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Objective:To examine the expression of core clock genes in the peripheral blood mononuclear cells (PBMCs) and the level of circadian disturbance-related proteins in the serum of chronic pancreatitis (CP) patients with pancreatic exocrine insufficiency (PEI), and explore their potential diagnostic value in clinical practice.Methods:The peripheral blood samples and related clinical data from 68 patients diagnosed with CP in Shanghai General Hospital from Jan 2015 to Jan 2022 were collected. Peripheral blood samples from 30 healthy individuals were used for control. The M-ANNHEIM classification system was used to stratify the clinical stages of patients with CP. The mRNA expression of the core clock genes, including Clock, Bmal1, Per1/2/3 and Cry1/2 in PBMCs was analyzed using realtime qPCR, and the expression of circadian disturbance-related proteins like TrkB, CD 36 and Rbp in serum was measured with ELISA. The receiver operating characteristic curve(ROC) and the area under curve (AUC) was used to test the efficiency for diagnozing PEI. Results:The mRNA expression of Per1 in CP patients was significantly decreased (0.76 vs 1, P<0.05), and the AUC for diagnozing PEI was 0.744 (95% CI 0.628-0.860), with a cut-off value of 0.72; and the sensitivity and specificity was 84.8% and 57.1%, respectively. The protein abundance of serum CD 36 was significantly increased in CP patients (33.85±19.74ng/ml vs 24.71±11.53 ng/ml, P<0.05); the AUC for diagnozing PEI was 0.834 (95% CI 0.735-0.932), with a cut-off value of 29.75 pg/ml; and the sensitivity and specificity was 74.3% and 84.8%, respectively. The expression of CD 36 was increased with the increase of CP clinical stage, and there were statistically significant differences between either two stages (all P value <0.05). The mRNA expression of Per1 in patients with CP in Stage Ⅰ was significantly higher than that in patients with CP in Stage Ⅱ or Ⅲ, and the differences were statistically significant ( P<0.05), but no statistical difference was found between Stage Ⅱ and Stage Ⅲ. Conclusions:The decreased expression of Per1 mRNA in PBMCs and increased level of CD 36 in serum are significantly related to the occurrence of PEI in CP, suggesting that they may have potential value for diagnozing PEI and guiding the clinical practice.
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Objective:To evaluate the effectiveness of contrast-enhanced ultrasound in the differential diagnosis of atypical adenomyosis and fibroids using a decision tree model.Methods:The data of cases with difficulty in differentiating atypical adenomyosis from fibroids on conventional ultrasound examination at Shengjing Hospital of China Medical University from April 2021 to April 2022 were selected and analyzed. Ninety-five patients with contrast-enhanced ultrasound examination were finally selected, including 64 patients in the pathologically confirmed adenomyosis group and 31 patients in the fibroids group. The data from the qualitative analysis and the quantitative analysis of the time-intensity curve (TIC) curve were collected separately, including the temporal variability of contrast entry into the lesion, i.e.the difference between the time when the contrast agent started to enter the lesion and the time when the contrast agent finally filled the lesion completely. Indicators were first screened for inclusion in the decision tree model by univariate and multifactorial analyses, and decision tree models based on qualitative analysis indicators, and qualitative and TIC-based analyses were developed to further assess the diagnostic efficacy of both models.Results:Through the univariate analysis, it showed that the qualitative analysis indicators of lesion onset enhancement pattern, enhancement intensity, intra-lesion contrast distribution, and post-contrast lesion border were of statistical significance (all P<0.05) between the two groups. The differences in contrast arrive time (AT), contrast time to peak (TTP), |ΔAT|, and |ΔTTP| in the TIC curve analysis indexes were statistically significant between the two groups (all P<0.05). The difference in lesion temporal phase variability was statistically significant between the two groups ( P<0.05). After further screening by multifactorial analysis, the accuracy and misdiagnosis rates were 87.40% and (17.90±3.90)% in the qualitative analysis-based decision tree model respectively, and 90.50% and (21.10±4.20) % in the qualitative and TIC curve-based analysis decision tree model respectively. The ROC curves were plotted according to the two groups of models, and the areas under the curves were 0.915 and 0.931 respectively. Conclusions:A decision tree model based on ultrasonographic image analysis has diagnostic value for the differential diagnosis of atypical adenomyosis and uterine fibroids.
