Association between depressive symptoms and risk of coronary heart disease in middle-aged and elderly Chinese community: An empirical analysis based on CHARLS database / 西安交通大学学报(医学版)

【Objective】 To investigate the association of depressive symptoms with the predicted risk of coronary heart disease in middle-aged and elderly Chinese based on a large community study. 【Methods】 A total of 2532 cases in the group without depression and 2758 cases in the group with depression were included. We compared the two groups in general demographics, information related to coronary heart disease risk, and physical function and ability to perform daily living. We also analyzed the factors associated with coronary heart disease risk by linear regression. 【Results】 ① Demographic information: The group with depression had a higher mean age, a higher proportion of women, more people with poor marital status, and a higher number of comorbid chronic diseases compared with the group without depression (all P<0.05). ② Risk indicators related to coronary heart disease: The group with depression had more people with diabetes and a significantly higher systolic blood pressure compared with the group without depression (P<0.05). The two groups did not significantly differ in the proportion of smokers, diastolic blood pressure, LDL-C, or HDL-C (all P>0.05). The risk of coronary heart disease was significantly higher in the group with depression than in the group without depression (P<0.05). ③ Physical function and ability of daily living: The physical function score, physical self-care score, and instrumental daily living ability were significantly higher in the group with depression than in the group without depression (all P<0.001). ④ Linear regression showed that except for gender, age, marital status, comorbid diabetes, smoking, systolic and diastolic blood pressure, HDL-C and LDL-C were associated with risk of coronary heart disease (P<0.05); CESD was the only factor associated with the risk of coronary heart disease [B=0.019, 95% CI: (0.015, 0.032), P=0.032]. 【Conclusion】 The risk of coronary heart disease is higher in middle-aged and elderly people with depressive symptoms than in those without depressive symptoms. Having depressive symptoms is one of the risk factors for coronary heart disease in middle-aged and elderly people.

Childhood maltreatment on psychiatric symptoms and drug efficacy in patients with schizophrenia / 西安交通大学学报(医学版)

【Objective】 To explore the effect of childhood maltreatment on clinical symptoms and early efficacy of antipsychotics in patients with schizophrenia. 【Methods】 Totally 73 schizophrenic patients were divided into mild maltreatment group(n=42) and severe maltreatment group(n=31) according to the Child Trauma Questionnaire(CTQ). The Positive and Negative Symptom Scale(PANSS) and Clinical Global Impression(CGI) were measured and compared between the two groups at baseline and 3 weeks after antipsychotic treatment to analyze the correlation between child maltreatment experience and mental symptoms and the response to early treatment of antipsychotics. 【Results】 PANSS positive factor score(P=0.026) and cognitive deficit factor score (P=0.042) were significantly higher in severe abuse group than in mild abuse group. The positive factor was significantly positively correlated with emotional abuse factor in CTQ score(r=0.257, P=0.028), and the cognitive deficit factor was significantly positively correlated with emotional neglect factor(r=0.283, P=0.015). After antipsychotic treatment, the reduction rate of PANSS negative factor in severe abuse group was significantly lower than that in mild abuse group(P=0.035), and had the highest correlation with CTQ physical abuse factor(r=-0.302, P=0.011). 【Conclusion】 The severity of childhood maltreatment experienced by schizophrenic patients is more related to positive symptoms and cognitive deficits, and more childhood maltreatment experience will affect the improvement of negative symptoms by antipsychotics, suggesting a poor prognosis.

Effects of endurance training on autophagy of substantia nigra neurons and secretion of plasma exosomes in Parkinson disease mice / 中华行为医学与脑科学杂志

Objective:To investigate the protective effect of endurance training on Parkinson disease(PD) mice and the effect of AMPK/mTOR pathway on autophagy and exosomes secretion.Methods:Thirty-two 10-week-old male C57BL/6 mice were randomly divided into quiet group, exercise group, PD quiet group and PD exercise group, with 8 mice in each group.The mice in exercise group and PD exercise group received 4-week treadmill endurance training.After training, mice in PD quiet group and PD exercise group were given rotenone (30 mg·kg -1·d -1) dissolved in 0.5% carboxymethyl cellulose salt solution and gavaged for 56 consecutive days.The mice in quiet group and exercise group were given 0.5% carboxymethyl cellulose salt solution by gavage.Then, the mice in exercise group and PD exercise group received treadmill endurance training for 4 weeks.The behaviors of mice in each group were measured after training.The content of tyrosine hydroxylase (TH) in substantia nigra of mice in each group was measured by immunohistochemistry.Western blot was used to detect the expression of plasma α-synuclein(α-syn), exosomes surface marker proteins CD9 and CD63, and the content of microtubule associated protein light chain 3-Ⅱ (LC3-Ⅱ), α-syn, adenine ribonucleotide dependent protein kinase (AMPK) and phosphorylated AMPK (p-AMPK), mammalian target of rapamycin (mTOR) and phosphorylated mTOR (p-mTOR) in substantia nigra of mice in each group.SPSS 20.0 software was used to analyze the data.One-way ANOVA was used for comparison among multiple groups and the LSD method was used for further pairwise comparison. Results:There was significant difference in the residence time of mice in the four groups on the rotarod instrument ( F=2 618.20, P<0.01). Compared with the quiet group, the residence time of PD quiet group decreased ((110.34±8.20) s, (186.20±6.83) s, P<0.01). Compared with the PD quiet group, the residence time of PD exercise group increased ((160.56±8.30)s, P<0.01). (2) There was no significant difference in the expression of plasma exosome marker proteins CD9 and CD63 among the four groups ( F=1.57, 1.26, both P>0.05). (3) There was significant difference in the expression of α-syn in plasma exosomes of the four groups ( F=1 303.99, P<0.01). The expression of α-syn in plasma exosomes in PD quiet group was higher than that of quiet group ((180.57±8.20), (100.00±0.00), P<0.01). Compared with the PD quiet group, the expression of α-syn in plasma exosomes in PD exercise group decreased ((150.23±7.30), P<0.01). (4) There was significant difference in the number of TH positive neurons in substantia nigra among the four groups ( F=447.09, P<0.01). Compared with the quiet group, the number of TH positive neurons in the substantia nigra of PD quiet group decreased ((48.23±6.30), (100.00±0.00), P<0.01). Compared with the PD quiet group, the number of TH positive neurons in the substantia nigra of PD exercise group increased ((68.62±8.20), P<0.01). (5) Western blot showed that there were significant differences in the expression of α-syn, p-mTOR, p-AMPK and LC3-Ⅱ in substantia nigra of the four groups ( F=753.62, 361.48, 261.95, 248.07, all P<0.01). Compared with the quiet group, the expression of α-syn in substantia nigra of PD quiet group increased ((184.16±15.31), (100.00±0.00), P<0.01), the expression of p-mTOR in substantia nigra increased ((156.77±3.99), (100.00±0.00), P<0.01), the expression of p-AMPK decreased ((70.65±8.43), (100.00±0.00), P<0.01), and the expression of LC3-Ⅱ in substantia nigra decreased ((72.25±7.86), (100.00±0.00), P<0.01). Compared with PD quiet group, the expression of α-syn in substantia nigra decreased ((158.23±9.30), P<0.01), the expression of p-mTOR in substantia nigra decreased ((123.61±16.86), P<0.01), the expression of p-AMPK increased ((96.35±9.45), P<0.01), and the expression of LC3-Ⅱ in substantia nigra increased ((108.89±10.67), P<0.01). Conclusion:Endurance training regulates autophagy and the expression of exosomes in PD mice through AMPK/mTOR signal pathway, protects dopaminergic neurons in mouse midbrain and improves motor function.

