Cognitive function of patients with comorbid borderline personality disorder and bipolar disorder / 四川精神卫生

BackgroundThe comorbidity rate of bipolar disorder and borderline personality disorder （BPD） is high， and the cognitive impairment of comorbidity patients is more serious. ObjectiveTo explore the difference of cognitive function between bipolar disorder patients with BPD or not， so as to provide references for clinical diagnosis and treatment. MethodsUsing simple random sampling， 60 patients with bipolar disorder comorbidity BPD treated in the First Hospital of Hebei Medical University from April 2021 to April 2022 were selected as the research group， including 33 patients with bipolar depression and 27 patients with bipolar mania. At the same time， 60 patients with bipolar disorder were randomly selected as the control group， including 35 patients with bipolar depression and 25 patients with bipolar mania. The cognitive function of patients was evaluated by the Chinese version of Repeatable Battery for the Assessment of Neuropsychological Status （RBANS） and the Stroop Color Word Test. ResultsThe immediate memory， visual span， speech function and total score of RBANS in the comorbid group were lower than those in the non-comorbid group， and the differences were statistically significant （t=-2.356， -2.138， -3.306， -2.729， P<0.05 or 0.01）. The single word time， single color time， double word time and double color time in Stroop Color Word Test in comorbid group were longer than those in non-comorbid group， and the differences were statistically significant （t=4.808， 3.341， 5.249， 5.167， P<0.01）. The immediate memory， visual span， speech function and total score in RBANS of bipolar depression patients with comorbid BPD were lower than those of bipolar depression patients without comorbid BPD （t=-2.446， -2.407， -2.231， -2.078， P<0.05）， and the time of single word， single color， double word and double color in Stroop Color Word Test were longer than those of non-comorbid BPD patients （t=-3.652， 3.035， 4.406， 5.016， P<0.01）. The speech function and total score of RBANS in bipolar manic patients in comorbid group were higher than those in non-comorbid group （t=-2.777， -2.347， P<0.05 or 0.01）， and the time of single word， single color， double word and double color in Stroop Color Word Test were longer than those in non-comorbid group （t=3.600， 2.658， 2.943， 4.337， P<0.05 or 0.01）. ConclusionThe cognitive impairment of bipolar disorder patients comorbid with BPD is more severe than that of patients without comorbid with BPD. ［Funded by Medical Science Research Project of Hebei Province in 2022 （number， 20221407）］

Research advances in frailty assessment of elderly patients with multiple myeloma / 中华老年医学杂志

Multiple myeloma(MM)is a common hematological malignancy of the elderly.It is characterized by the involvement of multiple organs and its treatment becomes more difficult when aging and frailty exert their influence.In elderly MM patients, frailty is associated with poor tolerance to treatment and poor outcomes.Individualized therapy based on frailty assessment can minimize treatment-related adverse effects and reduce the rate of treatment interruptions, thereby improving the survival in elderly patients.In this review, we aim to provide an overview of the frailty assessment systems for MM patients.We also discuss their clinical applications, issues to be addressed, and future directions for optimizing MM-specific frailty assessment to guide MM treatment in frail elderly patients.

