Recent advances of MDM2-p53 inhibitors / 药学学报

Protein-protein interactions (PPI) are involved in a variety of biological processes, including cell-to-cell interactions, metabolism and development control. The misregulation, post-translational modification and interference of PPI are related to a variety of human diseases, making the regulation of these interactions a very attractive field of drug discovery. In recent years, the interaction between MDM2 and p53 has become a research hotspot, which plays an important role in the treatment of tumors. But unfortunately there are no such inhibitors approved all over the world. In this view, recent advances of MDM2-p53 inhibitors were briefly described and its inhibitors with potential therapeutic activities in clinical studies were introduced.

Responses of Primary Afferent Fibers to Acupuncture-Like Peripheral Stimulation at Different Frequencies: Characterization by Single-Unit Recording in Rats / 神经科学通报·英文版

The pain-relieving effect of acupuncture is known to involve primary afferent nerves (PANs) via their roles in signal transmission to the CNS. Using single-unit recording in rats, we characterized the generation and transmission of electrical signals in Aβ and Aδ fibers induced by acupuncture-like stimuli. Acupuncture-like signals were elicited in PANs using three techniques: manual acupuncture (MAc), emulated acupuncture (EAc), and electro-acupuncture (EA)-like peripheral electrical stimulation (PES). The discharges evoked by MAc and EAc were mostly in a burst pattern with average intra-burst and inter-burst firing rates of 90 Hz and 2 Hz, respectively. The frequency of discharges in PANs was correlated with the frequency of PES. The highest discharge frequency was 246 Hz in Aβ fibers and 180 Hz in Aδ fibers. Therefore, EA in a dense-disperse mode (at alternating frequency between 2 Hz and 15 Hz or between 2 Hz and 100 Hz) best mimics MAc. Frequencies of EA output >250 Hz appear to be obsolete for pain relief.

Evaluation value of echocardiographic index and serum myocardial enzyme level changes for gestational hypertension／ / 心血管康复医学杂志

To explore relationship among disease severity , serum myocardial enzyme levels and echocar‐diographic indexes in patients with gestational hypertension (GH).Methods : A total of 101 GH inpatients treated in our department of gynecology from 2015 to 2018 were divided into severe group (severe preeclampsia and eclampsia patients , n＝46 ) and mild group (mild preeclampsia patients , n＝ 55 ) , and another 60 normal pregnant women were simultaneously selected as normal control group .Heart indexes , serum levels of creatine kinase isoenzyme MB (CK‐MB) and creatine kinase (CK ) were measured and compared among three groups .Results : Compared with normal control group , there were significant rise in LVESd , LVEDd , right ventricular diameter (RVD) , end‐di‐astolic interventricular septal thickness (IVSTd ) and left ventricular posterior wall thickness (LVPWT ) in mild group and severe group , and above indexes of severe group were significantly higher than those of mild group , P＜0.01 all.Compared with normal control group , there was significant rise in transmitral late diastolic peak flow ve‐locity (A) , and significant reductions in LVEF , cardiac output (CO) , cardiac index (CI) , transmitral early dias‐tolic peak flow velocity (E) and E／A in mild group and severe group ;compared with mild group , there was signifi‐cant rise in A , and significant reductions in LVEF , CO , CI , E and E／A in severe group , P＜0. 01 all .Compared with normal control group , there were significant rise in serum levels of CK‐MB [ (6.2 ± 2.5) IU／L vs.(9.4 ± 3.2) IU／L vs.(15. 3 ± 5. 7) IU／L] and CK [(41.8 ± 7.9) IU／L vs.(61.7 ± 12. 5) IU／L vs.(88. 7 ± 20. 4) IU／L] in mild group and severe group , and those of severe group were significantly higher than those of mild group , P＝0.001 all.Conclusion : Echocardiography and myocardial enzyme examination in GH patients help to understand functional state and structure of heart , which possess important significance for early identification and treatment .

