Effect of epalrestat combined with calcium dobesilate on diabetes peripheral neuropathy and oxidative stress / 中华内分泌外科杂志

Objective:To explore the effect of epalrestat combined with calcium dobesilate on cardiovascular and cerebrovascular diseases and oxidative stress in diabetes patients with peripheral neuropathy.Methods:In a retrospective analysis, 92 patients with diabetic peripheral neuropathy were admitted to the Department of Endocrinology and Metabolism Hospital of Bozhou People’s Hospital from Jun. 2018 to Jun. 2021, which were divided into observation group and control group according to the different treatment methods, with 46 cases in each group. The control group were treated with epalrestat. On this basis, the observation group were given calcium dobesilate combined treatment. The two groups were compared in terms of the Michigan diabetes neuropathy score (MDNS) Michigan neuropathy screening instrument (MNSI) score, oxidative stress reaction [serum superoxide dismutase (SOD), reduced glutathione (GSH) ], clinical efficacy, complications and adverse reactions Using t-test and chi square test.Result:After treatment, the MDNS and MNSI scores of both groups decreased, and the observation group [ (23.49±3.73), (8.49±1.97) ] were lower than the control group [ (28.49±3.85), (11.53±2.28) ] ( t=8.337, 6.843, P<0.05) ; After treatment, the levels of SOD and GSH in both groups increased compared to those before treatment, and the observation group [ (38.96±4.89), (89.79±6.92) ] were higher than the control group those [ (36.42±4.61), (86.74±6.20) ] ( t=2.563, 2.226, P=0.012, 0.028) ; The clinical efficacy of the observation group was higher than that of the control group ( Z=1.592, P=0.042) ; The incidence of complications in the observation group after 1 year was significantly lower than that in the control group ( χ2=4.389, P=0.036) ; The incidence of adverse reactions in the observation group was slightly lower than that in the control group ( χ2=0.155, P=0.694) . Conclusion:Epalrestat combined with calcium dobesilate is effective in the treatment of diabetes peripheral neuropathy, can effectively reduce complications, and has high treatment safety, which is worthy of clinical application.

Structural repurposing of SGLT2 inhibitor empagliflozin for strengthening anti-heart failure activity with lower glycosuria

Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been reapproved for heart failure (HF) therapy in patients with and without diabetes. However, the initial glucose-lowering indication of SGLT2i has impeded their uses in cardiovascular clinical practice. A challenge of SGLT2i then becomes how to separate their anti-HF activity from glucose-lowering side-effect. To address this issue, we conducted structural repurposing of EMPA, a representative SGLT2 inhibitor, to strengthen anti-HF activity and reduce the SGLT2-inhibitory activity according to structural basis of inhibition of SGLT2. Compared to EMPA, the optimal derivative JX01, which was produced by methylation of C2-OH of the glucose ring, exhibited weaker SGLT2-inhibitory activity (IC50 > 100 nmol/L), and lower glycosuria and glucose-lowering side-effect, better NHE1-inhibitory activity and cardioprotective effect in HF mice. Furthermore, JX01 showed good safety profiles in respect of single-dose/repeat-dose toxicity and hERG activity, and good pharmacokinetic properties in both mouse and rat species. Collectively, the present study provided a paradigm of drug repurposing to discover novel anti-HF drugs, and indirectly demonstrated that SGLT2-independent molecular mechanisms play an important role in cardioprotective effects of SGLT2 inhibitors.

Cardioprotective mechanism of SGLT2 inhibitor against myocardial infarction is through reduction of autosis

Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce cardiovascular mortality in patients with diabetes mellitus but the protective mechanism remains elusive. Here we demonstrated that the SGLT2 inhibitor, Empagliflozin (EMPA), suppresses cardiomyocytes autosis (autophagic cell death) to confer cardioprotective effects. Using myocardial infarction (MI) mouse models with and without diabetes mellitus, EMPA treatment significantly reduced infarct size, and myocardial fibrosis, thereby leading to improved cardiac function and survival. In the context of ischemia and nutritional glucose deprivation where autosis is already highly stimulated, EMPA directly inhibits the activity of the Na+/H+ exchanger 1 (NHE1) in the cardiomyocytes to regulate excessive autophagy. Knockdown of NHE1 significantly rescued glucose deprivation-induced autosis. In contrast, overexpression of NHE1 aggravated the cardiomyocytes death in response to starvation, which was effectively rescued by EMPA treatment. Furthermore, in vitro and in vivo analysis of NHE1 and Beclin 1 knockout mice validated that EMPA's cardioprotective effects are at least in part through downregulation of autophagic flux. These findings provide new insights for drug development, specifically targeting NHE1 and autosis for ventricular remodeling and heart failure after MI in both diabetic and non-diabetic patients.

