Molecular genetic characteristics of a family which coinheritance of rare-88 C>G (HBB:c.-138 C>G) β-thalassemia mutation with α-thalassemia and review of the literature / 中华预防医学杂志

The molecular genetic characteristics of a family with rare -88 C>G (HBB: c.-138 C>G) β-thalassemia gene mutation were studied using cohort study. The cohort study was conducted from June to August 2022 by Prenatal Diagnosis Center of Sanya Women and Children's Hospital Managed by Shanghai Children's Medical Center. The phenotype and genotype were analyzed by hematological cytoanalyzer, automatic electrophoretic analysis system, and next-generation sequencing (NGS). And then, Sanger sequencing was used to verify the rare gene results. The results showed that the proband, her father, her uncle and her younger male cousin had discrete microcytosis (MCV 70.1 fl, 71.9 fl, 73.1 fl and 76.6 fl, respectively) and hypochromia (MCH 21.5 pg,22.0 pg,22.6 pg and 23.5 pg, respectively), elevated hemoglobin A2 level (5.3%, 5.4%, 5.4% and 5.5%, respectively), slightly elevated or normal fetal hemoglobin (Hb F), but no anemia. The proband was identified to have co-inherited ɑ-thalassemia (Hb Westmead gene heterozygous mutation, ɑwsɑ/ɑɑ) and β-thalassemia with a rare -88 C>G (HBB: c.-138 C>G) heterozygous mutation (β-88 C>G/βN). Her mother had the same α-thalassemia as the proband. Her father, her uncle and her younger male cousin had the same rare -88 C>G heterozygous mutations as the proband. While her grandmother and younger brother were not carrier of thalassemia. In conclusion, 4 cases of rare -88 C>G(HBB:c.-138 C>G) heterozygous mutation had been detected in a Chinese family. Carriers of this beta-thalassemia are clinically asymptomatic. This study enriches the knowledge of the thalassemia mutation spectrum in Chinese people and provides valuable information for genetic counseling, prenatal diagnosis, and prevention of thalassemia, providing a scientific basis for improving the quality of birth population and preventing birth defects.

Efficacy and safety of salmeterol/fluticasone compared with montelukast alone (or add-on therapy to fluticasone) in the treatment of bronchial asthma in children and adolescents: a systematic review and meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Despite the recommendation of inhaled corticosteroids (ICSs) plus long-acting beta 2-agonist (LABA) and leukotriene receptor antagonist (LTRA) or ICS/LTRA as stepwise approaches in asthmatic children, there is a lack of published systematic review comparing the efficacy and safety of the two therapies in children and adolescents aged 4 to 18 years. This study aimed to compare the safety and efficacy of salmeterol/fluticasone (SFC) vs. montelukast (MON), or combination of montelukast and fluticasone (MFC) in children and adolescents aged 4 to 18 years with bronchial asthma.@*METHODS@#A systematic search was conducted in MEDLINE, EMBASE, the Cochrane Library, China BioMedical Literature Database, Chinese National Knowledge Infrastructure, VIP Database for Chinese Technical Periodical, and Wanfang for randomized controlled trials (RCTs) published from inception to May 24, 2021. Interventions are as follows: SFC vs. MON, or combination of MFC, with no limitation of dosage or duration. Primary and secondary outcome measures were as follows: the primary outcome of interest was the risk of asthma exacerbation. Secondary outcomes included risk of hospitalization, pulmonary function, asthma control level, quality of life, and adverse events (AEs). A random-effects (I2 ≥ 50%) or fixed-effects model (I2 < 50%) was used to calculate pooled effect estimates, comparing the outcomes between the intervention and control groups where feasible.@*RESULTS@#Of the 1006 articles identified, 21 studies met the inclusion criteria with 2643 individuals; two were at low risk of bias. As no primary outcomes were similar after an identical treatment duration in the included studies, meta-analysis could not be performed. However, more studies favored SFC, instead of MON, owing to a lower risk of asthma exacerbation in the SFC group. As for secondary outcome, SFC showed a significant improvement of peak expiratory flow (PEF)%pred after 4 weeks compared with MFC (mean difference [MD]: 5.45; 95% confidence interval [CI]: 1.57-9.34; I2 = 95%; P = 0.006). As for asthma control level, SFC also showed a higher full-controlled level (risk ratio [RR]: 1.51; 95% CI: 1.24-1.85; I2 = 0; P < 0.001) and higher childhood asthma control test score after 4 weeks of treatment (MD: 2.30; 95% CI: 1.39-3.21; I2 = 72%; P < 0.001) compared with MFC.@*CONCLUSIONS@#SFC may be more effective than MFC for the treatment of asthma in children and adolescents, especially in improving asthma control level. However, there is insufficient evidence to make firm conclusive statements on the use of SFC or MON in children and adolescents aged 4 to 18 years with asthma. Further research is needed, particularly a combination of good-quality long-term prospective studies and well-designed RCTs.@*PROSPERO REGISTRATION NUMBER@#CRD42019133156.

