Exploration of the Autonomy Issues in Addiction Treatment / 中国医学伦理学

Addiction is a state of chronic neurological dysfunction with repetitive and compulsive behavior as the main manifestation. One of the characteristics of this state is that addicts have significantly reduced autonomy for compulsive behaviors. The emergence of addictive behavior is based on the impaired autonomy of addicts, so the assessment of their condition, prognosis, and related moral responsibility are all related to their autonomy. By exploring whether the treatment of addicts should be based on autonomy as the core indicator to evaluate whether they can end treatment, and exploring the debate on addicts’ autonomy based on the disease model and moral model of addiction, it is believed that whether addicts have autonomy cognition is influenced by the causes of addiction. Furthermore, the issue of moral responsibility of addicts after treatment termination and the quantitative feasibility of autonomy were discussed, and it was advocated to determine the moral responsibility after addiction treatment based on their autonomy.

Postoperative rehabilitation effect and influence factors of adult prelingual deafness with cochlear implant / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate whether pre-lingual deafness adult caused by inadequate auditory compensation in childhood can benefit from cochlear implants and the related influencing factors. Methods: A total of 26 prelingual deafness as experimental group [11 males and 15 females, the age of operation was (24.5±5.7) years] and 13 postlingual deafness as control group [5 males and 8 females, the age at the time of operation was (42.2±11.4) years] were recruited. Objective assessment included hearing threshold and speech recognition rate tests while wearing cochlear implants. Subjective assessment used Nijmegen Cochlear Implant Questionnaire to assess hearing-related quality of life of subjects. The changes of hearing ability in the prelingual deafness group before and after operation and the differences with the postlingual deafness group were compared, and the correlation between speech recognition ability and the age diagnosed as severe or profound deafness, the age of hearing aid invalid, and duration of wearing cochlear implant were analyzed as factor indicators. All statistical results were analyzed by SAS 9.4 software. Results: In terms of objective indicators, the speech recognition rate of pre-lingual deafness was significantly lower than that of post-lingual deafness [(35.4±28.0)% vs (80.9±8.0)%,t=7.67, P<0.001], while there was no statistical difference in hearing threshold between the two groups [(34.8±4.0) dB HL vs (33.1±3.7) dB HL, t=1.30, P>0.05]. The indicators in the subjective questionnaire showed that the prelingual deafness group was only weaker in advanced sound perception, confidence and total mean score than the post-lingual deafness group (P<0.05), and there was no significant difference in other aspects(P>0.05), meanwhile, all indicators of the prelingual deafness group were significantly improved compared with the preoperative level (P<0.001). There was a moderate positive correlation between the hearing quality and the speech recognition rate in the prelingual deafness group(r=0.51, P=0.008). The regression analysis showed that the invalid age of hearing aid was the exact influencing factor of speech recognition rate. Conclusions: Certain prelingual deaf adults can adapt to cochlear implants and obtain different degrees of auditory assistance. Compared with the improvement of objective auditory ability assessment, the patient who received cochlear implantation gain more improvement in auditory related quality of life subjectively. The ineffective age of preoperative hearing aid is an important factor, which needs to be aroused sufficient preoperative attention.

Re-discussion on "Fenglong (ST 40) for phlegm" / 中国针灸

After reading the article, Tracing Origin and Development of "Fenglong (ST 40) for Phlegm": Examination and Verification published in Chinese Acupuncture & Moxibustion, the authors collected the original evidences also for the effect of Fenglong (ST 40) on phlegm disorders by tracing from 9 ancient books of acupuncture and moxibustion, explored the standardized expressions of its indications and analyzed the changes of its indications. In that article, it was viewed that the effect of Fenglong (ST 40) started to be generalized in treatment of phlegm disorders since the Ming Dynasty. On contrary, we believes that Fenglong (ST 40) works on strengthening the spleen and resolving dampness for the disorders caused by the broad meaning of "phlegm/damp". Based on it, since the Ming Dynasty, the effect of Fenglong (ST 40) is extended specifically for the disorders caused by the visible sputum from the lung, the narrowing mean of "phlegm". Hence, if "Fenglong (ST 40) for phlegm" is considered as an academic point of view, it needs an adequate evidences to expound and prove.

