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OBJECTIVE@#To evaluate the efficacy of the second-line nilotinib and third-line dasatinib on chronic myelogenous leukemia (CML) with failed first- and second-line treatments, and analyze the influencing factors of the efficacy.@*METHODS@#Selected 83 patients in The Third People's Hospital of Kunshan City, Jiangsu Province with CML who were treated with nilotinib as the second-line treatment after the failure of the first-line treatment with imatinib as the second-line treatment group (referred to as the second-line group) from January 2014 to December 2018, and 61 CML patients who were treated by dasatinib as the third-line treatment group (referred to as the third-line group) after the failure of the second-line treatment with nilotinib; the first-line treatment with imatinib failed, but due to various reasons, the patients were fully after being informed of the possible serious consequences of not changing the drug treatment, 37 CML patients who were still required to continue imatinib treatment served as the control group. The hematological, genetic and molecular responses of each group were compared for 3, 6, and 24 months of treatment. LogistiC regression was used to analyze the factors affecting the second and third line curative effects.@*RESULTS@#The three groups had statistically significant differences in the rates of achieving CHR, MCyR, and MMR at 3, 6, and 12 months of treatment (P<0.05). Compared the two groups, the CHR rates of the second-line group at 3, 6, and 12 months of treatment were 100.00%, 97.59%, and 95.18%, respectively; higher than the third-line group's 90.16%, 86.89%, 83.61% and the control group's 83.78%, 75.68% and 72.97%; the CHR rate of the third-line group was higher than that of the control group at 6 and 12 months of treatment. The rates of reaching MCyR at 3, 6, and 12 months after treatment in the second-line group were 87.95%, 93.98% and 93.98%, respectively, while those in the third-line group were 80.33%, 88.52% and 86.89%, which were higher than those of the control group of 67.57%, 64.86% and 48.65%. The rates of achieving MMR at 3, 6, and 12 months of treatment in the second-line group were 19.28%, 33.72% and 60.24%, respectively, and those in the third-line group were 11.48%, 26.23% and 49.18%, which were higher than those of the control group of 0.00%, 2.70% and 0.00%; The rate of reaching MMR within 12 months of treatment in the second-line group was higher than that of the third-line group, and the differences was statistically significant (P<0.05). There was no significant difference in the rate of reaching MCyR between the second-line group and the third-line group at 3, 6, and 12 months, and the rate of reaching MMR at 3 and 6 months (P>0.05). The incidence of nausea and vomiting among the three main non-hematological adverse reactions, and the incidence of grade 1~2 anemia among the hematological adverse reactions were statistically significant (P<0.05). There was no significant difference in the incidence of rash, eyelid edema, diarrhea, thrombocytopenia, leukopenia and neutropenia in the three groups (P>0.05). The incidence of nausea and vomiting and grade 1~2 anemia in the second-line group and the third-line group were higher than that of the control group, and the difference was statistically significant (P<0.05). There were statistically significant differences in Sokal score, medication compliance, and hematological adverse reactions between the MMR group and the non-MMR group (P<0.05). Logistic regression analysis showed that dose reduction or withdrawal during the treatment period, and grade 3~4 hematological adverse reactions were the main factors affecting the second and third line curative effects (OR=22.160, 2.715, 95% CI=2.795-93.027, 1.882-48.834).@*CONCLUSION@#The second-line nilotinib and the third-line dasatinib have a better effect on CML patients who have failed the first and second-line treatments. Grade 3~4 hematological adverse reactions, dose reduction or withdrawal are risk factors that affect the efficacy of second and third-line treatments.
