The application value and research progress of urine free DNA in tumor molecular diagnosis / 中华检验医学杂志

Urine cell-free DNA (ucfDNA) contains DNA fragments released from the lysis of cells in the urinary system, and circulating cell-free DNA (ccfDNA) can also enter the urine after glomerular filtration, and the mutation information carried by tumor DNA contained in ucfDNA and ccfDNA is consistent. Therefore, as a biomarker for molecular diagnosis of urological and non-urinary tumors, ucfDNA, has become a research hotspot in the field of liquid biopsy in recent years. UcfDNA has potential application value in individualized treatment, early diagnosis, dynamic monitoring of therapeutic efficacy, and prognosis assessment, etc. However, in order to realize the clinical application of urine ucfDNA, the extraction and accurate detection of ucfDNA still need to be solved.

Comparison of functional recovery of distal radius fracture by suture of pronator muscle through modified Henry approach / 中国骨伤

OBJECTIVE@#To investigate the effect of suture of pronator muscle on forearm function after modified Henry approach for distal radius fractures.@*METHODS@#from January 2018 to December 2020, 220 patients with distal radius fractures were treated with open reduction and locking plate internal fixation through the modified Henry approach. They were divided into two groups according to different suture methods. There were 112 cases in the intraoperative suture group, including 35 males and 77 females;The age ranged from 37 to 65(48.5±7.4) years;AO classification of fracture, 46 cases of type B and 66 cases of type C;After fracture reduction and locking plate fixation, the pronator muscle was opened and sutured. There were 108 cases in the non suture group, 32 males and 76 females;The age ranged from 34 to 67(47.6±7.8) years;There were 41 cases of fracture type B and 67 cases of fracture type C;After fracture reduction and locking plate fixation, the open pronator muscle was not sutured, and it was laid on the surface of the plate in situ. The range of wrist motion (pronation, supination, palmar inclination and dorsiflexion), the score of disability of arm shoulder and hand dash and visual analog scale(VAS) were compared between the two groups at 6 weeks and 6 months after operation.@*RESULTS@#All 220 patients were followed up for 6 to 18 (8.5±1.3) months. There was no significant difference in the range of motion and DASH score of forearm and wrist between the two groups 6 weeks after operation (P>0.05);There was significant difference in VAS score between suture group (2.6±1.2) and non suture group (5.8±2.3)(P<0.05). Six months after operation, there was no significant difference in the range of motion, DASH score and VAS score of forearm and wrist between the two groups(P>0.05).@*CONCLUSION@#The modified Henry approach has no obvious advantages in the range of wrist movement and upper limb function, but the intraoperative suture of pronator can reduce the early postoperative pain. It is suggested that the pronator should be sutured during the operation.

Efficacy and safety of controlled low central venous pressure applied during hepatectomy: a meta-analysis / 中华麻醉学杂志

Objective:To systematically evaluate the efficacy and safety of controlled low central venous pressure (CLCVP) applied in patients undergoing hepatectomy.Methods:PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP databases were searched from inception to October 1, 2022 for randomized controlled trials (RCTs) involving CLCVP in hepatectomy.All RCTs enrolled included CLCVP group and conventional operation group.The major evaluation indicators were intraoperative blood loss, operation duration and intraoperative blood transfusion.The secondary evaluation indicators were intraoperative monitoring indicators, postoperative liver and renal function, and complications at 1 day after operation.Meta-analysis was performed using the RevMan 5.3 software.Results:A total of 25 RCTs involving 1 816 patients were finally included.Compared with conventional operation group, the intraoperative blood loss was significantly reduced, the operation time was shorten, the rate of intraoperative blood transfusion was decreased, the amount of blood transfused was decreased ( P<0.01), and no significant change was found in intraoperative hemodynamic parameters and parameters of liver and renal function at 1 day after operation, and incidence of gas embolism, pleural effusion and bile leakage in CLCVP group ( P>0.05). Conclusions:CLCVP is safe and effective during hepatectomy.

