Research progress of nano-medical materials in the diagnosis and treatment of prostate cancer / 中华泌尿外科杂志

Nanomaterial technology is widely integrated with medical science, and nano-medical materials bring new opportunities for prostate cancer diagnosis and treatment. This article reviews the application of nanomaterials in the diagnosis and treatment of prostate cancer. The application of nanomedicine materials in molecular probe imaging technology and prostate cancer tumor marker-based diagnosis, as well as research progress in drug delivery, targeted modification, and combination therapy are summarized.

Macrophage Polarization and Anti-tumor Mechanism of Chinese Medicine：A Review / 中国实验方剂学杂志

Macrophages are natural immune cells with strong plasticity. The polarization of macrophages mainly responds to stimuli in the microenvironment by changing their phenotype and related functions. In recent years， studies have found that the polarization of macrophages is involved in the occurrence and development of various diseases such as bone arthritis， skin diseases， diabetes， coronary heart disease， breast cancer， colorectal cancer， and lung cancer， especially the metastasis of malignancies and drug resistance， through multiple signaling pathways， including nuclear factor kappa-B（NF-κB）， c-Jun N-terminal kinase（JNK）， protein kinase B （Akt）， mitogen-activated protein kinase （MAPK）， signal transducer and activator of transcription 6 （STAT6）， Wnt/β-catenin， and mammalian target of rapamycin （mTOR） and regulatory factors， such as granulocyte-macrophage colony-stimulating factor （GM-CSF）， interleukin （IL）-4， IL-10， transforming growth factor （TGF）-β， tumor necrosis factor（TNF）-α， and interferon-γ（IFN-γ）. Chinese medicine is also pivotal in the prevention and treatment of malignancies. In recent years， therefore， the specific anti-tumor mechanism of Chinese medicine and its active ingredients has become a research hotspot. The tumor microenvironment is crucial to the occurrence and development of tumors. The polarization of tumor-associated macrophages is involved in the proliferation， apoptosis， and metastasis of tumor cells. Therefore， targeted regulation of the polarization of tumor-associated macrophages is a potential target for clinical treatment of malignancies. Based on the research articles published in the past three years， this article reviewed macrophage polarization and the anti-tumor mechanism of Chinese medicine from four perspectives， i.e.， macrophage polarization， related pathways and regulatory factors of macrophage polarization， macrophage polarization and breast cancer， colorectal cancer， and lung cancer， and macrophage polarization and anti-tumor effects of Chinese medicine， active ingredients of Chinese medicine， and self-formulated prescriptions/classic prescriptions. This study is expected to provide certain ideas for the clinical treatment， basic research， and development of new Chinese medicine in the treatment of tumors.

Analysis of the factors influencing the pathological complete remission and prognosis of young breast cancer patients after neoadjuvant chemotherapy / 中国综合临床

