Preliminary application of combined auditory monitoring technique in resection of vestibular neurinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the value of electrically evoked auditory brainstem response (EABR) monitoring combined with brainstem auditory evoked potential (BAEP) and compound action potential (CAP) monitoring during vestibular schwannoma resection for the protection of the cochlear nerve. Methods: Clinical data from 12 patients with vestibular schwannomas who had useful hearing prior to surgery were analyzed at the PLA General Hospital from January to December 2021. Among them, there were 7 males and 5 females, ranging in age from 25 to 59 years. Before surgery, patients underwent audiology assessments (including pure tone audiometry, speech recognition rate, etc.), facial nerve function evaluation, and cranial MRI. They then underwent vestibular schwannoma resection via the retrosigmoid approach. EABR, BAEP, and CAP were simultaneously monitored during surgery, and patients' hearing preservation was observed and analyzed after surgery. Results: Prior to surgery, the average PTA threshold of the 12 patients ranged from11 to 49 dBHL, with a SDS of 80% to 100%. Six patients had grade A hearing, and six patients had grade B hearing. All 12 patients had House-Brackman grade I facial nerve function prior to surgery. The MRI indicated tumor diameters between 1.1 and 2.4 cm. Complete removal was achieved in 10/12 patients, while near-total removal was achieved in 2/12 patients. There were no serious complications at the one-month follow-up after surgery. At the three-month follow-up, all 12 patients had House-Brackman grade I or II facial nerve function. Under EABR with CAP and BAEP monitoring, successful preservation of the cochlear nerve was achieved in six of ten patients (2 with grade B hearing, 3 with grade C hearing, and 1 with grade D hearing). Successful preservation of the cochlear nerve was not achieved in another four patients (all with grade D hearing). In two patients, EABR monitoring was unsuccessful due to interference signals; however, Grade C or higher hearing was successfully preserved under BAEP and CAP monitoring. Conclusion: The application of EABR monitoring combined with BAEP and CAP monitoring during vestibular schwannoma resection can help improve postoperative preservation of the cochlear nerve and hearing.

Research on applying genetic and environmental risk score in risk-adapted colorectal cancer screening / 中华流行病学杂志

Objective: To evaluate the effectiveness of a risk-adapted colorectal cancer screening strategy constructed utilizing genetic and environmental risk score (ERS). Methods: A polygenic risk score (PRS) was constructed based on 20 previously published single nucleotide polymorphisms for colorectal cancer in East Asian populations, using 2 160 samples with MassARRAY test results from a multicenter randomized controlled trial of colorectal cancer screening in China. The ERS was calculated using the Asia-Pacific Colorectal Screening Score system. Logistic regression was used to analyze the association between PRS alone and PRS combined with ERS and colorectal neoplasms risk, respectively. We also designed a risk-adapted screening strategy based on PRS and ERS (high-risk participants undergo a single colonoscopy, low-risk participants undergo an annual fecal immunochemical test, and those with positive results undergo further diagnostic colonoscopy) and compared its effectiveness with the all-acceptance colonoscopy strategy. Results: The high PRS group had a 26% increased risk of colorectal neoplasms compared with the low PRS group (OR=1.26, 95%CI: 1.03-1.54, P=0.026). Participants with the highest PRS and ERS were 3.03 times more likely to develop advanced colorectal neoplasms than those with the lowest score (95%CI: 1.87-4.90, P<0.001). As the risk-adapted screening simulation reached the third round, the detection rate of the PRS combined with ERS strategy was not statistically different from the all-acceptance colonoscopy strategy (8.79% vs. 10.46%, P=0.075) and had a higher positive predictive value (14.11% vs. 10.46%, P<0.001) and lower number of colonoscopies per advanced neoplasms detected (7.1 vs. 9.6, P<0.001). Conclusion: The risk-adapted screening strategy combining PRS and ERS helps achieve population risk stratification and better effectiveness than the traditional colonoscopy-based screening strategy.

