Numerical Study on the Process of Human Brain Cooling Treated by Hemoperfusion Mild Hypothermia / 中国医疗器械杂志

Mild hypothermia, as a common means of intraoperative nerve protection, has been used in clinical practice. Compared with the traditional methods such as freezing helmet and nasopharyngeal cooling, hypothermic blood perfusion is considered to be a promising treatment for mild hypothermia, but it lacks experimental and theoretical verification of its cooling effect. In this study, the commercial finite element simulation software COMSOL combined the Pennes equation with the cerebrovascular network model to construct a new simplified human brain model, which was further used to simulate the cooling process of cerebral hypothermic blood perfusion. When the hypothermic blood perfusion was 33 ℃, the human brain could enter the mild hypothermic state within 4 minutes. By comparing with helmet cooling, the feasibility and efficiency of the blood perfusion scheme were verified. By comparing with the calculation results based on Pennes equation, the rationality of the model constructed in this study were verified. This model can non-intrusively predict the changes of brain temperature during surgery, and provide a reference for the setting of treatment parameters such as blood temperature, so as to provide personalized realization of safer and more effective mild hypothermia neuro protection.

Malignant melanoma of penis: a case report / 中华泌尿外科杂志

Melanoma of penis is rare. A case was reported in this paper. Penile mass was found for 14 months. Penile tumor resection+ left inguinal lymph node biopsy and bilateral ilioinguinal lymph node dissection were performed. Postoperative pathology showed malignant melanoma of the penis with bilateral ilioinguinal lymph node metastasis. This patient was treated with pabolizumab for 17 cycles. After 22 months follow-up, the patient had no disease progression.

Correlation between serum phosphorus levels and outcomes of weaning from mechanical ventilation in elderly chronic obstructive pulmonary disease patients with type Ⅱ respiratory failure / 中华老年医学杂志

Objective:To investigate the correlation between serum phosphorus levels and outcomes of weaning from mechanical ventilation in elderly chronic obstructive pulmonary disease(COPD)patients with type Ⅱ respiratory failure.Methods:A total of 142 hospitalized elderly COPD patients with type Ⅱ respiratory failure receiving mechanical ventilation in our hospital from August 2016 to December 2018 were retrospectively enrolled.Patients were divided into the successful weaning group(n=101)and the unsuccessful weaning group(n=41)based on weaning outcomes.General data, blood phosphorus levels on admission and before spontaneous breathing trials(SBT)and the incidence of hypophosphatemia were compared between the two groups.The logistic regression equation was used to analyze the related factors for the unsuccessful weaning, and the receiver operating characteristics(ROC)curve was drawn to analyze the value of serum phosphorus levels in predicting the failure of weaning.Methods:Compared with the successful weaning group, Acute Physiology and Chronic Health evaluation Ⅱ(APACHEⅡ)scores, rapid shallow breathing index(RSBI), and serum creatinine(Cr), C-reactive protein(CRP)levels were higher, while the oxygenation index(PaO 2/FiO 2), serum albumin(ALB)and magnesium levels were lower in the unsuccessful weaning group than in the successful weaning group( P<0.05). The incidences of hypophosphatemia on admission and before SBT were higher in the unsuccessful weaning group than in the successful weaning group(34.2% or 34/41 vs.17.8% or 18/101, 46.3% or 19/41 vs.25.7% or 26/101, χ2=4.452 and 5.716, P<0.05). Serum phosphorus levels on admission and before SBT were lower in the unsuccessful weaning group than in the successful weaning group[(0.82±0.21) mmol/L vs.(1.05±0.23) mmol/L, (0.71±0.19) mmol/L vs.(1.02±0.22) mmol/L, t=5.171 and 7.646, P<0.05)]. Multivariate logistic regression analysis showed that hypophosphatemia on admission or before SBT was an independent risk factor for unsuccessful weaning in elderly COPD patients with type Ⅱ respiratory failure( P<0.05). The areas under the ROC curve(AUC)of hypophosphatemia on admission and before SBT for predicting the failure of weaning was 0.657 and 0.776, respectively, and with 0.84 mmol/L and 0.76 mmol/L as the respective optimal threshold values, the sensitivity and specificity were 67.3% and 68.3% for AUC on admission and 76.5% and 85.6% for AUC before SBT, respectively.AUC of the serum phosphorus level was higher before SBT than on admission( Z=3.142, P<0.05). Conclusions:The decrease of blood phosphorus levels is common in elderly COPD patients with type Ⅱ respiratory failure, and hypophosphatemia has a high incidence and may be an independent risk factor for the failure of weaning.Blood phosphorus levels should be closely monitored in order to guide clinical weaning.

