The effectiveness and safety of concurrent chemoradiotherapy combined with nimotuzumab for patients with inoperable esophageal squamous cell carcinoma / 中华放射医学与防护杂志

Objective:To evaluate the effectiveness and safety of concurrent chemoradiotherapy combined with nimotuzumab in the treatment of patients with inoperable esophageal squamous cell carcinoma (ESCC).Methods:A retrospective analysis was conducted on the clinical data of 503 patients with inoperable ESCC who underwent concurrent chemoradiotherapy in the Department of Radiation Oncology, Changzhou No. 2 People′s Hospital Affiliated to Nanjing Medical University and Department of Radiation Oncology, Affiliated Hospital of Jiangnan University from 2014 to 2020. Among these patients, 69 received concurrent chemoradiotherapy combined with nimotuzumab (the combined therapy group) and 434 received concurrent chemoradiotherapy alone (the concurrent chemoradiotherapy group). Patients of both groups were matched at a ratio of 1∶2 using the propensity score matching (PSM) method. As a result, 168 patients were determined for clinical analysis, including 61 in the combined therapy group and 107 in the concurrent chemoradiotherapy group. The short-term efficacy and adverse reactions of both groups were compared. The overall survival (OS) curves and progression-free survival (PFS) curves were plotted using the Kaplan-Meier method for the Log-rank test.Results:The two groups showed no statistical difference ( P > 0.05) in clinical baseline characteristics after the PSM. The objective response rate (ORR) of the combined therapy group was significantly higher than that of the concurrent chemoradiotherapy group with statistically significant differences (85.2% vs. 71.0%, χ2 = 4.33, P = 0.037). There was no statistical difference (98.4% vs. 91.6%, P > 0.05) in the disease control rate (DCR) between the two groups. The combined therapy group had median PFS of 28.07 months and 1-, 3-, and 5-year PFS ratios of 78.2%, 37.5% and 29.1%, respectively. The concurrent chemoradiotherapy group had mPFS of 19.54 months and 1-, 3-, and 5-year PFS ratios of 72.9%, 28.3% and 21.3%, respectively. Both groups showed statistically significant differences in PFS ( χ2 = 4.49, P = 0.034). The combined group had median OS of 34.93 months and 1-, 3-, and 5-year OS ratios of 88.5%, 46.8% and 37.4%, respectively. The concurrent chemoradiotherapy group had mOS of 24.30 months and 1-, 3-, and 5-year OS ratios of 81.3%, 35.2% and 28.0%, respectively. Both groups showed statistically significant differences in OS (χ 2= 5.11, P = 0.024), but did not show statistical differences ( P > 0.05) in the severity degree of each adverse effect during the treatment. Conclusions:Concurrent chemoradiotherapy combined with nimotuzumab can improve the ORR and prolong the PFS and OS of patients with inoperable ESCC compared with concurrent chemoradiotherapy alone. Furthermore, combining with nimotuzumab does not increase adverse effects and can be tolerated by patients with high safety.

Application of CT radiomics analysis to predict symptomatic radiation pneumonitis for lung cancer / 中华放射医学与防护杂志

Objective:To build a predictive model for symptomatic radiation pneumonitis(RP) using the pretreatment CT radiomics features, clinical and dosimetric data of lung cancer patients by using machine learning method.Methods:A retrospective analysis of 103 lung cancer patients who underwent radiotherapy in the Affiliated Hospital of Jiangnan University from November 2018 to April 2020 was performed. Total normal lung tissues were segmented as an interested volume in pretreatment CT images, and then 250 radiomics features were extracted. The correlations of RP and clinical or dosimetric features were firstly investigated with univariate analysis. Then all clinical data, dosimetric data and CT radiomics features were collected and considered as predictors for modeling of RP grade ≥ 2. Features were selected through LASSO machine learning method, and the predictive model was built. Finally, nomogram for risk of RP were obtained according to the selected features.Results:The result of univariate analysis showed that symptomatic RP was significantly correlated with lung dosimetric parameters including mean lung dose (MLD), V20 Gy and V30 Gy( t=2.20, 2.34 and 2.93, P<0.05). Four features, including lung dose volume percentage V30 Gyand three radiomics features, entropy feature of GLCM, mean and median feature of wavelet histogram were selected among all clinical, dosimetric features and radiomics features. AUC of the predicted model obtained from selected features reached 0.757. For convenient clinical use, the nomogram were obtained, and then personalized RP risk prediction and early intervention could be performed according to this nomogram. Conclusions:Pretreatment CT radiomics and dosimetric features can be used in predicting symptomatic RP, which will be useful for advanced intervention treatment.

