Immunogenicity of Whole / 生物医学与环境科学（英文）

Objectives@#To evaluate the immunogenicity of @*Methods@#Protein extracts from @*Results@#Immunization with @*Conclusion@#This is the advanced study to investigate the immunogenicity of

Effects of brain-derived neurotrophic factor precursor on behavior and apoptosis signal pathway in prefrontal cortex of rats with post-stroke depression / 中华行为医学与脑科学杂志

Objective:To observe the changes of protein expression of apoptosis signal pathway in prefrontal cortex of rats with post-stroke depression(PSD) after lateral ventricle injected of brain-derived neurotrophic factor precursor(proBDNF).Methods:Among 55 healthy adult female SD rats, 25 rats were randomly selected as PSD group, and the other 30 rats were randomly divided into normal group ( n=10), depression group ( n=10) and stroke group ( n=10). The middle cerebral artery occlusion(MCAO) model was established by thread occlusion in the stroke group, the chronic stress depression model in the depression group was established by the combination of chronic unpredictable mild stress(CUMS) and the solitary feeding method.And the rats in the PSD group were established MCAO model first, then they were received CUMS stress and solitary rearing one week later so as to establish PSD model.Two weeks after the establishment of the model, 15 rats in PSD group were randomly divided into proBDNF group, rats in tPA group and NS control group.One week after buried tube of lateral ventricle, rats in tPA and proBDNF were injected into the lateral ventricle for one week.The protein expressions of c-Jun N-terminal kinase(JNK), p-JNK, p53, p-p53 and Bax in prefrontal cortex of rats in each group were detected by Western blot at the 4th and 8th week after modeling.SPSS 17.0 software was used for data analysis, one-way ANOVA was used for comparison between groups, and SNK- q was used for pairwise comparison. Results:The expressions of p-p53, p53, p-JNK, JNK and Bax in prefrontal cortex of normal group, depression group, stroke group and PSD group were significantly different at the end of 4th and 8th week after MCAO modeling ( F=3.426-90.355, all P<0.05). Post-hoc analysis showed that, compared with the normal group, the expressions of p-JNK (0.378±0.042) and Bax (0.478±0.054) in the prefrontal cortex of PSD rats increased significantly at the end of the 4th week(both P<0.05), and the expressions of p-JNK(0.411±0.056), p-p53 (0.286±0.083) and Bax (0.471±0.008) in the prefrontal cortex of PSD group increased significantly at the end of the 8th week(all P<0.05). After lateral ventricle injection of proBDNF, there were significant differences in the expression of p-p53, p53, p-JNK, JNK and Bax among proBDNF group, tPA group and NS group ( F=16.915-287.039, all P<0.01). Post-hoc analysis showed that, compared with NS group, the expressions of p-JNK (0.35±0.01)and p-p53 (0.31±0.01)in prefrontal cortex of proBDNF group increased significantly(both P<0.05). After lateral ventricle injection of proBDNF, there were significant differences in body weight, sucrose preference rate, horizontal movement distance among proBDNF group, tPA group and NS group ( F=18.741-76.305, all P<0.01), and compared with tPA group and NS group, behavioral indexes of proBDNF group (body weight (224.36±3.23) g, sucrose preference rate (69.83±1.72)%, horizontal movement distance (57.93±2.09) blocks, vertical movement distance (19.79±1.81)) decreased significantly(all P<0.05). Conclusion:The proBDNF promotes the activation of apoptosis signal pathway in the rats with PSD.

Liquiritin improves depressive behavior in rats with post-stroke depression by reducing apoptosis of amygdala cells / 国际脑血管病杂志

