Incremental value of epicardial fat volume on predicting obstructive coronary artery disease with myocardial ischemia / 中华心血管病杂志

Objective: This study aimed to investigate the association between epicardial fat volume (EFV) and obstructive coronary artery disease (CAD) with myocardial ischemia, and evaluate the incremental value of EFV on top of traditional risk factors and coronary artery calcium (CAC) in predicting obstructive CAD with myocardial ischemia. Methods: This study was a retrospective cross-sectional study. Patients with suspected CAD who underwent coronary angiography (CAG) and single photon emission computerized tomography-myocardial perfusion imaging (SPECT-MPI) at the Third Affiliated Hospital of Soochow University from March 2018 to November 2019 were consecutively enrolled. EFV and CAC were measured by non-contrast chest computed tomography (CT) scan. Obstructive CAD was defined as coronary artery stenosis≥50% in at least one of the major epicardial coronary arteries, and myocardial ischemia was defined as reversible perfusion defects in stress and rest MPI. Obstructive CAD with myocardial ischemia was defined in patients with coronary stenosis severity≥50% and reversible perfusion defects in the corresponding areas of SPECT-MPI. Patients with myocardial ischemia bot without obstructive CAD were defined as none-obstructive CAD with myocardial ischemia group. We collected and compared the general clinical data, CAC and EFV between the two groups. Multivariable logistic regression analysis was performed to identify the relationship between EFV and obstructive CAD with myocardial ischemia. ROC curves were performed to determine whether addition of EFV improved predictive value beyond traditional risk factors and CAC for obstructive CAD with myocardial ischemia. Results: Among the 164 patients with suspected CAD, 111 patients were males, and average age was (61.4±9.9) years old. 62 (37.8%) patients were included into the obstructive CAD with myocardial ischemia group. 102 (62.2%) patients were included into the none-obstructive CAD with myocardial ischemia group. EFV was significantly higher in obstructive CAD with myocardial ischemia group than in none-obstructive CAD with myocardial ischemia group ((135.63±33.29)cm3 and (105.18±31.16)cm3, P<0.01). Univariate regression analysis showed the risk of obstructive CAD with myocardial ischemia increased by 1.96 times for each SD increase in EFV(OR 2.96; 95%CI, 1.89-4.62; P<0.01). After adjustment for traditional risk factors and CAC, EFV remained as an independent predictor for obstructive CAD with myocardial ischemia (OR, 4.48, 95%CI, 2.17-9.23; P<0.01). Addition of EFV to CAC and traditional risk factors was related to larger AUC for predicting obstructive CAD with myocardial ischemia (0.90 vs. 0.85, P=0.04, 95%CI: 0.85-0.95) and the global chi-square increased by 21.81 (P<0.05). Conclusions: EFV is an independent predictor for obstructive CAD with myocardial ischemia. Addition of EFV to traditional risk factors and CAC has incremental value for predicting obstructive CAD with myocardial ischemia in this patient cohort.

Association between inflammation activity of left atrial epicardial adipose tissue measured by 18F-FDG PET/CT and atrial fibrillation / 中华心血管病杂志

Objective: To explore the association between inflammation activity of left atrial epicardial adipose tissue (LA-EAT) measured by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and atrial fibrillation (AF). Methods: A total of 78 patients with AF, who underwent 18F-FDG PET/CT in the Nuclear Medicine Department of the Third Affiliated Hospital of Soochow University due to abnormally elevated levels of tumor indicators or malignant tumors from March 2018 to December 2019, were enrolled in this retrospective study. According to the examination date of PET/CT and basic characteristics of AF patients (gender, age), a 1∶1 propensity score matching was used to enroll a non-AF control group (78 patients). The maximum standard uptake value of left atrial epicardial tissue (LA-EAT FDG SUVmax) and total EAT volume (V-EAT) were measured by 18F-FDG PET/CT. Left ventricular ejection fraction (LVEF) and left atrial diameter (LAD) were obtained by echocardiography. Blood lipids and biomarkers of inflammation were measured. The differences of clinical data and EAT-related indicators were compared between the AF group and control group. Logistic multivariate regression analysis was used to determine the related factors of AF. Then the receiver operating characteristic (ROC) curve was used to determine the cutoff value of LA-EAT FDG SUVmax on the diagnosis of AF. Univariate and multivariate logistic regression analysis were used to analyze the relationship between the increase of LA-EAT FDG SUVmax and AF. Results: The age was (66.9±10.2) years and there were 55 males (70.5%) in the AF group. The age was (66.9±8.0) years, and there were 52 males (66.7%) in the control group (both P>0.05). The LAD ((44.2±5.8) mm vs. (35.4±4.4) mm), V-EAT ((122.1±42.0) cm3 vs. (91.6±34.5) cm3), and LA-EAT FDG SUVmax ((1.6±0.3) vs. (1.4±0.2)) values were significantly higher, while LVEF ((60.1±4.7)% vs. (63.9±2.9)%) was lower in the AF group than in the control group (P all<0.001). Multivariate logistic regression analysis showed that LAD (OR=1.340, 95%CI 1.195-1.502), V-EAT (OR=1.016, 95%CI 1.001-1.031), and LA-EAT FDG SUVmax (OR=1.375, 95%CI 1.095-1.723) were positively correlated with AF, LVEF (OR=0.781, 95%CI 0.659-0.926) was negatively correlated with AF(P all<0.05). The area under the ROC curve of LA-EAT FDG SUVmax for diagnosis of AF was 0.680 (95%CI 0.597-0.764, P<0.001), and the best cut-off value was 1.415 with a sensitivity of 65.4% and specificity of 61.5%. After adjusting for high-density lipoprotein cholesterol, LVEF, LAD and V-EAT, LA-EAT FDG SUVmax≥1.415 was independently associated with AF (OR=2.982, 95%CI 1.122-7.926, P=0.010). Conclusions: The inflammatory activity of LA-EAT measured by 18F-FDG PET/CT is an independent risk factor of AF, and the increased inflammatory activity of LA-EAT is positively correlated with AF.

