Clinical Outcome and Risk Factors of Treatment Failure of Peritoneal Dialysis Associated Peritonitis Caused by Klebsiella Pneumoniae:A Multicenter Study / 中国医学科学院学报

Objective To investigate the treatment outcomes,prognosis,and risk factors of treatment failure of peritoneal dialysis associated peritonitis (PDAP) caused by Klebsiella pneumoniae,and thus provide clinical evidence for the prevention and treatment of this disease. Methods The clinical data of PDAP patients at four peritoneal dialysis centers from January 1,2014 to December 31,2019 were collected retrospectively.The treatment outcomes and prognosis were compared between the patients with PDAP caused by Klebsiella.pneumoniae and that caused by Escherichia coli.Kaplan-Meier method was employed to establish the survival curve of technical failure,and multivariate Logistic regression to analyze the risk factors of the treatment failure of PADP caused by Klebsiella pneumoniae. Results In the 4 peritoneal dialysis centers,1034 cases of PDAP occurred in 586 patients from 2014 to 2019,including 21 cases caused by Klebsiella pneumoniae and 98 cases caused by Escherichia coli.The incidence of Klebsiella pneumoniae caused PDAP was 0.0048 times per patient per year on average,ranging from 0.0024 to 0.0124 times per patient per year during 2014-2019.According to the Kaplan-Meier survival curve,the technical failure rate of Klebsiella pneumoniae caused PDAP was higher than that of Escherichia coli caused PDAP (P=0.022).The multivariate Logistic regression model showed that long-term dialysis was an independent risk factor for the treatment failure of Klebsiella pneumoniae caused PDAP (OR=1.082,95%CI=1.011-1.158,P=0.023).Klebsiella pneumoniae was highly sensitive to amikacin,meropenem,imipenem,piperacillin,and cefotetan,and it was highly resistant to ampicillin (81.82%),cefazolin (53.33%),tetracycline (50.00%),cefotaxime (43.75%),and chloramphenicol (42.86%). Conclusion The PDAP caused by Klebsiella pneumoniae had worse prognosis than that caused by Escherichia coli,and long-term dialysis was an independent risk factor for the treatment failure of Klebsiella pneumoniae caused PDAP.

Risk factors for postoperative nausea and vomiting in patients undergoing thoracic surgery / 中华麻醉学杂志

Objective:To identify the risk factors for postoperative nausea and vomiting (PONV) in the patients undergoing thoracic surgery.Methods:The medical records of patients of either sex, aged 18-80 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, underwent elective thoracic surgery from January 2018 to January 2020, were collected retrospectively.The age, gender, educational background, American Society of Anesthesiologists physical status, motion sickness, history of smoking, history of drinking, history of heart disease, history of hypertension, history of diabetes, preoperative blood routine, liver function, parameters of electrolytes; operation method, type of operation, operation time, intraoperative nerve block, consumption of dexamethasone before anesthesia induction and intraoperative sufentanil and dexmedetomidine, use of postoperative patient-controlled intravenous analgesia (PCIA), and postoperative rescue opioid analgesics and antiemetics were recorded.The patients were divided into PONV group and non-PONV group depending on the occurrence of nausea and vomiting within 24 h after operation.PONV group was further divided into nausea group (PON group) and vomiting group (POV group) according to whether vomiting occurred.Logistic regression analysis was used to identify the risk factors for PONV.Results:A total of 3 791 patients were enrolled in this study, with 144 cases in PONV group and 3 647 cases in non-PONV group.The incidence of PONV was 3.80%.There were 38 patients in POV group, and the incidence was 26.4%.The results of logistic regression analysis showed that motion sickness, female, pulmonary wedge resection, postoperative PCIA and increased use of postoperative rescue opioid analgesics were risk factors for PONV in the patients undergoing thoracic surgery, intraoperative use of dexmedetomidine was a protective factor for PONV; motion sickness, female and history of hypertension were risk factors for postoperative vomiting in the patients at risk for PONV ( P<0.05). Conclusions:Motion sickness, female, pulmonary wedge resection, postoperative PCIA, and increased use of postoperative rescue opioid analgesics are risk factors and intraoperative use of dexmedetomidine is a protective factor for PONV in the patients undergoing thoracic surgery; motion sickness, female and history of hypertension are risk factors for postoperative vomiting in the patients at risk for PONV.