Objective:To investigate the effect of liquiritin on the apoptosis of amygdala cell and the expression of apoptosis-related factors Bax and Bcl-2 protein in rats with post-stroke depression (PSD).Methods:Sixty rats were randomly divided into normal control group, stroke group, PSD group, citalopram group, liquiritin group, and normal saline control group ( n=10 in each group). The middle cerebral artery was occluded with a suture method to induce focal cerebral ischemia, and the PSD model was established by chronic and unpredictable mild stress stimulation and orphanism. At the same time every week after the model was made, the weight of rats in each group was measured and the depression behavior was evaluated, including sucrose water test and open field test. At 6 weeks after the model was made, TUNEL staining was used to detect the apoptosis of amygdala cell, immunofluorescence staining was used to detect the expression of Bax and Bcl-2 in the amygdala, and Western blot analysis was used to detect the protein expression of Bax and Bcl-2 in the amygdala. Results:Compared with the liquiritin group, citalopram group and normal control group, the body weight and sucrose solution preference of rats in the stroke group, PSD group and normal saline control group were decreased, and the horizontal and vertical movements in open field test were decreased; the differences were statistically significant (all P<0.01). TUNEL staining results showed that compared with the liquiritin group, citalopram group and normal control group, the number of apoptotic cells was significantly increased in the stroke group, PSD group, and normal saline control group; the difference was statistically significant (all P<0.01). The results of immunofluorescence staining showed that compared with the liquiritin group, citalopram group and normal control group, the number of bcl-2 immunoreactive cells in amygdala of the stroke group, PSD group and normal saline control group was significantly decreased, while the number of Bax immunoreactive cells was significantly increased; the difference was statistically significant (all P<0.01). Western blot analysis showed that compared with the liquiritin group and citalopram group, the expression of bcl 2 protein in amygdala of the stroke group, PSD group and normal saline control group was significantly decreased, while the expression of Bax protein was significantly increased; the difference was statistically significant (all P<0.01). Conclusion:Liquiritin can alleviate the symptoms of PSD, and its mechanism may be related to inhibiting the apoptosis of amygdala cells and regulating the expression of apoptosis-related factors.

Prognosis of patients with a single compared to multiple colorectal cancer liver metastases after hepatic resection / 中华肝胆外科杂志

Objective:To compare the prognosis of patients with a single compared to multiple colorectal cancer liver metastases (CRLM) after hepatectomy.Methods:The clinical data of 490 patients with colorectal cancer liver metastases who underwent hepatectomy at Department of Hepatopancreatobiliary Surgery Ⅰ, Peking University Cancer Hospital & Institute from January 2006 to December 2016 were retrospectively studied. There were 314 males and 176 females. The median age was 58 years (range 21 to 83 years). There were 200 patients in the single liver metastasis group and 290 patients in the multiple liver metastases group. The tumor recurrence and survival outcomes on follow-up were analyzed. Survival curves were plotted using the Kaplan-Meier method. Both overall survival and disease-free survival between two groups were compared by the log-rank test. Univariate and multivariate Cox regression analyses were used to analyze independent risk factors of overall survival.Results:The 1-, 3-, 5-, 10-year overall survival rates for the single versus the multiple liver metastases groups were 92.5%, 58.6%, 51.0%, 38.8% versus 90.7%, 53.2%, 41.1%, 29.9%. The differences were significant ( P<0.05). The disease-free survival was also significantly better in the single than the multiple groups ( P<0.05). Cox multivariate analysis showed that right-sided primary colonic tumor, preoperative carbohydrate antigen 19-9 level ≥50 U/ml, and RAS mutant were independent factors influencing survival in patients with single liver metastasis; while primary colonic tumor N 1-2, liver metastases diameter ≥5 cm, and RAS mutant were independent factors influencing survival in patients with multiple tumors. If the three independent factors affecting overall survival of patients with multiple liver metastases were assigned 1 point for each factor, the number of patients with scores of 0, 1, 2, and 3 were 50, 145, 84, and 11, respectively. The long-term survival of patients with a low score (0, 1) was similar to those with a single liver metastasis (both P>0.05). However, patients with a high score (2, 3) showed significantly worse long-term survival when compared with patients with a single liver metastasis (both P<0.05). Conclusions:The prognosis of patients with single colorectal liver metastasis was better than those with multiple liver metastases after hepatectomy. For patients with multiple liver metastases with fewer associated risk factors, surgical resection could still result in long-term survival outcomes which were comparable to those patients with a single liver metastasis.

