Construction and application value of CT based radiomics model in predicting the prognosis of patients with gastric neuroendocrine neoplasm / 中华消化外科杂志

Objective:To construct of a computed tomography (CT) based radiomics model for predicting the prognosis of patients with gastric neuroendocrine neoplasm (GNEN) and inves-tigate its application value.Methods:The retrospective cohort study was conducted. The clinico-pathological data of 182 patients with GNEN who were admitted to 2 medical centers, including the First Affiliated Hospital of Zhengzhou University of 124 cases and the Affiliated Cancer Hospital of Zhengzhou University of 58 cases, from August 2011 to December 2020 were collected. There were 130 males and 52 females, aged 64(range, 56-70)years. Based on random number table, all 182 patients were divided into the training dataset of 128 cases and the validation dataset of 54 cases with a ratio of 7:3. All patients underwent enhanced CT examination. Observation indicators: (1) construction and validation of the radiomics prediction model; (2) analysis of prognostic factors for patients with GNEN in the training dataset; (3) construction and evaluation of the prediction model for prognosis of patients with GNEN. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and the chi-square test, corrected chi-square test or Fisher exact probability were used for comparison between groups. The Kaplan-Meier method was used to calculate survival rate and draw survival curve, and the Log-rank test was used for survival analysis. The COX regression model was used for univariate and multivariate analyses. The R software (version 4.0.3) glmnet software package was used for least absolute shrinkage and selection operator (LASSO)-COX regression analysis. The rms software (version 4.0.3) was used to generate nomogram and calibration curve. The Hmisc software (version 4.0.3) was used to calculate C-index values. The dca.R software (version 4.0.3) was used for decision curve analysis. Results:(1) Construction and valida-tion of the radiomics prediction model. One thousand seven hundred and eighty-one radiomics features were finally extracted from the 182 patients. Based on the feature selection using intra-group correlation coefficient >0.75, and the reduce dimensionality using LASSO-COX regression analysis, 14 non zero coefficient radiomics features were finally selected from the 1 781 radiomics features. The radiomics prediction model was constructed based on the radiomics score (R-score) of these non zero coefficient radiomics features. According to the best cutoff value of the R-score as -0.494, 128 patients in the training dataset were divided into 64 cases with high risk and 64 cases with low risk, 54 patients in the validation dataset were divided into 35 cases with high risk and 19 cases with low risk. The area under curve (AUC) of radiomics prediction model in predicting 18-, 24-, 30-month overall survival rate of patients in the training dataset was 0.83[95% confidence interval ( CI ) as 0.76-0.87, P<0.05], 0.84(95% CI as 0.73-0.91, P<0.05), 0.91(95% CI as 0.78-0.95, P<0.05), respectively. The AUC of radiomics prediction model in predicting 18-, 24-, 30-month overall survival rate of patients in the validation dataset was 0.84(95% CI as 0.75-0.92, P<0.05), 0.84 (95% CI as 0.73-0.91, P<0.05), 0.86(95% CI as 0.82-0.94, P<0.05), respectively. (2) Analysis of prognostic factors for patients with GNEN in the training dataset. Results of multivariate analysis showed gender, age, treatment method, tumor boundary, tumor T staging, tumor N staging, tumor M staging, Ki-67 index, CD56 expression were independent factors influencing prognosis of patients with GNEN in the training dataset ( P<0.05). (3) Construction and evaluation of the prediction model for prognosis of patients with GNEN. The clinical prediction model was constructed based on the independent factors influen-cing prognosis of patients with GNEN including gender, age, treatment method, tumor boundary, tumor T staging, tumor N staging, tumor M staging, Ki-67 index, CD56 expression. The C-index value of clinical prediction model in the training dataset and the validation dataset was 0.86 (95% CI as 0.82-0.90) and 0.80(95% CI as 0.72-0.87), respectively. The C-index value of radiomics prediction model in the training dataset and the validation dataset was 0.80 (95% CI as 0.74-0.86, P<0.05) and 0.75(95% CI as 0.66-0.84, P<0.05), respectively. The C-index value of clinical-radiomics combined prediction model in the training dataset and the validation dataset was 0.88(95% CI as 0.85-0.92) and 0.83 (95% CI as 0.77-0.89), respectively. Results of calibration curve show that clinical prediction model, radiomics prediction model and clinical-radiomics combined prediction model had good predictive ability. Results of decision curve show that the clinical-radiomics combined prediction model is superior to the clinical prediction model, radiomics prediction model in evaluating the prognosis of patients with GNEN. Conclusions:The predection model for predicting the prognosis of patients with GNEN is constructed based on 14 radiomics features after selecting. The prediction model can predict the prognosis of patients with GNEN well, and the clinical-radiomics combined prediction model has a better prediction efficiency.