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Humans , Antineoplastic Agents/therapeutic use , Dasatinib/therapeutic use , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Protein Kinase Inhibitors/therapeutic use , Pyrimidines/therapeutic use , Treatment OutcomeABSTRACT
SUMMARY: Lumbar disc herniation is considered to be the main pathological factor for the common clinical disease of low back pain. Biomechanical factor is an important cause of lumbar disc herniation, so it is urgent to analyze the stress/strain behavior of intervertebral disc under different loading condition. Slow repetitive loading is considered to be an important factor of spine and disc injuries, and the effect of fatigue load on internal displacement in the intervertebral disc was investigated by applying the optimized digital image correlation technique in this study. The first finding was that fatigue load had a significant effect on the displacement distribution in the intervertebral disc under compression. Superficial AF exhibited the largest axial displacements before fatigue load, while it exhibited the smallest axial displacements after fatigue load. Inner AF exhibited slightly smaller radial displacements than outer AF before fatigue load, while it exhibited significantly greater radial displacements than outer AF displacements after fatigue load. The second finding was that fatigue load had a certain effect on the internal displacement distribution in the flexed intervertebral disc under compression. Middle AF exhibited the smallest axial displacements before fatigue load, while deep AF exhibited the smallest axial displacements after fatigue load. The radial displacement distribution did not change before and after fatigue load, as the radial displacement in outer AF was the smallest, while the radial displacement in inner AF was the largest. The third finding was that with the increase in fatigue time and amplitude, the Young's modulus of the intervertebral disc increased significantly. This study can provide the basis for clinical intervertebral disc disease prevention and treatment? and is important for mechanical function evaluation of artificial intervertebral disc as well.
RESUMEN: La hernia de disco lumbar se considera el principal factor patológico para la enfermedad clínica común del dolor lumbar. El factor biomecánico es una causa importante de hernia de disco lumbar, por lo que es urgente analizar el comportamiento de esfuerzo / tensión del disco intervertebral bajo diferentes condiciones de carga. La carga repetitiva lenta se considera un factor importante de lesiones de columna y disco, y en este estudio el efecto de la carga de fatiga sobre el desplazamiento interno en el disco intervertebral se investigó mediante la aplicación de la técnica de correlación de imagen digital optimizada. El primer hallazgo fue que la carga de fatiga tuvo un efecto significativo en la distribución del desplazamiento en el disco intervertebral bajo compresión. El AF superficial exhibió los desplazamientos axiales más grandes antes de la carga de fatiga, mientras que exhibió los desplazamientos axiales más pequeños después de la carga de fatiga. El AF interno exhibió desplazamientos radiales ligeramente más pequeños que el AF externo antes de la carga de fatiga, mientras que exhibió desplazamientos radiales significativamente mayores que los desplazamientos AF externos después de la carga de fatiga. El segundo hallazgo fue que la carga de fatiga tenía un cierto efecto sobre la distribución del desplazamiento interno en el disco intervertebral flexionado bajo compresión. El AF medio exhibió los desplazamientos axiales más pequeños antes de la carga de fatiga, mientras que el AF profundo exhibió los desplazamientos axiales más pequeños después de la carga de fatiga. La distribución del desplazamiento radial no cambió antes ni después de la carga de fatiga, ya que el desplazamiento radial en la FA externa fue el más pequeño, mientras que el desplazamiento radial en la FA interna fue el más grande. El tercer hallazgo fue que con el aumento del tiempo de fatiga y la amplitud, el módulo de Young del disco intervertebral aumentó significativamente. Este estudio puede proporcionar la base para la prevención y el tratamiento clínico de la enfermedad del disco intervertebral, y también es importante para la evaluación de la función mecánica del disco intervertebral artificial.
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Humans , Intervertebral Disc Displacement/etiology , Intervertebral Disc Displacement/pathology , Biomechanical Phenomena , Compressive Strength , Fatigue , Flexural Strength , Intervertebral Disc/pathology , Lumbar Vertebrae/pathology , Lumbosacral RegionABSTRACT
