, P=0.250, P>0.999; csPCa: P=0.700, P=0.250, P>0.999). The missed diagnosis rate of SBx for PCa and csPCa was 2.1% (12/560) and 1.8% (10/549), and that of TBx for PCa and csPCa was 1.8% (10/560) and 1.4% (8/549), respectively. However, the detection rate of TBx+6-core SBx for PCa and csPCa was 100%. Compared with TBx+SBx, TBx and TBx+6-core SBx had a fewer number of cores and a higher detection rate per core (P < 0.001).@*CONCLUSION@#For patients with a PI-RADS score of 5, TBx and TBx+6-core SBx showed the same PCa/csPCa detection rates and a high detection rates per core as that of TBx+SBx, which can be considered as an optimal scheme for prostate biopsy.

Comparison of domestic and imported hemostatic clips in preventing delayed post-polypectomy bleeding after endoscopic resection of colorectal polyps larger than 10 mm / 中华消化内镜杂志

Objective:To compare the efficacy of domestic and imported hemostatic clips in preventing delayed post-polypectomy bleeding (DPPB) after endoscopic resection of colorectal polyps ≥ 10 mm.Methods:Clinical data of 789 patients who underwent endoscopic resection of colorectal polyps (polyp diameter ≥10 mm) in Beijing Friendship Hospital, Capital Medical University from January 2018 to December 2019 were collected. The patients were divided into DPPB group ( n=15) and non-DPPB group ( n=774). Univariate and multivariate logistic regression models were used to analyze the influential factors for DPPB. The patients using one type of hemostatic clip were divided into the domestic hemostatic clip group ( n=499) and the imported hemostatic clip group ( n=208). The efficacy of hemostatic clips in preventing DPPB in the two groups was compared. Results:Among the 789 patients undergoing endoscopic resection of colorectal polyps, 1.9% (15/789) suffered from DPPB. Multivariate logistic regression analysis showed that pedunculated polyp was an independent risk factor for DPPB ( OR=6.621, 95% CI: 2.278-19.241, P=0.001), and closure of mucosal defect was an independent protective factor for DPPB ( OR=0.169,95% CI: 0.050-0.570, P=0.004). Regardless of physician experience, there was no significant difference between the domestic and imported hemostatic clip group in preventing DPPB after endoscopic resection of colorectal polyps ≥10 mm [experienced physicians: 1.8% (7/385) VS 0.6% (1/175), χ2=1.314, P=0.445; common physicians: 2.6% (3/114) VS 3.0% (1/33), χ2=0.010, P>0.999]. The domestic hemostatic clip group paid for less medical expenses than the imported hemostatic clip group (experienced physicians: 1 433.51±889.02 yuan VS 3 033.97±1 686.87 yuan, t<0.001 , P<0.001; common physicians: 1 181.58±815.29 yuan VS 3 303.46±1 690.43 yuan, t<0.001 ,P<0.001). Conclusion:Pedunculated polyp is an independent risk factor for DPPB after endoscopic resection of colorectal polyp larger than 10 mm, and clipping can significantly reduce the risk for DPPB. There is no significant difference in the prevention of DPPB between domestic and imported clips, but domestic clips compared with imported clips yield less medical burden, which are suitable for promotion to primary hospitals and major clinical centers.

Expression and Prognostic Value of Inward Rectifier Potassium Channel Subfamily J Member 11 mRNA in Gliomas / 肿瘤防治研究