Preliminary analysis of the effect of different administration routes of tranexamic acid on blood loss after total hip arthroplasty for female femur neck fractures / 中国骨伤

OBJECTIVE@#To study curative effect of different administration routes of tranexamic acid (TXA) on blood loss of elderly female patients with femoral neck fracture in total hip arthroplasty.@*METHODS@#From December 2015 to January 2018, 77 elderly women with femoral neck fractures undergoing total hip replacement were divided into four groups: group A, group B, group C, and group D. The group A (intravenous medication group) included 21 patients with an average age of (77.10±7.02) years old. The patients in group A received 15 mg/kg TXA intravenously 5 minutes before skin incision and intraoperative infusion of saline into the joint cavity. The group B(local medication group) included 18 cases, with an average age of (73.83±6.56) years old. The patients in group B received saline intravenously 5 minutes before skin incision and intraoperative infusion of 3 g TXA into the joint cavity. The group C (combined medication group) included 19 cases, with an average age of (74.26±6.04) year old. The patients in group C received 15 mg/kg TXA intravenously before operation and intraoperative infusion of 1.5 g TXA into the joint cavity. The group D (control group) included 19 cases, with an average age of (76.69±9.27) years old. The patients in group D received saline intravenously 5 minutes before skin incision and intraoperative infusion of saline into the joint cavity. The postoperative wound drainage volume, hemoglobin value, and the total blood loss calculated according to the height and weight and the hematocrit (HCT) before and after operation were observed and compared.@*RESULTS@#In group A, the postoperative drainage was(111.91±35.02)ml; the change of hemoglobin was(26.86±12.99) g/L; and total blood loss was(628.60±306.78) ml. In group B, postoperative drainage was(108.89±36.61) ml; change of hemoglobin was(26.28±8.59) g/L; and the total blood loss was (584.41±250.86) ml. In group C, postoperative drainage was(102.63±47.36) ml; change of hemoglobin was (26.89±12.47) g/L; and total blood loss was(634.78±384.89) ml. In group D, postoperative drainage was(107.37±40.53) ml; change of hemoglobin was(40.95±12.48) g/L; and total blood loss was(1 005.24±483.37) ml. There were no significant differences among 4 groups in postoperative drainage volume (>0.05). The hemoglobin and total blood loss in group A, B, and C were less than those in the group D(0.05).@*CONCLUSIONS@#Application of TXA can effectively reduce blood loss during perioperative period of total hip arthroplasty for elderly women with femoral neck fracture. The best administration route and dosage should be further studied.

Carotid Plaque Stiffness Measured with Supersonic Shear Imaging and Its Correlation with Serum Homocysteine Level in Ischemic Stroke Patients

OBJECTIVE: To ascertain the feasibility of using shear wave velocity (SWV) in assessing the stiffness of carotid plaque by supersonic shear imaging (SSI) and explore preliminary clinical value for such evaluation. MATERIALS AND METHODS: Supersonic shear imaging was performed in 142 patients with ischemic stroke, including 76 males and 66 females with mean age of 66 years (range, 45–80 years). The maximum, minimum, and mean values of SWV were measured for 129 carotid plaques. SWVs were compared between echolucent and echogenic plaques. Correlations between SWVs and serum homocysteine levels were investigated. Based on neurological symptom, the surrogate marker of vulnerable plaque (VP), binary logistic regression was performed and area under curve (AUC) of homocysteine only and homocysteine combing SWVmean was calculated respectively. RESULTS: Echogenic plaques (n = 51) had higher SWVs than echolucent ones (n = 78) (SWVmin 3.91 [3.24–4.17] m/s vs. 1.51 [1.04–1.94] m/s; SWVmean, 4.29 [3.98–4.57] m/s vs. 2.09 [1.69–2.41] m/s; SWVmax, 4.67 [4.33–4.86] m/s vs. 2.62 [2.32–3.31] m/s all p values < 0.01). Pearson correlation analysis showed that stiffness of plaques was negatively correlated with homocysteine level. R values for SWVmin, SWVmean, and SWVmax were −0.205, −0.213, and −0.199, respectively. Binary logistic regression analysis showed that sex (p = 0.008), low-density lipoprotein (p = 0.015), triglycerides (p = 0.011), SWVmean (p = 0.004), and hyper-homocysteinemia (p = 0.010) were significantly associated with symptomatic ischemic stroke. Receiver operating characteristic curves revealed that SWVmean combing serum homocysteine level (AUC = 0.67) presented better diagnostic value than serum homocysteine only (AUC = 0.60) for symptomatic ischemic stroke. CONCLUSION: Supersonic shear imaging could be used to quantitatively evaluate stiffness of both echolucent and echogenic carotid plaques. More importantly, SWVs of plaques were not only correlated to serum homocysteine level, but also associated with symptomatic ischemic stroke, suggesting that SSI might be useful for understanding more about VP.