Contrast-enhanced ultrasound and MRI in post-treatment evaluation of hepatocellular carcinoma after TACE / 中华肝胆外科杂志

Objective:To study the use of contrast-enhanced ultrasonography (CE-US) and contrast-enhanced MRI(CE-MRI) in evaluation of therapeutic effect of transcatheter arterial chemoembolization (TACE) on hepatocellular carcinoma (HCC).Methods:A retrospective study was conducted on 60 patients with HCC (with 114 lesions), who were treated with TACE in Affiliated Hospital of Xuzhou Medical University from January 2018 to December 2018. There were 53 males and 7 females, age ranged from 47 to 84 (mean age 61.9) years. CE-US, CE-MRI and digital subtraction angiography (DSA) were performed in all these patients within one week after TACE. Using DSA as the gold standard, the sensitivity, specificity and accuracy in the detection of residual lesions were compared between the two imaging methods. The consistency of results between CE-US and CE-MRI was analyzed.Results:CE-MRI and CE-US showed presence of active tumor foci (residual and/or recurrent lesion) in 78 lesions, and complete inactivation of HCC foci in 26 lesions. Ten lesions were diagnosed as active foci by CE-MRI, which were missed by CE-US. The diagnostic accuracy of CE-MRI was 100.0% (114/114), which was significantly better than the 91.2% (104/114) of CE-US ( P<0.05). The Kappa value between CE-US and CE-MRI was 0.781. The diagnostic coincidence between CE-MRI and CE-US was quite high. Among small lesions of less than 5 cm, the diagnostic accuracy of CE-MRI was 100.0% (78/78), which was significantly better than the 88.5% (69/78) of CE-US ( P<0.05). In large lesions of greater than 5 cm, the diagnostic accuracy of CE-MRI was comparable to that of CE-US. The difference was not significant ( P>0.05). The sensitivity of CE-MRI in detection of active lesions was higher than that of CE-US, and the specificity of the two imaging methods was consistent. The Kappa value between CE-US and CE-MRI was 0.747 for small lesions of less than 5cm, and 0.873 for large lesions of greater than 5 cm. The diagnostic coincidence between CE-MRI and CE-US was quite high. Conclusion:CE-MRI and CE-US can both be used as reliable imaging methods for evaluating the therapeutic effect of TACE for HCC.

The study of college students’ physical exercise behavior phase and process of change based on the Transtheoretical model / 中华疾病控制杂志

Objective To analyze the stage characteristics in the exercise behavior improvement of college students and explore the role of Process in the exercise behavior change based on the transtheoretical model, providing basis for the stage-matched intervention for the exercise behavior of college students. Methods There were 932 students who completed the questionnaires, from 5 universities in Shanxi Province were selected by using a stratified random cluster sampling method. Descriptive analysis was used to describe the exercise behavior of college students. Variance analysis and multivariate Logistic regression model were used to analyze the difference of the process of with stage of change among college students’ physical exercise. Multivariate variance analysis was used to analyze how personal characteristics affect process of change. Results Among all participants, 89.4% students knew the importance of physical exercise, and 29.4% students were satisfied with their physical exercise condition. The distribution of students’ physical exercise stage showed an inverted U-shape with left-side peak, and there was a significant difference between gender( 2=54.657, P<0.001). There were significant stage characteristics in the process of students' exercise behavior, gender had a significant main effects on mutual aid relation(F=7.400, P=0.07)and conscious control (F=7.778, P=0.005), gender and grade had interaction effects on social release (F=3.614, P=0.013). Conclusions The college students' exercise behavior showed the characteristics of “knowing but not to do”, which conformed to the Transtheoretical model. It is essential to develop targeted phased exercise intervention strategies according to the relationship between change of phase and change of procedure.