Clinical Study on Dynamic Detection of Minimal Residual Disease in Acute Myeloid Leukemia by Multiparameter Flow Cytometry / 中国实验血液学杂志

OBJECTIVE@#To investigate the prognostic significance of dynamic detection of minimal residual disease (MRD) in patients with acute myeloid leukemia (AML) by 8-color flow cytometry.@*METHODS@#MRD of 282 AML patients who achieved remission after initial therapy was detected by 8-color flow cytometry. MRD threshold for predicting recurrence was determined by receiver operating characteristic (ROC) curve, and time from MRD-positive to clinical recurrence was analyzed. The differences in overall survival (OS) time and relapse-free survival (RFS) time of patients with different MRD-changes were compared, and the related factors of recurrence in patients with MRD-negative were analyzed by univariate and logistic regression analysis.@*RESULTS@#ROC curve determined that the MFC-MRD threshold for predicting the recurrence of AML was 0.105%, and the recurrence rate of MRD-positive patients was significantly higher than that of MRD-negative patients [52.45% (75/143 cases) vs 35.97% (50/139 cases), P=0.005]. The patients in MRD persistent positive group and negative to positive group recurred earlier than those in positive to negative group and negative-positive fluctuation group (P<0.005). Survival analysis showed that OS and RFS time of patients with MRD persistent positive were significantly shorter than those of patients with MRD persistent negative, positive to negative, and negative-positive fluctuation (P<0.005). There was no significant difference in OS and RFS between MRD negative to positive group and MRD persistent positive group (P>0.005), either between MRD persistent negative group and MRD positive to negative group (P>0.005). Among 139 MRD-negative patients, 50 recurred. Univariate and logistic regression analysis showed that the risk of recurrence increased with the increase of white blood cells level (95%CI: 1.000-1.013, P=0.045). The risk of recurrence in patients without hematopoietic stem cell transplantation (HSCT) was 9.694 times higher than that in patients who received HSCT (95%CI: 1.720-54.651, P=0.010), and in the high-risk group was 5.848 times higher than that in the low-risk group (95%CI: 1.418-24.121, P=0.015).@*CONCLUSION@#The prognosis of AML patients with different MRD changes is significantly different. No matter MRD-positive or MRD-negative at the initial remission, dynamic detection of MRD after treatment is more helpful to accurately guide treatment.

Agkistrodon halys venom antitumor component-I inhibits vasculogenic mimicry in triple-negative breast cancer cells in vitro by down-regulating MMP2 / 南方医科大学学报

OBJECTIVE@#To investigate the inhibitory effect of agkistrodon halys venom antitumor component-I (AHVAC-I) on vasculogenic mimicry (VM) formation in triple-negative breast cancer MDA-MB-231 cells and explore its possible mechanism.@*METHODS@#CCK8 assay was used to determine the optimal concentration of AHVAC-I for cell treatment based on its halfinhibitory concentration (IC50). MDA-MB-231 cells were treated with different concentrations of AHVAC-I or 5-Fu, and the changes in vasomimetic capacity of the cells were examined using Matrigel assay. The expression levels of matrix metalloproteinase-2 (MMP2) and MMP9 in the treated cells were detected using quantitative PCR and Western blotting.@*RESULTS@#Compared with the control treatment with culture medium, treatment with 5, 10 and 20 μg/mL AHVAC-I significantly reduced vasomimetic ability of MDA-MB-231 cells in a dose-dependent manner (P < 0.01). MMP2 supplementation obviously restored the vasomimetic ability of the cells inhibited by AHVAC-I.@*CONCLUSION@#AHVAC-I inhibits VM formation in triplenegative breast cancer cells in vitro by down-regulating MMP2 production.

