Occurrence of hypopituitarism after severe craniocerebral trauma and its predictors / 中华内分泌外科杂志

Objective:To investigate the occurrence and predictors of hypopituitarism after traumatic brain injury (TBI) .Methods:A prospective study was conducted on 185 patients with severe TBI in the Emergency Department of the First Hospital of Shanxi Medical University from Jan. 2020 to May. 2022, of whom 108 were male and 77 were female; age ranged from 18 to 79 years, mean (51.32±9.34) years. Pituitary function was assessed within 3-7 d after the onset of TBI, and the occurrence of hypopituitarism after severe TBI was counted. 41 cases in the hypopituitarism group, 26 males and 15 females, aged (52.76±9.83) years, were divided into the hypopituitarism group (hypopituitarism occurred) and the non-hypopituitarism group (hypopituitarism did not occur) according to whether hypopituitarism occurred. In the non-decompensated group, there were 144 cases, 82 males and 62 females, aged (50.91±9.27) years. The clinical data of the decompensated and non-decompensated groups were compared, and the factors influencing the occurrence of hypopituitarism were analysed, and a logistic prediction model was constructed based on the relevant influencing factors. The value of this model in predicting the occurrence of hypopituitarism after severe TBI was evaluated by using the receiver operating characteristic (ROC) curve.Results:The prevalence of hypopituitarism in the 185 patients with severe TBI in this study was 22.16%; the Glasgow coma scale (GCS) score on admission was lower in the decompensated group than in the non-decompensated group [ (6.36±1.04) vs (7.48±0.59) ], the percentage of hyperbaric oxygen therapy was lower than in the non-decompensated group (21.95% vs 49.31%) , the percentage of intracranial pressure (82.93% vs 49.31%) , midline displacement ≥5 mm (78.05% vs 29.86%) , skull base fracture (34.15% vs. 17.36%) , diffuse cerebral edema (19.51% vs 4.17%) , and serum brain derived neurophic factor (BDNF) . Brain derived neurophic factor (BDNF) was higher than that in the non-reduced group [ (6.35±1.29) ng/ml vs (4.51±1.06) ng/ml], and neuronal-specific enolase (NSE) was higher than that in the non-reduced group [ (33.06±5.42) μg/L vs (23.15±4.97) μg/L]. (4.97) μg/L]. Vascular epithelial growth factor (VEGF) was higher than that in the non-reduced group [ (312.07±24.35) pg/ml vs (226.80±20.96) pg/ml], tumor necrosis factor-α (TNF-α) was higher than that in the non-reduced group [ (281.24±38.91) ng/L vs (186.91) pg/ml], and tumor necrosis factor-α (TNF-α) was higher than that in the non-reduced group (186.55±35.72) ng/L (all P<0.05) . Increased intracranial pressure, midline displacement ≥5 mm, diffuse cerebral edema, serum BDNF, NSE, VEGF, and TNF-α levels were all independent risk factors for the development of hypopituitarism after severe TBI, with admission GCS score and hyperbaric oxygen therapy as protective factors ( P<0.05) ; a logistic prediction model was constructed based on the influencing factors as: Logit ( P) = 5.264-0.880×admission GCS score + 1.618×increased intracranial pressure + 1.941×midline displacement ≥5 mm + 1.289×diffuse cerebral edema+1.306×BDNF+1.426×NSE+1.781×VEGF+1.615×TNF-α-0.758×hyperbaric oxygen therapy; the model predicted the occurrence of severe TBI after the area under the curve (AUC) of hypopituitarism was 0.930 (95% CI 0.883-0.962) , with a predictive sensitivity and specificity of 90.24% and 89.19%, respectively. Conclusions:The incidence of hypopituitarism is higher after severe TBI. Increased intracranial pressure, midline displacement ≥5 mm, diffuse cerebral edema, serum BDNF, NSE, VEGF and TNF-α levels are all used as predictors of hypopituitarism.

Pharmaceutical care of a critical patient with acute heart failure after PCI by clinical pharmacists / 中国药房

OBJECTIVE To explore the role of clinical pharmacists in the treatment of critical patients with acute heart failure after percutaneous coronary intervention （PCI）， and to provide reference for drug treatment and monitoring of such patients. METHODS Clinical pharmacists participated in the treatment of a critical patient with acute heart failure after PCI， and assisted physicians to jointly develop individualized medication plans based on domestic and foreign literature： it was suggested to give imipenem and cilastatin for anti-infective therapy， adjust drug dose according to renal function， and timely descend step therapy； Levetiracetam tablets were selected to prevent epilepsy； the differential diagnosis and treatment of rhabdomyolysis possibly caused by Atorvastatin calcium tablets were performed； the whole process of pharmaceutical care was conducted. RESULTS Physicians adopted the suggestions of clinical pharmacists. The acute heart failure of the patient was controlled， the pulmonary infection was improved， the adverse reaction symptoms were relieved， and the patient was successfully transferred out of the ICU. CONCLUSIONS For severe patients， when giving imipenem and cilastatin for anti-infection treatment，the clinical pharmacist should adjust the dose according to the patient’s renal function and be alert to the possible neurotoxicity. During the treatment with Atorvastatin calcium tablets，the clinical pharmacist should comprehensively analyze the risk of rhabdomyolysis. For the adverse reactions that have occurred， clinical pharmacist should promptly address symptomatic issues to ensure the safety and effectiveness of medication for patients.