Risk factors for neonatal asphyxia and establishment of a nomogram model for predicting neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture: a multicenter study / 中国当代儿科杂志

OBJECTIVES@#To investigate the risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture and establish a nomogram model for predicting the risk of neonatal asphyxia.@*METHODS@#A retrospective study was conducted with 613 cases of neonatal asphyxia treated in 20 cooperative hospitals in Enshi Tujia and Miao Autonomous Prefecture from January to December 2019 as the asphyxia group, and 988 randomly selected non-asphyxia neonates born and admitted to the neonatology department of these hospitals during the same period as the control group. Univariate and multivariate analyses were used to identify risk factors for neonatal asphyxia. R software (4.2.2) was used to establish a nomogram model. Receiver operator characteristic curve, calibration curve, and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the model for predicting the risk of neonatal asphyxia, respectively.@*RESULTS@#Multivariate logistic regression analysis showed that minority (Tujia), male sex, premature birth, congenital malformations, abnormal fetal position, intrauterine distress, maternal occupation as a farmer, education level below high school, fewer than 9 prenatal check-ups, threatened abortion, abnormal umbilical cord, abnormal amniotic fluid, placenta previa, abruptio placentae, emergency caesarean section, and assisted delivery were independent risk factors for neonatal asphyxia (P<0.05). The area under the curve of the model for predicting the risk of neonatal asphyxia based on these risk factors was 0.748 (95%CI: 0.723-0.772). The calibration curve indicated high accuracy of the model for predicting the risk of neonatal asphyxia. The decision curve analysis showed that the model could provide a higher net benefit for neonates at risk of asphyxia.@*CONCLUSIONS@#The risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture are multifactorial, and the nomogram model based on these factors has good value in predicting the risk of neonatal asphyxia, which can help clinicians identify neonates at high risk of asphyxia early, and reduce the incidence of neonatal asphyxia.

Application of cochlear nerve action potential monitoring in the resection of vestibular schwannomas / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the application of cochlear nerve action potential (CNAP) monitoring in the resection of vestibular schwannoma, especially evaluating its significance for hearing preservation. Methods: From April 2018 to December 2021, 54 patients with vestibular schwannoma who underwent resection via retrosigmoid approach were collected in Chinese PLA General Hospital. Before surgery, all patients had effective hearing (AAO-HNS grade C or above). Brainstem auditory evoked potential (BAEP) combined with CNAP monitoring was performed during surgery. The CNAP monitoring was combined with continuous monitoring and cochlear nerve mapping. And patients were divided into hearing preservation group and non-preserved group according to postoperative AAO-HNS grade. SPSS 23.0 software was used to analyze the differences of CNAP and BEAP parameters between the two groups. Results: A total of 54 patients completed intraoperative monitoring and data collection, including 25 males (46.3%) and 29 females (53.7%), aged 27-71 years with an average age of 46.2 years. The maximum tumor diameter were (18.1±5.9) mm (range 10-34 mm). All tumors were totally removed with preserved facial nerve function (House-Brackmann grade I-II). The hearing preservation rate of 54 patients was 51.9% (28/54). During surgery, the V wave extraction rate of BAEP waveform was 85.2% (46/54) before tumor resection, 71.4% (20/28) in the hearing preservation group after tumor resection, and disappeared in the hearing preservation group (0/26). CNAP waveform was elicited in 54 patients during operation. Differences were found in the distribution of CNAP waveforms after tumor resection. The waveforms of the hearing-preserving group were triphasic and biphasic, while those in the non-preserving group were low-level and positive. For hearing preservation group, the amplitude of N1 wave after tumor resection was significantly higher than that before tumor resection[14.45(7.54, 33.85)μV vs 9.13(4.88, 23.35)μV, P=0.022]; However, for the non-preserved group, the amplitude of N1 wave after tumor resection was significantly lower than that before tumor resection [3.07(1.96, 4.60)μV vs 6.55(4.54, 9.71)μV, P=0.007]; After tumor resection, the amplitude was significantly higher than that of the unreserved group [14.45(7.54, 33.85)μV vs 3.07(1.96, 4.60)μV, P<0.001]. Conclusions: BAEP combined with CNAP monitoring is conducive to intraoperative hearing protection, and the application of cochlear nerve mapping can prompt the surgeon to avoid nerve injury. The waveform and N1 amplitude of CNAP after tumor resection have a certain value in predicting postoperative hearing preservation status.