Construction of community remote rehabilitation networks for stroke patients based on Internet of things technology / 中华医院管理杂志

The development of information technology in the medical industry is accelerating the construction of 3-level rehabilitation networks centering on community-based rehabilitation, which is based on the Internet and in combination with the Internet of things(IOT). A municipal rehabilitation hospital cooperated with the health centers of sub-district communities in the city to build a remote rehabilitation network based on IOT technology, for rehabilitation training of community stroke patients. The two sides worked out a cooperation scheme on project management, designed and built a remote community rehabilitation management model. Under the remote monitoring and equipment data IOT, the medical team of the municipal rehabilitation hospital could formulate the therapeutic plan according to the immediately obtained relevant functional evaluation data, and the medical team of the community health service center was responsible for the implementation of the plan. Fifty-three patients in the experimental group received the training of remote lower limb intelligent feedback system based on IOT together with routine rehabilitation training. After 8 weeks of treatment, the functional evaluation data of the two groups were improved in varying degrees( P< 0.05), but the improvement of the experimental group was significantly better than that of the control group( P < 0.05). Remote rehabilitation under the construction path of remote rehabilitation network based on IOT technology could significantly promote the improvement of post-functional rehabilitation of community stroke patients. This study can provide reference for the construction of three-level remote rehabilitation networks based on IOT and the implementation of home-based remote rehabilitation therapy in the future.

The effect of nutrition support comprehensive nursing on the quality of life of patients with advanced gynecological tumor / 中国实用护理杂志

Objective:To explore the application value of nutritional support comprehensive nursing in patients with advanced gynecological tumor and analyze its impact on patients' quality of life.Methods:From May 2016 to August 2019, 110 patients with advanced gynecological tumors were enrolled in the First People′s Hospital of Lianyungang City. According to the random number table method, they were divided into control group and observation group with 55 cases in each group. The control group received standard nutritional nursing and the observation group received nutrition support comprehensive nursing. Three milliliters of fasting venous blood were collected at the time of admission and discharge for centrifugation. The serum albumin (ALB) and prealbumin (PA) levels of the two groups were measured. The body mass index (BMI) of the patients was calculated and the changes of their nutritional status were analyzed.The quality of life of cancer patients was evaluated by the European Cancer Research and Treatment Organization Quality of Life Questionnaire-Core 30 at the time of admission and discharge.Results:There was no significant difference in the serum ALB, PA and quality of life at the time of admission between the two groups( P>0.05). There was no significant difference in BMI at the time of admission and discharge in the two groups( P>0.05). The serum ALB and PA were (36.92±2.68), (0.26±0.07) g/L at discharge in the observation group, significantly higher than (35.42±2.71), (0.23±0.06) g/L in the control group ( t values were 2.918, 2.413, P<0.05). The scores of social function, emotional function, role function, physical function and total life quality score were 63.42±4.18,62.83±6.24,63.19±6.12,64.43±4.31,70.42±6.91 at discharge in the observation group,significantly higher than 57.34±5.06,56.39±7.37,60.45±5.99,61.46±5.08,66.35±5.96 in the control group ( t values were 2.373-6.870, P<0.05). The scores of diarrhea, constipation, insomnia, anorexia, nausea, fatigue in the observation group were 36.42±5.06,34.54±6.23,34.49±5.56,36.41±4.57,40.38±7.24,37.94±4.65,significantly lower than 40.83±4.81,38.74±5.12,38.43±4.97,40.43±6.24,43.29±5.12,40.19±3.97 in the control group ( t values were 2.434-4.685, P<0.05). Conclusions:Nutrition support comprehensive nursing for patients with advanced gynecological tumor can further improve their nutritional status and improve their quality of life.