Chronic spontaneous urticaria treated with bloodletting therapy and auricular point sticking on the base of xuanfu theory: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical therapeutic effect and the impacts on recurrence rate on chronic spontaneous urticaria (CSU) between the combined treatment of bloodletting therapy and auricular point sticking on the base of xuanfu theory and the oral solution of levocetirizine hydrochloride.@*METHODS@#A total of 86 patients with CSU were randomized into an observation group (43 cases, 1 case dropped off) and a control group (43 cases, 3 cases dropped off). In the observation group, bloodletting therapy at Dazhui (GV 14), Feishu (BL 13), Geshu (BL 17) and Pishu (BL 20) was combined with auricular point sticking at lung (CO14), kidney (CO10), shenmen (TF4) and heart (CO15), etc. This combined treatment was given once every two days. In the control group, the oral solution of levocetirizine hydrochloride was prescribed, 10 mL each time, once daily. The treatment lasted for 4 weeks in the two groups. Before and after treatment, urticaria activity score 7 (UAS7), the score of dermatology life quality index (DLQI) and the levels of serum immune globulin E (IgE), interleukin 4 (IL-4) and interferon γ (IFN-γ) were compared in the patients between the two groups. The clinical therapeutic effect was evaluated in patients of the two groups and the recurrence rate was followed up 4, 8 and 12 weeks after treatment separately.@*RESULTS@#After treatment, the scores of UAS7 and DLQI, as well as the levels of serum IgE and IL-4 were all reduced as compared with those before treatment in the two groups (P<0.05), and the level of serum IFN-γ was increased (P<0.05). The total effective rate was 83.3% (35/42) in the observation group and was 85.0% (34/40) in the control group. There was no statistical significance for the difference in the clinical therapeutic effect between the two groups (P>0.05). Eight and 12 weeks after treatment, the recurrence rates were 21.1% (4/19) and 26.3% (5/19) in the observation group, lower than 55.0% (11/20) and 65.0% (13/20) in the control group, respectively (P<0.05).@*CONCLUSION@#The combined therapy of bloodletting and auricular point sticking on the base of xuanfu theory relieves the clinical symptoms, regulates the levels of serum IgE, IL-4 and IFN-γ and improves the quality of life in the patients with CSU. The clinical therapeutic effect of this combined treatment is similar to the oral solution of levocetirizine hydrochloride. But, the recurrence rate of the combined treatment of bloodletting and auricular point sticking is lower and its long-term curative effect is better.

Functional Connectivity from Hypothalamus and Whole Brain Anisotropy in Patients with Dysphagia after Stroke: A Study with Magnetic Resonance Imaging / 中国康复理论与实践

Objective:To investigate the changes of the functional connectivity of hypothalamus and the whole brain anisotropy in patients with dysphagia after stroke using magnetic resonance imaging. Methods:From December, 2018 to December, 2019, 14 patients with dysphagia after stroke and 15 healthy controls matched in age, sex and dominant hemisphere were selected. The functional connections from bilateral hypothalamus were researched with resting-state functional nuclear magnetic resonance, and the correlation between functional connection and scores of Eating Assessment Tool-10 (EAT-10) was analyzed. Meanwhile, the whole brain white matter integrity was observed with diffusion tensor imaging, and the fraction anisotropy (FA) was compared. Results:Compared with the controls, the functional connections from left hypothalamus to left precentral gyrus, left postcentral gyrus, left marginal lobe, left parietal lobe and left occipital lobe decreased in the patients; while the functional connections to left thalamus, left midbrain and right occipital lobe increased; the functional connections from right hypothalamus to right precentral gyrus, bilateral marginal lobe, bilateral superior temporal gyrus and right parietal lobe decreased; the functional connection to bilateral parietal lobe and bilateral occipital lobe increased. There was negative correlation of EAT-10 scores to functional connection from left hypothalamus to left precentral gyrus (r = -0.595, P = 0.025) and left postcentral gyrus (r = -0.934, P < 0.001), and positive correlation to functional connections from left hypothalamus to left parietal lobe (r = 0.583, P = 0.028) and from right hypothalamus to left occipital lobe (r = 0.630, P = 0.016). Compared with the controls, FA decreased in bilateral precentral gyrus, bilateral postcentral gyrus, bilateral frontal lobe, bilateral parietal lobe, bilateral occipital lobe, bilateral caudate nucleus, bilateral thalamus, right medulla, right superior temporal gyrus, right pontine and left posterior cerebellar lobe in the patients; while FA increased in bilateral anterior lobe of cerebellum and right cingulate gyrus. Conclusion:The motor and sensory cortices are important for swallowing. Patients with dysphagia after stroke may spend more attention and visual compensation. Impairment of white matter is found in swallowing cortex, subcortical structure and brainstem swallowing center in patients with dysphagia after stroke.

Mechanism of Resveratrol in Treatment of Lung Adenocarcinoma： An Exploration Based on Database Mining and Molecular Biology / 中国实验方剂学杂志