Preparation Process of Baicalin Liposomes by Reverse Phase Evaporation / 中国药学杂志

OBJECTIVE: To study the preparation technology of baicalin glycosides liposomes. METHODS: Baicalin liposomes modified by vitamin E and Tween 80 were prepared by reverse phase evaporation method. The free drug was separated by ultracentrifugation and the encapsulation rate was determined by UV spectrophotometry. Based on the results from single factor tests, orthogonal experimental design was used to investigate the factors influencing the envelopment rate of liposomes. The baicalin liposomes prepared by the optimized process were characterized for particle size, Zeta potential, and morphology. RESULTS: The optimum conditions for the preparation of liposomes were as follows: the ratio of water phase to organic phase 1∶3, the concentration of baicalin 3 mg•mL-1, the ratio of cholesterol to soy lecithin 1∶6, dosage of vitamin E 2 mg,dosage of Tween 80 120 μL. The mean diameter was 52.2 nm, Zeta potential was -51.9 mV, the encapsulation rate was 70.22% and drug loading capacity was 3.18%. Transmission Electr Microscope(TEM) results showed that the shape of the liposomes was good, the particle size was relatively uniform and consistent with the results of laser granulometry. CONCLUSION: The stability of baicalin liposomes can be improved by the addition of vitamin E and Tween 80.

Therapeutic effect of transcatheter arterial chemoembolization combined with iodine-125 seed strand implantation for treating hepatocellular carcinoma with portal vein tumor thrombus / 中华肝胆外科杂志

Objective To study the efficacy of combined transcatheter arterial chemoembolization(TACE)with iodine-125 seed implantation in treating hepatocellular carcinoma(HCC)with portal vein tumor thrombus(PVTT).Methods From January 2015 to January 2019,eighty patients with HCC and PVTT who were treated at Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed.A total of 71 patients were male and 9 were female.aged(53.1±9.9)years.The patients included 48 patients(group A)who were treated with TACE alone and 32 patients(group B)with TACE combined with iodine-125 seed implantation.The survival time and disease control rate(DCR)of the intrahepatic lesions and PVTY in the two groups were compared.Results There were 32 patients who were successfully implan-ted with portal vein iodine-125 seed and stents.The DCR of PVTT in group B was significantly better than in group A(90.6％ vs.81.3％,P＜0.05).The DCR of the intrahepatic lesions in the two groups was 77.1％(group A)and 90.6％(group B).There was no significant difference between the two groups(P＞0.05).The survival times of group A and group B were(8.0±0.6)and(16.0±2.1)months,respectively.The median survival times were(7.6±1.0)and(14.8±1.5)months respectively.Group B had significantly better survival time than Group A,(both P＜0.05).Univariate and multivariate analysis showed that tumor size was an independent risk factor of prognosis(Regression coemcient:0.960,HR:0.383,95％CI:0.158-0.926,P＜0.05).125I treatment was a protective factor of prognosis(Regression coefficient:-1.525,HR:0.218,95％CI:0.100-0.473,P＜0.05).Conclusion For patients with HCC and PVTT.compared with TACE alone,TACE combined with iodine-125 seed implantation could safe-ly and effectively control portal vein tumor thrombus,and prolonged patient survival.

Therapeutic effect of transcatheter arterial chemoembolization combined with iodine-125 seed strand implantation for treating hepatocellular carcinoma with portal vein tumor thrombus / 中华肝胆外科杂志

Objective@#To study the efficacy of combined transcatheter arterial chemoembolization (TACE) with iodine-125 seed implantation in treating hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).@*Methods@#From January 2015 to January 2019, eighty patients with HCC and PVTT who were treated at Affiliated Hospital of Xuzhou Medical University were retrospectively analyzed. A total of 71 patients were male and 9 were female, aged (53.1±9.9) years. The patients included 48 patients (group A) who were treated with TACE alone and 32 patients (group B) with TACE combined with iodine-125 seed implantation. The survival time and disease control rate (DCR) of the intrahepatic lesions and PVTT in the two groups were compared.@*Results@#There were 32 patients who were successfully implanted with portal vein iodine-125 seed and stents. The DCR of PVTT in group B was significantly better than in group A (90.6% vs. 81.3%, P<0.05). The DCR of the intrahepatic lesions in the two groups was 77.1% (group A) and 90.6% (group B). There was no significant difference between the two groups (P>0.05). The survival times of group A and group B were (8.0±0.6) and (16.0±2.1) months, respectively. The median survival times were (7.6±1.0) and (14.8±1.5) months respectively. Group B had significantly better survival time than Group A, (both P<0.05). Univariate and multivariate analysis showed that tumor size was an independent risk factor of prognosis (Regression coefficient: 0.960, HR: 0.383, 95% CI: 0.158-0.926, P<0.05). 125I treatment was a protective factor of prognosis (Regression coefficient: -1.525, HR: 0.218, 95% CI: 0.100-0.473, P<0.05).@*Conclusion@#For patients with HCC and PVTT, compared with TACE alone, TACE combined with iodine-125 seed implantation could safely and effectively control portal vein tumor thrombus, and prolonged patient survival.