A comparative study of patent foramen ovale and white matter lesions in migraine without aura / 西安交通大学学报(医学版)

Objective To explore the effect of patent foramen ovale(PFO)on white matter lesions(WMLs) in migraine without aura(MwoA).Methods Thirty-five patients with MwoA were examined by contrast transcranial Doppler(cTCD)and magnetic resonance imaging(MRI).According to the results of PFO and MRI Flair data,the patients' age,sex and headache characteristics were matched,and the WMLs were compared between the PFO positive group and negative group.Results Seven cases of WMLs were recruited in PFO positive group(19 cases)and the WMLs were distributed in the frontal lobe and/or the parietal lobe.The score ranged from 1 to 7 points.Five cases of WMLs were enrolled in PFO negative group(16 cases)and the WMLs also were distributed in the frontal lobe and/or the parietal lobe.The score ranged from 1 to 3 points.There was no significant difference in WMLs between the groups(P＞ 0.05).Conclusion White matter lesions in migraine without aura are distributed in the frontal lobe and the parietal lobe,and these findings do not support a relationship between PFO and WMLs.

Transcutaneous electrical acupoint stimulation for asthenozoospermia / 中华男科学杂志

Objective@#To study the effect of transcutaneous electrical acupoint stimulation (TEAS) in the treatment of asthenozoospermia.@*METHODS@#We randomly divided 72 asthenozoospermia patients into a 2 Hz TEAS (n = 29), a 100 Hz TEAS (n = 20), and a blank control group (n = 23), those in the former two groups treated by 30 minutes of TEAS at 2 Hz and 100 Hz respectively, applied to the acupoints of bilateral Shenshu, left Zusanli, and Guanyuan, once a day for 60 days, while those in the blank control group left untreated. Using computer-assisted sperm analysis (CASA), we examined sperm concentration and motility as well as the percentages of grade a and grade a+b sperm in different groups of the patients.@*RESULTS@#Compared with the baseline, 2 Hz TEAS significantly increased sperm motility (［12.76 ± 1.39］ vs ［18.89 ± 2.46］%, P<0.05) and the percentage of grade a+b sperm ( ［10.68 ± 1.22］ vs ［16.32 ± 2.10］%, P<0.05) in the asthenozoospermic patients, while 100 Hz TEAS improved not only sperm motility (［12.32 ± 2.21］ vs ［23.81 ± 3.42］%, P<0.01) and the percentage of grade a+b sperm (［10.45 ± 1.98］ vs ［20.25 ± 2.82 ］%, P<0.01), but also the percentage of grade a sperm (［6.44 ± 1.16］ vs ［13.31 ± 2.30］%, P<0.05). Moreover, in comparison with the blank control group, 2 Hz TEAS also remarkably increased sperm motility (［9.57 ± 1.60］ vs ［18.89 ± 2.46］%, P<0.05) and the percentage of grade a+b sperm (［7.81 ± 1.31］ vs ［16.32 ± 2.10］%, P<0.05) in the asthenozoosperma patients, while 100 Hz TEAS improved not only sperm motility (［9.57 ± 1.60］ vs ［23.81 ± 3.42］%, P<0.01) and the percentage of grade a+b sperm (［7.81 ± 1.31］ vs ［20.25 ± 2.82］%, P<0.01) but also the percentage of grade a sperm (［4.87 ± 1.01］ vs ［13.31 ± 2.30］%, P<0.01). Meanwhile, the rate of clinical effectiveness was significantly higher in the 100 Hz TEASthan in the blank control group either in intention-to-treat (ITT) analysis (100% vs 18.18%) orper-protocol (PP) analysis (90% vs 0%), and so was it than in the 2 Hz TEAS group based on the data of ITT (100% vs 33.33%).@*CONCLUSIONS@#Both 2 Hz and 100 Hz TEAS are effective for the treatment of asthenozoospermia by improving sperm motility and vitality.