Evaluation and Comparison of SHA.LIN,S.T.O.N.E.Nephrolithometry Scoring System,and Clinical Research Office of the Endourological Society Nephrolithometry Nomogram for Predicting Stone Free Rate and Postoperative Outcomes after Percutaneous Nephrolithotomy / 中国医学科学院学报

To compare the accuracy of SHA.LIN,S.T.O.N.E.nephrolithometry scoring system,and Clinical Research Office of the Endourological Society(CROES)nephrolithometry nomogram in predicting percutaneous nephrolithotomy(PCNL)outcomes including stone free rate(SFR)and perioperative status. Methods The clinical data of 90 patients with nephrolithiasis undergoing PCNL in department of urology,China-Japan Friendship Hospital from January 2015 to March 2018 were retrospectively analyzed.The general data,stone characteristics,operation approaches,and perioperative variables were recorded.SHA.LIN,S.T.O.N.E.score,and CROES nomogram were assigned according to the computed tomography(CT)findings before surgery.Stone free status was evaluated by kidney-ureter-bladder one month after PCNL.The relationships of SHA.LIN score,S.T.O.N.E.score,and CROES score with SFR,postoperative complications,operation time(OT),length of hospital stay(LOS),estimated blood loss(EBL),and decrease of hemoglobin was evaluated.Receiver operating characteristic(ROC)curves were used to analyze the predictive accuracy. Results The SFR was 72.2%(65/90)and postoperative complications occurred in 33 cases(36.7%).The mean OT was(103.1±39.6)min,the mean EBL was(46.1±53.0)ml,the mean LOS was(15.3±5.2)d,the mean postoperative LOS was(8.5±3.4)d,and the mean decrease of hemoglobin was(16.1±10.2)g/L.Stone-free patients had significantly lower SHA.LIN score(8.23 10.36,=0.000)and S.T.O.N.E.score(7.05 8.16,=0.000)and significantly higher CROES score(188.50 143.89,=0.000)compared to patients with residual fragments.All these scores were not significantly associated with complications(>0.05).On the other hand,all these scores were significantly correlated with OT,EBL,and decrease of hemoglobin(SHA.LIN:=0.006,=0.028,=0.014;S.T.O.N.E.:=0.012,=0.047,=0.011;and CROES:=0.040,=0.045,=0.013).SHA.LIN(=0.001)and S.T.O.N.E.(=0.005)scores were associated with LOS.Logistic regression analysis revealed that SHA.LIN(=2.491),S.T.O.N.E.(=3.030),and CROES(=0.973)scores were significantly associated with stone-free status.ROC curves in predicting SFR showed that there was significant difference in the areas under the curves(AUC)for the SHA.LIN S.T.O.N.E.score [0.808(95% =0.711-0.905) 0.748(95% =0.632-0.864),=0.047].AUC for the CROES score [0.770(95% =0.664-0.877)] showed no significantly different for the SHA.LIN score or the S.T.O.N.E.score(>0.05). Conclusions All these three scoring systems have good predictive accuracy for SFR.SHA.LIN is more precise than S.T.O.N.E.in predicting SFR.However,they can not predict postoperative complications.