Preliminary experience of transoral robotic surgery for oropharyngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the oncological and functional efficacy and safety of transoral robotic surgery (TORS) in the treatment of oropharyngeal carcinoma. Methods: Twenty-six patients with oropharyngeal cancer were enrolled who underwent TORS at Beijing United Hospital from June 1, 2017 to December 31, 2020. Among them, 22 patients were males and 4 were females, aged 39 to 76 years old. T1-2 patients accounted for 88.5% (23/26). Clinicopathological data including the time of removal of gastric and endotracheal tube were collected. The SPSS software package was used for survival analysis, and the overall survival rate and disease-free survival rate were calculated. Results: All the 26 patients with oropharyngeal cancer received TORS without conversion to open surgery, and 20 of them underwent simultaneous cervical lymph node dissection. TORS operation time ranged from 65 to 360 minutes with an average of 215 minutes. Intraoperative blood loss ranged from 5 to 600 ml with an average of 70 ml. Four patients (15.4%) underwent tracheotomy, of whom 3 patients had the removals of tracheal tubes within 1 month after surgery and 1 case remained to wear a tube by the end of follow-up. Twelve patients (46.2%) underwent gastric tube implantation, among them, 11 patients had removals of gastric tubes within 1 month after surgery and 1 patient died of oropharyngeal hemorrhage 13 days after operation. One patient (3.8%) had a positive surgical margin and others had pathologically negative surgical margins. Sixteen patients (61.5%) received postoperative radiotherapy, of whom 11 patients (42.3%) received platinum-based concurrent chemotherapy. The median follow-up time was 21.5 months (0.4 to 45 months). The overall survival and the disease-free survival rates were 83.0% and 75.8%, respectively. Conclusion: The application of TORS in treatment of oropharyngeal cancer can achieve good oncological and functional outcomes in selected patients.

Eosinophilic vacuolated tumor of the kidney: clinicopathological and molecular characteristics / 中华病理学杂志

Objective: To study the clinicopathological features, immunophenotype, molecular changes, differential diagnosis and prognosis of eosinophilic vacuolated tumor (EVT) of the kidney. Methods: Four cases were collected retrospectively from 2014 to 2020 at Ningbo Diagnostic Pathology Center. The clinicopathologic features and immunophenotypic profile were studied by light microscopy and immunohistochemistry. Targeted next-generation sequencing (NGS) panel was used to detect cancer-associated mutation. Follow-up and literature review were also performed. Results: Among the 4 patients studied,2 were males and 2 were females. The age of the patients ranged from 44 to 63 years (the mean age: 51 years).Tumor size ranged from 1.5 to 4.2 cm (mean: 2.3 cm). Microscopically, tumors were well-circumscribed, unencapsulated. Thick-walled vessels and entrapped renal tubules were found within or at the periphery of the tumors. The tumors were predominantly composed of nest pattern, and focal tubular pattern. The tumor cells exhibited abundant, eosinophilic, granular cytoplasm and conspicuous, large nucleoli. Prominent intracytoplasmic vacuoles were seen. These cytoplasmic vacuoles varied in size and frequently coalesced into a large space. Loose fibromatous or hyaline stroma was focally noted. Immunohistochemically, the tumor cells in all cases exhibited a CD117+/CK7-phenotype. All cases were positive for CD10 and p504s. MTOR, S6 and cathepsin K were positive in 4 cases. TFE3, CA9, Melan A and HMB45 were negative in all cases. SDHB retained expression. NGS demonstrated MTOR mutations in all cases, and TSC2 mutation in 2 cases. Conclusions: EVT is a rarely oncocytic renal tumor with unique morphology, immunohistochemical phenotype, molecular profile and an indolent behavior. Recognition of the characteristics of this novel but rare entity will allow for better classification of renal tumors.

Clinical analysis on the root fracture of the maxillary first molar / 华西口腔医学杂志

OBJECTIVES@#This study aimed to investigate the common types and directions of root fractures of the maxillary first molar and the influence of root canal treatment on the prevalent sites of root fractures.@*METHODS@#A total of 274 maxillary first molars with root fractures diagnosed via cone beam computed tomography were included. The root fractures of nonendodontically and endodontically treated teeth were identified to be spontaneous and secondary root fractures, respectively. The sites, types, and directions of spontaneous and secondary root fractures were determined.@*RESULTS@#Among the spontaneous root fractures, the proportion of palatal root fractures (56.1%) was higher than those of mesial buccal root fractures (36.1%) and distal buccal root fractures (7.8%). Among the secondary root fractures, the proportion of mesial buccal root fractures (52.7%) was higher than those of palatal root fractures (36.5%) and distal buccal root fractures (10.8%). The distribution of predominant fracture sites was statistically significant (@*CONCLUSIONS@#This study provided an epidemiological basis for the clinical features of root fractures of the maxillary first molar. During the dia-gnosis and treatment of the maxillary first molar, the possibility of palatal root fractures should be considered. The occurrence of mesial buccal root fractures may be related to root canal treatment. Therefore, the risk of mesial buccal root fractures caused by iatrogenic factors should be minimized.