META analysis of mobile bearing and fixed bearing unicondyle replacement for medial knee osteoarthritis / 中国骨伤

OBJECTIVE@#To evaluate of the clinical effects of mobile-bearing(MB) and fixed-bearing(FB) unicompartmental knee arthroplasty(UKA) in the treatment of knee osteoarthritis by Meta-analysis.@*METHODS@#The literature on FB UKA and MB UKA in the treatment of knee osteoarthritis in PubMed, CNKI, Wanfang, Cochrane and EMBASE database were searched by computer from January 2000 to April 2020. According to the inclusion and exclusion criteria, two authors were selected independently and the selected literature was evaluated for quality.After literature data were extracted, Review Manager 5.3 software was used to analyze knee function score, postoperative activity, revision rate, polyethylene wear rate, pad dislocation, aseptic loosening, postoperative pain, knee arthritis progression, mechanical shaft alignment of lower limbs, and imaging clarity line respectively.@*RESULTS@#A total of 13 literatures were included in this meta-analysis, including 2 randomized controlled studies and 11 cohort studies. A total of 1 871 patients were included, including 913 in FB UKA group and 958 in MB UKA group. Meta analysis results showed that:postoperative knee joint function score[MD=-0.84, 95%CI(-1.46, -0.21), P=0.008] and postoperative knee joint range of motion [MD=-1.51, 95%CI(-2.84, -0.18), P=0.03] in FB UKA group were better than those in MB UKA group. Compared with FB UKA group, MB UKA group had a higher lower limb mechanical axis alignment rate[OR=2.08, 95%CI(1.27, 3.39), P=0.003], and the wear rate of polyethylene [OR=0.11, 95%CI(0.01, 0.91), P=0.04] was lower. There were no differences between two groups in the renovation rate [OR=1.16, 95%CI(0.75, 1.80), P=0.50), liner dislocation rate[OR=3.78, 95%CI(0.93, 15.29), P=0.06], aseptic loosening [OR=2.11, 95%CI(0.81, 5.51), P=0.13], postoperative pain[OR=1.13, 95%CI(0.37, 3.43), P=0.83], osteoarthritis progression[OR=1.28, 95%CI(0.67, 2.47), P=0.46)and imaging radiolucent line[OR=1.62, 95%CI(0.09, 30.22), P=0.75].@*CONCLUSION@#FB UKA has a higher postoperative functional score and range of motion.MB UKA has more advantages in the correction of lower limb mechanical axis, and the wear rate of polyethylene is also lower. There was no significant difference between the two groups in revision rate, dislocation of the liner, aseptic loosening, postoperative pain, progression of osteoarthritis, and postoperative translucency.

Efficacy and Mechanism of Qingre Lishi Prescription in Treating Children with Acute Bacterial Lower Urinary Tract Infection of Bladder Damp-heat Syndrome / 中国实验方剂学杂志