Solitary Fibrous Tumor of the Kidney Treated with Laparoscopic Partial Nephrectomy: A Case Report / 中国医学科学杂志(英文版)

We herein reported a 27-year-old woman with a right renal mass for two years. She underwent laparoscopic partial nephrectomy. Immunohistochemical examination of the specimen confirmed the diagnosis of solitary fibrous tumor by revealing its positive staining for cluster of differentiation (CD)34, epithelial membrane antigen (EMA), B-cell lymphoma-2 (Bcl-2) and CD99 in the tumor cells. No adjuvant treatment was carried out. The patient was in good health without local recurrence or metastasis during 2 years of follow-up. Laparoscopic partial nephrectomy for renal solitary fibrous tumor is an alternative treatment to radical nephrectomy. It can provide a good outcome. However, further follow-up and more cases of renal solitary fibrous tumor treated with laparoscopic partial nephrectomy are necessary to compare the oncological outcome with radical nephrectomy.

Effect of nutritional intervention on acute radiation oral mucositis in patients with head and neck cancer / 肠外与肠内营养

Objective:To explore the effect of nutritional intervention on nutritional status and acute radiation oral mucositis in patients with head and neck cancer.Methods:Sixty-eight patients with head and neck cancer received radiotherapy were randomly divided into two groups.There were thirty-three patients in nutritional intervention group(NI),the rest for the control group.The nutritional status score (PG-SGA),mean weight,body mass index (BMI)and acute radiation oral mucositis score in the two groups were before radiotherapy,at the end of radiotherapy,one month after radiotherapy were analyzed and compared.There was no significant difference in PG-SGA scores between the two groups before radiotherapy.The PG-SGA scores in NI remained stable,no difference at between each time point.At the end of radiotherapy and 1 month after radiotherapy,the PG-SGA scores in NI were significantly lower than those in CG (P ＜ 0.001,P ＜ 0.05 respectively),while the nutritional status deteriorated in CG and the scores at the end of radiotherapy and one month after radiotherapy were significantly higher than those before radiotherapy(P ＜ 0.001,P ＜ 0.05 respectively).The mean weight in NI remained stable during radiotherapy.At the end of radiotherapy,the mean weight in NI were significantly higher than those in CG (P ＜ 0.001).While the mean weight in CG were in the declining tendency,and at the end of radiotherapy they were significantly lower than those before radiotherapy P ＜ 0.001).The trend of BMI is the same as that of mean weight.There was no significant difference between the two groups in the incidence of severe acute radioactive oral mucosal reaction (1Ⅲ + Ⅳ grade) (P ＞ 0.05).At one month after radiotherapy,the incidence of total acute radiation mucositis (Ⅰ + Ⅱ + Ⅲ + Ⅳ) and severe acute radiation mucositis (Ⅲ + Ⅳ grade)in NI were significantly lower than those in CG(x2=4.556,P ＜ 0.053,P ＜ 0.05;x 2=4.712,P ＜ 0.05,P ＜ 0.05 respectively).Nutritional intervention can effectively maintain the nutritional status of patients received radiotherapy of head and neck cancer,and promote the recovery of acute radiation oral mucositis.

Survey of Rh Blood Type Phenotypes in Unpaid Blood Donors in Tongchuan Area of Shaanxi Province / 现代检验医学杂志

Objective To investigate the distribution of Rh blood type phenotype in unpaid blood donors in Tongchuan area and establish a Rh blood type phenotype database to provide a strong guarantee for clinical safe blood transfusion.Methods The Rh blood group antigens of 3 419 cases of blood donors samples were detected by the method of card column weak gel in the Tongchuan Blood Center from June 2015 to March 2017,and identification of RhD negative specimens were confirmed fordetermining the phenotype of its Rh blood group with indrect antiglobulin test.The cassification statistics were carried out and filed with computer.Rh distribution with other parts of the domestic distribution of blood type was compared using t test.Results The negative rate of RhD in 3 419 unrelated donors was 0.55％.The positive rates of other antigens in Rh were 99.45％,90.41％ in C,55.10％ in E,45.51％ in E and 92.19％ in E,respectively.D:0.921,C:0.673 7,c:0.320 7,E:0.275 5 and e:0.730 6.The distribution of Rh phenotype was:CCDee＞ CcDEe＞ CcDee＞ ccDEE＞ ccDEe＞ CcDEE＞ ccDee ＞ RhD negative.Statistical analysis showed that there was significant difference between the composition ratio of CCDee and ccDEE in Tongchuan and that in Nanning and Qiannan (x2 =21.552,P=0.016;x2=18.519,P=0.001).There was no significant difference between Shenyang,Xingtai and Tianjin Binhai (x2 =0.227～1.31,all P＞0.05).Conclusion The distribution of Rh phenotype in Tongchuan area has the characteristics of northern region[1～4].The RhD negative rate is in line with the distribution characteristics of Chinese Han population.Rh and Rh genotypes differ in southern and northern China,Phenotypic distribution of the investigation for the safety of blood transfusion is of great significance.