The secondary metabolites from a mutant 3d10-01 derived from Penicilliumchrysogenum S-3-25 by diethyl sulfate mutagenesis / 国际药学研究杂志

Objective To investigate the secondary metabolites from diethyl sulfate(DES)mutant 3d10-01 derived from Peni-cillium chrysogenum S-3-25. Methods The secondary metabolites were isolated by multiple separation techniques,such as silica gel,Sephadex LH-20 column chromatography and HPLC. The structures of the compounds were determined by ESI-MS and NMR spectroscopic data. The antitumor activity was assayed by the MTT method. HPLC-UV analysis was used to determine if compounds 1-7 were newly produced by the mutant. Results Seven secondary metabolites,including methyl 2,4-dihydroxy-3,5,6-trimethylbenzo-ate(1),6-hydroxymethyl-2,2-dimethylchromanone(2),regiolone(3),(3S,4S)-3,4-dihydro-3,4,8-trihydroxy(2H)naphthalenone (4),cerebroside C(5),cerebroside D(6)and dankasterone A(7),were isolated from the fermentation products of the mutant 3d10-01. Compounds 1,4 and 7 showed strong inhibitory effects on the five tested cell lines,but 2,3 and 6 only exhibited the proliferation of HL-60 cells to some extent. Compounds 1-4 and 7 were newly produced by the mutant 3d10-01. Conclusion Compounds 1-7 are firstly isolated from P. chrysogenum. The inhibitory effects on certain tested antitumor cell lines of compounds 1-4,6 and 7 are report-ed for the first time.

Pedicle screw fixation with kyphoplasty decreases the fracture risk of the treated and adjacent non-treated vertebral bodies: a finite element analysis / 华中科技大学学报（医学）（英德文版）

Adjacent vertebral fractures are common in patients with osteoporotic vertebral compression fractures (OVCFs) after kyphoplasty. This finite element study was to examine whether short segment pedicle screw fixation (PSF) with kyphoplasty may decrease the fracture risk of the treated and adjacent non-treated vertebrae after kyphoplasty for OVCFs. By simulating cement augmentation with or without short segment pedicle screw fixation (PSF), two tridimensional, anatomically detailed finite element models of the T10-L2 functional spinal junction were developed. The insertion of pedicle screws into the intact vertebra apparently decreased the stress distribution of the treated vertebra in vertical compression and other load situations. The stress distribution in the bone structures of the intact vertebra adjacent to the intact-screwed vertebra was much less than that in the one adjacent to the treated vertebra. The insertion of pedicle screws into the intact vertebra greatly decreased the maximum displacement of the cortical bones and cancellous bones of the vertebrae. Our results indicated that short segment PSF with kyphoplasty may decrease the fracture risk of the treated and adjacent non-treated vertebrae in the management of OVCFs.

Case-control study on effects of vacuum drainage on perioperative blood loss after total hip arthroplasty for the treatment of femoral neck fractures / 中国骨伤