Effects of different carbon sources on growth and active component contents in Salvia miltiorrhiza and S. castanea f. tomentosa hairy roots / 中国中药杂志

Salvia miltiorrhiza(Sm) and Salvia castanea f. tomentosa(Sc) hairy roots were used as experimental materials to study the effects of six different carbon sources, galactose, fructose, lactose, glucose, arabinose and sucrose(control), on fresh weight, dry weight, contents and yields of salvianolic acids and tanshinones. The results showed that galactose was most beneficial to the growth of two kinds of hairy roots, while lactose and arabinose were not conducive to their growth. As for Sm hairy roots, fructose significantly promoted the accumulation of salvianolic acid B, and the content increased by 5.801 times and 10.151 times compared with the control group, respectively. Glucose significantly promoted the accumulation of salvianolic acids. The content and yield of rosmarinic acid were 7.674 times and 9.260 times of that of the control group, and the content and yield of salvianolic acid B were 5.532 times and 6.675 times of the control group. For the hairy roots of Sc, galactose significantly increased the content and yield of rosmarinic acid, reaching 7.820 times and 9.944 times of the control group, respectively. Fructose promoted the increase of the content and yield of cryptotanshinone, reaching 9.242 times and 6.609 times of the control group, respectively. The study confirmed the optimal carbon source for the hairy root culture of Sm and Sc, and provided theoretical guidance for large-scale production of Sm drug-derived components and the utilization of Sc.

Relationship between fabella and posterolateral knee pain and common peroneal nerve injury / 中国骨伤

OBJECTIVE@#To analyze the incidence and characteristics of fabella in the Chinese population and its correlation with pain in the posterolateral region of the knee joint and common peroneal nerve palsy.@*METHODS@#Total 732 patients including 405 males(450 knees) and 327 females(383 knees) who underwent unilateral or bilateral knee MR imaging from September 2015 to July 2019 were retrospectively evaluated. The basic information of all patients was extracted from the hospital's his system. The patient's medical records were checked by telephone follow-up or his system, and the number of patients with posterolateral knee pain and common peroneal nerve paralysis were recorded.@*RESULTS@#The overall prevalence of fabella was 48.38%, 23.53% in men and 24.85% in women, there was no significant difference between them (@*CONCLUSION@#The prevalence of fabella us in Chinese population is 48.38%. There is no relationship between the incidence of gastrocnemius and gender, but the incidence of fabella is positively correlated with age, pain in the posterolateral region of the knee joint and the occurrence of common peroneal nerve symptoms.

Effects of alginate/glycol chitosan double-network hydrogel on immune response of regulatory t cells of mice / 解放军医学杂志

Objective To investigate the in vitro effect of alginate (Alg)/glycol chitosan (GC) double-network hydrogel on immune function of splenic regulatory T cells (Treg) of mice. Methods Single network hydrogel of Alg or GC and double-network (DN) gel material (Alg/GC) were prepared. Splenic CD4+CD25+Treg of BABL/c mice were isolated and purified by Magnetic Activated Cell Sorting (MACS) kit and further stimulated with different hydrogels for 24 hours and 48 hours with or without polymyxin B (PMB) exposure. Cells treated with Alg, or GC, or DN were divided into Alg group, GC group, DN group, respectively. Cells without hydrogens were served as control group. Expressions of the forkhead/winged helix transcription factor p3 (Foxp3) and cytotoxic T cell-associated antigen 4 (CTLA-4) on CD4+CD25+Treg were measured by flow cytometry. Their expression levels would be used to determine the conditions for further experiments. The CFSE kit was applied for assessing the proliferative activity of effector T cells (Teffs) after co-cultured with CD4+CD25+Treg. Enzyme linked immunosorbent assay (ELISA) was used to determine the cytokine levels including interleukin (IL)-10 and transforming growth factor (TGF)-β, IL-2, IL-4, and interferon (IFN)-γ. Results With or without PMB exposure, the expression of CTLA-4 and Foxp3 showed no significant difference under the stimulation of various hydrogels (P>0.05), including Alg, GC, and DN. Therefore, for further studies, cells were stimulated by different hydrogens in the presence of PMB for 24 hours. Cells without hydrogen simulation were served as control. Compared with the control group [(47.73±5.35)%], CTLA-4 expression was obviously up-regulated in both GC [(95.99±2.79)%] and DN [(92.21±2.97)%] hydrogel groups (P<0.05). In addition, TGF-β levels were markedly elevated in CD4+CD25+Treg stimulated with GC [(957.06±138.70)pg/ml] or DN [(905.03±73.04)pg/ml], compared with the level in the cells in the control group [(558.75±48.58)pg/ml, P<0.05]. However, no difference was detected in the expression of Foxp3 among different groups. In comparison with control group [proliferation (42.04±1.35)%, IL-4/IFN-γ (1.45±0.27)], Treg cells that were stimulated with GC or DN showed enhanced inhibitory effect on Teffs, including suppressed proliferation of Teffs [DN group (37.22±1.39)%, GC group (35.20±2.03)%] and increased ratio of IL-4/IFN-γ of Teffs [DN group (2.30±0.22), GC group (2.57±0.23)] (P<0.05). Conclusion Alg/GC double-network hydrogel can greatly enhance the immunosuppressive response of Treg, which is dominantly seen with GC single network hydrogel.