Objective To analyze the expression of KCNJ11 mRNA in gliomas and its prognostic value. Methods The clinical, histopathological and molecular pathological features of 273 patients with gliomas were collected from CGGA. We analyzed the differences of KCNJ11 mRNA expression in different types of gliomas and the survival time of patients with high and low expression of KCNJ11 mRNA in different subtypes of gliomas. Results The expression levels of KCNJ11 mRNA in young glioma and primary glioma patients were higher than those in old glioma and recurrent glioma patients, respectively (P=0.008, 0.001). The expression of KCNJ11 mRNA in oligodendroglioma was the highest, astrocytoma was the second, and glioblastoma was the lowest (P=0.000). The expression of KCNJ11 mRNA in WHOⅡ grade glioma was the highest, WHOⅢ was the second, and WHOⅣ was the lowest (P=0.000). The expression levels of KCNJ11 mRNA in IDH-mutant type glioma patients were higher than those in IDH-wild type glioma patients (P=0.000). The expression of KCNJ11 mRNA in deletion of 1p/19q glioma patients was higher than that in non-deletion of 1p/19q ones (P=0.000). The expression of KCNJ11 mRNA in MGMT methylated glioma patients was higher than that in non-methylated ones (P=0.036). The survival time of patients with high expression of KCNJ11 mRNA (≥2.77) was longer than that with low expression (P=0.000). Multivariate Cox analysis showed that the high expression of KCNJ11 mRNA was an independent factor affecting the good prognosis of patients with glioma. Conclusion The expression of KCNJ11 mRNA is negatively related to the malignant degree of the tumor. The high expression of KCNJ11 mRNA is an independent factor affecting the good prognosis of patients with glioma.

Impact of chronic obstructive pulmonary disease on postoperative complications and short-term prognosis in patients undergoing oesophagectomy / 中国胸心血管外科临床杂志

@#Objective    To provide clinical reference for the perioperative management of esophageal cancer patients with different stages of chronic obstructive pulmonary disease (COPD) through investigating the impact of COPD on postoperative complications and survival in esophageal cancer patients undergoing oesophagectomy. Methods    The clinical data of 163 patients who underwent radical resection of esophageal cancer in our department from January 2015 to January 2018 were retrospectively analyzed, including 124 males and 39 females, with a median age of 64 years (IQR: 23.8 years). They were divided into a COPD group (n=87) and a non-COPD group (n=76) according to the presence of COPD before operation. The clinical data were collected and the postoperative complications and 2-year survival between the two groups were compared and analyzed. Results    The incidence of major postoperative complications (pulmonary infection, respiratory failure, arrhythmia and anastomotic leakage) in the COPD group were higher than those in the non-COPD group (all P<0.05). Spearman correlation analysis showed that the severity of preoperative COPD was positively correlated with the incidence of postoperative complications in patients with esophageal cancer (r=0.437, P<0.001). The incidence of postoperative respiratory failure and mortality in patients with severe COPD were significantly higher than those in patients without COPD and those with mild or moderate COPD. The 2-year survival rate of patients with esophageal cancer in the COPD group was lower than that in the non-COPD group (56.1%vs. 78.5.%, P=0.001), and the severity of COPD was negatively correlated to the survival rate. Conclusion    COPD significantly increases the incidence of postoperative complications in patients with esophageal cancer, which is not conducive to the prognosis of patients, and the severity of COPD is correlated with postoperative complications and 2-year survival rate.

Clinical application of supraclavicular fasciocutaneous island flap in the repair of tracheal defects / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the clinical application of supraclavicular fasciocutaneous island flap (SIF) in the repair of tracheal defect. Methods: From May 2016 to March 2021, the clinical data of 10 patients (8 males,2 females,aged 27-73 years old) were retrospectively analyzed who underwent repair surgery with SIF for trachea defects after resection of cervical or thoracic tumors, including 2 cases of laryngotracheal adenoid cystic carcinoma, 2 cases of laryngeal carcinoma, 3 cases of esophageal carcinoma, 2 cases of thyroid carcinoma and one case of parathyroid carcinoma. All of the primary tumors were at T4. The outcomes of 10 cases with tracheal defect repaired by SIF were evaluated. Results: The areas of the SIF were (3-7) cm × (6-10) cm, the thicknesses of the flaps were 8-11 mm, and the lengths of the pedicles were 10-15 cm. The blood supply of the SIF came from the transverse carotid artery. The skin defects of the donor areas of the shoulders were directly closed. After 1-60 months of follow-up, all the flaps survived. The flaps, tracheas as well as shoulder wounds healed well. Conclusion: The SIF is suitable for the repair of tracheal defects. It has perfect thickness compatible with the trachea. The technique is simple and microsurgical technique is not needed, with a good application prospect.