Expressions of Bcl-2, Bax and Ki67 in the primary pterygium / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To research the expressions of B-cell lymphoma gene 2 (Bcl-2), Bcl-2 associated X-protein (Bax) and Ki67 (proliferating cell marker) in the primary pterygium and normal bulbar conjunctiva, to explore the pathogenesis of pterygium. METHODS: Thirty pterygium were surgically removed and 5 normal bulbar conjunctivas were also obtained. Formalin-fixed, paraffin-wax-embedded tissues were analyzed by immunohistochemistry with Bcl - 2, Bax, Ki67. RESULTS:The mean positive expression of Bcl-2, Bax and Ki67 in the primary pterygium was 14.73%, 7.00% and 12.73%, respectively 4.00%,6.00% and 0 in normal conjunctiva group. The expression of Bcl-2 and Ki67 in the head of primary pterygium was higher than that of neck and body. CONCLUSION: Bcl-2 and Ki67 have highly expressions in the primary pterygium, the expressions in the head of primary pterygium is the highest, the expressions in normal bulbar conjunctiva is low or no. There is no significant difference in the expression of Bax in the primary pterygium and normal bulbar conjunctiva. Apoptosis imbalance and abnormal proliferation of cells may be one of the mechanisms for the occurrence and development of the primary pterygium.

Study on corneal edema related factors after phacoemulsification in patients with diabetic cataract / 国际眼科杂志(Guoji Yanke Zazhi)

Cataract is the first ophthalmological blinding eye disease. In recent years, phacoemulsification has become the preferred method for the treatment of cataract due to its short time and small damage, which is widely used by ophthalmologists. With the continuous improvement of technology, serious complications caused by phacoemulsification become less and less. But the phenomenon of postoperative corneal edema is not uncommon. The incidence of corneal edema is especially high in patients with diabetic cataracts. This paper reviewes the concept of corneal edema, pathogenesis and the related factors of corneal edema after phacoemulsification in diabetic cataract patients.

Evaluation of early left ventricular remodeling after acute myocardial infarction by gated myocardial perfusion imaging through animal experiments / 中华核医学与分子影像杂志

Objective To assess left ventricular remodeling (LVRM) after acute myocardial in-farction (AMI) quantitatively by SPECT gated myocardial perfusion imaging (GMPI), and further explore its influencing factors. Methods Twelve Ba-Ma miniature swine were used to establish AMI model. GMPI was performed at the baseline (before AMI), 24 h, 1 and 4 weeks after AMI. Infarct expansion index, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction ( LVEF) and myocardial perfusion defect were measured. Meanwhile, creatine kinase isozyme MB (CK-MB) and hypersensitive cardiac troponin I (hs-cTn I) were detected. The changes of LVEDV and LVESV before and after AMI (ΔLVEDV and ΔLVESV) were calculated. Repeated measurement analy-sis of variance, the least significant difference t test and Pearson correlation analysis were performed. Re?sults Nine AMI swine were successfully created. LVRM was present 24 h after AMI. LVEDV and LVESV were significantly greater than those before AMI and aggravated within 1 week after AMI, then were down-wards at 4 weeks after AMI. Before AMI, 24 h, 1 and 4 weeks after AMI, the LVEDV was (34.44±7. 90), (47.56±22.66), (71.89±14.90) and (70.33±19.47) ml (F = 28.836, P<0.001), and the LVESV was (10.11±5.49), (25.33±11.62), (40.89±15.88) and (35.44±17.11) ml (F = 22.450, P<0. 001). In-farct expansion index increased progressively within 4 weeks after AMI (F= 16.054, P<0.001). LVEF was significantly lower after AMI than that before AMI (F = 18.267, P<0.001) and improved at 4 weeks after AMI compared to that at 1 week ((52.56±14.96)％ vs (45.11±15.80)％; t= 2.440, P<0. 05). There was a significant correlation between the change in perfusion defect and the ΔLVEDV or ΔLVESV (r values:0. 731 and 0.700, both P<0.05) at 1 week after AMI. In addition, hs-cTn I at 24 h was correlated withΔLVEDV at 24 h and 4 weeks after AMI, respectively (r values: 0.669 and 0.693, both P<0.05). Conclu?sions LVRM and cardiac dysfunction occur in the early period after AMI. LVRM and cardiac dysfunction are most severe at 1 week after AMI, and recover at 4 weeks after AMI, whereas infarct expansion is aggra-vated within 4 weeks. Infarct size and hs-cTn I are closely related to the degree of LVRM.