Molecular Mechanism of Nelumbinis Plumula Alkaloids in Prevention and Treatment of Non-Small Cell Lung Cancer： an Analysis Based on Network Pharmacology and Cell Experiment / 中国实验方剂学杂志

Objective:To explore the potential molecular mechanism of Nelumbinis Plumula alkaloids （NAPs） in the prevention and treatment of non-small cell lung cancer （NSCLC） based on network pharmacology and cell experiment. Method:The main active components of NAPs were obtained by searching Traditional Chinese Medicine System Pharmacology Database and Analysis Platform （TCMSP） and Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine （BATMAN-TCM）， and their main targets were predicted and analyzed by employing Swiss Target Prediction. The main target genes of NSCLC were retrieved from GeneCards， Online Mendelian Inheritance in Man （OMIM） and DrugBank databases. The resulting common targets were imported into STRING platform for constructing the protein-protein interaction （PPI） network， followed by gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis based on Database for Annotation， Visualization， and Integrated Discovery （DAVID）. The NAPs-common target -pathway network was constructed by Cytoscape 3.7.1. After NSCLC cell line A549 was treated with isoliensinine， the cell morphology was observed under an inverted fluorescence microscope. The effect of isoliensinine on A549 vitality was detected by cell counting kit-8 （CCK-8） assay and the target protein changes were verified by Western blot. Result:The main active components for NAPs against NSCLC were lysicamine， liensinine， and isoliensinine. The phosphatidylinositol-3-kinase-protein kinase B （PI3K-AKT）， RAS-related protein 1 （Rap1）， epidermal growth factor family of receptor tyrosine kinases （ErbBs）， and hypoxia inducible factor-1 （HIF-1） pathways were mainly involved for binding adenosine triphosphate （ATP） and regulating protein kinase activity. The main targets included protein kinase B-1 （AKT1）， alpha catalytic subunit of phosphoinositol-3-kinase （PIK3CA）， cyclin-dependent kinase 2 （CDK2）， mitogen-activated protein kinase-1 （MAPK1）， epidermal growth factor receptor （EGFR）， adenosine triphosphate-binding cassette B1 （ABCB1）， mammalian target of rapamycin （mTOR）， tyrosine kinase （Src）， Janus kinase 1 （JAK1）， and G1-phase-specific gene cyclin-D₁ （CCND1）. The <italic>in vitro</italic> cell experiment also revealed that isoliensinine down-regulated the expression of phosphorylated AKT （p-AKT） and phosphorylated mTOR （p-mTOR） in a concentration- and time-dependent manner and inhibited the growth of A549 cells. Conclusion:NAPs exert the preventive and therapeutic effects against NSCLC through multiple components， multiple targets， and multiple pathways， especially the PI3K-AKT pathway.

Cementing the apical and terminal pedicle screw applied in osteoporotic spine with lumbosacral degenerative disease: A finite element analysis / 中国组织工程研究

BACKGROUND: Cement-augmented pedicle screw is an effective fixation for osteoporotic spine, and it is important to reduce the rate of cement leakage. OBJECTIVE: To evaluate the stability of cementing the apical and terminal pedicle screw applied in osteoporotic spine with lumbosacral degenerative disease by finite element analysis. METHODS: An intact finite element model of L2-5 segment was established by using CT scan data of one normal male volunteer. After verifying the validity of the intact model, the cementing apical and terminal pedicle screw and cement-augmented pedicle screw models of double/multi-level segment fixation were established, respectively. A 150 N vertical axial pre-load was imposed on the superior surface and a 10 N·m moment was applied on the superior surface along the radial direction to simulate six different physiological motions: flexion, extension, left bending, right bending, left rotation, and right rotation. The different of range of motion, cage stress, and pedicle screw stress on fixed segments were compared between models. RESULTS AND CONCLUSION: (1) The validity showed that the range of motion of the intact model was similar to cadaveric studies in all directions. (2) The range of motion of cementing the apical and terminal pedicle screw group was slightly larger than that of cement-augmented pedicle screw group and the difference between the two groups was less than 0.15°. The two fixation methods could maintain the similar stability of the operation segment. (3) The difference of the cage stress and instrument stress was also small between the two groups. (4) These results suggest that compare with cement-augmented pedicle screw, cementing the apical and terminal pedicle screw can increase the approximate stability in double-level and multi-level segment fusion. The cementing the apical and terminal pedicle screw procedure may reduce the risk of cement leakage and patient costs, and offer a useful alternative to the cement-augmented pedicle screw procedure.