<p><b>OBJECTIVE</b>To compare postoperative blood loss under different negative pressures of drainage after total hip arthroplasty for the treatment of femoral neck fractures.</p><p><b>METHODS</b>From January 1st to December 30th 2013, 74 patients with femoral neck fractures treated with total hip arthroplasty were randomly divided into two groups: high negative pressure drainage group and low negative pressure drainage group. In high negative pressure drainage group, there were 34 cases including 10 males and 24 females, with a mean age of (75.94 ± 9.02) years old, and the patients were treated with 60 kPa negative pressure of drainage. In the low negative pressure drainage group, there were 40 cases including 13 males and 27 females, with an average age of (74.93 ± 8.90) years old, and the patients were treated with 30 kPa negative pressure of drainage. The amount of total drainage, total blood loss, and hemoglobin change were compared between these two groups.</p><p><b>RESULTS</b>All the patients got primary healing without infections. In high negative pressure drainage group,the change of hemoglobin was (41.74 ± 15.69) g/L, total blood loss was (1,217.73 ± 459.50) ml and the drainage volume was (312.94 ± 103.44) ml; while in low negative pressure drainage group,the results were (34.90 ± 12.90) g/L, (904.01 ± 381.58) ml and (129.25 ± 44.25) ml separately. All the results in high negative pressure drainage group were higher than those in the other group. Three days after operation, the change of hemoglobin was (46.00 ± 13.29) g/L and total blood loss was (1,304.72 ± 421.75) ml; while in low negative pressure drainage group, the changes of hemoglobin was (43.87 ± 11.39) g/L and total blood loss was (1,196.78 ± 344.20) ml; there were no statistically significant differences between two groups.</p><p><b>CONCLUSION</b>When placing drainage devices after total hip arthroplasty for the treatment of femoral neck fractures, the level of negative pressure should be chosen according to preoperative level of hemoglobin and HCT in patients. For old patients with femoral neck fracture, low negative pressure is more suitable.</p>

Association of the Single-Nucleotide Polymorphism and Haplotype of the Complement Receptor 1 Gene with Malaria

PURPOSE: Although the polymorphisms of erythrocyte complement receptor type 1 (CR1) in patients with malaria have been extensively studied, a question of whether the polymorphisms of CR1 are associated with severe malaria remains controversial. Furthermore, no study has examined the association of CR1 polymorphisms with malaria in Chinese population. Therefore, we investigated the relationship of CR1 gene polymorphism and malaria in Chinese population. MATERIALS AND METHODS: We analyzed polymorphisms of CR1 gene rs2274567 G/A, rs4844600 G/A, and rs2296160 C/T in 509 patients with malaria and 503 controls, using the Taqman genotyping assay and PCR-direct sequencing. RESULTS: There were no significant differences in the genotype, allele and haplotype frequencies of CR1 gene rs2274567 G/A, rs4844600 G/A, and rs2296160 C/T polymorphisms between patients with malaria and controls. Furthermore, there was no association of polymorphisms in the CR1 gene with the severity of malaria in Chinese population. CONCLUSION: These findings suggest that CR1 gene rs2274567 G/A, rs4844600 G/A, and rs2296160 C/T polymorphisms may not be involved in susceptibility to malaria in Chinese population.

Effect of ulinastatin combined rivaroxaban on deep vein thrombosis in major orthopedic surgery

OBJECTIVE@#To explore the effect of ulinastatin (UTI) continuous infusion combined Rivaroxaban on the deep vein thrombosis in patients undergoing major orthopedic surgery.@*METHODS@#Forty-five patients undergoing major orthopedic surgery were randomly divided into three groups:ulinastatin continuous infusion (Uc) group, ulinastatin single injection (Us) group and control (C) group. All patients received patient-controlled intravenous analgesia (PCIA) after operation, and took Rivaroxaban 10 mg orally 12 hours after operation. Ulinastatin (5 000 U/kg) was given intravenously to both Uc and Us groups preoperatively. Group C was given isometric normal saline, group Uc was pumped UTI continuous intravenously at the end of surgery (10 000 U/kg) to 48 hours through PCIA pump. The values of hematocrit (HCT), thrombomodulin (TM), Interleukin (IL-6), thrombin-antithrombin complex (TAT), D-Dimer (D-D) were normally tested before surgery (T1), at the end of the surgery (T2), 12 hours (T3), 24 hours (T4) and 48 hours (T5) after surgery.@*RESULTS@#Compared with T1, there was an upward tendency in TM, IL-6, TAT, and D-D after operation in group C group (P0.05).@*CONCLUSIONS@#During the perioperative period, ulinastatin continuous infusion combined Rivaroxaban can correct blood hypercoagulability through different approaches in patients undergoing major orthopedic surgery.