Is drainage necessary in pelvic fracture patients with modified Stoppa approach? / 中华骨科杂志

Objective:To investigate the effect of the placement of a drainage tube on the prognosis of patients with pelvic fractures treated by modified Stoppa approach.Methods:The medical records of patients with pelvic fractures treated with modified Stoppa approach from August 2012 to August 2017 were retrospectively analyzed. A total of 43 patients including 32 males and 11 females (mean age 47.6 years, range from16 to 69) were included in the study. According to Young-Burgess classification, there were 12 cases of Lateral Compression type LC-I type; 20 cases of Anterior and Posterior Compression type APC-I type and 11 cases of APC-II type. All patients were treated with modified Stoppa approach to reduce the fracture and fix with plate and screw. According to whether a drainage tube was placed during the operation, 22 cases were placed with a drainage tube (drainage group), and 21 cases were not placed with a drainage tube (non-drainage group). The main observation indicators were the intraoperative conditions, antibiotic application, incision suture removal time, postoperative body temperature change, hospital stay and clinical function (Harris score).Results:Wound infection was not observed in two groups. The duration of antibiotic use in the drainage group was 5.0 d (2.0, 8.0) d, and the non-drainage group was 4.0 d (2.0, 5.0) d, the difference was not statistically significant ( Z=1.161, P=0.924). The hospital stays of the two groups were 18.5 d (15.0, 24.3) d and 19.0 d (13.0, 26.0) d, respectively, and the difference was not statistically significant ( Z=0.542, P=0.591). The operation time was 150.2±52.4 min in the drainage group and 138.8±41.2 min in the non-drainage group, and the difference was not statistically significant ( t=0.791, P=0.433). The blood loss in the drainage group was 604.6±387.3 ml, and the non-drainage group was 581.0±275.0 ml. The difference was not statistically significant ( t=0.276, P=0.784). The postoperative body temperature changes of patients in the drainage group and non-drainage group were on day 1 (37.5±0.5 ℃ vs. 37.4±0.4 ℃, t=0.322, P>0.05), day 3 (37.1±0.4 ℃ vs. 37.0±0.4 ℃, t=0.286, P>0.05), day 5 (37.0± 0.3 ℃ vs. 36.8±0.2 ℃, t=2.127, P>0.05), on the 7th day (36.8±0.2 ℃ vs. 36.7±0.4 ℃, t=0.491, P>0.05), the difference was not statistically significant. The time for suture removal of surgical incision was 14.1±0.6 d in the drainage group and 13.9±0.6 d in the non-drainage group, and the difference was not statistically significant ( t=1.072, P=0.329). The Harris scores of the two groups were 96 (91, 100) points for the drainage group and 96 (93, 97) points for the non-drainage group, and the difference was not statistically significant ( Z=0.107, P=0.607). Conclusion:There is no significant influence of the application of drainage on recovery of wound or function for patients with pelvic surgery.

Radiomics features on ultrasound imaging for the prediction of disease-free survival in triple negative breast cancer: A multi-institutional study / 中华超声影像学杂志

Objective:To investigate the effectiveness of radiomics model based on preoperative ultrasound in predicting disease-free survival (DFS) in patients with triple negative breast cancer (TNBC) from multicenter data.Methods:A total of 418 patients with TNBC between July 2012 and December 2016 were consecutively recruited for this study from three different institutions including the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital of Chinese Medicine and General Hospital of Eastern Theater Command. In the training cohort ( n=271) from institution 1(the First Affiliated Hospital of Nanjing Medical University), least absolute shrinkage and selection operator (LASSO) logistic regression algorithm was employed to select recurrence-related radiomics features and build a signature derived from the grayscale US images. The relationship between the radiomics score (Rad-score) and DFS was evaluated. Univariate and multivariate cox regression were utilized to identify the significant radiomics features and clinical-pathologic variables, which were integrated into a radiomics nomogram. An independent external cohort ( n=147) from the other two institutions was validated for evaluating the calibration and discrimination of the predictive nomogram. Results:Higher Rad-score was an independent risk predictor of worse DFS in two cohorts (both P<0.05). The radiomics model, comprising axillary lymph node status, Ki-67 index and radiomics signature, showed better prognostic performance ( P<0.01) than those of the clinical-pathologic model or tumor node metastasis (TNM) staging system with the concordance index (C-index) of 0.75 (95% CI=0.72-0.78) and 0.73(95% CI=0.71-0.75) in the training and validation cohorts respectively. Furthermore, the calibration curves achieved satisfactory agreement and the decision curves further confirmed the clinical utility of the radiomics nomogram. Conclusions:The US-based radiomics signature is a powerful predictor for the assessment of DFS in patients with TNBC. Moreover, the proposed radiomics model integrating the optimal radiomics signature and clinical-pathologic data could improve personalized DFS estimation.