A study on classification of nervous system symptoms of rare diseases in China by adopting method in Or-phanet database / 实用医学杂志

Objective The intention of this thesis is to present the nervous system symptoms of rare diseases with a view to raising researchers′awareness of these symptoms,providing one of bases for other relevant researches in the future. Methods Based on the classification in Orphanet database,rare neurological diseases are picked out and put into different groups.The diseases with the same neurological symptoms and signs are in the same group. Then,differences and similarities of the diseases in the same group are analyzed. Results 57 kinds of rare neurological diseases are sorted out from rare diseases list and account for 31.49% of total diseases in the list.These diseases are characterized by aspecific,complex and interlaced neurological abnormalities.Specifically, the above-mentioned neurological abnormalities include 10 kinds of neurological symptoms and signs like peripheral neuropathy,epilepsy,and neuromuscular diseases.Conclusions Rare diseases,in most cases,are featured with complex neurological abnormalities,which presents great challenges for identification and diagnosis.In view of this fact,it is helpful to analyze the connection between rare diseases and their symptoms by adopting the classification in Orphanet database,which is beneficial for promoting identification on neurological symptoms and signs of rare diseases.

Frequency-Selectable RF Ablation Treatment System / 中国医疗器械杂志

In order to support study of new radiofrequency ablation treatments and finally realize of precise conformal ablation of targeted tissue, this paper proposed a system which is able to generate radio frequency currents at different frequencies. The designed system bases on the basic principle of Class E power amplifier and uses MSP430 microcontroller as a controller and uses a touch screen as human-machine interface to design a frequency-selectable radiofrequency ablation treatment system,. The RF signals at frequencies of 230 kHz, 460 kHz, 920 kHz, and 2 000 kHz were tested to verify the feasibility of the system, and by using a tissue phantom, tested the heating ability of the RF signals at frequencies of 460 kHz, 920 kHz, and 2 000 kHz. The results show the device could well heat the tissue at the three frequencies. The study has also found that both the highest temperature and the ablation area decreases with RF frequency, when using the constant power control mode.

DACT2 gene promoter area methylation status and mRNA expression in renal cell carcinoma / 重庆医学

Objective To explore the role of the DACT2 gene in the occurrence and development of renal cell carcinoma(RCC).Methods The samples of RCC tissues and corresponding tumor-adjacent tissues after radical operation and normal kidney tissues were collected.The methylation specific PCR (MSP) and real time fluorescence reverse transcriptase-PCR (RT-PCR) methods were adopted to detect the methylation status and mRNA expression of DACT2.The streptavidin-peroxidase (SP) method labeled by immunohistochemistry peroxidase was used to examine the expression of β-catenin protein.Then the relationship between DACT2 gene methylation status and mRNA expression with the clinicopathologic characteristics was analyzed.The relationship between DACT2 gene methylation with mRNA and β-catenin expression was analysed,as well.Results The DACT2 mRNA relative expression level in RCC tissues was 0.427±0.025,which was significantly lower than (0.801±0.047) in tumor-adjacent tissues and (0.872±0.022) in normal tissue,the positive rate of DACT2 gene methylation in RCC tissues was 45.76%,which was significantly higher than 6.78% in tumor-adjacent tissues and 5.08% in normal tissues,the difference was statistically significant (P0.05).The DACT2 gene mRNA expression level in RCC tissues and promoter area methylation occurrence rate had no obvious correlation with the clinical data such as patients age,gender,tumor size,clinical stage and Fuhrman grade (P>0.05).The DACT2 gene mRNA relative level in the methylation group was lower than that in the non-methylation group,the difference was statistically significant (P<0.05).The expression rate of β-catenin protein in cytoplasma in RCC tissues was higher than that in the tumor-adjacent tissues and normal tissues,the difference was statistically significant (P<0.05),moreover,DACT2 gen methylation had a positive correlation with β-catenin protein expression (r=0.324,P=0.012).Conclusion The decrease of DACT2 gene promoter area methylation and mRNA relative expression level may participate in the RCC occurrence,but has no relationship with RCC clinical progression.Methylation occurred in DACT2 gene promoter area may be one of reasons causing mRNA relative expression decrase.DACT2 gene methylation occurrence in RCC tissue might be related to the high expression of β-catenin.