Objective:To explore the clinicopathological factors that influence the prognosis and pathological complete response (PCR) of young breast cancer patients after neoadjuvant chemotherapy.Methods:From January 2007 to December 2017, 87 cases of female breast cancer patients aged ≤40 who received neoadjuvant chemotherapy and were admitted to the breast surgery department of Qingdao 8th people′s hospital were analyzed retrospectively.According to the pathological results, , the patients were divided into three groups: 30 in the PCR group and 57 in the non PCR group. To compare the correlation between the composition of PCR, recurrence/metastasis and death and clinicopathological characteristics, and to analyze the relationship between PCR and disease-free survival(DFS) and overall survival(OS).Results:After neoadjuvant chemotherapy, 30 of the 87 patients reached to PCR (34.5%). The proportion of PCR after neoadjuvant chemotherapy in young breast cancer is related to estrogen receptor (ER), progesterone receptor (PR), preoperative lymph node status, Ki67 level and molecular typing( χ 2 values were 3.592, 4.614, 8.373, 4.251 and 14.569, respectively, P values were 0.047, 0.032, 0.039, 0.039 and 0.006, respectively; the proportion of recurrence and metastasis patients with Er, PR and human epidermal growth factor receptor 2 2, HER-2, tumor size and lymph node status were correlated (χ 2 values were 8.778, 6.243, 9.413, 14.910, 23.074, P values were 0.003, 0.013, 0.009, 0.002, < 0.001, respectively); the proportion of dead patients was correlated with Er, PR, HER-2, grade, tumor size and lymph node status (χ 2 values were 6.686, 4.340, 11.874, 15.707, 12.428, 26.564, respectively, P values were 0.010, 0.037, 0.003, < 0.001, 0.006, < 0.001). Er, PR, HER-2, tumor size, preoperative lymph node status and molecular typing were correlated with DFS ( HR(95% CI) was 0.53 (0.31-0.93), 2.12 (1.21-3.64), 0.46 (0.27-0.77), 1.91 (1.40-2.62), 2.22 (1.55-3.20), 1.21 (0.95-1.55), all P< 0.05), while er, PR, HER-2, classification, tumor size and preoperative lymph node status were closely correlated with OS ( HR(95% CI was 0.47 (0.23-0.98), 2.14 (1.03-4.44), 0.37 (0.19-0.76), 2.90 (1.45-5.79), 1.86 (1.24-2.79) and 2.22 (1.39-3.56), respectively (all P < 0.05)). Among the 33 patients with recurrence and metastasis, 5 (16.7%)patients had PCR, while the remaining 28 (49.1%)patients had not reached PCR, accounting for 49.1% (28/57) of all the non PCR patients. The difference between the two groups was statistically significant ( P = 0.019). Among the 21 patients who died, there were 2 patients with PCR, accounting for 6.7% (2/30) of all the patients with PCR; the remaining 19 patients did not reach PCR, accounting for 33.3% (19/57) of all the patients without PCR. The difference between the two groups was statistically significant( P= 0.026). Conclusion:The proportion of PCR, DFS and OS in young breast cancer patients after neoadjuvant chemotherapy were affected by many clinicopathological factors.

Efficacy and safety of anticoagulant therapy with warfarin in hemodialysis patients with atrial fibrillation / 中华全科医师杂志

Objective To evaluate the efficacy and safety of anticoagulant therapy with warfarin for hemodialysis patients with atrial fibrillation.Methods A cohort of 118 hemodialysis patients with atrial fibrillatio were enrolled.The patients were divided into two groups:in warfarin group (n=53) the standard medication of warfarin was given for at least 3 months by adjusting the INR between 2.0 and 3.0;while no anticoagulants were given after discharge in non-warfarin group (n=65).Patients were followed up regularly,the events of stoke,death and bleeding were documented and compared between two groups.Results There were no significant differences in age,sex,underlying disease,predictive score of stroke risk in patients with non-valvular atrial fibrillation (CHA2DS2-VASc),predictive score of bleeding risk in patients with non-valvular atrial fibrillation (HAS-BLED) and dialysis frequency between the two groups (P＞0.05).There were no significant differences in events of ischemic stroke [11％(6/53) vs.12％(8/65),x2=0.027,P=0.87],bleedings [(9％(5/53) vs.5％(3/65),P=0.46] and gastrointestinal bleeding events [6％(3/53) vs.3％ (2/65),P=0.66] between two groups.There were no significant differences in the death event [15％(10/53) vs.22％(14/65),x2=0.129,P=0.72] and cardiac death [9％(5/53) vs.11％(7/65),x2=0.057,P=0.81] between two groups.Conclusion This study suggests that warfarin may not prevent ischemic stroke in hemodialysis patients with chronic atrial fibrillation,further studies are needed to determine the risks and benefits of anticoagulation therapy in these patients.