Precise evaluation of biological behavior for colorectal cancer liver metastases / 中华肝胆外科杂志

The incidence of colorectal cancer liver metastases (CRLM) has been gradually increased in recent years. Surgical resection is the most important treatment method for CRLM patients, but the recurrence rate was as high as 60%-70% after surgical resection. Therefore, it is very important to clarify the high-risk prognostic factors for tumor recurrence in patients with CRLM after surgery. Based on the prognostic factors we can accurately evaluate the biological behavior of each patient before surgery and select suitable preoperative chemotherapy regimen, timing and method of localized treatment for them. Thereby the survival benefit from surgical resection of those patients could be maximized. In this article we discussed several important factors affecting the tumor recurrence and survival of patients with CRLM undergoing surgical resection, including clinical risk factor score, preoperative chemotherapy response, the genetic status and the primary tumor location, and explain in detail.

Impact of mutant RAS on prognosis of patients after hepatic resection for colorectal cancer liver metastases / 中华肝胆外科杂志

Objective To study the impact of RAS status on prognosis of patients after liver resection for colorectal cancer liver metastases (CRLM).Methods The data of 545 consecutive CRLM patients who underwent liver resection at the Hepatopancreatobiliary Surgery Department I,Peking University Cancer Hospital between January 1st,2008 and December 31st,2016,were retrospectively reviewed.According to the inclusion and exclusion criteria,356 patients were eventually included into this study.There were 232 males and 124 females,with ages ranging from 21 to 83 years.The clinical and follow-up data of patients with wild-type and mutant RAS were compared.Survival was estimated by the Kaplan-Meier method,and the difference was compared by the log-rank test.Factors influencing survival of these patients were assessed by univariate and multivariate Cox regression analyses.Results There were 247 patients with wild-type RAS and 109 patients with mutant RAS,respectively.The median overall survival of patients with wild-type and mutant RAS were 74 and 30 months respectively.Compared with mutant RAS patients,wild-type RAS patients had significantly better cumulative survival and disease free survival rates (both P ＜ 0.05).Multivariate Cox regression analyses revealed disease free interval from primary to metastases ≤ 12 months (HR =1.673,95％ CI:1.016-2.637),largest hepatic tumor diameter ＞ 5 cm (HR =1.717,95 ％ CI:1.102-2.637),and mutant RAS (HR =1.836,95％ CI:1.322-2.550) were independent risk factors for patients with colorectal cancer liver metastases after hepatic resection.Conclusion Mutant RAS was a poor prognostic factor of survival after liver resection in CRLM patients

Histological assessment of canine acute intestinal injury model induced by radiation / 解放军医学杂志

Objective To evaluate acute intestinal injury models induced by radiation through histological analysis. Methods A total of 41 Beagle canines were randomized into control group (n=8) and 11 radiation groups (at dose of 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 30Gy, 3 each group). Animals were given single-dose from X-ray delivered at dose rates of 250cGy/min using tridimensional conformal radiotherapy (3D-CRT) on the abdomen, followed by histological analysis on the intestine. Results We successfully developed canine acute intestinal injury model using irradiation. The intestinal mucosal injury showed a dose-dependent manner. The greater radiation dose was received, the more severe pathological mucosal injury observed. For dogs that received 8Gy, their small intestine exhibited a slight grade of apoptosis and partial loss of the intestinal villi in the epithelial cells. For dogs that received moderate irradiation dose of 10-14Gy, we observed partially damaged mucosa, glandular dilatation, inflammatory infiltration, vascular congestion, and hemorrhage in their intestine tissue. For dogs that received the high dose of 16-30Gy, their intestine histologic changes included diffuse intestinal necrosis, erosions or exfoliation, as well as extensive congestion and bleeding. Conclusions A canine model of acute intestinal injury induced by irradiation in a dose-dependent manner was successfully established. This model would pave the foundation for better irradiation model development and be beneficial to develop novel and effective radioprotective agents.