Lateral Hypothalamic Area Glutamatergic Neurons and Their Projections to the Lateral Habenula Modulate the Anesthetic Potency of Isoflurane in Mice / 神经科学通报·英文版

The lateral hypothalamic area (LHA) plays a pivotal role in regulating consciousness transition, in which orexinergic neurons, GABAergic neurons, and melanin-concentrating hormone neurons are involved. Glutamatergic neurons have a large population in the LHA, but their anesthesia-related effect has not been explored. Here, we found that genetic ablation of LHA glutamatergic neurons shortened the induction time and prolonged the recovery time of isoflurane anesthesia in mice. In contrast, chemogenetic activation of LHA glutamatergic neurons increased the time to anesthesia and decreased the time to recovery. Optogenetic activation of LHA glutamatergic neurons during the maintenance of anesthesia reduced the burst suppression pattern of the electroencephalogram (EEG) and shifted EEG features to an arousal pattern. Photostimulation of LHA glutamatergic projections to the lateral habenula (LHb) also facilitated the emergence from anesthesia and the transition of anesthesia depth to a lighter level. Collectively, LHA glutamatergic neurons and their projections to the LHb regulate anesthetic potency and EEG features.

Efficacy and prognostic factors in children with non-core binding factor acute myeloid leukemia / 中国当代儿科杂志

OBJECTIVE@#To compare the efficacy of the CAMS-2005 and CAMS-2009 regimens in treating children with non-core binding factor acute myeloid leukemia (non-CBF AML) and to study the prognosis factors.@*METHODS@#A total of 161 children who were initially diagnosed with non-CBF AML from April 2005 to December 2015 were enrolled as study subjects, and were divided into a CAMS-2005 regimen group (n=52) and a CAMS-2009 regimen group (n=109) according to the chemotherapy regimen provided. The efficacy was retrospectively compared between the two groups.@*RESULTS@#The complete remission (CR) rate at the first course of treatment was higher in the CAMS-2009 regimen group than that in the CMAS-2005 regimen group (63.3% vs 46.2%; P0.05). Children who achieved CR at the first course of treatment had significantly higher OS and event-free survival rates than those who did not achieved CR (P<0.01).@*CONCLUSIONS@#The CAMS-2009 regimen is superior to the CAMS-2005 regimen in improving the CR rate in children with non-CBF AML after induction treatment. Whether CR is achieved at the first course of treatment can affect the OS rate of children with non-CBF AML.

Primitive Neuroectodermal Tumor as the Second Malignant Neoplasm in a Long-Term Survivor Child of Acute Lymphoblastic Leukemia: A Case Report / 中国医学科学杂志(英文版)

Acute lymphoblastic leukemia (ALL) is a common pediatric cancer. The second malignant neoplasms (SMNs) in long-term survivors of pediatric ALL are relatively rare. Herein we report a 10-year-old girl who was diagnosed as primitive neuroectodermal tumor (PNET) 5 years after the initial diagnosis of ALL with radiotherapy-free treatment. PNET is an exceedingly rare neoplasm in SMNs of survivors of childhood ALL. It is predisposed to be misdiagnosed and the pathogenesis is unclear. The outcome is poor. Long-term follow-up is necessary for the survival children of ALL.