Study on the Biological Function of Abemecilib in Inhibiting the Proliferation, Invasion and Migration of Small Cell Lung Cancer with High c-Myc Expression / 中国肺癌杂志

BACKGROUND@#Small cell lung cancer (SCLC) with high c-Myc expression is prone to relapse and metastasis, leading to extremely low survival rate. Cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor Abemaciclib plays a key role in the treatment of tumors, but the effects and mechanisms on SCLC remain unclear. This study was to analyze the effect and molecular mechanism of Abemaciclib in inhibiting proliferation, migration and invasion of SCLC with high c-Myc expression, with a view to expanding a new direction for reducing the recurrence and metastasis.@*METHODS@#Proteins interacting with CDK4/6 were predicted using the STRING database. The expressions of CDK4/6 and c-Myc in 31 cases of SCLC cancer tissues and paired adjacent normal tissues were analyzed by immunohistochemistry. The effects of Abemaciclib on the proliferation, invasion and migration of SCLC were detected by CCK-8, colony formation assay, Transwell and migration assay. Western blot was used to detect the expressions of CDK4/6 and related transcription factors. Flow cytometry was used to analyze the effects of Abemaciclib on the cell cycle and checkpoint of SCLC.@*RESULTS@#The expression of CDK4/6 was associated with c-Myc by STRING protein interaction network. c-Myc can directly modalize achaete-scute complex homolog 1 (ASCL1), neuronal differentiation 1 (NEUROD1) and Yes-associated protein 1 (YAP1). Moreover, CDK4 and c-Myc regulate the expression of programmed cell death ligand 1 (PD-L1). Immunohistochemistry showed that the expressions of CDK4/6 and c-Myc in cancer tissues were higher than those in adjacent tissues(P<0.0001). CCK-8, colony formation assay, Transwell and migration assay verified that Abemaciclib could effectively inhibit the proliferation, invasion and migration of SBC-2 and H446OE(P<0.0001). Western blot analysis further showed that Abemaciclib not only inhibited CDK4 (P<0.05) and CDK6 (P<0.05), but also affected c-Myc (P<0.05), ASCL1 (P<0.05), NEUROD1 (P<0.05) and YAP1 (P<0.05), which are related to SCLC invasion and metastasis. Flow cytometry showed that Abemaciclib not only inhibited the cell cycle progression of SCLC cells (P<0.0001), but also significantly increased PD-L1 expression on SBC-2 (P<0.01) and H446OE (P<0.001).@*CONCLUSIONS@#Abemaciclib significantly inhibits the proliferation, invasion, migration and cell cycle progression of SCLC by inhibiting the expressions of CDK4/6, c-Myc, ASCL1, YAP1 and NEUROD1. Abemaciclib can also increase the expression of PD-L1 in SCLC.

Effect of antidepressants on thyroid hormone level in adolescent depression with suicidal ideation / 上海预防医学

ObjectiveTo compare the differences in thyroid hormone levels between adolescents with and without suicidal ideation， and to explore the association between thyroid hormone/suicidal ideation and the antidepressant treatment. MethodsA total of 100 patients were divided into non-suicidal ideation group and suicidal ideation group according to the SIOSS. The levels of thyroid-stimulating hormone （TSH）， triiodothyronine （T3）， thyroxine （T4）， free triiodothyronine （FT3） and free thyroxine （FT4） were compared between the two groups as well as their changes after 6 weeks of antidepressant treatment. ResultsThe levels of FT3， FT4 and T4 in the non-suicidal ideation group were higher than those in the suicidal ideation group. After 6 weeks of antidepressant treatment， the levels of FT3， FT4 and T4 in the suicide ideation group were higher than those before the treatment. The FT3 level in the male non-suicidal ideation group was higher than that in the suicidal ideation group. The levels of FT4 and T4 in the female non-suicidal ideation group were higher than those in the suicidal ideation group （all P<0.05） ConclusionThere are differences in thyroid hormone levels between adolescents with and without suicidal ideation （both with first-episode depression）， and patients with suicidal ideation have significant changes after treatment with antidepressants.