Advances in research on altered cardiomyocyte autophagy and its regulatory mechanisms in the elderly / 中华老年医学杂志

Cardiomyocyte autophagy plays an important role in maintaining normal cardiac structure and function.Recent studies have shown that cardiomyocyte autophagy is decreased in the aging heart.The expression of autophagy-related genes Atg5, Atg7 and Beclin1 decreases in the aging myocardium.Decreased cardiomyocyte autophagy in the aging heart is associated with dysregulation of phosphatidylinositol-3-kinase(PI3K)/serine-threonine kinase(Akt)/mammalian target of rapamycin(mTOR), adenosine monophosphate-activated protein kinase(AMPK)and/or the SIRT1 signaling pathways.In addition, reactive oxygen species and some neural hormonal factors such as endothelin-1 can also mediate the decrease of cardiomyocyte autophagy in cardiac aging.The regulation of cardiomyocyte autophagy may provide new strategies for the prevention and treatment of cardiomyopathy in the elderly.

CT findings of gastritis cystica profunda / 中华放射学杂志

Objective:To explore the CT imaging and clinical features of gastritis cystica profunda (GCP) and improve the level of diagnosis.Methods:From June 2015 to August 2019, the clinical and CT imaging data of 9 GCP patients confirmed by pathology in the First Affiliated Hospital of Zhengzhou University were retrospectively collected. These 9 GCP patients included 3 male and 6 female, aged from 44 to 66 years, with an avereage age of (59±7) years. All the 9 patients underwent plain and enhanced abdominal CT scan. The location, shape, size, margin, density, enhancement pattern and enhancement degree of the lesions were analyzed and summarized.Results:The lesions are more common in gastric antrum (3 cases) and gastric fundus (3 cases). CT imaging showed thickening gastric wall thickening in 3 cases, circular ovoid or circular mass shadow protruding into the gastric cavity in 6 cases. Solid components were dominant in 2 cases and cystic components were dominant in 7 cases. In arterial phase, solid components showed significantly enhancement in 6 cases and moderate enhancement in 3 cases, while muscle layer of lesions were characterized by mild enhancement in 5 cases and moderate enhancement in 4 cases. In venous phase, solid components illustrated as significantly enhancement in 6 cases with progressive pattern and moderate enhancement in 3 cases, while the muscle layer of lesions were featured as progressive moderate enhancement in 4 cases and there is no significant enhancement in the rest 5 cases whose enhancement degree were similar to that of normal gastric wall. Additionally, the surface of the cyst covered with intact mucosa in 7 cases and in other 2 cases without complete mucosa.Conclusion:On the basis of accurate localization, CT scan could provide rich information including size, shape, internal structure and state around the lesion, which is of great value for the diagnosis of GCP.

Matched comparison of low kVp imaging and CT spectral imaging in image quality and radiation dose at abdominal CT / 中华放射学杂志

Objective To investigate the image quality and radiation dose of spectral CT with automatic spectral imaging mode selection (ASIS) and adaptive statistical iterative reconstruction (ASIR) at abdominal CT as compared with low-kVp CT with ASIR.Methods Two hundred patients underwent the plain and arterial-phase (AP) and portal venous-phase (PVP) contrast-enhanced abdominal CT scan were analyzed prospectively.The patients were randomly assigned to the control group (low-kVp CT scan) and study group (spectral CT scan),if BMI ≤ 23.9 kg/m2,patients were assigned into group A (80 kVp) or group B (spectral CT with ASIS);if 24.0 kg/m2 ≤ BMI＜28.9 kg/m2,patients were assigned into group C (100 kVp) or group D (spectral CT with ASIS)(n=50 each).Groups A and B,groups C and D were matched by gender,age,body mass index,cross sectional area and contrast agent dose respectively.Low-kVp images and monochromatic images (40 to 60 keV) were all reconstructed by using ASIR.Radiation dose and quantitative parameters (image noise in HU and contrast-to-noise ratio of the liver,aorta and portal vein) were compared by using t test while overall image quality was assessed by Mann-Whitney U test between the matched groups.Results Radiation dose in the group B was significantly higher than group A (increased by 10％,P＜0.05) but there was no significant differences between groups C and D (P＞0.05).Compared to the control group,image noises in the study group were higher at 40 keV and 50 keV (P＜0.05),but similar at 40 keV (P＞0.05).At the energy level of 40 keV,the study group showed higher CNRs,but lower overall image quality scores than the control group except for the similar image quality scores between groups A and B during AP (P＜0.05).At the energy level of 50 keV,the CNRs and overall image quality scores in the study group were higher than or similar to the control group.At the energy level of 60 keV,the study group showed lower or similar CNRs,but higher or similar overall image quality scores compared with the control group.Conclusions The radiation dose of spectral CT with ASIS technique was slightly higher than 80 kVp CT but similar to 100 kVp CT.By combining ASIR technique,monochromatic image at 50 keV can maintain or improve CNR and overall image quality as compared with low-kVp images.