The role of Glasgow prognostic score in prognostic evaluation of nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective:To assess the role of Glasgow prognostic score (GPS) in the prognostic evaluation of nasopharyngeal carcinoma patients.Methods:Clinical data of 129 nasopharyngeal carcinoma patients who received radical radiotherapy in Affiliated Hospital of Jiangnan University from January 2012 to December 2013 were retrospectively analyzed. Clinicopathological characteristics of the patients were collected, including gender, age, TNM staging, pathological type and treatment regimen, etc. The GPS before and at 3 months after radiotherapy were calculated. The survival curve was drawn by the Kaplan- Meier method. Cox regression model was used for analysis of prognostic factors. The area under the receiver operating characteristic (ROC) curve (AUC) was utilized to evaluate the predictive capability of clinical parameters on prognosis. Results:With a median follow-up of 89.0 months (range: 5.1-104.6 months), the 5-year progression-free survival (PFS) of 129 patients was 79.8% and 84.5% for the 5-year overall survival (OS). At 3 months after radiotherapy, the 5-year PFS were 85.6%, 61.1% and 33.3% in the GPS 0, 1 and 2 groups, and 90.4%, 66.7% and 33.3% for the 5-year OS, respectively (all P<0.01). At 3 months after radiotherapy, the GPS, clinical staging (Ⅰ-Ⅲ vs. Ⅳ A) and concurrent chemotherapy were significantly correlated with PFS and OS (all P<0.01). ROC curve showed that at 3 months after radiotherapy, the AUC values of GPS, clinical staging and two combined in predicting OS were 0.694, 0.815 and 0.860, respectively. Conclusions:At 3 months after radiotherapy, higher GPS is an independent poor prognostic factor for nasopharyngeal carcinoma patients. The combination of GPS and clinical staging yields high accuracy in the prognostic evaluation of nasopharyngeal carcinoma patients.

Three-dimensional reconstruction of human kidney based on UroMedix-3D system and its application in kidney surgery / 南方医科大学学报

OBJECTIVE@#To explore the feasibility of rapid and accurate three-dimensional (3D) image reconstruction using Uromedix-3D software for urological surgery.@*METHODS@#The original renal thin-slice enhancement CT data were obtained from patients with kidney lesions treated in our hospital between December, 2015 and October, 2018. The self-developed Uromedix- 3D system was used to reconstruct the normal kidney structures, blood vessels, collecting systems and the lesions. The spatial anatomic relationships of the structures were measured and digitized for surgical planning.@*RESULTS@#3D reconstruction of the kidneys was performed in a total of 173 cases, and the mean time for reconstruction was 31.24±2.012 min. Of these cases, 147 (84.9%) had renal tumors, and 2 had renal tumors with tumor thrombus. In addition to renal tumors, the Uromedix-3D system was also used for reconstructing other lesions including UPJO, kidney stones and retroperitoneal masses. Renal artery reconstruction was performed in 170 cases, which allowed observation of the precise terminal branches (up to 7th grade arterial branch) of the artery; 109 (64%) cases showed the 5th grade arterial branch or above. Renal artery variations were detected in 37 cases, including accessory renal artery (24 cases) and multiple renal arteries (13 cases). The renal veins were reconstructed in 164 cases, and second grade or above (up to the 4th grade) vein branches were observed in 138 (84%) cases.@*CONCLUSIONS@#Uromedix-3D system can accurately and efficiently reconstruct the 3D structure of human kidneys and the renal lesions based on enhanced CT data. The reconstructed 3D model allows objective assessment of the spatial anatomical relationship of the lesions to provide assistance in surgical planning.

Pulmonary function analysis of 21 children with idiopathic pulmonary hemosiderosis / 中华实用儿科临床杂志