Objective:To explore the mechanism of resveratrol （RSV） in the treatment of lung adenocarcinoma （LUAD） based on bioinformatics and molecular biology. Method:The targets of RSV were retrieved from DrugBank and then imported into STRING for constructing a protein-protein interaction （PPI） network.TCGA database was utilized to analyze the expression of target genes in tumor and normal tissues， followed by the prediction of their impacts on tumor occurrence and development and the screening of target genes using random forest and univariate Cox regression models.With the results of bioinformatics taken into consideration， the mechanism of RSV in inhibiting LUAD was further explored by molecular biology. Result:Ten Hub genes were screened out from the PPI network of RSV targets.Among them， solute carrier family 2 member 1 （SLC2A1）， arachidonate 5-lipoxygenase （ALOX5）， peroxisome proliferative activated receptor gamma （PPARG）， and arachidonate 15-lipoxygenase （ALOX15） differed significantly in their expression in tumor and normal tissues.As revealed by random forest and univariate COX regression analysis， SLC2A1 was of great significance to the survival and prognosis of patients with LUAD.The survival analysis through Kaplan-Meier （KM） plotter indicated that the SLC2A1 expression was closely related to the overall survival （OS）， first progression （FP）， and post-progression survival （PPS） of LUAD patients.The molecular biological experiments further proved that RSV inhibited the proliferation and migration of LUAD cells by reducing the expression of SLC2A1.As verified by immunohistochemical scoring， SLC2A1 protein expression in tumor tissue was significantly different from that in normal tissue. Conclusion:RSV inhibits the proliferation and migration of LUAD cells by reducing the expression of SLC2A1， which has far-reaching significance in the clinical treatment of LUAD.

Prevalence and risk factors of renal function decline in elderly people in a community in Shanghai / 上海预防医学

Objective:To determine the prevalence of renal function decline in the elderly population in a community and risk factors. Methods:Data in the physical examination of the elderly population aged over 60 years old in a community in 2018 were collected and analyzed. Estimated glomerular filtration rate was calculated by modified modification of diet in renal disease （MDRD） formula. Association between renal function decline and risk factors were determined. Results:Among the 9 626 elderly people， the prevalence of renal function decline was 10.71%， which increased with age. Multivariate logistic regression showed that men， age， anemia， abnormal uric acid， hypertension， hyperlipidemia， diabetes， glutamine transaminase， and the history of stroke were the independent risk factors associated with renal function decline. Conclusion:The prevalence of renal function decline in elderly people in a community in Shanghai is relatively high. It is necessary to pay attention to early screening and take effective preventive measures， such as health education， scientific exercise and reasonable diet， chronic disease management and other measures.

Transcriptome sequencing and metabolome analysis reveal the mechanism of Shuanghua Baihe Tablet in the treatment of oral mucositis / 中国天然药物

Oral mucositis (OM) caused by cancer therapy is the most common adverse reaction in the radiotherapy of head and neck tumors. In severe cases, it can lead to the interruption of treatment, which affects the control of the disease and the quality of life. Shuanghua Baihe Tablet (SBT) is a traditional Chinese medicine (TCM) formula, which is administerd to treat OM in China. It has been clinically effective for more than 30 years, but the underlying mechanism is not completely understood. With the development of multiple omics, it is possible to explore the mechanism of Chinese herbal compound prescriptions. Based on transcriptomics and metabolomics, we explored the underlying mechanism of SBT in the treatment of OM. An OM model of rats was established by 5-FU induction, and SBT was orally administered at dosages of 0.75 and 3 g·kg

Application of nerve block in total knee arthroplasty under general anesthesia / 中国骨伤

OBJECTIVE@#To evaluate the effect of femoral and sciatic nerve block in total knee replacement of elderly patients under general anesthesia.@*METHODS@#From July 2017 to July 2019, 60 patients with unilateral total knee replacement were selected, including 35 males and 25 females; aged 66 to 74(70.2±10.3) years;BMI 18 to 25 (21.3 ± 3.5) kg /m;course 2 to 3 (1.2±0.3) days. The patients were divided into general anesthesia group (G group) 30 cases and general anesthesia plus nerve block group(GNB group) 30 cases. In GNB group, the femoral nerve sciatic nerve block was guided by ultrasound before anesthesia induction, 20 to 25 ml was injected into the femoral nerve puncture point with 0.5% ropivacaine, 15 to 20 ml was injected into the sciaticnerve puncture point, and the total volume was no more than 40 ml. Postoperative intravenous analgesia (PCIA) was performed in two groups. The dosage of propofol and remifentanil was recorded. Forty-eight hours after operation, the incidence of postoperative nausea and vomiting (PONV) and postoperative farsightedness were recorded. When VAS>3, tramadol 2 mg / kg was injected intravenously, and the additional times of tramadol were recorded. Forty-eight hours after operation, patients' satisfaction score was used to record the length of stay.@*RESULTS@#Compared with group G, the dosage of propofol and remifentanil decreased, the incidence of PONV and the number of additional tramadol decreased, and the patients' satisfaction increased (0.05). The ROM and HSS scores of two groups after treatment were higher than those before treatment (0.05). The ROM and HSS scores of the GNB group after treatment were higher than those of the G group (<0.05), and the VAS scores were lower than those of the G group (<0.05).@*CONCLUSION@#The application of femoral sciatic nerve block in total knee replacement under general anesthesia in elderly patients has good postoperative analgesic effect, and can reduce the dosage of general anesthesia, reduce PONV, and increase patient satisfaction.

