Pediatric Spinal Trauma at a Single Level 1Trauma Center: Review of 62 Cases

Background@#Traumatic spinal injuries in children are uncommon and result in different patterns of injuries due to the anatomical characteristics of children’s spines. However, there are only a few epidemiological studies of traumatic spinal injury in children. The purpose of this study was to investigate the characteristics of traumatic spinal injury in children. @*Methods@#We retrospectively reviewed the cases of pediatric patients (age < 18 years) with traumatic spinal injury who were treated at a level 1 trauma center between January 2017 and December 2021. We divided them into three groups according to age and analyzed demographics, injury mechanism, level of injury, and injury pattern. @*Results@#A total of 62 patients (255 fractures) were included, and the mean age was 13.8 ± 3.2 years. There were 5 patients (22 fractures) in group I (0–9 years), 24 patients (82 fractures) in group II (10–14 years), and 33 patients (151 fractures) in group III (15–17 years). Both the Injury Severity Score and the Revised Trauma Score were highest in group I, but there was no statistical difference between the age groups. Fall from height was the most common injury mechanism, of which 63% were suicide attempts. The level of spinal injury was different in each age group, T10–L2 injury being the most common. In all age groups, the number of multilevel continuous injury was larger than that of single-level injury or multilevel noncontinuous injury. Surgical intervention was required in 33.9%, and mortality was 3.2%. @*Conclusions@#In our study, fall from height was the most common mechanism of injury, and there were many suicide attempts associated with mental health issues. Thoracolumbar junction injuries were predominant, and the rate of multilevel contiguous injuries was high. The support and interest of the society and families for adolescent children seem crucial in preventing spinal trauma, and image testing of the entire spine is essential when evaluating pediatric spinal injuries.

Neglect and associated factors among children aged 3-6 years in families with non only children in Beijing-Tianjin-Hebei Region / 中国学校卫生

Objective@#To analyze the neglect status of children aged 3-6 years old from non-only-child families in Beijing-Tianjin-Hebei region and influencing factors, so as to provide assistance for the healthy growth of preschool children from non-only-child families.@*Methods@#From April to June 2022, 2 882 parents of preschool children from 15 kindergartens were selected in urban areas of Beijing-Tianjin-Hebei by randomized cluster sampling method, and were investigated with general information and neglect experiences. The χ 2 test, t-test and ANOVA were used to compare the neglect status of different categories of preschool children, and the binary Logistic regression method was used to analyze the influencing factors of the neglect of preschool children who were not only children.@*Results@#The detection rate of neglect among children aged 3-6 years from non-only-child families in the Beijing-Tianjin-Hebei region was 33.47%, the detection rate of neglect among children from only-child families was 9.24%, and the difference was statistically significant ( χ 2=261.94, P <0.01). The neglect score for children aged 3-6 years in non-only-child families was (42.35±7.52), the neglect score for onechild families was (38.16±6.56), and the difference was also statistically significant ( t=15.95, P <0.01). Binary Logistic regression analysis showed that family income <4 000 yuan/month ( OR= 2.75, 95%CI =1.18-6.32), grandparents or other relatives as the primary guardian ( OR=2.18, 95%CI =1.35-3.52), and poor parental relationship ( OR=2.64, 95%CI =1.42-3.87), average ( OR=2.31, 95%CI =1.32-4.01) non-only-child preschoolers had a higher risk of neglect ( P <0.05).@*Conclusion@#Neglect is prevalent among 3-to 6-year-old children from non-only-child families in the Beijing-Tianjin-Hebei region. Targeted intervention measures based on influencing factors should be taken to reduce neglect among preschool children.