Effect of hydroxysafflor yellow A on depressive-like behavior and expression of GABAAR protein in hippocampus of chronic restraint stress model mice / 中华行为医学与脑科学杂志

Objective:To investigate the effects of hydroxysafflor yellow A (HSYA) on depressive-like behavior and expression of type A γ-aminobutyric acid receptor(GABAAR)in hippocampus of chronic restraint stress model mice.Methods:The SPF grade male C57BL/6C mice were divided into Control group, HSYA group, Model group, Model + HSYA group and Model + fluoxetine group according to random number table method, with 12 mice in each group.Mice model of depression was established by chronic restraint stress.Mice in HSYA group and Model+ HSYA group were intraperitoneally injected with HSYA(20 mg/kg), mice in Model+ fluoxetine group were injected intraperitoneally with fluoxetine (10 mg/kg), and mice in Control group and Model group administered with 0.9% sodium chloride solution intraperitoneally once a day for 14 days.Then, the forced swimming test (FST) and tail suspension test (TST) were performed to evaluate the depressive-like behavior of mice, and the protein expression levels of different subtypes of GABAAR in the hippocampus of mice were determined by Western blot.SPSS 19.0 and GraphPad Prism 8.0 software were used for data statistical analysis and mapping.One-way ANOVA was used for comparison among groups, and Tukey-HSD test was used for further pairwise comparison.Results:(1) In the behavioral tests, there were significant differences in swimming immobility time of FST and tail suspension immobility time of TST among the five groups ( F=21.59, 20.81, both P<0.05). The swimming immobility time ((143.91±9.97) s) and tail suspension immobility time (( 107.00±6.54) s) in Model group were higher than those in Control group ((52.92±6.70) s, ( 43.50±5.96) s, both P<0.05). There were no significant difference in swimming immobility time and tail suspension immobility time between Model+ HSYA group ((26.17±7.69)s, ( 20.17±7.89)s) and Model+ fluoxetine group ((61.60±16.22)s, (34.14±10.74)s)(both P>0.05), but the swimming immobility time and tail suspension immobility time in these two groups were lower than those in Model group (both P<0.05). (2) The Western blot results showed that there were significant differences in the expression of GABAARβ1 and GABAARβ2 protein in hippocampus among the four groups ( F=12.21, 11.40, both P<0.05). The expression levels of GABAARβ1(45.60±10.76) and GABAARβ2 (46.27±4.82) protein in hippocampus of Model group were lower than those in Control group ((100.00±3.44), (100.00±3.26), both P<0.05). Compared to Model group, the expression of GABAARβ1 (79.91±5.00) and GABAARβ2 (79.08±5.53) protein in hippocampus of Model+ HSYA group were higher (both P<0.05). In addition, the expression of GABAARα1 and GABAARγ1 proteins in hippocampus were not significantly different among the four groups( F=0.23, 0.10, both P>0.05). Conclusion:HSYA can effectively alleviate depressive-like behavior in depression model mice, which may be related with the upregulation of GABAARβ1 and GABAARβ2 of hippocampus tissue.

The impact of cognitive emotion regulation strategies on adolescents with unipolar depression and bipolar depression / 中华行为医学与脑科学杂志

Objective:To explore the impact of different dimensions of cognitive emotion regulation strategies on adolescents with unipolar depression and bipolar depression.Methods:From June 2019 to July 2021, a total of 216 adolescents with depressive disorder were selected, including 134 patients in unipolar depression group, 82 patients in bipolar depression group, and 111 normal controls were selected at the same time.Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) and cognitive emotion regulation questionnaire (CERQ) were used to evaluate the emotional symptoms and cognitive emotion regulation strategies of all enrolled subjects. SPSS 23.0 was used for statistical analysis of the data. Kruskal-Wallis rank sum test and multiple Logistic regression analysis were used for statistical analysis.Results:There were significant differences in the dimensions of cognitive emotion regulation strategies and emotional symptoms among the three groups (all P<0.01). The scores of self-blame (14.00(12.00, 17.00), 13.50(12.00, 16.00), 12.00(11.00, 12.00)), rumination (15.00(12.00, 19.00), 14.00(12.00, 17.00), 12.00(10.00, 13.00)) and catastrophizing (13.00(11.00, 17.00), 12.00(9.00, 16.00), 8.00(6.00, 12.00)) in bipolar depression group and unipolar depression group were significantly higher than those in normal control group (all P<0.01). The score of blaming others (11.00(8.75, 13.25), 9.00(8.00, 12.00)) in bipolar depression group was significantly higher than that in normal control group ( P<0.01). The score of positive reappraisal (12.00(12.00, 15.00), 11.00(8.75, 13.00)) in normal control group was significantly higher than that in unipolar depression group ( P<0.01). The putting into perspective score(10.00(8.00, 12.00), 12.00(10.00, 13.25), 12.00(10.00, 13.00)) of normal control group was significantly lower than those of unipolar depression and bipolar depression group (both P<0.01). The scores of HAMD (25.00(22.00, 26.25), 23.00(18.00, 28.00), 3.00(0, 6.00)) and HAMA (17.00(14.00, 21.00), 20.00(16.00, 27.00), 1.00(0, 3.00)) both in unipolar depression group and bipolar depression group were significantly higher than that in normal control group (both P<0.01). Multivariate Logistic regression analysis showed that self-blame, rumination, and catastrophizing were risk factors for unipolar depression ( OR=1.19, 95% CI=1.05-1.35; OR=1.17, 95% CI= 1.06-1.30; OR=1.14, 95% CI=1.02-1.27) and bipolar depression( OR=1.30, 95% CI=1.14-1.50; OR=1.21, 95% CI=1.07-1.36; OR=1.13, 95% CI=1.01-1.28) compared to normal controls, while positive reappraisal were protective factors for unipolar depression ( OR=0.83, 95% CI=0.73-0.95) and bipolar depression ( OR=0.84, 95% CI=0.73-0.98). However, after controlling for HAMD, HAMA and gender, the effects of each dimension of cognitive emotion regulation strategies on unipolar depression and bipolar depression were no longer significant(both P>0.05). Conclusion:The negative cognitive emotion regulation strategies are correlated with the risk of disease in adolescents with unipolar and bipolar depression, and this effect is affected by the patients' own depression, anxiety and other factors.