Objective To evaluate the injury of pulmonary function of children with idiopathic pulmonary hemosiderosis(IPH) and the changes after treatment,and to provide some guidance for the diagnosis and treatment of IPH.Methods Twenty-one children with IPH who were admiued at Children's Hospital of Fudan University between June 2012 and May 2016 were selected.The pulmonary function and clinical data of them were analyzed.Results The general pulmonary function of 21 children with IPH before treatment with glucocorticoid was reported that 4 cases (19.05％) were normal and 17 cases (80.95％) were abnormal,including 11 cases (52.38％) with restrictive ventilatory disorder,4 cases (19.05％) with mixed ventilatory disorder,1 case (4.76％) with obstructive ventilatory disorder,and 1 case (4.76％) with small airway dysfunction.Pulmonary function test was performed on 15 cases after 1-2 months of treatment with glucocorticoid.The results showed that maximal vital capacity (VCmax％) vs.the expected value was (77.91 ± 18.86)％ vs.(60.43 ± 23.70)％,forced vital capacity (FVC％) vs.the expected value was (78.96 ±19.24)％ vs.(61.03 ±24.62)％ and forced expiratory volume in one second (FEV1％) vs.the expected value was (86.03 ± 21.69) ％ vs.(65.17 ± 26.89) ％,which were significantly higher than those before treatment,and the differences were statistically significant (t =-4.13,-4.01,-4.54,all P ＜ 0.05).Three cases were followed up for 18 to 40 months by detecting pulmonary function and the results of dynamic monitoring of pulmonary function showed a fluctuation in FVC％ [case 1:(69.6-84.2) ％;case 2:(56.1-73.7) ％;case 3:(40.4-70.2) ％].Conclusion The characteristic pulmonary function changes in children with IPH are restrictive ventilatory disorder.Pulmonary function test play a significant role in diagnosis,treatment and prognosis of IPH.

Relationship Between Ambulatory Pulse Pressure, Pulse Pressure Index and Coronary Artery Disease in Hypertension Patients / 中国循环杂志

Objective: To investigate the relationship between 24-hour ambulatory pulse pressure (24hPP), 24-hour ambulatory pulse pressure index (24hPPI), night-time ambulatory pulse pressure index (NPPI) and coronary artery disease (CAD) occurrence in hypertension patients. Methods: A total of 305 subjects received ambulatory blood pressure monitoring (ABPM) in our hospital from 2016-05 to 2016-07 were enrolled. Base on ABPM information, 24hPP, 24hPPI and NPPI were calculated to analyze their relationship to CAD occurrence. 24hPP was defined by 24-hour mean systolic blood pressure (24hSBP) minus 24hDBP, 24hPPI by the ratio of 24hPP/24hSBP and NPPI by the ratio of night (22:00-6:00) PP/SBP. Results: There were 222/305 (72.8%) subjects with hypertension. Compared with normotension subjects, hypertension patients had increased 24hPP: (49.0±11.6) mmHg vs (42.2±7.4) mmHg, P<0.001, 24hPPI: (0.39±0.06) vs (0.37±0.05), P=0.004 and NPPI: (0.40±0.07) vs. (0.38±0.06), P=0.009 respectively. 116/222 (52.3%) hypertension patients suffered from CAD. Compared with non-CAD patients, CAD patients presented elevated 24hPP: (50.9±12.2) mmHg vs (47.0±10.6) mmHg, P=0.013, 24hPPI: (0.41±0.07) vs. (0.38±0.06), P<0.001 and NPPI: (0.42±0.07) vs. (0.38±0.06), P<0.001 respectively. Among 83/305 (27.2%) normotension subjects, the above indexes were similar between CAD patients and non-CAD subjects. Logistic regression analysis demonstrated that with adjusted age, gender, body mass index (BMI) and antihypertensive medication, 24hPPI [OR=1.95, 95% CI 1.11-3.44, P=0.020] and NPPI [OR=2.21, 95% CI 1.28-3.82, P<0.01] were related to CAD occurrence. ROC curve analysis showed that 24hPPI and NPPI were superior to 24hPP for CAD screening and prediction in hypertension patients. Conclusion: 24hPPI and NPPI were closely related to CAD occurrence in hypertension patients, they were both helpful for CAD screening and prediction in hypertension patients.

Relationship of lipid accumulation product with hypertension and diabetes among Beijing residents study / 中华预防医学杂志

