Effect of meridian sinew releasing technique on moxibustion sensation of heat-sensitive moxibustion in patients with knee osteoarthritis / 中国针灸

OBJECTIVE@#To observe the effect of meridian sinew releasing technique on moxibustion sensation of heat-sensitive moxibustion in patients with knee osteoarthritis (KOA).@*METHODS@#A total of 60 patients with KOA were randomly divided into an observation group and a control group, 30 cases each group. In the observation group, on the basis of the meridian sinew releasing technique, moxibustion sensation exploration method was applied at Dubi (ST 35) area on the affected side. In the control group, moxibustion sensation exploration method was applied at Dubi (ST 35) area on the affected side. The meridian sinew releasing technique was performed for 20 min each time, the moxibustion sensation exploration method was performed for 60 min each time, once a day for 3 days. The excitation rate, latency, duration time and intensity value of moxibustion sensation of heat-sensitive moxibustion were recorded on the 1st, 2nd and 3rd days of exploration in the two groups.@*RESULTS@#The excitation rate on the 3rd day of exploration and total excitation rate in the observation group were higher than the control group (P<0.05). On the 1st, 2nd and 3rd days of exploration, the latency of moxibustion sensation of heat-sensitive moxibustion in the observation group was shorter than the control group (P<0.05), the duration time was longer than the control group (P<0.05), and the intensity value was higher than the control group (P<0.05).@*CONCLUSION@#Meridian sinew releasing technique could improve the excitation rate of moxibustion sensation of heat-sensitive moxibustion in patients with KOA, shorten the latency, prolong the duration time, and improve the intensity value.

Optimization of indirect immunofluorescence on salt-split skin and its application in detection of bullous pemphigoid antibodies / 中华皮肤科杂志

Objective:To optimize indirect immunofluorescence on salt-split skin (IIF-SSS), and to evaluate its performance in detection of bullous pemphigoid (BP) antibodies.Methods:Normal human foreskin and non-foreskin skin tissues were used to prepare salt-split substrates under 3 different experimental conditions: traditional group rotated at 4 ℃ for 48 - 72 hours, low-temperature immersion group soaked at 4 ℃ for 48 - 72 hours, room-temperature immersion group soaked at 25 ℃ (range: 23 - 27 ℃) for 24 hours. Serum samples were obtained from 20 patients with bullous pemphigoid (BP) in Hospital of Dermatology, Chinese Academy of Medical Sciences between August 2019 and August 2020, and subjected to IIF on the intact skin or salt-split substrates by using a multiple dilution method. Paired-sample t test was used for comparisons of means between two paired samples. Results:No dermal-epidermal separation was observed in the substrates prepared in the low-temperature immersion group at 48 - 72 hours, while dermal-epidermal separation occurred in the lower lamina lucida of the foreskin and non-foreskin substrates in the room-temperature immersion group and the traditional group. For the 20 patients with BP, the reciprocal end-point titers ( M[ Q1, Q3]) detected with the salt-split non-foreskin skin and salt-split foreskin in the room-temperature immersion group, and with the salt-split non-foreskin skin in the traditional group were 5 120 (2 560, 17 920), 1 280 (640, 2 560), 1 280 (640, 2 560), respectively. Moreover, 19 (95%) patients with BP showed that the reciprocal end-point titers detected with the substrates in the room-temperature immersion group were 1 - 5 times those in the traditional group ( t = 8.04, P<0.001), suggesting that the performance of salt-split skin in the room-temperature immersion group was superior to that in the traditional group in the detection of BP antibodies; however, there was no significant difference in the reciprocal end-point titers of BP antibodies between the salt-split foreskin in the room-temperature immersion group and salt-split non-foreskin skin in the traditional group ( t<0.001, P>0.05). The reciprocal end-point titers in 20 BP sera detected by conventional IIF on the intact non-foreskin skin and foreskin were 320 (160, 640) and 480 (160, 1 120), respectively; the reciprocal end-point titers detected by IIF on the salt-split foreskin and non-foreskin skin in the room-temperature immersion group, as well as on the salt-split non-foreskin skin in the traditional group, were all consistent with or 1 - 7 times higher than those detected by conventional IIF ( t = 6.47, 14.83, 5.26, respectively, all P<0.001) . Conclusion:The soaking method at room temperature 25 ℃ (23 - 27 ℃) for preparing salt-split substrates has advantages of short duration and simple procedure, and the sensitivity of IIF-SSS using the substrates prepared by this method is equal or superior to the traditional salt-split method for detecting BP antibodies.