Potential Mechanism of Action of Qiangxin Decoction （强心汤） for Chronic Heart Failure Based on Network Pharmacology and Molecular Docking / 中医杂志

ObjectiveTo reveal the targets and molecular mechanisms of the action of Qiangxin Decoction （强心汤） for the treatment of chronic heart failure based on the combination of network pharmacology and molecular docking. MethodsThe active ingredients of Qiangxin Decoction were retrieved from TCMSP database， and the targets of chronic heart failure were screened by searching GeneCards， OMIM， TTD， PharmGkb， and DrugBank databases， and the intersections were taken to obtain the intersecting targets of Qiangxin Decoction for the treatment of chronic heart failure. STRING platform was used to construct the protein-protein interaction network （PPI）， Cytoscape 3.8.0 software was used to calculate the network topology to screen the core targets， and R 4.2.3 was used to construct the “active ingredient-target” network by analyzing the GO enrichment analysis and KEGG pathway enrichment analysis. AutoDock 1.5.7 was used for molecular docking to predict the binding performance of active ingredients and core targets. ResultsSeventy-five intersecting targets were identified for the treatment of chronic heart failure with Qiangxin Decoction， among which the core targets were estrogen receptor 1 （ESR1， degree value=7）， nuclear receptor coactivator 1 （NCOA1， degree value=8）， glucocorticoid receptor （NR3C1， degree value=7）， and nuclear receptor coactivator 2 （NCOA2， degree value=7）. GO enrichment analysis showed that the top 3 items with the smallest P value in molecular function were G protein-coupled amine receptor activity， postsynaptic neurotransmitter receptor activity， and neurotransmitter receptor activity （P＜0.01）； the top 3 items with the smallest P value in biological process were adenylyl cyclase-activated adrenergic receptor signaling pathway， adrenergic receptor signaling pathway， and adenylyl cyclase-regulated G protein-coupled receptor signaling pathway （P＜0.01）； the top 3 items with the smallest P values in cellular composition were components of the postsynaptic membrane， synaptic membrane， and presynaptic membrane （P＜0.01）. KEGG enrichment analysis showed that the top 5 key signaling pathways were neuroactive ligand-receptor interactions， calcium signaling pathway， dopaminergic synapses， cocaine addiction， and cyclic guanosine monophosphate-protein kinase G （cGMP-PKG） signaling pathway. The molecular docking results showed that lignans and isoflavones had lower binding energies and more structural stability with the four core targets （ESR1， NCOA1， NR3C1， NCOA2）. ConclusionThe treatment of chronic heart failure by Qiangxin Decoction was associated with neuroactive ligand-receptor interactions， calcium signaling pathway， dopaminergic synapses， chemoattractant-receptor activation， cGMP-PKG signaling pathway， lipids and atherosclerosis， and cAMP signaling pathway， and lignans and isoflavones may be the core active compounds in its treatment of chronic heart failure.

Impact of the Varian real-time position management respiratory gating system on radiotherapy planning dosimetry / 中华放射医学与防护杂志

Objective:To study the impact of the Varian real-time position management (RPM) respiratory gating system on radiotherapy planning dosimetry.Methods:The radiotherapy plans of 40 cases with thoracic or abdominal tumors were retrospectively selected in this study. The motion phantom for quality control was adopted to generate respiratory gating signals, and the 30%-60% stable phase at the end of expiratory was selected as the respiratory gating window. The dose verification for the abovementioned radiotherapy plans was performed using the Portal Dosimetry (PD) system under RPM respiratory gating mode with the Edge accelerator. Afterwards, dose analysis was performed with different γ passing rate criteria and the distribution characteristics of γ values were analyzed. Finally, the verification results between the non-gating mode and the gating mode were compared.Results:Under the respiratory gating mode, the passing rates of all intensity-modulated radiation therapy/volumetric-modulated arc therapy (IMRT/VMAT) plans with or without flattening filters were over 95.5% by γ criteria of (3%, 3 mm) or (3%, 2 mm) and were over 90% by stricter γ criteria of (2%, 2 mm). All plans met the clinical requirements recommended by the American Association of Physicists in Medicine (AAPM). The passing rates of dose verification under non-gating mode were slightly better than those under respiratory gating mode, and the differences between the two modes were statistically significant (3%/3 mm, Z =-1.45; 3%/2 mm, Z =-2.86; 2%/2 mm, Z =-3.70; 1%/1 mm, Z =-4.52; P<0.05). There was no significant difference in the minimum and maximum values of γ and the share of γ > 1.5 of plan verification result under the two modes. However, the average value and standard deviation of the γ were generally smaller under the non-gating mode. Conclusions:The impact of the introduction of RPM respiratory gating technology on dose is clinically acceptable, and the execution of these plans in this gating mode is safe and reliable.