Objective:To observe the efficacy of Qingre Lishi prescription in treating children with acute bacterial lower urinary tract infection of bladder damp-heat syndrome， and to explore its mechanism of action. Method:Eighty children with acute bacterial lower urinary tract infection of late bladder damp-heat syndrome who were admitted to the Affiliated Hospital of Changchun University of Chinese Medicine were divided into control group and observation group， 40 cases in each group. Patients in control group were given Bazhengsan for oral treatment on basis of basic treatment， while patients in observation group were given Qingre Lishi prescription for oral administration plus external washing treatment. After two weeks of treatment， the clinical and etiological effect， traditional Chinese medicine （TCM） syndrome scores， antipyretic time and urinary negative time， adverse reactions， and urine pathogens （<italic>Escherichia coli， Enterococcus faecalis， Strange proteus， Klebsiella pneumoniae</italic>）， serum inflammatory factor indicators ［tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， interleukin-6 （IL-6）， interleukin-8 （IL-8）， calcium lowering PCT， white blood cell count （WBC） and serum C-reactive protein （CRP）］， immune function indicators ［T cell subsets （CD3⁺， CD4⁺， CD8⁺） and complement （C3， C4）］ were comapred between two groups. Result:The clinical efficacy of observation group was 92.50% （37/40）， which was significantly higher than 65.00% （26/40） in control group （<italic>χ²</italic>=9.038， <italic>P</italic><0.01）， the etiological efficacy of observation group was 87.50% （35/40）， which was significantly higher than 60.00% （24/40） in control group （<italic>χ²</italic>=7.813， <italic>P</italic><0.01）. After treatment， the scores of TCM syndromes of the two groups were significantly reduced （<italic>P</italic><0.05）. The scores of fever， frequent urination， urgent urination， painful urination， difficulty urinating and abdominal pain in two groups were significantly lower than those before treatment （<italic>P</italic><0.05）， and the TCM syndrome scores in observation group were lower than those in control group （<italic>P</italic><0.05）， the antipyretic time and urinary bacteria turning negative time of observation group were significantly lower than those in control group （<italic>P</italic><0.05）， the <italic>Escherichia coli， Enterococcus faecalis， Proteus mirabilis， Klebsiella pneumoniae</italic> pathogenic bacteria detected in both groups were both significantly lower than those before treatment （<italic>P</italic><0.05）. After treatment， the levels of inflammatory factors such as TNF-<italic>α</italic>， IL-6， IL-8， PCT， WBC and CRP in two groups were significantly lower than those before treatment （<italic>P</italic><0.05）， the immune function of the two groups was significantly improved， and the levels of CD3⁺， CD4⁺， C3， and C4 in observation group were higher than those in control group（<italic>P</italic><0.05）， and the CD8⁺ level was lower than that in control group （<italic>P</italic><0.05）. The incidence of adverse reactions had no significant difference between two groups. Conclusion:Qingre Lishi prescription has good clinical effect in treating children with acute bacterial lower urinary tract infection with bladder damp-heat syndrome. It can improve TCM syndromes and clinical symptoms. Its mechanism is related to inhibiting pathogenic bacteria， reducing inflammation， and improving immune function， and it has good security.

Laparoscopic hiatal hernia repair plus fundoplication for gastroesophageal reflux disease: report of 206 cases / 中华普通外科杂志

Objective:To evaluate the effect of laparoscopic hiatal hernia repair plus fundoplication on gastroesophageal reflux disease (GERD).Methods:The clinical data of 206 GERD patients with esophageal hiatal hernia treated by laparoscopic esophageal hiatal hernia repair + fundoplication at the gastroesophageal reflux center of Zhejiang People′s Hospital from Jan 2016 to Jun 2019 was retrospectively analyzed, including basic data, symptom score, auxiliary examination and follow-up.Results:All 206 patients underwent laparoscopic anti-reflux surgery successfully. There was no conversion to open surgery and no death. Preoperative Deemester scores were 46.49±37.42, while Deemester score 6 month after surgery were 6.38±4.69.Mean follow-up time was 15 months and good result were achieved in 98% of follow-up cases.Conclusion:Laparoscopic repair plus fundoplication for GERD is of minimally invasive and satisfactory, while the preoperative evaluation of surgical indications is properly conducted.

A multi-center cross-sectional study on blood purification among adult patients in intensive care unit in China: a study protocol / 中华医学杂志(英文版)

BACKGROUND@#Blood purification (BP) is one of the most important rescue measures for patients with critical illness in the intensive care unit (ICU), especially for those with acute kidney injury. The purpose of this nationwide survey was to reveal the real world of current BP practice in different ICUs all over China. This study was designed to be a multi-center cross-sectional study.@*METHODS@#All adult patients (over 18 years of age), who were admitted to ICU and required BP in 35 sub-centers across China were included during 30-day survey period in 2018. Demographic characteristics and clinical data were recorded including the timing of treatment initiation, indications, modality, relative contraindication, establishment of vascular access, selection of filter/membrane, settings, anti-coagulation, executive department, complication, intake, and output.@*DISCUSSION@#This nationwide survey may contribute to reveal the real world of current BP practice in different ICUs all over China.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry, ChiCTR-EOC-17013119; http://www.chictr.org.cn/showproj.aspx?proj=22487.