Recent research on the mechanism of mesenchymal stem cells in the treatment of bronchopulmonary dysplasia / 中国当代儿科杂志

Bronchopulmonary dysplasia (BPD) is a chronic lung disease due to impaired pulmonary development and is one of the main causes of respiratory failure in preterm infants. Preterm infants with BPD have significantly higher complication and mortality rates than those without BPD. At present, comprehensive management is the main intervention method for BPD, including reasonable respiratory and circulatory support, appropriate enteral nutrition and parenteral nutrition, application of caffeine/glucocorticoids/surfactants, and out-of-hospital management after discharge. The continuous advances in stem cell medicine in recent years provide new ideas for the treatment of BPD. Various pre-clinical trials have confirmed that stem cell therapy can effectively prevent lung injury and promote lung growth and damage repair. This article performs a comprehensive analysis of the mechanism of mesenchymal stem cells in the treatment of BPD, so as to provide a basis for clinical applications.

A study on application of deep learning reconstruction in low-dose brain CT in children with craniocerebral trauma / 中华放射学杂志

Objective:To explore the application value of deep learning reconstruction (DLR) in low-dose brain CT imaging in children with craniocerebral trauma.Methods:The CT data of 51 children with craniocerebral trauma complicated with intracerebral hemorrhage who received low dose brain CT were retrospectively collected in Hunan Children′s Hospital between June 2020 and February 2021. All images were reconstructed at 1.25 mm and 5 mm slice thickness utilizing two reconstruction algorithms and divided into six subgroups: ASIR-V with three different blending ratios (0, 50%, 100%), and DLR with three different reconstruction strengths [low (L), media (M) and high (H)]. The objective parameters including CT value, signal to noise ratio (SNR) and contrast to noise ratio (CNR) of dorsal thalamus (grey matter), white matter of frontal lobe and hemorrhagic lesion, as well as basicranial artifact noise (SD) and background SD were measured and calculated. Subjective evaluation was performed with a 5-point scale scoring. Objective parameters and subjective scores were compared among different groups using randomized block analysis of variance and Friedman test, respectively. The objective and subjective differences between 1.25 mm DLR-H and ASIR-V50% images were analyzed using paired samples t-test and correlated sample rank sum test. Results:The average CT dose index volume, dose length product and size-specific dose estimate of head CT were 17.7 (11.9, 21.1) mGy, 248.4 (142.2, 338.1) mGy·cm and (15.7±2.8) mGy. With the same thickness, the difference of CT values between the DLR and ASIR-V groups were stastistically significant ( P<0.05). The subjective scores of DLR groups were significantly better than those of ASIR-V; the higher was the reconstruction grade of ASIR-V and DLR, the higher SNR and CNR values and the lower SD value were obtained for each structure (all P<0.05). DLR images showed better objective parameters than ASIR-V50% images. Background:SD was lowest on DLR-H and ASIR-V100% images, with no significant difference found between these two groups. Using 1.25 mm thickness, DLR-H images showed higher SNR (for both gray matter and white matter) and CNR than ASIR-V100% images ( P<0.05). The subjective score was decreased with the slice thickness reduced. However, the average subjective scores of 1.25 mm DLR images were all over 3 points, while those of 1.25 mm ASIR-V images were less than 3 points, which could not fully meet the needs of diagnosis. Images of 1.25 mm DLR-H had higher background SD and artifact SD than 5 mm ASIR-V50% images ( t=2.96, 2.83, P=0.005, 0.007), while the score and other objective parameters were not statistically different between these two groups ( P>0.05). Conclusion:In children′s low-dose cerebral CT, DLR can improve image quality, with the DLR-H images displaying the highest image quality. It can also increase the SNR and CNR of gray and white matter of images with thin thickness.

Discovery of a small-molecule inhibitor of carbamoyl phosphate synthase 1 and its anti-colorectal cancer mechanism / 药学学报

The carbamoyl phosphate synthase 1 (CPS1) enzyme is involved in the first phase of the urea cycle, providing a prerequisite molecule for pyrimidine synthesis, as well as promoting tumor cell proliferation and growth. Studies have found that CPS1 is highly expressed in a variety of tumors, including colorectal cancer, lung cancer, etc. and its overexpression is related to the poor prognosis of tumors. Thus, small molecules targeted to inhibit the function of CPS1 in tumors may provide therapeutic benefits for cancer patients who overexpress CPS1. In this study, the function of CPS1 was investigated in vitro, and we found that overexpression of CPS1 can enhance the migration ability of colorectal cancer cells HCT15. Here, based upon the existing crystal structure, combined with high-throughput virtual screening, we obtained 8 candidate small molecule compounds. In vitro activity evaluation, we found that compound 3 has good anti-HCT15, HCT116 cell proliferation activity (HCT15, IC50, 7.69 ± 1.10 μmol‧L-1, HCT116, IC50, 13.53 ± 0.46 μmol‧L-1). Subsequently, molecular docking and molecular dynamics (MD) simulation analysis showed that, compound 3 could target and inhibit the activity of CPS1. In vitro studies showed that compound 3 could inhibit the migration of HCT15 cells, as well as induced cell cycle arrest and apoptosis. Taken together, this study found that compound 3 is a potential small molecule inhibitor that targets CPS1, which provides the experimental basis and theoretical basis for the development of targeted intervention small molecule therapeutic drugs. Based upon the chemical structure of compound 3, we will shed new light on further optimizing its activity and therapeutic potential, which may provide a therapeutic benefit to the patients with CPS1-related tumors.