Application of optical surface monitoring system in intra-fraction motion monitoring in frameless cranial stereotactic radiotherapy / 中华放射医学与防护杂志

Objective:To establish a novel clinical application process of the optical surface monitoring system (OSMS) in the cranial frameless stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT), and to assess the accuracy and effectiveness of the OSMS in the intra-fraction motion monitoring of both cranial phantoms and cranial SRT patients fixed using the Q-Fix encompass immobilization system.Methods:The deviations of OSMS in the real-time motion monitoring were assessed by determining the deviations between the displacement of the cranial SRS phantoms detected by the OSMS and the predefined displacement of the Varian Edge six degrees of freedom (6DoF) couch. The ability of the OSMS to conduct real-time monitoring of the head movement was also analyzed when one camera was blocked by the rotary gantry of the accelerator and when the couch was at non-zero angles. Moreover, ten patients who received 50 fractions of cranial frameless SRT were enrolled in this study. All the patients were fixed using the Q-Fix Encompass system, and their intra-fraction motion was monitored using the OSMS. The intra-fraction errors of OSMS real-time monitoring throughout the treatment were obtained from the OSMS logs. The patients received cone-beam computed tomography (CBCT) after the beam delivery, and the six-dimensional errors were obtained as intra-fraction motion errors of the CBCT.Results:For the cranial phantoms, there was a close correlation between the OSMS monitoring deviations and the predefined displacement in six dimensions. The OSMS-detected 3D vector deviations in the translational and rotational directions were (0.28±0.10) mm and (0.15±0.09)°, respectively when the angel both the gantry and couch was 0° and were (0.35±0.13) mm and(0.17±0.09)°, respectively, when one camera was blocked. The OSMS monitoring deviations with the couch at a non-zero degree were greater than those at zero degree. The maximum deviations occurred when the couch was at 270° and were (0.69±0.19) mm and (0.32±0.12)°, respectively, in the translational and rotational directions. For the cranial SRT patients fixed using the Q-Fix Encompass system, the OSMS and CBCT showed comparable intra-fractional motion deviations, which were (0.40±0.26) and (0.29±0.10) mm, respectively in the translational direction and were (0.33±0.20)°and (0.26±0.08)° in the rotational direction.Conclusions:The OSMS is an effective tool for optically guided radiotherapy, which allows for intra-fraction real-time motion monitoring with sub-millimeter accuracy. Therefore, to ensure the accurate preformation of cranial SRS/SRT, it is necessary to conduct the intra-fractional position monitoring using OSMS.

Clinicopathological features of follicular lymphoma in children / 中华病理学杂志

Objective@#To investigate the clinicopathologic features of follicular lymphoma (FL) in children.@*Methods@#One female and one male patients with FL diagnosed in the First College of Clinical Medical Science, China Three Gorges University and Beijing Friendship Hospital of the Capital University of Medical Science in February 2016 and June 2015 were studied by HE immunohistochemistry, EBER in situ hybridization, IgH and IgK gene rearrangement analysis and IRF4 fusion gene detection.@*Results@#The two patients′ age were 6.3 and 12 years, respectively. The lesions involved head and neck lymph nodes with duration of more than 2 months. Histopathologically, the lesions consisted of nodular proliferation of lymphoid follicles with diffuse distribution of large cells. Starry sky phenomenon was seen in one of the two cases. Immunohistochemistry showed that one case was positive for bcl-2 and MUM1, but negative for bcl-6 and CD10. Ki-67 index was>50% and oligoclonal IgK rearrangement was observed. The second case showed positivity for bcl-6, and CD10 but negative for bcl-2. Ki-67 index was>50% and clonal IgH FR1-JH and IgH FR2-JH rearrangements were detected. Both cases showed no evidence of IRF4 gene fusion.@*Conclusions@#Childhood FL is a rare B-cell lymphoma with characteristic features and high-grade histomorphology. However, its immunophenotype and molecular genetic characteristics are divergent.