Reproductive outcomes of fertility-sparing treatment for gynecologic malignancies / 中国实用妇科与产科杂志

Cervical cancer,endometrial cancer and ovarian cancer are common gynecologic malignancies.Recently,with the younger onset age and delay of childbearing,the fertility-sparing treatment has been increasingly used.In the fertility-sparing treatment for gynecologic malignancies,we should protect the fertility of patients without increasing tumor recurrence,which requires the multidisciplinary cooperation to develop individualized treatment strategy,provide optimal reproductive guidance and finally improve the reproductive outcomes.

The protective effects of Astragaloside Ⅳ on diastolic function of rat thoracic aortic rings impaired by microvesicles / 中国应用生理学杂志

OBJECTIVES@#To investigate the effects of Astragaloside IV (AST) on diastolic function of rat thoracic aorta rings which was injured by microvesicles derived from hypoxia/reoxygenation (H/R)-treated human umbilical vein endothelial cells (HUVECs), and the mechanism of AST.@*METHODS@#H/R-induced endothelial microvesicles (H/R-EMVs) were generated from cultured HUVECs under the condition of hypoxia for 12 hour/Reoxygenation for 4 hour, H/R-EMVs were stored in D-Hank's solution. Male Wistar rats were underwent thoracotomy, the thoracic aorta with intact endothelium were carefully removed and cut into 3~4 mm rings. The experiment was divided into six groups. H/R-EMVs group:thoracic aortic rings of rats were incubated in culture medium and treated with H/R-EMVs in a final concentration of 10g/ml; different doses of AST groups:thoracic aortic rings of rats were treated with 10, 20, 40, 60 mg/L AST co-incubated with 10g/ml H/R-EMVs respectively; control group were treated with the same volume of D-Hank's solution. Duration of incubation was 4 h, each group was tested in five replicate aortic rings. Effects of AST on endothelium-dependent relaxation were detected. The production of nitric oxide (NO) and the level of endothelial NO synthase (eNOS), phosphorylated eNOS (p-eNOS, Ser-1177), serine/threonine kinase (Akt), phosphorylated Akt (p-Akt, Ser-473), extracellular regulated protein kinases (ERK1/2) and phosphorylated ERK1/2 (p-ERK1/2, Thr202/Tyr204) of rat thoracic aortic rings were detected.@*RESULTS@#Teng/ml H/R-EMVs could impaire the relaxation of rat thoracic aortic rings significantly (<0.01). Compared with H/R-EMVs group, relaxation of rat thoracic aortic rings was increased by 20, 40 and 60 mg/L AST in a concentration-dependent manner (<0.01), the level of NO production was also enhanced (<0.05, <0.01). The level of t-eNOS, t-Akt and ERK1/2 was not changed, but the level of p-eNOS, p-Akt and p-ERK1/2 increased by the treatment with AST (<0.01).@*CONCLUSIONS@#AST could effectively ameliorate endotheliumdependent relaxation of rat thoracic aortic rings impaired by H/R-EMVs in a concentration-dependent manner, the mechanism might involve the increase in production of NO, and the protein level of p-eNOS, p-Akt and p-ERK1/2.