Different internal fixation methods of oblique lateral interbody fusion: a finite element analysis / 医学研究生学报

ObjectiveThere is still controversy about which internal fixation method should be used in oblique lateral interbody fusion (OLIF). This paper aims to compare the biomechanical stability of OLIF with different internal fixation methods.MethodsA 31-year-old healthy male volunteer was selected to have a 64-slice spiral CT scan of his lumbar spine. Mimics 19.0, Geomagic Studio 2013, SolidWorks 2017 and other software were used to build a three-dimensional model of L3-L5, and OLIF surgery was simulated to build OLIF finite element models with five different fixation methods: pedicle screw (PS), lateral single rod screw (LSRS), lateral double rod screw (LDRS), lateral single rod screw+ipsilateral translaminar facet screw (LSRS+ITLFS), lateral single rod screw+contralateral translaminar facet screw (LSRS+CTLFS). After validating the validity of the model, the motion modes of spinal flexion, extension, lateral bending and rotation were simulated, and the fixed segment activity and stress distribution characteristics of each model were compared.ResultsIn terms of fixed segment activity, PS had the best fixation effect, and its range of motion (ROM) was the smallest in all 6 modes. The ROM of the vertebral body was maximized when the LSRS was fixed in all directions. LSRS+ITLFS, LSRS+CTLFS and PS had the similar ROM. In terms of maximum stress of cage, PS had the minimum one except in the left bending. LSRS+ITLFS had little stress in all directions except in flexion; LSRS+CTLFS had little stress in all directions except in extension. In terms of the maximum stress in internal fixation, PS had the least one in all directions; LSRS+CTLFS followed, and the maximum stress appeared in extension and right bending (123.05MPA and 91.74MPA, respectively).ConclusionIn OLIF surgery, PS has the best biomechanical effect. LSRS+CTLFS has the similar effect and its clinical operation is simple with relatively small surgical injury, thus providing a reference for clinical choice.

Preparation and Preliminary Evaluation of Paclitaxel-loaded TPGS-CR Polymeric Micelles / 中国药学杂志

OBJECTIVE: To prepare paclitaxel loaded D-α-tocopheryl polyethylene glycol 1000 succinate(TPGS)-modified carboxymethyl chitosan-rhein polymeric micelles (PTX/TPGS-CR PMs) and preliminarily evaluate their performance. METHODS: PTX/TPGS-CR PMs was prepared by dialysis method, and the preparation procedure of PTX/TPGS-CR PMs was optimized by single factor with the drug loading, encapsulation rate and particle size as the indicators, then the optimized preparation procedure was verified. The safety of PTX/TPGS-CR PMs was initially investigated by the hemolysis test and the vascular irritation test. The cytotoxicity of PTX/TPGS-CR PMs in Hela cells was studied by MTT assay. Cell uptake experiments were performed by laser confocal microscopy and flow cytometry to investigate the uptake of PTX/TPGS-CR PMs by Hela cells. RESULTS: The particle size and PDI of PTX/TPGS-CR PMs prepared by the optimized preparation were (197.3±4.4) nm and (0.131±0.021), respectively. The Zeta potential was (-31.8±0.5) mV. The drug loading and encapsulation efficiency were (48.20±3.03)% and (87.26±4.91)%, respectively. The hemolytic test results showed that the hemolysis rate was less than 1.71%. No obvious irritation was observed after intravenous injection. The cytotoxicity of PTX/TPGS-CR PMs in Hela cells was concentration-and time-dependent. Cell uptake experiments showed that PTX/TPGS-CR PMs could be efficiently uptake by Hela cells. CONCLUSION: The PTX/TPGS-CR PMs has high drug loading and encapsulation efficiency, good safety. And they exhibite slightly better antitumor activity in vitro than Taxol®.