Chronic kidney disease after adrenalectomy in a patient with primary aldosteronism / 北京大学学报(医学版)

We report one case of estimated glomerular filtration rate (eGFR) decline after taking unilateral adrenalectomy due to aldosterone adenoma. A 60-year-old male with 23-year history of hypertension was reported to the endocrinologist due to hypokalemia (serum potassium 3.01 mmol/L). Urine microalbumin/creatinine (ALB/CR) was 70.15 mg/g, serum creatinine was 82 μmol/L and eGFR was 89.79 mL/(min·1.73 m2). Random serum aldosterone was 172.2-203.5 ng/L, and random plasma rennin activity was 0-0.17 μg/(L·h). His captopril challenge test suggested that his aldosterone le-vels were suppressed by 8% (< 30%) and the adrenal enhanced computed tomography scan revealed a left adrenal tumor. The patient was diagnosed with primary hyperaldosteronism (PA), aldosterone adenoma and underwent left laparoscopic adrenalectomy. Histological examination confirmed adrenal cortical adenoma. One week after the operation, his serum creatinine was increased to 127 μmol/L compared with preoperative level; eGFR was 32.34 mL/(min·1.73 m2). His systolic blood pressure (SBP) was 110 mmHg and diastolic blood pressure (DBP) was 60 mmHg (hypotensive drugs discontinued), and serum potassium level was 5.22 mmol/L. At the end of the 2-year follow up, the serum creatinine of this patient remained at 109-158 μmol/L and eGFR fluctuated from 63.28-40.12 mL/(min·1.73 m2). PA is one of the most common causes of secondary hypertension. Several studies have reported renal function deterioration of PA patients after unilateral adrenalectomy, like the patient in this article. Age, preoperative plasma aldosterone concentration, albuminuria and preoperative potassium level might be significant predictors of a decrease in the eGFR. Growing evidence suggests that aldosterone could contribute to structural kidney damage, arterial injury and hemodynamic disorder. At the same time, patients with PA exhibit glomerular hyperfiltration and glomerular vascular hypertension, leading to the misinterpretation of renal function in PA patients as subtle kidney damage may be masked by the glomerular hyperfiltration before treatment. After a unilateral adrenalectomy, glomerular hyperfiltration by aldosterone excess is resolved and renal damage can be unmasked. In conclusion, kidney function deterioration after adrenalectomy can be detected in some patients with PA. Thus, accurate evaluation of kidney function in patients with PA may be essential, especially for those with preoperative risk factors for postoperative renal impairment. After unilateral adrenalectomy, close monitoring of renal function and adequate management are required for PA patients.

Evaluating continence recovery time after robot-assisted radical prostatectomy / 北京大学学报(医学版)

OBJECTIVE@#To evaluate urinary continence recovery time and risk factors of urinary continence recovery after robot-assisted laparoscopic radical prostatectomy (RARP).@*METHODS@#From January 2019 to January 2021, a consecutive series of patients with localized prostate cancer (cT1-T3, cN0, cM0) were prospectively collected. RARP with total anatomical reconstruction was performed in all the cases by an experienced surgeon. Lymph node dissection was performed if the patient was in high-risk group according to the D'Amico risk classification. The primary endpoint was urinary continence recovery time after catheter removal. Postoperative and pathological variables were analyzed. Continence was rigo-rously analyzed 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks after catheter removal. Continence was evaluated by recording diaper pads used per day, and all the patients were instructed to perform the 24-hour pad weight test until full recovery of urinary continence. The patient was defined as continent if no more than one safety pad were needed per day, or no more than 20-gram urine leakage on the 24-hour pad weight test. Time from catheter removal to full recovery of urinary continence was recorded, and risk factors influencing continence recovery time evaluated.@*RESULTS@#In total, 166 patients were analyzed. The mean age of the enrolled patients was 66.2 years, and the median prostate specific antigen (PSA) was 8.51 μg/L. A total of 59 patients (35.5%) had bilateral lymphatic dissection, and 28 (16.9%) underwent neurovascular bundle (NVB) preservation surgery. Postoperative pathology results showed that stage pT1 in 1 case (0.6%), stage pT2 in 77 cases (46.4%), stage pT3 in 86 cases (51.8%), and positive margins in 28 patients (16.9%). Among patients who underwent lymph node dissection, lymph node metastasis was found in 7 cases (11.9%). Median continence recovery time was one week. The number of the continent patients at the end of 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks were 65 (39.2%), 32 (19.3%), 34 (20.5%), 24 (14.5%), and 9 (5.4%). Two patients remained incontinent 24 weeks after catheter removal. The continence rates after catheter removal at the end of 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks were 39.2%, 58.4%, 78.9%, 93.4%, and 98.8%, respectively. Univariate COX analysis revealed that diabetes appeared to influence continence recovery time (OR=1.589, 95%CI: 1.025-2.462, P=0.038). At the end of 48 hours, 4 weeks, 12 weeks, and 24 weeks after catheter removal, the mean OABSS score of the continent group was significantly lower than that of the incontinent group.@*CONCLUSION@#RARP showed promising results in the recovery of urinary continence. Diabetes was a risk factor influencing continence recovery time. Bladder overactive symptoms play an important role in the recovery of continence after RARP.