Effects of ultrasound-guided low-power microwave ablation for the treatment of liver cancer in special sites / 实用放射学杂志

Objective To investigate the curative effect and clinical application value of ultrasound-guided low-power microwave ablation in treating liver cancer with special sites (including the leiosn near the gallbladder,diaphragmatic dome,gastrointestine, heart,blood vessels and hepatic portal canal with the shortest distance between the tumor and the organs or lumen less than 0.5 cm). Methods Forty patients with liver cancer with special sites including neighboring the gallbladder in 9 cases,diaphragmatic dome in 7 cases,gastrointestine in 5 cases,portal vein in 1 1 cases,hepatic vein in 3 cases,inferior vena cava in 3 cases and heart in 2 cases were selected as the treatment group and other 40 cases with primary liver cancer with common site were selected as the control group by stratified random selection,during the same period.Ultrasound-guided microwave ablation was performed,all patients were followed up at 6 months,12 months,18 months and 24 months,and the survival rate was calculated.Results The negative rate of AFP in the treatment group and control group was 83.0% and 82.0%,respectively.The survival rates of the treatment group and the control group at 6 months,12 months,18 months and 24 months were 100.0%,95.0%,90.0%,80.0% and 100.0%,97.5%,92.5%,85.0%. Conclusion Ultrasound-guided low-power microwave ablation in treating the liver cancer with special sites is very effective and safe. The curative effect is similar to that of liver cancer with common site and can be widely used in clinic.

Relationship between TREM-1 gene polymorphism and susceptibility to coronary atherosclerotic heart disease / 中华检验医学杂志

Objective To explore the relationship between gene polymorphisms of triggering receptor expressed on myeloid cells-1 ( TREM-1 ) rs2234237A/T, rs9471535A/G and susceptibility to coronary atherosclerotic heart disease ( coronary heart disease for short , CHD).Methods A case-control study.120 patients with CHD ( CHD group) and 90 healthy people (Normal control group ) were selected from November 2016 to April 2017 in Jingzhou Central Hospital.The single nucleotide polymorphisms (SNPs) of TREM-1gene (rs2234237 and rs9471535)were analyzed using Sanger method in all subjects. Comparing baseline clinical data and the distribution of genotype frequencies in the two groups .Non conditional logistic regression was used to analyze the relationship between TREM -1 gene ( rs2234237 and rs9471535) polymorphisms and susceptibility to CHD .Results The proportion of gender as well as level of age, body mass index, total cholesterol, triglyceride and low density lipoprotein cholesterol were not statistically significant between the two groups ( χ2＝0.575, P＞0.05; t＝-1.670, P＞0.05; t＝-1.719, P＞0.05; t＝1.011, P＞0.05; t＝-1.834, P＞0.05; t＝0.474, P＞0.05, respectively), while the proportion of smoking, hypertension and diabetes as well as level of high density lipoprotein cholesterol and fasting plasma glucose were statistically significant between the two groups (χ2＝4.321, P＜0.05; χ2＝39.213, P＜0.01; χ2＝24.184, P＜0.01; t＝5.476, P＜0.01; t＝-5.106, P＜0.01, respectively).The distribution of rs2234237, rs9471535 genotypes and alleles was statistically significant in the two groups (rs2234237: χ2＝6.893, P＜0.05; χ2＝7.159,P＜0.05, respectively; rs9471535: χ2＝8.284, P＜0.05; χ2＝8.314, P＜0.05, respectively).The genotype frequency of rs2234237(AT+TT)in CHD group was significantly lower than in the control group (38.3% vs 53.3%,χ2＝4.680, P＝0.031), and the genotype frequency of rs9471535 ( AG +GG) in CHD group was significantly lower than in the control group (37.5% vs 53.3%, χ2＝5.225, P＝0.022) .In addition, the T allele frequency of rs2234237 in CHD group was significantly lower than in the control group (21.7%vs 33.3%, χ2＝7.159, P＝0.007) , and the G allele frequency of rs9471535 in CHD group was significantly lower than in the control group(20.8%vs 33.3%, χ2＝8.314, P＝0.004).The CHD risk of people carrying rs2234237 TT was 0.173 times of AA (95% CI: 0.048 -0.629, P＝0.008), and the CHD risk of people carrying rs9471535 GG was 0.108 times of AA(95% CI: 0.026-0.450, P＝0.002).However, carriers with T allele of rs2234237(AT+TT) or with G allele of rs9471535(AG+GG)were not significantly associated with the CHD risk(P＞0.05).Conclusions TREM-1 gene rs2234237 A/T and rs9471535 A/G polymorphisms are significantly associated with susceptibility to CHD .rs2234237 TT genotype and rs9471535 GG genotype might act as protective factors of CHD.