A multi-center cross-sectional study on blood purification among adult patients in intensive care unit in China: a study protocol / 中华医学杂志(英文版)

Background:@#Blood purification (BP) is one of the most important rescue measures for patients with critical illness in the intensive care unit (ICU), especially for those with acute kidney injury. The purpose of this nationwide survey was to reveal the real world of current BP practice in different ICUs all over China. This study was designed to be a multi-center cross-sectional study.@*Methods:@#All adult patients (over 18 years of age), who were admitted to ICU and required BP in 35 sub-centers across China were included during 30-day survey period in 2018. Demographic characteristics and clinical data were recorded including the timing of treatment initiation, indications, modality, relative contraindication, establishment of vascular access, selection of filter/membrane, settings, anti-coagulation, executive department, complication, intake, and output.@*Discussion:@#This nationwide survey may contribute to reveal the real world of current BP practice in different ICUs all over China.@*Trial registration:@#Chinese Clinical Trial Registry, ChiCTR-EOC-17013119; http://www.chictr.org.cn/showproj.aspx?proj=22487.

Analysis of the diagnosis and treatment of ureteral endometriosis by laparoscopic surgery in 16 patients / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the clinical characteristics and the feasibility of laparoscopic treatment of ureteral endometriosis.METHODS: Retrospective analysis of the clinical characteristics,treatment methods and prognosis of 16 patients with ureteral endometriosis from Renji Hospital of Shanghai Jiao Tong University School of Medicine from January 2015 to February 2017.RESULTS: Ureteral stricture is the main symptom for all these 16 patients.15 patients merged with other deep infiltrating endometriosis(DIE)(15/16).All patients underwent laparoscopic surgery.Ureterolysis plus ureteral stent placement were performed in 8 patients,while laparoscopic ureteroneocystostomy in 6 and 2 abandoned surgery.Radical resection of DIE lesions were performed in 15 patients,hysterectomy in 4 patients,adenomyotomy in 2 patients,one-sided or double-sided ovarian cyst removal in 5 patients,ovariocystectomy and adnexectomy in 3 patients.More than 2 surgeries were performed in 1 patient.15 patients preserve ovarian function.No serious postoperative complications.CONCLUSION: Ureteral endometriosis is rare and difficult to diagnosis as lacking of specific symptoms.Laparoscopic treatment can achieve satisfactory therapeutic outcome.

Initial experience of total laparoscopic radical resection for Bismuth type Ⅲ a hilar cholangiocarcinoma: a report of three cases / 中华肝胆外科杂志

Objective To analyze the initial experience of total laparoscopic radical resection for patients with Bismuth type Ⅲa hilar cholangiocarcinoma.Methods A retrospective study was conducted to analyze the clinical data of three patients with Bismuth type Ⅲa hilar cholangiocarcinomatotal who underwent laparoscopic radical resection in Zhejiang Provincial People's Hospital from February to May in 2017.Results The three patients all underwent the operations successfully.The operation time ranged from 490.0 to 580.0 min.The intraoperative blood loss ranged from 300.0 ml to 1 200.0 ml.There was no severe perioperatire complication or death.One patient developed biliary leakage which responded to drainage without reoperation.Another patient developed pleural effusion treated with minimal invasive drainage.The length of postoperative hospital stay ranged from 10.0 to 18.0 days.Histopathology showed two patients with well-differentiated adenocarcinomas and one patient with poorly differentiated adenocarcinoma.The number of lymph nodes harvested ranged from 8 ～ 13.Two patients had no regional lymph node metastasis and one patient had regional lymph node metastasis (1/13).The hilar bile duct resection margins of the three patients were all negative.There was no evidence of tumor recurrence on following up for 7 ～ 10 months.Conclusions It was safe and feasible to carry out total laparoscopic radical resection in selected patients with Bismuth type Ⅲa hilar cholangiocarcinoma.More patients and longer follow-up are required to study the long term oncological results.