Analysis of the effect of multimedia interactive teaching mode on the standardized residency training in department of geriatrics / 中华医学教育探索杂志

Objective:To explore the effect of multimedia interactive teaching mode on the standardized residency training in department of geriatrics.Methods:This study selected 80 geriatric residents taking the standardized training in the Department of Geriatrics, First Hospital of Jilin University from October 2019 to October 2020, and they were randomly divided into experimental group and control group. The control group adopted the traditional teaching mode to train the residents, while the experimental group adopted the multimedia interactive teaching mode to train the residents. After training for 3 months, the theoretical knowledge and clinical skills examination results after the training, comprehensive ability before and after the training, and the satisfaction with the training mode after the training were compared between the two groups. SPSS 26.0 was performed for t test. Results:There were significant differences between the two groups in the scores of theoretical knowledge[(92.06±4.75) vs. (87.54±4.23)] and clinical skills [(89.63±4.28) vs. (80.09±4.13)]( P<0.05), and the scores of theoretical knowledge and clinical skills in the experimental group were significantly higher than those in the control group ( P<0.05). There was no significant difference in the scores of thinking ability, clinical practice ability, scientific research ability, innovation ability and doctor-patient communication ability between the two groups before the training ( P>0.05). However, after the training, the above abilities were all improved ( P<0.05), and the scores of the experimental group were significantly higher than those of the control group ( P<0.05). The satisfaction of the experimental group was higher than that of the control group in improving cognitive speed, improving understanding, enhancing memory, improving problem analysis, stimulating learning interest, improving classroom participation, knowledge expansion, cultivating critical thinking, improving overall clinical thinking, and improving clinical work proficiency ( P<0.05). Conclusion:The application of multimedia interactive teaching mode in standardized residency training of geriatrics can improve the theoretical knowledge and clinical skills examination results of residents, enhance their comprehensive ability, and improve their satisfaction with the training mode.

Research progress of exosomes based targeted delivery of antitumor drugs / 药学学报

Exosomes are one of the most important ways of cell-to-cell communication in living lives. They are involved in major physiological and pathological processes, including drug resistance, infection propagation, cancer development and cardiovascular diseases. The biological functions of exosomes made it possess characteristics of low immunogenicity, high delivery efficiency, ability to cross multiple biological barriers and targeting capacity, which also encourage people to try to use it as a drug carrier to overcome the disadvantages of poor stability, low solubility, low bioavailability and high toxicity of some drugs. In this paper, the latest progress of exosomes in the delivery of antitumor drugs, including small chemotherapeutic drugs, biological macromolecules and nucleic acid drugs, is reviewed. In addition, the isolation, drug loading, and modification method and the application prospect of exosomes are also discussed.

Influence of deep invasive tumor thrombus on the surgical treatment and prognosis of patients with non-metastatic renal cell carcinoma complicated with venous tumor thrombus / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the impact of deep invasive tumor thrombus on the surgical complexity and prognosis of patients with renal cell carcinoma complicated with inferior vena cava tumor thrombus.@*METHODS@#We retrospectively reviewed the clinical data of 94 patients with non-metastatic renal cell carcinoma complicated with inferior vena cava tumor thrombus, who underwent surgical treatment in Peking University Third Hospital from January 2017 to June 2020. The patient's general condition, clinicopathological characteristics, surgery and survival information were collected. The patients were divided into two groups based on the intra-operative findings of tumor thrombus adhesion to the venous wall, of which 64 cases were in the deep invasive tumor thrombus (DITT) group and 30 cases were in the non-invasive tumor thrombus (NITT) group. Chi-square, t test and Mann-Whitney U test were used for categorical and continuous variables respectively. Kaplan-Meier plots and multivariable Cox regressions were performed to evaluate the influence of DITT on the prognosis of the patients with renal cell carcinoma with inferior vena cava tumor thrombus.@*RESULTS@#DITT significantly increase the difficulty of surgery for the patients with renal cell carcinoma with venous tumor thrombus, which was mainly reflected in the longer operation time (362.5 vs. 307.5 min, P=0.010), more surgical bleeding (1 200 vs. 450 mL, P=0.006), more surgical blood transfusion (800 vs. 0 mL, P=0.021), more plasma transfusion (200 vs. 0 mL, P=0.001), a higher proportion of open surgery (70.3% vs. 36.7%, P=0.002), a longer post-operative hospital stay (9.5 vs. 8 days, P=0.036), and a higher proportion of post-operative complications (46.9% vs. 13.8%, P=0.002). DITT was associated with worse overall survival of the patients with renal cell carcinoma with inferior vena cava tumor thrombus (P=0.022). Even in the multivariate analysis, DITT was still a poor prognostic factor for the overall survival of these patients [HR: 4.635 (1.017-21.116), P=0.047].@*CONCLUSION@#For patients with non-metastatic renal cell carcinoma with inferior vena cava tumor thrombus, DITT will significantly increase the difficulty of surgery, and may lead to poor prognosis.