Advances of ecotropic viral integration site 1 gene in acute lymphoblastic leukemia / 国际肿瘤学杂志

As an proto-oncogene,ecotropic viral integration site 1 (EVI1) gene is over-expressed in acute myeloid leukemia (AML) because of chromosomal translocation or other genetic abnormalities,finally cause poor prognosis.In recent years,an increasing research of the expression of EVI1 in acute lymphoblastic leukemia (ALL),especially in pediatric ALL.The overexpression of EVI1 gene also suggest a poor prognosis,which is closely relate to the age.But the relationship between the expression of EVI1 gene and mixed lineage leukemia (MLL) and BCR-ABL gene rearrangement needs to be further studied.Researching the expression of EVI1 gene in ALL and exploring targeted therapeutic agents are important research directions in the future.

Advances of ecotropic viral integration site 1 gene in acute lymphoblastic leukemia / 国际肿瘤学杂志

As an proto-oncogene,ecotropic viral integration site 1 (EVI1) gene is over-expressed in acute myeloid leukemia (AML) because of chromosomal translocation or other genetic abnormalities,finally cause poor prognosis.In recent years,an increasing research of the expression of EVI1 in acute lymphoblastic leukemia (ALL),especially in pediatric ALL.The overexpression of EVI1 gene also suggest a poor prognosis,which is closely relate to the age.But the relationship between the expression of EVI1 gene and mixed lineage leukemia (MLL) and BCR-ABL gene rearrangement needs to be further studied.Researching the expression of EVI1 gene in ALL and exploring targeted therapeutic agents are important research directions in the future.

Efficacy and safety of nebulized hypertonic saline in different concentration in infants with moderate to severe bronchiolitis / 中国小儿急救医学

Objective To evaluate the efficacy and safety of frequently nebulized hypertonic saline(HS) in different concentration with Terbutaline in infants with moderate to severe bronchiolitis.Methods A total of 195 infants were randomly enrolled to either Group A(5% HS 4ml+Terbutaline 2.5mg,n=65),Group B(3% HS 4ml + Terbutaline 2.5mg,n=65) or Group C[0.9% normal saline(NS) 4ml + Terbutaline 2.5mg,n=65].All the infants were given inhalation treatment q6h after admission for 4 times,and then q8h till the remission of wheezing.The primary outcome was the hospital length of stay(LOS),and the secondary outcomes were the clinical severity score(CSS),remission time of wheezing,cost and side effects.

Comparison of the Skin and Skeletal Muscle Contusion in Rats Induced by Blunt Force with Different Heights / 法医学杂志