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There is an accumulating body of evidence implicating the muscarinic acetylcholine receptor 4 (M4) in schizophrenia and dementia with Lewy bodies, however, a clinically validated M4 positron emission tomography (PET) radioligand is currently lacking. As such, the aim of this study was to develop a suitable M4 PET ligand that allows the non-invasive visualization of M4 in the brain. Structure-activity relationship studies of pyrazol-4-yl-pyridine derivates led to the discovery of target compound 12 - a subtype-selective positive allosteric modulator (PAM). The radiofluorinated analogue, [18F] 12, was synthesized in 28 ± 10% radiochemical yield, >37 GBq/μmol and an excellent radiochemical purity >99%. Initial in vitro autoradiograms on rodent brain sections were performed in the absence of carbachol and showed moderate specificity as well as a low selectivity of [18F] 12 for the M4-rich striatum. However, in the presence of carbachol, a significant increase in tracer binding was observed in the rat striatum, which was reduced by >60% under blocking conditions, thus indicating that orthosteric ligand interaction is required for efficient binding of [18F] 12 to the allosteric site. Remarkably, however, the presence of carbachol was not required for high specific binding in the non-human primate (NHP) and human striatum, and did not further improve the specificity and selectivity of [18F] 12 in higher species. These results pointed towards significant species-differences and paved the way for a preliminary PET study in NHP, where peak brain uptake of [18F] 12 was found in the putamen and temporal cortex. In conclusion, we report on the identification and preclinical development of the first radiofluorinated M4 PET radioligand with promising attributes. The availability of a clinically validated M4 PET radioligand harbors potential to facilitate drug development and provide a useful diagnostic tool for non-invasive imaging.
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Urinary tract infection (UTI) is one of the most common infectious diseases. It has the characteristics of high recurrence rate and prolonged course. At present, the problem of antibiotic resistance is becoming more and more serious, the incidence of adverse reactions is high, and the disadvantages of long-term administration appear, which brings severe challenges to the treatment of recurrent urinary tract infection. The prevention and treatment of UTI recurrence has become the focus of research. Recurrent urinary tract infection is related to the immune regulation mechanism of the body. Administration of immune regulation can provide new ideas for prevention and treatment. The vaccine based on immune regulation to prevent rUTI has made some progress. It can not only reduce the frequency of recurrences, but also decrease related symptoms. At the same time, the vaccine has good tolerance, high safety and good application prospect. This paper aims to summarize the progress of immune regulation and immune vaccines in vivo and clinical research.
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Lipid metabolism disorders contribute to hyperlipidemia and hepatic steatosis. It is ideal to develop drugs simultaneous improving both hyperlipidemia and hepatic steatosis. Nitazoxanide is an FDA-approved oral antiprotozoal drug with excellent pharmacokinetic and safety profile. We found that nitazoxanide and its metabolite tizoxanide induced mild mitochondrial uncoupling and subsequently activated AMPK in HepG2 cells. Gavage administration of nitazoxanide inhibited high-fat diet (HFD)-induced increases of liver weight, blood and liver lipids, and ameliorated HFD-induced renal lipid accumulation in hamsters. Nitazoxanide significantly improved HFD-induced histopathologic changes of hamster livers. In the hamsters with pre-existing hyperlipidemia and hepatic steatosis, nitazoxanide also showed therapeutic effect. Gavage administration of nitazoxanide improved HFD-induced hepatic steatosis in C57BL/6J mice and western diet (WD)-induced hepatic steatosis in Apoe -/- mice. The present study suggests that repurposing nitazoxanide as a drug for hyperlipidemia and hepatic steatosis treatment is promising.