Rethinking of the conversion therapy in colorectal cancer patients with liver metastasis / 中华肿瘤杂志

The incidence of colorectal cancer liver metastasis (CRLM) has gradually increased in recent years. Surgical resection is the main method to achieve long-term survival for patients with CRLM. However, only 20% of these patients have the chance to undergo surgical resection. If the unresectable metastases can be converted to resectable ones by effective conversion therapy, the 5-year survival rate of patients received liver resection can exceed to 30%, which is significantly better than palliative treatment. Therefore, for patients who are initially unresectable, rationally developing a conversion therapy strategy to convert the initial unresectable CRLM into resectable ones is the key to improve the long-term survival of CRLM patients. However, there are still many controversies in clinical practice. In this article, we discuss three critical issues related to the conversion therapy for CRLM based on previous related researches and our experience, including the applicable population of conversion therapy, how to choose a conversion regime and the recognition and treatment of disappeared lesions after chemotherapy.

Perioperative chemotherapy in patients with colorectal cancer liver metastasis / 中华胃肠外科杂志

The incidence of colorectal cancer liver metastasis (CRLM) increased gradually in recent years. Surgical resection is the most important treatment for CRLM patients to obtain long-term survival, with a 5-year survival rate of about 50%. However, only 20% of the CRLM patients are initially resectable. The recurrence rate after surgery is more than 70%. Perioperative chemotherapy has been widely used with the development of effective chemotherapy regimens and targeted therapies. For patients with initially resectable liver metastases, perioperative chemotherapy may help reduce recurrence and prolong survival. For patients with unresectable liver metastases, conversion chemotherapy with high efficiency provides opportunity for radical resection. However, CRLM is a disease with high heterogeneity and with many factors influencing prognosis, and there is a lack of large-scale prospective clinical trial evidence in many problems. Hence there are still many controversies in the clinical practice of perioperative chemotherapy, including whether chemotherapy alone is the best preoperative treatment for resectable CRLM, whether preoperative chemotherapy combined with targeted therapy is superior to chemotherapy alone, who can benefit most from preoperative chemotherapy combined with targeted therapy, who are the exact patients suitable for conversion therapy, how to choose the best first-line conversion therapy. Here we discuss the current status of research on perioperative chemotherapy in three aspects: neoadjuvant chemotherapy, conversion therapy and adjuvant chemotherapy. We also emphasized the importance of multidisciplinary team during the treatment process to give patients individualized therapy considering their specific conditions.

Expression and Clinical Significance of Late Endosomal/Lysosomal Adaptor,Mitogen-activated Protein Kinase and Mammalian Target of Rapamycin Activator 3 in Bladder Carcinoma / 中国医学科学院学报

Objective To investigate the expression and clinical significance of late endosomal/lysosomal adaptor,mitogen-activated protein kinase and mammalian target of rapamycin activator 3(LAMTOR3)in bladder carcinoma.Methods Oncomine and Expression Atlas were used to extract the useful mining gene chip database for analyzing the expression of LAMTOR3 in bladder carcinoma tissues and cell lines,and the correlation of LAMTOR3 with the clinicopathological features were analyzed.RT-PCR,Western blot,and immunohistochemistry were performed to detect the expression of LAMTOR3 in bladder carcinoma cell lines,specimens,and adjacent normal tissues for verifying the results exploited from the above databases.Results The Expression Atlas showed that LAMTOR3 had high expressions in Hs172.T,HT-1376,RT4,JMSU-1,and T24 cell lines among 20 bladder carcinoma cell lines,among which the LAMTOR3 expression was different.Oncomine reported that LAMTOR3 expression in bladder carcinoma,including invasive(=2.857,=0.005)and non-invasive carcinoma(=3.105,=0.003),was significantly higher than that in adjacent normal tissues.The expression of LAMTOR3 was positively correlated with pathological grade(<0.05).The expressions of LAMTOR3 mRNA in bladder carcinoma cell lines,including UMUC3(=10.84,=0.0084),J82(=21.75,=0.0021),5637(=45.88,=0.0005),and T24(=87.58,=0.0001)were significantly higher than that in normal bladder cell line SV-HUC-1,while its expression in bladder carcinoma tissues was significantly higher than that in adjacent normal tissues(<0.05),so was its protein level in tissues(<0.05).Immunohistochemistry showed that LAMTOR3 protein was over-expressed in bladder carcinoma tissues;its level in invasive carcinoma tissues was higher than that in no-invasive carcinoma tissues and was related closely with the clinical stages(=9.189,=0.002),pathological grades(=4.746,=0.029),and lymphatic metastasis(=6.210,=0.013)but had no significant correlation to sex(=0.965,=0.326),age(=2.126,=0.145),and distant metastasis(=1.261,=0.261).Conclusion LAMTOR3 is highly expressed in bladder carcinoma cell lines and tissues and plays a key role in the development and progression of bladder carcinoma.

