Prediction Model of Treatment Effect of Anlotinib on Extensive-stage Small Cell Lung Cancer Based on Combination of Disease and Syndrome Information / 肿瘤防治研究

Objective To construct a nomogram prediction model for the treatment effect of anlotinib with the participation of traditional Chinese medicine syndrome elements on the patients with extensive-stage small cell lung cancer (ES-SCLC) who previously received multiple lines of chemotherapy. Methods The clinical data of 127 patients with ES-SCLC who received at least two cycles of anlotinib treatment were retrospectively studied. Kaplan-Meier method was used to analyze the relationship between each factor and the overall survival time. Cox regression analysis was applied to screen the independent influencing factors of the prognosis of patients with ES-SCLC. R language was employed to build a nomogram prediction model, C-index was used to evaluate the model, and calibration curve was adopted to verify the accuracy of the model. Results Age, PS score, brain metastases, qi deficiency syndrome, yin deficiency syndrome, and blood stasis syndrome were related risk factors for ES-SCLC treated with anlotinib. PS score, brain metastasis, and blood stasis syndrome were independent prognostic factors. On the basis of these three independent influencing factors, a nomogram model was established to predict the prognosis of patients with ES-SCLC treated with anlotinib. The predicted risk was close to the actual risk, showing a high degree of coincidence. Conclusion The nomogram model established with PS score, blood stasis syndrome elements, and brain metastasis as independent factors can predict the prognosis of patients with ES-SCLC receiving second- and third-line treatment of anlotinib.

Predictors of HBsAg clearance in HBeAg-negative chronic hepatitis B patients treated with pegylated interferon α-2b and the construction of a nomogram model / 临床肝胆病杂志

ObjectiveTo establish an early predictive model using serological markers based on LASSO regression for predicting the possibility of HBsAg clearance in HBeAg-negative chronic hepatitis B （CHB） patients treated with pegylated interferon α-2b （PEG-IFNα-2b）， and to investigate the diagnostic value of the model. MethodsA total of 136 HBeAg-negative CHB patients who received PEG-IFNα-2b treatment in the Affiliated Hospital of Xuzhou Medical University from April 2020 to October 2021 were enrolled， among whom 47 received PEG-IFNα-2b for the first time （previously untreated） and 89 received PEG-IFNα-2b after 48 weeks of treatment with nucleos（t）ide analogues （treatment-experienced）. The patients were randomly assigned to a training set with 95 patients and a validation set with 41 patients at a ratio of 7∶3， and related data were collected for both groups， including virological markers， routine blood test results， and liver function at baseline and week 12 of treatment. According to HBsAg status at week 48 of treatment， the patients were divided into seroconversion group with 38 patients and non-seroconversion group with 98 patients. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical variables between two groups. The LASSO regression analysis and univariate and multivariate logistic regression analyses were used to establish a nomogram model； the receiver operating characteristic （ROC） curve was used to assess its predictive ability， and the area under the ROC curve （AUC） was used for comparison of predictive value. ResultsIn the training set， 95 HBeAg-negative CHB patients were treated with PEG-IFNα-2b for 48 weeks， among whom there were 27 patients in the seroconversion group and 68 in the non-seroconversion group. The univariate Logistic regression analysis， with P<0.2 as the criterion for screening， showed that 9 indicators were included in the LASSO regression analysis， i.e.， sex， baseline HBV DNA level， the reduction in HBV DNA in 0 — 12 weeks， baseline HBsAg level， the reduction in HBsAg in 0 — 12 weeks， baseline aspartate aminotransferase （AST） level， the reduction in AST in 0 — 12 weeks， baseline alanine aminotransferase （ALT） level， and the reduction in ALT in 0 — 12 weeks. The LASSO regression analysis showed that sex， baseline HBsAg level， the reduction in HBsAg in 0 — 12 weeks， and the reduction in ALT in 0 — 12 weeks were non-zero variables and were included in the multivariate Logistic regression analysis. The multivariate Logistic regression analysis obtained 4 independent predictive factors， i.e.， sex （odds ratio ［OR］=5.38， 95% confidence interval ［CI］： 1.11 — 34.21， P=0.049）， baseline HBsAg level （OR=0.12， 95%CI： 0.04 — 0.26， P<0.001）， the reduction in HBsAg in 0 — 12 weeks （OR=5.54， 95%CI： 1.97 — 19.18， P=0.003）， and the reduction in ALT in 0 — 12 weeks （OR=0.99， 95%CI： 0.97 — 1.00， P=0.039）. A nomogram model was established based on the results of the multivariate Logistic regression analysis， and the ROC curve was used to assess the predictive value of this nomogram model. This nomogram model had an AUC of 0.934 （95%CI： 0.886 — 0.981） in the training set and an AUC of 0.921 （95%CI： 0.838 — 1.000） in the validation set. In addition， the results of calibration curve and decision curve analyses showed that the model had good consistency and accuracy. ConclusionBased on general information and serological markers， the LASSO regression analysis is used to establish a nomogram model using sex， baseline HBsAg level， the reduction in HBsAg in 0 — 12 weeks， and the reduction in ALT in 0 — 12 weeks， and this model can be used to predict the probability of achieving HBsAg clearance in HBeAg-negative CHB patients treated with PEG-IFNα-2b， which provides important reference and theoretical support for the clinical treatment of patients.