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Monoacylglycerol lipase (MAGL) is a pivotal enzyme in the endocannabinoid system, which metabolizes 2-arachidonoylglycerol (2-AG) into the proinflammatory eicosanoid precursor arachidonic acid (AA). MAGL and other endogenous cannabinoid (EC) degrading enzymes are involved in the fibrogenic signaling pathways that induce hepatic stellate cell (HSC) activation and ECM accumulation during chronic liver disease. Our group recently developed an 18F-labeled MAGL inhibitor ([18F]MAGL-4-11) for PET imaging and demonstrated highly specific binding in vitro and in vivo. In this study, we determined [18F]MAGL-4-11 PET enabled imaging MAGL levels in the bile duct ligation (BDL) and carbon tetrachloride (CCl4) models of liver cirrhosis; we also assessed the hepatic gene expression of the enzymes involved with EC system including MAGL, NAPE-PLD, FAAH and DAGL that as a function of disease severity in these models; [18F]MAGL-4-11 autoradiography was performed to assess tracer binding in frozen liver sections both in animal and human. [18F]MAGL-4-11 demonstrated reduced PET signals in early stages of fibrosis and further significantly decreased with disease progression compared with control mice. We confirmed MAGL and FAAH expression decreases with fibrosis severity, while its levels in normal liver tissue are high; in contrast, the EC synthetic enzymes NAPE-PLD and DAGL are enhanced in these different fibrosis models. In vitro autoradiography further supported that [18F]MAGL-4-11 bound specifically to MAGL in both animal and human fibrotic liver tissues. Our PET ligand [18F]MAGL-4-11 shows excellent sensitivity and specificity for MAGL visualization in vivo and accurately reflects the histological stages of liver fibrosis in preclinical models and human liver tissues.
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Pharmaceutical cocrystals are multicomponent systems in which at least one component is an active pharmaceutical ingredient and the others are pharmaceutically acceptable ingredients. Cocrystallization of a drug substance with a coformer is a promising and emerging approach to improve the performance of pharmaceuticals, such as solubility, dissolution profile, pharmacokinetics and stability. This review article presents a comprehensive overview of pharmaceutical cocrystals, including preparation methods, physicochemical properties, and applications. Furthermore, some examples of drug cocrystals are highlighted to illustrate the effect of crystal structures on the various aspects of active pharmaceutical ingredients, such as physical stability, chemical stability, mechanical properties, optical properties, bioavailability, sustained release and therapeutic effect. This review will provide guidance for more efficient design and manufacture of pharmaceutical cocrystals with desired physicochemical properties and applications.
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As a serine hydrolase, monoacylglycerol lipase (MAGL) is principally responsible for the metabolism of 2-arachidonoylglycerol (2-AG) in the central nervous system (CNS), leading to the formation of arachidonic acid (AA). Dysfunction of MAGL has been associated with multiple CNS disorders and symptoms, including neuroinflammation, cognitive impairment, epileptogenesis, nociception and neurodegenerative diseases. Inhibition of MAGL provides a promising therapeutic direction for the treatment of these conditions, and a MAGL positron emission tomography (PET) probe would greatly facilitate preclinical and clinical development of MAGL inhibitors. Herein, we design and synthesize a small library of fluoropyridyl-containing MAGL inhibitor candidates. Pharmacological evaluation of these candidates by activity-based protein profiling identified
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Purpose@#Gastric cancer (GC) has substantial biological differences between Asian and non-Asian populations, which makes it difficult to have a unified predictive measure for all people. We aimed to identify novel prognostic biomarkers to help predict the prognosis of Asian GC patients. @*Materials and Methods@#We investigated the differential gene expression between GC and normal tissues of GSE66229. Univariate, multivariate and Lasso Cox regression analyses were conducted to establish a four-gene-related prognostic model based on the risk score. The risk score was based on a linear combination of the expression levels of individual genes multiplied by their multivariate Cox regression coefficients. Validation of the prognostic model was conducted using The Cancer Genome Atlas (TCGA) database. A nomogram containing clinical characteristics and the prognostic model was established to predict the prognosis of Asian GC patients. @*Results@#Four genes (RBPMS2, RGN, PLEKHS1, and CT83) were selected to establish the prognostic model, and it was validated in the TCGA Asian cohort. Receiver operating characteristic analysis confirmed the sensitivity and specificity of the prognostic model. Based on the prognostic model, a nomogram containing clinical characteristics and the prognostic model was established, and Harrell’s concordance index of the nomogram for evaluating the overall survival significantly higher than the model only focuses on the pathologic stage (0.74 vs. 0.64, p < 0.001). @*Conclusion@#The four-gene-related prognostic model and the nomogram based on it are reliable tools for predicting the overall survival of Asian GC patients.
