Correlation Analysis of " Toxin Damaging Brain Collaterals" from Glymphatic System / 中国实验方剂学杂志

The collaterals are branches of the meridians and vessels system, and have the roles of connecting upper-lower and interior-exterior portions of the body, the characteristics of two-way flow in supporting the operation of Qi and blood, and the functions of material exchange and metabolism. The brain is the intersection of the Yang meridians. Crisscross brain collaterals permeate Qi and blood to enrich the brain, and spread Yang Qi, in order to warm the brain-mind, and provide material basis and source power to the " brain governing mind" . Under pathological conditions, cerebral collaterals are blocked, and toxic pathogens are endogenous, resulting in " toxin damaging brain collaterals" . This theory is not only applied to the study of stroke pathogenesis, but also extended to other encephalopathy, such as dementia, which promoted the development of the theory of pathogenesis in traditional Chinese medicine. Recently, a " glymphatic system" was discovered in the brain, which is an exchange flow system of cerebrospinal fluid-brain interstitial fluid mediated by astrocyte. The glymphatic system transports nutrients and neuroactive substances, such as glucose, lipids, electrolytes and apolipoprotein E in the cerebrospinal fluid, to brain tissue, and also removes metabolic products (such as lactic acid), soluble proteins (such as β-amyloid protein and Tau protein) from the brain and foreign bodies, which are important liquid flow systems that maintain the homeostasis of the brain. The discovery of the glymphatic system provides a new perspective for the study of pathological mechanism of neurological diseases, and may become a new target for interventions in neurological diseases, such as cerebrovascular diseases and neurodegenerative diseases. As a widely distributed cerebral metabolic waste removal way and material delivery system, the lymphatic system may be the biological foundation of " brain collateral" disease, and a cross point of understanding on " toxin impairing brain collaterals" by Western and traditional Chinese medicine. The study based on the glymphatic system will give a more rational explanation on " toxic damage to brain collaterals" .

Intrarectal local anesthesia versus periprostatic nerve block in transrectal prostate biopsy for patients with different prostate volumes: A prospective randomized controlled trial / 中华男科学杂志

<p><b>Objective</b>To evaluate the analgesic effect of intrarectal local anesthesia (IRLA) versus that of periprostatic nerve block anesthesia (PPNB) in initial transrectal ultrasound-guided prostate biopsy (TRUS-PB) for patients with different prostate volumes (PV).</p><p><b>METHODS</b>A total of 253 patients undergoing initial TRUS-PB in our hospital from January 2014 to November 2017 were divided into three PV groups (<50 ml, 50－100 ml, and >100 ml), each again randomized into three subgroups (control, IRLA, and PPNB) with the random number table method. The pain during the procedure was assessed based on the Visual Analogue Scale (VAS) scores and the blind method was used by the biopsy operator, VAS valuator and data analyst.</p><p><b>RESULTS</b>Among the patients with PV <50 ml, the VAS scores in the blank control, IRLA, and PPNB subgroups were 4.39±0.87, 3.51±0.84 and 3.43±1.07, respectively, remarkably higher in the control than in the IRLA and PPNB groups (P<0.05), but with no statistically significant differences between the latter two (P>0.05). Among those with PV of 50－100 ml, the VAS scores in the three subgroups were 4.50±1.05, 4.38±1.13 and 3.38±1.44, respectively, markedly higher in the control and IRLA than in the PPNB group (P<0.05), but with no statistically significant differences between the former two groups (P>0.05). Among those with PV >100 ml, the VAS scores in the three subgroups were 5.19±1.05, 5.00±1.25 and 4.19±0.91, respectively, remarkably higher in the former two groups than in the latter (P<0.05), but with no statistically significant differences between the former two groups (P>0.05).</p><p><b>CONCLUSIONS</b>Either IRLA or PPNB can be recommended for initial TRUS-PB in patients with PV <50 ml, PPNB for those with PV of 50－100 ml, and PPNB with other painkillers for those with PV >100 ml.</p>

Expressions of Inhibitors of DNA Binding-1 and Matrix Metalloproteinase-9 in Colorectal Adenocarcinoma Tissues and Their Correlations with Microvessel Density / 中国医学科学院学报

Objective To explore the expressions of inhibitors of DNA binding-1 (Id-1) and matrix metalloproteinase-9 (MMP-9) in colorectal carcinoma tissues and its correlation with microvessel density (MVD). Methods The expressions of Id-1 and MMP-9 as well as CD34-labelled MVD in colorectal adenocarcinoma tissues (n=50) and normal adjacent tissues (n=50) were examined by immunohistochemistry. Results The positive expressions of Id-1 and MMP-9 were seen in 72.00% (36/50) and 78.00%(39/50) of colorectal adenocarcinoma tissues,which were significantly higher than those [24.00%(12/50) and 28.00% (14/50)] in normal adjacent tissues (P=0.000). The MVD value (17.22±2.08) in colorectal adenocarcinoma tissues was significantly higher than that (5.36±2.17) in normal adjacent tissues (P=0.000). The expressions of Id-1 and MMP-9 and MVD were significantly correlated with serosa invasion,TNM stage,carcinoembryonic antigen(+),lymph node metastasis,vascular invasion,and liver metastasis (all P<0.05) but not with the patient's age,gender,tumor size,and differentiation degree (all P>0.05). The MVD value with Id-1 and MMP-9 positive expression were significantly higher than those with Id-1 and MMP-9 negative expression (all P=0.000). The expression of Id-1 in colorectal adenocarcinoma tissues showed significantly positive correlation with that of MMP-9 (r=0.429,P=0.000). Cox multivariate analysis showed that Id-1 and MMP-9 expressions were independent prognostic factors for colorectal carcinoma. Conclusions The high expressions of Id-1 and MMP-9 have high correlations with the development and progression of colorectal adenocarcinoma and have positive correlation with MVD. Both of them may be involved in the microvascular generation and the invasion and hematogenous metastasis of colorectal carcinoma.

Risk factors of gastroparesis syndrome after abdominal non-gastroduodenal operation and its prevention

OBJECTIVE@#To investigate risk factors of gastroparesis syndrome (PGS) after abdominal non-gastroduodenal operation and its prevention.@*METHODS@#Clinical data of 22 patients with PGS after abdominal non-gastroduodenal operation was analyzed retrospectively, and compared with the patients of non-PGS after abdominal non-gastroduodenal operation during the same time. The possible influencing factors of PGS were analyzed by single factor analysis and logistic regression analysis.@*RESULTS@#All 13 selected factors related with PGS, including age, disease category (benign and malignant), operation time, intraoperative blood loss, postoperative analgesic pump, postoperative enteral nutrition time, postoperative parenteral nutrition time, perioperative blood glucose level, perioperative nutrition status (anaemia or lower proteinemia), pylorus obstruction before surgery, intra-abdominal infection after surgery, and spiritual factor were related with PGS. The statistical analysis showed that the difference was statistical significant (P0.05); non-conditional multivariate analysis showed that malignant tumor, perioperative nutrition status, pylorus obstruction, operation time, blood loss, intra-abdominal infection after surgery, and mental factor were significant related with PGS as dependent variable and related risk factors in single factor analysis as independent variables (P <0.05).@*CONCLUSIONS@#PGS is a result of multiple factors, and among these factors, malignant tumor, poor nutrition status, pylorus obstruction before surgery, longer operation-time, more blood loss, intra-abdominal infection after surgery, and mental factor are major risk factors of PGS.