miR-222 can inhibit the autophagy of renal cell carcinoma cells through down-regulating the expression of DDIT4 / 中国癌症杂志

Background and purpose:MicroRNA (miRNA, miR) plays an important regulatory role in cancer. miR-222 is reported to be up-regulated in various tumors, but its role in renal cell carcinoma (RCC) remains unclear. In this study, we detected the expression of miR-222 in both RCC and adjacent tissue samples. The aim of this study was to investigate the role of miR-222 in RCC. Methods:The expression levels of miR-222 in RCC tissue samples were quantified by quantitative real-time polymerase chain reaction (qRT-PCR). DDIT4 and LC3-Ⅱ protein expressions were determined by Western blot. Dual luciferase assay was performed to verify the target of miR-222. EGFP-LC3 microscopy assay was performed to assess autophagy. Results:Results from qRT-PCR showed that the expression of miR-222 was up-regulated in RCC tissues. Knockdown of miR-222 with speciifc antagomiR decreased the cell viability of 786-O cells, whereas overexpression of miR-222 increased the cell viability (P<0.01). The levels of DDIT4 were up-regulated in 786-O cells transfected with miR-222 antagomiR, whereas overexpression of miR-222 induced the down-regulation of DDIT4 expression. Data from dual luciferase assay indicated that miR-222 directly targeted the expression of DDIT4. Consistently, the expression of DDIT4 in RCC tissues was down-regulated compared with adjacent tissues. Knockdown of miR-222 in 786-O cells induced a signiifcant increase of autophagosome formation and LC3 lipidation.These results supported that miR-222 could inhibit autophagy in RCC cells, which may affect the clinical characteristcs of RCC. Conclusion: miR-222 is up-regulated in RCC and can inhibit the autophagy of RCC cells through down-regulating the expression of DDIT4.

Hinokitiol induces clear cell renal cancer 786-O cell apoptosis via autophagy induction / 中国肿瘤临床

Objective: To investigate the effects of hinokitiol on the proliferative inhibition and apoptosis induction in human clear cell renal cancer 786-O cells. Methods:CCK-8 assays were performed to analyze the effects of hinokitiol on the proliferation of 786-O cells. The apoptosis rate was determined by flow cytometry. EGFP-LC3 microscopy assays were performed to assess the autoph-agy flux. Cleaved Caspase-3, LC3, and P62 were detected by Western blot. Results: Hinokitiol could inhibit the proliferation of the 786-O cells and could induce cell apoptosis via Caspase pathway. Hinokitiol induced the autophagy of 786-O cells, increased LC3 ex-pression, and downregulated P62 expression. Conclusion: Hinokitiol can inhibit the proliferation of 786-O cells and can induce cell apoptosis via autophagy induction.

Effects of short message service platform system on return visit rate, glycosylated hemoglobin level and glucose control rate for diabetics / 中华全科医师杂志

A total of 296 patients were randomly divided into short message group (n =153) and non short message group (n =143).The former group received short message service (SMS) for follow-ups while the latter group had routine oral follow-ups.The return visit rate,recall rate of glycosylated hemoglobin (HbA1c),HbAlc level and glucose control rate for diabetics were assessed after one-year follow-up.The return visit rate (96％) and recall rate of HbAlc (78％) in the short message group were significantly higher than those in the non-short message group (59％,25％,P ＜0.01 for both).The HbAlc level after one-year follow-up (6.51 ± 0.74) ％ was lower than that one year before (6.85 ± 1.26) ％ in the short message group.The glucose control rate after one year (82％) were significantly higher than that one year before in the short message group (65％) and that after one year in the non-short message group(59％,P ＜ 0.01).Use of SMS platform system for follow-ups and health education can effectively improve the return visit rate and glucose control rate,lower the HbA1c level.in diabetics.