Detection rate of Helicobacter pylori and its clinical significance in children with Meckel's diverticulum / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To determine the detection rate of Helicobacter pylori (Hp) in children with Meckel's diverticulum (MD) and its clinical significance among children with MD.</p><p><b>METHODS</b>Eighty-one children with MD were divided into two groups according to the presence (n=45) or absence (n=36) of digestive hemorrhage. The detection rates of Hp in MD tissues and stomach tissues were determined by immunohistochemistry. The detection rates of Hp were compared between the two groups and between the MD tissues with different clinical features in the hemorrhage group.</p><p><b>RESULTS</b>The detection rate of Hp in MD tissues for the hemorrhage group was 76% (34/45), which was significantly higher than that for the non-hemorrhage group (47%, 17/36) (P<0.05). The detection rate of Hp in stomach tissues for the hemorrhage group (87%, 39/45) was insignificantly higher than that for the non-hemorrhage group (67%, 24/36) (P>0.05). Among patients in the bleeding group, the detection rate of Hp in MD tissues showed no relationship with age, sex, preoperative hemorrhage frequency, amount of hemorrhage, length of MD, basal diameter of MD, and pathological type (P>0.05), but was related to location of MD, presence or absence of ulcer, and depth of ulcer (P<0.05). For the hemorrhage group, a significant positive correlation was found between the detection rates of Hp in MD tissues and stomach tissues (P<0.05), as shown by the Spearman correlation analysis.</p><p><b>CONCLUSIONS</b>The detection rate of Hp in MD tissues is increased in children with MD complicated by digestive hemorrhage. Hp infection may play some role in the hemorrhage process among children with MD.</p>

Determination of enantiomeric impurity of timolol maleate in bulk substances and eye drops / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To determine the enantiomeric impurity contents of domestic timolol maleate in bulk drugs and eye drops.</p><p><b>METHODS</b>Enantiomer impurity of timolol was assayed by chiral high performance liquid chromatography. The chromatographic conditions were as follows:chiralcel OD chiral column (4.6 mm ×150 mm, 5μm), detection wavelength:297 nm, mobile phase:hexane-isopropanol-diethylamine (480:20:1), column temperature:25 ℃, flow rate:1.0 ml/min, sample injection volume:5 μl.</p><p><b>RESULTS</b>The resolution between R- and S-timolol was more than 4. The enantiomeric impurity contents were less than 0.67% on average in two batches of timolol maleate bulk drugs, and 0.31% on average in three batches of timolol maleate eye drops.</p><p><b>CONCLUSION</b>Enantiomeric impurity contents in each batch of products all meet European Pharmacopoeia criteria, which can be used as references in Chinese Pharmacopoeia criteria.</p>

Enantiomeric separation and impurity determination of valaciclovir hydrochloride / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To determine the contents of L-enantiomer impurity in valaciclovir hydrochloride.</p><p><b>METHODS</b>Valaciclovir enantiomers were separated and determined by using chiral high performance liquid chromatography. Chromatographic conditions were as follows:CROWNPAK(®) CR(+) chiral column (4 mm×150 mm, 5 μm), detection wavelength:254 nm, mobile phase:water-methanol-perchloric acid (19:1:0.1), flow rate:0.75 ml/min, sample injection volume:10 μl.</p><p><b>RESULTS</b>D-valaciclovir was completely separated from L-enantiomer impurity. The contents of L-enantiomer impurity were 0.65%-2.62% on average in 8 batches of valaciclovir hydrochloride.</p><p><b>CONCLUSION</b>Enantiomeric impurity contents in each batch of products were all meet criteria of United States Pharmacopeia, which can be used in criteria of Chinese Pharmacopeia as references.</p>

Effect of ulinastatin combined rivaroxaban on deep vein thrombosis in major orthopedic surgery