The analysis of characteristic parameters based on the ultrasonic original radio-frequency signals of normal gastrocnemius / 中华超声影像学杂志

Objective:To analyze the influence of different factors on the entropy and grayscale values extracted from the ultrasonic original radio-frequency signals of normal human gastrocnemius.Methods:The ultrasonic original radio-frequency signals of 10 healthy men and 10 healthy women admitted to the Department of Ultrasound of First Affiliated Hospital of Nanjing Medical University from October to December 2019 in natural ankle joint position, maximum plantar flflexion and maximum dorsiflflexion position were collected, and the entropy and grayscale values were obtained by processing these signals with MATLAB software to analyze the differences of parameters in different positions and sections, and to discuss the influence of age, gender and BMI on them.Results:Comparison of the values between different sections: the differences between longitudinal extraction entropy values and transverse extraction entropy values at the maximum dorsiflexion position were statistically significant ( P<0.05), the differences between longitudinal extraction grayscale values and transverse extraction grayscale values at the natural position were statistically significant ( P<0.05) and both of values extracted in the longitudinal plane were higher than those extracted in the transverse plane. Comparison of the values among different positions of the ankle joints: the values of the maximal metatarsal flexion were statistically different from those of the natural position and the maximal dorsiflexion ( P<0.05), and the values of the maximal metatarsal flexion were the lowest, while the entropy and gray values of the natural position and the maximal dorsiflexion were not statistically different ( P>0.05). There was no significant difference in ultrasonic characteristic parameters between different genders and different age groups ( P>0.05). There was no correlation between BMI and characteristic parameters ( P>0.05). Conclusions:The entropy and grayscale values extracted from the original radio-frequency ultrasonic signals of healthy persons′ gastrocnemius can quantitatively reflect the difference in muscle structure from different positions and setions. As a result, this method can be considered in the quantitative evaluation of neuromuscular diseases.

Clinical significance of minimal residual disease in B-lineage acute lymphoblastic leukemia pediatric patients with different fusion gene backgrounds / 中国当代儿科杂志

OBJECTIVE@#To study the clinical significance of minimal residual disease (MRD) in B-lineage acute lymphoblastic leukemia (B-ALL) pediatric patients with different fusion gene backgrounds.@*METHODS@#A retrospective analysis was performed on the medical data of 441 B-ALL children who were treated from January 2008 to April 2015. Among the 441 children, 336 had negative fusion gene, 79 had positive @*RESULTS@#In patients with negative fusion gene, the positive MRD group had significantly lower overall survival (OS) rate and event-free survival (EFS) rate (@*CONCLUSIONS@#MRD has the most definite prognostic significance in pediatric B-ALL patients with negative fusion gene, while it has unsatisfactory prognostic significance in those with positive

Robot-assisted laparoscopic upper urinary tract reconstruction surgery: A review of 108 cases by a single surgeon / 北京大学学报(医学版)

OBJECTIVE@#To summarize the experiences and outcomes of 108 robot-assisted laparoscopic upper urinary tract reconstruction surgeries conducted by a single surgeon.@*METHODS@#We consecutively and retrospectively reviewed 108 patients who underwent robot-assisted laparoscopic upper urinary tract reconstruction surgeries by a single surgeon from November 2018 to January 2020. The patient demographics, perioperative variables, postoperative complications and follow-up data were recorded. Fifty-three modified dismembered pyeloplasties (MDP), 11 spiral flap pyeloplasties (SFP), 11 ure-teroureterostomies (UUT), 4 lingual mucosal onlay graft ureteroplasties (LMU), 5 appendiceal onlay flap ureteroplasties (AU), 11 ureteral reimplantations (UR), 6 Boari flap-Psoas hitch surgeries (BPS) and 7 ileal ureter replacements (IUR) were enrolled finally. The success was defined as the improvement in subjective pain levels, and the improvement in the degree of hydronephrosis at ultrasound.@*RESULTS@#All the surgeries were successfully completed without open or laparoscopic conversion. The median operative time was 141 min (range: 74-368 min), median blood loss was 20 mL (range: 10-350 mL) and median hospital stay was 4 d (range: 3-19 d) in MDP group, with the success rate of 94.3%. The median operative time was 159 min (range: 110-222 min), median blood loss was 50 mL (range: 20-150 mL) and median hospital stay was 5 d (range: 3-8 d) in SFP group, with the success rate of 100%. The median operative time was 126 min (range: 76-160 d), median blood loss was 20 mL (range: 10-50 mL) and median hospital stay was 5 d (range: 4-9 d) in UUT group, with the success rate of 100%. The median operative time was 204 min (range: 154-250 min), median blood loss was 30 mL (range: 10-100 mL) and median hospital stay was 6 d (range: 4-7 d) in LMU group, with the success rate of 100%. The median operative time was 164 min (range: 135-211 min), median blood loss was 75 mL (range: 50-200 mL) and median hospital stay was 8.5 d (range: 6-12 d) in AU group, with the success rate of 100%. The median operative time was 149 min (range: 100-218 min), median blood loss was 20 mL (range: 10-50 mL) and median hospital stay was 7 d (range: 5-10 d) in UR group, with the success rate of 90.9%. The median operative time was 166 min (range: 137-205 min), median blood loss was 45 mL (range: 20-100 mL) and median hospital stay was 5 d (range: 4-41 d) in BPS group, with the success rate of 83.3%. The median operative time was 270 min (range: 227-335 min), median blood loss was 100 mL (range: 10-100 mL) and median hospital stay was 7 d (range: 5-26 d) in IUR group, with the success rate of 85.7%.@*CONCLUSIONS@#The surgeon performed and modified numerous complicated upper urinary tract reconstruction surgeries by the robotic platform, which facilitated the development of the standardized upper urinary tract reconstruction surgical technique.