Risk factors of renal sinus invasion in clinical T1 renal cell carcinoma patients undergoing nephrectomy / 北京大学学报(医学版)

OBJECTIVE@#To summarize the clinicoradiological characteristics of clinical T1 renal cell carcinoma patients and to investigate the risk factors of renal sinus invasion in cT1 renal cell carcinoma patients undergoing nephrectomy.@*METHODS@#A retrospective study was conducted in cT1 renal cell carcinoma patients from January 2016 to August 2019 in Department of Urology, Peking University Third Hospital, who underwent partial or radical nephrectomy by analyzing clinicopathological and radiological data. The influencing factors of renal sinus invasion for cT1 renal cell carcinoma were determined by χ2 test, Mann-Whitney U test and Logistic regression analysis.@*RESULTS@#A total of 507 patients were enrolled, including 354 males (69.8%) and 153 females (30.2%). The median age was 59 years and the median body mass index (BMI) was 25.5 kg/m2. Eighteen patients (3.6%) had gross hematuria preoperatively. The median tumor diameter was 3.5 cm. Three hundred twenty-two patients (63.5%) were staged clinical T1a and 165 cases (36.5%) were staged clinical T1b. The median R.E.N.A.L. score was 8. Three hundred fifty-nine patients (70.8%) had regular tumor border and 148 (29.2%) irregular. All the patients underwent surgical treatment, including 186 (36.7%) partial nephrectomy and 321 (63.3%) radical nephrectomy. Postoperative pathology showed seventy-five patients (14.8%) had renal sinus invasion, including 18 in cT1a (5.6%) and 57 in cT1b (30.8%). Univariate analysis showed that age (P=0.020), R.E.N.A.L. score (R value, E value, N value, P < 0.001) and tumor border (P < 0.001) were associated risk factors for cT1 renal cell carcinoma with renal sinus invasion. On multivariate binary Logistic analysis, R.E.N.A.L. score (P≤0.020) and irregular tumor border (P=0.001) were independent risk factors.@*CONCLUSION@#For cT1 renal cell carcinoma patients undergoing nephrectomy, about 15% had renal sinus invasion postoperatively. High R.E.N.A.L. score and irre-gular tumor border help predicting cT1 renal cell carcinoma renal sinus invasion.

Summary of Research on Intervention of Chinese Medicine in Breast Cancer Treatment / 中国实验方剂学杂志