Comparative study on sepsis models induced by Escherichia coli subtypes / 天津医药

Objective To investigate the degrees of injury severity of sepsis models made by different kinds of Escherichia coli. Methods The 152 mice were randomly divided into control group, DH5α group, 44102 group, and 25922 group, with 38 rats in each group. DH5α group, 44102 group and 25922 group were intraperitoneally injected with 300 μL of Escherichia coli DH5α, 44102 and 25922 at the concentration of 1.0 × 109CFU/kg to prepare sepsis models of different kinds of Escherichia coli. Control group was injected intraperitoneally with the same amount of normal saline. (1) After 8 h, four mice were taken from each group for peripheral blood bacterial culture . (2) After 12 h, ten mice in each group were used for measuring serum levels of TNF-α and IL-6 by enzyme-linked immunosorbent assay (ELISA). (3) Western blot assay was used to determine the serum levels of high-mobility group protein (HMGB1) in four mice of each group. (4) Ten mice in each group were used to measure serum levels of alanine transaminase (ALT), aspartate aminotransferase (AST), creatinine (CR) and blood urea nitrogen (BUN) by automatic biochemical analyzer. (5) After liver, lung and kidney tissues were fixed with formaldehyde, hematoxylin-eosin (HE) staining was performed (n=10 for each group). Results In DH5α group, 44102 group and 25922 group, bacteria, inflammatory cytokines TNF-α, IL-6 and HMGB1 protein, liver and kidney indicators ALT, AST, CR and BUN showed a sequential increasing trend (P＜0.01). The severe degrees of alveolar structure damage, hepatic cell infiltration and renal glomerular atrophy were DH5α group, 44102 group and 25922 group in turn. There were no obvious damages of lung, liver or kidney tissues in control group. Conclusion Escherichia coli 25922 induces severe sepsis injury and can be used to study the animal models of the initial inflammatory phase of sepsis. Escherichia coli 44102 induces moderate damage of sepsis and can be used in animal models that do not require definitive sepsis staging experiments. Escherichia coli DH5α induces less damage of sepsis and can be used to explore immunosuppressive therapy of the animal model of sepsis.

Similarity Evaluation of the Dissolution Curves between Generic and Original Metoprolol Tartrate Tablets / 中国药房

OBJECTIVE:To establish the method for dissolution determination of Metoprolol tartrate tablets,and to evaluate the similarity of dissolution curves of generics and original drugs. METHODS:The paddle method was adopted with rotational the speed of 50 r/min,using pH 1.2 hydrochloric acid solution,pH 4.5 acetate buffer solution and pH 6.8 phosphate buffer solution as dissolution media. Fiber-optical drug dissolution real-time measurement instrument was used to determine the dissolution curves of generic and original Metoprolol tartrate tablets with optical distance of 10 mm. Similarity factor (f2) method was used to evaluate its similarity. RESULTS:In 3 dissolution mediums,the f2 of generic and original Metoprolon tartrate tablets were 80.5,66.8, 69.4,respectively,which indicated that the dissolution curves showed similarity. CONCLUSIONS:Established real-time dissolution process analysis method is suitabe for the dissolution determination of Metoprolol tartrate tablets. Generic and eriginal show the sim-ilarity in dissolation behavier,so they have good consistency in quality.

Comparison of efficacy of different treatments for pulmonary embolism / 华中科技大学学报（医学）（英德文版）

An optimal therapy for pulmonary embolism (PE) was explored by comparing three different methods in order to alleviate the sufferings of PE patients and reduce the mortality. Eighty patients with PE diagnosed by computed tomography angiography (CTA) were treated with thrombolysis, anticoagulation only, or surgery/intervention. The clinical efficacy of different treatments were compared and analyzed. Twenty-four out of the 26 patients (92%) in anticoagulation only group showed improvement in CTA and clinical presentations, which was significantly higher than that in the thrombolysis group (87%, n=39, P<0.05). However, there was no significant difference in the rate of mortality between thrombolysis group and anticoagulation only group. In the surgery/interventional group (n=15), the success rate was 47%, and the mortality rate was 14%. Both of them were significantly different from those in thrombolysis and anticoagulation only groups (both P<0.05). Log-rank analysis of the data of 5-year follow-up revealed that the survival time in surgery/intervention group was significantly shorter than in the other two groups (P<0.05). It was suggested that it is of importance to choose the appropriate therapeutic regimen for PE patients. Mortality may be reduced and prognosis may be improved with anticoagulation only and thrombolysis therapy.

Comparison of efficacy of different treatments for pulmonary embolism / 华中科技大学学报（医学）（英德文版）

An optimal therapy for pulmonary embolism (PE) was explored by comparing three different methods in order to alleviate the sufferings of PE patients and reduce the mortality. Eighty patients with PE diagnosed by computed tomography angiography (CTA) were treated with thrombolysis, anticoagulation only, or surgery/intervention. The clinical efficacy of different treatments were compared and analyzed. Twenty-four out of the 26 patients (92%) in anticoagulation only group showed improvement in CTA and clinical presentations, which was significantly higher than that in the thrombolysis group (87%, n=39, P<0.05). However, there was no significant difference in the rate of mortality between thrombolysis group and anticoagulation only group. In the surgery/interventional group (n=15), the success rate was 47%, and the mortality rate was 14%. Both of them were significantly different from those in thrombolysis and anticoagulation only groups (both P<0.05). Log-rank analysis of the data of 5-year follow-up revealed that the survival time in surgery/intervention group was significantly shorter than in the other two groups (P<0.05). It was suggested that it is of importance to choose the appropriate therapeutic regimen for PE patients. Mortality may be reduced and prognosis may be improved with anticoagulation only and thrombolysis therapy.