Home-based Telerehabilitation Guidance for Stroke Patients / 中国康复理论与实践

Objective:To explore the effects of home-based telerehabilitation guidance on physical function and activities of daily living for stroke patients. Methods:From September, 2015 to March, 2018, 240 stroke recovering patients from three community health service centers in Fengtai District, Beijing for outpatient rehabilitation were randomly divided into control group (n = 120) and tele-rehab group (n = 120). Both groups accepted routine rehabilitation for six months, while the tele-rehab group received telerehabilitation guidance in addition. They were assessed with Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) before and after treatment. Results:The scores of FMA and MBI improved after treatment in both groups (|t| > 14.536, P < 0.001), and improved more in the tele-rehab group than in the control group (|t| > 2.200, P < 0.05). Conclusion:Home-based telerehabilitation guidance may enhance the effect of community-based outpatient rehabilitation for stroke patients.

The prediction of disease progression by 18Fluorodeoxyglucose-positron emission computed tomography/CT in patients with dermatomyositis and interstitial lung disease / 中华内科杂志

To investigate the predictive value of [ 18F]fluorodeoxyglucose-positron emission computed tomography(PET)/CT for disease progression in patients with dermatomyositis (DM) and interstitial lung diseases (ILD). Sixty-seven DM patients who underwent [ 18F] FDG-PET/CT imaging were retrospectively analyzed from January 2012 to September 2017 at PLA General Hospital. Their clinical manifestations and imaging characteristics were recorded. Compared with those chronically progressed (C-ILD), patients with rapid progression (RP-ILD) had significantly higher erythrocyte sedimentation rate (ESR) and standardized uptake value (SUV) in lungs ( P<0.05). In patients with RP-ILD, SUV in lungs was positively correlated with age, disease course, and ESR. Receiver operating characteristic curve analysis suggested that when lung SUV cut off value was 2.25, the sensitivity and specificity to predict disease progression was 77.8% and 72.8%, respectively. Old age, longer disease course, low creatine kinase level, higher ESR, and high SUV are prognostic factors for DM-associated ILD.

Clinical and imaging characteristics of 110 patients with infectious sacroiliitis / 中华内科杂志