Loss of GRB2 associated binding protein 1 in arteriosclerosis obliterans promotes host autophagy / 中华医学杂志(英文版)

BACKGROUND@#Arteriosclerosis obliterans (ASO) is a major cause of adult limb loss worldwide. Autophagy of vascular endothelial cell (VEC) contributes to the ASO progression. However, the molecular mechanism that controls VEC autophagy remains unclear. In this study, we aimed to explore the role of the GRB2 associated binding protein 1 (GAB1) in regulating VEC autophagy.@*METHODS@#In vivo and in vitro studies were applied to determine the loss of adapt protein GAB1 in association with ASO progression. Histological GAB1 expression was measured in sclerotic vascular intima and normal vascular intima. Gain- and loss-of-function of GAB1 were applied in VEC to determine the effect and potential downstream signaling of GAB1.@*RESULTS@#The autophagy repressor p62 was significantly downregulated in ASO intima as compared to that in healthy donor (0.80 vs. 0.20, t = 6.43, P < 0.05). The expression level of GAB1 mRNA (1.00 vs. 0.24, t = 7.41, P < 0.05) and protein (0.72 vs. 0.21, t = 5.97, P < 0.05) was significantly decreased in ASO group as compared with the control group. Loss of GAB1 led to a remarkable decrease in LC3II (1.19 vs. 0.68, t = 5.99, P < 0.05), whereas overexpression of GAB1 significantly led to a decrease in LC3II level (0.41 vs. 0.93, t = 7.12, P < 0.05). Phosphorylation levels of JNK and p38 were significantly associated with gain- and loss-of-function of GAB1 protein.@*CONCLUSION@#Loss of GAB1 promotes VEC autophagy which is associated with ASO. GAB1 and its downstream signaling might be potential therapeutic targets for ASO treatment.

Therapeutic effect of adjuvant treatment of acupuncture in a period of day from 7:00 am to 9:00 am on non-dipper essential hypertension / 中国针灸

OBJECTIVE@#To compare the infuences on circadian rhythm of blood pressure in the patients with non-dipper essential hypertension between the combined treatment of time acupuncture and western medication and the simple western medication.@*METHODS@#A total of 70 patients with non-dipper essential hypertension were randomized into an acupuncture plus western medication group (35 cases, 2 cases dropped out) and a western medication group (35 cases). In the western medication group, levamlodipine maleate tablets were taken orally, 2.5 mg each time, once daily. In the acupuncture plus western medication group, on the base of the treatment as the western medication group, acupuncture was applied specially in the period of the day from 7:00 am to 9:00 am. The acupoints included Fengchi (GB 20), Zhongwan (CV 12), Tianshu (ST 25), Hegu (LI 4), Quchi (LI 11), Zusanli (ST 36), etc. Acupuncture was given once daily, 5 treatments a week. The duration of treatment in the two groups was 4 weeks. The clinic blood pressure before and after treatment, 24 h ambulatory blood pressure and the levels of serum melatonin (MT) and 5-serotonin (5-HT) were observed in the two groups.@*RESULTS@#The total effective rate of anti-hypertension was 75.8% (25/33) in the acupuncture plus western medication group, better than 54.3% (19/35) in the western medication group (<0.05). The 24 h average systolic blood pressure, the daytime average systolic blood pressure, the daytime average diastolic pressure, and the nighttime average systolic blood pressure were all reduced after treatment in the two groups (<0.05). The reduction effect of the aforementioned 4 indexes in the acupuncture plus western medication group was much more obvious as compared with the western medication group (<0.05). After treatment, the serum level of MT was increased and 5-HT decreased in the patients of two groups (<0.05). The serum level of MT in the acupuncture plus western medication group was higher than that in the western medication group and the level of 5-HT was lower than the western medication group (<0.05).@*CONCLUSION@#Time acupuncture therapy in the period of the day from 7:00 am to 9:00 am, combined with western medication effectively reduce blood pressure and regulate the levels of serum MT and 5-HT so as to maintain the circadian rhythm of blood pressure in patients with non-dipper essential hypertension. The therapeutic effect of this combined treatment is superior to simple western medication.