Determination of five neurotransmitters in the rat brain for the study of the hypnotic effects of Ziziphi Spinosae Semen aqueous extract on insomnia rat model by UPLC-MS/MS / 中国天然药物

Ziziphi Spinosae Semen (ZSS) has been used for treatment of insomnia in China for centuries. To reveal the influence of insomnia on the levels of the neurotransmitters including serotonin (5-HT), glutamic acid (Glu), γ-aminobutyric acid (GABA), noradrenaline (NE) and dopamine (DA), and to study the role of ZSS aqueous extract in the treatment of insomnia, an UPLC-ESI- MS/MS method was developed and validated for simultaneous determination of five neurotransmitters in the rat brain. The brain samples were pretreated by one-step direct protein precipitation with acetonitrile. The analytes were detected in positive mode with multiple reaction monitoring (MRM) and the procedure was completed in less than 10 min. The method showed a good linearity (R > 0.9967) with the other validation parameters were within acceptance range. The results indicated that the concentration of 5-HT, GABA and DA is significantly lower (P < 0.01) in para-chlorophenylalanine (PCPA)-induced insomnia rat model group, while Glu and NE significantly higher than those in control group (P < 0.01). Treatment with ZSS aqueous extract (4 or 8 g·kg·d for seven days) could ameliorate the symptoms of insomnia by significantly changing the levels of the neurotransmitter parameters mentioned above. The data obtained in this study demonstrate that ZSS aqueous extract could ameliorate the symptoms of insomnia by modulating the levels of monoamines and amino acid neurotransmitters in the brain.

Effect of thoracic paravertebral nerve block on postoperative chronic pain in patients undergoing thoracic surgery / 中华麻醉学杂志

Objective To evaluate the effect of thoracic paravertebral nerve block (TPVB) on postoperative chronic pain in patients undergoing thoracic surgery.Methods One hundred and forty patients of both sexes,aged 25-64 yr,with body mass index of 18-24 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective thoracoscopic radical resection of lung cancer,were divided into 2 groups (n=70 each) using a random number table method:control group (group C) and TPVB group (group P).Two-point (T4,6) TPVB was performed on the affected side under ultrasound guidance before anesthesia induction,and 0.5％ ropivacaine 20 ml was injected into each puncture site in group P.Sufentanil 0.1 μg/kg was intravenously injected at 10 min before the end of operation in group C.Analgesic pump was connected at the end of operation in two groups,and patient-controlled intravenous analgesia was performed with sufentanil.The patients were followed up after operation.Sufentanil 0.1 μg/kgwas intravenously injected when visual analogue scale score ≥4.The total consumption of sufentanil and the number of requirements for rescue analgesia were recorded at 48 h after operation in both groups.The patients were followed up to 2 months by telephone after operation,the occurrence of postoperative chronic pain was recorded,and the effect of pain on daily life and grade of treatment measures were evaluated.Results Compared with group C,the total consumption of sufentanil and the number of requirements for rescue analgesia were significantly reduced,and the impact of postoperative chronic pain on daily life and grade of treatment measures for pain were decreased in group P (P＜0.05).There was no significant difference in the incidence of postoperative chronic pain between the two groups (P＞ 0.05).Conclusion Although TPVB cannot reduce the incidence of postoperative chronic pain,it can relieve the degree of postoperative chronic pain in patients undergoing thoracic surgery.

Establish mouse osteoblast -osteoclast cell co-culture system in a Transwell chamber / 中国骨伤

<p><b>OBJECTIVE</b>To establish osteoblast-osteoclast cell co-culture system in a Transwell chamber, and detect cell viability of osteoblasts and osteoclasts in system.</p><p><b>METHODS</b>Osteoblast MC3T3-E1 and mouse monocytes RAW264.7 were cultivated in vitro. RANKL-induced mouse RAW264.7 monocytes differentiated into mature osteoclasts, osteoblast-osteoclast cell co-culture system was established in Transwell chamber. Cell activity of osteoblasts and osteoclasts were detected by CCK-8 experimenting, Alizarin Red staining, TRAP staining. The expression of OPG, ALP, RANKL, TGF-b1 gene and RANKL protein in osteoblast MC3T3-E1 were detected by PCR, Western-Blot methods. Also, the expression of RANK, NF-κB in gene and protein level in osteoclast were measured through the same method respectively.</p><p><b>RESULTS</b>The co-culture system of Mouse MC3T3-E1 cells and RAW264.7 cell were established in Transwell chamber. Co-culture system affected cell division activities of osteoblasts and osteoclasts. Differentiation of osteoblasts were increased, while differentiation of osteoclast division were slight decreased under microscope observation. OPG (0.65±0.08) and ALP (0.16±0.01) gene expression of co-culture system were less than single culture OPG(1.00±0.08) and ALP (1.01±0.16); TGF-b1(4.42±0.21) and RANKL(4.12±1.04) of osteoblasts in co-culture system were higher than TGF-b1(1.00±0.10) and RANKL(1.00±0.09) under single culture. However, gene expression of RANK(0.63±0.06) and NF-κB(0.64±0.08) in co-culture system were decreased than RANK(1.00±0.08) and NF-κB(1.00±0.09), in single culture, and had significant differences. Similarly, protein expression of OPG(0.43±0.05) and NF-κB(0.59±0.05) of co-culture system were less than OPG(0.84±0.06) and NF-κB(1.13±0.03) of single culture. While RANKL protein expression (0.54±0.03)of co-culture system was more than single culture RANKL(0.31±0.03), and had statistically differences, which was in agreement of the trend of gene expression change.</p><p><b>CONCLUSIONS</b>Co-culture system of mouse MC3T3-E1 cells and RAW264.7 cell was viable in Transwell chamber, and the activity of osteoblasts is higher than osteoclasts in co-culture system.</p>