Research on risk control of hematodialysis equipment based on statistical data of failure / 中国医学装备

Objective:To investigate various risk factors that influence the safety of using hemodialysis equipment, and carry out risk control and reduce risk of using equipment through analyzed the statistical result of failure data of equipment.Methods:Based on all kinds of fault messages record in 2016, the failure data of 390 cases were carried out classified statistic analysis by using Microsoft Excel.Results: Through the statistic analysis of failure rate of 2016 year, there were four main factors were obtained. Aimed at the three higher percent factors that were equipment fault(85.1％), material(11.2％) and human reason(3.7％), respectively., the current management system of hemodialysis equipment was optimized and operation process was standardized from three aspects that included equipment management, material management, and the training and check for staff.Conclusion: Based on the analysis and research for the failure types of hemodialysis equipment purchased from different years, and the analysis of relevant reasons, the corresponding countermeasure of quality management is established, and the main body of responsibility is clarified, and the operative risk of hemodialysis equipment is effectively reduced.

Study and clinical application of wild-type blocking probe for improving trace amount mutation detection of BRAF V600E gene / 国际检验医学杂志

Objective To study the screening of trace amount mutation of BRAF V 600E gene for avoiding the appearance of ineffective treatment in cancer patients .Methods The internal competitive amplification fragments were used to improve the inhibition of wild-type blocking (WTB) probe on wile-type BRAF V600E gene to increase the detection efficiency of BRAF V600E genotype of trace amount mutation occurrence .Re-sults When the template DNA concentration was 50 -200 ng/μL ,the constructed trace amount gene muta-tion real time fluorescence quantitative detection method could completely block the amplification of the wild-type BRAF V600E gene .The sensitivity of this assay reached as high as 0 .1％ ,which was in line with the sen-sitivity requirement for the gene trace amount mutation detection technique .In the colorectal biopsy tissues from 50 cases of suspected colorectal cancer ,8 cases (16 .0％ ) of BRAF V600E gene trace amount mutation were detected by using this constructed method ,which had higher detection rate .Conclusion The constructed gene trace amount mutation detection method can make the rapid ,simple and low cost quantitative analysis for BRAF V600E gene trace amount mutation in clinical samples .

Finite element analysis for self-made femoral head brace device in the treatment of early femoral head necrosis / 中国组织工程研究

BACKGROUND: Core decompression for early adult ischemic necrosis of femoral head gets the identity of most scholars, but the postoperative femoral head easily experiences collapse. How to prevent collapse is still a problem to be solved currently. OBJECTIVE: To perform biomechanical analysis of femoral head ischemic necrosis by using the finite element method and to provide biomechanical basis for the treatment of early adult femoral head necrosis. METHODS: One fresh femur specimen died of accidental death in youth and young adults was obtained, and no deformity or fracture was found. X-ray confirmed that it did not have tumor or osteoporosis. Spiral CT was used to scan normal femoral head and neck, pulp core decompression of femoral head and neck, brace device placement and bone-graft of femoral head and neck for acquiring image data from the proximal to distal vertical longitudinal axis. Scanning data were input in the Mimics software. Finite element method was utilized for biomechanical analysis of femoral head and neck of three models. RESULTS AND CONCLUSION: (1) The stress dispersal and downward conduction of normal femoral head was concentrated in the shaft of the femur and the tensile stress was concentrated in the rotor socket. (2) After pulp core decompression, the stress concentration, displacement and strain increased in the weight-bearing area of femoral head. (3) The stress of the internal bracing was similar to that of normal femoral head. (4) The stress of weight bearing area of femoral head is concentrated, and the strain is increased, so that weight bearing area is easy to collapse after pulp core decompression. The more stress distribution, more bearing load and less strain of implant and bone graft model, are conformed to the normal mechanical properties of the normal femoral head and neck.

Safety management of clinical medical imaging equipment / 医疗卫生装备

Objective To execute safety management of clinical medical imaging equipment to enhance medical service quality.Methods The classification and main products of medical imaging equipment were introduced.The common failures were analyzed,and the main causes involved in equipment,personnel and environment.The safety management of medical imaging equipment was implemented from the aspects of assets management,quality control management and measurement management.Results The safety management decreased the failure rate,prolonged the service life,reduced the cost,provided data for clinical service and shortened the treatment time.Conclusion The medical equipment management department performs safety management from the aspects of assets management,quality control management and measurement management,so that the efficiency of medical imaging equipment can be ensured.