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Objective:To discuss the causes and solutions for failed anterior ring fixation for unstable pelvic fractures.Methods:A retrospective analysis was conducted of the 84 patients who had been admitted to Department of Orthopedics and Joint Surgery, Jiangmen Central Hospital for unstable pelvic fractures from January 2009 to March 2019. They were 56 males and 28 females, aged from 19 to 64 years (mean, 42.5 years). By the Tile classification, 22 cases were type B1, 16 type B2, 10 type B3, 22 type C1, 6 type C2 and 8 type C3. Simple anterior ring fixation was performed for 21 cases and combined anterior and posterior ring fixation for 63 ones. The Matta's criteria were applied for the evaluation of fracture reduction. The cases of failed anterior ring fixation and their solutions were recorded and analyzed.Results:All patients were followed up for 6 to 36 months (average, 13.5 months). Failed anterior ring fixation was observed in 7 cases (8.3%) at 3 to 75 days after operation (average, 29.1 days). The failure was attributed to improper operation timing and unstable anterior ring fixation in 2 cases, mere unstable anterior ring fixation in one, wrong choice of anterior ring fixators and improper rehabilitation in 2 cases, poor intraoperative reduction in one and unstable posterior ring fixation in one. In the 2 failed cases that had been treated by external fixators, one underwent revision and the other conservative treatment. In the 5 cases that had been treated by plating, 4 underwent revision and one conservative treatment. By the Majeed criteria, the pelvic function was evaluated at the final follow-up as excellent in 2, good in 2 and fair in one in the 5 cases of revision who obtained follow-up from 11 to 24 months(average, 17.2 months) after revision; malunion was observed in the 2 cases of conservative treatment.Conclusions:Failed anterior ring fixation for unstable pelvic fracture may be caused by improper operation timing, wrong choice of anterior ring fixators, intraoperative malreduction, unstable pelvic ring fixation and improper rehabilitation. The key solution to failed anterior ring fixation is to find the specific causes. Plate revision may lead to fine therapeutic efficacy.
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@#Abstract The indomethacin-nicotinamide cocrystal was prepared by hot melt extrusion(HME)to improve the dissolution of indomethacin in vitro. The optimum preparation conditions were investigated using temperature and rotate speed as variables. Thermogravimetric analysis(TGA), determination of content and determination of related substances were performed to evaluate the thermal stability of indomethacin during the process. Cocrystal was also prepared by solution crystallization from acetonitrile. The products obtained by the two methods were characterized by differential scanning calorimetry(DSC), Fourier transform infrared(FTIR)and powder X-ray diffraction(PXRD). The solubility and dissolution advantages of cocrystal were evaluated. The results showed that the HME method could successfully prepare the indomethacin-nicotinamide cocrystal at 115 °C and eutectic mixture was formed during the process. The cocrystal significantly improved the solubility and dissolution of indomethacin in deionized water, with pH 5. 5 and pH 6. 8 phosphate buffer. The preparation of poorly soluble drug cocrystal by HME can significantly improve its solubility, providing new idea for the development of poorly soluble drugs and HME technology.
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This study showed a case of a patient with central dislocation of the femoral head without involvement of anterior or posterior column of the acetabulum. The patient was associated with endocrine disorders caused by pituitectomy, severe osteoporosis caused by a long-term gulucocorticoids intake history, and poor bone quality of the quadrilateral plate. The direct impact of the femoral head on the quadrilateral plate after trauma resulted in purely central dislocation of the femoral head. 3D printing technique was used to print the fracture model for observation of the fracture morphology and the simulated operation before surgery. The variable-angle locking acetabular plate with a propeller-like shape was designed on the basis of the mirror of the ipsilesional semi-pelvis. This fracture was reduced via the lateral-rectus approach under direct vision. The quadrilateral surface fractures were fixed by the variable-angle locking acetabular plate which was used as a template for reduction. The follow up after surgery showed good reduction and fixation, equal length of double lower limbs, good positive and passive motion of the injured hip joint and without perioperative complications. This report describes an isolated quadrilateral plate fracture that has not yet been classified. It was effectively treated by using a customized variable-angle locking acetabular plate with a propeller-like shape via the lateral rectus approach.