Clinical analysis on arthroscopic debridement for the treatment of early infection after total knee replacement / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical effects of arthroscopic debridement versus open debridement on controlling and treatment of infection after total knee replacement.</p><p><b>METHODS</b>From October 2009 to September 2016 in three hospitals, 11 patients with 11 joints which were infected after total knee replacement were randomly divided into two groups:5 cases in arthroscopy group and 6 cases in routine group. Patients in arthroscopy group were treated with arthroscopic debridement to remove the necrotic tissues, then closed-type irrigation with sensitive antibiotics by using two sebific ducts were performed continuously for 2 or 3 weeks until the flushing fluid became clear for 3 or 5 days;other 6 patients in routine group were treated with open surgical debridement and the following procedures in keeping with those in the arthroscopy group. Operation time, blood loss and incision length were recorded during the operation, and pain scores were recorded on the 1st, 3rd and 7th day after the operation. The curative effects were evaluated according to the Hospital for Special Surgery score system.</p><p><b>RESULTS</b>The local and general symptoms of the 11 patients disappeared, and the test outcomes of biochemistry, blood and synovial fluid were normal. All patients were followed up, and the duration ranged from 6 to 18 months. Infection recurrences were observed in 1 case of arthroscopy group and 2 cases of routine group 3 months later after operation, and all these patients who underwent the second time operation with arthroscopic debridement were cured. According to the Hospital for Special Surgery score system, 3 cases obtained excellent result, 2 good, no poor and bad cases in arthroscopy group;3 cases obtained excellent result, 1 good, 1 poor and 1 bad in routine group.</p><p><b>CONCLUSIONS</b>If the sensitive antibiotics can be found for the infected joints without obvious destruction of bone and no prosthesis loosening, it has a better therapeutic effect by using arthroscopic debridement combined with continuous drainage and irrigation. The method has a better curative effect with smaller trauma.</p>

Progress of research on pterygial pathogenesis / 国际眼科杂志(Guoji Yanke Zazhi)

?Pterygium is one of the most common ocular surface diseases. Its exact etiology and pathogenesis are not completely understood. At present, it is considered that its occurrence and development is the result of many factors. Current studies have indicated that the occurrence of pterygium is closely related to the environmental factors. Long time exposure to sunlight, dust, pollen and other long - term chronic stimulation are the main incentive factors. Various factors have caused limbal barrier dysfunction, induced the level of a variety of growth factors and inflammatory factors increased, so that the conjunctival tissue degenerate and proliferate to the cornea in the formation of pterygium. In this paper, the research progress of the pathogenesis of pterygium is reviewed.

Vascular Endothelial Growth Factor and Cluster of Differentiation 34 for Assessment of Perioperative Bleeding Risk in Gastric Cancer Patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Angiogenesis is the formation of new blood vessels to supply nutrients to tumors. Vascular endothelial growth factor (VEGF) and cluster of differentiation 34 (CD34) are important signaling proteins involved in angiogenesis. Many studies have demonstrated that VEGF and CD34 are related to tumor progression. This study focused on the relationship between VEGF, CD34, and perioperative hemorrhage in patients with gastric cancer.</p><p><b>METHODS</b>To observe the relationship between VEGF and CD34, we tracked 112 patients with advanced gastric cancer for 5 years to assess factors related to hemorrhage, using immunohistochemistry. The results were subjected to statistical analysis using a 2 × 2 contingency table, logistic regression, and receiver operating characteristic (ROC) test.</p><p><b>RESULTS</b>The concentrations of VEGF and CD34 were critically correlated with perioperative hemorrhage and neural invasion in patients with gastric cancer (P < 0.05). Expression of VEGF and CD34 was related (P < 0.05, χ2 = 6.834). VEGF and CD34 co-expression strongly increased the risk of preoperative bleeding (area under the ROC curve >0.7, P < 0.05).</p><p><b>CONCLUSIONS</b>Expression of VEGF and CD34 was critically correlated with perioperative hemorrhage in gastric cancer patients. Co-expression of VEGF and CD34 could be an effective indicator for evaluating the risk of perioperative bleeding in gastric cancer patients.</p>

A retrospective study of Schatzker III tibial plateau--fracture using minimally invasive fixation and bone grafting through medial side / 中国骨伤