Perfluoropentane droplets enhanced HIFU therapeutic effect / 中国医疗器械杂志

A small HIFU system was used to investigate the phase-shift droplet vaporization in vivo and its effect on thermal absorption in tissue-mimicking phantoms. The experiments demonstrated that droplets could be vaporized to bubbles in vivo by the small HIFU system and the volume of bubbles could increase by tens of times. With appropriate droplets concentration, lesion volume produced by HIFU could be increased significantly under the same HIFU parameter.

Clinical efficacy of three-dimensional conformal radiotherapy combined with thermochemotherapy in the treatment of locally advanced pancreatic cancer / 中国医师杂志

Objective To evaluate the clinical efficacy of three-dimensional conformal radiotherapy (3D-CRT) combined with thermochemotherapy in the treatment of locally advanced pancreatic cancer (LAPC).Methods From June 2008 to June 2011,70 patients with LAPC were divided into radiotherapy group (30 patients) and combination group (40 patients).Radiotherapy used 3D-CRT with a 90％ to 95％ isodose curve,a single dose of 1.8 to 2.OGy,and total radiation dose 50 ～ 70 Gy.The combination group patients received simultaneous thermotherapy at 41.5 ～43.5 ℃ (1 h/fraction,twice a week for 6 times),and hyperthermia given simultaneously injected using arsenic trioxide 20 mg,recombinant mutant human tumor necrosis factor(rmhTNF) intravenous infusion of 10 million U,4 to 6 times,or 3D-CRT at the same time and the treatment given after gemcitabine(0.6 ～ 1.0 g/m2) on Days dl and 8 and cisplatin (DDP) (20 ～ 30 mg/m2) on Days d1-3 intravenous infusion,repeated every 28 days for 3 ～ 6 cycles.Results At 3 months after treatment,the total response (complete remission and partial remission) rate was 70.0％ (49/70),the efficiency of radiotherapy combined with chemotherapy,and radiotherapy combined with thermo-chemotherapy were 56.5％ and 88.2％,and the radiotherapy alone group was 56.7％.There were significant difference in efficiency between radiotherapy combined with thermo-chemotherapy group compared to radiotherapy-chemotherapy group and radiotherapy group (x2 =4.68,4.98,P ＜ 0.05),the last two groups showed no significant difference (P ＞ 0.05).The 1-year and 2-year survival rate was 46.8％ and 20.3％,respectively.The 1-year and 2-year survival rates were 52.4％ and 26.7％ in combination group,and 42.5％ and 16.2％ in radiotherapy group (x2 =14.17,P ＜ 0.05 ; x2 =9.74,P ＜ 0.05).No serious complications such as perforation,bleeding,and high fever were seen during treatment and follow-up.Conclusions 3D-CRT combined with thermochemotherapy is well tolerated and is relatively effective for the LAPC patients.

Relationship between skin carotenoid levels and individual's lifestyle / 中华健康管理学杂志

Objective To explore the relation of skin carotenoid levels with lifestyle.Methods Complete clinical data of 493 adults who received health check-up in our hospital between December 2010 and December 2011were collected for this retrospective study.The relationship between skin carotenoid level and lifestyle was investigated.ResultsNo strong relationship between skin carotenoid level and age,education level,occupation and marriage status was found ( x2 values were 2.150,6.443,4.560 and 2.028,respectively; all P ＞0.05 ).However,skin carotenoid was significantly correlated with dietary variety,intake of fruits and vegetables,exercise frequency,cigarette smoking,passive smoking,mood,sleeping and gender( x2 values were 520.234,89.936,4.002,81.428,154.271,84.871,11.546 and 2.150,respectively ; all P ＜0.05 ).Conclusions Our data suggest a relationship between lifestyle and skin carotenoid level.Skin carotenoid assessment may help to detect bad lifestyle in time.

Expression and clinical significance of osteopontin and MMP-9 in pancreatic carcinoma / 中国医师杂志