Thevalueofmonochromaticenergyimagingderivedfrom RevolutionCTindetectingcoronary plaqueswithdifferentconcentrationofcontrastagent:aphantomexperiment / 实用放射学杂志

Objective Toexplorethevalueofmonochromaticenergyimaginggeneratedfrom RevolutionCTindetectingcoronary plaquesindifferentconcentrationsofcontrastagent.Methods Sixtesttubesnumbered3,4,5,6,8and9inthephantom wereselectedand filledupwithdifferentconcentrationsofiodinesolutions(20,10,5,2.5,0,13mgI/mL,respectively),fishbonesimulatingcalcified plaqueandstreakyporksimulatinglipid/fibrousplaque.EachtubeunderwentspectralCTscan(studygroup,70keV monochromatic energyimaging)and120kVpCTscan (controlgroup)respectivelyinRevolutionCT.Theabilityofplaquedetectionwasevaluated subjectively,andfurtheranalysis was madeontheimages withascoregreaterthanorequaltothreepoints.One-way ANOVA and Bonferroni m ethod w ere used to co m pare the C T values and C N R in different tubes in the intra-group co m parison ,w hile paired t test and M ann-W hitney U testwereusedfortheinter-groupcomparison.Results TheoverallimagequalityofNo.4,5and9testtubes inbothgroupsmettheclinicaldiagnosticlevel.Intheintra-groupcomparison,No.5testtubeshowedhigherCNRofcalcifiedplaque andNo.9testtubeshowedhigherCNRoflipidplaqueandfibrousplaquethantheothers(t=4.105-29.214,allP<0.001).Whilein theinter-groupcomparison,thestudygroupshowedsimilarCNRofcalcifiedplaqueinNo.9testtube(t=-1.576,P=0.130)tothecontrol group,andhigherCNRintheothersthanthecontrolgroup(Z=-4.074--3.815,t=-14.782--3.520,allP<0.05).Conclusion Comparedwith120kVpCTimages,monochromaticenergyimagingat70keVfrom RevolutionCTshowedbetteroverallimagequality andcoulddisplaycoronaryplaquesbetterwiththecontrastagent concentrationfrom5mgI/mLto13mgI/mL.

Clinical efficacy of stereotactic radiation therapy combined with temozolomide on recurrent brain glioma / 中南大学学报(医学版)

Objective:To investigate the clinical efficacy of stereotactic radiation therapy combined with temozolomide on recurrent glioma.Methods:A total of 36 patients with recurrent glioma were retrospectively analyzed and divided into a control group (n=12),who received stereotactic radiation therapy,and an experimental group (n=24),who received stereotactic radiation therapy plus temozolomide.The clinical efficacy and adverse reactions for the 2 groups were compared.Results:Total effective rate and local control rate for clinical treatment were 66.67％ and 93.94％,respectively.Late adverse reaction was not observed.The effective rate and local control rate in the experimental group were 77.27％ and 95.45％,which were slight higher than those in the control group,with no statistical significance (P＞0.05).The 0.5-,1-,2-,3-year follow-up total survival rates were 90.91％,63.64％,42.42％,and 15.15％,respectively.The 0.5-,1-,2-,3-year follow-up survival rates in the experimental group were 95.45％,72.72％,54.54％ and 22.73％,respectively,while those in the control group were 81.82％,45.45％,18.18％,and 0％,respectively.Survival analysis showed the survival time for the experimental group was significantly longer than that of the control group (30.00 months vs 14.00 months,P=0.010).Conclusion:Stereotactic radiation therapy combined with temozolomide for recurrent glioma is effective,and it has positive effect on improving the clinical efficacy and survival rate for the patients.