Construction and Validation of A Predictive Model Including TCM Pathogenic Syndrome for Short-term Efficacy of PD-1 Inhibitors in Advanced Non-small Cell Lung Cancer / 肿瘤防治研究

Objective To evaluate predictive factors affecting the short-term efficacy of PD-1 inhibitors in non-small cell lung cancer (NSCLC) and to construct a prediction model. Methods From October 2019 to November 2021, 221 patients with advanced NSCLC who met the inclusion criteria and were treated with PD-1 inhibitors were prospectively enrolled. Patients who were enrolled before May 1st, 2021 were included inthe modeling group (n=149), whereas those who enrolled thereafter were included in the validation group (n=72). The general clinical data of patients, information of the four TCM diagnoses were collected, and TCM syndrome elements were identified. R software version 4.0.4 was used in constructing a nomogram clinical prediction model of objective response rate. The predictive ability and discrimination of the model were evaluated and externally validated by using a validation group. Results After two to four cycles of PD-1 inhibitor therapy in 221 patients, the overall objective response rate was 44.80%. Multivariate logistic regression analysis of the modeling group showed that the TPS score (OR=0.261, P=0.001), number of treatment lines (OR=3.749, P=0.002), treatment mode (OR=2.796, P=0.019), qi deficiency disease syndrome elements (OR=2.296, P=0.043), and syndrome elements of yin deficiency disease (OR=3.228, P=0.005) were the independent predictors of the short-term efficacy of PD-1 inhibitors. Based on the above five independent predictors, a nomogram prediction model for the short-term efficacy of PD-1 inhibitors was constructed. The AUC values of the modeling and validation groups were 0.8317 and 0.7535, respectively. The calibration curves of the two groups showed good agreement between the predicted and true values. The mean absolute errors were 0.053 and 0.039, indicating that the model has good predictive performance. Conclusion The nomogram model constructed on the basis of the syndrome elements of Qi-deficiency disease and Yin-deficiency syndrome of TCM, as well as TPS score, number of treatment lines and treatment mode, is a stable and effective tool for predicting the short-term efficacy of PD-1 inhibitors in advanced non-small cell lung cancer.

Study on radiation safety supervision countermeasures of nuclear technology utilization in Sichuan province / 中国辐射卫生

This review summarizes the basic situation and characteristics of nuclear technology utilization and radiation safety supervision in Sichuan Province, analyzed the main problems of radiation safety supervision, put forward the corresponding countermeasures and suggestions, and provided reference for improving the radiation safety supervision ability of the whole province.

Analysis of the changes of inflammatory cytokine levels in patients with critical coronavirus disease 2019 undergoing invasive mechanical ventilation / 中华危重病急救医学