Objective:To evaluate the value of standardized uptake value of the left ventricle (SUV LV) during 18F-fluorodeoxyglucose (FDG) PET/CT imaging in the detection of the cardiotoxicity of anthracycline in non-Hodgkin lymphoma (NHL). Methods:Twenty-two patients(13 males and 9 females, age: ( 58±13 ) years) diagnosed as NHL from January 2016 to June 2019 were retrospectively enrolled in the study. All patients received chemotherapy regimens containing anthracycline. The gated myocardial perfusion imaging (GMPI) and whole body 18F-FDG PET/CT imaging were performed before and after chemotherapy in Changzhou First People′s Hospital. The significant reduction of diastolic function after chemotherapy measured by GMPI was defined as anthracycline induced myocardial injury. The SUV LV before and after chemotherapy and the changes (ΔSUV LV ) in patients with or without myocardial injury were compared with independent-sample t test or paired t test. The receiver operating characteristic (ROC) curve analysis was used to determine whether SUV LV could be used to detect anthracycline induced myocardial injury. Results:The reduction of LVEF after chemotherapy was more significant in myocardial injury group ( n=6) than that in patients without myocardial injury ( n=16; ΔLVEF: (-5.8±7.5)% vs (2.7±3.8)%, t=2.657, P<0.05). After chemotherapy, an increase was found in SUV LV of patients with myocardial injury (maximum SUV LV (SUV LVmax): 7.5±4.4 vs 2.6±1.0, t=2.585, P<0.05; mean SUV LV (SUV LVmean): 3.7±2.2 vs 1.6±0.8, t=2.119, P>0.05), but no differences were found in SUV LV of patients without myocardial injury (SUV LVmax: 5.7±4.9 vs 5.6±4.8, SUV LVmean : 2.8±2.3 vs 2.8±2.2; t values: 0.130, 0.069, both P>0.05). Compared with patients without myocardial injury, patients with myocardial injury had higher ΔSUV LV ( t values: 2.494, 2.163, both P<0.05) and lower pre-chemotherapy SUV LVmax ( t=2.436, P<0.05). ROC curve analysis showed that ΔSUV LVmax and ΔSUV LVmean could be used for the detection of chemotherapy induced cardiotoxicity, and higher area under curve (AUC) of ΔSUV LVmaxwas found (AUC=0.844, 95% CI: 0.673-1.000). When the threshold value was 1.1, the sensitivity and specificity of ΔSUV LVmax in the detection of myocardial injury were 5/6 and 13/16, respectively. Conclusions:Higher ΔSUV LVmax and ΔSUV LVmean, as well as lower baseline SUV LVmax are correlated with cardiotoxicity of anthracycline. ΔSUV LVmax has a potential for the diagnosis of anthracycline induced cardiotoxicity in patients with NHL.
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BACKGROUND@#Transcranial alternating current stimulation (tACS) offers a new approach for adult patients with major depressive disorder (MDD). The study is to evaluate the efficacy and safety of tACS treating MDD.@*METHODS@#This is an 8-week, double-blind, randomized, placebo-controlled study. Ninety-two drug-naive patients with MDD aged 18 to 65 years will receive 20 daily 40-min, 77.5-Hz, 15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas on weekdays for 4 consecutive weeks (week 4), following a 4-week observation period (week 8). The primary outcome is the remission rate defined as the 17-item Hamilton depression rating scale (HDRS-17) score ≤7 at week 8. Secondary outcomes are the rates of response at weeks 4 and 8 and rate of remission at week 4 based on HDRS-17, the proportion of participants having improvement in the clinical global impression-improvement, the change in HDRS-17 score (range, 0-52, with higher scores indicating more depression) over the study, and variations of brain imaging and neurocognition from baseline to week 4. Safety will be assessed by vital signs at weeks 4 and 8, and adverse events will be collected during the entire study.@*DISCUSSION@#The tACS applied in this trial may have treatment effects on MDD with minimal side effects.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry, ChiCTR1800016479; http://www.chictr.org.cn/showproj.aspx?proj=22048.
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The solubility of nebivolol hydrochloride was determined in acidic aqueous media in the absence and presence of different concentration of NaCl, NaBr, or NaI at 37 ℃ in order to facilitate proper selection of dissolution media that have adequate discriminating power for enhancing the likelihood of a generic drug product to successfully pass in-vivo bioequivalence test. In the range of pH 5.0 to pH 1.0, the solubility of nebivolol hydrochloride decreased with the decrease in the pH of aqueous solution, and the solubility of nebivolol hydrochloride further decreased with the increase in the concentration of added sodium chloride. The solubility decrease of a few weakly basic drug molecules in acidic media and in higher concentration of added chloride was published previously by other researchers, and the observed decrease in the solubility in the presence of higher chloride concentration was interpreted in terms of common-ion effect. However, the results in this paper showed that the solubility of nebivolol hydrochloride also decreased when sodium chloride was replaced with sodium bromide or iodide. The approach described in this paper (i.e. substituting sodium chloride with sodium bromide or iodide) provides an effective method to verify whether common-ion effect is the true (or at least the sole) driving force behind the observed decrease in the solubility of nebivolol hydrochloride in the presence of sodium chloride. The solubility decrease reported in this paper can be interpreted in terms of salting-out effect of sodium chloride, bromide, and iodide. For hydrochloride salt of a weakly basic drug molecule like nebivolol hydrochloride, its solubility in an acidic dissolution medium can be purposely decreased to the lower end of sink condition by adding sodium chloride to make the resulting medium more discriminating. As shown in this paper, a medium at pH 1.2 with added sodium chloride is discriminating and this medium is shown to be bio-relevant to the in-vivo data collected under fasting condition (in-vivo study protocol was approved by Institutional Review Board).