Abdominal CT with low radiation dose in obese patients: application of wide-detector helical CT combined with adaptive statistical iterative reconstruction-V (ASIR-V) / 中华放射医学与防护杂志

Objective To investigate the value of wide-detector helical CT combined with adaptive statistical iterative reconstruction-V (ASIR-V) in the low radiation dose CT examination of upper abdomen in obese patients.Methods In the first phantom experiment part,the optimal percentage of pre-and post-ASIR-V of abdominal scanning (120 kVp,NI =10 HU) were explored.The second human experiment was performed based on the phantom study,and our institutional review board approved this prospective study,each participant provided written informed consent.87 obese patients (body mass index,BMI ≥30 kg/m2) underwent contrast-enhanced abdominal CT scan were randomly divided into two scan protocols [protocol A:n =43,120 kVp,detector coverage of 80 mm,40％ pre-ASIR-V (group A1)and combined with 60％ post-ASIR-V (group A2) respectively;protocol B,n =44,120 kVp,detector coverage of 40 mm,40％ ASIR (group B)].Quantitative parameters [image noise and contrast-to-noise ratio (CNR)] and qualitative visual parameters (overall image quality as graded on a 5-point scale) were compared.Weighted effective dose (E) were assessed.Results The optimal percentage of pre-and post-ASIR-V of abdominal scanning were 40％ and 60％,respectively.The effective radiation dose in protocol A [(4.55 ± 0.95) mSv] was decreased for 53％ as compared with protocol B [(9.58 ± 2.04) mSv](t =-14.773,P ＜ 0.001).During the arterial phase and portal venous phase,except for the CNRs of liver,Group A2 showed higher CNRs (q =2.160-3.209,P ＜ 0.05),lower image noise(q =-4.212--3.202,P＜0.05),and higher overall image quality scores(Z =-5.155--2.561,P ＜0.05) as compared with group A1 and group B.Group A1 showed similar CNRs,similar image noise(P ＞ 0.05),and lower overall image quality scores (Z =-3.298--3.030,P ＜ 0.05) than group B.The overall image quality scores in group A were all greater than 3 point and met the clinical diagnostic level.Conclusions Compared with stand-detector helical CT in obese patients,the wide-detector helical CT combined with 40％ pre-ASIR-V could reduce the radiation dose by 53％,and improve overall image quality by combining post-ASIR-V technique.

Advanced gastric cancer reproducibility of region of interests in spectral CT imaging and their relationship with micro-vessel density / 中华放射学杂志

Objective To determine the consistency of spectral CT parameters in advanced gastric cancer using different region of interests (ROIs) and their relationship with tumor micro-vessel density (MVD).Methods Thirty patients with histologically proven gastric cancer were prospectively enrolled.All the patients were examined using spectral-dual-phase-abdominal CT and treated successfully with radical surgery within 2 weeks after CT scanning.Two observers independently acquired iodine concentration(IC), normalized IC(nIC),and CT value at workstation using three different ROI protocols:10 mm2 circular ROI near tumor border where enhanced obviously,30 mm2 near the tumor center and the freehand outline ROI. The Data of the two observers were tested with interclass correlation coefficient (ICC) and Bland-Altman plot.The mean value of each parameter was documented as the final result.Differences of each group of ROI data were compared using ANOVA test. All the specimen were pathologically examined and MVD was counted. The relationship of each parameter to tumor MVD was analyzed by Pearson correlation. Results All of the IC,nIC and CT values obtained by the 2 observers using three ROI measurements were consistent well,and the ROI-outline had the highest ICC than that of smaller circular ROIs(ICC:0.991 to 0.997).The 95% differences confident interval of nIC-AP and nIC-VP using freehand outline ROI by two observers were-0.003 to 0.002 and -0.001 to 0.012, respectively. The outline-ROI method had better inter-observer accuracy. There were significant differences between the means of the all parameters with three ROI protocols (P<0.05). Values of ROI-10 mm2 were highest, while the values of ROI-outline were lowest (P<0.05).The mean counts of tumor MVD was(29.0±8.4)/high magnification.The nIC in venous phase(VP)had good correlations with intra-tumoral MVD, especially the ROI-outline (r=0.670, P<0.01), within different ROI measurements.Conclusions The different ROI selection in tumor has significant impact on the final CT parameters. Outlined ROI protocol improves inter-observer consistency and nIC-VP obtained by this method can indirectly reflect the condition of tumor angiogenesis.