Objective:To investigate the relationship between the changes of inflammatory cytokine levels and prognosis of patients with critical coronavirus disease 2019 (COVID-19) undergoing invasive mechanical ventilation (IMV).Methods:A retrospective study was conducted. The clinical date of critical COVID-19 patients undergoing IMV who were hospitalized in Wuhan Union Hospital, Tongji Medical College of Huazhong University of Science and Technology from February 4th to March 25th in 2020 were collected. At the same time, the inflammatory cytokine levels including interleukins (IL-2, IL-4, IL-6, IL-10) and tumor necrosis factor-α (TNF-α) at 48 hours before IMV and 48 hours after IMV of all the patients, as well as the 48 hours after weaning or right before death were recorded. Multivariate unconditional Logistic regression analysis was used to screen the independent risk factors of death during hospitalization.Results:Among the 43 patients, 13 patients improved and 30 died. Compared with the survival group, the patients in the non-survival group were older (years old: 67.6±7.3 vs. 58.5±11.9, P < 0.05), with higher rates of hypertension, diabetes and coronary heart disease (53.3% vs. 15.4%, 63.3% vs. 23.1%, 26.7% vs. 0%, all P < 0.05), and the time from onset to admission to hospital, admission to ICU and IMV were longer (days: it was 9.17±5.00 vs. 5.07±2.49, 17.10±7.11 vs. 12.23±5.05, and 17.90±7.46 vs. 12.61±5.60, respectively, all P < 0.05). The IL-6 and TNF-α levels on 48 hours after IMV in the non-survival patients increased significantly as compared with those before 48 hours and the surviving patients. Especially, the IL-6 levels increased significantly as compared with those at 48 hours after IMV and 48 hours after weaning in the surviving patients [ng/L: 800.00 (194.25, 2 000.00) vs. 22.03 (6.66, 28.21), 3 204.00 (1 264.88, 5 000.00) vs. 5.00 (3.98, 12.27), both P < 0.01]. The IL-10 level before death in the non-survival patients increased significantly as compared with that at 48 hours after weaning in the surviving patients [ng/L: 55.89 (26.07, 100.14) vs. 3.53 (2.76, 12.36), P < 0.05]. There were no significant differences in the levels of IL-2 and IL-4 between the two groups at every time point. The variables of age, basic diseases, the IL-6 level after IMV were included in the multivariate unconditional Logistic regression analysis, which showed that age [odds ratio ( OR) = 0.821, 95% confidence interval (95% CI) was 0.695-0.968], hypertension ( OR = 0.027, 95% CI was 0.002-0.378), diabetes mellitus ( OR = 0.054, 95% CI was 0.005-0.611), coronary heart disease ( OR = 0.042, 95% CI was 0.002-0.968) and the IL-6 level after IMV ( OR = 0.902, 95% CI was 0.819-0.994) were independent risk factors for death during hospitalization in patients with critical COVID-19 undergoing IMV (all P < 0.05). Conclusions:The levels of inflammatory cytokine including IL-6, IL-10, and TNF-α increased significantly with aggravation in critical COVID-19 patients undergoing IMV, especially IL-6. IL-6 was an independent risk factor for death of critical COVID-19 patients undergoing IMV.

Postoperative recurrent pattern and the lymph node metastatic stations of the thoracic esophageal squamous cell carcinoma / 中华放射肿瘤学杂志

Objective@#To investigate postoperative recurrent pattern of the thoracic esophageal squamous cell carcinoma (TESCC), aiming to provide a basis for the delineation of postoperative radiotherapy volume for TESCC.@*Methods@#Clinical data of 66 TESCC patients who recurred after the radical esophagectomy in Zhongnan Hospital of Wuhan University from 2011 to 2017 were retrospectively analyzed. According to the AJCC 8th edition-defined classification of esophageal carcinoma, regional lymph node stations 1 to 8M were defined as the upper-middle mediastinum region (UMMR), and stations 8Lo, 9 and 15 were defined as the inferior mediastinum region (IMR), stations 16 to 20 were regarded as the upper abdominal lymph node region (UAR).@*Results@#Among all 66 patients, 41 cases (62%) experienced loco-regional recurrence alone, 25 cases (38%) presented with distant metastasis alone. A total of 54 patients with 148 lymph node recurred after treatment. The highest risk region of lymph node recurrence was UMMR (118/148, 80%), after that, followed by UAR (24/148, 17%). With regard to 9 cases of UAR, 6 patients had lower TESCC, and 8 patients (89%) were graded as ≥ pathological stage Ⅲ.@*Conclusions@#The highest risk region of lymph node recurrence is UMMR in TESCC patients undergoing radical esophagectomy, which should be considered as the target volume in postoperative radiotherapy. For patients with lower TESCC ≥ pathological stage Ⅲ, UAR might be the target volume with cautions. Anastomosis and IMR are probably not the routine treatment volumes.