Breast cancer is a malignant tumor with a variety of complex mechanisms. Current researchers generally believe that its cause may be related to living environment， daily mood， heredity， behavior habits， et al， but its specific pathogenesis has not yet been studied clearly. With the rapid increase in the number of breast cancer patients worldwide， the clinical treatment methods in most countries have also been continuously improved. At present， the methods such as surgery， radiotherapy and chemotherapy， immunotherapy， and endocrine therapy are mainly adopted in clinical practice. These methods have increased the survival rate of patients， but still with the possibility of recurrence and metastasis， and there are obvious sequelae. Some postoperative patients also experience psychological pressure and burden， which would greatly affect the quality of life. A large number of experiments and clinical experience have proved that due to its unique advantages， traditional Chinese medicine（TCM） has serially improved its current status in the extensive treatment of breast cancer. No matter in post-operative rehabilitation or in the process of co-radiation and chemotherapy， it has played an increasingly prominent role. TCM can improve human immunity， regulate the body's environment， effectively prevent the recurrence and metastasis of breast cancer， improve postoperative recovery， reduce the complications of radiation treatment and iatrochemistry， expressively improve the quality of life of patients， and prolong the survival time of patients. In recent years， the effectiveness of TCM in the treatment of breast cancer has brought more and more great trust from the patients in TCM， and most patients are willing to actively receive TCM treatment， so the mechanisms and approaches of TCM intervention in the treatment of breast cancer still need further research and exploration by our medical workers. By consulting the latest domestic and foreign literature， we reviewed the research progress on five approaches of TCM intervention in the treatment of breast cancer， including signaling pathways， immunotherapy， endocrine therapy， chemotherapy， and radiotherapy. Signal pathway intervention was explained mainly based on wingless-type MMTV integration site family members（Wnt）signaling pathway ， B-cell lymphoma-2 （Bcl-2）-associated X protein（Bax）/Bcl-2/cysteinyl aspartate specific proteinase-3（Caspase-3）signaling pathway， phosphatidylinositol 3-kinase（PI3K）/protein kinase B（PKB/Akt）/mammalian target of rapamycin（mTOR）signaling pathway， a highly conserved signal transduction pathway to regulate cell-cell communication（Notch）signaling pathway， mitogen-activated proteinkinase （MAPK） signaling pathway， etc. This article aims to provide reference for the treatment of breast cancer by Chinese medicine.

High tibial osteotomy combined with lateral retinacular release for the treatment of knee varus osteoarthritis with lateral patellar compression syndrome / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of high tibial osteotomy combined with arthroscopic lateral retinacular release in the treatment of knee varus osteoarthritis.@*METHODS@#From October 2017 to April 2019, a retrospective analysis was performed on 43 patients with knee varus osteoarthritis and lateral patellar compression syndrome treated by high tibial osteotomy combined with arthroscopic lateral retinacular release. There were 15 males and 28 females, aged 53 to 72(62.05±5.17) years. The visual analogue scale(VAS), Lysholm, and the knee range of motion were used to evaluate knee pain and functional recovery before operation, 2 weeks, 3 months and 12 months after operation. And the congruence angle (CA), patellar tilt angle (PTA), and femala-tibial angle (FTA) were measured respectively before and 12 months after operation to evaluate the congruence of patellar joint, and the improvement of line of gravity of lower limb.@*RESULTS@#All 43 patients were followed up for more than 12 months, with a follow-up time of 14 to 28 (19.60±4.50) months. The VAS scores decreased from 6.65±0.65 before operation to 2.16±0.95, 0.51±0.77 and 0.33±0.64 at 2 weeks, 3 months and 12 months after operation, and the difference was statistically significant (@*CONCLUSION@#High tibial osteotomy combined with arthroscopic lateral retinacular release can relieve weight-bearing pain in frontal axis and improve the function of knee in sagittal axis.

Herbalogical analysis of Aconiti Carmichaeli Radix / 中国中药杂志

Tianxiong has been used as a Chinese medicinal in China for thousands of years, and the earliest record can be traced back to the Shennong's Classic of Materia Medica. It is effective in dispersing wind, dissipating cold, and replenishing fire to streng-then yang. To clarify the origin of Tianxiong, the present herbalogical study reviewed the ancient and modern literature from the origin, processing, and clinical efficacy. Before the Tang Dynasty, although the description of Tianxiong was quite superficial, an apparent difference between Tianxiong and Fuzi was recognized. In the Tang and Song Dynasties, Tianxiong and Fuzi were mistakenly recognized to be prepared from a same plant since their raw materials came from artificial cultivation. Medical literature in the Ming and Qing Dynasties mostly followed the previous records, with the origin of Tianxiong remaining controversial. There were three mainstream views about the origin of Tianxiong according the ancient medical books. First, Tianxiong was a kind of Aconiti Radix(Chuanwu) without attachment of Fuzi. Second, Tianxiong was the large Fuzi. Third, Tianxiong derived from Aconiti Kusnezoffii Radix(Caowu) about 10 cm in length. By contrast, Fuzi in a large size was simply regarded as Tianxiong in modern times. The processing methods were diversified in the ancient times, and the fire-processing was continuously applied. With the deepening of the research on the efficacy and detoxification mechanism, more methods were discovered, such as processing with ginger juice, child's urine and alcohol. As for modern times, the processing of Tianxiong has not been nearly passed down. The characteristic processing of Tianxiong only handed down in Sichuan province and Lingnan area, which can be discriminated by the last step. The efficacies of Tianxiong can be directly understood from its literal name, including dispersing wind, dissipating cold, and replenishing fire to assist yang. Nowadays, Tianxiong is mostly used to strengthen yang.