Effects of Different Inflammatory Factors on Hepatocyte Kinase Receptors and Ligands in Human Periodontal Ligament Fibroblasts / 中国医学科学院学报

Objective To investigate the effects of different inflammatory factors on hepatocyte kinase receptor(Eph)and ligand(ephrin)in human periodontal ligament fibroblasts(hPDLFs).Methods hPDLFs were stimulated with either 10 ng/ml tumor necrosis factor-α(TNF-α)or 10 ng/ml interleukin(IL)-1β,and then the expressions of Eph and ephrin at both mRNA and protein levels were determined at 0,1,2,6,12,and 24 hours.Results The levels of Eph receptors and ephrin ligand changed in a time-dependent manner in human periodontal ligament fibroblasts after treatment with TNF-α or IL-1β. The expression of ephrinA2 significantly increased in both groups within 24 hours(all <0.05). In the TNF-α group,the mRNA expression of ephrinA2 significantly increased at 1 h and was significant higher that in the IL-1β group at 24 h(<0.05). EphB4 showed a time-dependent decline after a short period of high expression.Conclusions Both TNF-α and IL-1β can cause changes in the expressions of Eph receptors and ephrin ligands in hPDLFs. The changes induced by both are consistent,although the effect of TNF-α is more pronounced.

Establishment of a mouse model of pneumonia with an isolated epidemic ST23 Klebsiella pneumonia strain / 中华微生物学和免疫学杂志

Objective To establish a mouse model of pneumonia with C57BL/6 and MyD88KO mice after infection with an isolated ST23 Klebsiella pneumonia (KP) strain, which was an epidemic strain and identified by multilocus sequence typing (MLST). Methods Fifty C57BL/6 mice were randomly di-vided into three groups:KP infection,control and immunosuppressive groups. Thirty MyD88KO mice were divided into KP infection and control groups. All mice in the KP infection groups were infected with 50 μl of ST23 KP strain through nasal dripping. Equal volume of PBS was used to set up the control groups. Mice in the immunosuppressive group were first injected with cyclophosphamide for three days and then infected with equal volume of ST23 KP strains through nasal dripping. Clinical signs and survival curves during KP infec-tion were monitored. Moreover,pulmonary bacterial loads and histopathological changes in the KP-infected mice were detected at different time points. Results ST23 KP-infected C57BL/6 mice showed inflammatory cell infiltration in lung tissues on the 10th day and remained alive on the 21st day. All ST23 KP-infected MyD88KO mice died on the 5th day with severe histopathological damage in lung tissues. C57BL/6 mice that pretreated with cyclophosphamide had similar symptoms with MyD88KO mice after infection and died on the 5th day. Some critical inflammatory mediators such as TNF-a,nitric oxide synthase 1 (NOS1) and NF-κBp65 were up-regulated in lung tissues of mice after KP infection. No inflammatory syndromes were found in the mice of PBS control groups. Conclusion This study suggests that the mouse model of pneumonia is successfully established with KP strain. It will help researchers to study the characteristics and pathogenesis of ST23 KP strain-induced pneumonia and to seek safe treatments in the future.