Postoperative recurrent pattern and the lymph node metastatic stations of the thoracic esophageal squamous cell carcinoma / 中华放射肿瘤学杂志

Objective To investigate postoperative recurrent pattern of the thoracic esophageal squamous cell carcinoma (TESCC),aiming to provide a basis for the delineation of postoperative radiotherapy volume for TESCC.Methods Clinical data of 66 TESCC patients who recurred after the radical esophagectomy in Zhongnan Hospital of Wuhan University from 2011 to 2017 were retrospectively analyzed.According to the AJCC 8th edition-defined classification of esophageal carcinoma,regional lymph node stations Ⅰ to 8M were defined as the upper-middle mediastinum region (UMMR),and stations 8Lo,9 and 15 were defined as the inferior mediastinum region (IMR),stations 16 to 20 were regarded as the upper abdominal lymph node region (UAR).Results Among all 66 patients,41 cases (62％) experienced locoregional recurrence alone,25 cases (38％) presented with distant metastasis alone.A total of 54 patients with 148 lymph node recurred after treatment.The highest risk region of lymph node recurrence was UMMR (118/148,80％),after that,followed by UAR (24/148,17％).With regard to 9 cases of UAR,6 patients had lower TESCC,and 8 patients (89％) were graded as ≥ pathological stage Ⅲ.Conclusions The highest risk region of lymph node recurrence is UMMR in TESCC patients undergoing radical esophagectomy,which should be considered as the target volume in postoperative radiotherapy.For patients with lower TESCC ≥ pathological stage Ⅲ,UAR might be the target volume with cautions.Anastomosis and IMR are probably not the routine treatment volumes.

Ultrasonographic evaluation of dysphagia after stroke / 国际脑血管病杂志

Ultrasound is one of the most commonly used examination methods in clinical practice. Dysphagia after stroke can seriously affect the prognosis and quality of life of patients. In recent years, the advantages of ultrasound evaluation of swallowing function have received increasing attention. This article reviews the previous studies of ultrasound assessment of swallowing function.

Clinical efficacy and prognostic factors of stereotactic body radiotherapy for pulmonary oligometastases / 中华放射肿瘤学杂志

Objective To evaluate the clinical efficacy and prognostic factors of stereotactic body radiotherapy(SBRT)for pulmonary oligometastases,and to further explore the patients most suitable for SBRT. Methods From 2012 to 2105,51 patients with 76 oligometastatic lung tumors were treated with SBRT.In those patients,27 had primary lung tumors and the others had extrapulmonary tumors. Seven patients had squamous cell carcinoma,thirty-five had adenocarcinoma, and the rest had other types of cancer. The patients received radiotherapy at a dose of 50 Gy in five fractions or 60 Gy in three fractions. Survival analysis was made by the Kaplan-Meier method. A multivariate analysis was made by the Cox model. Results The 1-and 2-year local control rates were 86%(65/76)and 80%(61/76),respectively. The 1-and 2-year overall survival(OS)rates were 80%(41/51)and 55%(28/51),respectively. The median survival time was 30(2-57)months,while the median progression-free survival time was 8(1-32)months. Twenty-one patients had grade 1 radiation pneumonitis(RP),while one patient had grade 2 RP. The multivariate analysis revealed that no more than 2 oligometastatic lung tumors,progression-free interval(PFI), and a performance score(PS)no higher than 1 were independent factors for OS(all P<0.05). Conclusions SBRT is effective and safe for treating pulmonary oligometastases. The number of oligometastatic lung tumors,PFI,and PS are independent prognostic factors for OS. Suitable patients and the appropriate timing of treatment are key to the efficacy of SBRT.

Reducing maternal parenting stress of children with autism spectrum disorder: father′s involvement / 中华儿科杂志