Prevalence and influencing factors of peritoneal calcification in patients with long peritoneal dialysis duration / 中华肾脏病杂志

Objective To investigate the prevalence and related factors of peritoneal calcification in peritoneal dialysis(PD)patients with long dialysis duration,and to explore the relationship between peritoneal calcification and vascular calcification.Methods This cross-section study enrolled PD patients who had received PD for more than 4 years in Peking University People's Hospital.Peritoneal calcification and abdominal aortic calcification were reviewed by CT scan.Demographic data,clinical characteristics,laboratory data including calcium phosphorus metabolism indexes(Ca,P,ALP and iPTH)and PD adequacy were collected.The influencing factors of peritoneal calcification were analyzed by Logistic regression analysis.The correlation between peritoneal calcification and abdominal aortic calcification were tested by Spearman correlation analysis.SPSS 19.0 was used for statistical analysis.Results(1)Seventy-nine PD patients were enrolled:32 males(40.5％);mean age was(58.7±13.1)years and average PD duration was 77.25(58.00,88.00)months.The major primary diseases were glomerulonephritis(46.8％)and diabetic nephropathy(30.4％).(2)6 patients(7.6％)had CT-detectable peritoneal calcification.77(97.5％)patients were found with various degrees of peritoneal thickening.The prevalence of peritoneal calcification was 7.6％in patients with PD duration more than 4 years,10.3％in patients with PD duration more than 6 years,18.8％in patients with PD duration more than 8 years and 40.0％in patients with PD duration more than 10 years,showing an increasing trend.Compared with non-peritoneal calcification group,the patients in peritoneal calcification group received higher doses of Vitamin D(P ＜ 0.001)and lower triglyceride levels(P=0.041).The patients were divided into two groups according to whether dialysis duration was longer than 9 years,and the proportion of patients with long PD duration in peritoneal calcification group was higher(P=0.013).Logistic regression analysis showed that PD duration,calcium and phosphorus metabolism indexes were not independent risk factors of peritoneal calcification.High vitamin D dose was an independent risk factor for peritoneal calcification(B=2.667,OR=14.394,95％CI 1.655-125.165,P=0.016).(3)74 patients were found with abdominal aortic calcification in different degrees,and the prevalence rate of abdominal aortic calcification was 93.7％.Spearman correlation analysis showed that there was no correlation between peritoneal calcification and vascular calcification(r=0.70,P=0.542).Conclusions The prevalence of peritoneal calcification in long PD duration patients is low.Peritoneal calcification may be associated with high Vitamin D dose and long PD duration.

Effects of seasonal changes on peritoneal dialysis associated peritonitis in peritoneal dialysis patients / 中华肾脏病杂志

Objectives To investigate the effects of seasonal changes on peritoneal dialysis associated peritonitis (PDAP) in patients on peritoneal dialysis (PD),and to provide evidence for clinical prevention and treatment of PDAP.Methods All episodes of PD-related peritonitis during clinic follow-up in maintenance PD patients from Jan 1st,2007 to Dec 31st,2015 in Peking University People's Hospital were reviewed.The incidence of peritonitis,laboratory indexes,pathogens and clinical outcomes in different seasons were recorded and analyzed.One-way ANOVA and chi square test were employed to compare the incidence of PDAP and related data in different seasons,and Pearson correlation was used to analyze correlations between PDAP rate and monthly mean temperature and mean humidity.Results During nine years,a total of 119 PD patients occurred 190 times of peritonitis during home PD.The PDAP rate in summer was the highest,0.21 episodes/year,followed by spring (0.16 episodes/year) and autumn (0.16 episodes/risk year),but there was no significant difference among peritonitis rates in four seasons.There were significant positive correlation between monthly mean temperature,monthly mean humidity and the peritonitis rate (mean temperature:r=0.828,P ＜ 0.01;mean humidity r=0.657,P ＜ 0.05).(2) As for bacteria,in Summer the PDAP rate caused by Staphylococcus aureus and Coagulase negative staphylococcus (CoNS),and Gram-negative bacteria was higher than that in other seasons,but there was no statistical difference.There were significant positive correlation between monthly mean temperature,mean humidity and the rate of CoNS peritonitis (mean temperature:r=0.704,P ＜ 0.05;mean humidity:r=0.607,P ＜ 0.05).(3) There were no statistical difference among results of PD related peritonitis in different seasons about general situation,clinical manifestation,causes of peritonitis and laboratory index before peritonitis episodes.PD procedure-related problems were the main cause of peritonitis in summer and autumn.(4) The cure rate of all peritonitis was 90％.The highest cure rate was in autumn and winter,while the lowest cure rate was in summer,but no statistical difference.Among the peritonitis episodes with treatment failure,52.6％ occurred in summer.Conclusions There is some correlation between the rate of PDAP and seasons.Higher temperature and higher humidity were significantly correlated with higher peritonitis rate,especially the rate of CoNS peritonitis.The prognosis of PDAP in summer was relatively poor,with higher proportion of hospitalization and lower cure rate.