Prophylactic octreotide in the prevention of pancreatic fistula and its related complications after pancreatic resection: a Meta-analysis / 中华肝胆外科杂志

Objective To study the clinical impact of prophylactic octreotide on patients who underwent pancreatic resection using evidence-based medicine.Methods Electronic databases which included the Cochrane library,Pubmed and Embase were searched.A Meta-analysis of all randomized controlled trials (RCTs) on the clinical impact of prophylactic octreotide on pancreatic resection was performed.The evaluation of the literature quality and the effective of the data were based on the Cochrane Handbook for systematic reviews.The Review Manager 5.3 was used for the meta-analysis.Results 13 studies which involved 2 108 patients were included into this study,with 1 057 patients in the octreotide group and 1 051 patients in the control group.Meta-analysis revealed that the rates of pancreatic fistula (PF),including Class A,B and C and the total postoperative complication rate were lower in patients treated with prophylactic octreotide than those without octreotide (14.7％ vs.21.6％,RR =0.67,95％ CI:0.56-0.81,P ＜ 0.05;25.7％ vs.35.7％,RR =0.71,95％ CI:0.58-0.87,P ＜0.05).However,octreotide did not significantly reduce the incidences of clinically relevant fistulas including Class B and C,perioperative mortality,delayed gastric enptying,bleeding,abdominal infection,postoperative pancreatitis,and re-operation (all P ＞ 0.05).Conclusion Octreotide reduced PF including Class A,B and C and decreased the total complication rate,but did not reduce the clinically relevant fistulas and perioperative mortality.

Hp infection and expression of TGF-βR II,IL-6 and TNF-α in patients with chronic atrophic gastritis / 中国免疫学杂志

Objective:To investigate the effect of Helicobacter pylori(Hp) infection in patients with chronic atrophic gastritis (CAG) and the expression of transforming growth factor-β receptorⅡ,interleukin 6 and tumor necrosis factor-α in gastric mucosa.Methods:76 cases of gastroscope biopsy specimens were collected in the CAG patients,the infection of Hp was detected by PCR fluorescence,and immunohistochemical staining was used to determine the expression of TGF-βRⅡ,IL-6 and TNF-α in gastric foveolar epithelium and stromal inflammatory cells.Results:There were significant differences in chronic inflammation between Hp-positive and Hp-negative group (P<0.05).Expression of IL-6 in stromal inflammatory cells was significantly different between Hp-positive and Hp-negative group (P<0.05).Expression of TGF-βRⅡ and TNF-α was not significantly different in two groups(P>0.05).IL-6 expressed instromal inflammatory cells were correlated with chronic inflammation (r=0.249,P=0.03).The degree of intestinal metaplasia and dysplasia were correlated with the atrophic severity respectively(r=0.697,0.366).Conclusion:IL-6 is related to the chronic inflammation in patients with CAG who has Hp infection.The chronic atroplic severity promotes the development of intestinal metaplasia and dysplasia.

The current application of stem cell based therapy in pulmonary hypertension / 药学学报

Pulmonary hypertension (PH) is a progressive cardiopulmonary disease with high mortality and increased prevalence. The target therapy of pulmonary hypertension is mainly dependent on vasodilation, but how to improve vascular remodeling with stem cell therapy has not been fully understood. Over the past ten years, the researches on endothelial progenitor cells, mesenchymal stem cells and pluripotent cells have brought the hope to patients with pulmonary hypertension. This article mainly introduces the latest progress of stem cell technology in the intervention of pulmonary hypertension, and discusses the problems in the application.

Regulatory Effects of Erythropoietin-producing Hepatocyte Kinase Receptor and Ephrin Ligand on Bone Remodeling / 中国医学科学院学报

During the process of bone remodeling,the bone homeostasis is tightly controlled by the coupling of bone resorption and bone formation,depending upon cellular communication between osteoclasts and osteoblasts. Many studies have identified that the bi-directional transduction of erythropoietin producing hepatocyte kinase receptor and ephrin ligand (Eph/ephrin) is one of signal transduction pathways in bone remodeling. This review focus on the potential role of Eph/ephrin in bone remodeling,especially in alveolar remodeling.