Objective@#To explore the lipid accumulation product (LAP) formula for Beijing adults and to investigate the relationship between lipid accumulation product and hypertension, as well as diabetes.@*Methods@#A cross-sectional study with a representative sample of 19 606 residents in Beijing aged 18-79 years was conducted in 2011. The sex-specific hypothetical minimum waist circumference (WC) was calculated in order to obtain the more applicable LAP formula. Multivariate logistic regression was used to analyze the associations of LAP, combination of LAP and body mass index (BMI) with hypertension and diabetes.@*Results@#The LAP formula for Beijing adults was established as follows: LAP (male)= (WC-61.3) × TG, and LAP (female)= (WC-55.6) × TG. There was an obvious trend of increased risk of hypertension and diabetes with an increment in the tertiles of the LAP both in men and women. The OR (95%CI) for hypertension in the group with highest tertile LAP was 3.62 (3.11-4.22) in men, and 5.79 (4.84-6.93) in women, compared with the lowest tertile group, respectively; and the corresponding OR for diabetes was 3.47 (2.73-4.41) in men, and 4.10 (2.90-5.80) in women, respectively. Compared with the lowest tertile of LAP and normal BMI group, the OR (95%CI) for hypertension in the highest tertile of LAP and obesity group was 6.79 (5.50-8.37) in men, and 9.75 (7.76-12.25) in women, respectively; while the corresponding value for diabetes was 3.97 (2.87-5.49) in men, and 4.13 (2.78-6.14) in women, respectively.@*Conclusion@#The elevated level of LAP was associated with an increased risk of hypertension and diabetes among Beijing adults. LAP could be an important predictor for hypertension and diabetes.

Electrocardiogram Characteristics of Suspected Vasovagal Syncope Patients With Positive Head-Up Tilt Test / 中国循环杂志

Objective: To investigate the dynamic electrocardiogram (ECG) changes of head-up tilt test in patients with suspected vasovagal syncope. Methods: A total of 502 outpatients of our hospital with suspicious vasovagal syncope from 2015-08 to 2016-12 were enrolled. All patients received head-up tilt test with synchronization of 12 lead ECG. Based on head-up tilt test result, the patients were divided into 2 groups: Positive group,n=244 and Negative group,n=258. The P wave duration, corrective QT (QTc) duration and P wave axis in ECG were compared between 2 groups. Results: Compared with Negative group, Positive group had the longer P wave duration (95.65±38.50) ms vs (88.61±17.09) ms,P<0.05; P wave axis was right shifted before syncope (69.87±18.18)° vs (66.82±16.51)° , while left shifted during syncope (62.87±25.39)° vs (68.47±15.30)° and after syncope (56.87±22.45)° vs (68.49±16.35)°, allP<0.05; the shorter QTc duration before syncope (418.69±92.35) ms vs (435.76±59.29) ms,P<0.05. Conclusion: The patients with vasovagal syncope had some speciifc ECG features during head-up tilt test including P wave duration, P wave axis and QTc duration, those may play certain forewarning function for vasovagal syncope onset.

Clinical outcome of modified posterolateral approaches for the treatment of posterolateral tibial plateau fractures / 中国综合临床

Objective To observe the clinical outcome of modified posterolateral approaches for the treatment of posterolateral tibial plateau fractures. Methods From January 2012 to January 2015,13 patients with posterolateral tibial plateau fractures were identified in the Second Hospital of Changzhou Affiliated to Nan?jing Medical University. All the posterolateral fractures were fixated with a plate. The knee function was evaluated at the last follow?up by the Hospital for Special Surgery( HSS) Score,and the occurrence of postoperative compli?cations were observed. Results Thirteen patients were followed up for an average of 14. 4 months,all patients obtained bony union. There were no significant differences regarding the mean HSS score among 3 months, 6 months and 1 year post?operation((71. 6±1. 5) points, (76. 4±1. 6) points, (83. 2±1. 1) points;P=0. 154) . There were no significant differences regarding the tibial plateau angle and posterior slope angle on radiograph?ies of inside and outsideamong immediate,6 and 12 months postoperation((83. 7±1. 7)°,(84. 3±1. 5)°,(85. 1 ±1. 4)°,(85. 4±1. 5)°;(7. 7±1. 5)°,(7. 7±1. 4)°,(7. 7±1. 3)°,(7. 6±1. 8)°;P=0. 223,0. 191). No com?plications associated with the approach were observed and there was no infection,no malunion or fixation failure either. Conclusion In the treatment of posterolateral tibial plateau fractures,the modified posterolateral approa?ches can result in excellent fracture reduction under direct visualization and allow for posterior buttress plating.