Clinical performance of rensin-bonded composite strip crowns in primary incisors / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the clinical success of the treatment of maxillary anterior primary incisors caries with composite resin strip crowns.@*METHODS@#Children who presented with severe early childhood caries and were treated comprehensive caries under general anesthesia from January to December 2016 were enrolled in this study. Composite crowns using preformed celluloid crown (3M ESPE, USA) called as "strip crown technique" were applied to treat vital primary incisors with two or multiple surface cavities. Selective etchings of enamel, Universal Bond adhesive and 3M Z350 resin were used to make strip crowns. The patients returned at the end of 6, 12 and 18 months and received clinical and radiologic examinations. Dentists who did not attend the treatment evaluated the strip crowns clinically by modified United States Public Health Service (USPHS) criteria.@*RESULTS@#Four hundred eighteen restorations, placed in 127 children aged 1.17-5.75 years (average of 3.22), were evaluated. The overall retention rate was 97.8% at the end of 6 months, 93.6% at 12 months and 89.2% at 18 months. After 18 months, 28 restorations (6.7%) were totally lost and 4.1% were rated as having lost some resin material. Only four teeth (1.0%) had secondary caries at the end of 18 months and 1.4% teeth had pulpal pathology requiring root canal treatment. Composite crowns had good performance in contour and adjacent contact and improved aesthetics significantly. Twenty-nine teeth (6.9%) showed mild gingivitis and 93.1% showed healthy gingival. 11.2% of the teeth demonstrated color change because plaque accumulation and the polish could remove the stains. The complete loss of strip crowns was mainly related to eating bites.@*CONCLUSION@#Strip crowns performed well for restoring primary incisors with large or multisurface caries for periods of over 18 months. The strip crowns can be a durable and aesthetic restoration for vital carious primary incisors with adequate tooth structure after caries removal. Functional movement is an important cause of complete loss. Because of the high technical sensitivity and its requirement of the cooperation of children, strip crowns are more suitable for older and cooperative children as well as children receiving dental treatment under sedation or general anesthesia.

Effect of alisol A 24-acetate on proliferation of aorta smooth muscle cells in rats induced by ox-LDL / 中国中药杂志

Alisol A 24-acetate, a triterpenoid extracted from Alisma orientale, has shown anti-atherosclerotic actions and many studies have proved that oxidized low density lipoprotein (Ox-LDL) could promote proliferation of aorta smooth muscle cells (VSMCs) which are closely related to atherosclerosis (AS). The purpose of this study was to evaluate the effect of alisol A 24-acetate on the proliferation of VSMCs isolated from the thoracic aorta of rats induced by ox-LDL. VSMCs were induced by ox-LDL(50 mg·L⁻¹) to establish the proliferation model and intervened by alisol A 24-acetate (5, 10, 20 mg·L⁻¹) for 12, 24 and 48 h. Then the proliferation of VSMCs was detected by MTT assay; protein expression levels of VSMCs PCNA, cyclinD1, cyclinE, p21, p27 and VSMCs PCNA, p21and p27 mRNA expression levels were detected by Western blot and Real-time polymerase chain reaction (RT-PCR) respectively. The results showed that ox-LDL could induce the proliferation of VSMCs (<0.05), increase the protein expression levels of PCNA, cyclinD1 and cyclinE in the VSMCs (<0.05) and inhibit the protein and mRNA expression levels of p21 and p27 (<0.05). As compared with the model group, alisol A 24-acetate inhibited the proliferation of VSMCs in rats induced by ox-LDL and inhibited the protein expression of VSMCs PCNA, cyclinD1, cyclinE and enhanced the protein and mRNA p21 and p27 expression levels (<0.05). The effect was more obvious with the increase of concentration of alisol A 24-acetate. These data indicate that alisol A 24-acetate can inhibit the proliferation of VSMCs induced by ox-LDL and the mechanism may be associated with inhibiting expression of cyclin protein, including cyclinD1, cyclinE, p21, p27 and so on.