Objective@#To explore the relationship between fathers′ nursing time and maternal parenting stress of children with autism spectrum disorder(ASD).@*Method@#Mothers of 98 ASD children who were first diagnosed in the department of Child Health Care, Children′s Hospital of Fudan University during June 2015 to January 2016 were included in the ASD group, with mothers of 92 typical children from a Community Maternal and Child Health Hospital and a kindergarten in the control group. The evaluation of parenting stress, parents′ nursing time and other related factors were cross-sectionally analyzed. Interview was conducted with the following tools: Parental Stress Index-Short Form(PSI-SF)for maternal parenting stress, and self-made General Parenting Information Questionnaire for nursing time of both parents and other related factors. The relationships were analyzed by Multiple Linear Regression analysis and Wilcoxon Rank-Sum test.@*Result@#Maternal parenting stress of ASD children had a significant negative correlation with father′s nursing time in total score of parenting stress, PCDI domain and PD domain (t=-2.76, -2.98, -2.79; P=0.007, 0.004, 0.006), within which PD domain also included family annual income and mothers′ nursing time (R2=0.22, 0.24, 0.25); while no such correlation was found in control group in terms of father′s nursing time(P=0.22, 0.42, 0.06). Wilcoxon Rank-Sum test showed that in 62 (63.3%) double-income ASD families and 72(78.3%) double-income typical families, there were significant differences between ASD fathers′ and ASD mothers′and typical fathers′nursing time(2.0(0.5, 2.1)vs. 3.5(2.4, 6.0)vs. 3.0(2.0, 4.7)h, t=-86.32、-49.65, all P<0.01).@*Conclusion@#Lack of fathers′ involvements was common in ASD children′s families. Increasing these fathers′ nursing time, as well as their enthusiasm and initiative in the family intervention could relieve maternal parenting stress and improve the intervention pattern of ASD children.

The effect of ziprasidone and risperidone on schizophrenia patients and the change of leptin ,adiponectin levels / 国际检验医学杂志

Objective To observe the effects of ziprasidone and risperidone on schizophrenia patients and the change of serum leptin and adiponectin levels .Methods Totally 80 cases of schizophrenia patients were randomly divided into ziprasidone group and risperidone group ,which were treated for 8 weeks .Measure the positive and negative symptoms scale (PANSS) score and body weight of that number ,leptin and adiponectin at baseline ,treatment 4 weeks and 8 weeks respectively for patients ,at the end of the experiment ,the results for statistical analysis .Results Two groups of 4 ,8 weeks after treatment scores compared with baseline scores dropped significantly ,the difference was statistically significant(P<0 .05) .Risperidone group after treatment ,leptin levels significantly increased body mass index ,and adiponectin levels significantly decreased ,compared with the baseline before treatment was statistically significant difference(P<0 .05) .Conclusion Ziprasidone and risperidone in treatment of schizophrenia have similar efficacy .Ziprasidone has no significant effect on body weight ,leptin and adiponectin levels in treatment of schizophrenia patients . However ,risperidone has a significant effect ,long-term use should pay attention to the side effects .

Comparative study of curative effect and blood glucose and lipid in schizophrenic patients who treated with ziprasidone and risperidone / 国际检验医学杂志

Objective To observe the effects of ziprasidone and risperidone on patients with schizophrenia and their influence on bloodglucoseandlipids.Methods 96patientswithschizophrenicenrolledinthestudywererandomlydividedintotwogroups,zi‐prasidone and risperidone group ,and both were treated for 8 weeks .Their blood glucose ,blood lipid of base line and at the end of the 4th ,8th week were determined respectively .Results The positive and negative symptoms scores of the two groups by using Positive and Negative Syndrome Scale(PANSS) before and after treatment were not statistically different(P> 0 .05) .Compared with the baseline scores ,scores at the end of 4th and 8th week in both ziprasidone and risperidone groups significantly decreased(P0 .05) .After 8 weeks′ treatment ,the ef‐fective rate was 91 .7% in ziprasidone groups and 89 .6% in risperidone group .There were no significant differences between the two groups(P>0 .05) .The blood lipids and glucose levels were less increased after ziprasidone treatment ,but was not statistically significant(P>0 .05) .The blood lipids and glucose levels significantly increased after risperidone treatment(P<0 .05) .Conclusion Ziprasidone and risperidone had the same effect on schizophrenia .Ziprasidone had no effect on blood glucose and lipids in schizo‐phrenic patients ,while risperidone could increase blood glucose and lipids level ,we should pay attention to the side effects of long‐term use .