Evaluation of physical and neurocognitive development of infants conceived from frozen embryo transfer / 上海交通大学学报（医学版）

Objective • To evaluate the physical and neurocognitive development of infants conceived from frozen embryo transfer (FET). Methods • Two hundred and forty-eight infants (1.5-4 years old) conceived from FET and natural conception (NC) were recruited as the follow-up cohort of FET offspring, and their physical and neurocognitive development were followed up and evaluated. Multiple Logistic regression analysis was used to assess the potential risk of cognitive retardation in FET offspring. Results • There was no significant difference in composition ratio of Z score for height, weight and body mass index between the FET group and the NC control group. Multiple Logistic regression analysis showed that compared with the NC control group, the risk of neurocognitive development abnormalities and retardation was higher in the FET group, especially in fine motor (OR=3.01, 95%CI 1.48-6.11) and social development domains (OR=3.76, 95%CI 1.63-8.69); and in the FET group, the social development risk of female infants was higher than that of male infants. Conclusion • FET may exert a negative impact on the early neurocognitive development of infants.

Evaluation of cartilage regeneration by arthroscopy after high tibial osteotomy / 中国骨伤

OBJECTIVE@#To evaluate the cartilage regeneration in the knee joint by arthroscopy after high tibial osteotomy.@*METHODS@#Eleven patients were included in the study who were treated with high tibial osteotomy and underwent microscopy when the internal fixation was unloaded from September 2017 to September 2019. Among them, there were 2 males and 9 females, aged from 55 to 64 years old. The internal and external compartment pictures of the knee were taken before and after surgery of removing the internal fixation and the International Cartilage Repair Society (ICRS) grading systerm was used to evaluate the degree of cartilage damage on the medial and lateral femoralcondyles and tibial plateau. The Westrn Ontarioand Mcmaster Universities osteoarthritis index (WOMAC) and the weight bearing line (WBL) were used to evaluate the function of the knee and the alignment of the lower limb.@*RESULTS@#All 8 patients were followed up for more than 12 months, ranging from 12 to 22 months. The degenerated cartilage of the medial femoral condyle and medial tibial plateau was covered by newly regenerated cartilage. WOMAC score decreased from 102-127 to 41-52 and WBL was improved from 17%-34% to 58%-64%. All incisions healed in stageⅠ, and no complications such as internal fixation rupture and infection occurred during and after the operation.@*CONCLUSION@#High tibial osteotomy can relieve the pain of the knee and the dysfunction by adjusting lower limb alignment, and the degenerated cartilage could be regenerated in the medial femoral condyle and medial tibial plateau.

Herbalogical study of Aconiti Lateralis Radix Praeparata(Fuzi) / 中国中药杂志

As a most important Chinese materia medica, Aconiti Lateralis Radix Praeparata(Fuzi) had been widely used in China for thousands of years. This herbalogical study was systematically performed based on variation characteristics of the naming, habitat, harvesting, processing and properties. The sharp toxicity of Fuzi had been well known since the spring and autumn period in the history, which was much earlier than that its medical properties was understood and applied. Sichuan province was regarded as the geo-authentic region of Fuzi all along, where the best quality goods could be provided for clinic use. The study showed the harvesting time of Fuzi was changing in different periods, and the possible effects were of climate change and artificial planting. The perishable characteris-tics of Fuzi severely limited its storage period; therefore, different kinds of storage methods were effectively used since Tang Dynasty. For thousands of years, Fuzi had been processed with various accessories to reduce toxicity, while simultaneously the study on processing mechanism was on going all the time. Fuzi was widely used in clinical practice to cure Yang depletion syndrome, which was based on its function of enhancing Yang and removing cold. Along with the further study on quality evaluation standard, Fuzi will probably get a much wider range of applications.