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Objective@#To evaluate the left ventricular systolic synchrony and investigate the early diagnostic value of left ventricular systolic dyssynchrony on cardiotoxicity caused by anthracyclines in patients with diffuse large B-cell lymphoma (DLBCL).@*Methods@#Thirty-two patients (22 males, 10 females, age: 22-73(54.4±14.2) years) from June 2016 to January 2019 with confirmed DLBCL and normal gated myocardial perfusion imaging (GMPI) before anthracyclines chemotherapy were enrolled prospectively. GMPI was performed after 6 cycles or more of chemotherapy. Changes of myocardial markers, electrocardiogram (ECG) indicators, left ventricular function indicators including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), peak filling rate (PFR), summed motion score (SMS) and summed thickening score (STS) as well as left ventricular systolic synchrony indicators including phase bandwidth (BW), phase standard deviation (SD) and entropy before and after anthracyclines chemotherapy were analyzed. Paired t test, Wilcoxon signed rank test and χ2 test were used for data analysis.@*Results@#Compared with pre-chemotherapy, the left ventricular systolic synchrony indicators were significantly higher than those before chemotherapy (BW: (42.81±11.37)° vs (29.28±8.68)°; SD: (11.65±4.64)° vs (8.79±3.14)°; entropy: (39.84±5.51)% vs (36.19±5.94)%; t values: -9.132 to -3.173, all P<0.05). There were no significant differences in other indicators (t values: -1.161 to 1.750, z values: -1.633 to -0.096, all P>0.05). Of 32 patients, 13 patients (40.62%) had left ventricular systolic dyssynchrony, and the rate of chemotherapy-induced left ventricular systolic dyssynchrony was significantly higher than that of left ventricular dysfunction (15.62%, 5/32; χ2=4.947, P=0.025). All 5 patients with left ventricular dysfunction caused by chemotherapy had left ventricular systolic dyssynchrony. The LVEF of the chemotherapy-induced left ventricular systolic dyssynchrony group was significantly lower than that of the left ventricular systolic synchronization group ((54.54±9.25)% vs (66.79±7.65)%; t=4.087, P<0.01).@*Conclusion@#Left ventricular systolic dyssynchrony can be appeared in DLBCL patients after chemotherapy and is significantly earlier than left ventricular dysfunction, which can be an early indicator of cardiotoxicity caused by anthracycline chemotherapy.
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Objective To evaluate the left ventricular systolic synchrony and investigate the early diagnostic value of left ventricular systolic dyssynchrony on cardiotoxicity caused by anthracyclines in pa-tients with diffuse large B-cell lymphoma ( DLBCL) . Methods Thirty-two patients ( 22 males, 10 females, age:22-73(54.4±14.2) years) from June 2016 to January 2019 with confirmed DLBCL and normal gated myocardial perfusion imaging (GMPI) before anthracyclines chemotherapy were enrolled prospectively. GMPI was performed after 6 cycles or more of chemotherapy. Changes of myocardial markers, electrocardiogram (ECG) indicators, left ventricular function indicators including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume ( LVEDV) , left ventricular end-systolic volume ( LVESV) , peak filling rate ( PFR) , summed motion score ( SMS) and summed thickening score ( STS) as well as left ventricular systolic synchrony indicators including phase bandwidth ( BW) , phase standard deviation ( SD) and entropy before and after anthracyclines chemotherapy were analyzed. Paired t test, Wilcoxon signed rank test and χ2 test were used for data analysis. Results Compared with pre-chemotherapy, the left ventricular systolic synchrony indicators were significantly higher than those before chemotherapy (BW: (42.81±11.37)° vs (29.28±8. 68)°;SD:(11.65±4.64)° vs (8.79±3.14)°;entropy:(39.84±5.51)％ vs (36.19±5.94)％;t values: -9.132 to-3.173, all P<0.05) . There were no significant differences in other indicators ( t values:-1.161 to 1.750, z values:-1.633 to-0.096, all P>0.05). Of 32 patients, 13 patients (40.62％) had left ventricular systolic dyssynchrony, and the rate of chemotherapy-induced left ventricular systolic dyssynchro-ny was significantly higher than that of left ventricular dysfunction (15.62％, 5/32;χ2=4.947, P=0.025). All 5 patients with left ventricular dysfunction caused by chemotherapy had left ventricular systolic dyssyn-chrony. The LVEF of the chemotherapy-induced left ventricular systolic dyssynchrony group was significantly lower than that of the left ventricular systolic synchronization group ((54.54±9.25)％ vs (66.79±7.65)％;t=4.087, P<0.01) . Conclusion Left ventricular systolic dyssynchrony can be appeared in DLBCL patients after chemotherapy and is significantly earlier than left ventricular dysfunction, which can be an early indi-cator of cardiotoxicity caused by anthracycline chemotherapy.