Effects of octreotide on the apoptosis of human HSCs and expression of Bcl-2/Bax in HSCs / 实用医学杂志

Objective To investigate the effects of octreotide on the apoptosis of human hepatic stellate cells (HSCs) and expression of Bcl-2/Bax in HSCs,and to reveal the mechanism underlying octreotide against hepatic fibrosis. Methods HSCs lines (HSC-LX2) were incubated with different concentrations of octreotide for 24 and 48 hours. Cell apoptosis was evaluated by Fitc-tunel fluorescence staining. Bcl-2 and Bax protein exoression in HSC-LX2 was detected by immunocytochemistry. Meanwhile, Bcl-2 protein of HSC-LX2 were detected by Western blot assay. Results Octreotide could promote the apoptosis of HSC-LX2, and the apoptosis rate was significantly increased with the concentration of octreotide(P < 0.05). The HSC-LX2 were incubated with the same concentration of octreotide for 24 and 48 hours, the cell apoptosis rate of 48-hour octreotide treatment was significantly higher than that of 24-hour octreotide treatment (P < 0.05). The immunocytochemistry result indicated that octreotide could significantly decrease Bcl-2 expression and increase Bax expression in HSC-LX2 (P<0.05); Western blot assay showed that octreotide could also significantly inhibit Bcl-2 expression in HSC-LX2 (P<0.05). Conclusions Octreotide could induce the apoptosis of HSCs in a dose-and time-dependent manner, the mechanism of octreotide inducing HSCs apoptosis might be associated with down-regulation of Bcl-2 and upregulation of Bax in HSC.

Apparent Diffusion Coefifcient and Diffusion Weighted Imaging Findings in Portal Vein Tumor Thrombus Caused by Hepatic Carcinoma / 中国医学影像学杂志

Purpose To explore the findings and diagnostic values of apparent diffusion coefficient (ADC) and diffusion weighted image (DWI) of the portal venous tumor thrombus (PVTT) caused by hepatic carcinoma.Materials and Methods Thirty-one patients with hepatic carcinoma (43 lesions) with 63 PVTT in the main branches and trunks diagnosed by clinical and MRI were enrolled. All patients underwent conventional MRI (cMRI) imaging, DWI and ADC imaging, the features of cMRI, DWI and ADC were observed, the relevance of ADC values between the hepatic carcinoma lesion and PVTT were analyzed.Results Among the total 43 lesions, DWI image showed low signal, iso-signal and high signal in 1, 4 and 38 lesions, respectively; and ADC image showed low signal, iso-signal and high signal in 36, 5 and 2 lesions, respectively. In the total 63 PVTT, DWI showed low signal, iso-signal and high signal in 4, 7 and 52 lesions, respectively;while their ADC images showed low signal, iso-signal and high signal in 54, 6 and 3 branches, respectively. There was good consistency for the results of two observers on the findings of ADC of tumor lesions (Kappa=0.8334,P<0.05), and a moderate consistency on that of PVTT (Kappa=0.5215,P<0.05). The average ADC value of tumor lesion and PVTT was (1.127±0.268)×10-3 mm2/s and (1.021±0.363)×10-3 mm2/s, respectively; there was a correlation of the mean values of ADC between tumor lesion and PVTT (r=0.246,P<0.05). Conclusion The features such as low signal and low value on ADC image and high signal on DWI obtain a certain clinical application value for qualitative diagnoses of PVTT.

Expression of Axin, β-catenin and p53 and their significance in pleural fluid of lung adeno-carinoma patients / 临床与实验病理学杂志

Purpose To investigate the expression of Axin, β-catenin and p53 in the pleural fluid and to discuss their relationships and significances. Methods The expression of Axin, β-catenin and p53 was detected using immunocytochemistry in adenocarinoma cells of the pleural fluid from 40 patients with primary lung adenocarcinomas or reactive mesothelial cells of the pleural fluid from 40 pa-tients with benign lung diseases. Results Axin positive expression rate was 30% (12/40) in cases with primary lung adenocarcino-mas. The positive expression rate of β-catenin was 15% (6/40) on cell membrane and 60%(24/40) in cytoplasm. The expression rate of p53 was 57. 5% (23/40) in cases of primary lung adenocarcinomas. The expression of Axin was positively correlated with the membranous expression of β-catenin, and negatively correlated with p53 in cancer cells of the pleural fluids. The positive expression rate of Axin was 77. 5% (31/40), but the expression rate of p53 was 1. 25% (5/40). There was no expression ofβ-catenin in reac-tive mesothelial cells from benign lung diseases. Conclusions The expression of Axin is significantly reduced in adenocarcinoma cells. The expression rate ofβ-catenin in cytoplasm is higher than that in membrane of cancer cells. It has a certain value to detect the expression of Axin,β-catenin and p53 for diagnosis and differential diagnosis of lung adenocaicinomas from benign lung diseases.