Low Doses of Nonylphenol Promote Growth of Colon Cancer Cells through Activation of ERK1/2 via G Protein‒Coupled Receptor 30 / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Nonylphenol (NP) is an endocrine disruptor found in products such as cleaners, plastics, and detergents. It exerts actions similar to endogenous 17β-estradiol (E2) and is reported to influence various cancers. However, its role in colon cancer remains elusive. MATERIALS AND METHODS: Colon cancer cell lines COLO 205 and SW480 were employed in our study. The cells were treated with NP or E2 followed by measurement of apoptosis and proliferation using flow cytometry and MTT assays, respectively. G protein–coupled estrogen receptor 30 (GPR30) expression was visualized using immunofluorescence and Western blot. To investigate the underlying mechanism, the expression levels of GPR30, p-protein kinase A (PKA), c-myc, cyclin D1, and ERK1/2 were analyzed using Western blot. Meanwhile, the GPR30 antagonist G15 was utilized to validate the role of GPR30 in colon cancer progression. Finally, the effect of a GPR30 inhibitor on tumor growth was determined in vivo using tumor xenograft mouse models. RESULTS: NP facilitated the proliferation of colon cancer cells and induced apoptosis failure in vitro. Western blot revealed increased GPR30 expression levels in response to NP treatment. Cyclin D1, p-PKA, c-myc, and proliferating cell nuclear antigen, proteins that regulate the cell cycle, were all upregulated by NP, and NP-mediated ERK1/2 activation and subsequent cell proliferation were abrogated by the GPR30 inhibitor G15. Moreover, colon cancer mice that received G15 administration demonstrated impaired tumor growth in vivo. CONCLUSION: Low dose NP promotes the growth of colon tumors through GPR30-mediated activation of ERK1/2 signaling.

Clinical diagnosis and treatment strategies of pituicytomas / 医学研究生学报

Objective Reports are rarely seen on the clinical studies of pituicytomas. This article discusses the clinical diagnosis, treatment strategies, pathological features and postoperative complications of pituicytomas. Methods This retrospective study included 10 cases of pituicytomas treated in our hospital from July 2008 to July 2018. All the patients underwent microsurgery, gross total resection of the tumor in 6 cases and subtotal resection in the other 4. We analyzed the histopathological features, postoperative complications and follow-up data of the patients. Results The tumors were tightly organized morphologically, consisting of bipolar spindle-shaped cells, arranged like crosswise-woven fiber bundles or in a storiform pattern, the cytoplasm stained red and eosinophilic, the nuclei medium-sized, round, oval or spindle shaped, mildly heterotypical, with visible microencapsulation and abundant interstitial blood vessels. The main postoperative complications included insipidus in 8 cases, hyponatremia in 4, decreased visual acuity in 3, hypopituitarism in 2, and intracranial infection in 1. Of the 9 patients followed up, 1 experienced recurrence at 2 years postoperatively and received another surgery, with no more recurrence hitherto. Conclusion Definite diagnosis of pituicytoma depends on pathological examination, and adequate attention should be paid to the prevention and management of such postoperative complications as insipidus and hyponatremia.

Expression of long non-coding RNA MTHFD2 and its biological role in human glioblastoma / 医学研究生学报