Quality control of Dandeng Tongnao Ruanjiaonang based on UPLC fingerprint combined with chemical pattern recognition / 中国中药杂志

To establish the ultra performance liquid chromatography (UPLC) fingerprint of Dandeng Tongnao Ruanjiaonang and conduct a systemic, comprehensive quality evaluation of the drug by combining with a chemical pattern recognition method. In this study, Waters UPLC ultra-high performance liquid chromatography instrument and ACQUITY UPLCHSS T3 chromatographic colum n were employed to perform the separation with acetonitrile-0.1% formic acid aqueous solution as the mobile phase for gradient elution; and the detection wavelength was set at 256 nm to establish the UPLC fingerprint of 10 batches of Dandeng Tongnao Ruanjiaonang. Then, the further quality assessment of the drug was carried out by similarity evaluation, Cluster Analysis(CA), Principal Component Analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). Finally, 77 peaks were recognised as common peaks in the fingerprint, and 15 peaks of them were identified using standard references. The similarity value of these 10 batches of drugs was all above 0.960, indicating a relatively stable quality. But minor differences were still discovered between the batches of the drug by CA and PCA. Finally, 6 common peaks were recognised as the quality makers using OPLS-DA method. The analysis method established in this study was scientific, accurate, reliable and simple; fingerprint combined with chemical pattern recognition technique can be used to systematically and comprehensively evaluate the drug quality of Dandeng Tongnao Ruanjiaonang; what's more, it could also provide a reference for the quality control of traditional Chinese medicine and its preparations at the same time.

Mechanism and Its Countermeasure of Hypomethylating Agent Resistance in Patients with Myelodysplastic Syndrome--Review / 中国实验血液学杂志

Hypomethylating agents(HMA) currently are widely used in the treatment of myelodysplastic syndromes (MDS), provide a significant improvement in the treatment of MDS. However, resistance to HMA is an almost universal phenomenon. This review was focused on immune effects related to DNA methylation, and to explore the mechanism underlying HMA resistance involved in immune checkpoint pathways. However, the optimal role of checkpoint blockade therapy (CBT) and immune checkpoint pathways remain in HMA failure questionable. The better understanding of immune checkpoint pathways in resistance of HMA offers a compelling rationale to introduce CBT in patients as a novel treatment option. CBT is an established strategy in solid tumors with potential as an adjunctive therapy in hematologic malignancies, therefore, may alter the treatment landscape in MDS. The suitability and effectiveness of combining HMA with CBT need to be confirmed by the results of ongoing clinical trials, so as to find novel strategies to improve outcome after failure of HMA.

The absolute value of lymphocyte counts and the response to decitabine treatment in patients with myelodysplastic syndrome / 解放军医学杂志

Objective To investigate the relations of absolute lymphocyte counts (ALC) to the therapeutic responses in patients with myelodysplastic syndrome (MDS) after the first course of decitabine (DAC) treatment.Methods Clinical data of 35 patients with MDS and MDS-derived secondary acute myeloid leukemia (AML) who were admitted in the Affiliated Hospital of Hebei University from Jan.2014 to Dec.2016 and treated with DAC were included in the present study.The patients were grouped into high lymphocyte group (H-Lym,ALC ≥ 1.2 × 109/L) and low lymphocyte group (L-Lym,ALC＜1.2 × 109/L) based on the ALC in days 28-35 after the first course of DAC treatment.The baseline data of both groups were compared with Pearson x2 analysis,while t test was used to analyze the changes of lymphocyte number before and after the first course of DAC treatment.Progressionfree survival (PFS) was estimated with Kaplan-Meier method,and the cumulative survival (CS) was compared between the two groups using log-rank test.Results Of the 35 patients,15 were in H-Lym group and 20 in L-Lym group.No significant difference existed in the baseline lymphocyte levels between the two groups (P＞0.05).The statistically significant differences (P＜0.05) existed only in the patients of the two groups who were with the proportion of bone marrow blasts ≥ 10％.The ALC in H-Lym group were slightly higher after the first course of DAC treatment than that at the time of diagnosis,but with no statistically significant (P＞0.05).However,the ALC in L-Lym group were significantly lower after the first course of DAC treatment than that at the time of diagnosis (P＜0.05).Patients had higher overall response rate (ORR) in H-Lym group than in L-Lym group (80％ vs.40％,P＜0.05).The median PFS was 10 months in H-Lym group and 7.6 months in L-Lym group (P＜0.05).Univariate analysis showed that the low ALC was a poor prognostic factor for the progression ofMDS (P＜0.05).Conclusion Patients with ALC ≥ 1.2 × 109/L after the first course of DAC treatment will have better ORR and longer PFS.