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OBJECTIVE@#To investigate the predictive effect of platelet activation index expression before and after adenosine bisphosphate activation on bleeding risk in patients with primary immune thrombocytopenia (ITP).@*METHODS@#Eighty-nine patients with ITP admitted in our hospital from January 2017 to October 2018 were selected and inrolled in ITP group, the bleeding scoreing and grading were performed by using the ITP-BAT for ITP patients, then 89 ITP patients were divided into 4 subgroups: nothing bleeding symptom group, mild bleeding symprom group, mode rate bleeding symptom group and severe bleeding symptom group according to bleeding scores and grades obtained from ITP-BAT detection. At the same time, 22 persons underwent the health physical examination were selected and enrolled in control group. The adenosine diphosphate (ADP) was used as activator for all patients and controls. The flow cytonetry was used to analyze the expression of platelet membranc glyco protein (GPⅠb, GPⅡb /Ⅲ a) and P-selectin before and after ADP activation, the multiple linear person's correlation analysis was used to analyze the correlation of bleeding degree of ITP patients before and after ADP acbivation with the expression levels of GPⅠb, GPⅡb/Ⅲa and P-selectin.@*RESULTS@#After the ADP activation, the expression level of GPⅠb significantly decreased, while the expression levels of GPⅠb, GPⅡb/Ⅲ a and P-selectin significantly increased in control group, nothing bleeding symptom group and mild bleeding symptom group; but the expression level of GPⅠb significantly increased, while the expression level of GPⅡb/Ⅲ a significantly decreased in moderate and severe bleeding symptom group, the both differences were statistically significant (P＜0.05). however, the expression level of P-selectin in moderate and severe bleeding symptom groups before and after ADP activation was not statistivally significant (P＞0.05). Before ADP activation, the expression level of GPⅠb in ITP subgroups was lower than that in control group, the expression level of GPⅡb/Ⅲ a in ITP subgroups was higher than that in control group, the expression level of P-selectin in moderate and severe bleeding symptom groups was higher than that in control group (P＜0.05). After ADP activation, the expression levels of GPⅠb and P-selectin in ITP subgroups both were lower than those in control group, the expression level of GPⅡb/Ⅲa in ITP subgroups was higher than that in control group (P＜0.05). The comparison among ITP subgroups showed that before ADP activation, the expression level of GPⅠb in moderate and severe bleeding symptom groups was lower than that in nothing bleeding symotom and mild bleeding symptom groups, while the expression levels of GPⅡb/Ⅲa and P-selectin were higher than those in nothing bleeding symptom and mild bleeding symptom groups (P＜0.05), however, after ADP activation, the expression level of GPⅠb in moderate and severe bleeding symptom groups was higher than that in nothing bleeding symptom and mild bleeding symptom groups, while the expression levels of GPⅡb/Ⅲ a and P-selection in moderate and severe bleeding symptom groups were lower than those in nothing and mild bleeding symptom groups (P＜0.05). The correlation analysis showed that before ADP activation, the expression levels of GPⅠb and GPⅡb/Ⅲa positivdy correlated with the bleeding risk (r=0.483, 0.504), and the P-selectin not correlated with the bleeding risk (r=0.000); however, after ADP activation, the expression level of GPⅠb and GPⅡb/Ⅲ a negatively correlated with the bleeding risk (r=-0.627, -0.406, -0.108).@*CONCLUSION@#The expression level of platelet activation indicators before and after ADP activation is of certain value for prevention of bleeding risk in ITP patients and can be used as a reference indicator for the treatment and efficacy evaluation.