Objective The long non-coding RNA (lncRNA) MTHFD2 gene is expressed differentially in glioblastoma (GBM) and normal brain tissues, but its biological role in tumors, and particularly in GBM, remains unclear. This study aims to investigate the expression of lncRNA MTHFD2 in the GBM tissue and four GBM cell lines, and explore the effect of its down-regulated expression on the biological function of GBM cells. Methods Specimens of GBM and the paracancerous tissue (as normal control) were collected from 9 patients treated by surgical resection in our Department of Neurosurgery between September and December 2017 LV-MTHFD2-shRNA (U251 shRNA and U-87MG shRNA groups) and empty LV-control solution (U251 shRNA and U-87MG control groups) were transfected into the U251 and U-87MG cell lines. The expressions of lncRNA MTHFD2 in the GBM tissue and the GBM cell lines were detected by qRT-PCR, the chemosensitivity and proliferation of the cells after transfection measured by CCK-8 assay, and the changes in the cell migration ability determined by Transwell assay. Results The relative expression of lncRNA MTHFD2 was significantly higher in the GBM than in the normal tissue (5.13 ± 3.96 vs 1.27 ± 0.58, P < 0.05), while that of MTHFD2 was remarkably lower in the U251 shRNA than in the U251 control group (0.05 ± 0.01 vs 1.00 ± 0.00, P < 0.01), and so was that in the U-87MG shRNA than in the U-87MG control (P < 0.05). The number of cells penetrating the Transwell membrane was markedly lower in the U251 shRNA group than in the U251 control (41.4 ± 6.99 vs 125.8 ± 25.27 per field of view, P < 0.01), and so was that in the U-87MG shRNA than in the U-87MG control (P < 0.05). CCK-8 assay showed that, at 4 days after transfection, the A value was significantly decreased in the U251 shRNA and U-87MG shRNA groups as compared with the U251 control and U-87MG control groups (P < 0.05). Cellular drug resistance test manifested remarkably reduced fifty percent inhibitory concentrations (IC50) in the U251 shRNA and U-87MG shRNA groups as compared with the U251 control and U-87MG control groups (P < 0.05). Conclusion DDown-regulation of the expression of lncRNA MTHFD2 can inhibit the proliferation and migration of U251 and U-87MG cells and enhance the chemosensitivity of the cells to temozolomide, which suggests that lncRNA MTHFD2 could be a potential therapeutic target against GBM.

Role of bronchoalveolar lavage fluid analysis in the diagnosis of hypersensitivity pneumonitis / 中国实用内科杂志

Hypersensitivity pneumonitis is a group of granulomatous lung disease caused by repeated exposure and sensitization to a variety of organic antigens. Establishing a diagnosis of HP is challenging as no gold standard for diagnosis of HP is currently available. The diagnosis is based on integration of history, clinical manifestations, pulmonary function, high-resolution chest CT(HRCT), bronchoalveolar lavage fluid(BALF) analysis and histopathological features, which is a multidisciplinary diagnosis. The BALF cell profile in HP is characterized by a significant increase in the percentage of lymphocytes. BALF cellular analysis can provide additional supportive evidence of the diagnosis of HP, which narrows the differential diagnosis of HP and helps some patients avoid surgical lung biopsy.

Delayed-Onset Leg Weakness Caused by Posterior Migration of a Herniated Disc to the Thecal Sac Mimicking Epidural Hematoma in a Flexion-Distraction Injury of the Lumbar Spine: A Case Report

OBJECTIVES@#To document the first known case of posterior migration of a herniated disc in a lumbar flexion-distraction injury.SUMMARY OF LITERATURE REVIEW: Lumbar disc herniation is sometimes confused with epidural hematoma, especially when the disc migrates posterior to the thecal sac. There has been no report of posterior migration of a herniated disc after a lumbar flexion-distraction injury.@*MATERIALS AND METHODS@#A 47-year-old woman with no pertinent medical history was diagnosed with a flexion-distraction injury of the L2–L3 vertebrae after a motor vehicle accident. The patient had no neurological deficit initially. Magnetic resonance imaging (MRI) showed a space-occupying lesion with T2 hyperintensity and T1 isointensity on the dorsal side of the thecal sac at L2–L3. After posterior lumbar fixation and fusion, progressive leg weakness occurred 1 week postoperatively.@*RESULTS@#A second operation revealed no evidence of epidural hematoma, but a sequestrated disc. Decompression and sequestrectomy were performed, and the patient's neurological status had recovered fully at 4 months postoperatively.@*CONCLUSIONS@#This case highlights the potential for posterior migration of a herniated disc with flexion-distraction injuries of the thoracolumbar spine. Discontinuity of the posterior annulus fibrosus on MRI may aid the distinction of posterior migration of a herniated disc from epidural hematoma. Because posterior migration of a herniated disc is associated with progressive neurological deficits, surgeons must consider decompression surgery when such herniation is suspected, even in the absence of neurological symptoms.