Analysis of prognostic factors for acral lentiginous melanoma based on SEER database / 中华皮肤科杂志

Objective:To investigate prognostic factors for acral lentiginous melanoma (ALM) , and to construct a nomogram to verify the predictive value of these factors.Methods:Clinical data on 1 573 patients with ALM were collected from the Surveillance, Epidemiology, and End Results (SEER) database of National Cancer Institute in United States between 2004 and 2015. Data about patients′ age, gender, ulcer status, SEER staging, surgical protocols, T-, N- and M-staging, overall survival rates and disease-specific survival rates were extracted. Chi-square test was used to analyze the correlation of clinical characteristics with overall survival rates and melanoma-specific survival rates, and univariate and multivariate Cox proportional hazards regression models were used to investigate prognostic factors and establish predictive models.Results:Among the 1 537 patients with ALM, 714 were males, 823 were females, 818 were under 64 years of age, and 1 363 were Caucasian. Skin lesions occurred on the lower limbs and buttocks in 1 205 cases, and 974 cases had ulcers; according to the SEER staging, non-spread localized skin lesions were observed in 1 048 cases. There were significant differences in the mortality rate among patients of different ages at diagnosis, different gender, with different ulcer status, surgical status, and at different SEER stages, T-stages, N-stages and M-stages (all P < 0.001) . Univariate and multivariate Cox regression analysis showed that age ≥ 65 years, male, ulcers and distant lymph node metastasis in the SEER staging were associated with increased risk of death in the patients (all P < 0.05) , and the mortality rate was significantly higher in the patients with T2-, T3- or T4-stage ALM than in those with T1-stage ALM (all P < 0.05) , and higher in the patients with N1-, N2- and N3-stage ALM than in those with N0-stage ALM (all P < 0.05) . Conclusion:Age, gender, ulcer status, SEER stage, T-stage and N-stage are independent prognostic factors for overall survival rates and disease-specific survival rates of ALM.

Application value of phase contrast MR angiography in assessment of the functional posterior communicating artery in patients with posterior circulation ischemia / 中华放射学杂志