OBJECTIVES@#To explore the differences in the repair process of skin and skeletal muscle after contusion caused by blunt force attack with different heights.@*METHODS@#Three degrees of contusion were performed on SD rats' right hind limbs by a designed free-dropping device falling from 15, 30 and 50 cm heights, which as a main consideration factor for degree of injury. The repair process of skin and skeletal muscle at 6 h, 24 h, 3 d, 7 d and 13 d after contusion were observed using routine histological methods.@*RESULTS@#Hematoma within skin and/or muscle was found in the rats' hind limbs after contusion with three different heights. The repair processes were similar at 24 h after contusion. However, with the increase of height, the display degree was more obvious. At 3 d after contusion, the RBC of the hemorrhagic region would be decomposed and elapsed in 15 cm contusion group, but for 30 cm contusion group, it delayed to 7 d. At 13 d after contusion, the similar result was found in 15 cm and 30 cm contusion groups, in contrast, the 50 cm contusion group was still in the proliferative phase.@*CONCLUSIONS@#With the increase of height, the occurring rate of hematoma within skin and muscle at the same time increases, and the more serious histological appearance after contusion, including inflammation and proliferation, the longer healing process are observed. According to the results of present study and considering forensic application, the contusion model with 50 cm height （2.58 J/cm²） is recommended as the experimental animal model for the future study of wound age estimation on contusion.

Applicative value of acoustic radiation force impulse imaging in differential diagnosis of small hypoechoic thyroid nodules / 中华超声影像学杂志

Objective To investigate the applicative value of acoustic radiation force impulse imaging (ARFI) in the differential diagnosis of small hypoechoic thyroid nodules.Methods 31 patients were pathologically confirmed as having a total of 44 small hypoechoic thyroid nodules ≤ 1 cm in diameter,followed by analyses of the characteristics of their ARFI images,including virtual touch tissue imaging (VTI) and virtual touch tissue quantification (VTQ).Based on VTI images of the nodules,the hardness of small hypoechoic thyroid nodules was respectively scored,and the ratios of VTI images to gray scale image areas were calculated.With pathological diagnosis as the gold standard,VTI scores,area ratios and VTQ values of the ROC curve in diagnosis of thyroid malignant nodules were sketched so as to explore the optimal cut-off points in VTI scores,area ratios and VTQ values in the diagnosis of malignant nodules.Results By the ROC curve test,VTI score of 3 was determined as the cut-off point of areas ratio,with the sensitivity and specificity of diagnosing thyroid cancer being 96.0 ％ and 94.7％,respectively.There were 34 nodules with VTI score greater than 3 (including 9 benign nodules and 25 malignant nodules) and 10 nodules with VTI score of 3 or less (all benign nodules).Malignant thyroid nodules had higher ratio of VTI images to gray scale image area than that of the benign nodules (1.58 ± 0.18 vs 1.30 ± 0.10,P ＜0.05).When 1.47 was set as the cut-off point of areas ratio,the sensitivity and specificity of diagnosing thyroid cancer were 80.0％ and 94.7％,respectively.The VTQ value of 2.76 m/s in diagnosis of thyroid malignant nodules was designated as the cut-off point,with a sensitivity of 88.0 ％,specificity of 94.7 ％.Conclusions The ARFI technique is able to provide information of thyroid nodule hardness,which guarantees its high applicative value in the differential diagnosis of small hypoechoic thyroid nodules.

Catheter directed thrombolysis for early left lower extremity deep venous thrombosis without vena cava filters protection / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the indications, safety and efficacy of catheter directed thrombolysis for early left lower extremity deep venous thrombosis (DVT) without vena cava filters protection.</p><p><b>METHODS</b>Clinical data of 54 cases of early left lower extremity DVT received catheter directed thrombolysis without vena cava filters from July 2008 to June 2010 were retrospectively analyzed. The thrombosis was entire without free floating clots and no thrombosis in vena cava detected with ultrasound scan. Twenty-five patients were male and 29 were female with the average age of 52.8 years. Fifty-one of which were iliofemoral and popliteal, the other 3 were iliofemoral. The course were ≤ 7 d in 45 cases and these were 8 to 30 d in 9 cases. Urokinase of 300 000 U was infused through catheters per 2 h twice a day. Meanwhile 4000 U of low weight heparin was administered subcutaneously per 12 h, or heparin infusion at dosage of 18 U×kg(-1)×h(-1).</p><p><b>RESULTS</b>The procedure technically succeeded in all patients. In total cases venous score decreased to 4.6 ± 2.1 post 6 to 10 d of thrombolysis from 10.8 ± 1.0 with thrombolysis rate of 58% ± 18% which was not significantly different between groups of ≤ 7 d and 8 to 30 d (t = 1.02, P = 0.34). On 14(th) day, 11 patients (20.4%) completely recovered, 35 cases (64.8%) experienced large improvement, 8 patients (14.8%) had mild improvement and nobody was failed, resulting in total efficacy of 100%. No patient developed clinical symptomatic pulmonary embolism. SpO2 did not alter markedly post thrombolysis [(91.0 ± 2.6)% vs. (90.8 ± 2.4)%, t = 2.03, P = 0.05]. No patients suffered from cerebral hemorrhage and haemoturia, and catheter induced inflammation occurred in 4 cases (7.41%). There was mild bleeding in puncture sites in 11 patients (20.4%) during the course. There were 36 patients (66.7%) had been followed up with the time of 6 to 21 months. In which 31 cases had no lower extremity edema or had mild edema after activities. Two patients developed serious edema after activities for deep venous insufficiency. Three cases combined with malignant tumor or renal failure recurred.</p><p><b>CONCLUSIONS</b>For early left extremity DVT which is entire without free floating clots and no thrombosis in vena cava, catheter directed thrombolysis without filter protection maybe administered with safety, efficiency and lower expense.</p>