Delayed-Onset Leg Weakness Caused by Posterior Migration of a Herniated Disc to the Thecal Sac Mimicking Epidural Hematoma in a Flexion-Distraction Injury of the Lumbar Spine: A Case Report / 대한척추외과학회지

STUDY DESIGN: Case report. OBJECTIVES: To document the first known case of posterior migration of a herniated disc in a lumbar flexion-distraction injury. SUMMARY OF LITERATURE REVIEW: Lumbar disc herniation is sometimes confused with epidural hematoma, especially when the disc migrates posterior to the thecal sac. There has been no report of posterior migration of a herniated disc after a lumbar flexion-distraction injury. MATERIALS AND METHODS: A 47-year-old woman with no pertinent medical history was diagnosed with a flexion-distraction injury of the L2–L3 vertebrae after a motor vehicle accident. The patient had no neurological deficit initially. Magnetic resonance imaging (MRI) showed a space-occupying lesion with T2 hyperintensity and T1 isointensity on the dorsal side of the thecal sac at L2–L3. After posterior lumbar fixation and fusion, progressive leg weakness occurred 1 week postoperatively. RESULTS: A second operation revealed no evidence of epidural hematoma, but a sequestrated disc. Decompression and sequestrectomy were performed, and the patient's neurological status had recovered fully at 4 months postoperatively. CONCLUSIONS: This case highlights the potential for posterior migration of a herniated disc with flexion-distraction injuries of the thoracolumbar spine. Discontinuity of the posterior annulus fibrosus on MRI may aid the distinction of posterior migration of a herniated disc from epidural hematoma. Because posterior migration of a herniated disc is associated with progressive neurological deficits, surgeons must consider decompression surgery when such herniation is suspected, even in the absence of neurological symptoms.

Scopariusols L-T, nine new ent-kaurane diterpenoids isolated from Isodon scoparius / 中国天然药物

Nine new ent-kaurane diterpenoids, named scopariusols L-T (1-9), were isolated from the aerial parts of Isodon scoparius. Their structures were characterized mainly by analyzing the NMR and HR-ESI-MS data, and the absolute configuration of 1 was determined by single-crystal X-ray diffraction. Compound 1 was active against five human tumor cell lines (HL-60, SMMC-7721, A-549, MCF-7, and SW-480), and it also inhibited NO production in LPS-stimulated RAW264.7 cells, with an IC value of 0.6 μmol·L.

Effect of stent-assisted coil embolization for the treatment of A1 segment anterior cerebral artery aneu-rysms / 医学研究生学报

Objective It is difficult to conduct the intravascular interventional treatment of A1 segment anterior cerebral ar-tery aneurysms. This article aimed to investigate the effect of stent-assisted coil embolization for the treatment of A1 segment anterior cerebral artery aneurysms. Methods Retrospective analysis was made on the clinical data of 8 patients with A1 segment anterior cer-ebral artery aneurysms who were treated in Department of Neurosurgery in Nanjing General Hospital of Nanjing Military Command from June 2015 to July 2017. All the patients underwent endovascular intervention under static inhalation combined with general anesthesia. Immediately after the operation,angiography was performed to observe the embolization of the aneurysm and imaging follow-up was per-formed. The follow-up period was 6 to 30 months,with an average of (13±9) months,followed by Glasgow Outcome Scale (GOS) sco-ring. Results Immediate postoperative angiography showed that all 8 aneurysms were completely embolized and the parent artery re-mained. Seven patients had no ruptured hemorrhage and no new neu-rological dysfunction,with 5 points of GOS score and good prognosis. Five patients underwent DSA follow-up after surgery with no developed aneurysm. Conclusion Stent-assisted coil embolization is techni-cally feasible in treating A1 segment anterior cerebral artery aneu-rysms,which is a choice worthy of clinical promotion.