Objective:To investigate the clinical and imaging characteristics of infectious sacroiliitis.Methods:A total of 110 patients diagnosed with infectious sacroiliitis were retrospectively analyzed between 2008 and 2017.Clinical manifestations and therapeutic responses, laboratory tests such as HLA-B 27, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), T cell spot test for tuberculosis infection(TB-SPOT), Brucella agglutination test ect., blood culture of pathogens, pathological findings as well as magnetic resonance imaging were all recorded and analyzed. Results:Among the 110 patients, the male to female ratio was 44 to 66 with an average age 15-58(29.4±10.8) years and the course of disease 0.3-60 (5.7±13.2) months. As to the pathogens, 71 cases were pyogenic, 24 cases with tuberculous sacroiliitis, and 15 cases were brucellosis infections. The majority of patients (97.3%) had unilateral sacroiliac joint involvement. Ten (9.1%) patients suffered infectious sacroiliac arthritis after delivery. Hip pain was the main clinical manifestation (83/110,75.5%) and fever as the second (77/110,70.0%). HLA-B 27 was positive in 11 patients (10.0%). Both ESR and CRP were elevated in the majority. There were 103 patients receiving sacroiliac joint puncture biopsy. Seven patients were diagnosed through blood culture or brucellosis agglutination test. Bone marrow edema and osteolytic lesions in magnetic resonance imaging (MRI) were more common in pyogenic or tuberculous sacroiliitis than in brucellosis infections. Conclusion:Infectious sacroiliitis should be differentiated from spondyloarthritis, which develops more in female patients, with short disease duration and fever, mostlynegative HLA-B 27. The majority patients present unilateral sacroiliitis. Active inflammatory lesions are usually beyond sacroiliac joints with osteolytic changes in MRI examinations.

Diagnostic efficiency of semi-quantitative analysis by mean counting ratio method of thyroid scan / 中国医师进修杂志

Objective:To assess the diagnostic efficient of mean counting ratio method, and to simplify and improve the semi-quantitative method of defining excessive uptake of thyroid nuclides.Methods:One hundred and nine imaging results of thyroid scan in Dalian Municipal Central Hospital from April 2017 to January 2018 were delineated the FOI by two experienced deputy chief physicians and the ratio of average counts per unit area was determined. Clinical diagnosis of hyperthyroidism was used as gold standard, and receptor operation characteristic (ROC) curve was drawn and the optimal diagnostic threshold was calculated. The sensitivity, specificity, accuracy, positive and negative predictive values were calculated and the consistency of the two physicians′ diagnosis was analyzed.Results:The best diagnostic threshold was 6.94 by drawing ROC curve from the measurements of two physicians. The value greater than this was used as a criterion to define the excessive uptake of technetium in thyroid gland. For doctor 1, the sensitivity, specificity and accuracy of differential diagnosis of hyperthyroidism based on diagnostic threshold were 86.0%(37/43), 100.0%(66/66) and 95.5%(103/109), respectively. For doctors 2, they were 88.4%(38/43), 100.0%(66/66) and 95.4%(104/109), respectively. The concordance rate was 96.6%(86/89), interclass correlation coefficient (ICC) was 0.98.Conclusions:Average counting ratio method provides reliable semi-quantitative cut off value for differential diagnosis of high Tc uptake. It has good application value. Different physicians independently complete the semi-quantitative analysis of Tc uptake by average counting ratio method, which has good consistency. In practice, it is simpler and easier than the thyroid/background ratio method.

Three-dimensional reconstruction of carp brain tissue and brain electrodes for biological control / 生物医学工程学杂志

In order to accurately implant the brain electrodes of carp robot for positioning and navigation, the three-dimensional model of brain structure and brain electrodes is to be proposed in the study. In this study, the tungsten electrodes were implanted into the cerebellum of a carp with the aid of brain stereotaxic instrument. The brain motor areas were found and their three-dimensional coordinate values were obtained by the aquatic electricity stimulation experiments and the underwater control experiments. The carp brain and the brain electrodes were imaged by 3.0 T magnetic resonance imaging instrument, and the three-dimensional reconstruction of carp brain and brain electrodes was carried out by the 3D-DOCTOR software and the Mimics software. The results showed that the brain motor areas and their coordinate values were accurate. The relative spatial position relationships between brain electrodes and brain tissue, brain tissue and skull surface could be observed by the three-dimensional reconstruction map of brain tissue and brain electrodes which reconstructed the three-dimensional structure of brain. The anatomical position of the three-dimensional reconstructed brain tissue in magnetic resonance image and the relationship between brain tissue and skull surface could be observed through the three-dimensional reconstruction comprehensive display map of brain tissue. The three-dimensional reconstruction model in this study can provide a navigation tool for brain electrodes implantation.