Preliminary experience in guiding individualized targeted therapy of advanced metastatic renal cell carcinoma with gene detection technology / 中华泌尿外科杂志

Objective To explore the efficacy and tolerance of adverse reactions of gene detection technique in guiding individualized targeted therapy for advanced metastatic renal cell carcinoma.Methods Retrospective analysis was performed on the clinical data of 62 patients with advanced metastatic renal cell carcinoma before and after receiving targeted drug treatment in our department from October 2015 to October 2017.Among the 62 patients,there were 36 males and 26 females,with an average age of (54 ± 13) years old.16 patients were treated with sunitinib,20 patients were treated with sorafenib and 26 patients were treated with pazopanib.A total of 28 patients (individualized group) were selected to receive targeted drug according to the results of gene detection,and 34 patients were treated with targeted drug empirically (empirical group).In individualized group,there were 17 males and 11 females with the average age of (51.3 ± 15.6) years old.20 patients accepted the operation.The distant metastasis included bone metastasis in 21 cases,lung metastasis in 7 cases,liver metastasis in 16 cases,epidermal metastasis in 4 cases and lymphatic metastasis in 14 cases.According to risk of MSKCC,the case number of low risk,moderate risk and high risk were 15,7,6,respectively.7 patients were treated with sunitinib,8 patients were treated with sorafenib and 13 patients were treated with pazopanib.In empirical group,there were 19 males and 15 females with the average age of (56.3 ± 10.1) years old.22 patients accepted the operation.The distant metastasis included bone metastasis in 20 cases,lung metastasis in 5 cases,liver metastasis in 13 cases,epidermal metastasis in 3 cases and lymphatic metastasis in 15 cases.According to risk of MSKCC,the case number of low risk,moderate risk and high risk were 20,g,6,respectively.9 patients were treated with sunitinib,12 patients were treated with sorafenib and 13 patients were treated with pazopanib.The baseline characteristics of the two groups of patients,including gender,age,whether operation was performed,site of metastasis,and risk of MSKCC,didn't show significant difference.Patients in both groups received the standard treatment regimen and the follow-up duration was 4-26 months to observe the efficacy,progression-free survival and tolerance to adverse reactions of the targeted therapy.Results After 12 months of treatment,15 patients in the individualized group was recorded objective remission.7 patients in the empirical group was recorded objective remission,as well.The tumor control efficacy of the individualized group was significantly better than that of the empirical group (46.4％ vs.20.6％,P =0.03).Meanwhile,the median progression-free survival time (15.2 months,3.7-24.2 months) in the individualized group was significantly longer than that in the empirical group (12.1 months,2.8-22.1 months) (P =0.009).Compared with the empirical group,the higher incidence of targeted treatment-related adverse reactions occurred in the individualized group,including thrombocytopenia (46.4％ vs.17.6％ P =0.014),leukopenia (46.4％ vs.17.6％ P =0.005),hypertension (71.4％ vs.44.1％,P =0.031) and hypothyroidism(60.7％ vs.29.4％,P=0.013).Conclusions Compared with the patients with empirical drugs,the application of gene detection technique to select individualized targeted drugs for the treatment of advanced metastatic renal cancer is obvious curatively effective,and to a certain extent extends the progression-free survival time of patients.

Surface Electromyography Changes of Vastus Medialis, Rectus Femoris and Vastus Lateralis during Stair Descent in Healthy Youth / 中国康复理论与实践

@#Objective To evaluate the activities of vastus medialis, rectus femoris and vastus lateralis during stair descent in healthy youth. Methods Thirty healthy college students were recruited from the Capital Medical University 2015 admissions in 2016. The electrode was put on the dominant side of the quadriceps. Surface electromyography was used to record muscle activity during stair descent. Results During stair descent, the maximum amplitude and mean amplitude were significantly lower in rectus femoris than in vastus medialis and vas-tus lateralis (P<0.001). No significant difference was found between vastus medialis and vastus lateralis (P>0.05). Conclusion The activa-tion of both vastus medialis and vastus lateralis during stair descent is significantly higher than that of rectus femoris. The coactivation of vastus medialis and vastus lateralis is equal in healthy youth.