Clinical features and prognosis of children with acute lymphoblastic leukemia and different platelet levels / 中国当代儿科杂志

OBJECTIVE@#To study the association of platelet level at diagnosis with prognosis in children with acute lymphoblastic leukemia (ALL).@*METHODS@#A total of 892 children with ALL who underwent chemotherapy with the CCLG-ALL 2008 regimen were enrolled. According to the platelet count at diagnosis, these children were divided into normal platelet count group (platelet count ≥100×109/L; n=263) and thrombocytopenia group (platelet count 0.05). The normal platelet count group still had a significantly higher 10-year EFS rate than the thrombocytopenia group after the children with MLL gene rearrangement were excluded (P0.05). The <20×10/L subgroup had significantly lower 10-year EFS and OS rates than the normal platelet count group, the (50- <100)×10/L subgroup, and the (20- <50)×10/L subgroup (P<0.05). After the children with MLL gene rearrangement were excluded, the <20×10/L subgroup still had significantly lower 10-year EFS and OS rates than the normal platelet count group, the (50-<100)×10/L subgroup, and the (20- <50)×10/L subgroup (P<0.05).@*CONCLUSIONS@#ALL children with MLL gene rearrangement often have the clinical manifestation of thrombocytopenia. Platelet level at diagnosis is associated with the prognosis of ALL children. The children with normal platelet count have a low recurrence rate and good prognosis, and those with a platelet count of <20×10/L have the worst prognosis.

Clinical Efficacy of Modified BU/CY as Conditioning Regimen Combined with Autologous Peripheral Blood Hematopoietic Stem Cell Transplantation in Young Acute Myeloid Leukemia Patients with Low or Intermediate Risk / 中国实验血液学杂志

OBJECTIVE@#To investigate the safety and efficacy of autologous peripheral blood hematopoietic stem cell transplantation (auto-PBHSCT) using modified BU/CY conditioning regimen for young AML patients of low and middle risk in the first complete remission (CR1).@*METHODS@#Ten young AML patients of low and middle risk who did not want to accept allogeneic hematopoietic stem cell transplantation（allo-HSCT）and underwent auto-PBHSCT in CR1 during May 2013 to December 2016 were retrospectively analyzed. From 3 months after auto-PBHSCT, the maintenance therapy with interleukin-2 (IL-2) or IL-2 combined with histamine dihydrochloride was performed for these patients in the next 18 months. The side effects of the conditioning regimen, hematopoietic recovery time, transplant-related mortality (TRM) within 100 days and 1 year after auto-PBHSCT, relapse rate, leukemia-free survival (LFS) rate at 2 years and 3 years, overall survival (OS) were evaluated at 3 years and 4 years.@*RESULTS@#Gastrointestinal side effects were the major non-hematologic toxicity reaction, among which, 7 cases relatively mild and 3 cases displayed moderate, just one case suffered from severe reaction. In 4 cases, the mild liver damage occurred, but no hemorrhagic cystitis occurred. All the patients experienced different kinds of infection, including 5 cases of bloodstream infection, 2 cases of gastrointestinal infection, 3 cases of crissum infection and 2 cases of oral infection. The myeloablative effect occurred in all ten patients. The median times for absolute neutrophil count (ANC)0.5×10/L at 10 to 19 days, median was 13 days after auto-PBHSCT. The patients achieved platelet count >20×10/L at 10 to 72 days; median was 32 days after auto-PBHSCT. The TRM within 100 days and 1 year after transplantation was 0. The relapse occurred in 2 cases at 6 and 14 months after auto-PBHSCT raspectively. The median follow-up time was 48.1 months, and the median survival time was 54.7 months after transplantation. The 2-year and 3-year LFS were 100% (10 cases) and 80% (8 cases), respectively. The 3-year and 4-year OS were 80% (8 cases) and 70% (7 cases), respectively.@*CONCLUSION@#Modified BU/CY as conditioning regimen for auto-PBHSCT can achieve the myeloablative effect without raising TRM and obtain good LFS and OS. As for young AML patients without high risk, it is a valuable therapeutic option, especially for those lacking the chance of allo-HSCT.