Evaluation of Septin9, SDC2, TFPI2 methylation and fecal occult blood in the screening of large intestine lesions / 中华检验医学杂志

Objective:To investigate the clinical application value of peripheral blood methylation Septin9 gene in peripheral blood combined with SDC2 gene methylation and TFPI2 gene methylation and fecal occult blood test in colorectal lesion screening.Methods:Through random-selection method. Seventy-five patients with colorectal cancer and 50 patients with advanced adenoma who were treated in our hospital from January 2017 to June 2019 were enrolled as the colorectal cancer group and the advanced adenocarcinoma group, respectively, and the results of the negative test were used as controls Methylation-specific PCR (MSP) was used to detect the methylation status of the Septin9, SDC2 and TFPI2 genes in all patients and the fecal occult blood test for colorectal cancer and advanced adenocarcinoma. In addition, the receiver operating characteristic curve (ROC curve) was drawn to compare the diagnostic value of combined detection and individual detection.Results:The positive rate of Septin9, SDC2, TFPI2 methylation and FOBT in colorectal cancer group was 53.04% (61/115 cases), 55.65% (64/115 cases), 59.13% (68/115 cases) and 26.09% (30/115 cases), respectively. The positive detection rates of Septin9, SDC2, TFPI2 methylation and FOBT in the advanced adenoma group were 33.33% (30/90 cases), 50% (45/90 cases), 40.00% (36/90 cases) and 17.78% (16/90 cases), respectively. The detection sensitivity (82.7%) was higher than the sensitivity of each single test and combined detection of SDC2 and TFPI2 gene methylation: Septin9 methylation (66.7%), SDC2 methylation (69.3%), TFPI2 methylation (73.3%), FOBT (26.7%), SDC2 and TFPI2 methylation combined detection (77.3%), while maintaining a high specificity (80.0%). Septin9, SDC2, TFPI2 gene methylation joint inspection screening advanced adenomas detection sensitivity (70.0%) was higher than the sensitivity of each single test and combined detection of SDC2 and TFPI2 gene methylation: (40.0%), SDC2 Septin9 gene methylation gene methylation (64.0%), TFPI2 methylation (50.0%), FOBT (18.0%), SDC2 and TFPI2 gene methylation detection (64.0%), and also maintained a high specificity (82.5%). ROC curve analysis showed that the area under the ROC curve of the three gene methylation combined screening for colorectal cancer was significantly higher than that of Septin9, SDC2, TFPI2 gene methylation, FOBT alone, and SDC2 combined with TFPI2 gene methylation detection (0.684, 0.765, 0.623, 0.796 and 0.566), and the difference was statistically significant ( P<0.05); and the area under the ROC curve of three gene methylation combined screening screening for advanced adenomas was significantly higher than the area under the ROC curve of Septin9, SDC2, TFPI2 gene methylation, FOBT alone, and SDC2 combined with TFPI2 gene methylation (0.568, 0.685, 0.535, 0.723 and 0.489), and the difference was statistically significant ( P<0.05). Conclusions:Combined detection of Septin9, SDC2 and TFPI2 gene methylation can improve the sensitivity of colorectal lesion diagnosis and maintain high specificity. It has the clinical application value for early screening and diagnosis and treatment of colorectal cancer.

Clinical and imaging characteristics of 110 patients with infectious sacroiliitis / 中华内科杂志

Objective@#To investigate the clinical and imaging characteristics of infectious sacroiliitis.@*Methods@#A total of 110 patients diagnosed with infectious sacroiliitis were retrospectively analyzed between 2008 and 2017.Clinical manifestations and therapeutic responses, laboratory tests such as HLA-B27, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), T cell spot test for tuberculosis infection(TB-SPOT), Brucella agglutination test ect., blood culture of pathogens, pathological findings as well as magnetic resonance imaging were all recorded and analyzed.@*Results@#Among the 110 patients, the male to female ratio was 44 to 66 with an average age 15-58(29.4±10.8) years and the course of disease 0.3-60 (5.7±13.2) months. As to the pathogens, 71 cases were pyogenic, 24 cases with tuberculous sacroiliitis, and 15 cases were brucellosis infections. The majority of patients (97.3%) had unilateral sacroiliac joint involvement. Ten (9.1%) patients suffered infectious sacroiliac arthritis after delivery. Hip pain was the main clinical manifestation (83/110,75.5%) and fever as the second (77/110,70.0%). HLA-B27 was positive in 11 patients (10.0%). Both ESR and CRP were elevated in the majority. There were 103 patients receiving sacroiliac joint puncture biopsy. Seven patients were diagnosed through blood culture or brucellosis agglutination test. Bone marrow edema and osteolytic lesions in magnetic resonance imaging (MRI) were more common in pyogenic or tuberculous sacroiliitis than in brucellosis infections.@*Conclusion@#Infectious sacroiliitis should be differentiated from spondyloarthritis, which develops more in female patients, with short disease duration and fever, mostlynegative HLA-B27. The majority patients present unilateral sacroiliitis. Active inflammatory lesions are usually beyond sacroiliac joints with osteolytic changes in MRI examinations.