Human U Three Protein 14a Expression is Increased in Hepatocellular Carcinoma and Associated with Poor Prognosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Human U three protein 14a (hUTP14a) promotes p53 degradation. Moreover, hUTP14a expression is upregulated in several types of tumors. However, the expression pattern of hUTP14a in hepatocellular carcinoma (HCC) remains unknown. The aim of this study was to investigate hUTP14a expression and its prognostic value in HCC.</p><p><b>METHODS</b>The hUTP14a expression was evaluated using immunohistochemistry (IHC) in HCC tissue specimens. The correlations between hUTP14a expression and clinicopathological variables were analyzed. The Kaplan-Meier method was used to analyze the association between hUTP14a expression and survival. Independent prognostic factors associated with overall survival (OS) and disease-free survival (DFS) were analyzed using the Cox proportional-hazards regression model.</p><p><b>RESULTS</b>The IHC data revealed that the hUTP14a positivity rate in HCC tissue specimens was significantly higher than that in nontumorous tissue specimens (89.9% vs. 72.7%, P < 0.05). The hUTP14a expression was detected in both the nucleolus and the cytoplasm. The positivity rate of nucleolar hUTP14a expression in HCC tissue specimens was higher than that in the nontumorous tissue specimens (29.3% vs. 10.1%, P < 0.05). No significant difference was found between HCC and nontumorous tissue specimens of cytoplasmic hUTP14a expression (60.6% vs. 62.6%, P > 0.05). In addition, no significant correlation was found between nucleolar hUTP14a expression and other clinicopathological variables. The 5-year OS and DFS rates in patients with positive nucleolar hUTP14a expression were significantly lower than those in patients with negative hUTP14a expression (P = 0.004 for OS, P = 0.003 for DFS). Multivariate analysis showed that nucleolar hUTP14a expression was an independent prognostic factor for OS (P = 0.004) and DFS (P < 0.001).</p><p><b>CONCLUSIONS</b>The positivity rate of hUTP14a expression was significantly higher in HCC specimens. Positive expression of nucleolar hUTP14a might act as a novel prognostic predictor for patients with HCC.</p>

Surgical treatment for open tarsometatarsal joint injury / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the surgical method and clinical efficacy for open tarsometatarsal joint injuries.</p><p><b>METHODS</b>From March 2011 to January 2015, 21 patients with open tarsometatarsal joint injuries were treated with stage-surgery method, including 14 males and 7 females with an average age of 45.6 years old ranging from 20 to 75 years. Injury site occurred in the left foot of 13 cases and right foot of 8 cases. Traffic injury was in 5 cases, crush injury in 6 cases, heavy crushing was in 10 cases. According to Myerson to classify for tarsometatarsal joint injury, 5 cases were type B2, 9 cases were type C1, and 7 cases were type C2. And according to Gustilo to typing for soft tissue injury, 5 cases were type IIB, 10 cases were type IIIA, 6 cases were type IIIB. Fracture healingand complications were observed after operation and clinical effects were evaluated according to the midfoot score of AOFAS.</p><p><b>RESULTS</b>All the patients were followed up from 11 to 40 months with an average of 16.2 months. The fracture healing time was from 10 to 16 weeks with an average of 12.3 weeks. No complications such as deep infection, nonunion and osteomyelitis were found. Midfoot score of AOFAS at last follow-up was 83.0±14.9, 9 cases got excellent results, 8 good, 2 fair, 2 poor. Two patients complicated with severe traumatic arthritis once again underwent tarsometatarsal arthrodesis.</p><p><b>CONCLUSIONS</b>For the treatment of open tarsometatarsal joint injury, reasonable debridement, comprehensive assessment for the soft tissue injury, correctly grasp the surgical indications and time of internal fixation, can reduce the incidence of deep infection and osteomyelitis.</p>