Comparison of clinical features between chronic active Epstein-Barr virus infection and infectious mononucleosis in adult patients / 中华临床感染病杂志

Objective:To compare the clinical features between chronic active Epstein-Barr virus infection(CAEBV) and infectious mononucleosis(IM)in adult patients.Methods:Clinical data from 56 adult IM patients and 14 adult CAEBV patients admitted in the First Affiliated Hospital of Nanjing Medical University during January 2011 to December 2019 were enrolled. Clinical manifestations, laboratory indicators, treatment and outcomes were compared between two groups. Chi-square test and Mann-whitney U test were used to analyze data. Results:The average age of CAEBV patients was higher than that of IM patients [36.0(23.8, 50.5)years vs. 19.0(17.3, 22.8) years; U=90.0, P<0.05]. The symptoms of sore throat, throat congestion, tonsilla enlargement and lymphadenopathy in IM group were more common than those in CAEBV group( χ2=14.088, 16.875, 31.855 and 10.938, all P<0.01). However, the incidence of pulmonary infection, sleepiness/dysphoria and splenomegaly in CAEBV group were significantly higher than those in IM group( χ2=17.217, 5.809 and 6.254, P<0.05 or <0.01). The white blood cell counts, hemoglobin levels, platelet counts, alanine aminotransferase(ALT) and albumin in CAEBV group were significantly lower than those in IM group( U=47.0, 49.5, 158.5, 173.0 and 263.5, all P<0.01). The levels of neutrophil ratio, C-reactive protein, serum ferritin and EBV DNA load in CAEBV group were significantly higher than those in IM group( U=145.0, 140.0, 128.5 and 115.0, P<0.05 or <0.01). The proportions of CD3 + T cell counts and CD8 + T cell counts in CAEBV group were significantly lower compared to those in IM group( U=42.0 and 24.5, P<0.01); the proportions of CD4 + T cell counts, the CD4 + T/CD8 + T cell counts ratio and B lymphocytes in CAEBV group were significantly higher compared to those in IM group( U=29.0, 23.5 and 34.5, P<0.01). Fifty-six IM patients were all cured and discharged from hospital. In CAEBV group, 8 cases died, 3 cases were improved and 3 cases lost follow-up. Conclusions:Patients with IM represent a favorable prognosis, while the prognosis of CAEBV is relatively poor and complication with HLH may occur. For older patients with EBV infection complicated with pulmonary infection, lethargy/irritability, attention should be paid to monitor blood routine, liver function, serum EBV DNA load and peripheral blood lymphocyte subsets.

A retrospective clinical study of patients with pregnancy-associated breast cancer among multiple centers in China (CSBrS-008) / 中华医学杂志(英文版)

BACKGROUND@#Pregnancy-associated breast cancer (PABC) is a special type of breast cancer that occurs during pregnancy and within 1 year after childbirth. With the rapid social development and the adjustment of reproductive policies in China, the average age of females at first childbirth is increasing, which is expected to lead to an increase in the incidence of PABC. This study aimed to accumulate clinical experience and to investigate and summarize the prevalence, diagnosis, and treatment of PABC based on large multicenter samples in China.@*METHODS@#According to the Chinese Society of Breast Surgery, a total of 164 patients with PABC in 27 hospitals from January 2016 to December 2018 were identified. The pregnancy status, clinicopathological features, comprehensive treatment methods, and outcomes were retrospectively analyzed. Survival curves were plotted using the Kaplan-Meier method.@*RESULTS@#A total of 164 patients of PABC accounted for 0.30% of the total number of cases in the same period; of which, 83 patients were diagnosed during pregnancy and 81 patients during lactation. The median age of PABC was 33 years (24-47 years). Stage I patients accounted for 9.1% (15/164), stage II 54.9% (90/164), stage III 24.4% (40/164), and stage IV 2.4% (4/164). About 9.1% (15/164) of patients were luminal A. Luminal B patients accounted the most (43.3% [71/164]). About 15.2% (25/164) of patients were human epidermal growth factor receptor 2 (Her-2) overexpression and 18.9% (31/164) of patients were triple-negative breast cancer. For pregnancy breast cancer, 36.1% (30/83) of patients received direct surgery and 20.5% (17/83) received chemotherapy during pregnancy. About 31.3% (26/83) chose abortion or induction of labor. The median follow-up time was 36 months (3-59 months); 11.0% (18/164) patients had local recurrence or distant metastasis and 3.0% (5/164) died.@*CONCLUSIONS@#It is safe and feasible to standardize surgery and chemotherapy for PABC.