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Objective@#To evaluate clinical efficacy and surgical techniques of customized variable-angle locking acetabular wing plates in treatment of complex acetabular fractures in the elderly through the lateral-rectus approach.@*Methods@#Data of 11 elder patients of complex acetabular fractures (mean age 75 y, range: 60-93 y; 8 males, 3 females) admitted to our department from March 2016 to March 2017 were retrospectively analyzed. According to Judet-Letournel classification of acetabular fractures, there were 2 cases of anterior column and posterior hemitransverse fractures, 9 cases of both-column fractures. The customized variable-angle locking acetabular wing plates were designed by mimics software and then produced before surgery. During the operation, the customized variable-angle locking acetabular wing plate was applied to reduction and fixation via the anterior lataral-rectus approach. The effect of fracture reduction was assessed by Matta's criteria. The clinical effect was assessed by Harris Hip score and the modified Merle d' Aubigné-Postal score at the 6th month of postoperative follow-up.@*Results@#The average time of designing and producing customized variable-angle locking acetabular wing plates was 4 d (3-5 d), the average operation time was 95 min (45-150 min), and the average intraoperative bleeding was 600 ml (250-1 400 ml). All patients were followed up, with an average follow-up of 18 m (6-24 m). All fractures were healed, with an average healing time of 8 weeks (6-12 weeks). Reduction quality: excellent in 8 cases, good in 2 cases, poor in 1 case, with an overall excellent and good rate of 90.9%. The result of Harris Hip scoring: excellent in 7 cases, good in 3 cases, and acceptable in 1 case, with a total excellent and good rate of 90.9%; Modified Merle d' Aubigné-Postal soring: excellent in 6 cases, good in 3 cases, and acceptable in 2 cases, with an overall excellent and good rate of 81.8%. There were 2 cases of obturator nerve injury, 1 case of fat liquefaction of incision, 3 cases of traumatic hip arthritis. During the follow-up, no complications such as ectopic ossification, plate fracture and screw loosening were found.@*Conclusion@#The customized variable-angle locking acetabular wing plates in treatment of complex acetabular fractures in the elderly via the lateral-rectus approach can achieve satisfactory reduction and firm fixtation.
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This study showed a case of a patient with central dislocation of the femoral head without involvement of anteri?or or posterior column of the acetabulum. The patient was associated with endocrine disorders caused by pituitectomy, severe osteo?porosis caused by a long-term gulucocorticoids intake history, and poor bone quality of the quadrilateral plate. The direct impact of the femoral head on the quadrilateral plate after trauma resulted in purely central dislocation of the femoral head. 3D printing technique was used to print the fracture model for observation of the fracture morphology and the simulated operation before sur?gery. The variable?angle locking acetabular plate with a propeller?like shape was designed on the basis of the mirror of the ipsile?sional semi-pelvis. This fracture was reduced via the lateral?rectus approach under direct vision. The quadrilateral surface frac?tures were fixed by the variable?angle locking acetabular plate which was used as a template for reduction. The follow up after sur?gery showed good reduction and fixation, equal length of double lower limbs, good positive and passive motion of the injured hip joint and without perioperative complications. This report describes an isolated quadrilateral plate fracture that has not yet been classified. It was effectively treated by using a customized variable?angle locking acetabular plate with a propeller?like shape via the lateral rectus approach.