Discussion on robot-assisted laparoscopic cystectomy and Ileal neobladder surgery preoperative care

To investigate the clinical applications of robot-assisted radical cystectomy with orthotopic ileal neobladder [RARC-INB] and make a preliminary summary. Retrospective analysis the clinical data of 12 patients underwent robotic bladder cancer [da vinci surgical system] assisted laparoscopic cystectomy with ileal orthotopic neobladder from March 2015 to April 2015. 12 cases were successful, with no surgical intervention, and organ damage occurred. The operation time was 330470 min, which average [390.0 +/- 61.5] min; blood loss was 90870 ml, which average [185.0 +/- 88.3] ml. One case of intraoperative blood transfusion was 400 ml. The enjoin eating time of postoperative intestinal ventilation was 36 d, and the average time was [4.0 +/- 1.5] d. Removal of ureteral stents time was 1428 d and the average time was [21 +/- 7] d. Removal of the catheter time was 1828 d and the average time was [23 +/- 5] d. Postoperative hospital stay 1929 d and the average time was [24 +/- 5] dRARC-INB make the surgical tends to simplify, which was conducive to surgeon intraoperative control and assurance. RARC-INB make the surgical tends to use less trauma, less bleeding, complete lymphadenectomy, quick recovery, etc. It is a safe, effective and reliablethe method in the treatment of invasive bladder cancer. So the method should be widely applied

Insulin resistance in non-diabetic peritoneal dialysis patients and its influencing factors / 中华肾脏病杂志

Objective To observe insulin resistance (IR) in non-diabetic peritoneal dialysis (PD) patients,and analyze its related factors.Methods The non-diabetic PD patients who had been on stable PD at least three months were eligible to enroll.The patients were measured for their height,weight,waist to hip ratio,fasting glucose,fasting insulin,lipids and other biochemical indicators,dialysis adequacy indicators in August 2012,and divided into two groups depended on median HOMA-IR in August 2012.Results A total of 56 patients were enrolled and divided into two groups according to median HOMA-IR,including high IR group (HOMA-IR≥ 1.79,n=29) and low IR group (HOMA-IR ＜ 1.79,n=27).Compared to low IR group,high IR group were older [(57.9±14.2) years vs (48.7±14.5) years],had higher daily dialysate glucose load [(138.7±28.5) mmol/L vs (114.0± 21.5) mmol/L],higher waist-to-hip ratio [(0.91±0.08) vs (0.86±0.07)],higher BMI [(23.0±3.0) kg/m2 vs (21.2±3.1) kg/m2],higher triglycerides [(2.51±1.36) mmol/L vs (1.42±0.48) mmol/L],lower high-density lipoprotein cholesterol [(1.00±0.27) mmol/L vs (1.23±0.32) mmol/L],and lower Kt/V [(1.74±0.37) vs (2.08±0.56)].Multivariate logistic regression showed that age (β=0.122,P=0.033),triglycerides (β=1.798,P=0.030) and daily dialysate glucose load (β=0.094,P=0.031) associated with the degree of insulin resistance.Conclusion More dialysate glucose exposure is a risk factor of the occurrence of insulin resistance in non-diabetic patients with peritoneal dialysis.

Influence of hepatic oval cell on the expression of ERK and P38MAPK signaling pathway protein in liver tissue of murine hepatofibrosis / 中华普通外科杂志

Objective To observe the influence of hepatic oval cell (HOC) on the expression ERK and P38MAPK signaling pathway protein in liver tissue of murine experimental hepatofibrosis (HF).Method SD rats were fed with 10% ethanol and food with high-fat and low-protein, and were injected subcutaneously with carbontetrachloride once every four days for 8 weeks to establish hepatic fibrosis. HOGs were isolated from male HF rats by collagenase porfusion of the liver. HF rats at 8th week were transplanted with 0. 5 ml HOC suspension medium at a density of 1 × 109 cell /ml via portal vein, and the rats were sacrificed at 8th, 15th, 30th day respectively. Histopathologic changes of liver tissues were observed by HE and Masson. The expression of ERK and P38MAPK signaling pathway protein were determined by Western blotting. Result Hepatofibrosis was reversed and the degree of hyperplasia fibrilcollagen in hepatic fibrosis rats decreased significantly by HOC transplantion. HOC down-regulated the protein expression of Ras, ERK,p-ERK, c-fos, c-jun, STAT3, ALB, FGF-3, PCNA ( F = 91.88,36.28,54.66,93.07,64.76,58.49,52.63,20.45 ,27.03, all P ＜ 0.05 ), up-regulated the protein expression level of HNF-α1, PDGF-Rβ significantly in liver tissues(F = 18.63,25.99,P ＜0.05). Conclusions HOC improves the degree of hepatofibrosis through inhibiting hyperplasia of collagen fibril in liver tissue of hepatofibrosis rats. With the presence of HOC the expression of c-fos,c-jun,STAT3,5 was not activated by p-P38MAPK. The expression of c-kit and HNF-1α increased and that liver tissue injury alleviated, and hepatofibrosis was improved.