Discovery of a small-molecule activator of beclin-1 that induces autophagy-associated cell death and apoptosis in triple negative breast cancer / 药学学报

Autophagy is a lysosomal degradation pathway, and plays a crucial role in cellular homeostasis, development, immunity, tumor suppression, metabolism, prevention of neurodegeneration, and lifespan extension. Thus, pharmacological stimulation of autophagy may be an effective approach for preventing or treating certain human diseases and/or aging. Here, combined with allosteric site identification methods, high-throughput virtual screening, and in vitro activity evaluation, we found that compound 10 can activate autophagy and has good anti-MDA-MB-231 cell proliferation activity (the half maximal inhibitory concentration IC50 = 8.25 ± 1.53 μmol·L-1). Subsequently, molecular docking, molecular dynamics simulation, and immunoblotting assay demonstrate that compound 10 can target and activate beclin-1. In vitro studies have shown that compound 10 can induce autophagy-associated cell death in MDA-MB-231 cells. In addition, it was found that compound 10 can induce apoptosis in MDA-MB-231 cells. Taken together, we identified the candidate compound 10 as an effective and selective targeting beclin-1 to activate autophagy as a lead compound, which provide a reference for further development and optimization of small molecule drugs targeting beclin-1 to activate autophagy for clinical treatment.

Multidisciplinary cooperation strengthens individualized management of breast cancer in pregnancy / 中华外科杂志

As the pregnant patient with breast cancer is in a special physiological period, both the efficacy of mother and the safety of developing fetus should be considered during the whole process of diagnosis and treatment. It is particularly important for multidisciplinary teams including breast, obstetrics and nursing departments to make a secure and effective individualized plan for those in different gestational week and different stages of breast cancer development. Pregnancy risk assessment and whole-process multidisciplinary case management mode for breast cancer during pregnancy are helpful for the early detection of abnormal health status of pregnant women and fetuses, enabling rapid and efficient treatment, reducing the occurrence of adverse medical events, and maximizing the safety of pregnant women and fetuses. Obstetricians should pay attention to the chief complaints of pregnant women and conduct regular breast ultrasound examinations. Once anything suspicious is found, breast surgeons need to take charge of a multidisciplinary discussion. Not only should the multidisciplinary collaborative outpatient clinic determine the treatment plan for breast cancer during pregnancy, but also the concept of multidisciplinary collaboration should be incorporated into the follow-up treatment process, including active surgical treatment, selection of neoadjuvant chemotherapy and adjuvant chemotherapy, avoidance of endocrine therapy, targeted therapy and radiotherapy, and adherence to multidisciplinary follow-up, etc. Multidisciplinary case management of breast cancer during pregnancy is necessary and feasible, and more prospective clinical studies need to be carried out to help improve clinical diagnosis and treatment strategies.

The CT imaging features of hepatoblastoma in term neonates / 中华放射学杂志

Objective@#To investigate the CT features of hepatoblastoma in term neonates.@*Methods@#The clinical data and abdominal CT features of 7 children with neonatal hepatoblastoma confirmed by surgical pathology from January 2015 to January 2019 in Hunan Children′s Hospital were retrospectively analyzed, focusing on the position, size, shape, density and dynamic enhancement characteristics of the mass.@*Results@#All 7 cases were solitary intrahepatic mass, which affected the liver SⅥ in 2 cases, SⅦ in 2 cases, SⅤ+Ⅵ in 1 case, SⅡ+Ⅲ in 1 case, SⅣa+Ⅴ+Ⅷ in 1 case. The maximum diameters were 2.9-10.2 cm (median maximum diameter 4.7 cm). Four cases tumors were spherical shape, while 3 cases were irregular lobulation and extended to the outside of live. The boundary was clear in 6 cases and fuzzy in 1 case. Necrosis, calcification, patchy hemorrhage was shown in 4 cases, 1 case, 5 cases, respectively. All 7 cases tumors showed heterogeneous enhancement, with multiple nodular and lamellar obvious enhancement at the center and edge of the tumor in arterial phase, and gradually filling-in, presented as multiple bands and island-like enhancement, with prominent edge enhanced but no enhancement in the necrotic area in portal venous and delayed phase. The tumor invaded portal vein and bile duct in hilar area in 1 case, with the intra-hepatic bile duct dilation. The caliber of the abdominal aorta below celiac trunk became thinner in 3 cases. 6 cases were epithelial fetal type and 1 case was mixed type with pathological confirmed.@*Conclusion@#The main CT manifestations of neonatal hepatoblastoma are spherical or lobulated, with varied degrees of necrotic, hemorrhage and calcification, and heterogeneous enhancement with gradually regional expansion.