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Objective To evaluate clinical efficacy and surgical techniques of customized variable-angle locking acetabular wing plates in treatment of complex acetabular fractures in the elderly through the lateral-rectus approach.Methods Data of 11 elder patients of complex acetabular fractures (mean age 75 y,range:60-93 y;8 males,3 females) admitted to our department from March 2016 to March 2017 were retrospectively analyzed.According to Judet-Letournel classification of acetabular fractures,there were 2 cases of anterior column and posterior hemitransverse fractures,9 cases of both-column fractures.The customized variable-angle locking acetabular wing plates were designed by mimics software and then produced before surgery.During the operation,the customized variable-angle locking acetabular wing plate was applied to reduction and fixation via the anterior lataralrectus approach.The effect of fracture reduction was assessed by Matta's criteria.The clinical effect was assessed by Harris Hip score and the modified Merle d' Aubigné-Postal score at the 6th month of postoperative follow-up.Results The average time of designing and producing customized variable-angle locking acetabular wing plates was 4 d (3-5 d),the average operation time was 95 min (45-150 min),and the average intraoperative bleeding was 600 ml (250-1 400 ml).All patients were followed up,with an average follow-up of 18 m (6-24 m).All fractures were healed,with an average healing time of 8 weeks (6-12 weeks).Reduction quality:excellent in 8 cases,good in 2 cases,poor in 1 case,with an overall excellent and good rate of 90.9％.The result of Harris Hip scoring:excellent in 7 cases,good in 3 cases,and acceptable in 1 case,with a total excellent and good rate of 90.9％;Modified Mere d' Aubigné-Postal soring:excellent in 6 cases,good in 3 cases,and acceptable in 2 cases,with an overall excellent and good rate of 81.8％.There were 2 cases of obturator nerve injury,1 case of fat liquefaction of incision,3 cases of traumatic hip arthritis.During the follow-up,no complications such as ectopic ossification,plate fracture and screw loosening were found.Conclusion The customized variable-angle locking acetabular wing plates in treatment of complex acetabular fractures in the elderly via the lateral-rectus approach can achieve satisfactory reduction and firm fixtation.
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Objective To summarize the clinical data of atypical hemolytic uremic syndrome (aHUS) and analyze the treatment and prognosis.Methods A prospective cohort study was conducted on 66 cases in Beijing Children's Hospital affiliated to Capital Medical University from January 2011 to December 2017.The children were divided into positive and negative auto-antibody groups according to the results of anti-factor H autoantibody test.The clinical characteristics,treatment plan and prognosis of the two groups were compared.Results Among the 66 children who met the inclusion criteria,there were 43 cases (65.2％) in the positive group,with an average onset age of (8.0±2.9) years.There were 23 eases (34.8％) in the negative group,with an average onset age of (3.0± 2.6) years.On the basis of plasma treatment,in the positive group,the usage rate of hormone was 83.3％ (35/42) and the usage rate of immunosuppressive agents was 42.9％(18/42),while in the negative group,the rates were 63.6％(14/22) and 13.6％(3/22) respectively.The average follow-up time was 19.3 months.One child in each group was lost to follow-up.In the positive group,8 cases recurred (19.0％)and the average recurrence interval time was 16.1 months.In the negative group,7 cases recurred (31.8％) and the average recurrence interval time was 9.3 months.And the recurrent interval time in the positive group was more longer than the negative group (P ＜ 0.05).A total of 85.9％(55/64) children had complete hemolysis control and complete recovery of renal function,in which the positive group was 85.7％(36/42) and negative group was 86.4％(19/22).However,7.8％(5/64) children had abnormal renal function,in which the positive group was 9.5％(4/42) and the negative group was 4.5％(1/22).And 4.7％(3/64) children died,in which the positive group was 2.4％(1/42) and the negative group was 9.1％ (2/22).The one left (1.6％) showed dialysis dependence,which was positive for the auto-antibody.Multifactor Cox regression analysis showed that the age of less than 3 years old was the risk factor of poor prognosis (HR=4.651,95％CI 0.988-21.898,P=0.047).Conclusions The positive proportion of anti-factor H autoantibody in children with aHUS is high.The age of these children is older.Individualized therapy based on anti-factor H autoantibody and immunosuppressive therapy is of great significance for disease remission,preventing recurrence and improving the prognosis.Age less than 3 years old is the risk factor for poor prognosis.