A multi-center trial for the efficacy of nebulized budesonide inhalation in infants and young children with asthma exacerbations / 中国小儿急救医学

Objective To observe the efficacy and safety of different initial doses of nebulized budesonide inhalation (BI) in infants and young children with moderate to severe asthma exacerbations.Methods A multi-center,parallel controlled clinical trial was performed during Sep 2008 to Apr 2010 in three hospitals,which were Department of Pediatrics,Shanghai Jiaotong University Affiliated Shanghai First People's Hospital,Department of Pediatrics,Shanghai Jiaotong University School of Medicine Affiliated Xinhua Hospital,and Department of Respiratory,Fudan University Affiliated Children's Hospital.One hundred and fifty children aged 6 to 36 month with moderate to severe asthma exacerbations were randomly divided into two groups.The high-starting-dose group was treated with a dose of 1 mg nebulized BI every 8 h for 2 days,while the conventional-starting-dose group was treated with a dose of 0.5 mg cvcry 8 h for 4 days.The terbutaline sulfate aerosol liquid was administered with a dose of 2.5 mg each time as needed.The primary outcome measures were severity scores,which were assessed at admission (0 h),and 8 h,16 h,24 h,48 h,72 h after treatment separately.The secondary outcome measures included the use of β2 receptor agonist,the systemic use of corticosteroids,average length of hospital stay and total cost.The data was analyzed with SPSS 13.0.Results (1) The clinical severity scores were significantly decreased at all time points after treatment in both groups (P ＜ 0.05).Compared with conventional starting-dose of BI,high starting-dose of 3.25 ± 1.82,P ＜ 0.01).(2) The terbutaline doses and the systemic corticosteroids do-ses were significantly reduced in high-starting-dose group compared with conventional-starting-dose group [(16.27 ± 12.99) mg vs (22.90 ± 18.27) mg,P ＜ 0.05 ; (4.54 ± 18.18) mg vs (11.16 ± 21.34) mg,P ＜ 0.05).The average length of hospital stay and the total cost of the two groups showed no significant differences (P ＞ 0.05).(3) There were no side effects associated with BI.Conclusion Compared with conventional treatment,high-starting-dose of BI can control symptoms fast and reduce the use of systemic corticosteroid without any side effects.BI improved symptoms more quickly at 8 h (2.87 ± 1.60 vs 4.48 ± 2.24,P ＜ 0.01) and 16 h (2.48 ± 1.56 vs

Andrographolide inhibits extracellular signal-regulated kinase 1/2 signaling pathway in activated macrophages / 中西医结合学报

Objective: To investigate the effects of andrographolide on extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway and tumor necrosis factor-α (TNF-α) expression in lipopolysaccharide (LPS)-activated macrophages. Methods: LPS-activated mouse peritoneal macrophages were cultured in media with different concentrations of andrographolide. Cytotoxicity of andrographolide was detected by cell counting kit-8. The macrophages were lysed, and then expressions of phosphorylated ERK1/2, JNK and p38 and nuclear factor-κB inhibitor (IκBα) protein were detected by Western blotting and TNF-α mRNA expression was detected by reverse transcription-polymerase chain reaction. Supernatants of the macrophages were used to detect content of TNF-α protein by enzyme-linked immunosorbent assay. Results: Andrographolide at 1-100 μg/mL showed no cytotoxicity on LPS-activated mouse peritoneal macrophages. Andrographolide inhibited ERK1/2 phosphorylation in LPS-activated murine peritoneal macrophages, which was concentration-dependent (P<0.01). Andrographolide at 1-25 μg/mL had no effects on phosphorylation levels of JNK and p38 and IκBα degradation in LPS-stimulated mouse peritoneal macrophages. In activated macrophages, TNF-α expression was inhibited by 12 μg/mL andrographolide and 20 μmol/L PD98059 (inhibitor of ERK1/2 signaling pathway) at both mRNA expression and protein secretion levels. Conclusion: In LPS-activated macrophages, andrographolide may inhibit the expression of TNF-α by inhibiting ERK1/2 signaling pathway.