Expression of micro RNA- 561 in esophageal squamous cell carcinoma and its clinical significance / 中国医师进修杂志

investigate the clinical significance and expression of microRNA(miR)-561 in esophageal squamous cell carcinoma. Methods From January 2015 to February 2016, 96 specimens of adjacent tissues and cancer tissues from patients with esophageal squamous cell carcinoma who underwent surgery in Dongfeng Hospital Affiliated of Hubei University of Medicine were selected to detect the expression level of miR-561. Cell culture experiments were used to detect the expression level of miR-561 in Het-1a, Kyse150 and Eca109 cell lines. The correlation between clinical features and the expression level of miR-561 was counted. The expression level of miR-561 in patients with esophageal squamous cell carcinoma was analyzed. The relationship between the level of miR-561 and prognosis was investigated. Results Relative expression of miR-561 in esophageal squamous cell carcinoma cell lines Eca109 and Kyse150 (1.61 ± 0.30, 1.21 ± 0.28) was significantly lower than that in Het-1a (2.56 ± 0.51), and the difference was statistically significant (P < 0.05). The relative expression of miR-561 in esophageal squamous cell carcinoma tissues was significantly lower than that in adjacent tissues (0.80 ± 0.17 vs. 1.51 ± 0.42), and the difference was statistically significant (P<0.05). The expression of miR-561 in esophageal squamous cell carcinoma was correlated with alcohol drinking history, lymph node metastasis, differentiation degree and tumor stage (P<0.05). Cox multivariate regression analysis showed that the independent risk factors affecting the prognosis of patients were the expression of miR-561, TNM stage and lymph node metastasis (P<0.05). The survival rate of patients with esophageal squamous cell carcinoma whose expression of miR-561 did not decrease at follow-up was significantly higher than that of patients with decreased expression of miR-561 (P<0.05). Conclusions In patients with esophageal squamous cell carcinoma, the expression of miR-561 is low, and the development, occurrence and prognosis of esophageal squamous cell carcinoma are closely related with it.

Efficacy and mechanism of Lianhua Qingwen Capsules(LHQW) on chemotaxis of macrophages in acute lung injury (ALI) animal model / 中国中药杂志

This paper was mainly to discuss the potential role and mechanism of Lianhua Qingwen Capsules(LHQW) in inhibiting pathological inflammation in the model of acute lung injury caused by bacterial infection. For in vitro study, the mRNA expression of MCP-1 in RAW264.7 cells and THP-1 cells, the content of MCP-1 in cell supernatant, as well as the effect of LHQW on chemotaxis of macrophages were detected. For in vivo study, mice were randomly divided into 7 groups, including normal group, model group(LPS 5 mg·kg~(-1)), LHQW 300, 600 and 1 200 mg·kg~(-1)(low, middle and high dose) groups, dexamethasone 5 mg·kg~(-1) group and penicillin-streptomycin group. Then, the anal temperature was detected two hours later. Dry weight and wet weight of lung tissues in mice were determined; TNF-α and MCP-1 levels in alveolar lavage fluid and MCP-1 in serum were detected. In addition, the infiltration of alveolar macrophages was also observed and the infiltration count of alveolar macrophages was measured by CCK-8 method. HE staining was also used to observe the inflammatory infiltration of lung tissues in mice. Both of the in vitro and in vivo data consistently have confirmed that: by down-regulating the expression of MCP-1, LHWQ could efficiently decrease the chemotaxis of monocytes toward the pulmonary infection foci, thus blocking the disease development in ALI animal model.