Neutrophil-Lymphocyte Ratio as a Prognostic Predictor in Patients with Newly Diagnosed Angioimmunoblastic T Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the prognostic evaluation value of neutrophil-lymphocyte ratio (NLR) in patients with newly diagnosed angioimmunoblastic T cell lymphoma (AITL).@*METHODS@#Clinical data of 39 patients with newly diagnosed AITL in our hospital from March 2010 to August 2018 were colleated and retrospective analyzied, and the relationship between NLR before treatment and the prognosis of AITL patients was analyzed.@*RESULTS@#Among 39 AITL patients, the median value of NCR was 5.43. Based on the cut-off value (5.43), all the patients were divided into 2 groups: high NLR group (5.43, n=20) and a low NLR group (＜5.43, n=19). The total effective rate of treatment was lower in the high NLR group as compered with low NLR group (P=0.041). Univariate analysis showed that, age ＞60 years old, extranodal involvement＞1 as well as high NLR were the independent risk factors that affected overall survival (OS) in newly diagnosed AITL patients. Multivariate Cox analysis showed that extranodal involvement＞1 and high NLR were the independent risk factors that affected OS in newly diagnosed AITL patients.@*CONCLUSION@#The NLR may be an independent prognostic factor in patients with newly diagnosed AITL. High NLR associated with poor prognosis.

The CT imaging features of hepatoblastoma in term neonates / 中华放射学杂志

Objective:To investigate the CT features of hepatoblastoma in term neonates.Methods:The clinical data and abdominal CT features of 7 children with neonatal hepatoblastoma confirmed by surgical pathology from January 2015 to January 2019 in Hunan Children′s Hospital were retrospectively analyzed, focusing on the position, size, shape, density and dynamic enhancement characteristics of the mass.Results:All 7 cases were solitary intrahepatic mass, which affected the liver SⅥ in 2 cases, SⅦ in 2 cases, SⅤ+Ⅵ in 1 case, SⅡ+Ⅲ in 1 case, SⅣa+Ⅴ+Ⅷ in 1 case. The maximum diameters were 2.9-10.2 cm (median maximum diameter 4.7 cm). Four cases tumors were spherical shape, while 3 cases were irregular lobulation and extended to the outside of live. The boundary was clear in 6 cases and fuzzy in 1 case. Necrosis, calcification, patchy hemorrhage was shown in 4 cases, 1 case, 5 cases, respectively. All 7 cases tumors showed heterogeneous enhancement, with multiple nodular and lamellar obvious enhancement at the center and edge of the tumor in arterial phase, and gradually filling-in, presented as multiple bands and island-like enhancement, with prominent edge enhanced but no enhancement in the necrotic area in portal venous and delayed phase. The tumor invaded portal vein and bile duct in hilar area in 1 case, with the intra-hepatic bile duct dilation. The caliber of the abdominal aorta below celiac trunk became thinner in 3 cases. 6 cases were epithelial fetal type and 1 case was mixed type with pathological confirmed.Conclusion:The main CT manifestations of neonatal hepatoblastoma are spherical or lobulated, with varied degrees of necrotic, hemorrhage and calcification, and heterogeneous enhancement with gradually regional expansion.

Preliminary evaluation of MR diffusion tensor imaging in children with acute renal injury / 中国医师杂志

Objective To investigate the study of magnetic resonance (MR) diffusion tensor imaging in children with acute kidney injury,and further improve the clinical research level of early diagnosis of acute kidney injury (AKI).Methods Twenty-two children who met the clinical AKI diagnostic criteria were collected from the Children's Hospital of Hunan Province.Twenty-three children volunteers were collected as the control group.The anisotropy fraction (FA) and mean diffusion coefficient (ADC) values of the renal cortex and medulla of all the tested children were detected,and the serum creatinine value and disease test results of children with AKI were collected.Spearman correlation analysis was used to analyze the correlation between the renal and medullary ADC values and FA values and serum creatinine values in the children with AKI.Results There were no significant differences in the FA,ADC values of left and right renal cortex and medulla of case group (P ＞ 0.05).There were no significant differences in the FA,ADC values of left and right renal cortex and medulla of control group (P ＞ 0.05).The medullary FA value,cortical FA and ADC value of the children with AKI were significantly lower than those of normal children (P ＜ 0.05).There was no significant difference in medullary ADC values between children with AKI and normal children (P ＞ 0.05).The medullary FA value and cortical ADC value of AKI patients were negatively correlated with serum creatinine value (r =-0.868,-0.436,P ＜ 0.05),and there was no correlation between cortical FA,medullary ADC and serum creatinine in the rest of the children.Conclusions As a non-invasive imaging method,diffusion tensor imaging (DTI) can reflect the early renal damage of AKI and has potential application value for clinical diagnosis of AKI.