Influence of noninvasive ventilator in the treatment of plasma C-reactive protein , endothelin-1 and tumor necrosis factor-α in patients with obstructive sleep apneahypopnea syndrome / 实用医学杂志

Objective To investigate the effect of noninvasive ventilator therapy on serum C-reactive protein (CRP), endothelin-1 (ET-1) and tumor necrosis factor-α (TNF-α) levels in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and its clinical significance. Methods One hundred cases of moder-ate and severe OSAHS patients were selected by the method of parallel opening. All of the patients were given health education requirement , quitting smoking and wine , low fat diet and exercise to lose weight and other con-ventional treatment. The patients were randomly divided into the treatment group of 42 cases with noninvasive ventilator treatment , 44 cases treated with conventional treatment , to observe the changes of serum CRP , ET-1 and TNF-α levels and PSG parameters after 12 weeks in two groups. Results Apnea hypopnea index (AHI), oxygen desaturation index (ODI), the lowest oxygen saturation (LSpO2), and the average oxygen saturation MSpO2 in OSAHS patients were significantly improved after treatment (P < 0.01), but the degree of improvement in the two groups after treatment was significantly higher than the control group (P < 0.01). Plasma CRP, ET-1 and TNF-α levels in the two groups after treatment were lower than before treatment (P < 0.05 or P < 0.01), but the treatment group was significantly higher than that of the control group ( P < 0 . 05 or P < 0 . 01 ) . Conclusion Noninvasive ventilator therapy in improving the OSAHS monitoring data of patients with PSG can effectively reduce the serum CRP, TNF-α, ET-1 level, reduce the body′s inflammatory reaction.

Prognostic value of right ventricular end-diastolic diameter in patients with chronic systolic heart failure / 中华老年医学杂志

Objective To investigate the prognostic value of right ventricular end-diastolic diameter (RVDD) in patients with chronic systolic heart failure (CHF).Methods A retrospective study was conducted with clinical data of inpatients from 12 third-grade class-A hospitals of Hubei Province between 2000 to 2010,followed up by phone calls.Based on RVDD,patients diagnosed with chronic systolic CHF were divided into four groups:＞38 mm,31-38 mm,25-30 mm and ＜25 mm groups;based on prognosis,patients were divided into the death group and the survival group.Of the death group,patients were further divided into the heart failure death subgroup and the sudden cardiac death subgroup.Single-factor and multi-factor Cox survival analyses were conducted to analyze the relationships between RVDD and mortality,including all-cause mortality,CHF mortality and sudden cardiac death (SCD).Results A total of 16681 patients were enrolled in this study.They were followed up for 1-4 years,during which 6453 died.Multivariate Cox survival analysis showed that the mortality risk for patients with RVDD between 25-30 mm,between 31-38 mm,and ＞38 mm groups was 1.87,2.41,3.95 times that for patients with RVDD＜25 mm,respectively (95％CI:1.64-2.13,2.06-2.80,3.61-4.32,all P＜0.01).The risk of sudden cardiac death for patients with RVDD＞38mm was 3.82 times that for patients with RVDD＜25 mm (95％CI:2.27-5.94,P＜0.01).The areas under the ROC curve for death by the best prediction model alone and RVDD combined with the best respectively.RVDD increased the areas under the ROC curve for all cause mortality,CHF mortality and sudden cardiac death.The best prediction model combined with RVDD could discriminate between total mortality,heart failure mortality and sudden cardiac death for patients with different causes of death in multivariate analysis.Conclusions RVDD has a predictive value in the prognosis of patients with chronic systolic heart failure.RVDD increases the sensitivity and specificity of the best prediction model for total mortality prediction in patients with chronic systolic heart failure.RVDD increases the sensitivity and specificity of the best prediction model to discriminate between all-cause mortality,heart failure mortality and sudden cardiac death in patients with different causes of death.RVDD＞38 mm can serve as an indicator for the assessment of sudden cardiac death in CHF patients.