Objective: To explore the effect of ulinastatin (UTI) continuous infusion combined Rivaroxaban on the deep vein thrombosis in patients undergoing major orthopedic surgery. Methods: Forty-five patients undergoing major orthopedic surgery were randomly divided into three groups:ulinastatin continuous infusion (Uc) group, ulinastatin single injection (Us) group and control (C) group. All patients received patient-controlled intravenous analgesia (PCIA) after operation, and took Rivaroxaban 10 mg orally 12 hours after operation. Ulinastatin (5 000 U/kg) was given intravenously to both Uc and Us groups preoperatively. Group C was given isometric normal saline, group Uc was pumped UTI continuous intravenously at the end of surgery (10 000 U/kg) to 48 hours through PCIA pump. The values of hematocrit (HCT), thrombomodulin (TM), Interleukin (IL-6), thrombin-antithrombin complex (TAT), D-Dimer (D-D) were normally tested before surgery (T1), at the end of the surgery (T2), 12 hours (T3), 24 hours (T4) and 48 hours (T5) after surgery. Results: Compared with T1, there was an upward tendency in TM, IL-6, TAT, and D-D after operation in group C group (. P0.05). Conclusions: During the perioperative period, ulinastatin continuous infusion combined Rivaroxaban can correct blood hypercoagulability through different approaches in patients undergoing major orthopedic surgery.

Logistic regression analysis of high-risk factors for neonatal incarcerated hernia with intestinal necrosis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the high-risk factors for neonatal incarcerated hernia with intestinal necrosis by logistic regression analysis.</p><p><b>METHODS</b>Retrospective analysis was performed on the clinical data of 131 neonates with incarcerated oblique inguinal hernia containing the intestine. Of the 131 cases, 14 suffered from intestinal necrosis. The high risk factors for neonatal incarcerated hernia with intestinal necrosis were determined by logistic regression analysis.</p><p><b>RESULTS</b>Manual reduction after incarceration (>2 times) (χ2 = 69.289, P<0.01), incarceration history (>2 times) (χ2 = 84.731, P<0.01), and mesentery incarceration (χ2 = 80.233, P<0.01) were the high-risk factors for neonatal incarcerated hernia with intestinal necrosis.</p><p><b>CONCLUSIONS</b>Intestinal necrosis tends to occur in neonates with incarcerated hernia who have incarceration or received manual reduction more than twice and suffer from mesentery incarceration. Manual reduction is prohibited for these cases, which should be surgically treated immediately.</p>

Survival analysis of patients with spontaneous rupture of hepatocellular carcinoma / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the prognostic factors influencing overall survival (OS) in patients with spontaneous rupture of hepatocellular carcinoma (HCC-SR).</p><p><b>METHODS</b>The medical records of 44 patients with HCC-SR treated in our department from January 1, 2005 to April 1 2011 were retrospectively reviewed. The clinical and prognostic data of 19 HCC-SR patients who received curative hepatectomy were compared with data of 137 HCC patients with no SR who were managed by curative hepatectomy during the same period. Type of HCC-SR was defined according to previously established criteria. The clinicopathological data were evaluated for possible associations with OS of HCC-SR by univariate analysis with the Kaplan-Meier method followed by multivariate analysis with the Cox proportional hazard model.</p><p><b>RESULTS</b>While some clinical features differed between the HCC-SR patients and non-HCC-SR patients, the postoperative prognosis was comparable between the two groups: (1) The 1-, 2-, 3- and 5-year postoperative cumulative recurrence rates were 78.9% (15/19), 89.5% (17/19), 94.7% (18/19) and 94.7% (18/19) in the HCC-SR group but 43.1% (59/137), 54.0% (74/137), 59.1% (81/137) and 66.4% (91/137) in the non-HCC-SR group respectively, and the differences reached statistical significance (P = 0.006, 0.003, 0.002, and 0.014); (2) The 1-, 2-, 3- and 5-year postoperative disease-free survival rates were 10.5% (2/19), 5.3% (1/19), 5.3% (1/19) and 5.3% (1/19) in the HCC-SR group but 40.1% (55/137), 21.2% (29/137), 12.4% (17/137) and 4.4% (6/137) in the non-HCC-SR group respectively, and only the 1-year disease-free survival rate was significantly different (P = 0.032); (3) The 1-, 2-, 3- and 5-year postoperative OS rates were 42.1% (8/19), 10.5% (2/19), 5.3% (1/19) and 5.3% (1/19) in the HCC-SR group but 59.1% (81/137), 32.8% (45/137), 19.0% (26/137) and 6.6% (9/137) in the non-HCC-SR group, and none of the differences reached statistical significance (P = 1.972, 0.061, 0.200, 1.000). Multivariate analysis identified that severity of concomitant liver cirrhosis, levels of alpha fetoprotein (AFP), choice of treatment modality, and type of HCC-SR acted as factors influencing OS.</p><p><b>CONCLUSIONS</b>Patients with HCC-SR receiving curative hepatectomy have higher postoperative recurrence rates than their non-HCC-SR counterparts, but the two groups have similar postoperative OS rates. OS is influenced by severity of concomitant liver cirrhosis, level of AFP, choice of treatment modality, and type of HCC-SR.</p>