Clinical effect of extended lumpectomy in the treatment of patients with single benign thyroid disease / 中国基层医药

Objective:To investigate the clinical effect of extended lumpectomy in the treatment of patients with single benign thyroid disease of different sizes.Methods:From June 2008 to June 2011, 132 patients with single benign thyroid lesion in the Second People′s Hospital of Changshu were selected as observation group.According to the size of the lump, 132 patients with single benign thyroid disease were divided into two groups: ≤2cm group(64 patients) and >2cm group(68 patients). In addition, 62 patients with single benign thyroid lesion underwent subtotal thyroidectomy at the same time were randomly selected as control group.The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost and postoperative complications (hoarseness, water bucking, low calcium, hypothyroidism, tumor recurrence) of the two groups were recorded and compared with the control group.Results:The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost of ≤2cm group were less or shorter than those of the control group[(3.6±0.4)cm vs.(4.5±0.6)cm, (40.1±9.6)min vs.(76.2±15.3)min, (52.2±17.8)mL vs.(82.1±16.8)mL, (49.8±15.7)mL vs.(78.1±12.4)mL, (4.9±0.9)d vs.(6.1±1.2)d, (7125.2±219.4)CNY vs.(8321.2±308.1)CNY, t=9.935, 15.917, 9.690, 11.205, 6.363, 25.161, all P<0.05]. The incidence of postoperative hoarseness in ≤2cm group was lower than that in the control group[0.0%(0/132) vs.6.5%(4/62), χ 2=4.4244, P<0.05]. The incidence of postoperative hypothyroidism in ≤2cm group was lower than that in the control group[0.0%(0/132) vs.8.1%(5/62), χ 2=5.374, P<0.05]. The incidences of postoperative water bucking, low calcium and tumor recurrence of ≤2cm group had no statistically significant differences compared with those of the control group (χ 2=2.097, 1.040, 0.968, all P>0.05). The operating time, hospital cost of >2cm group were less than those of the control group[(49.6±12.7)min vs.(76.2±15.3)min, (7 641.6±382.4)CNY vs.(8 321.2±308.1)CNY, t=10.820, 11.090, all P<0.05). The incision size, intraoperative blood loss, postoperative drainage volume, hospital day of ≤2cm group had no statistically significant differences compared with those of the control group( t=1.740, 1.709, 1.850, 1.487, all P>0.05). The incidences of postoperative hoarseness, water bucking, low calcium and hypothyroidism of ≤2cm group had no statistically significant differences compared with those of the control group (χ 2=2.175, 0.443, 1.105, 1.670, all P>0.05). The patients were followed-up for 7-10 years, the postoperative recurrence rate in >2cm group was higher than that in the control group[10.3%(7/68) vs.1.6%(1/62), χ 2=4.232, P<0.05]. Conclusion:Compared with conventional subtotal thyroidectomy, extended lumpectomy in the treatment of patients with small single benign thyroid disease(≤2cm) has good effect.The incision size, operating time, intraoperative blood loss, postoperative drainage volume, hospital day, hospital cost, postoperative hoarseness and postoperative hypothyroidism are less than subtotal thyroidectomy.And it don't increase tumor recurrence rate of ipsilateral thyroid gland.So it is worthy of clinical application.But it is not suitable for larger single benign thyroid disease (>2cm) because of higher recurrence rate.

To evaluate the extravascular lung water in patients of bilateral lung transplantation with lung ultrasonography and SDC-1 / 中华胸心血管外科杂志

Objective:The purpose of this study was to explore new method for evaluating the severity of extravascular lung water in patients after bilateral lung transplantation.Methods:The study was performed in 50 patients after bilateral lung transplantation in our hospital from 2017 to 2018. Picco were implanted during the operation .Two hours after the operation, a doctor monitored the index of EVLWI and PVPI.At the same time, another doctor carried out examination of lung ultrasonography and Calculated the numbers of B line. After ultrasonography, the doctor used ELISA to determine the level of SDC-1.Results:EVLWI were significantly correlated with the number of B-line and the level of SDC-1 ( RS=0.833, RS=0.747, P<0.05), PVPI were significantly correlated with the number of B-line and the level of SDC-1 ( RS=0.738, RS=0.626, P<0.05). Conclusion:The number of B-line and the level of SDC-1 have a good correlation with extravascular lung water. The combination of the two indicators might be used as a reliable index for evaluating the degree of extravascular lung water after bilateral lung transplantation.