Surface Electromyography Changes of Vastus Medialis, Rectus Femoris and Vastus Lateralis during Stair Descent in Healthy Youth / 中国康复理论与实践

@#Objective To evaluate the activities of vastus medialis, rectus femoris and vastus lateralis during stair descent in healthy youth. Methods Thirty healthy college students were recruited from the Capital Medical University 2015 admissions in 2016. The electrode was put on the dominant side of the quadriceps. Surface electromyography was used to record muscle activity during stair descent. Results During stair descent, the maximum amplitude and mean amplitude were significantly lower in rectus femoris than in vastus medialis and vas-tus lateralis (P<0.001). No significant difference was found between vastus medialis and vastus lateralis (P>0.05). Conclusion The activa-tion of both vastus medialis and vastus lateralis during stair descent is significantly higher than that of rectus femoris. The coactivation of vastus medialis and vastus lateralis is equal in healthy youth.

Antioxidative effect of luteolin pretreatment on simulated ischemia/reperfusion injury in cardiomyocyte and perfused rat heart / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the antioxidative effect and mechanism of luteolin on rat cardiomyocytes and isolated hearts followed by simulated ischemia/reperfusion (SI/R) injury.</p><p><b>METHODS</b>The left ventricular cardiomyocytes and the isolated hearts from adult rats were subjected to SI/R injury. The experiment groups included control, SI/R, luteolin + SI/R (Lut + SI/R), vitamin E (Vit E) + SI/R, and LY294002 + luteolin + SI/R (LY + Lut + SI/R) groups. Cell viability, shortening amplitude, lactate dehydrogenase (LDH) release, superoxide dismutase (SOD) activity, the production of reactive oxygen species (ROS) and malondialdehyde (MDA), expression levels of Akt, phosphorylated Akt, NOX2 (gp91phox), NOX2 mRNA, mitogen-activated protein kinase (p38 MAPK) and phosphorylated p38MAPK were all measured after 3-h simulated ischemia and 2-h simulated reperfusion procedure in cardiomyocytes. Vit E was used as a standard control. The contractile function of isolated hearts was further observed after they were subjected to 30-min global ischemia and 120-min reperfusion.</p><p><b>RESULTS</b>Pretreatment with 8-μmol/L luteolin substantially increased cell viability and shortening amplitude, while reducing evidence of oxidative stress-induced damage in the cells. In addition, the expression of NOX2, NOX2 mRNA and phosphorylation of p38MAPK were all downregulated. Furthermore, pretreatment with 40-μmol/L luteolin improved the recovery of myocardial contractile function following SI/R-induced injury, and luteolin markedly increased phosphorylation of Akt. However, all of the above effects were partially inhibited by the phosphatidylinositol 3-kinase (PI3K) inhibitor, LY294002.</p><p><b>CONCLUSIONS</b>Luteolin prevents SI/R-induced myocardial damage by reducing oxidative stress-induced injury in isolated rat hearts and cardiomyocytes, and the cardioprotection induced by luteolin was partially mediated by the PI3K/Akt pathway.</p>

Iindividual choice of distal fibula internal fixation for ankle fractures in elderly / 中国骨伤

<p><b>OBJECTIVE</b>To explore individual choice and therapeutic effect of distal fibula internal fixation in treating ankle fractures in elderly.</p><p><b>METHODS</b>From May 2012 to April 2015, 68 elderly patients with ankle fractures were treated by surgical operation, included 37 males and 31 females with an average of 69.2 years old ranging from 62 to 81 years. According to Danis-Weber classification, there were 19 cases belong to type A, 31 cases belong to type B, and 18 cases belong to type C. According to Lange-Hanson classification, 22 cases were supinatio-extorsion, 18 were pronate-extorsion, 19 were supinatio-adduction, and 9 were pronate-abduction. All patients were performed individyually with different internal fixation methods for the treatment of distal fibula fracture according to different types of fracture. Clinical results were evaluated based on clinical examination, radiographic evaluation and AOFAS score.</p><p><b>RESULTS</b>Twelve patients were treated with Herbert screw, 7 cases with Kirschner wire tension band, 5 cases with 1/3 tube plate, 6 cases with reconstruction plate, 17 cases with fibular end dissection steel plate composite, and 21 cases with distal fibula anatomic locking plate. All patients were followed up from 12 to 26 months with an average of 17.7 months. The operative incision of all patients were primary healed. And there was no bone nonunion, ankle instability, internal fixation loosening and fracture occurred. Fracture healing time ranged from 2.7 to 4 months with an average of 3.2 months, and had significant differences among different groups(<0.05). There were no statistical differences in AOFAS score, VAS score and motion of ankle joint among different internal fixation groups(>0.05). Dorsal stretch was 6° to 18° with an average of 15°, plantar flexion ranged from 26°to 47° with an average of 37°. AOFAS score at the latest following-up was 88.4±4.3, 34 patients got an excellent result, 30 good and 4 fair.</p><p><b>CONCLUSIONS</b>Good clinical results could be obtained by using individualized internal fixation for distal fibula fracture for the treatment of the ankle fractures in elderly.</p>