CT and MRI manifestation of primary spinal large B cell lymphoma / 中国骨伤

<p><b>OBJECTIVE</b>To investigate CT and MRI characteristics of primary spinal large B cell lymphoma.</p><p><b>METHODS</b>CT and MRI data of 23 patients with primary spinal large B cell lymphoma confirmed by histopathology were retrospectively analyzed from March 2011 to August 2015. Among them, including 14 males and 9 females aged from 28 to 70 years old with an average of 53.4 years old. The clinical manifestation mainly focus on pain around spinal and minority peripheral nerve symptom. The courses of disease ranged from 2 weeks to 3 months with an average of 9 weeks. Nine patients underwent CT plain scan, 8 patients underwent plain and enhanced CT; 21 patients underwent MRI plain scan and enhanced; 15 patients underwent CT and MRI examination. The location, bone changes, shape, density, signal intensity and enhancement characteristics of lesions were observed and compared with pathology.</p><p><b>RESULTS</b>Location and size of lesion showed cervical vertebrae in 1 case, thoracic vertebrae in 16 cases, lumbar vertebrae in 2 cases, and sacral vertebrae in 4 cases. Mass was larger, the largest cross-sectional size of group was up to 73 mm× 125 mm. CT examination showed that 11 cases with "cloud and mist" shape change, 6 cases with compression fractures, and with "floating ice" shape change, 9 cases with "oversleeve" shape change, 11 cases with spinal stenosis; enhancement scan showed obvious reinforcement. MRI showed slightly low signal on T1WI and T2WI were slightly high signal, and signal was uneven, and enhancement scan showed obvious reinforcement, 13 of 16 cases with spinal canal stenosis changed like "oversleeve", intervertebral space showed no significant stenosis. Comparison of CT and MRI showed the manifestation of bone destruction by CT was superior than that of MRI, but the range of lesion, and related surrounding structures were not better than MRI. MRI displayed the range of lesion usually bigger than CT. Pathology results showed that 23 patients were all primary spinal large B cell lymphoma.</p><p><b>CONCLUSIONS</b>Primary spinal large B cell lymphoma has certain features in age, location and imaging findings. The "cloud and mist", "floating ice" and "oversleeve" shape bony destruction by CT and MRI has certain significance to diagnosis of primary spinal large B cell lymphoma.</p>

Efficacy evaluation of laparoscopy assisted ultrasound guided radiofrequency ablation in the treatment of hepatocellular carcinoma beneath the diaphragm / 解放军医学杂志

Objective To explore the feasibility,safety and efficacy of laparoscopy assisted ultrasound guided radiofrequency ablation (RFA) in the treatment of hepatocellular carcinoma (HCC) beneath the diaphragm.Methods Twentythree consecutive patients with solitary HCC beneath the diaphragm were treated by laparoscopy assisted ultrasound guided RFA in the Chinese PLA General Hospital from January 2013 to March 2016.We observed the p erioperative complications and followedup long-term effect.Results All the 23 patients successfully underwent laparoscopy assisted ultrasound guided radiofrequency ablation.No serious complications such as massive hemorrhage,biliary fistula and severe pleural effusion,hemopneumothorax occurred in the patients during perioperative period.CT examination 2-3 days after the operation revealed that the tumor was completely covered by the ablation area.Besides,the survival condition was satisfactory during follow-up period of 9-38 months.Conclusion Laparoscopy-assisted ultrasound-guided radiofrequency ablation is effective and safe for HCC beneath the diaphragm.