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Humans , Adenosine , Blood Platelets , P-Selectin , Platelet Activation , Platelet Count , Purpura, Thrombocytopenic, IdiopathicABSTRACT
OBJECTIVE@#To investigate the efficacy and safety of decitabine combined with half-course pre-excitation for the treatment of elderly patients with acute myeloid leukemia (AML).@*METHODS@#44 cases of newly diagnosed elderly AML admitted in our hospital from January 2016 to December 2017 were selected for the retrospective analysis. The patients were randomly divided into 2 groups: pre-excitation therapy group as control and combined therapy group. The 22 patients in pre-excitation therapy group reccived the routine complete course pre-excitation treatment, 22 patients in combined therapy group received the desitabine combined the half course pre-excitation treatment. The therapentic efficacy and adverse reactions during treatment were compared between 2 groups. All patients were followed-up and the survival rate at 6,12 and 24 months was compared between 2 groups.@*RESULTS@#The remission rate(RR) in the combined therapy group was 72.73%, and that in the control group was 50.00%, with significant statistically difference (P0.05). The incidence of pulmonary infection, intestinal infection and other complications in combined therapy group was 13.64%, which was lower than that in control group 31.82%, and the difference of two groups was statistically significant (P<0.05). No serious complications such as arteriovenous thrombosis occurred in either group, and no patients died during chemotherapy.@*CONCLUSION@#Combination of disitamine and half-course prestimulation treatmentis is a safe and effective and elderly patients with AML shown a good tolerance.
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Aged , Humans , Antineoplastic Combined Chemotherapy Protocols , Azacitidine , Decitabine , Therapeutic Uses , Leukemia, Myeloid, Acute , Drug Therapy , Retrospective Studies , Treatment OutcomeABSTRACT
Objective@#To analyze the imaging characteristics and diagnostic value of 18F-fluorodeoxyglucose (FDG) PET/CT in muscular inflammation in dermatomyositis (DM), as well as the relationship between maximum standardized uptake value (SUVmax) and activity of muscular inflammation.@*Methods@#From July 2013 to November 2016, 17 hospitalized DM patients (8 males, 9 females, age range: 35-78 years) who underwent 18F-FDG PET/CT were retrospectively reviewed, including 13 typical DM (TDM) and 4 amyopathic DM (ADM). Seventeen healthy volunteers (8 males, 9 females, age range: 35-78 years) in the same period were enrolled as the control group. The proximal limb muscles of whole body were divided into 7 areas, and the SUVmax of each was measured and recorded. Two-sample t test, one-way analysis of variance, Dunnett-t test and Spearman correlation analysis were used to analyze data.@*Results@#Five TDM cases showed diffuse increased FDG uptake in global muscles; 8 TDM cases showed increased FDG uptake in local muscles, mainly in the shoulder and hip. The FDG uptake by muscles of 4 ADM patients was similar with that of controls. The SUVmax was lower and lower in the order of shoulder and back muscles, hip muscles, thoracic vertebra muscles, cervical vertebra muscles, biceps, proximal quadriceps and lumbar vertebra muscles in DM group. The muscle SUVmax of DM, TDM, ADM and the controls were 1.92±0.86, 2.14±0.85, 1.19±0.44 and 0.93±0.26, respectively (F=69.50, P<0.001). Muscle SUVmax of DM group was higher than that of controls, muscle SUVmax of TDM was higher than that of ADM, and muscle SUVmax of ADM was higher than that of controls (t values: 4.102-11.970, all P<0.05). Muscle SUVmax of 9 DM patients with interstitial lung disease (ILD) was lower than that of patients without ILD (1.73±0.09 vs 2.13±0.13; t=5.857, P<0.001). Muscle SUVmax of DM was positive correlated with serum levels of creatine kinase (CK) and creatine kinase isoenzyme composed by M and B subunits (CK-MB) (rs values: 0.814 and 0.751, both P<0.001).@*Conclusion@#18F-FDG PET/CT is helpful to detect muscular inflammation of DM and it can reflect the activity and severity with SUVmax, and meanwhile evaluate the condition of ILD associated with DM.