Expression of mannose-binding lectin in lesions of psoriasis vulgaris / 中华皮肤科杂志

Objective To investigate the expression of mannose-binding lectin (MBL) in lesions of patients with psoriasis vulgaris,and to explore the relationship between MBL and psoriasis pathogenesis.Methods Immunohistochemistry and Western blot were performed to detect the expression of MBL in lesional and normalappearing perilesional skin of 30 patients with progressive psoriasis vulgaris,as well as in normal skin of 30 healthy human controls.Statistical analysis was carried out by t test using SPSS13.0 software.Results Immunohistochemistry showed that MBL was expressed in lesional psoriatic skin,but weakly expressed or absent in normalappearing perilesional skin and normal control skin,with the relative expression level of MBL in lesional skin significantly higher than that in perilesional skin and normal control skin (0.636 7 ± 0.515 1 vs.0.416 3 ± 0.160 1 and 0.381 6 ± 0.310 9,t =2.24,2.32,respectively,both P ＜ 0.05).Western blot revealed a positive expression of MBL protein in all the skin specimens,and the expression intensity of MBL protein in lesional psoriatic skin was significandy increased compared with perilesional psoriatic skin and normal control skin (0.273 1 ± 0.129 4 vs.0.186 3 ± 0.193 1 and 0.149 2 ± 0.268 7,t =2.05,2.28,respectively,both P＜ 0.05).No significant difference was shown in the expression of MBL protein between perilesional psoriatic skin and normal control skin by immunohistochemistry (t =1.51,P ＞ 0.05) or Western blot (t =0.61,P ＞ 0.05).Conclusion There is a high expression of MBL protein in lesions of patients with psoriasis vulgaris,which may be somewhat associated with the pathogenesis of psoriasis.

Determination of gene polymorphism and serum concentration of mannose-binding lectin in patients with psoriasis / 中华皮肤科杂志

Objective To determine the gene polymorphism and serum concentration of mannose-binding lectin (MBL) in patients with psoriasis,and to analyze the relationship between MBL and psoriasis.Methods Totally,67 patients with psoriasis vulgaris and 69 healthy human controls were enrolled in this study.Venous blood samples were obtained from all the subjects.Genomic DNA was extracted,and PCR-restriction fragment length polymorphism (PCR-RELP) analysis was conducted to determine the polymorphism at codon 54 of the MBL gene.Enzyme-linked immunosorbent assay was performed to measure the serum level of MBL.A chi-square goodness-of-fit test was carried out to evaluate Hardy-Weinberg equilibrium,t test to compare the serum concentration of MBL,and chi-square test to compare the frequency of genotypes and alleles of MBL gene codon 54.Results The patients with psoriasis showed higher frequency of GGC/GAC heterozygote but lower frequency of GGC/GGC homozygote (x2 =10.36,P ＜ 0.05),together with increased frequency of GAC allele but decreased frequency of GGC allele (x2 =8.31,P ＜ 0.05),at codon 54 of the MBL gene compared with the healthy controls.The variant allele GAC at codon 54 of the MBL gene was markedly associated with psoriasis (OR =3.383,95％ CI 1.585-7.211,P ＜ 0.05).The serum concentration of MBL was (2.193 7 ± 0.816 3) mg/L in patients with psoriasis,significantly lower than that in the healthy controls ((3.269 5±1.205 8) mg/L,t=6.11,P＜ 0.05).Conclusion MBL might be associated with the pathogenesis of psoriasis to some degree.

Agomelatine versus sertraline for the treatment of elderly patients with post-stroke depression: a randomized, double-blind, controlled trial / 国际脑血管病杂志

Objeetive To investigate the effectiveness and safety of agomelatine for the treatment of elderly patients with post-stroke depression.Methods A total 80 elderly patients with post-stroke depression were randomly divided into either an agomelatine group or a sertraline group.The Hamilton Depression Scale (HAMD),National Institutes of Health Stroke Scale (NIHSS) and Barthel Index were used to evaluate the patients before and after 1,2,4,and 6 weeks,respectively.Results HAMD,NIHSS,and Barthel index scores were improved significantly after treatment in the agomelatine group (n =38) and the sertraline group (n =42).There were significant improvement in the scores of HAMD,NIHSS and Barthel Index with time in both groups (all P ＜0.001).There were no significant difference in the scores of HAMD and NIHSS at different time points after treatment between the agomelatine group and the sertraline group,and the Barthel Index scores began to have significance difference from the fourth week after treatment (all P ＜ 0.05).Conclusions The efficacy of agomelatine for the treatment of PSD is almost the same as sertraline,and the effect of improving activities of daily living is better than sertraline.The safety of both agomelatine and sertraline is good.