The value of diffusion tensor imaging and fiber tractography in cervical spondylotic myelopathy / 中国骨伤

<p><b>OBJECTIVE</b>To study the diagnostic value of diffusion tensor imaging (DTI) in cervical spondylotic myelopathy.</p><p><b>METHODS</b>Twenty healthy volunteers and fifty patients with cervical spondylotic myelopathy underwent DTI in the Affiliated Hospital of Medical College of Ningbo University from January 2014 to April 2015. Healthy volunteers served as controls. Fifty patients were divided into three groups (group A , B, C) according to cervical MRI scan standard. Group A (17 cases) had only the dura mater spinalis compressed; Group B (23 cases) showed the cervical spinal cord compressed, but no high signal in it; Group C (10 cases) had the cervical spinal cord compressed with high signal in the same level. The average apparent diffusion coefficients(ADC) and fractional anisotropy (FA)values in these examinee were analyzed and all subjects were performed fiber tracking.</p><p><b>RESULTS</b>There was no statistically significant differences in ADC and FA values in C2/C3, C3/C4, C4/C5, C5/C6, C6/C7 of control group (P>0.05). The average ADC and FA values in control group were (0.875 +/- 0.096) x10(3) mm2/s and 0.720 +/- 0.051, respectively; compared with group A,there was no statistically significant difference; compared with group B and C, there was significant difference; comparison among group A, B, C, there was significant differences.</p><p><b>CONCLUSION</b>DTI can early and accurately quantify the changes of microstructure in cervical spondylotic myelopathy. Fiber tracking can show the damage range of spinal cord lesions.</p>

CT and MRI manifestations of the axial area primary peripheral primitive neuroectodermal tumors / 中国骨伤

<p><b>OBJECTIVE</b>To explore CT and MRI manifestations of the axial area peripheral primitive neuroectodermal tumors (pPNETs) in order to improve the knowledge of this disease.</p><p><b>METHODS</b>The clinical data of 10 patients with pPNETs underwent pathologically confirmed were retrospectively analyzed from October 2008 to May 2014. There were 7 males and 3 females, aged from 8 to 49 years old with median of 23.6 years. The preoperative multi-slice spiral CT scan was completed in 3 cases, plain CT scan and enhancement in 4 cases; MRI and enhancement scanning in 5 cases; and among them, 2 cases underwent both MRI and CT scan.</p><p><b>RESULTS</b>In-bone type was found 6 cases and out-bone type was found 4 cases. Three cases occurred in sacral vertebrae, 2 cases in lumbar vertebrae, 1 case in cervical vertebrae, 1 case in cervical spinal canal, 1 case in coccyx, 1 case in the right iliac bone, 1 case in presacral space. Cross sectional the smallest tumor maximum level was 1.1 cmx 1.2 cm in size, the biggest tumor was 8.0 cm x 9.2 cm, the median size was 4.4 cm x 5.7 cm, of them, the tumor of maximal diameter larger than 5 cm had 6 cases. Except 2 cases-without destruction of bone, the other 5 cases with osteolytic destruction, 2 cases with calcification, 1 case with mixed. Equidensite was main in CT scan, 1 case with uniform density, other 6 cases with uneven density,in which 3 cases with "floating ice" change; 1 case with moderate strengthening, other 3 cases with obviously strengthening, 2 cases with multiple small blood vessels in enhancement scanning. MRI of 5 cases showed the signal of isointensity on T1WI, the slightly high signal on T2WI and the signal was not uniform; after enhancement scan, the signal of 5 cases obviously enhanced. Two patients complicated with vertebral compression fractures, no periosteal reaction was found in all patients, and no the destruction of intervertebral disk was found in 5 patients of MRI scan.</p><p><b>CONCLUSION</b>The axial area pPNETs is common among children and the youth, and the mass often is huge. The mass of in-bone type often envelopes the vertebral body, and main located on prevertebral space, all associated with bone destruction, osteolytic destruction is common, and primary vertebral bodies also is common, attachment primary or involvement is few found, it can involve the spinal canal and anterior wall of spinal canal is common, some cases complicate with multiple newly born small vessels. The mass of out-hone type in deep soft tissue is common, minority primary spinal canal, many complicated with vertebral bone destruction, osteolytic destruction was main. The intervertebral disk was not invaded and intervertebral space has not stenosis. CT scan offer complicate with "floating ice" sign, and in-bone type is common. Isointensity is main on MRI TlWI and slightly longer signal is main on MRI T2WI, strengthening signal is obvious.</p>

Screening of proteins interacting with RSK4 in breast cancer by affinity purification and liquid chromatography/mass spectrometry / 中国癌症杂志