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Objective To study the mechanical properties of collagen molecules by molecular dynamics simulation,and to determine the relationship between the mechanical properties of the microstructure of cartilage and the macroscopic mechanical properties. Methods Obtaining the collagen molecular model from the protein database and using GROMACS molecular dynamics simulation software,an analog box was built with a size of 24 nm× 3.2 nm × 3.2 nm. The simulation system contained 6 719 water molecules, 20 sodium ions and 20 chloride ions. This solution was equivalent to a saline environment. The uniaxial tensile simulation of collagen molecules was executed under the conditions of different temperature,different tensile rates and different pressures in this environment.Results When the temperature was constant, the tensile rate and the elastic modulus of collagen increased; when the tensile rate was certain, the temperature of the simulation system rose while the modulus of elasticity decreased;under the conditions of certain temperature and tensile rate, the pressure of the system gradually increased,and its modulus of elasticity decreased gradually. Conclusion Through the uniaxial tensile simulation of collagen molecules under different conditions,the mechanical laws of collagen molecules are obtained.There is a certain correlation between the elastic modulus and the tensile strain during the stretching process,and a way of thinking is provided on the study of the correlation of cartilage rate from the microscopic aspect.
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BACKGROUND: Uncertainty of repairing articular cartilage defects is highly associated with the mechanical behaviors of the defected area, and the mechanical environment varies with the defect shape, depth and load. OBJECTIVE: To study the mechanical behaviors of articular cartilage defects under physiological load by finite element analysis. METHODS: The axisymmetric model of articular cartilage injury and repair based on transversely isotropy was established using ABAQUS software. The mechanical behaviors of the defect zone repaired with different repair shapes (cylindrical, frustum of a cone, orthorhombic prism, elliptical column) and depths of tissue-engineered cartilage under compressive load were analyzed. RESULTS AND CONCLUSION: The simulation results showed that there were significant differences in the mechanical behaviors of the defect area repaired with tissue-engineered cartilage in different shapes and depths. The stress concentration was the most obvious at the middle-layer defect repair, and the stress distribution was more reasonable at the deep (whole) layer defect repair. Furthermore, the distribution of the stress field and the liquid flow field at the cylinder-shaped tissue-engineered cartilage repair was the closest to the normal cartilage. That is to say, the tissue-engineered cartilage in cylinder or frustum-cone shape is recommended to repair cartilage defect. Importantly, the middle-layer repair is inadvisable.
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Translational medicine is a new research system for rapid translation from basic research achievement to clinical treatment. This article summarized the research progress in the field of translational medicine in the recent months, and carried out an inventory of the frontier from important journals (such as Nature, Science, J Clin Invest, Nat Genet, Cell, Eur Heart J) in order to provide references for scientists and doctors, and promote the translation from basic medicine to clinical diagnosis and treatment.
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This article summarizes the research progress in the field of translational medicine in the recent months,and carries out an inventory of the frontier from important journals (such as Nature,Science,Clin Invest,Diabetes) in order to provide references for scientists and doctors.
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This article summarizes the research progress in the field of cancer in the recent month,and carries out an inventory of the frontier of tumor research from important journals (such as Nature,Science,Lancet,Cell,Cancer Res) in order to provide references for scientists.
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The functions of academic medical libraries in teaching, scientific research, clinical service and management were elaborated in detail according to the《Library regulations in general colleges and universities》issued by Ministry of Education and the requirements of state on medical education with the practical experiences of academic medical libraries summarized in knowledge management, scientific communication, subject evaluation and with the ideas proposed for the development of academic medical libraries.
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Objective To study the damage propagation and evolution mechanism of cartilage under compressive load. Methods The fiber-reinforced porous elastic model of cartilage with micro-defect was established by using finite element method, and the process of damage evolution under compressive load was simulated and analyzed with parameters. The patterns of stress and strain distributions on cartilage matrix and collagen fiber at different damage extension stage were obtained. Results The strain in surface and the forefront of cartilage damage increased significantly with the increase of compression displacement, and they were obviously in positive correlation; in the process of damage evolution, there was a trend that cartilage extended to the deep and both sides simultaneously; cracks and damage in cartilage extended preferentially along the fiber tangent direction. With the aggravation of cartilage damage, the lateral extension speed was significantly faster than the longitudinal extension speed. Conclusions The process of cartilage damage extension has a close relationship with the distribution of fibers. And the damage in matrix and fiber promote each other. The evolution speed and degree of cartilage vary constantly in different layers and at different stages. These results can provide the qualitative reference for prediction and repair of cartilage damage, as well as the theoretical basis for explaining clinical pathological phenomena of damage degeneration and treatment.