Differences in distribution and drug resistance of pathogens for hospital-acquired urinary tract infections between patients in internal medicine wards and surgical wards / 中华临床感染病杂志

Objective To investigate the distribution and drug resistance of pathogens for hospital-acquired urinary tract infections between patients in internal medicine wards and in surgical wards .Methods A total of 586 midstream urine samples were collected from patients in the First Municipal Hospital of Qinhuangdao during January 2012 and December 2014.Vitek 2 Compact system was applied in bacteria identification and drug sensitivity tests .Excel and SPSS 11.5 software were applied for data analysis . Results A total of 661 strains were isolated , in which 404 strains were from internal medicine wards and 257 strains were from surgical wards .Escherichia coli (44.6%vs.33.1%) and Enterococcus (23.0%vs. 16.3%) infections were more common in the internal medicine wards (χ2 =8.620 and 4.309, P<0.05), while the occurrence of Pseudomonas aeruginosa infection (4.0%vs.24.5%) was higher in surgical wards (χ2 =63.056, P <0.01).Escherichia coli and Klebsiella pneumonia strains were highly sensitive to piperacillin/tazobactam, cefptetan, amikacin, imipenem, and meropenem, and the sensitivity rates were from 85% to 100.0%.The sensitivity rates of Escherichia coli to ampicillin/sulbactam, levofloxacin and ciprofloxacin were <30%, and strains from surgical wards had lower sensitivity rates to these drug than those isolated from internal medicine wards (χ2 =4.987, 4.575 and 5.359, P<0.05).The sensitivity rates of Klebsiella pneumonia isolated from internal medicine wards to ceftazidime , gentamicin and aztreonam were 68.8%, 60.6% and 69.7%, which were higher than those isolated from surgical wards (36.0%, 32.0%, and 40.0%), and the differences were of statistical significance (χ2 =6.068,4.661 and 5.115, P<0.05).Pseudomonas aeruginosa strains were highly sensitive to piperacillin/tazobactam and amikacin, and the susceptibilities of strains isolated from surgical wards (98.4%and 96.8%) were higher than those isolated from internal medicine wards (75.0% and 81.3%) (χ2 =11.797 and 5.221, P <0.05). Pseudomonas aeruginosa strains isolated from surgical wards were also highly sensitive to cefepime (92.1%), but the sensitive rate of strains from internal medicine wards was only 37.5%, and the difference was of statistical significance (χ2 =24.696, P<0.01).Enterococcus faecium and Enterococcus faecalis were sensitive to tigecycline , vancomycin and linezolid with the sensitivity rates over 95%.Except quinupristin/dalfopristin and tetracycline , the sensitivities of Enterococcus faecalis to other antibiotics were higher than Enterococcus faecium.Susceptibility of Enterococcus faecium from surgical wards (33.3%) to moxifloxacin was lower than those from internal medicine wards (70.8%), and the difference was of statistical significance (χ2 =4.629, P <0.05).Conclusion There are differences in distribution and antimicrobial susceptibility of pathogens isolated from internal medicine wards and from surgical wards .

lateral cervical cyst as the initial presentation of an occult papillary thyroid carcinoma: a case report

Papillary carcinoma accounts for 85% to 90% of all malignant thyroid tumors. Papillary thyroid carcinoma commonly extends to the lymphatic system; metastatic lymph nodes usually present as a solid mass in the anterior or lateral aspect of the neck. Cervical cysts are usually considered benign lesions; branchial cleft cysts are the most common neck. A lateral cervical cyst as the initial manifestation of an occult thyroid carcinoma is rare. Aside from a thorough physical examination of the head and neck, ultrasound, should be performed to determine the diagnosis for a lateral cervical cyst. Excisional biopsy should be performed, if the case of lateral cervical cyst, as the initial presentation of an occult papillary thyroid carcinoma