Objective To investigate the expression and the role of osteopontin(OPN)and matrix metalloproteinase-9(MMP-9)in the invasion and metastasis of pancreatic carcinoma.Methods Human pancreatic cancer cell line MIA PaCa-2 was cultured in vitro.The location of OPN protein in pancreatic tumor cell line was detected by immunofluorescence staining.100 cases of pancreatic cancer and 40 cases of adjacent normal pancreatic tissues were used to analysis.The expressions of OPN and MMP-9 were investigated by immunohistochemistry assay.Results OPN expressed in the cell membrane and cytoplasm,OPN and MMP-9 in pancreatic cancer tissues positive rates were 73.0%(73/100)and 68.0%(68/100),which were higher than that in adjacent normal pancreatic tissues(all P ＜ 0.05).OPN and MMP-9 expression were associated with pancreatic tumor grade,lymph node metastasis and perineural invasion of pancreatic cancer(P ＜ 0.05).OPN and MMP-9 in pancreatic cancer tissues were positively correlated(r,=0.39,P ＜ 0.01).Conclusions OPN and M MP-2 might play an important role in the development of invasion and metastasis of pancreatic carcinoma.OPN and MMP-2 might play synergetic roles in the progression of pancreatic carcinoma.

Efficacy of three dimensional conformal radiotherapy combined with concurrent taxotere in treatment of patients with esophageal carcinoma / 中国基层医药

Objective To evaluate the efficacy and toxicity of three dimensional confoimal radiotherapy(3D-CRT)concurrent taxotere for patients with esophageal carcinoma.Methods Ninty-six patients with esophageal carcinoma were received 3D-CRT concurrent taxotere,the radiotherapy was carried out by 3D-CRT,to a total dose 95% PTV 66Gy/33f/6.6W.The trial results were evaluated by the clinical curative effect criterion.Results Complete response rate(CR)was 67.7%.Overall response rate(CR+PR)was 89.6%.The local control rates of 1 year and 3 years were 86.5% and 63% ,respectively.The survival rates of 1 year and 3 years were 76.1% and 50.0%,respectively.The main acute toxic effect was radioactive esophagitis.Conclusions 3D-CRT concurrent taxotere could improve the overall response rate and survival rate of esophageal carcinoma.Although it increased the acute toxic effect,the patients could accept the therapy.

Analysis of the Long-term Curative Effects of Radical Nephrectomy / 中国肿瘤临床

Objective:To analyze the factors that affect patient prognosis after radical nephrectomy.Meth-ods:A total of 389 cases of renal cell carcinoma treated with radical nephrectomy between January 1 993 and December 2006 were reviewed.All the data were encoded.inserted into an Excel database and then ana-lyzed by SPSS 1 3.0 software.The cumulative survival rates were calculated by life-table method.We as-sessed the impact of multiple covariates on survival time with the Cox Regression model.Results:The patho-logical results showed that 307 cases were clear call carcinoma,51 cases were papillary renal cell carcinoma,21 cases were chromophobic renal cell carcinoma,2 cases were collecting duct carcinoma.and 8 cases were unclassified.One hundred and ninety-eight cases were of T1N0M0, 113 cases were of T2N0M0, 3 cases were of T1N1M0,10 cases were of T2N1M0, 51 cases were of T3N0M0, and 14 cases were of T3N1M0, Two hundred and sixty-eight cases were followed up.The 1-year survival rate was 96.5%,the 3-year survival rate was 90.7%.the 5-year survival rate was 75.7%.and the 10-year survival rate was 65.8%.Multivariable analysis revealed that significant prognostic factors included TNM stage,Robson stage.vena cava and supplementary treat-ment(X2=22.50.P=0.001).The most important prognostic factor was pathological stage(TNM and Robson).The regression coefficients were 0.533 and 0.674,and the relative risk was 1.941 and 2.01 1(P=0.004 and p=0.002).Conclusion:Radical nephrectomy is safe and effective.TNM stage.Robson stage and vena cava are prognostic factors.Supplementary treatment is a protective factor.

Clinical significance of lymph node micrometastases in stage Ⅱ rectal cancer patients / 中国医师进修杂志

Objective To explore the clinical significance of lymph node micrometastases in stage Ⅱ rectal cancer patients. Methods Forty-two patients with rectal cancer underwent total mesorectal exci-sion between January 2000 and August 2001 were included, 484 lymph nodes were studied in paraffin blocks that had previously been considered free by conventional histopathological examination. These lymph nodes were submitted to immunohistochemical analysis using cytokeratin 20 (CK20) monoclonal antibodies to identify micrometastases. Five-year follow-up information was obtained on these patients. Observed survival rates and assessed respectively in the patients with and without micrometastases. Results Micrometastases were detected in 33 lymph nodes (6.8% ,33/484) of 15 cases (35.7%, 15/42). The five-year survival rate was 40.0% in the patients with micrometastases, whereas in the patients without micrometastases, the survival rate was 92.6%(P = 0.000,by the Log-rank test). By multivariate Cox regression analysis, lymph node mi-cromctastases was closely correlated with post-operative recurrence or metastases, the value of RR was 11.435. Conclusions Detection of micrometastases is an important prognostic tool in stage Ⅱ rectal can-cer. In this study, lymph nodes micrometastases is an independent prognostic factor for overall survival. These patients maybe get benefit from adjuvant chemotherapy.