Objective:To investigate the application value of phase contrast MR angiography (PC MRA) in quantitative assessment for the hemodynamic features of functional posterior communicating artery (F-PCoA) in the patients with posterior circulation ischemia (PCI).Methods:Data of PC MRA in our Hospital from April 2015 to March 2017 were collected retrospectively. Twenty-six patients (PCI group) were diagnosed as PCI with F-PCoA, and other 25 patients were defined as non-PCI group including 10 patients with F-PCoA (non-PCI group 1) and 15 patients without F-PCoA (non-PCI group 2). The cross-sectional area, mean flux, mean velocity, minimum flux, maximum flux, minimum velocity, and maximum velocity were recorded, and the peak height of flux (maximum flux-minimum flux) and peak height of velocity (maximum velocity - minimum velocity) of basilar artery (BA) were calculated. The subtype, cross-sectional area, mean flux, mean velocity, blood flow direction, and absolute flux of F-PCoA in anterior-posterior direction(sum of both sides)were recorded and analyzed statistically.Results:The F-PCoA of 36 cases in PCI group and non-PCI group 1 were divided into three types: type A: the F-PCoA was consistent with anatomical posterior communicating artery (A-PCoA), accounting for 83.3%(30/36 cases); type B: the F-PCoA was not consistent with A-PCoA, accounting for 13.9%(5/36 cases);and type C: a mixed type with the F-PCoA was consistent with A-PCoA in only one side, accounting for 2.8%(1/36 cases). There were no significant differences in the composition of F-PCoA subtype (χ 2=0.609, P=0.737) and the absolute flux of F-PCoA in anterior-posterior direction( t=-0.576, P=0.568) between PCI group and non PCI group 1. It could be unidirectional or bidirectional blood flow forasingle F-PCoA during a cardiac cycle. The blood flow direction of bilateral F-PCoA was similar or not in one single case. The obviously main wave peak of the absolute flux curve of F-PCoA in anterior-posterior direction in PCI group were observed. There was a significant difference in the cross-sectional area of BA between non PCI group 1 and 2( t=-2.856, P=0.009), however no significant differences were found in the genders, mean flux, mean velocity, minimum flux, maximum flux, peak height of flux, minimum velocity, maximum velocity, and peak height of velocity of BA. Conclusions:PC MRA can be used to quantificationally assess the hemodynamic characteristics of F-PCoA such as flow direction, velocity and flux direction, absolute flux in anterior-posterior direction and morphological changes of F-PCoA, which may provide more information for the PCI diagnosis and treatment.

A social ecological approach to understanding of youth injury associated factors and health implications / 中国学校卫生

Objective@#To explore the related factors and working way of adolescent injury,and to provide a basis for the effective prevention and intervention of adolescent injury.@*Methods@#The framework of the questionnaire in this study was developed based on the Social Ecology Model. A cross-sectional survey was conducted on a valid sample of 4 309 students from 8 junior high schools and 8 senior high schools in Beijing and Zhongshan city respectively, using stratified random cluster sampling method. Students from grade 7 to grade 12 were invited to participate and investigated with injury prevalence.@*Results@#The incidence of adolescent injury by person and by person-time was 15.53% and 22.49% respectively, and there were differences by sex, age and regions(χ2=15.92，11.45，20.33，P<0.05). The occurrence of adolescent injury was affected by adolescent psychological behavior and social environment through different underlying pathways. The intrapersonal factors and perception of environmental safety showed direct effects on the adolescents’ injuries (effect size was 0.29 and 0.05 respectively, P<0.05).@*Conclusion@#Adolescent injury is associated with diverse factors and pathways in a synergistic and complex manner, suggesting that a three-dimensional and diverse strategy should be taken to intervene the injures.

Applicability of CT examination decision rules in head injured children / 中华急诊医学杂志

Objective To explore the applicability of the three commonly used CT examination decision rules in Chinese head injured children. Methods This prospective observational study included 1538 children and adolescents (aged < 18 years), who were treated at the Emergency Department of First Hospital of Shanxi Medical University after head injuries. The three clinical decision rules include the Children's Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE; UK); the prediction rule for the identification of children at very low risk of clinically important traumatic brain injury, that was developed by the Pediatric Emergency Care Applied Research Network (PECARN; USA), and the Canadian Assessment of Tomography for Childhood Head Injury (CATCH) rule. Diagnostic accuracy had been evaluated by using the rule-specific predictor variables to predict each rule-specific outcome measure in populations who met inclusion and exclusion criteria for each rule. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and ROC curve were referred to the diagnostic accuracy. Indicators were characterized by 95％ CI. Results Of the 1538 patients, CTs were obtained for 339 patients (22.04％). Forty-nine patients (3.19％) had positive CT results, 8 patients (0.52％) underwent neurosurgery, 2 patients (0.13％) died, and 1 patient (0.07％) may be missed. In this study, CHALICE was applied for 1394 children (90.70％; 95％ CI: 89.24％-92.15％), PECARN for 801 children (52.11％; 95％ CI: 49.62％-54.61％), and CATCH for 325 patients (21.15％; 95％CI: 19.10％-23.19％). The validation sensitivities of CHALICE, PECARN, and CATCH rules were 92.6％(74.2％-98.7％), 100％ (56.1％-100％), and 85.7％ (42.0％-99.2％), respectively; the specificities were 78.1％(75.7％-80.2％), 48.0％ (44.5％-51.5％) and 70.8％ (65.4％-75.6％); positive predictive value were 7.7％ (5.1％-11.3％), 0.9％ (0.4％-1.9％) and 6.1％ (2.5％-13.2％); and negative predictive value were 99.8％ (99.2％-100％), 99.1％ (98.1％-99.6％), and 99.6％ (97.2％-100％), respectively. Conclusions The clinical decision rules of CHALICE, PECARN and CATCH have high sensitivities. The specificity of PECARN rule is lower than those of CHALICE and CATCH rules. The above three clinical decision rules can be used for the decision of CT examination in Chinese children with head injury in practice.