Study on the effects of RCCS simulated microgravity on the metabolism of human keratinocyte / 解放军医学杂志

Objective: To investigate the effects of RCCS simulated microgravity on the metabolism of the human keratinocyte cell line HaCaT. Methods: The rotary cell culture system (RCCS) was used to simulate the microgravity environment, and HaCaT cells were cultured in vitro and divided randomly into simulated microgravity group (SMG) and normal gravity group (NG). The two group HaCaT cells were collected respectively after 1 d, 2 d and 3 d culture, and the samples were analyzed by LC/MS metabolomics. The differential metabolites between the SMG and NG cells were identified with partial least squares discriminant analysis ((O)PLS-DA), and the data were input into the KEGG database for the construction and functional analysis of metabolic pathways. Results: Comparing to NG cells, after 1 d culture, there were 74 different metabolites in SMG cells, among which 16 were up-regulated and 58 were down-regulated; after 2 d culture, there were 89 different metabolites, among which 15 were up-regulated and 74 down-regulated; after 3d culture, there were 100 different metabolites, of which 23 were up-regulated and 77 were down-regulated. The differentially expressed 49 metabolites (VIP>1 and P<0.05) after 3 d were set as target metabolites, within which the sphingosine, glutamate, and docosapentaenoic acid were down-regulated, and dehydrated sorbitol was up-regulated. KEGG analysis indicated that the metabolic pathways involved were amino acid metabolism, lipid metabolism, cell proliferation and apoptosis, substance transport, catabolism, and signal transduction. Conclusion: RCCS simulated microgravity may have significant impacts on keratinocyte metabolism mainly involving metabolites such as sphingolipids and glutamate as well as the related signaling pathways.

Initial experience of ileal ureter replacement combined with augmentation cystoplasty in the treatment of ureteral stenosis with contracted bladder / 中华泌尿外科杂志

Objective To explore the availability and safety of ileal ureter replacement combined with ileal augmentation cystoplasty in treating ureteral stenosis with contracted bladder.Methods From August 2015 to November 2018,three patients who underwent ileal ureter replacement combined with augmentation cystoplasty were treated with ileal ureter replacement combined with augmentation cystoplasty.There were 1 male and 2 females with the age ranging from 34 to 55 years (mean 39 years).Two patients suffered from left ureter stenosis,and one patient had stenosis on the both sides.The length of the ureter stenosis ranged from 6 to 18 cm (mean 9.8 cm).The preoperative bladder capacity ranged from 60 to 150 ml (mean 103.3 ml).In the surgery,part of ileum was used to replace the ureter,and the distal intestine was made into U-shape to enlarge the bladder.Results All operation were completed successfully.The operation time ranged from 220 to 400 min (mean 303.0 min),and the blood loss ranged from 150 to 500 ml (mean 283.3 ml).Laparoscopic surgery was performed in 1 case and open surgery in 2 cases.Three weeks after the surgery,the bladder volume underwent cystography ranged from 300 to 400 ml (mean 360.0 ml).Three months after the surgery,the postvoid residual urine volume ranged from 20 to 50 ml (mean 33.3 ml).Postoperative frequency and urgency of urine were completely relieved in 1 case,alleviated in 2 cases.Flank pain was completely relieved in 1 case,and alleviated in 2 cases postoperatively.The serum creatinine of 2 patients mildly increased after the surgery,while 1 patient remained stable.For complications,1 patient had urinary infection,and 1 patient suffered from metabolic acidosis.Conclusions Ileal ureteral replacement combined with augmentation cystoplasty can be the choice of treatment for long segment ureteral stenosis and enlarge the bladder simultaneously.The postoperative complications and the kidney functions should be regularly followed up.