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Objective To explore the effect of hypergravity on morphology and osteogenesis function of preosteoblast MC3T3-E1 cells. Methods The cultured MC3T3-E1 cells under hypergravity by different loading forces were divided into five groups, including control group, 5 g group, 10 g group, 15 g group and 20 g group. The experimental groups were loaded for 30 min each time in the three successive days, and the control group was synchronously exposed to the same surrounding except for difference in g-value. The morphology of cytoskeletal protein was observed by phalloidin staining, The alkaline phosphatase (ALP) content was examined by ALP activity assay kit, the gene expression of ALP, collagen Ⅰ(ColⅠ), osteocalcin (OC), runt-related transcription factors (Runx2) was measured by real-time quantitative PCR, and the protein expression of ColⅠ and OC was tested by Western blot. Results Under the condition of hypergravity, cell body of osteoblast became thinner, but its surface area increased significantly; with the structure of skeletal arrangement becoming loose, actin microfilament structure reduced so that arrangement of actin-like dispersion orderly lowered. The gene expressions of related indicators of osteogenic differentiation including ALP, ColⅠ, OC, Runx2 loaded by hypergravity were significantly up-regulated, which was the same as ColⅠ protein and OC protein after hypergravity loading. There was only a very minute quantity of small red-orange nodules in the control group, while the cells after hypergravity loading in experimental groups obviously formed various sizes of red-orange nodules. Conclusions Under hypergravity, changes in osteoblast morphology can be triggered by rearrangements of skeletal structure. Furthermore, osteoblast maturation and differentiation can be stimulated effectively by up-regulating differentiation-related gene and protein expressions.
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Objective To obtain the ratcheting strain of articular cartilage under different loading conditions, and construct the theoretical model so as to predict the ratcheting strain of cartilage. Methods The fresh articular cartilage obtained from the trochlear of distal femur was used as experimental subject. The ratcheting strain of articular cartilage was tested under cyclic compressive loads by applying the non-contact digital image correlation technique. The theoretical model was constructed to predict the ratcheting strain of articular cartilage with different stress amplitudes and stress rates. The results from predictions were compared with the experimental results. Results The ratcheting strain of cartilage increased rapidly at initial stage and then showed the slower increase with cycles increasing. The ratcheting strain increased with stress amplitude increasing when the stress rate was constant. However, the ratcheting strain decreased with stress rate increasing when the stress amplitude was constant. When the stress rate increased, the ratcheting stain decreased. The prediction results of the established theoretical model were in good agreement with experimental results. Conclusions The ratcheting strain of articular cartilage is proportional to the stress amplitude, and inversely proportional to the stress rate. The established theoretical model can predict the ratcheting strain of articular cartilage and provide guidance for the construction of tissue engineered artificial cartilage.
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Objective:To study the safety and efficacy of doxofylline for treating the patients with ticagrelor caused dyspnea.Methods:A total 172 coronary artery disease (CAD) patients with ticagrelor caused dyspnea in our hospital from 2015-02 to 2016-07 were studied.The patients were divided into 2 groups:Intervention group,patients received doxofylline at 200 mg twice per day for 5 days and Control group,patients received placebo.n=86 in each group.Dyspnea remission rate of was recorded at 1 day after treatment;platelet aggregation rate before and after treatment,cardiac death,myocardial infarction (MI),stroke,bleeding and other adverse cardiovascular and cerebral events were compared at 6 month after treatment.Results:Compared with Control group,Intervention group had improved dyspnea remission rate at 1 day after treatment (93％ vs 63％),P＜0.05;platelet aggregation rate [before doxofylline application:(35.53±5.1)％ vs (35.16±4.6)％,after doxofylline application:(26.48±4.3)％ vs(25.98±4.7)％]adverse cardiovascular and cerebral events were similar between 2 groups before and after doxofylline application,P＞0.05.Conclusion:Doxofylline was effective for treating the patients with ticagrelor caused dyspnea,it does not affect platelet aggregation effect of ticagrelor.