Flow cytometric analysis of circulating microvesicles derived from myocardial Ischemic preconditioning and cardioprotection of Ischemia/reperfusion Injury in rats / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To establish a flow cytometric method to detect the alteration of phenotypes and concentration of circulating microvesicles (MVs) from myocardial ischemic preconditioning (IPC) treated rats (IPC-MVs), and to investigate the effects of IPC-MVs on ischemia/reperfusion (I/R) injury in rats.</p><p><b>METHODS</b>Myocardial IPC was elicited by three.cycles of 5-min ischemia and 5-min reperfusion of the left anterior descending (LAD) coronary artery. Platelet-free plasma (PFP) was isolated through two steps of centrifugation at room temperature from the peripheral blood, and IPC-MVs were isolated by ultracentrifugation from PFR PFP was incubated with anti-CD61, anti-CD144, anti-CD45 and anti-Erythroid Cells, and added 1, 2 µm latex beads to calibrate and absolutely count by flow cytometry. For functional research, I/R injury was induced by 30-min ischemia and 120-min reperfusion of LAD. IPC-MVs 7 mg/kg were infused via the femoral vein in myocardial I/R injured rats. Mean arterial blood pressure (MAP), heart rate (HR) and ST-segment of electro-cardiogram (ECG) were monitored throughout the experiment. Changes of myocardial morphology were observed after hematoxylin-eosin (HE) staining. The activity of plasma lactate dehydrogenase (LDH) was tested by Microplate Reader. Myocardial infarct size was measured by TTC staining.</p><p><b>RESULTS</b>Total IPC-MVs and different phenotypes, including platelet-derived MVs (PMVs), endothelial cell-derived MVs (EMVs), leucocyte-derived MVs (LMVs) and erythrocyte-derived MVs (RMVs) were all isolated which were identified membrane vesicles (<1 Vm) with corresponding antibody positive. The numbers of PMVs, EMVs and RMVs were significantly increased in circulation of IPC treated rats (P<0.05, respectively). In addition, at the end of 120-min reperfusion in I/R injured rats, IPC-MVs markedly increased HR (P<0.01), decreased ST-segment and LDH activity (P < 0.05, P < 0.01). The damage of myocardium was obviously alleviated and myocardial infarct size was significantly lowered after IPC-MVs treatment (P < 0.01).</p><p><b>CONCLUSION</b>The method of flow cytometry was successfully established to detect the phenotypes and concentration alteration of IPC-MVs, including PMVs, EMVs, LMVs and RMVs. Furthermore, circulating IPC-MVs protected myocardium against I/R injury in rats.</p>

Features of a Chinese family with cerebral cavernous malformation induced by a novel CCM1 gene mutation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Familial cerebral cavernous malformations (CCMs), characterized by hemorrhagic stroke, recurrent headache and epilepsy, are congenital vascular anomalies of the central nervous system. Familial CCMs is an autosomal dominant inherited disorder and three CCM genes have been identified. We report a Chinese family with CCMs and intend to explore clinical, pathological, magnetic resonance imaging (MRI) features and pathogenic gene mutation of this family.</p><p><b>METHODS</b>Totally 25 family members underwent brain MRI examination and clinical check. Two patients with surgical indications had surgical treatment and the specimens were subjected to histopathological and microstructural examination. In addition, polymerase chain reaction (PCR) and direct sequencing were performed with genomic DNA extracted from 25 family members' blood samples for mutation detection.</p><p><b>RESULTS</b>Brain MRI identified abnormal results in seven family members. All of them had multiple intracranial lesions and four cases had skin cavernous hemangioma. T2-weighted sequence showed that the lesions were typically characterized by an area of mixed signal intensity. Gradient-echo (GRE) sequence was more sensitive to find micro-cavernous hemangiomas. There was a wide range in the clinical manifestations as well as the age of onset in the family. The youngest patient was an 8-year-old boy with least intracranial lesions. Histopathological and microstructural examination showed that CCMs were typically discrete multi-sublobes of berry-like lesions, with hemorrhage in various stages of illness evolution. They were formed by abnormally enlarged sinusoids and the thin basement membranes. A novel T deletion mutation in exon 14 of CCM1 gene was identified by mutation detection in the seven patients. But unaffected members and healthy controls did not carry this mutation.</p><p><b>CONCLUSIONS</b>The clinical manifestations were heterogenic within this family. We identified a novel mutation (c.1396delT) was the disease-causing mutation for this family and extended the mutational spectrum of CCMs.</p>