Evaluation of credibility and repeatability of modified acetabular fracture classification system / 中华创伤杂志

The Letournel-Judet classification system for acetabular fractures is widely used, but there are still some shortcomings, such as incomplete classification and confusion of classification concepts, which cannot effectively guide the treatment. Professor Hou Zhiyong proposed and elaborated an improved acetabular fracture classification system based on the concept of three columns of acetabulum. However, the credibility and repeatability of the classification still lacked validation from clinical data. In this regard, the author included 463 patients with relatively complete imaging data admitted to Third Hospital of Hebei Medical University and Honghui Hospital affiliated to Xi'an Jiaotong University Medical College in the past five years. Four trauma orthopedists classified the patients according to the modified classification method of acetabular fracture. After two months, the original sequence of imaging data was disrupted and re-classified by the same trauma orthopedists. The consistency of the classification was evaluated by Kappa test and compared with Letournel-Judet classification. The results showed that credibility and repeatability of the modified classification were higher than Letournel-Judet classification, suggesting the feasibility of clinical application.

Effects of biomimetic network membrane prepared by chitosan/gelatin/pectin on proliferation and mineralization of mesenehymal stem cells / 吉林大学学报(医学版)

Objective::To explore the effects of the biomimetic network membrane prepared by chitosan/gelatin/pectin on the proliferation and mineralization of mesenchymal stem cells (MSCs) , and to evaluate its feasibility of constructing tissue engineering bone.Methods:Chitosan, gelatin and pectin were made into a new biomimetic network membrane in a certain ratio by biomimetics.The experiment was divided into control group (MSCs+conventional medium) , material group (MSCs+network membrane+conventional medium) and material+OS group (MSCs+network membrane+OS medium) .The cell morphology was observed by inverted phase contrast microscope;the growth and secretion of extracellular matrix of the MSCs were observed under scanning electron microscope (SEM) .The proliferation of cells was determined by MTT assay (The MSCs were divided into negative control group and material group, and they were cultivated with blank medium and medium including materials) .The expression of calcium in MSCs was detected by Alizarin Red staining.Real-time polymerase chain reaction (RT-PCR) was used to determine the expression levels of osteocalcin (OC) mRNA and osteopontin (OPN) mRNA in the MSCs.Results:The network membrane was semitransparent thin film.The MSCs were short shuttle and clustered under inverted phase contrast microscope.After cultured for 7d, the MSCs were shuttle;after cultured for 14d, the number of MSCs was increased, with pseudo feet on the membrane;after cultured for21d, the MSCs clustered with a lot of neo-formed extracellular matrix.The MTT results showed that there was no significant difference in the proliferation level of MSCs between material group and negative control group (P＞0.05) .The Alizarin Red staining results showed that the MSCs in the network membrane were dyed orange red.The RT-PCR results showed that the expression levels of OC mRNA in the MSCs in material group and material+OS group were lower on the 7th and 14th days, but on the 21th day, the expression levels were significantly increased and reached the peak;the expression level of OC mRNA in the MSCs in material group was significantly increased on the 7th day, and the expression level reached the peak on the 14th day, then fell slightly on the 21th day;compared with control group, the expression levels of OC mRNA and OPN mRNA in the cells in material group and material+OS group at different time points were significantly increased (P＜0.01) , but there were no significant differences between material group and material+OS group (P＞0.05) .Conclusion:Chitosan/gelatin/pectin biomimetic network membrane has good biocompatibility, and MSCs can grow and proliferate well on the membrane.The membrane can induce the MSCs to express mineralization-related genes and proteins without inducers.

Research progress of Lgr5-positive stem cells in the formation of organoid in 3D culture / 中华耳鼻咽喉头颈外科杂志

Stem cell is critical to regeneration of tissue or organ of human. How to promote repair or regeneration in the tissues/organ using its pluripotency is always an important issue. Lgr5-possitive cell is one type of the stem cell-like cells capable of pluripotent differentiation in various tissues/organs of both humans and mice. Current study showed that single or small amount Lgr5-possitive stem cells can grow and form a plurality of organs in 3D culture system, and some organs can present similar biological and physiological properties with the progenitor they were derived. These studies provided new insight into future orientation, for example, Lgr5-possitive inner ear cells were confirmed as inner ear pluripotent cells population, the experiences obtained from organoid studies of Lgr5-possitive cells have certainly showed potential in the future study of inner ear stem cells. This review will focus on the recent progress associated with Lgr 5-positive stem cells forming organoids in the 3D culture.