Values of D-dimer,cTnT and myocardial enzymogram detections in the diagnosis of acute myocardial infarction / 国际检验医学杂志

Objective To investigate the value of D‐dimer (D‐D) ,cardiac troponin T(cTnT) and myocardial enzymogram detec‐tions in clinical diagnosis of acute myocardial infarction (AMI) .Methods 36 cases of AMI patients (AMI group) and 20 cases of healthy people (control group) were selected as study subjects .The plasma levels of D‐D ,cTnT and myocardial enzymogram of two groups were detected ,and the sensibility and specificity of these indexes were analyzed .Results The levels of D‐D ,cTnT ,CK ,CK‐MB ,AST and LDH in AMI group were significantly higher than those of control group (P<0 .05) .The positive rates of cTnT ,D‐D and myocardial enzymogram in AMI patients were 91 .67% ,69 .44% ,and 66 .67% ,respectively .The positive rate of cTnT was significantly higher than those of D‐D and myocardial enzymogram (P<0 .05) .Both of the diagnosis sensibility and specificity of plasma cTnT were significantly higher than those of D‐D and myocardial enzymogram (P<0 .05) .Conclusion Comparing with D‐D and myocardial enzymogram ,plasma cTnT has better diagnosis sensibility and specificity .Joint detection of kinds of indexes could improve the accuracy .

Retinoschisis and intravitreal ranibizumab treatment for myopic choroidal neovascularization / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intravitreal ranibizumab injection is effecitve on treating myopic CNVs, but it could be a risk factor for developing more severe retinoschisis in eyes with preexisted retinoschisis and epiretinal membrane. This study aimed to explore the incidence and features of retinoschisis after intravitreal ranibizumab injection for myopic choroidal neovascularization.</p><p><b>METHODS</b>Eighty-three eyes of 81 patients with choroidal neovascularization secondary to pathologic myopia were treated with intravitreal ranibizumab injection. The best corrected visual acuity and optical coherence tomography (OCT) images were recorded at baseline and every month thereafter. Central retina thickness and maximal retina thickness were measured. The subjects were divided into three groups. Eleven eyes that had retinoschisis and epiretinal membrane were in group 1, six eyes that had simple epiretinal membrane were in group 2, and 66 eyes that had neither retinoschisis nor epiretinal membrane were in group 3. Six contralateral eyes in group 1 which had retinoschisis and epiretinal membrane but were not treated with intravitreal ranibizumab injection were set as the control group.</p><p><b>RESULTS</b>Seven of the 11 eyes in group 1 developed more severe retinoschisis, the mean maximal retinal thickness increased from (380.28 ± 90.13) to (467.00 ± 70.20) µm (P < 0.05). The retinoschisis of all 6 eyes of the control group did not aggravate. Compared with the control group, the aggravation ratio of retinoschisis increased significantly (P < 0.05). No new onset of retinoschisis took place in group 2 and group 3.</p><p><b>CONCLUSION</b>Intravitreal ranibizumab injection may be a risk factor for aggravation of retinoschisis in eyes with preexisted retinoschisis and epiretinal membrane.</p>

The effects of lifestyle factors on the incidence of central obesity in Chinese adults aged 35-74 years / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the incidence of central obesity and its characteristics, and explore the effects of lifestyle factors on incidence of central obesity in Chinese adults aged 35-74 years.</p><p><b>METHODS</b>A total of 27 020 Chinese adults aged 35 to 74 years were enrolled in a prospective follow-up study (the study cohort was built from 1998 to 2000, respectively) during 2007 and 2008. Central obesity was defined as waist circumference ≥ 90 cm in men, ≥ 85 cm and ≥ 80 cm in women, respectively. Multivariate logistic regression was used to estimate relative risks (RR) of central obesity for lifestyle factors after adjusting factors including genders, age, southern and geographic region, urbanization, lifestyles, and so on.</p><p><b>RESULTS</b>Among Chinese adults aged 35-74 years, the standardized annual incidence of central obesity (waist ≥ 90 cm) was 2.19% for men and this rate decreased gradually with age among people younger than 65 years old. The incidence of central obesity was 2.64% (waist ≥ 85 cm) and 4.06% (waist ≥ 80 cm) for women, respectively, and this rate increased obviously among people aged 55 to 74 years. Participants with ≥ 12 years' education (RR = 0.84, 95%CI:0.74-0.96) had a lower risk of central obesity(waist ≥ 90 cm for men, waist ≥ 85 cm for women). And this risk increased as the monthly household per capita income increased. Compared with the reference group, people involved in housework or retirees (RR = 1.17; 95% CI: 1.01-1.36), drinking alcohol (RR = 1.15, 95% CI: 1.01-1.32) or scented tea (RR = 1.49, 95%CI:1.28-1.72) had a higher risk of developing central obesity, while drinking milk (RR = 0.85, 95% CI: 0.74-0.97) or black tea (RR = 0.74, 95% CI: 0.58-0.95), had a lower risk of developing central obesity.</p><p><b>CONCLUSION</b>A healthy lifestyle plays a key role in the prevention and control of central obesity in Chinese adults, and a healthy way of lifestyle should be promoted in the whole society to decelerate the epidemic of the central obesity.</p>