Clinical Pathway System Design of Stroke Syndrome of TCM in the Hospital of Rehabilitation / 医学信息学杂志

Based on the introduction to the current situation of research on the standard for stroke syndrome of Traditional Chinese Medicine (TCM),the paper sorts out and collects related medical cases of stroke based on clinical data,builds models of the relationship between clinical information of TCM and syndrome categories through support vector machine after qualitative and quantitative analysis on the data standard in the clinical pathway of stroke,observes the predictive accuracy,and provides reasonable and reliable information support for clinical decision of stroke.

Mediating effects of self-compassion in relation of personality, and self-esteem to social physique anxiety in middle school student / 中国心理卫生杂志

Objective:To explore the mediating effects of self-compassion among personality,self-esteem and social physique anxiety in middle school students.Methods:The Social Physique Anxiety Scale (SPAS),Eysenck Personality Questionnaire-Revised Short Scale for Chinese (EPQ-RSC),Self-Esteem Scale (SES) and Self-Compassion Scale(SCS) were used to measure social physique anxiety,extroversion,neuroticism,self-esteem and self-compassion.Results:Boys got lower SPAS scores [(38 ± 8) vs.(39 ± 7);P ＜ 0.05] than girls.The SPAS scores were negatively correlated with the scores of extroversion,SES,SCS(r =-0.54--0.26,P ＜ 0.01),while the SPAS scores were positively correlated with the scores of neuroticism (r =0.44,P ＜ 0.01).Self-compassion played a partly mediating role between neuroticism and social physique anxiety,self-esteem and social physique anxiety,the confidence interval from Bootstrap output were 95 ％ (0.09-0.21) and 95 ％ (-0.22--0.08).The effect of neuroticism and self-esteem accounted for 45.5％,39.0％ of total effect.Conclusion:It suggests that self-compassion could mediate the relation of neuroticism and self-esteem to social physique anxiety partially.

Clinical Features in Pulmonary Hypertension Patients Combining Obstructive Sleep Apnea / 中国循环杂志

Objective: To observe clinical features in pulmonary hypertension (PH) patients combining obstructive sleep apnea (OSA). Methods: Sleep apnea monitoring was conducted in 65 PH patients with right cardiac catheterization in our hospital from 2016-04 to 2016-08. General clinical tests and the parameters of sleep respiration and right cardiac catheterization were recorded. OSA was diagnosed by apnea hypopnea index (AHI)≥5, different parameters were compared between PH patients with and without OSA. Results: The average patients' age was (41.98±15.26) years including 72.31% (47/65) female, 26 (40%) patients combining OSA with the mean AHI at (18.12±13.40). Compared to those without OSA, PH with OSA patients had the elder age, more male and higher proportions of chronic thromboembolic PH, lung diseases or hypoxia; increased AHI, apnea index (AI), obstructive AI (oAI); more patients with nocturnal hypoxia>10% and SaO2<90%, increased BMI, more NYHA Ⅲ and elevated NT-proBNP; while decreased mean oxygen saturation, minimum oxygen saturation, PaO2, 6 minute walk distance and cardiac index, all P<0.05. Drug therapy was similar between 2 groups. Conclusion: Nocturnal hypoxia and OSA were common in PH patients, elder age and male gender were the risk factors for PH combining OSA; the patients had lower partial pressure of oxygen especially at night, longer time of hypoxia and severer cardiac function damage. It is necessary to conduct sleep apnea monitoring to alert sleep apnea and hypoxia in relevant patients.