The application of real-time three-dimensional transesophageal echocardiography in percutaneous left atrial appendage closure / 中华超声影像学杂志

Objective To evaluate the application of real-time three-dimensional transesophageal echocardiography (RT-3D TEE)in left atrial appendage (LAA)closure.Methods After excluding valvular disease,21 of 36 atrial fibrillation (AF)patients suffered the percutaneous LAA closure were chosen to measure left ventricular ejection fraction (LVEF)and to observe if the thrombus or the cloudiness echo will occur.The multiple planner reconstruction function was applied to rebuild sections and to observe the LAA anatomical morphology and its internal structure.During operation,the Flexi Slice function was used to measure the dimensions of LAA ostium,RT-3D mode was used to monitor sheath transport and closure device release,and to immediately evaluate the effect of blocking and complications after the operation. Results The exam before the closure procedure showed 5 of 36 patients' left ventricular ejection fraction (LVEF)<40% and one or more thrombus or the cloudiness echo were found in other 10 patients' which were thus excluded from the study.RT-3D TEE examination in the 21 patients revealed 8 single-lobe cases, 8 double-lobes cases and 5 patients with multi-lobe.Two patients of them need a special device.The maximum dimensions of LAA ostium was (22.24±4.35)mm,the fixed plate size of conventional LAmbreTM device was (28.26±5.23)mm.All patients choiced an average (1 .1 ±0.30)closure device and get the best sealing effect evaluated by RT-3D TEE immediately after operation,10 cases of them has about 1 -3 mm residual leakage exist around the closure.None of the patients with a new pericardial effusion and cardiac tapenade,no closure shift and embolism events.Conclusions RT-3D TEE can real-time and dynamically observe LAA anatomical morphology and its internal structure,compared with other imaging techniques, RT-3D TEE has irreplaceable advantages in the percutaneous LAA closure.

Detection of IL-35 in plasma in the patients with active tuberculosis complicated with bronchiectasis and its clinical significance / 国际检验医学杂志

Objective To detect plasma interleukins-35 (IL-35 )level in the patients with active tuberculosis complicated with bronchiectasis and to analyze its clinical significance.Methods Peripheral blood of patients with active tuberculosis from depart-ment of Dongguan 6th People′s hospital were collected,assigned to the active tuberculosis complicated with bronchiectasis group and active tuberculosis group.The healthy volunteers served as the control group.The plasma IL-35 level was measured by ELISA, and peripheral blood neutrophils and lymphocytes were detected by hematology analyzer.Results The levels of plasma IL-35 signif-icantly increased in both patients with active tuberculosis complicated with bronchiectasis and patients with active tuberculosis.The level of plasma IL-35 of patients with active tuberculosis complicated with bronchiectasis was significantly higher than that of the patients with active tuberculosis.The absolute value and percentage of peripheral blood neutrophils of patients with active tubercu-losis complicated with bronchiectasis were significantly higher than those of healthy volunteers.However,the percentage of periph-eral blood lymphocytes of patients with active tuberculosis complicated with bronchiectasis was significantly lower than that of healthy volunteers.Pearson correlation analysis showed that the absolute value of peripheral blood neutrophils of patients with ac-tive tuberculosis was positively correlated to the level of plasma IL-35.Conclusion IL-35 may play an important role in the progres-sion of active tuberculosis complicated with bronchiectasis.The determination of IL-35 may be helpful to the diagnosis of patients with active tuberculosis complicated with bronchiectasis.

Clinical value of two-dimensional and real-time three-dimensional transesophageal echocardiography for the guidance of left atrial appendage closure:a comparison study for LAmbre device selection / 中华超声影像学杂志