Effects of severe fever with thrombocytopenia syndrome virus infection on the expression of TLR2 and inflammatory cytokines in mouse peritoneal macrophages / 医学研究生学报

Objective The secretion level of inflammatory factors is closely related to the severity of severe fever with thrombocytopenia syndrome (SFTS). This paper mainly discussed the effect of SFTSV infection on the expression of Toll-like receptor 2（TLR2） and inflammatory factors in macrophages in mice. Methods The expression of TLR2 andTNF-α, IFN-β, IL-6, IL-10 and other inflammatory factors were observed at 0, 6, 12, 24, 36, 48, 72 hours after SFTSV infected mice macrophages by qPCR, Western blot and ELISA. Results QPCR results showed that the mRNA levels of TNF-α at 0, 6, 12, 24, 36, 48, 72 h were 0.85±0.14, 15.23±2.45, 28.67±1.59, 94.52±7.05, 55.86±1.82, 23.55±6.15, 9.76±2.03, and the mRNA levels of IFN-β were 0.93±0.21, 1.55±0.33, 14.51±1.98, 55.16±3.64, 26.57±1.49, 9.22±0.51, 5.18±1.06. QPCR results showed that the mRNA levels of TNF-α and IFN-β produced by abdominal macrophages in the infected mice showed a trend of first increasing (the highest at the 24 hour) and then decreasing, and the difference of TNF-α and IFN-β mRNA levels at other time points was statistically significant compared with that at the 0 hour (P<0.05). However, IL-6 and IL-10 mRNA levels continued to increase, and the difference at other time points was statistically significant (P<0.05). ELISA results showed that the expression of four inflammatory factors showed a trend of gradual increase: TNF-α 0 and 72 h were (38.31±4.25, 140.41±23.45) pg/mL; IFN-β 0th and 72th were (17.56±0.66, 1084.93±111.42) pg/mL; IL-6 protein 0 and 72 h were (113.30±0.07, 2302.32±134.09) pg/mL; IL-10 protein 0 and 72 h were (515.00±21.21, 2590.40±226.19) pg/mL, respectively, with significant increases at the 24, 36, 48 and 72 hours compared with that at the 0 hour (P<0.05). The expression of TLR2 mRNA generated by mouse peritoneal macrophages showed a trend of first increasing and then decreasing, and increased to the highest level at 24 h, and the difference between each time point and 0 h was statistically significant (P<0.01). The expression of TLR2 gradually increased after infection with time extension. Conclusion SFTSV infection can up-regulate the expression of TLR2 in macrophages, thereby leading to the increased secretion of the cytokines.

Establishment and Effect of Management and Control Model for Perioperative Prophylactic Use of Antibiotics in Urinary Surgery Department of A Hospital / 中国药房

OBJECTIVE： To provide reference for perioperative prophylactic use of antibiotics in urinary surgery department. METHODS： In response to irrational perioperative prophylactic use of antibiotics in urinary surgery department， taking type Ⅱ incision surgery and special diagnosis and treatment and preventive drug use as an example， the management and control mode for perioperative prophylactic use of antibiotics was established and intervened in urinary surgery department so as to intervene in antibiotics use through formulating surgical type risk classification system， forming perioperative medication clinical pathways such as type Ⅱ incision surgery and urinary calculi surgery with different infection risk， establishing tracking and supervision mechanism. The rationality indexes of perioperative prophylactic medication such as the rate of prophylactic antibiotics use were compared among related medical records collected from urinary surgery department within 3 months before and after intervention （186 records before intervention， 179 records after intervention）. Antibiotics use density （AUD） and amount of antibiotics in urinary surgery department were compared within 3 months before and after intervention to evaluate management and control effect. RESULTS： Among surveyed medical records， compared with before intervention， the rate of prophylactic antibiotics use was decreased from 97.3％ （181/186） to 91.6％ （164/179）； the rate of rational drug selection was increased from 17.7％ （32/181） to 71.3％ （117/164）； correct rate of medication timing was increased from 9.9％ （18/181） to 32.3％ （53/164）； the rate of rational post-operative prevention course was increased from 17.1％ （31/181） to 37.2％ （61/164）， with statistical significance （P＜0.05 or P＜0.01）. Average AUD was deceased from 83 DDD to 70 DDD within 3 months after intervention， and the amount of antibiotics was decreased from 689 669.23 yuan to 531 040.11 yuan. CONCLUSIONS： Established management and control mode for perioperative prophylactic use of antibiotics in type Ⅱ incision surgery and special diagnosis and treatment and preventive drug use can effectively reduce the rate of prophylactic antibiotics， AUD and amount of antibiotics in urinary surgery department， and promote rational use of antibiotics during perioperative period.