Construction of human PKD2 lentivirus to rectify polycystin-2 expression and Wnt/β-catenin signaling pathways in the Pkd2-null cell lines / 中华泌尿外科杂志

Objective To establish PKD2 gene recombinant lentivirus and to investigate its restorative effects on polycystin-2 and Wnt/β-catenin signaling pathways in Pkd2-null cell lines.Methods From August 2016 to February 2017,PKD2 gene was cleaved from the pcDNA3.1-TM-PKD2 plasmid and was inserted into the pLV-sfGFP 2A Puro by restriction enzymes Xba Ⅰ and Xho Ⅰ.The recombinant pLV-sfGFP-PKD2 plasmid was sequenced to verify a correct construction.Then we obtained recombinant lentiviruses by co-transfecting 293T cells with recombinant plasmid and packaging plasmids.B3/D3 (Pkd2 +/-) and B2/E8 (Pkd2-/-) cell lines were used to evaluate the effectiveness of lentivirus,they were divided into experimental group,control group,blank group and treated with pLV-sfGFP-PKD2 virus,pLV-sfGFP virus or culture media,respectively.The expression of PC2 was detected by Western blotting and immunofluorescence staining.Finally the cell proliferation was evaluated by detecting of proliferating cell nuclear antigen.The changes of Wnt/β-catenin signaling pathway were evaluated by real-time quantitative PCR.Results Enzyme digestion analysis and DNA sequencing showed that the recombinant plasmid pLV-sfGFP-PKD2 was constructed successfully.After infected with pLV-sfGFP-PKD2 virus,the expression of PC2 in the experimental group B2 and E8 cells(0.668 ±0.013,0.763 ±0.021) was restored to the normal level,compared with control group B3 and D3 cells,respectively (0.687 ± 0.015,P =0.164;0.776 ± 0.008,P =0.409).The proliferative activity in experimental group B2 cells(0.573 ±0.010) was significantly lower than that in control group B2 cells (0.848 ±0.031,P ＜0.01),and was returned to the level of blank group B3 cells (0.585 ±0.017,P =0.369).Reexpression of PKD2 in experimental group B2 cells also reduced the expression of Wnt7a,β-catenin,back to blank group B3 cells' level(0.037 ±0.005 vs.0.037 ±0.004,P=0.969;0.554 ±0.008 vs.0.571 ±0.013,P =0.64).Conclusions The recombinant pLV-sfGFP-PKD2 lentivirus has been constructed successfully.The lentivirus could rectify the absence of PC2 in PKD2-null cell lines,by which the hyperactivated Wnt/β-catenin signaling pathway and the abnormal cell proliferation caused by PC2 deficiency could be also restored to normal levels.

Overcoming Cancer Multidrug Resistance by Doxorubicin-TiO2 Nanoparticles / 中国药学杂志

OBJECTIVE To investigate the effect of TiO2 nanoparticles on overcoming cancer multidrug resistance(MDR). METHODS: Doxorubicin-TiO2 nanoparticles(DTN) were prepared, the K562/DOX cells were chosen as the model cells. And doxorubicin solution(F-DOX) and doxorubicin liposomes(DOX-L) were also prepared as the control. The MTT assay were measured, and the amount of doxorubicin in the K562/DOX cells at different time were determined by HPLC. The P-gp expression were detected by flow cytometry. RESULTS: The MTT assay shows that IC50 of group DTN were lower than that of group F-DOX. The uptake test shows that amount of doxorubicin in K562/DOX cells of group DTN was 1.23 times of group DOX-L when in 4 h, and the efflux test shows that amount of doxorubicin in K562/DOX cells was 1.18 times of group DOX-L. The flow cytometry result revealed that the effect of TiO2 nanoparticles on overcoming MDR maybe through down-regulating the expression of P-gp in K562/DOX cells. CONCLUSION: The TiO2 nanoparticles are a new inorganic materials-based nanoparticles which promising approach to overcome MDR.