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Objective To investigate the effectiveness and safety of anterior vitrectomy combined with capsular retractor and Cionni modified capsular tension ring (MCTR) in traumatic lens subluxation surgery with anterior vitreous prolapse.Methods This study comprised 16 patients (16 eyes) of traumatic lens subluxation with anterior vitreous prolapse,in which iridodialysis was in 3 eyes,express implantation in 1 eye and Ahmed glaucoma valve implantation in 1 eye.According to the severity of lens subluxation,the patients were divided into three levels,including 90°-120° (7 eyes),120°-180° (5 eyes) and 180°-270° (4 eyes).Considering the anterior vitreous prolapse,anterior vitrectomy or/and pars plan vitrectomy was conducted with assistance of triamcinolone acetonide.After continuous curvilinear capsulorhexis,two to four capsular retractors were placed in the capsulorhexis to support and center the capsule.MCTR was inserted with scleral suture fixation after phacoemulsification.At last,the foldable IOL was implanted to capsular bag.Postoperative visual acuity,intra-and post-operative complications,anterior capsular opening,IOL positions and intraocular pressure (IOP) were assessed during 3 months' follow up.Results All patients had successfully undergone phacoemulsification,MCTR insertion and IOL implantation.Seven eyes were inserted with 2-eyelet MCTR and nine eyes were inserted with 1-eyelet MCTR.The postoperative visual acuity was better than 0.5 in 9 eyes,between 0.3 and 0.5 in 4 eyes,between 0.1 and 0.3 in 2 eyes,and less than 0.1 in 1 eye.Compared with pre-operation,the difference in the visual acuity was statistically significant (x2 =17.503,P =0.000).The scheimpflug images obtained from the Pentacam,which demonstrated that the IOL was well centered,and no MCTR and IOL decentration occurred.The common intraand post-operative complications were residual cortex,aqueous misdirection syndrome,anterior capsular tears,anterior capsular phimosis and posterior capsular opacification.Conclusion The effective application of anterior vitrectomy is the key point to reduce surgical complications.Anterior vitrectomy combined with insertion of capsular retractor and MCTR is an ideal surgical option for patients of traumatic lens subluxation with anterior vitreous prolapse.
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Aim To establish the rat model of Spleen-Qi deficiency, analyse the metabolic pathways and investigate the connection between the changed urinary metabolites and Spleen-Qi deficiency, in order to explore the potential mechanisms of Spleen-Qi deficiency.Methods With the binding methods of diarrhea induced by bitter and cold, abnormal of starvation and excessive tiredness, the rat Spleen-Qi deficiency model was established.Then the activity of creatine phosphokinase(CPK) was detected.The endogenous metabolites in the urine were detected by NMR, and the data were analyzed with multivariate and statistical methods.Then the metabolites were selected that could be clearly distinct in the two groups with the fold change value(>1.2) and the P<0.05 of Student′s t-test.Both the pathway analysis and enrichment analysis were performed with Metabo Analyst 3.0.Results Compared with the normal rats, the activity of CPK decreased significantly in model rats(P<0.05).A significant separation appeared in the principal components analysis(PCA) score plot when the control group and the model group were compared, indicating that the Spleen-Qi deficiency model was successfully duplicated.The 33 differential metabolites, which mainly involved in the metabolic pathways, were distinguished from the comparision of Spleen-Qi deficiency model group and control group.The metabolic pathways was related to energy metabolism, amino acid metabolism, nucleotide metabolism and disturbance of gut microbes.Conclusions The main energy metabolic pathways (tricarboxylic acid cycle, glycolysis and liquid oxidation) may be disturbed in Spleen-Qi deficiency rats.The energy supply function is suppressed, which leads to the fatigue and weight loss in rats.