<p><b>OBJECTIVE</b>To investigate clinical effects of minimally invasive fixation and bone grafting througn medial side for the treatment of Schatzker III tibial plateau fracture.</p><p><b>METHODS</b>From April 2009 to August 2011, 18 patients with Schatzker III tibial plateau fracture were treated with minimally invasive fixation and bone grafting through medial side. There were 15 males and 3 females ranging in age from 64 to 73 years, with an average of (69.75 ± 1.22) years. Sixteen patients were caused by falling down, 2 cases were caused by traffic accident. Operative time and length of incision were be recorded. Clinical and radiological follow-up was performed after operation. Hospital for Special Surgery (HSS) score and Kellgren-Lawrence score were used to evaluate clinical effects.</p><p><b>RESULTS</b>The mean operative time was (45.32 ± 1.58) min, and the mean length of incision was (5.21 ± 0.65) cm. Postoperative X-ray showed excellent reduction. Eighteen patients were followed up for 10 to 13 months with an average of (11.5 ± 1.35) months. The mean HSS score was 86.51 ± 2.71, 12 cases got excellent results,4 good and 2 fair. Three patients were developed mild osteoarthritis according to the Kellgren-Lawrence system.</p><p><b>CONCLUSION</b>Minimally invasive fixation and bone grafting through medial side, not only could reduce surgical invasive, but also guarantee early function activities. It has advantages of keeping well after reduction. So it has the favorable future in clinic.</p>

Roles of non-coding RNA in pancreatic islet development and functioning / 中国医学科学院学报

Non-coding RNA is a kind of non-coding protein RNA which is widely present in most of the organisms. Non-coding RNA plays key roles in the embryonic development,cell fate determination,and growth control in the living organisms. MicroRNA and long non-coding RNA involve in differentiation of endocrine cell,insulin gene expression and secretion,and insulin resistance,which are closely associated with diabetes.

Involvement of endoplasmic reticulum stress in apoptosis of testicular cells induced by low-dose radiation / 华中科技大学学报（医学）（英德文版）

The study examined the role of endoplasmic reticulum stress (ERS) and signaling pathways of inositol-requiring enzyme-1 (IRE1), RNA-activated protein kinase-like ER kinase (PERK) and activating transcription factor-6 (ATF6) in apoptosis of mouse testicular cells treated with low-dose radiation (LDR). In the dose-dependent experiment, the mice were treated with whole-body X-ray irradiation at different doses (25, 50, 75, 100 or 200 mGy) and sacrificed 12 h later. In the time-dependent experiment, the mice were exposed to 75 mGy X-ray irradiation and killed at different time points (3, 6, 12, 18 or 24 h). Testicular cells were harvested for experiments. H2O2 and NO concentrations, and Ca(2+)-ATPase activity were detected by biochemical assays, the calcium ion concentration ([Ca(2+)]i) by flow cytometry using fluo-3 probe, and GRP78 mRNA and protein expressions by quantitative real-time RT-PCR (qRT-PCR) and Western blotting, respectively. The mRNA expressions of S-XBP1, JNK, caspase-12 and CHOP were measured by qRT-PCR, and the protein expressions of IRE1α, S-XBP1, p-PERK, p-eIF2α, ATF6 p50, p-JNK, pro-caspase-12, cleaved caspase-12 and CHOP by Western blotting. The results showed that the concentrations of H2O2 and NO, the mRNA expressions of GRP78, S-XBP1, JNK, caspase-12 and CHOP, and the protein expressions of GRP78, S-XBP1, IRE1α, p-PERK, p-eIF2α, ATF6 p50, p-JNK, pro-caspase-12, cleaved caspase-12 and CHOP were significantly increased in a time- and dose-dependent manner after LDR. But the [Ca(2+)]i and Ca(2+)-ATPase activities were significantly decreased in a time- and dose-dependent manner. It was concluded that the ERS, regulated by IRE1, PERK and ATF6 pathways, is involved in the apoptosis of testicular cells in LDR mice, which is associated with ERS-apoptotic signaling molecules of JNK, caspase-12 and CHOP.

Involvement of endoplasmic reticulum stress in apoptosis of testicular cells induced by low-dose radiation / 华中科技大学学报（医学）（英德文版）