Analysis of the influence of nine occult HBV infection-related S-gene mutations on HBsAg detection / 解放军医学杂志

Objective To determine the reactivity of occult HBV infection (OBI)-related S-gene mutations to various anti-HBs antibodies (Abs) and HBsAg detection reagents.Methods Nine representative S-gene mutations M1-M9 (including 5 novel mutations M1-M5) from 1 OBI patient and 3 OBI blood donors were investigated.S-gene recombinant plasmids harboring 9 mutants or wild-type sequences constructed before were transfected into Chinese hamster ovary (CHO) cells,respectively.HBsAg expression levels and reactivity with various anti-HBs Abs and regular HBsAg detection reagents of all the mutants were analyzed.Results Compared to wild-type strain,intracellular HBsAg levels of the 9 mutants were obviously reduced upon Roche quantitative Elecsys assay.In contrast,analysis of the same samples using anti-His-tag Ab showed that the levels of HBsAg-Histag fusion protein were significantly reduced only in mutants M1,M6,and M7.The results of reactivity of mutant HBsAg against 6 anti-HBs Abs (S/CO values) showed that poor reactivity was observed for most mutants.Specifically,M1-,M4-,M7-,and M9-produced HBsAg with Ab4,and M9-produced HBsAg with Ab6 had the worst reactivity (S/CO＜1) compared to the wild-type.The results of reactivity of mutant HBsAg with 6 commercial HBsAg detection reagents showed that the reactivity for most mutants was significantly lower than that of the wild-type (P＜0.05).The miss rates of ELISA reagents D,E,and F were 11.1％,22.2％,and 55.6％,respectively.Conclusions Lower-affinity of studied mutant HBsAg with anti-HBs is one of the major causes of OBI presentation.The regular HBsAg detection reagents used currently in clinic show a significant deficiency in detection of the mutant HBsAg and thus need to be improved.

Effects of video games on neurological function and living ability in stroke patients with hemiplegia:a meta-analysis / 中华护理杂志

Objective To evaluate the effects of video games on neurological function and living ability in stroke patients by meta-analysis.Methods A computer retrieval of electronic databases was carried out to collect randomized controlled trials(RCTs) evaluating effects of video games for improving neurological function and living ability in stroke patients.The quality of included studies was critically evaluated and data was analyzed using RevMan 5.3 software.Results Totally 15 studies and 588 patients were included.Results of meta-analysis showed that neurological function and living ability could be improved by video games in stroke patients.For the same length of time as conventional rehabilitation,combination of video games and conventional rehabilitation had better effects on daily living ability than conventional rehabilitation.Adding a certain period of time of video games training on the basis of conventional rehabilitation had better effects on extremity motion function and daily living ability than conventional rehabilitation.Conclusion Video games together with conventional rehabilitation can better improve neurological function and daily living ability in stroke patients compared with conventional rehabilitation.

Simultaneous determination of five constituents in Maxing Kanggan Granules by HPLC / 中成药

AIM To establish an HPLC method for the simultaneous content determination of five constituents in Maxing Kanggan Granules (Isatidis Radix,Houttuyniae Herba,Scutellariae Radix,etc.).METHODS The analysis of 70％ ethanol extract of this drug was performed on a 30 ℃ thermostatic Wondasil C18 column (250 mm × 4.6 mm,5 μm),with the mobile phase comprising of acetonitrile-0.1％ phosphoric acid flowing at 1.0 mL/min in a gradient elution manner,and the detection wavelengths were set at 245,327,280 and 250 nm.RESULTS (R,S)-goitrin,chlorogenic acid,baicalin,baicalein and glycyrrhizic acid showed good linear relationships within the ranges of 0.24-6.05 μg/mL (r =0.999 9),0.70-17.40 μg/mL (r =0.999 9),28.59-714.70 μg/mL (r =0.999 6),1.67-41.65 μg/mL (r =0.999 5) and 2.59-64.80 μg/mL (r =0.999 7),whose average recoveries were 99.53％,99.41％,98.66％,98.31％ and 99.25％ with the RSDs of 1.02％,1.05％,1.26％,0.85％ and 1.43％,respectively.CONCLUSION This simple,accurate and reproducible method can be used for the quality control of Maxing Kanggan Granules.