Background and purpose:As a tumor suppressor gene, ribosomal S6 kinase 4 (RSK4) plays important roles in inhibiting cell proliferation, migration and inducing cell apoptosis. However, the proteins interacting with RSK4 are still unknown. This study aimed to screen proteins interacting with RSK4 in breast cancer cell line MDA-MB-231 by lfag-tag affnity puriifcation and LC-MS/MS (liquid chromatography/mass spectrometry).Methods:The pcDNA3.1/EGFP-RSK4-Flag eukaryotic expression vector was constructed by inserting full lengthRSK4 gene into vector pcDNA3.1/EGFP-Flag. And then the recombinant plasmids were transferred into MDA-MB-231 cells. Real-timelfuorescent quantitative polymerase chain reaction (RTFQ-PCR) and Western blot were used to detect the expression of RSK4 in MDA-MB-231 cells. Affnity puriifcation and LC-MS/MS were applied to screen proteins interacting with RSK4, and the related action mechanism of RSK4 with its interacted proteins was detected based on bioinformatics gene ontology (GO) and ingenuity pathway analysis (IPA).Results:Twenty-four proteins, such as serine/threonine-pro-tein kinase 38 (STK38)/serine/threonine-protein kinase 38-like (STK38L), MOB kinase activator 2 (MOB2) and protein arginineN-methyltransferase 5 (PRMT5), were successfully identiifed by Flag-tag affnity puriifcation followed by LC-MS/MS analysis, which probably interacted with RSK4. Bioinformatics analysis of the identiifed proteins suggested the proteins interacting with RSK4 were involved in diverse biological pathways, such as apoptosis and cell migration. Conclusion:According to bioinformatics results of proteins interacting with RSK4 identiifed by affnity puriifcation and LC-MS/MS, biological networks of RSK4 are involved in apoptosis and migration in breast cancer cells.

The impact of RNA interference-induced ADAR1 down-regulation on cell proliferation of liver cancer / 中华肝胆外科杂志

Objective To observe the impact of RNA interference-induced ADAR1 down-regulation on cell proliferation of liver cancer.Methods Small interfering RNA (siRNA) was transfected into liver cancer cell line SMMC-7721.ADAR1 expression was detected by RT-PCR and Western blotting.Cell proliferation was determined by methyl thiazol tetrazolium (MTT) assay.Results After transfection for 24,48,and 72 h,ADAR1 mRNA expression was 0.612 ± 0.086,0.264 ± 0.018,0.156 ± 0.063 in experimental group and 1.032 ± 0.107,0.898 ± 0.092,0.968 ± 0.074 in control group,respectively.Experimental group had significantly lower ADAR1 mRNA than the other groups (P ＜ 0.05),and there was no statistically significant difference between control and blank group (P ＞ 0.05).ADAR1 protein relative expression was 0.684 ± 0.079,0.324 ± 0.042,0.145 ± 0.058 in experimental group and 1.002 ± 0.092,0.917 ± 0.068,0.972 ± 0.073 in control group,respectively,which was statistically significant (P ＜ 0.05).After transfection with siRNA,the proliferation ability of SMMC-7721 cells was enormously inhibited (P ＜ 0.05).Conclusion ADAR1 mRNA and protein level could be significantly decreased by specific RNA interference,and cell proliferation in SMMC-7721 cells were also greatly inhibited.

Epidemiological Study of Sepsis in China: Protocol of a Cross-sectional Survey / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sepsis is the leading cause of death among critically ill patients. Herein, we conducted a national survey to provide data on epidemiology and treatment of sepsis in the clinical practice in China, which has no detailed epidemiological data available on sepsis.</p><p><b>METHODS</b>This was a prospective cross-sectional survey from December 1, 2015 to January 31, 2016 in all provinces/municipalities of the mainland of China. The primary outcome of this study was the incidence of sepsis, and the secondary outcome was its etiology in China. Patients with sepsis admitted to the Intensive Care Units were included in this study. The demographic, physiological, bacteriological, and therapeutic data of these patients were recorded. The incidence of sepsis was estimated using the data from the sixth census in China, reported by the Chinese National Health and Family Planning Commission and the National Bureau of Statistics as the standard population. The independent risk factors for increased mortality from sepsis were calculated.</p><p><b>CONCLUSIONS</b>This study indicated the incidence and outcome of sepsis in China. It also showed the most common etiology of different sites and types of infection, which could guide empiric antibiotic therapy. Moreover, it provided information on the independent risk factors for increased mortality due to sepsis. The findings provide evidence to guide clinical management and may help improve the outcome in septic patients.</p><p><b>TRIAL REGISTRATION</b>ClinicalTrials.gov, NCT02448472; https://clinicaltrials.gov/show/NCT02448472.</p>