The study examined the role of endoplasmic reticulum stress (ERS) and signaling pathways of inositol-requiring enzyme-1 (IRE1), RNA-activated protein kinase-like ER kinase (PERK) and activating transcription factor-6 (ATF6) in apoptosis of mouse testicular cells treated with low-dose radiation (LDR). In the dose-dependent experiment, the mice were treated with whole-body X-ray irradiation at different doses (25, 50, 75, 100 or 200 mGy) and sacrificed 12 h later. In the time-dependent experiment, the mice were exposed to 75 mGy X-ray irradiation and killed at different time points (3, 6, 12, 18 or 24 h). Testicular cells were harvested for experiments. H(2)O(2) and NO concentrations, and Ca(2+)-ATPase activity were detected by biochemical assays, the calcium ion concentration ([Ca(2+)]i) by flow cytometry using fluo-3 probe, and GRP78 mRNA and protein expressions by quantitative real-time RT-PCR (qRT-PCR) and Western blotting, respectively. The mRNA expressions of S-XBP1, JNK, caspase-12 and CHOP were measured by qRT-PCR, and the protein expressions of IRE1α, S-XBP1, p-PERK, p-eIF2α, ATF6 p50, p-JNK, pro-caspase-12, cleaved caspase-12 and CHOP by Western blotting. The results showed that the concentrations of H2O2 and NO, the mRNA expressions of GRP78, S-XBP1, JNK, caspase-12 and CHOP, and the protein expressions of GRP78, S-XBP1, IRE1α, p-PERK, p-eIF2α, ATF6 p50, p-JNK, pro-caspase-12, cleaved caspase-12 and CHOP were significantly increased in a time- and dose-dependent manner after LDR. But the [Ca(2+)]i and Ca(2+)-ATPase activities were significantly decreased in a time- and dose-dependent manner. It was concluded that the ERS, regulated by IRE1, PERK and ATF6 pathways, is involved in the apoptosis of testicular cells in LDR mice, which is associated with ERS-apoptotic signaling molecules of JNK, caspase-12 and CHOP.

Case-control study on minimally invasive plate osteosynthesis for the treatment of proximal humeurs fractures in elderly patients / 中国骨伤

<p><b>OBJECTIVE</b>To compare clinical efficacy for the treatment of proximal humeurs fractures in elderly patients between the minimally invasive plate osteosynthesis (MIPO) with less invasive stabilization system (LISS) and the open reduction and internal fixation (ORIF) with locking compression plate (LCP).</p><p><b>METHODS</b>From June 2008 to June 2011, 40 elderly patients suffering from proximal humeurs fractures were divided into two groups: 20 cases in minimally invasive group and 20 cases in routine group. Mini-incision approach from the lateral shoulder (minimally invasive group) and LISS can be chosen. It was short for MIPO. The antero-medial incision was used in routine group, LCP can be chosen in the method of ORIF. The operation time, the blood loss, the incision length, soreness at 1st, 3rd and 7th days after operation were recorded. The postoperative Neer score, the healing time of bone were recorded. The curative effects were compared according to Neer score system.</p><p><b>RESULTS</b>The mean operation times were (133.60 +/- 8.90) min and (132.70 +/- 8.41) min in minimally invasive group and routine group (P > 0.05). The blood losses were (155.20 +/- 19.07) ml and (324.05 +/- 48.32) ml (P < 0.05). The incision lengths were (8.15 +/- 1.89) cm and (13.05 +/- 1.95) cm (P < 0.05). The pain scores on the 1st,3rd and 7th days after operation were (6.20 +/- 2.39) and (8.33 +/- 3.01) (P < 0.05), (3.83 +/- 2.09) and (5.31 +/- 2.22) (P < 0.05), (1.22 +/- 0.89) and (3.13 +/- 1.75) (P < 0.05). The postoperative Neer scores were 93.16 +/- 2.55 and 80.31+/- 2.22 (P < 0.05) and the healing times of bone were (6.60 +/- 2.33) months and (8.93 +/- 3.41) months (P < 0.05). There were statistially differences in the blood losses, incision lengths, postoperative pain scores, postoperative Neer scores and the healing times of bone between two groups (P < 0.05). The operation time between the two groups had no statistically different (P > 0.05). According to Neer score system, 13 patients obtained an excellent results, 2 good, 5 fair in minimally invasive group; 6 patients obtained an excellent results, 5 good, 9 fair in routine group.</p><p><b>CONCLUSION</b>To compare with the routine group of ORIF, MIPO with LISS has the advantages of small incision, easier operation, less blood loss and improved postoperative shoulder joint function recovery for treatment of proximal humeurs fracture in elderly patients. It is another better method of internal fixation.</p>

The assessment of hemoperfusion for the treatment of acute methamidophos poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To explore the effect of hemoperfusion(HP) about the patients of methamidophos poisoning.</p><p><b>METHODS</b>On the basis of comprehensive treatment,15 cases of severe acute methamidophos poisoning patients were treated with HP, Blood samples were collected at 7 time points, before and 5, 15, 30, 45, 60mins following the beginning and the end of hemoperfusion. Blood samples were used for measuring the concentration of methamidophos and perfusion devices were used for measuring the volume of methamidophos adsorbed by the device after hemoperfusion.</p><p><b>RESULTS</b>15 patients live in 12 cases, 3 cases of death. HP (former) blood Cholinesterase vigor were 662.60 + 632.05, HP (after) blood cholinesterase vigor were 2577.52 + 920.38 IU/L; The difference of blood Cholinesterase vigor between the before and after HP was statistically significant (P < 0.01). The patients' methamidophos concentration of blood when HP treated 45, 60, 120 min were respectively (851 + 672), (680 + 529), (587 + 520) microg /ml, there were significantly lower than that the patients' methamidophos concentration of blood who were before HP (1659 + 1105) microg/ml, a statistically significant difference (P < 0.01).</p><p><b>CONCLUSION</b>HP can be cut down obviously methamidophos poisoning patients serum concentrations of toxic, the experimental method directly prove the clinical application of carbon HP can really adsorption methamidophos.</p>