Applicable Value of AMSS-PCR in Lung Cancer Gene Mutation Detection / 中国肺癌杂志

BACKGROUND@#The detection of driver oncogenes of lung cancer is of great importance. There are various gene detection techniques nowadays which are different from each other. We carried out this study to investigate the specificity and sensitivity of assay panels based on an Amplification Refractory Mutation System-polymerase chain reaction (ARMS-PCR) technique of Amplification Mutation Specific System (AMSS) in detection of lung cancer gene mutation. To estimate the applicable value of assay panels in clinical settings.@*METHODS@#We collected cancer tissue specimens or fluid specimens from 309 patients. Mutation results were presented for those samples previously detected by ARMS-PCR. In comparison, we carried out AMSS-PCR using (epidermal growth factor receptor, EGFR) assay panel and Six-Alliance assay panel as well as Sanger sequencing. Software SPSS 22.0 (SPSS IBM) was used for statistical analysis.@*RESULTS@#The rates of consistency between the results by assay panels and Sanger sequencing or ARMS-PCR were 97.41% and 97.73%, respectively. Besides, EGFR assay panel had higher consistency rates with other detection methods than Six-Alliance assay panel. As for consistency test, the Kappa values of assay panels with Sanger sequencing, assay panels with ARMS-PCR, and ARMS-PCR with Sanger sequencing were 0.946, 0.953, and 0.913, respectively. The receiver operating characteristic curve (ROC) area under curve (AUC) of assay panels was 0.976 referring to Sanger sequencing, and 0.975 as ARMS-PCR was referred to.@*CONCLUSIONS@#AMSS-PCR can make an optimal cancer gene mutation detection method for clinical settings.

Analysis of Clinical Characteristics for Primary Adrenal Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore clinical characteristics of the Primary Adrenal Lymphoma(PAL), so as to enhance the understanding of diagnosis, treatment and prognosis of PAL.</p><p><b>METHODS</b>The clinical data of 2 patients with PAL retrospectively analyzed and the clinical characteristics were explored in combination with releted literalures.</p><p><b>RESULTS</b>Adrenal gland neoplasm was found in 2 patients by imaging examination. The pathological type of one case was diffuse large B cell lymphoma, the other one was extranodal NK/T-cell lymphoma. The former refused to hosipitali3t and the other received to be admited in hospital after the definite diagnosis. She died at the 32th day after diagnosis, due to the complication with acute pancreatitis before chemotherapy. The latter accepted the scheme of"Gemox"combining with the scheme"VP-16+DXM"to control hemophagocytic lymphohistiocytosis. The patient's condition deteriorated rapidly after a short period of improvement, then died at the 40th day after chemotherapy because of multiple organ failure.</p><p><b>CONCLUSION</b>PAL is a rare extra-nodal lymphoma with higher malignancy, the combination of chemotherapy and radiotherapy results in the best outcome among all the treatments. The prognosis of patients with different pathological types was diverse, thus it is very important to choose the appropriate treatment according to different pathological types.</p>

Clinical analysis of twenty patients with hepatic echinococcosis in Nanjing City / 中华地方病学杂志

Objective To investigate the epidemiological and clinical features of patients with hepatic echinococcosis in Nanjing City. Methods Epidemiological data, clinical manifestations, laboratory and image examination results, diagnosis and treatment of twenty patients with hepatic echinococcosis from January 2009 to December 2016 at the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Results A total of 20 hospitalized cases were investigated, of which 7 cases were males and 13 cases were females, the median age was 48 years (17 - 76 years). One case came from Tibet which was the epidemic area of hepatic echinococcosis;the other 19 cases were local hepatic echinococcosis patients including 3 cases that had raised dogs for many years and 2 cases engaged in processing and selling livestock products. Among the 20 cases, 14 cases had no remarkable symptoms and not sought medical advice until imaging examination showed focal liver lesions during a routine check-up, 2 cases saw a doctor due to hepatic cyst, 1 case due to progressive enlarged hepatic hemangioma, the remaining 3 cases due to abdominal discomfort or pain. In addition, 7 cases were diagnosed definitely in 7 to 14 days, 4 cases in 15 to 30 days, 5 cases in > 30 to 60 days, 1 case in 3 months, 1 case in 7 years and 1 case in 9 years. Thirteen patients had partial hepatectomy; the other 7 patients received endocystectomy. All patients had a good prognosis during the follow-up period. Conclusions Most of the local hepatic echinococcosis cases have no definite epidemiological data and no significant manifestations, leading to misdiagnosis and missed diagnosis. Clinical medical staff should strengthen their understanding of imaging characteristics especially the sonographic features of hepatic echinococcosis.