Predicting Therapeutic Response by Lymphocyte Level at 28th Day after DAC Treatment in Patients with MDS / 中国实验血液学杂志

OBJECTIVE@#To investigate a reliable clinical indication for predicting the therapeutic response of decitabine therapy in the patients with myelodysplastic syndromes (MDS).@*METHODS@#The clinical efficacy of decitabine for 55 cases of MDS was analyzed retrospectively. According to the lymphocyte level at d28 after the first time treatment with decitabine, the patients were divided into high lymphocyte level group (H-Lym≥1.2×10/L) and low lymphocyte level group (L-Lym<1.2×10/L), and the overall response rate (ORR) and the progression-free survival (PFS) time in 2 groups were compared.@*RESULTS@#As compared with L-Lym group, the ORR and PFS time in H-Lym group were significantly enhanced ［(76.0% vs 50.0%) (P<0.05) and median time (15.7 months vs 8.5 months)(P<0.05), respectively］;the ratio of platelet level ≥100×10/L in H-Lym group was very significantly higher than that in L-Lym group (72.0% vs 20.0%)(P<0.01). Multivariat analysis showed that the risk of disease progression in L-Lym group was 4.45-fold of H-Lym group (95% CI:1.58-12.59)(P<0.05).@*CONCLUSION@#The patients with lymphocyte level ≥1.2×10/L at day 28 after the first time treatment with decitabine show the higher ORR and longer PFS time, therefore. the lymphocyte level at day 28 after first time treatment with decitabine can be used as an early clinical indicator for predecting the response to decitabine treatment.

Inhibitory effect of combination of tanshinoneⅠ,metformin and aspirin on malignant melanoma model mice / 中国药理学与毒理学杂志

OBJECTIVE To explore the antitumor effects of combined tanshinoneⅠ(TanⅠ),metformin (Met) and aspirin (Asp) on malignant melanoma in mice and the possible mechanisms. METHODS C57BL/6 mice were injected with 0.1 mL B16F10 cells(2.8×109L-1)to establish the subcutaneous trans-plantation tumor model at the right forelimbs axillary.Then,the mice were divided into 8 groups according to body mass,including model group, TanⅠgroup(20 mg·kg-1,ip),Asp group(210 mg·kg-1,orally in drinking water), Met group (70 mg·kg-1, orally in drinking water), Asp+Met group, TanⅠ+Asp group, TanⅠ+Met group and TanⅠ+Asp+Met group,10 mice in each group.Each mouse drank about 7 mL of water every day for a total of 18 d.The mouse body mass was measured every other day and the tumor diameter was calculated every day. The mice were sacrificed after treatment, the tumor mass was measured and the tumor inhibitory rates were counted. The histopathological changes of the liver and spleen were observed with HE staining. The percentage of lymphocytes in the tumor tissue such as CD8+T,CD4+T and Treg cells was detected by flow cytometry.Inflammatory factors such as interleukin-6 (IL-6),IL-1β and tumor necrosis factor-α (TNF-α) were detected by ELISA. RESULTS The body mass (including tumor mass)of mice in different groups increased during the experiment,but that of TanⅠ+Asp+Met group increased more slower than in model group(P<0.01).At the end of the experiment,no lesions were seen in any liver or spleen tissue by pathological observation,and the number of survivors was 8/10(model group),8/10(TanⅠgroup),7/10(Asp group),7/10(Met group),8/10(TanⅠ+Asp group), 8/10 (TanⅠ+Met group), 7/10 (Asp+Met group) and 5/10 (TanⅠ+Asp+ Met group), respectively. Compared with model group,there were no obvious changes in tumor volume or tumor mass in TanⅠ, Asp and Met groups and other two-two joint groups,but the tumor volume and tumor mass in TanⅠ+Asp+ Met group were significantly decreased (P<0.01, P<0.05), and the tumor inhibitory rate in this group was 46.2%.Compared with the model group,the percentage of CD8+T cells increased(P<0.05) in TanⅠ+Asp+Met group,but there were no significant changes in other groups.The contents of IL-6, IL-1β and TNF-α in tumor tissue of TanⅠ+Met group were much higher than in model group(P<0.01, P<0.05,P<0.05)and the content of IL-6 increased in TanⅠ+Asp+Met group(P<0.01).CONCLUSION Combination of TanⅠ,Asp and Met can effectively inhibit the growth of melanoma in mice,which may be related to the increasing percentage of CD8+T lymphocytes and IL-6 in tumor tissue.However there are possibly some side effects.