Expression and clinical significance of bFGF and MMP9 in nasopharyn-geal carcinoma / 中国病理生理杂志

AIM:To detect the expression of basic fibroblast growth factor (bFGF) and matrix metalloprotei-nase 9 (MMP9) in nasopharyngeal carcinoma (NPC) and its correlation with clinicopathological features and prognosis of the patients.METHODS:The expression of bFGF and MMP9 was detected by the method of SP immunohistochemical staining in biopsy tissues of NPC patients.The relationship between the expression and the clinical significance was analyzed as well.RESULTS:In 289 cases of NPC patients, the positive rates of bFGF and MMP9 were 71.3% and 61.6%, respectively.Correlation analysis demonstrated that the expression rates of bFGF and MMP9 were both positively associated with N stage and clinical stage in NPC patients.The high expression rates of both bFGF and MMP9 were associated with poor overall survival and progression-free survival of NPC patients.Furthermore, the positive rate of bFGF was positively correlated with that of MMP9, and over-expression of both bFGF and MMP9 was correlated with the poorest survival outcomes in NPC patients.CONCLUSION:bFGF and MMP9 are over-expressed in NPC tissues and significantly associated with NPC recurrence and poor outcome.The combined interpretation of bFGF and MMP9 expression levels leads to refinement of the risks for the NPC patients and could be chosen as the prognostic biomarkers.

Effects of Dexmedetomidine on Agitation of Wilson's Disease Patients with Secondary Hypersplenism after General Anesthesia of Splonectomy / 中国药房

OBJECTIVE:To observe the effects of dexmedetomidine (Dex) on postoperative agitation of Wilson's disease patients with secondary hypersplenism after genernl anesthesia of splenectomy.METHODS:A total of 60 Wilson's disease patients with secondary hypersplenism underwent general anesthesia of splenectomy duning Jan.-Dec.2016 were divided into control group and observation group according to random number table,with 30 cases in each group.Observation group was given intravenous pump of Dex 0.4 μg/kg at constant speed 15 min before anesthesia induction,and then maintained at 0.4 tg/(kg·h)till splenectomy completed.Control group was given constant volume of normal saline.Other anesthesia plans were same in 2 groups.Mean arterial pressure (MAP),heart rate (HR) and pulse oxygen saturation (SpO2) of 2 groups were observed before pumping (T0),before intubation (T1),1 min after intubation (T2),before extubation (T3),3 min after extubation (T4).Riker sedation-agitation score (SAS) were recorded in 2 groups at T3 and T4.The duration of stay in postanesthesia intensive care unit (PACU) and the occurrence of bradycardia were compared between 2 groups.RESULTS:At T0,there was no statistical significance in MAP,HR or SpO2 levels between 2 groups (P＞0.05).At T1,T2,T3 and T4,MAP and HR levels of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).SpO2 were 100％ at each time point,there was no statistical significance between 2 groups (P＞0.05).Riker SAS scores of observation group was significantly lower than that of control group,with statistical significance (P＜0.05).The incidence of bradycardia in observation group was 26.67％,which was significantly higher than 3.33％ of control group,with statistical significance (P＜0.05).But this symptom was corrected after intravenous injection of atropine.The duration of stay in PACU in observation group was significantly shorter than control group,with statistical significance (P＜0.05).CONCLUSIONS:Dex can keep postoperative hemodynamics stable in Wilson's disease patients with secondary hypersplenism,reduce agitation and shorten the time of the patients transferring from PACU.

Clinical investigation on transarterial chemoembolization with indigenous drug-eluting beads in treatment of unresectable hepatocellular carcinoma / 浙江大学学报·医学版

To evaluate the efficacy and safety of drug-eluding beads transarterial chemoembolization (DEB-TACE) in treatment of unrecectable hepatocellular carcinoma (HCC).The clinical data of 42 consecutive HCC patients undergoing TACE were retrospectively analyzed, including 20 cases received conventional TACE (cTACE group) and 22 cases received TACE with epirubicine-loaded microspheres (CalliSpheres) (DEB-TACE group). MRI scans were performed 1 week before and 1, 3 and 6 months after initial therapy. The response to treatment, disease recurrence, complications and adverse effects were documented and compared between two groups.There were no significant differences in 1-month, 3-month and 6-month objective response rate (CR+PR) and disease control rate (CR+PR+SD), disease recurrence, complications and adverse effects of interventional therapy between cTACE group and DEB-TACE group. Additionally, there were no significant differences about locoregional biliary injuries, intrahepatic biloma, and newly detected intra- or extrahepatic HCC on MRI between cTACE group and DEB-TACE group.There were no statistically significant differences between cTACE group and DEB-TACE group with regard to the short-term response, disease recurrence, complications and side effects. Hepatic-locoregional complications may be more frequent in DEB-TACE group than those in cTACE group.