Clinical analysis and treatment strategies for post-hepatectomy haemorrhage / 中华肝胆外科杂志

Objective To analyze the clinical data of patients with post-hepatectomy haemorrhage (PHH) and to discuss the treatment strategies.Method The clinicopathologic data of patients with PHH between 2005-2014 in the HPB Surgery Ward I,Peking University Cancer Hospital,were studied retrospectively.Results In the study period of 10 years,25 of 1 548 patients who underwent hepatectomy suffered from PHH,and 76％ (19/25) of these patients had underlying liver diseases.The common surgical operations followed by PHH were right hemihepatectomy (11/25),and segment Ⅶ/Ⅷ resection (8/25).The median time for PHH to be diagnosed was 27 h,and the median time from diagnosis of postoperative bleeding to reoperation or intervention was 3.5 h.Using the classification of PHH by the International Study Group of Liver Surgery (ISGLS),there were 1 patient in grade A,16 patients in grade B,and 8 patients in grade C.The perioperative mortality of PHH was 8％ (2/25).The most common bleeding site was from the hepatic artery.Conclusions PHH is a serious complication after liver resection,with low occurrence but high mortality.Most patients with PHH can be managed by conservative treatment.Emergency reoperation is required when instability in vital signs appears.Careful evaluation before operation,strict hemostasis during operation,and close monitoring after operation can effectively reduce the incidence and mortality of PHH.

Surgical treatment of colorectal cancer liver metastasis / 中国肿瘤临床

Surgical resection is currently the only cure treatment for colorectal carcinoma liver metastasis (CRLM). The efficien-cy of surgical resection has improved with the development of systemic chemotherapy and targeted drugs and the application of hepatic arterial infusion chemotherapy in recent years. The number of patients benefiting from surgery has gradually increased. The progression of surgical techniques such as radiofrequency ablation and staged hepatectomy provides chances of cure for patients with CRLM. Multi-disciplinary team creates the opportunity of individual diagnosis and treatment for growing number of patients with CRLM, which, in turn, promotes the treatment of CRLM to a more precise future.

Serum levels of 25-hydroxyvitamin D in children with autism spectrum disorders / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To examine serum 25-hydroxyvitamin D levels in children with autism spectrum disorders (ASD) and to explore the relationship between vitamin D level and ASD.</p><p><b>METHODS</b>Serum levels of 25-hydroxyvitamin D levels were determined by the HPLC-MS/MS method in 117 children with newly diagnosed ASD and 109 healthy controls. Vitamin D status were classified into normal (>30 ng/mL), insufficiency (10-30ng/mL) and deficiency (<10 ng/mL) according to 25-hydroxyvitamin D levels.</p><p><b>RESULTS</b>Serum level of 25-hydroxyvitamin D (19±9 ng/mL)in children with ASD was significantly lower than that in healthy controls (36±13 ng/mL; P<0.01). The rate of vitamin D insufficiency plus deficiency in the ASD group was significantly higher than in the control group (89.7% vs 52.3%; P<0.01).</p><p><b>CONCLUSIONS</b>Vitamin D insufficiency or deficiency is common in children with ASD and might be as one of the environmental or genetic factors for ASD.</p>