Integrated intervention in management of type 2 diabetes / 中华内分泌代谢杂志

Objective To test the effectiveness of an integrated intervention to improve control and management of type 2 diabetic patients.Methods The study was designed as a randomized and multi-center clinic trial for 24 weeks.150 overweight patients from 2 companies and one hospital in Shanghai were recruited.The principal objective of the project was to compare the effectiveness of a structured diabetes management program consisting of 200 kcal breakfast as a meal replacement with low glycemic index (GI),scheduled blood glucose monitoring(6 times per week),low GI diet consulting,monitoring and medical check up and nutritional education (diet consulting,health education on nutrition and healthy lifestyle) in overweight individuals with type 2 diabetes.Results At 12th week,the level of fasting blood glucose(FBG) in both groups decreased by 16.5% and 10.6%,and at 24th week,the FBG also decreased by 25.0% in intervention group,but in control group FGB increased 2.8% (P＜0.01).Meanwhile,there were 8.2% and 11.1% reductions in HbA1C respectively at 12th week and at 24th week in intervention group,while the values were increased slightly in control group(P＜0.01).Compared with control group,waist circumference,hip circumference,and blood pressure were significantly reduced after treatment for 24 weeks in intervention group (P＜0.01).Conclusions Integrated intervention is an effective approach in managing FBG,HbA1C blood pressure,and weight control in overweight diabetic patients.

Research of chitosan nanoparticles loaded with gene / 国际生物医学工程杂志

The technique of RNA interference has been used in the area of cardiovascular system. Chitosan nanoparticles(CS-NP) has been a hotspot of the research due to its good biological characteristics and has a great potential to be used as the carrier for gene delivery. This article gives a simple review the application of the techniques, the currently used preparation methods of CS-NP, the factors that affect the rate of complexing of plasmid with CS-NP, the transfection efficiency of plasmid CS-NP compounds, and its in vitro drug releasing behavior.

Determination of Alkaloid in Cut Crude Drug of Aconite Root by LC-MS / 中国中医药信息杂志

Objective To establish a method for the determination of Alkaloid in cut crude drug of aconite root.Method Contents of aconitine,hypaconitine and mesaconitine incrude drug of aconite root were determined by LC-MS.It was carried out on Inertsil ODS-3 column(150 mm?4.6 mm,5 ?m),with acetonitrile-ammonium acetate buffer solution(60:40) as mobile phase,at a flow rate of 0.2 mL/min and temperature of 30 ℃.Result The method of determining Alkaloid content in crude drug of aconite root was established and 25 lots of crude drugs were determined.Conclusion The method was sensitive and specifical,can be used to control the quality of cut crude drug from aconite root.

Two conditional media promoting the differentiation murine embryonic stem cells into hematopoietic stem cells / 中南大学学报(医学版)

Objective To derive hematopoietic stem cells with functional properties of hematopoietic reconstitution from murine embryonic stem (ES) cells. Methods ES-D3 cells by formation of the day-4 embryoid bodies (4dEBs) were induced into hematopoietic stem cells by co-culture with murine bone marrow endothelial cell-conditional medium (mBMEC-CM) and the fetal liver stromal cell-conditional medium (FLSC-CM). This experiment was designed to 4 groups (mBMEC-CM + FLSC-CM group, mBMEC-CM group, FLSC-CM group, and the control group). Results The total cell numbers, CD34 + cell numbers, and colony numbers formed in the mBMEC-CM + FLSC-CM group were the highest among the 4 groups. The cells in the mBMEC-CM + FLSC-CM group resumed the hematopoietic system of the mice after being transplanted with the inducing cells. Conclusion The culture condition combing mBMEC-CM with FLSC-CM can promote murine ES cells differentiating into hematopoietic stem cells with functional properties of hematopoietic reconstitution.