Incidence of obesity and its modifiable risk factors in Chinese adults aged 35-74 years: a prospective cohort study / 中华流行病学杂志

<p><b>OBJECTIVE</b>To examine the incidence of obesity and its modifiable risk factors in Chinese adults aged 35-74 years.</p><p><b>METHODS</b>A total of 27 020 participants aged 35 to 74 years from two prospective cohort studies in China were followed up in the years of 2007 and 2008. Obesity and overweight were defined as body mass index ≥ 28.0, and 24.0-27.9 kg/m(2), respectively. Relative risks of obesity for risk factors were computed by using logistic regression.</p><p><b>RESULTS</b>The annual incidence rates of obesity and overweight were 6.97 ‰ and 24.83 ‰ in Chinese adults aged 35-74 years, respectively. Women had a higher incidence of obesity than men (7.74 ‰ vs. 6.10 ‰). Participants in northern China had a higher incidence than those in southern (9.29 ‰ vs. 5.10 ‰) part of the country. Adults in rural had a higher incidence than those in urban (7.28 ‰ vs. 6.52 ‰). After adjusting for the baseline variables, such as gender, age, geographic region, degree of urbanization, the relative risk for obesity was 0.82 (95% CI:0.68-0.99) for participants with ≥ 12 years' education, compared with those <12 years. Participants with middle income, less physical activity at work/housework or being retirees, consuming more red meat and scented tea etc, had higher risk of incidence of obesity. Participants who consumed milk and moderate amount of fruits, would show a lower risk of obesity.</p><p><b>CONCLUSION</b>The incidence of obesity was 6.97 ‰ in Chinese middle and older adults. Our results underscored that the promotion of healthy lifestyle which include issues as increasing physical activity, consuming moderate amount of fruits and milk but less red meat, drinking less scented tea etc, could play key roles in obesity prevention and control among the Chinese adults, especially among people with low education level or with middle income.</p>

Relationship Between Blood Pressure Variability and Ambulatory Arterial Stiffness Index in Both Normal Subjects and Hypertensive Patients / 中国循环杂志

Objective: To investigate the relationship between blood pressure variability and ambulatory arterial stiffness index (AASI) in both normal subjects and hypertensive patients. Methods: A total of 280 consecutive subjects without antihypertensive medication were studied. All subjects received ambulatory blood pressure monitoring (ABPM) and AASI was calculated as 1 minus the regression slope of diastolic blood pressure value vs systolic blood pressure value according to ABPM recording. Results: ① There were 161 subjects with male gender, 138 patients with hypertension, and the average age was (50.4 ± 13.3) years.②Pearson analysis indicated that AASI was related to age (r=0.272, P0.05 respectively.④Multiple linear regression analysis demonstrated that with adjusted age, gender, BMI and blood pressure, AASI was independently related to 24-hour mean pulse pressure (β=0.003, P Conclusion:AASI is closely related to blood pressure variability, it’s a comprehensive index for arterial stiffness and blood pressure variability.

Effect of Age and Gender on Head-up Tilt Test for Diagnosing the Patients With Suspected Vasovagal Syncope / 中国循环杂志

Objective: To explore the effect of age and gender on head-up tilt test (HUTT) for diagnosing the patients with suspected vasovagal syncope (VVS). Methods: A total of 1223 patients who received HUTT in our hospital from 2008-08 to 2012-12 were studied. The patients were from 7 to 79 years of age and divided into 4 groups. Group 1, the patients≤20 years of age, n=145, Group 2, the patients at (21-40) years, n=375, Group 3, the patients at (41-60) years, n=584 and Group 4, the patients>60 years, n=119. The HUTT comprised a 30 min basic phase and 20 min sublingual nitroglycerin provocation phase. According to ECG and blood pressure changes, the HUTT positive patients included vasodepressor type, cardio-inhibitory type and mixed type. Results: The overall positive rate of HUTT was 51%(624/1223) and the female was higher than male, (60.1%vs 39.9%), P=0.001. The positive rates in 4 age groups were at 68.3%, 49.1%, 48.6% and 47.9% respectively. In HUTT positive patients, there were 51.4% (321/624) patients with mixed type of VVS, 28.7% (179/624) with vasodepressor type of VVS and 19.9% (124/624) with cardio-inhibitory type of VVS. The positive HUTT reaction was inlfuenced by the age as in male:x2=15.65, P=0.016 and in female:x2=18.84, P=0.004. For basic phase of HUTT, there were 74.8%of positive reactions started at 22.5 (17.5-27.5) min of the test without age difference, P>0.05;for sublingual nitroglycerin provocation phase of HUTT, there were 81.9%positive reactions started at 7.5 (5-10) min and the female was earlier than male (7.5 vs 10) min, P=0.004. Conclusion: There were age and gender differences for HUTT diagnosing the patients with VVS for their positive rate, type and starting time.