Diagnostic value of 3D-indirect magnetic resonance arthrography in detecting meniscal tears of the knees / 中国骨伤

<p><b>OBJECTIVE</b>To explore the diagnostic value of 3D-indirectmagnetic resonance (MR) arthrography in detecting meniscustears of the knees.</p><p><b>METHODS</b>Form January 2013 to January 2014, routine plain MR of the knees followed by the 3D-indirect MR arthrography was performed in 42 patients with suspected meniscal tears clinically. There were 31 males and 11 females, with an average age of 38.4 years old (ranged, 21 to 67 years old). The duration of the course ranged from 2 h to 15 d. The clinical symptom was knee pain. All the patients got subsequently arthroscopic examination or operation. The sensitivity and specificity of routine plain MR and 3D-indirect MR arthrography were compared based on the results of arthroscopic examination or operation.</p><p><b>RESULTS</b>The signal intensity in the area of meniscal tears on image of 3D-indirect MR arthrography was obviously higher than that of routine plain MR. The sensitivity of 3D-indirect MR arthrography was 85.79% (87/102), while the routine plain MR was 52.94% (54/102), and the specificity improved from 67.78%(61/90) to 86.67%(78/90). The difference was statistically significant (χ2 = 25.90, P < 0.01; χ2 = 9.13, P < 0.01).</p><p><b>CONCLUSION</b>In comparison with the routine plain MR findings, 3D-indirect MR arthrography demonstrates meniscus tears of the knee with the better sensitivity and specificity.</p>

Pharmaceutical Care for One Patient with Bone Tuberculosis Complicated with Tubercular Meningitis / 中国药师

Objective:To explore the approaches and ideas for the pharmaceutical care performed by clinical pharmacists for the patients with bone tuberculosis and tubercular meningitis. Methods:Pharmacists participated in the clinical consultation for one patient with bone tuberculosis and tubercular meningitis. The methods and effect of clinical pharmacists were analyzed comprehensively in re-spect of the adjustment of anti-tuberculosis treatment scheme according to the disease condition, attention pald to the adverse reactions of anti-tuberculosis drugs, medical education for the patient and so on. Results: During the treatment, clinical pharmacists did have some actions to assist doctors in rational drug use, and the suggestions of clinical pharmacists in the consultation obtalned clinical rec-ognition, which significantly improved the effect of the medication. Conclusion:Clinical pharmacists can perform individual pharma-ceutical care for patients and help clinicians optimize drug therapy, which can improve the safety and efficacy of medication.

Multi-slice computed tomography manifestation of primary pulmonary sarcomatoid carcinoma / 中华全科医师杂志

Retrospective analysis of multi-slice computed tomography (MSCT) manifestations were conducted for 8 cases of pathologically confirmed primary pulmonary sarcomatoid carcinoma.And the relevant literature was also reviewed.The lesion sites were right upper lobe (n =5),lower lobe (n =2) and left upper lobe (n =1).One case was difficult to distinguish because of its huge mass and the remainder was all peripheral.With pseudocapsule (n =4),coarse calcification (n =1),hilar & mediastinal node metastasis (n =2) and cavity (n =1).The manifestations included extensive lung alveolar septal thickening & ground glass (n =1) and massive deep leaf & glitches (n =2).The scans were non-enhanced alone (n =1) and non-enhanced & enhanced (n =7).Six cases had shaped enhancement while another 5 uneven thickness of annular enhancement.And 4 cases had floating-ice change.Primary pulmonary sarcomatoid carcinoma is common in subpleural lung lobe.And the floating-ice sign is valuable in the diagnosis of sarcomatoid carcinoma.