Basic research of fibrosis on atherosclerotic plaque stability and related drug application / 中国中药杂志

In the background of the high incidence and high mortality of cardiovascular diseases,atherosclerosis is the main pathological feature of cardiovascular diseases and the core pathological basis for disease progression. In the evolution of atherosclerotic plaques,the rupture of unstable plaques,plaque shedding and formation of thrombosis are the most dangerous parts. In this process,the formation of plaque fibrosis is the core mechanism regulating plaque stability. Additionally,fibrosis reflects dynamic changes in the inflammatory processes and pathological changes. In view of the inflammation regulation and fibrosis regulation,this paper clarified the process of atherosclerotic plaque,explained the roles of relevant inflammatory cells and cytokines in plaque stability,and summed up drug researches related with stable plaque in recent years. In the future,improving the fibrosis will be a new idea for stabilizing plaque in atherosclerosis drug development.

Research advancement in natural anti-cancer product / 中国中药杂志

Human health has been severely threatened by malignant tumors continuously.Rational and effective drug use provides an effective means for the treatment of malignant tumors,and is expected to become an important way to solve the problem of tumor treatment in the future.In recent years,with the escalation of new cancer theories and the emergence of clinical drug resistance,innovative research and development of anti-cancer drugs has always been a hot spot and focus in cancer research.Among them,the discovery of novel anti-cancer drugs from natural compound is of top priority due to its strong anti-cancer efficacy and the abundant drug resources.Therefore,it is imperative to systematically summarize the cutting-edge advancements of the natural products and their potential pharmacological mechanisms according to the characteristics of tumor progression,and put forward the new directions and trends for further development of anti-cancer natural products in the future.Specifically,the research advancements on anti-cancer effect of natural products were reviewed,focusing on both the traditional and innovative application.We hope this review could bring the light on the research path of the natural anti-cancer products clearly and comprehensively,and also provide inspirations for innovative,safer and more effective anti-cancer drug development and exploration.

Diagnosis and treatment of 8 cases of children ingesting multiple magnetic foreign bodies by mistake / 中国小儿急救医学

Objective To explore the clinical characteristics of multiple magnetic digestive tract for-eign bodies ingested by mistake,to review the previous literature and provide reference for clinical treatment. Methods The clinical data,treatment process and outcome of 8 cases of children with multiple magnetic for-eign bodies admitted to Shanxi Children′s Hospital were retrospectively analyzed,and relevant literatures were reviewed. Results Eight children with multiple magnets were aged 1 to 9 years old,and their medical history ranged from 5 hours to 2 months. Number of magnets ingested was 2-25. During the operation,6 patients were found with multiple intestinal perforations,1 with internal fistula and 2 with internal abdominal hernia,with at least 2 perforations and at most 6 perforations. The perforation sites located in the distal esophagus,stomach, duodenum,jejunum, ileum and colon. Seven cases were treated by emergency surgery, and 1 case was removed by colonoscopy and discharged after conservative treatment. One case underwent simple repair, 1 case underwent gastrojejunostomy,intestinal perforation repair;partial intestinal resection was performed in 2 places in 2 cases;partial intestinal resection was performed in 1 place and simple repair in the other places in 2 case;1 case of fistula in child with intestinal anastomosis laparoscopic exploration,incision bowel resec-tion. Seven cases recovered after surgical treatment. The child with intestinal obstruction after colonoscopy was discharged uneventfully 9 days later by conservative treatment, no complications occurred by followed-up. Combined with experience and literature,we developed a management algorithm for digestive tract magnet foreign body. Conclusion Accidental ingestion of multiple magnets can cause multiple digestive tract perfo-rations,internal hernia,intestinal obstruction and other serious diseases,which should be treated as soon as possible. Therefore,it is necessary to strengthen the understanding of multiple magnet foreign bodies in chil-dren,early detection and early treatment.