MRI outstands mammogram in sensitivity of breast ductal carcinoma in situ:an analysis of 122 cases / 中华外科杂志

<p><b>OBJECTIVES</b>To compare the sensitivity of mammogram and breast dedicated MRI in detecting ductal carcinoma in situ with microinvaion (DCIS-MI) and ductal carcinoma in situ (DCIS) lesions, and to further investigate the independent predictive factors of mammogram and MRI sensitivity.</p><p><b>METHODS</b>From August 2009 to November 2011, 122 consecutive confirmed breast cancer patients who had received operations were recruited for this clinical research. These patients were divided into two groups including DCIS (72 cases) and DCIS-MI (50 cases) based on pathologic reports. All the patients were female, with mean ages of 52.6 years and 54.4 years. Preoperative bilateral breast mammogram, breast dedicated MRI depictions and reports as well as histopathological reports were collected.</p><p><b>RESULTS</b>Sensitivity of MRI outstood mammogram in each subgroups: 84.7% vs. 42.4% in DCIS (χ(2) = 27.028, P = 0.000), 94.0% vs. 80.0% in DCIS-MI group (χ(2) = 4.540, P = 0.040). And further analysis showed that MRI was more sensitive to high nuclear grade DCIS and DCIS-MI lesions than low nuclear grade ones (OR = 3.471, P = 0.031).</p><p><b>RESULTS</b>of logistic regression analysis proved microcalcification was an independent predictive factor of mammogram sensitivity (OR = 11.287, P = 0.001).</p><p><b>CONCLUSIONS</b>Sensitivity of breast dedicated MRI is superior to mammogram in detecting DCIS and DCIS-MI groups. Lesions with microcalcifiation is an independent predictive marker which meant that mammogram would achieve high detection rate in cancers presented calcification on mammogram image when compared with non-calcification. Diagnostic performance of breast MRI is less affected by clinical and pathological characteristics of the early stage breast cancer patients but further increased detection rate is observed in DCIS and DCIS-MI with high nuclear grade lesions which indicated that MRI could detect more early stage cancers with relative more aggression biological behaviour and provide these patients with early surgical interventions before possible progression to invasive breast cancers.</p>

Accuracy of physical examination, ultrasonography, and magnetic resonance imaging in predicting response to neo-adjuvant chemotherapy for breast cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Accurate evaluation of response following chemotherapy treatment is essential for surgical decision making in patients with breast cancer. Modalities that have been used to monitor response to neo-adjuvant chemotherapy (NAC) include physical examination (PE), ultrasound (US), and magnetic resonance imaging (MRI). The purpose of this study was to evaluate the accuracy of PE, US, and MRI in predicting the response to NAC in patients with breast cancer.</p><p><b>METHODS</b>According to the response evaluation criteria in solid tumors guidelines, the largest unidimensional measurement of the tumor diameter evaluated by PE, US, and MRI before and after NAC was classified into four grades, including clinical complete response, clinical partial response, clinical progressive disease, clinical stable disease, and compared with the final histopathological examination.</p><p><b>RESULTS</b>Of the 64 patients who received NAC, the pathologic complete response (pCR) was shown in 13 of 64 patients (20%). The sensitivity of PE, US, and MRI in predicting the major pathologic response was 73%, 75%, and 80%, respectively, and the specificity was 45%, 50%, and 50% respectively. For predicting a pCR, the sensitivity of PE, US, and MRI was 46%, 46%, and 39%, respectively, and the specificity was 65%, 98%, and 92% respectively.</p><p><b>CONCLUSIONS</b>Compared with final pathologic findings, all these three clinical and imaging modalities tended to obviously underestimate the pCR rate. A more appropriate, universal, and practical standard by clinical and imaging modalities in predicting the response to neo-adjuvant chemotherapy in vivo is essential.</p>