The evaluation of teaching effectiveness of integrated curriculum in laboratory diagnostics for liver disease / 中华医学教育探索杂志

Objective To explore the application of the model centering on organ system teaching in experimental diagnostics and evaluated its teaching effect.Methods A total of 185 clinical medical undergraduates of grade 2012 and 2013from School of Basic Medical Science in Tianjin Medical University joined the integrated curriculum of laboratory diagnostics for liver disease (abbreviated as integrated group).All of the teachers from varied professional fields were reconstituted into integrated teaching group.Training lecture was unified according to the new integrated teaching material.In order to make a contrast,180 clinical medical undergraduates of the grade 2010 and 2011 were involved in traditional laboratory diagnostics curriculum (abbreviated as traditional group).The results of terminal test of the integrated group and traditional group were analyzed with SPSS 21.0 software and Excel 2007.Glossary items,multiple choice,were indicated by scoring rate,and the objective items and subjective items total scores were indicted by real scores.Results Significant difference was found in the scoring rate of the glossary items,objective items,subjective items and the total scores between the two groups (P＜0.01).The records of students were [75.00％ (50.00％,100.00％)],(72.28 ± 22.63),(90.70 ± 22.36),(79.96 ± 18.59) in the integrated group and [66.67％ (33.33％,83.33％)],(61.43 ± 28.85),(72.92 ± 22.14),(69.10 ± 17.95) in the traditional group.The scoring rate in the integrated group was higher than that in the traditional group (P＜0.01).But the records of multiple choice were [100.00％ (0.00％,100.00％)] in the traditional group and [66.67％ (66.67％,100.00％)] in the integrated group.Conclusions The model centering on organ system teaching model is much more reliable and it may improve the teaching quality.

Relationship between the lumbar quantitative computed tomography values and contrast agent dispersion in osteoporotic thoracolumbar fractures / 中国组织工程研究

BACKGROUND: Percutaneous vertebroplasty (PVP) is usually used for osteoporotic thoracolumbar fractures,which has various advantages such as easy to operate, short operation time, less trauma, rapid recovery,analgesic effect and so on. But its application is restricted due to nerve compression symptoms and pulmonary embolism caused by bone cement leakage. Thereafter, how to reduce the leakage of bone cement is an issue of concern.OBJECTIVE: To investigate the relationship between the lumbar quantitative computed tomography (QCT) values and contrast agent dispersion in osteoporotic thoracolumbar fractures. METHODS: Sixty cases of osteoporotic thoracolumbar fractures undergoing PVP were enrolled, and received QCT examination before surgery, and contrast agent was injected intraoperatively. X-ray examination was conducted to detect the bone mineral density, contrast agent dispersion and leakage of bone cement, and the relationship between the lumbar QCT values and contrast agent dispersion as well as leakage of bone cement.RESULTS AND CONCLUSION: (1) There were 110 vertebral fractures, and 74 vertebrae with contrast agent diffusing more than vertebral midline, accounting for 67.3%. There was significant difference in the contrast agent dispersion among groups (P 0.05). (3) These results suggest that contrast agent dispersion in osteoporotic thoracolumbar fractures has a certain relationship with the lumbar QCT values, and lumbar QCT values with more contrast agent dispersion, but the lumbar QCT values have no correlation with bone cement leakage. Therefore, choosing a appropriate approach based on the QCT values and contrast agent dispersion can reduce leakage and improve the safety of PVP.

Preliminary study of acoustic radiation force impulse technique estimating the change of kidney in rabbits with hypothermia and rewarming / 中华医学超声杂志（电子版）

Objective To explore the value of acoustic radiation force impulse imaging (ARFI) technique in the evaluation of the change of kidney in rabbits with hypothermia and rewarming. Methods Sixteen New Zealand rabbits were placed in -25 ℃ environment for 8 hours, then rewarmed in 23℃ environment. Ultrasonic examinations were performed at room temperature in the time of T0and the time of T1-T8. The right kidney were evaluated by two-dimensional ultrasound and ARFI technique. Results No significant changes were found in the echo and volume of kidney from T1to T8. SWV of kidney descended greatly from T0to T1and raised from T2to T3gradually, then it descended from T3to T8gradually. Significant difference of SWV of kidney were found from T1to T8compared with that at T0(P < 0.05). Conclusions ARFI Technique can estimate the change of kidney in rabbits with hypothermia and rewarming. It can provide more useful information for clinical diagnosis.