Objective To explore the clinical value of two‐dimensional transesophageal echocardiography (2D‐TEE) and real‐time three‐dimensional transesophageal echocardiography (RT3D‐TEE) for the left atrial appendage (LAA) closure procedures by the visualization of LAA shape by 2D‐TEE and RT3D‐TEE and the comparison between the measurement of LAA ostium and the sized LAmbreTM device during the procedure .Methods Forty‐one atrial fibrillation patients ,who had undergone 2D‐TEE examination at our hospital ,were enrolled in the study .At the mid‐esophageal ,dimensions of inner and outer ostium and depth of LAA were measured at the 2D‐TEE views of 0 ,45 ,90 and 135 degree respectively . RT3D‐TEE views were acquired and the maximal and the minimal dimensions of LAA inner ostium were measured .The measurement by RT3D‐TEE and 2D‐TEE were compared to find the difference and correlation .Eleven of 41 patients who have complied with the requirements for the LAA closure ,were undergone the procedures ,measured the dimension of LAA inner ostium at selective angiography intraoperative .Sizes of closure disks of the closure device and the measurement at selective angiography were recorded to compare the measurement at RT3D‐TEE and 2D‐TEE .Results Forty‐one atrial fibrillation patients were completed TEE examination successfully .Inner ostial dimension of LAA was (20.0±04.3)cm,(19.7±03.8)cm,(21.2±04.6)cm,(23.0±05.0)cmat2D‐TEEviewsof0,45,90and135 degree ,respectively .The maximum dimensions of LAA inner ostium by RT3D‐TEE was (2 4.9 ± 0 5.2)cm . At 2D‐TEE views ,the maximum dimensions of LAA inner ostium was at 135 degree ,there was a difference between it and the measurement by RT3D‐TEE ( P =0 0.12) .Monitoring by TEE ,LAA closure procedures with LAmbreTM device were successful for all 11 patients ,the landing zone by selective angiography was (2 4.9 ± 0 4.4)cm ,and the appropriate sized closure disk of the LAmbreTM device was 2 4. - 3 6. cm . Correlation between the measurements by RT3D‐TEE and selective angiography and the sized closure disk were r =0 8.16 ,P =0 0.02 and r =0 9.14 ,P =0 0.00 ,respectively .Correlation between the measurements by 2D‐TEE and selective angiography and the sized closure disk were r =0 6.93 ,P =0 0.18 and r =0 6.88 , P=0 0.19 ,respectively .Conclusions There was better correlation among the measurements by RT3D‐TEE and selective angiography and the size of closure device .Therefore ,compared to 2D‐TEE ,the guidance of RT3D‐TEE was more accurate during LAA closure procedures for LAmbreTM device selection .

Role of transforming growth factor-β1 in epithelial-mesenchymal transition of mesothelial cells and its effect on peritoneal metastasis of gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To elucidate the role of transforming growth factor-beta1(TGF-β1) in epithelial-mesenchymal transition of mesothelial cells and peritoneal metastasis of gastric cancer.</p><p><b>METHODS</b>HMrSV5 cells, a human peritoneal mesothelial cell line, were incubated with TGF-β1, and their morphological changes were observed by phase contrast microscopy. Expressions of α-smooth muscle actin (α-SMA), vimentin, cytokeratin, E-cadherin, phosphorylated-Smad2 and Smad2 were examined by Western blotting. After fibroblastic-like mesothelial cells were co-incubate with HSC-39 cells(gastric cancer cell line), the adhesion and invasion potential of HSC-39 were evaluated by adhesion and invasion assay in vitro.</p><p><b>RESULTS</b>Few mesothelial cells converted to spindle fibroblast-like morphology for 24 h, and remarkable phenotypic changes were observed at 72 h of TGF-β1 activation. TGF-β1 could induce α-SMA and vimentin expression, and down-regulate cytokeratin and E-cadherin expression in mesothelial cells (P<0.05). TGF-β1 induced phosphorylation of Smad2 within 15 min of stimulation, reached a maximum at 30 min after treatment and remained high level during the experiment without affecting total Smad2 expression(P>0.05). The percentage of HSC-39 gastric cancer cells adhered were significantly increased as compared to the control. When the mesothelial cells were treated by TGF-β1 for 72 h, the increased adhesion percentage was(146±17)%(P<0.05). After fibroblastic-like mesothelial cells co-incubated with HSC-39 cells for 48 h, more cancer cells [(61.1±11.4) cells/view field] invaded the coated membrane as compared to the control group [(31.9±8.1) cells/view field] (P<0.05).</p><p><b>CONCLUSION</b>TGF-β1 can induce the transition of mesothelial cells into myofibroblasts and Smad2 signal pathway may play a role in this transition, which is associated with increased adhesion and invasiveness of gastric cancer cells, and provides favorable environment for the dissemination of gastric cancer.</p>