The pharmacological mechanism of gastrodin on calcitonin gene-related peptide of cultured rat trigeminal ganglion / 药学学报

The Chinese herbal medicine Tianma (Gastrodia elata) has been used for treating and preventing primary headache over thousands of years, but the exact pharmacological mechanism of the main bioactive ingredient gastrodin remains unclear. In present study, the effects of gastrodin on calcitonin gene-related peptide (CGRP) and phosphorylated extracellular signal-regulated kinase1/2 (pERK1/2) expression were observed in rat trigeminal ganglion (TG) after in vitro organ culture to explore the underlying intracellular mechanism of gastrodin on primary vascular-associated headache. CGRP-immunoreactivity (CGRP-ir) positive neurons count, positive area, mean optical density and integrated optical density by means of immunohistochemistry stain were compared at different concentrations of gastrodin, which was separately co-incubated with DMEM in SD rat TG for 24 hours. Only at 5 or 10 mmol L(-1) concentration, gastrodin demonstrated significantly concentration-dependent reduction of CGRP-ir (+) expression and its action closed to 1.2 mmol L(-1) sumatriptan succinate. While at 2.5, 20, and 40 mmol L(-1) concentration, gastrodin did not show remarkable effects on CGRP-ir (+) expression. The optimal concentration of gastrodin (5 and 10 mmol L(-1)) similarly inhibited CGRP-mRNA expression level separately compared with 1.2 mmol L(-1) sumatriptan succinate and 10 micromol L(-1) flunarizine hydrochloride, which was quantitatively analyzed by real-time PCR (RT-PCR). pERK1/2 level was examined by Western blotting after co-cultured with optimal concentration of gastrodin and effective specific ERK1/2 pathway inhibitors PD98059, U0126. The result indicated that gastrodin significantly reduced pERK1/2 protein actions similarly to ERK1/2 pathway specific blockade. It suggests ERK1/2 signaling transduction pathway may be involved in gastrodin intracellular mechanism. This study indicates gastrodin (5 and 10 mmol L(-1)) can remarkably reduce CGRP-ir (+) neuron, CGRP-mRNA and pERK1/2 expression level in cultured rat TG, with its actions similar to the effective concentration of sumatriptan succinate, flunarizine hydrochloride and specific ERK1/2 pathway blocker. The intracellular signaling transduction ERK1/2 pathway may be involved in the gastrodin reducing CGRP up-regulation in rat TG after organ culture.

Retroperitoneal Laparoscopic Live Donor Nephrectomy: Report of 105 Cases / 华中科技大学学报（医学）（英德文版）

Retroperitoneal laparoscopic live donor nephrectomy offers an intrinsic advantage over conventional transperitoneal laparoscopic nephrectomy because of the potentially lower risk for early and late donor intraperitoneal complications.Herein we presented our experience performing retroperitoneal laparoscopic live donor nephrectomy in 105 donors.All donor nephrectomy was successful.There were no donor deaths and no conversion to open surgery.Mean operation time was 112 min (range,70—200 min).Intraoperative blood loss was 10—150 mL with an average of 30 mL.Warm ischemia time was 1.3 to 6 min with an average of 3.1 min.Postoperative retroperitoneal hematoma occurred in only one case and there were no other surgical complications.Donors were discharged from the hospital 5 to 10 days postoperation.Average postoperative hospital stay was 6.4 days.One graft was removed due to acute rejection.Delayed graft function occurred in two recipients but renal function returned to normal within four weeks.The other recipients had normal renal function in two weeks except three recipients in four weeks.We believe that retroperitoneal laparoscopic live donor nephrectomy is safe,reliable,and less invasive.