Clinical effect of autologous fat transplantation with plasma fiber de-fatting on improving facial contour / 中华医学美学美容杂志

Objective To study the clinical efficacy of autologous fat transplantation combined with plasma fiber de-fatting in improving the facial contour.Methods A lot of 110 cases were collected.The surgical designation was according to the patients' facial features and their wishes.Facial fiber and autologous fat filling technology were combined in clinical application.The satisfaction and postoperational complications were evaluated.Results A lot of 110 cases were followed-up for 6 to 24 months postoperatively.95 cases were well satisfied.15 cases were satisfied.All cases had no hematoma,induration,infection and other complications.The effect was stable.Conclusions Autologous fat transplantation combined with plasma fiber de-fatting can effectively improve the facial contour and skin texture.

Clinical features of pancreatic cystic neoplasms and its therapeutic strategy / 临床肝胆病杂志

The detection rate of pancreatic cystic neoplasms obviously increases with the development of imaging technology. However, it is still difficult to make the differential diagnosis between different types of pancreatic cystic neoplasms. For pancreatic cystic neoplasms, the physical condition of the patient, tumor size, location, patient preference, and other potential factors should be considered to develop an individualized treatment. The incidence rate of complications is high, although the operative mortality of pancreatic cystic neoplasms is very low. Therefore, it is necessary to strictly make the treatment decision for pancreatic cystic neoplasms.

Comparative analysis in ultrastructure and histological types for congenital cystic adenomatoid malformation / 中华实用儿科临床杂志

Objective To explore relationship between imaging classification and pathological type,and the electron microscopic ultrastructure by observing the ultrastructural features of congenital cystic adenomatoid malformation (CCAM).Methods Children with CCAM in the Guangdong Women and Children Hospital from May 2014 to November 2014,were analyzed,imaging classification was performed according to enhanced Computed Tomography (CT) scanning,and the surgical specimens were stained by HE and scanning electron microscope was used to observe the tissue structures of various of CCAM.Results Eight cases were enrolled in this research (5 boys and 3 girls),and the mean age of surgery was (5.4 ± 1.1) month old.According to the features of enhanced CT scanning,there were 2 cases of the type-Ⅰ,and the other 3 cases of type-Ⅱ,and 3 cases of type-Ⅲ;According to the characteristics of the pathological types,there was 1 case of type-Ⅰ,4 cases of type-Ⅱ,and the other 3 cases of type-Ⅲ.There was 1 case which classified as type-Ⅰ by CT,however classified as type-Ⅱ by pathological typing.The findings of CT features were in complete correspondence with the pathological types in the rest cases.Electron microscopic findings showed the alveolar spaces were enlarged,the alveolar cells were reduced,the lamellar bodies were decreased and immature and microvilli were also decreased.There was no significant difference between Ⅰ and Ⅱ type under the viewpoint of electron microscope.The common features between type Ⅰ,and type Ⅱ included that the alveolar space was enlarged,the alveolar space had been pressed between enlarged alveolar space,the alveolar cell were decreased and immature,and fibrous hypertrophy was also found.Conclusions There are differences between ultrastructural analysis and clinical pathological typing which suggests the clinical importance of the electron microscopy ultrastructural analysis combined with pathology for typing.There need further clinical and laboratory studies,especially the combination of microscopy-electrical control microscope for typing with related predictive models for follow-up of CCAM.

Anti-inflammation and Bacteriostasis Effects of Qinlian Liyan Heji / 医药导报

Objective To study the mechanism of anti-inflammation and bacteriostasis effect of Qinlian Liyan Heji. Methods To assess the anti-inflammatory effect, blood capillary permeability in mice was increased by acetic acid, the swelling of toe in rats was induced by albumen, and granuloma was induced by cotton ball in mice.The agar dilution method was used to check the minimal inhibitory concentration of Qinlian Liyan Heji on Staphylococcus aureus, Staphylococcus epidermidis, Moraxella catarrhalis, Klebsiella pneumoniae.The microdilution method was used to detect the minimal inhibitory concentration of Qinlian Liyan Heji on group A streptococci, Streptococcal pneumonia and Haemophilus influenzae. Results Contrast to the negative control group, Qinlian Liyan Heji significantly inhibited the increase of blood capillary permeability caused by acetic acid in the middle dose and the high dose groups.In the low dose and middle dose groups, Qinlian Liyan Heji obviously reduced the swelling of plantar in 2, 3, 4, 5 h.In the high dose group, Qinlian Liyan Heji markedly lowered the swelling of plantar in 1, 2, 3, 4, 5 h. Qinlian Liyan Heji significantly reduced the granuloma caused by cotton ball. On the other hand, Qinlian Liyan Heji exerted bacteriostatic effect on the above 7 types of bacteria. Conclusion Qinlian Liyan Heji has effects of anti-inflammation and bacteriostasis.