Effects of Periodontal Ligament Cells on Alveolar Bone Metabolism under the Action of Force and Inflammatory Factors and Its Molecular Mechanisms / 中国医学科学院学报

Periodontal ligament may have independent response to orthodontic stimulation and thus initiate alveolar bone osteogenesis and osteoclasts. Orthodontic-induced alveolar bone remodeling has no bone loss,while inflammation can lead to alveolar bone loss,suggesting that force signal and inflammatory factors may induce the differentiation of undifferentiated cells in the periodontal ligament via different pathways. The strength of the force and the nature of the force (basal tension and fluid shear force) may affect the differentiation of periodontal ligament cells,and may produce antagonistic or synergistic effect with the inflammatory factors through complex autocrine and paracrine regulation,resulting in local bone reconstruction,which is manifested as bone deposition and bone absorption. Studies have shown that Wnt signaling is an important regulatory pathway for osteoblast differentiation. Inflammatory factors can block the differentiation of stem cells into osteoblasts. The Wnt pathway is closely related to the effects of force and inflammatory factors on the differentiation of periodontal ligament cells.

Effects of Force and Inflammatory Factors on the Expressions of Osteogenesis Regulators in Human Periodontal Ligament Cells / 中国医学科学院学报

Objective To observe the effects of force signals and inflammatory cytokines on the expressions of functional proteins during the differentiation of periodontal ligament cells(PDLCs) into osteoclasts. Methods The caries-free premolars that needed to be removed for orthodontic treatment were collected,human periodontal ligament cells were cultured in vitro.Human PDLCs were exposed to inflammatory cytokines including interleukin(IL)-1β,-6,-23,and tumor necrosis factor alpha(TNF-α). Cyclicmechanical tension with a maximum 5% elongation for different durations(0,2,4,8,12,and 24 hours) were applied. Then the expressions of signaling molecules related to osteoclastogenesis(OPG) and receptor activated nuclear factor κB ligand(RANKL) were determined at protein levels by Western blotting. Results Inflammatory cytokines improved the expressions of osteoclastgenesis regulators in hPDLCs,while cyclic-tension force reduced their expressions. However,the combined effect of inflammatory cytokines and cyclic-tension force resulted in high expressions of osteoclastgenesis regulators. Conclusion Inflammatory cytokines can promote the expressions of the osteoclastgenic factors,which can not be offset by cyclic-tension force.

Endoscopic decompression of the optic canal for traumatic optic neuropathy / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Traumatic optic neuropathy (TON) is a serious complication of head trauma with the incidence rate of 0.5%-5%. The aim of this study was to investigate the therapeutic efficacy of endoscopic decompression of the optic canal for optic nerve injuries.</p><p><b>METHODS</b>In this study, 11 patients treated in our hospital from January 2009 to January 2015 with the visual loss resulting from TON were retrospectively reviewed for preoperative vision, visual evoked potential (VEP) scan, surgical approach, postoperative visual acuity, complications, and follow-up results.</p><p><b>RESULTS</b>All these patients received endoscopic decompression of the optic canal. At the 3-month follow- up, the visual acuity improvement rate of the 11 patients was 45.5%. The vision acuity of 2 cases improved from hand movement to 0.08 and 0.3 after operation. Another patient's vision acuity returned to 0.05 compared to light sensation preoperatively. Two cases had finger counting before surgery but they had a vision acuity of 0.4 and light sensation respectively after surgery. However, the other 6 cases' vision did not improve after surgery.</p><p><b>CONCLUSION</b>Endoscopic decompression of the optic canal is an effective way to cure TON. VEP could be used as an important reference for preoperative and prognosis evaluation. Operative time after trauma is only a relative condition that may affect the therapeutic effect of optic canal decompression. Poor results of this procedure may be related to the severity of the optic nerve injury.</p>