Diagnostic Essentials of Solid Pseudopapillary Tumor of Pancreas on CT / 中山大学学报(医学科学版)

[Objective]To discuss the CT diagnosis and differential diagnosis of solid pseudopapillary tumor of the pancreas (SPTP).[Methods]The CT findings of 20 patients with SPTP proved by surgically pathology were retrospectively analyzed and summa?rized.[Results]SPTP were composed of solid and cystic components with surrounding capsule resulting to clear demarcation between tumor and normal pancreas without dilation of pancreatic duct. The tumor parenchyma was slightly hyperenhancement on arterial phase and showed gradual enhancement on venous and delayed phase.[Conclusions]The CT findings of SPTP have relative specifici?ty and can contribute to early diagnosis and differential diagnosis of SPTP.

Modulation of fructo-oligosaccharide during silybin-meditated improvement of nonalcoholic fatty liver / 中国药理学通报

Aim To examine weather fructo-oligosaccharides(FOS) and silybin(Sil) could exhibit synergetic effect on treating obesity-associated non-alcoholic fatty liver disease(NAFLD).Methods Seventy mice were randomly divided into two groups:control group (NCD,fed with normal chow diet),the other sixty mice were fed with high-fat diet (HFD) to establish NAFLD model.Seventy days after the establishment of experimental model,the latter group was then randomly subdivided into six groups:model (HFD),Sil (30mg· kg-1),FOS (2 000 mg · kg-1),Sil (30 mg ·kg-1) combined with FOS of high,medium and low dose respectively.The NCD and HFD group were given 0.5％ CMC,and the other groups were fed with high-fat diet and given 10 mL · kg-1 by gavage daily,then body weight and food intake were recorded.Fasting blood glucose,insulin,homeostasis model of assessment for insulin resistence index (HOMA-IR) and oral glucose tolerance tests(OGTT) were measured after 120 days.All mice were sacrificed after 130 days,and blood and liver were collected.Levels of TC,TG,ALT,AST in serum were detected,and liver index and pathology were also examined.Results FOS (2 000 mg · kg-1) showed obvious synergism for Sil-mediated attenuation of levels of TC,TG,ALT,AST in serum,fasting blood glucose,insulin,HOMA-IR,OGTI curve,liver index and pathology,but FOS (4 000 mg · kg-1) could not bring superiority with a double dose,except for its improvement in body weight of mice with NAFLD.Conclusions In the treatment of NAFLD,FOS exhibits synergetic effect with Sil.This agent might be a potent candidate for obesity and NAFLD prevention,through modulating the composition of gut microbiota.

Evaluation of OSCE in the phase Ⅰ skill examination of standarlized training of Beijing radiology residents / 基础医学与临床

This study evaluated the application of the objective structured clinical examination ( OSCE) in the stageⅠskills examination of the standardized training of radiology residents in Beijing .The subjects were selected from the radiology residents who took the phase Ⅰthe skill examination from 2014 to 2016.The composition of the can-didates , the average score and pass rate of the candidates were evaluated .The subjective evaluation was impliment-ed by questionnaire feedback .The results show that the proportion of undergraduate education in the composition of the candidates gradually increased , the doctoral and master 's pass rate is higher than the undergraduate students , the average score of the overall score for the doctoral examination average higher than the master 's degree and un-dergraduates;survey results show that the concept of OSCE was more and more familiar in the candidates through the 3 years, the candidates also agree with the popular form of this examination , but the concept of competency in the training process remains to be further promoted , in particular , to strengthen the communication skills training; for the examination process organization , the candidates generally reflects good .According to the analysis of the OSCE examinations and questionnaires from 2014 to 2016 , we believe that the future training of radiology residents should combine the training content with the academic qualifications .Candidates are highly receptive to OSCE in the form of daily training , especially focus on competency and communication skills training .