Severe uremic lung:A case report and review / 北京大学学报(医学版)

We investigated the clinical and photographic characteristics of uremic lung and review the associated literature,so as to improve the diagnostic and therapeutic abilities of uremic lung.The clinical symptoms and signs together with the photographic characteristics of the patient who was diagnosed as uremic lung complicated with pulmonary infection and congestive heart failure in our division were analysed and the associated literature was reviewed.The patient was admitted for the complaint of cough,expectoration and dyspnea.He was diagnosed as chronic renal failure with pulmonary infection and congestive heart failure.The symptoms alleviated after adequate hemodialysis and antibiotic therapy.However,mild dyspnea remained with photographic examination still showing consolidation in the lungs.The diagnosis of uremic lung was established after the exclusion of pulmonary infections of other pathogens and tumor.After 8-month maintenance hemodialysis,the pulmonary lesions were thoroughly absorbed.Uremic lung is a common complication of end-stage renal failure.The diagnosis is established after the exclusion of cardiac pulmonary edema,pulmonary infections and tumors.Sufficient hemodialysis is the most adequate treatment for uremic lung.Abstract:SUMM ARY W e investigated the clinical and photographic characteristics of urem ic lung and review the associated literature,so as to improve the d iagnostic and therapeutic abilities of urem ic lung.The clinical symptoms and signs togetherwith the photographic characteristics of the patientwho was d iagnosed as ure-m ic lung complicated with pulmonary infection and congestive heart failure in our d ivision were analysed and the associated literature was reviewed.The patientwas adm itted for the complaint of cough,expecto-ration and dyspnea.He was d iagnosed as chronic renal failure with pulmonary infection and congestive heart failure.The symptoms alleviated after adequate hemod ialysis and antibiotic therapy.However,m ild dyspnea remained with photographic exam ination still showing consolidation in the lungs.The d iagnosis of urem ic lung was established after the exclusion of pulmonary infections of other pathogens and tumor.Af-ter 8-month maintenance hemod ialysis,the pulmonary lesionswere thoroughly absorbed.Urem ic lung is a common complication of end-stage renal failure.The d iagnosis is established after the exclusion of card iac pulmonary edema,pulmonary infections and tumors.Sufficient hemod ialysis is the most adequate treat-ment for urem ic lung.

Effects of low molecular weight heparin on vascular endothelial growth factor expression of early diabetic nephropathy / 北京大学学报(医学版)

Objective: To investigate the effects of low molecular weight heparin(LMWH) on vascular endothelial growth factor(VEGF) expression of early diabetic nephropathy. Methods: Ninety-five male SD rats were randomly divided into three groups: normal control rats, STZ-induced diabetic rats and diabetic rats treated with LMWH. The renal tissues were subjected to immunohistochemical staining after 1,2,4,6,and 8 weeks’ treatment respectively to quantify the VEGF expression. Results: Immunohistochemical staining demonstrated an increasing in VEGF positive cells in diabetic rats. It was found that there were significant differences in VEGF staining intensity between diabetic rats and normal control rats and between LMWH treated rats and untreated diabetic rats after two weeks treatment. Conclusion: The inhibition of VEGF expression may be one of the mechanisms of LMWH’s renal protective effects on early diabetic nephropathy.

Experimental Study on Bupleuri in Combination With Saliva Miltiorrhiza in Treatment of Hepatic Fibrosis in Rats / 中国药房

OBJECTIVE:To investigate the effects of Bupleuri plus Saliva miltiorrhiza on preventing the formation of hepatic fibrosis in rats METHODS:To establish an animal model of hepatic fibrosis by feeding high fat diet and 10% alcohol and subcutaneously injecting CCl4 and to detect the zymogram and biochemical parameters and observe the pathological changes of liver tissue RESULTS:Bupleuri and Saliva miltiorrhiza could significantly depress the activities of ALT,AST,MAO,ALP and had no influence on the ?-GT in serum,the serum TG was decreased and TG in tissue was obviously raised and serum GSH was elevated in hepatic fibrosis rat The extract could significantly decreased the levels of PC Ⅰ and PC Ⅲ in hepatic fibrosis rat The histopathological examination showed that the extract could diminish liver degeneration and necrosis,and block the formation of fiber diazoma,the degree of collagen proliferation was significantly lower than that of the control group CONCLUSION:Bupleuri and Saliva miltiorrhea extract could effectively protect the liver cell,and could retard the formation of hepatic fibrosis as well