Functions of interleukin-8 and leukotriene B4 in chronic obstructive pulomonary disease / 中国综合临床

Objective To explore the changes of the levels of IL-8,LTB4 and its function in invasion in patients with chronic obstructive pulmonary disease(COPD).Methods The concentrations of IL-8 and LTB4 in serum and sputum were determined with enzyme linked immunosorbent assay(ELISA)in 30 cases of patients with COPD in acute aggravating stage and paracmasis and in 20 cases healthy adults.Blood routines were detected in all obstructs.Results The concentrations of IL-8 in serum and sputum in acute aggravating stage were(181.41±18.49)ng/L and(74.03±20.64)ng/L,significantly higher than those in paracmasis and the reference group(152.33±17.48)ng/L and(42.30±14.99)ng/L,P＜0.05).The concentrations of IL-8 in serum and sputum in paracmasis were significantly higher than those in reference group[(52.75±13.79)pg/ml and(17.15±5.36)ng/L,P＜0.05].The concentrations of LTB4 in sputum in acute aggravating stage were(2300.91±496.01)ng/L,significantly higher than those in paracmasis and the reference group[(1884.14±651.37)ng/L,P＜0.05].LTB4 level in acute aggravating is not significantly different from those in paracmasis and the reference group[(1941.30±301.62)ng/L and(1880.77±302.11)ng/L,P＞0.05).Conclusion Both IL-8 and LTB4 play important roles in the coupe of inflammatory reaction of air passage of COPD.

The research on expression and clinical significance of MCM2 in BTCC / 中国癌症杂志

Background and purpose:It is verifi ed that MCM2 is a specifi c marker in the cell cycle,and expressed in all cells entering into the cycle,however,no expression is found in the differentiated cells and static period cell.Therefore,in the abnormally proliferative developmental cells and mutagenic cells,MCM2 could be used to mark the status of the cells as a cellular proliferative marker,and then to be a diagnostic tool for some heterotypical pathological changes and tumors.Our study demonstrated that the expression and clinical significance of MCM2 in bladder transitional cell cancer(BTCC).Methods:The expression of MCM2 was examined by immunohistochemistry Streptavidin-Peroxidase method in 12 cases of normal bladder tissues and 42 cases of BTCC.Results:The positive expression of MCM2 in BTCC was 100%,whereas in normal tissues,no positive expression was found(P0.05).The expression of MCM2 was closely associated with tumor pathological grade(P

Investigation into the status quo of the contingent of pharmacists in medical institutions of Shanghai / 中华医院管理杂志

Objective To find out about the status quo of the contingent of pharmacists in medical institutions of Shanghai so as to provide basis for promoting reform in the mode of pharmacological work in the hospital and adopting the system of clinical pharmacists. Methods An investigation through questionnaires was made into over 6 000 pharmacists from 416 hospitals(28 third-tier hospitals, 52 second-tier hospitals, and 336 first-tier hospitals) with respect to their professional titles, educational backgrounds, and distribution of posts. Results On average, the number of personnel with senior or medium professional titles in third-tier hospitals was markedly higher than that in second- or first-tier hospitals; people with doctoral or master's degrees were distributed mosdy in third-tier hospitals; the proportion of personnel with senior or medium professional tides on emergency outpatient posts in second- or third-tier hospitals was lower than diat in other departments; and on average, the number of resident pharmacists per hundred beds was less than one. Conclusion There is a drastic shortage and unbalanced distribution of personnel with senior or medium professional titles in the contingent of pharmacists in Shanghai and the structures of the professional tides and educational backgrounds of the pharmacological personnel lag behind the needs for clinical pharmacological services. Efforts must be made to improve the overall quality and expertise of the contingent of pharmacists so as to get ready in terms of qualified personnel for the adoption of die system of clinical pharmacists.