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<p><b>OBJECTIVES</b>To study the correlation between MRI apparent diffusion coefficient (ADC) and expression of Ki-67 in gastric cancers, and to investigate the application of ADC value in diagnosing the malignance of gastric cancer.</p><p><b>METHODS</b>A retrospective cohort analysis was performed on 87 gastric cancer patients who received MRI examination and radical resection at Zhejiang Provincial Hospital of Traditional Chinese Medicine from November 2014 to August 2015. All the postoperative resected samples were confirmed as gastric cancer. Preoperative MRI examination was performed by using Siemens 3.0-T Verio MRI with following parameters: section thickness 3 mm, gap 1 mm, matrix 182×320, field of view 40 cm. Plain scan was followed by T1-weighted fat suppression technique VIBE 3D(TR3.92/TE1.39,90degree) scans at arterial phase (the 30th second), portal venous phase (the 60th second), lag period (the 90th second), axial planes and coronal planes (the 180th second), and sagittal planes (the 210th second), respectively. ADC value of tumor was measured at b-factor of 800 s/mmand ADC map was generated from DWI data on the work station. The expression of Ki-67 in cancer tissue was detected by routine immunohistochemical (SP) staining after surgery. Correlation between ADC value and the expression of Ki-67 in gastric cancer was analyzed.</p><p><b>RESULTS</b>Irregular thickening of the gastric wall and inhomogeneous enhancement of the tumor after injection of the contrast material appeared in gastric cancer. Gastric cancer tissue presented hyperintensity and normal gastric wall presented isointensity in DWI image (b=800 s/mm). Compared with normal gastric tissue, mean ADC value of gastric cancer tissue was significant lower [(1.114±0.265)×10mm/s vs. (2.032±0.202)×10mm/s, t=26.209, P=0.000]. The ADC values of high-middle differentiation group, middle-low differentiation group, low differentiation group and signet ring cell carcinoma/mucinous adenocarcinoma group were (1.347±0.234)×10mm/s, (1.179±0.257)×10mm/s, (0.996±0.185)×10mm/s and (1.082±0.230)×10mm/s, respectively. The difference of mean ADC value among different tumor stages was significant(F=8.498, P=0.000). Along with the Ki-67 expression up-regulated, the ADC value decreased in cancer tissue. The Ki-67 expressions in cancer tissue was negatively correlated with cancer ADC values (r=-0.570, P=0.000). Furthermore, negative correlations of Ki-67 expressions with ADC values of high-middle differentiation group (r=-0.627, P=0.016), low differentiation group (r=-0.787, P=0.000) and signet ring cell carcinoma/mucinous adenocarcinoma group (r=-0.792, P=0.000) were observed respectively, while Ki-67 expression was not correlated with ADC value of middle-low differentiation group.</p><p><b>CONCLUSION</b>The ADC value of gastric cancer can reflect the level of tumor differentiation, and is negatively correlated with Ki-67 expression in cancer tissues.</p>
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Objective To explore the effect of tert?butylhydroquinone(tBHQ)on ultraviolet B(UVB)?induced oxidative damages in human im?mortalized keratinocytes(HaCaT),and discuss its mechanism. Methods The cultured HaCaT cells were randomly divided into 4 groups:control group(G1),ultraviolet irradiation group(G2),25μmol/L tBHQ pretreatment before ultraviolet irradiation group(G3),and 50μmol/L tBHQ pre?treatment before ultraviolet irradiation group(G4). The content of reactive oxygen species was detected by DCFH?DA method,and the cell prolifera?tion was evaluated by MTT. Western blot was used to measure the protein expression of nuclear factor E2?related factor 2(Nrf2)in both nuclear fac?tions and whole?cell of HaCaT. The mRNA expressions of CAT and SRX were determined by real?time RT?PCR. Results The content of reactive oxygen species in HaCaT cells was increased,and the cell proliferation rate was decreased significantly after ultraviolet irradiation. The pretreatment of 25 and 50μmol/L tBHQ can inhibit the UVB?induced oxidative damage in a dose?dependent manner in HaCaT cells. Compared with G2 group, tBHQ pretreatment could dose?dependently increase the level of Nrf2 protein in nuclear factions and whole?cell of HaCaT,and also the mRNA ex?pressions of CAT and SRX. Conclusion UVB irradiation can induce oxidative stress damages of HaCaT cells. tBHQ may inhibit the UVB?induced oxidative damages through enhancing Nrf2 expressions and nuclear translocation,then activating the transcription of the downstream antioxidant en?zymes CAT and SRX.