Clinicopathological features of three cases of spindle cell rhabdomyosarcoma and review of literatures / 临床与实验病理学杂志

Purpose To investigate the clinicopathological characteristics and differential diagnosis of spindle cell rhabdomyosarcoma ( SCRM) . Methods Three cases of SCRMs were analyzed by gross examination, microscopy and immunohistochemistry. Relevant lit-eratures were reviewed to summarize the diagnostic features of SCRM and its differential diagnosis. Results All the 3 cases were male infants aged from 2 days to 4 years. 2 cases were located in paratesticular and 1 in back. Tumors were all well-circumscribed but unen-capsulated, with white-gray cut surface, firmed and sized 2. 0 to 6. 0 cm in diameter. Histologically, tumors displayed invasive growth but were well-circumscribed. Tumor cells were spindle to round with eosinophilic cytoplasm and fascicular, storiform, wavy appear-ance. Horizontal structure and striated muscle brood cells were observed in some cells or local regions. A small amount of collagen fi-brils were observed in the mesenchymal components. The nucleus were long or fine wavy with unconspicuous nuclear atypia, mitosis could be occasional observed. Immunohistochemically, tumor cells were positive for vimentin, desmin, myogenin and MyoD1. CK,α-inhabin, AFP, CD34 and S-100 were negative. Conclusions SCRM is a rare and new type of rhabdomyosarcoma that commonly oc-curred in infant. It should be differentiated from other tumors, such as infantile fibromatosis, congenital fibrosarcoma, fibrosarcoma, leiomyosarcoma, triton tumor, malignant melanoma of promoting the fibrous tissues.

Characteristics and laws of acupoint selection in treatment of hyperlipidemia with acupuncture and moxibustion / 中国针灸

To refine and analyze the characteristics and laws of acupoint selection in treatment of hyperlipidemia with acupuncture and moxibustion. By retrieving the main databases of Chinese and English version, the clinical research literature is included on the definite acupoints for hyperlipidemia treated with acupuncture and moxibustion, and the characteristics and laws are analyzed on the acupoint selection for hyperlipidemia treated with acupuncture and moxibustion. It is found out that the special points have been mainly used in treatment of hyperlipidemia. The first five top acupoints of high frequency use include Fenglong (ST 40), Zusanli (ST 36), Sanyinjiao (SP 6), Neiguan (PC 6) and Tianshu (ST 25). Totally 10 meridians are involved in acupoint prescriptions. The meridians of higher frequency use include the Stomach Meridian, the Spleen Meridian, the Conception Vessel, the Bladder Meridian and the Pericardium Meridian. The specific points are mainly from the Stomach Meridian, the Spleen Meridian, the Conception Vessel, the Bladder Meridian and the Pericardium Meridian in the treatment of hyperlipidemia. The acupoint prescription of acupuncture and moxibustion for hyperlipidemia is characterized as determining the treating principle based on the spleen theory, selecting the acupoints along the running courses of the spleen and stomach meridians, combining the nearby acupoints with the distal ones, selecting the acupoints for adjusting the deficiency and excess of zangfu and syndrome differentiation, collaborating the acupoints located in the front and on the back, as well as supplementing the acupoints based on symptoms.

Perinatal diagnosis and treatment of congenital bronchogenic cysts in infants / 中华实用儿科临床杂志

Objective To discuss the diagnosis and early intervention treatment of fetal congenital broncho-genic cysts based on the cases reviewed. Methods The clinical features of 7 infants presenting bronchogenic cysts diagnosed antenatally from January 2013 to May 2014 in Guangdong Women and Children's Hospital and Health In-stitute were reviewed retrospectively. Pathology,the prenatal diagnosis and treatment of bronchogenic cysts experience were summarized combined with CT after birth and surgery. Results Based on the prenatal diagnosis of fetal and postnatal CT and surgical pathology,a total of 7 cases with congenital bronchial cysts were diagnosed. Of which 4 ca-ses were suggestive of congenital cystsic adenomatoid malformation by prenatal diagnosis,and the other 3 cases had fetal bronchial cysts by prenatal diagnosis,antenatal diagnosis was accurate in 42. 9%(3 / 7 cases). CT examinations were taken in 7 cases after birth,and the cyst excision was performed on them with surgery thoracic approach;the average age at surgery was(5. 3 ± 1. 7)months. Four cases had simple bronchial cystss,2 cases with congenital cystsic adenomatoid malformation,1 case with congenital pulmonary sequestration. The accuracy of CT diagnosis was 85. 7%(6 / 7 cases). All surgical treatment was effective. Conclusions Fetal bronchial cysts is always associated with the other presence of lung congenital malformations. Prenatal diagnosis of congenital bronchial cysts is difficult. Prenatal diagnosis is difficult to exclude congenital cystsic adenomatoid malformation. To avoid symptoms like oppres-sion,infection,prenatal diagnosis combined with CT examination after birth and early treatment are necessary and reliable clinically.