Bone marrow mesenchymal stem cells differentiate into neuron-like cells induced by combination of two cytokines / 中国组织工程研究

BACKGROUND:Bone marrow mesenchymal stem cells (BMSCs) can be induced to differentiate into neuron-like cells directional y. Accordingly, BMSCs can be used as seed cells theoretical y in constructing tissue-engineered peripheral nerves. OBJECTIVE:Using combination of two cytokines to induce BMSCs differentiating into neuron-like cells directional y, and further to discusse its application in peripheral nerve injury. METHODS:BMSCs were isolated and purificated from the bone marrow of Wistar rats by using the differential adherence method. Basic fibroblast growth factor and epidermal growth factor were used to induce the BMSCs differentiating into neuron-like cells. The morphological change was observed and the neuronal specific markers were detected by immunohistochemistry technique. The morphological and immunohistological changes were also studied after the induce agent were removed. RESULTS AND CONCLUSION:With presence of morphological and immunohistochemical features of nerve cells induced by neurotrophic factors, BMSCs exhibited two or more processes that were interconnected as a meshwork;cellnucleus and nucleus could be observed with strong light refraction of cytoplasm. After immunohistochemical staining, neuroln specific enolase, neurofilament protein and synaptophysin protein positive cells were detected. A great amount of cells reversed to their original fibroblast-like morphology, and the expression of the three above-mentioned proteins decreased as the induce agent withdrawn. Our study showed that BMSCs can be induced to differentiate into neuron-like cells, but the transdifferentiation is a short-time reversible phenomenon.

The expression and clinical significance of VEGF-C and CD24 in lung cancer / 中华胸心血管外科杂志

Objective To study the expressions of VEGF-C and CD24 in lung cancer and their clinical significance,and to discuss the relationship between their expressions as well.Methods The methods of RT-PCR and immunohistochemical staining are adopted.The expression levels of VEGF-C,CD24 mRNAs and proteins in 138 primary lung cancer patients'cancer tissues and paracancerous tissues are detected.Results (1) The expression levels of VEGF-C,CD24 mRNA and proteins in lung cancer tissues are all higher than those in paracancerous tissues (P ＜ 0.05).There is evident positive correlativity between the expressions of VEGF-C and CD24 in lung cancer(P ＜ 0.05) (2) The expression levels of VEGF-C,CD24 mRNA and proteins in the metastasis group are all higher than those in the non-metastasis group (P ＜ 0.05).(3) There is evident correlativity between the expression of VEGF-C,CD24 and lymph node metastasis,TNM staging(P ＜ 0.05).(4) The expressions of VEGF-C,CD24 mRNA and proteins are both related to the short-term prognosis of the Stage ⅢA patients.Conclusion VEGF-C and CD24 are both abnormally expressed in lung cancer tissues,which can be used as a marker of lung cancer diagnosis.

Initial experience of previously blocking both pulmonary artery and veins in true video assisted thoracic surgery for the treatment of NSCLC / 中华胸心血管外科杂志

ObjectiveWe evaluate our experience of previously blocking both pulmonary artery and veins in true video assisted thoracic surgery (VATS) for the treatment of non-small-cell lung carcinoma ( NSCLC ).MethodsSix patients undergoing lobectomy with previously blocking both pulmonary artery and veins in the VATS in our institution between December 2007 and June 2011 were reviewed.ResultsIn our series,six patients required previously blocking both pulmonary artery and veins in the VATS,The mean occlusion time of PA and PV was (42.0 ± 8.6 ) min and ( 39.3 ± 8.2 ) min,respectively.Four patients required partial PA reconstruction.The mean repair time of the PA was (21.25 ±9.91 ) min.No complications attributable to the technique or mortality were seen.There were no local recurrences on the pulmonary artery.ConclusionIt is feasible and safe that the technology of previously blocking of the pulmonary artery and veins was applied in VATS.This technique can reduce the risk of intraoperative bleeding and the chance of converting to open thoracotomy,and extend the inclusion criteria of VATS lobectomy.