The study on the lowered tumorigenicity of hepatocellular carcinoma cells cotransfected with chemokine mMIP-1α and costimulatory molecule m4-1BB L in vivo / 中华消化杂志

Objective To investigate the effects of macrophage inflammatory protein-1α (MIP-1α) combined with molecule 4-1BB L on the tumorigenicity of hepatocellular carcinoma cells in vivo. Methods Mouse MIP-1α (mMIP-1α) expressed Hepa 1-6 cells were transfected with m4-1BBL recombinant retrovirus, the anti-histidinol cells clones were selected and amplified. The expression of m4-1BB L was confirmed by flow cytometry. The growth curve of Hepa 1-6 cells transfected with mMIP-1α and m4-1BBL alone or together was drawn and compared. C57B/L Mice were randomly divided into 7 groups, 9 mice in each group, injected with mMIP-1α+m4-1BB L Hepa 1-6 cells, m4-1BB L Hepa 1-6 cells, mMIP-1α Hepa 1-6 cells, Hepa 1-6 cells, pLXSHD Hepa 1-6 cells or PBS respectively. The tumorigenicity of hepatocellular carcinoma cells and the mice survival rate were compared between each groups. Results Hepa 1-6 mMIP-1α+m4-1BB L cells which expressed both mMIP-1α and m4-1BB L were successfully established. The expression of mMIP-1α and m4-1BB L alone or together did not affect the growth curve of Hepa 1-6 cells. Observed for 5 weeks, no tumor developed in Hepa 1-6 mMIP-1α+m4-1BB L injected mice. The tumorigenicity of Hepa 1-6 mMIP-1α+m4-1BB L was lower than that of Hepa 1-6 mMIP-1α or Hepa 1-6 m4-1BB L in vivo. The survival rate of Hepa 1-6 mMIP-1α+m4-1BBL injected mice(9/9) was higher than that of Hepa 1-6 m4-1BB L injected mice (6/9)or Hepa 1-6 mMIP-1α injected mice (1/9). Conclusion Chemokine MIP-1α combined with costimulatory 4-1BB L lowered the tumorigenicity of hepatocellular carcinoma cells in vivo, and prolonged the mice survival period.

Hypolipemic treatment of hyperlipidemic pancreatitis with enema / 国际中医中药杂志

Objective To investigate hypolipemic treatment of hyperlipidemic panereatiti(HLP)with integrated traditional Chinese and western medicine.Methods Cinical data of 20 patients of HLP were analyzed retrospectively.Eight patients in the control group were treated with conventional therapies,while 12 patients in the treatment group were treated as follows:①Enema with 180ml solution(50% magnesium sulfate 30 ml.Glycerin 60ml,water 90ml).②Rhubarb gastrogavage with 9 g tid.③Intravenous drip with 24 g salvia miltiorrhiza qd.Results The treatment group had significant difference comparing with the control group in terms of the serum TG in 48 hours(P<0.01),time of autonomous bowel movement recover(P<0.01),days of abdominal pain disappear(P<0.05),days of hospitalization(P<0.01).Conclusion The treatment of Enema with 180 ml solution.Rhubarb gastrogavage with 9g tid,and Intravenous drip with 24 g salvia miltiorrhiza qd can relieve the symptoms of HLP and decrease blood-fat greatly.

Co-risk factors in early life for childhood asthma and obesity / 国际儿科学杂志

Childhood asthma and obesity are significant public health problems all over the world.In the past decades,the prevalence of both diseases has increased considerably.Because both asthma and obesity appear to have their beginnings in early childhood,common exposures that predispose individuals to both conditions may explain how they are associated.These exposures include common genetic predictors,prenatal exposure to specific nutrients and overall maternal nutrition, colonization patterns of the neonatal and infant gut,birth weight and infant weight gain,and sedentary behaviors in early life.