Left atrial appendage morphology in patients with atrial fibrillation in China: implications for stroke risk assessment from a single center study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The left atrial appendage (LAA) is thought to be the main source of thrombi in patients with atrial fibrillation (AF). The purpose of this study was to describe the LAA orifice diameter, LAA length, and morphologic type of the LAA in Chinese patients with AF as well as to evaluate whether these LAA parameters are associated with a history of stroke in patients with AF from a single center in China.</p><p><b>METHODS</b>The study population consisted of 219 consecutive patients with drug-refractory, symptomatic paroxysmal, or persistent AF scheduled to undergo radiofrequency catheter ablation in our single center. All patients underwent extensive clinical assessment and multidetector computed tomography to fully explore the anatomy of the LAA.</p><p><b>RESULTS</b>Of the 219 patients who underwent catheter ablation procedures, chicken wing LAA morphology was found in 114 patients (52.2%), windsock in 52 (23.9%), cauliflower in 29 (13.0%), and cactus in 24 (10.9%). Compared with the windsock LAA morphology, cactus had a larger left atrial diameter ((42.40 ± 3.68) and (37.91 ± 4.32) mm, P = 0.005) and LAA orifice diameter ((27.38 ± 3.70) and (24.14 ± 3.58) mm, P = 0.048). The LAA length was significantly larger in the chicken wing morphology than in the windsock ((37.50 ± 6.74) and (31.33 ± 3.92) mm, P = 0.015) and cauliflower morphologies ((37.50 ± 6.74) and (31.33 ± 3.92) mm, P = 0.015). According to their medical records, 26 patients (11.9%) had suffered a prior stroke. Compared with patients who had no history of stroke, the prior-stroke patients were older (62.04 ± 8.07 and 58.24 ± 9.24, P = 0.047) and there were fewer patients with chicken wing (23.1% and 59.1%, P = 0.001) and more patients with cauliflower (26.9% and 9.8%, P = 0.046). Multivariate Logistic regression analysis demonstrated that age (odds ratio (OR) 1.26; 95% confidence interval (CI) 1.08-1.47; P = 0.003), non-chicken wing morphology (OR 5.82; 95% CI 1.61-21.03; P = 0.007), and LAA orifice diameter (OR 1.25; 95% CI 1.05-1.49; P = 0.014) were independent predictors of stroke after adjusting for all parameters that emerged as potential confounders with univariate analysis.</p><p><b>CONCLUSION</b>LAA analysis can potentially be used to inform guidance on the implication for stroke risk assessment.</p>

Genes associated with hypospadias: an update / 中华男科学杂志

Hypospadias is one of the most common congenital malformations, and its main clinical manifestation is the abnormal opening of the urethra. Etiologically, it can be attributed to many factors, mainly including genetic, hormonal, and environmental factors. Recently studies about its genetic etiologies have found a variety of hypospadias-associated genes from the aspects of epidemiology and polymorphism, mainly those involving the formation of the penis, the development of the testis, the anabolism of androgens, and so on. This review focuses on the progress in the studies on the genetic etiology of hypospadias.

Plasma amino acid profiling of "same symptom for different disease" in Uyghur medicine based on high-performance liquid chromatography / 中南大学学报(医学版)

OBJECTIVE@#To determine the plasma amino acid metabolism of "same symptom for different diseases" in different cancer patients in Uyghur medicine.@*METHODS@#Plasma amino acid concentration was tested by high-performance liquid chromatography (HPLC) in cancer patients with different symptom, and the spectral profiles were subjected to a t-test for statistical significance.@*RESULTS@#Compared with the healthy group, lung cancer, cervical cancer, breast cancer and gastric cancer patients with abnormal Savda had lower concentration of plasma amino acids except some amino acids. Lung cancer patients with abnormal Savda had higher concentration of plasma phenylalanine, serine, cystine, valine, isoleucine, leucine and aspartic acid than Unsavda patients (P<0.05). Cervical cancer patients with abnormal Savda had low concentration of plasma arginine, but higher concentration of plasma cystine than Unsavda patients (P<0.05). Breast cancer patients with abnormal Savda had higher concentration of plasma leucine, serine, taurine, cystine, tyrosine, valine, isoleucine and asparagine than Unsavda patients (P<0.05). Gastric cancer patients with abnormal Savda had high concentration of plasma cystine but lower concentration of plasma phenylalanine, threonine and arginine than Unsavda patients (P<0.05).@*CONCLUSION@#Different tumor patients with abnormal Savda have common characteristics and significant differences.