A prospective comparative study on naloxone combined haloperidol treatment for excited type delirium in elderly / 中华行为医学与脑科学杂志

Objective Compared with haloperidol treatment,naloxone and naloxone combined haloperidol treatments were assessed in their efficacy and safety for excited type delirium in elderly.Methods The elderly patients with delirium were divided into haloperidol treatment (H),naloxone treatment (N) and combined treatment (C) in a prospective randomized controlled design.Delirium score scale (DSS) was used before and after treatments respectively.Clinical global impression scale-severity of illness (CGI-SI) score was evaluated daily to assess the onset time and improvement of delirium.Agitation-calmness evaluation scale (ACES) observed calmness effect in agitated patients before and after every medication intervention.Treatment emergent symptom scale (TESS) assessed side effects of all medications.Results The duration of three groups(H(4.0 ±2.9)d,N(4.2± 3.5) d,C (3.2 ± 3.2) d) had no significant difference (P ＞ 0.05) by multiple comparison.Compared the onset time of three groups (H (2.4 ± 1.6) d,N (2.4 ± 1.4) d,C (1.3 ± 0.9) d),the combined group was faster than the other two groups (all P ＜ 0.05),no significant difference between the two groups(P ＞ 0.05).DSS scores had no significant differences (P＞ 0.05) in three groups before treatment,so did CGI-SI scores.In the end,DSS scores were(H:18.8 ± 11.5,N:27.7 ± 7.2,C:29.5 ± 5.6) respectively.Statistically naloxone group and combined group with no significant difference (P ＞ 0.05),were better than the haloperidol group (all P ＜ 0.01) in recovery.At the same time CGI-SI scores were (H:3.3 ± 1.5,N:2.5 ± 1.5,C:1.8 ± 0.9) respectively.Statistically combined group was better than the haloperidol group (P ＜ 0.01),and no significant difference with naloxone group (P ＞ 0.05).Three groups had no significant difference in ACES scores (P ＞ 0.05) before and after medication interventions(H:5.9 ± 1.6,N:6.2 ± 1.8,C:6.4 ± 1.6) (P ＞ 0.05).Haloperidol group had 4 cases of extrapyramidal symptom evaluated by TESS and combined group had 2 cases.Two groups had no significant difference (Chisquare test P ＞ 0.05) in extrapyramidal symptom incidence.The naloxone group showed no side effects.Conclusion Naloxone combined haloperidol is slight better than naloxone,more than haloperidol in terms of efficacy.Haloperidol equally with combined medication showed more side effects than naloxone.

Antifungal susceptibility and genotypes of Candida albicans / 中华皮肤科杂志

ObjectiveTo test the susceptibilities of Candida albicans to 5 antifungal agents including methylrosanilinium chloride and to estimate their relationship with the genotypes of C.albicans.MethodsThe susceptibilitiesof 67C.albicansisolatestomethylrosaniliniumchloride, fluconazole, amphotericinB,itraconazole and ketoconazole were determined by using a broth dilution method as described in the National Committee for Clinical Laboratory Standards(NCCLS) document M27-A2.DNA was extracted from the C.albicans isolates and subjected to the amplification of 25S ribosomal DNA(rDNA) introns by PCR.The C.albicans isolates were divided into A,B and C genotypes according to the amplicons.The relationship was analyzed statistically by exact probability test between the genotypes and antifungal susceptibility of C.albicans.ResultsOf the 67 C.albicans isolates,8.96％ were resistant to fluconazole,2.98％ to itraconazole,1.49％ to ketoconazole,and no resistance to amphotericin B was observed.The minimum inhibitory concentration (MIC) of methylrosanilinium chloride varied from 0.125 to 4 mg/L.Statistical analysis revealed no significant correlation between the genotypes and autifungal susceptibilities of C.albicans(all P ＞ 0.05).Conclusions More attention should be given to the increasing resistance to fluconazole and itraconazole in some isolates of C.albicans as well as to the favorable antifungal activity of methylrosanilinium chloride.The antifungal resistance shows no apparent correlation to the genotypes of C.albicans.