Increased levels of p53 and PARP-1 in EL-4 cells probably related with the immune adaptive response induced by low dose ionizing radiation in vitro / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This paper is to explore the DNA repair mechanism of immune adaptive response (AR) induced by low dose radiation (LDR), the changes of mRNA levels and protein expressions of p53, ATM, DNA-PK catalytic subunit (DNA-PKcs) and PARP-1 genes in the LDR-induced AR in EL-4 cells.</p><p><b>METHODS</b>The apoptosis and cell cycle progression of EL-4 cells were detected by flow cytometry in 12 h after the cells received the pre-exposure of 0.075 Gy X-rays (inductive dose, D1) and the succeeding high dose irradiation (challenge dose, D2; 1.0, 1.5, and 2.0 Gy X-rays, respectively) with or without wortmannin (inhibitor of ATM and DNA-PK) and 3-aminobenzamid (inhibitor of PARP-1). And the protein expressions and mRNA levels related to these genes were detected with flow cytometry and reverse transcription-polymerase chain reaction in 12 h after irradiation with D2.</p><p><b>RESULTS</b>The mRNA and protein expressions of p53 and PARP-1 in EL-4 cells in the D1 + D2 groups were much lower than those in the D2 groups, and those of PARP-1 in the 3-AB + D2 and the 3-AB + D1 + D2 groups were much lower than those in the D2 and the D1 + D2 groups. The percentage of apoptotic EL-4 cells in the 3-AB + D1 + D2 groups was much higher than that in the D1 + D2 groups, that in the G₀/G₁ and the G₂ + M phases was much higher, and that in the S phase were much lower. Although the ATM and DNA-PKcs mRNA and protein expressions in wortmannin + D1 + D2 groups were much lower than those in the D1 + D2 groups, there were no significant changes in the apoptosis and cell cycle progression between the wortmannin + D1 + D2 and the D1 + D2 groups.</p><p><b>CONCLUSION</b>PARP-1 and p53 might play important roles in AR induced by LDR.</p>

Effectiveness of inactivated poliomyelitis vaccine for primary vaccination / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the immunological effectiveness of inactivated poliomyelitis vaccine (IPV) for children's primary vaccination in China and to compare with the oral poliomyelitis vaccine (OPV) used in routine vaccination.</p><p><b>METHODS</b>The 2-month-old children were randomly immunized with IPV and OPV, with 208 subjects in each group. The pre- and post-vaccination blood samples were collected. Micro-neutralization method was used to measure the antibody response against 3 types of polioviruses. chi2 test was used to evaluate the statistical difference of protection rates between two groups, while the antibody titers were transformed by logarithm and analyzed by Z-test. P < 0.05 was always used to define the significance of analysis.</p><p><b>RESULTS</b>After 3 doses of immunization, the protection rates in IPV group reached to 100.0% (186/186), 97.3% (181/186), 98.9% (184/186) for poliovirus type 1, 2, 3, respectively, and in OPV group were 97.4% (188/193), 100.0% (193/193), 95.3% (184/193), respectively. The geometry mean titers (GMTs) were 151.2, 86.7, 211.3 for IPV group; and 1089.5, 538.2, 203.7 for OPV group. IPV showed comparable protection rates with OPV for type 1 and 2 (chi2(I) = 2.991, P = 0.084; chi2(II) = 3.512, P = 0.061), while type 3 was higher than OPV (chi2(III) = 4.143, P = 0.042). The GMT of type 1 and 2 in IPV group were lower than OPV group (Z(I) = 12.537, P = 0.000; Z(II) = 13.415, P = 0.000), while the GMT of type 3 were comparable in two groups (Z(III) = 0.067, P = 0.947).</p><p><b>CONCLUSION</b>IPV showed roughly comparable immunological effectiveness in young children. The protection rates for type 1 and 2 were similar to OPV, while type 3 was higher than in OPV group; In terms of GMT,type 1 and 2 in IPV group were lower than OPV, but type 3 were comparable to OPV group.</p>