Effect of parecoxib on postoperative hyperalgesia induced by remifentanil-based anesthesia / 中华麻醉学杂志

Objective To investigate the effect of parecoxib on postoperative hyperalgesia induced by remifentanil-based anesthesia.Methods One hundred ASA Ⅰ or Ⅱ patients,aged 21-64 yr,weighing 50-80 kg,undergoing elective laparoscopic operation,were randomly divided into 5 groups ( n =20 each):parecoxib group (group P),small dose remifentanil group (group S),large dose remifentanil group (group L),small dose remifentanil + parecoxib group (group SP) and large dose remifentanil + parecoxib group (group LP).Parecoxib 40 mg was injected intravenously at 30 min before anesthesia in groups P,SP and LP.Anesthesia was induced with midazolam0.05 mg/kg,etomidate 0.2 mg/kg,cisatracurium 0.15 mg/kg and remifentanil 1 μg/kg (fentanyl 4 μg/kg in group P).The patients was tracheal intubated and mechanically ventilated.PETCO2 was maintained at 35-45 mm Hg.Anesthesia was maintained with infusion of remifentanil at 0.05 μg·kg-1 ·min-1 (in groups S and SP) or at 0.3 μg· kg- 1· min- 1 (in groups L and LP) combined with inhalation of sevoflurane and infusion of cisatracurium at 0.12 mg·kg-1·h-1.At 30 min after operation,numeric rating scale (NRS) was used to assess the degree of pain at rest and during activity.Tramadol 1.5 mg/kg was injected intravenously after operation if needed.NRS scores were maintained ≤5.The use of tramadol and adverse effects during 24 h after operation were recorded.Results Compared with group P,NRS scores at rest and during activity were significantly increased at 30 min after operation in groups S and L,the incidence of shivering and the number of patients who needed tramadol were significantly increased in group L,and no change was found in NPS scores at rest and during activity at 30 min after operation,the incidence of adverse effects and the number of patients who needed tramadol in groups SP and LP.Compared with group S,NRS scores at rest and during activity at 30 min after operation,the incidence of shivering and the number of patients who needed tramadol were significantly increased in group L,NRS scores at rest and during activity at 30 min after operation were significantly decreased and no change was found in the incidence of adverse effects and the number of patients who needed tramadol in group SP.Compared with group L,NRS scores at rest and during activity at 30 min after operation,the incidence of shivering and the number of patients who needed tramadol were significantly decreased in group LP.Conclusion Intravenous injection of parecoxib 40 mg at 30 min before anesthesia can attenuate postoperative hyperalgesia induced by remifentanil-based anesthesia.

Alcohol consumption and the incidence of metabolic syndrome in Chinese population / 中华健康管理学杂志

Objective To examine the relationship between alcohol consumption and the incidence of metabolic syndrome (MS) in Chinese adults.Methods A total of 27020 Chinese adults aged 35 to 74years were enrolled in this prospective cohort study.Frequency or type of alcohol consunption was assessed in 1998 and 2000.Follow-up study on MS was conducted during 2007 and 2008.Results Over an average 8years' follow-up,2362 MS patients were identified among 14 572 individuals who did not have MS at baseline.After adjustment for age,location,education level,physical activity,cigarette smoking,body mass index and the number of MS components,compared with non-drinkers,relative risk ( RR ( 95％ confidence interval (CI))) and the Population Attributable Risk Percent (PARP) of MS of male drinkers was 1.24( 1.06 to 1.45 ) and 10.13％,respectively.RR (95 ％ CI) of MS was 1.36 ( 1.02 to 1.82 ),1.34 ( 1.03 to 1.74) and 1.41 (1.13 to 1.77) for male drinkers consuming alcohol 10.1 -20 g/d,20.1 -40 g/d,and ＞40 g/d.RR(95％ CI) of MS was 1.25 ( 1.01 to 1.55) for males drinking 2 -5 times/week and 1.26(1.04 to 1.52) for males drinking ≥6 times/week.RR (95％ CI) of MS was 1.60 ( 1.05 to 2.45),1.30(1.02 to 1.65) and 1.27 (1.06 to 1.52) for beer,liquor and the beer + liquor male consumers.The corresponding RR(95％ CI) was 2.67(1.26 to 5.65) and 3.38 (1.35 to 4.22) for female drinkers consuming alcohol 10.1 -20 g/d and ＞20 g/d.Conclusions Drinking alcohol more than 10 g/d may be associated with an increasing risk of MS,especially for women.Drinking more than twice per week,beer and/or liquor consumption can significantly increase the risk of MS in men.