Analysis of deaths caused by secondary damages of road traffic accidents: 17 fatal cases / 法医学杂志

OBJECTIVE@#To explore the forensic identification points of deaths caused by secondary damages of road traffic accidents.@*METHODS@#Seventeen deaths caused by secondary damages of road traffic accidents were collected. Through scene investigation and necropsy, the basic information of the accidents, distribution and property of the injuries, and other information were collected. According to the collected data, the scene was reconstructed in order to confirm the injury process, analyze the way, mechanism and severity of injury, distinguish antemortem injury from postmortem injury, and determine the cause of deaths.@*RESULTS@#Certain features such as serious injuries, multiple traumas, combined injuries, co-existence of antemortem and postmortem injuries, multiple causes of wounds, complex injury mechanism, as well as the mutual damaging and overlapping injuries were quite characteristically noted in these secondary traffic accident cases.@*CONCLUSION@#Forensic assessment of deaths caused by secondary damages of road traffic accidents should be synthetically analyzed and judged through scene investigation and necropsy.

Analysis of Deaths Caused by Secondary Damages of Road Traffic Accidents：17 Fatal Cases / 法医学杂志

Objective To explore the forensic identification points of deaths caused by secondary dam-ages of road traffic accidents. Methods Seventeen deaths caused by secondary dam ages of road traffic accidents were collected. Through scene investigation and necropsy, the basic inform ation of the acci-dents, distribution and property of the injuries, and other inform ation were collected. A ccording to the collected data, the scene was reconstructed in order to confirm the injury process, analyze the way, mechanism and severity of injury, distinguish antem ortem injury from postm ortem injury, and determ ine the cause of deaths. Results C ertain features such as serious injuries, multiple traum as, com bined in-juries, co-existence of antem ortem and postm ortem injuries, multiple causes of wounds, com plex injury mechanism , as well as the mutual dam aging and overlapping injuries were quite characteristically noted in these secondary traffic accident cases. Conclusion Forensic assessment of deaths caused by secondary dam ages of road traffic accidents should be synthetically analyzed and judged through scene investigation and necropsy.

Association between intraocular pressure and systemic factor / 中华实验眼科杂志

Background Abnormality of intraocular pressure (IOP) leads to ocular shape change and functional damage.Previous study on the influence factors of IOP mostly focus on eye tissue,but the research of systemic affecting factor is lack.Objective This study was to survey the distribution of IOP and its association with the systemic factors in Chinese population.Methods A cross-section study was designed in this study.The subjects were enrolled from the government employees physical check-up cohort in Guangzhou.IOP was measured using non-contact tonometry.The height,weight and blood pressure were measured based on a presupposed standard protocol.Fundus and slit lamp examinations were performed by trained ophthalmologists.Frequency-doubled perimetry was carried out in the subjects with the suspicious optical disc abnormality,and abnormal perimetry result and operated eye were rejected in the survey.The operative history was learned by questionnaire.Stata 11.0 was used for the data analysis.Results Total 7763 subjects finished all the examination,including 4213 male and 3550 female.Four hundred and fifteen subjects were excluded due to previous intraocular surgery and glaucoma,and the clinical data of the right eyes of 7348 subjects who were eligible for the protocol were brought into statistical analysis.The mean IOP was (15.6±2.8) mmHg in the subjects,and that in the male and female subjects was (15.6±2.8) mmHg and (15.7±2.8) mmHg,respectively,showing a statistically significant difference (t =2.415,P =0.016).A good consistence was found in the IOP between the right eyes and the left eyes (r=0.830,P＜0.001).The IOP value in the subjects presented with a near normal distribution.IOP value was gradually decreased with the increase of age.Multivariate regression suggested a negative correlation between IOP and age or gender (P＜0.001) as well as a positive correlation between IOP and body weight index (BMI),systolic blood pressure or diastolic blood pressure (P ＜0.001).Conclusions Similar to other studies in East Asia population,IOP is associated with age,gender,BMI,systolic and diastolic blood pressure in this survey.