Research progress in predictive biomarkers related to tumor immunotherapy / 国际肿瘤学杂志

Tumor immunotherapy is a treatment method mainly for programmed cell death-1 (PD-1) and its ligand PD-L1. PD-1/PD-L1 inhibitors have obvious clinical benefits and long-lasting responses in a variety of tumors. But overall response rates are still low. Studies show that PD-L1 and tumor mutation burden can predict the effect of immunotherapy. MSI-H/dMMR, TP53 and KRAS mutations are positively correlated with the effect of immunotherapy. While MDM2/4, EGFR, ALK and other genes are negatively correlated with the effect of immunotherapy.

The correlations between vascular and bronchial abnormality on high resolution CT and the invasiveness of lung adenocarcinoma in subsolid nodules / 中华放射学杂志

Objective@#To observe the vascular and bronchial abnormalities in subsolid nodules on high resolution CT (HRCT), and analyze its correlations with the classification and subtypes of lung adenocarcinoma.@*Methods@#Pathological and radiographic data of 315 surgically resected subsolid nodules (226 were pure ground-glass opacities, and 89 were part solid nodules with tiny solid components ≤ 6 mm) were retrospectively reviewed. The morphologic changes of the blood vessels and bronchia/bronchioles in ground-glass opacity on HRCT were evaluated, and their correlations with histopathology classification were analyzed. Chi-square test was performed for analysis of correlations with categorical variables, whereas the one-way ANOVA analysis was performed for analysis of correlations with continuous variables (e.g., lesion dimension).@*Results@#Forty-eight pre-invasive lesions (PILs), 29 minimally invasive adenocarcinomas (MIAs), and 238 invasive adenocarcinomas (IACs) were analyzed. IACs were divided into 2 groups according to the percentage of lepidic pattern: lepidic predominant (lepidic pattern ≥ 50%, n=145), and non-lepidic predominant (lepidic patten<50%, n=93). The prevalence of vascular and bronchial abnormalities was higher in IACs (59.24% & 18.49% in IACs, 13.79% & 3.45% in MIAs, and 0% & 0% in PILs). The abnormalities of vessels and bronchi in nodules on HRCT were correlated with the PIL/MIA/IAC classifications (χ2=69.797, P<0.001, χ2=14.213, respectively). Moreover the prevalence of valcular and bronchial abnormalities significantly increased from non-lepidic predominant IACs (78.49%, 26.88%) compared to lepidic predominant IACs (46.90%, 13.10%), these morphologic abnormalities correlated with a higher percentage of non-lepidic pattern, which were considered with higher invasiveness, in IACs (P<0.001, χ2=22.139, P=0.012, χ2=6.253, respectively).@*Conclusion@#The morphologic changes of blood vessels and bronchia/bronchioles within the subsolid nodules on HRCT help to differentiate IAC from PIL and MIA, also correlate with the proportion of non-lepidic pattern in IACs, even when the solid component undeveloped or very tiny.

Effect of umbilical cord mesenchymal stem cells on proliferation and apoptosis of ovarian cancer cells / 中南大学学报(医学版)

To observe the effects of human umbilical cord mesenchymal stem cells (UC-MSCs) on the proliferation and apoptosis of human ovarian cancer cell SKOV3.
 Methods: Transwell co-culture was used to observe the targeted homing effect of UC-MSCs on ovarian cancer cells. MTT assay was used to detect the inhibitory effect of UC-MSCs conditioned medium on SKOV3 proliferation, and Annexin V-FITC/PI double staining was used to detect the apoptotic rate. Real-time PCR was used to detect the expression levels of Ki-67, Bcl-2 and Bax genes-relevant to proliferation and apoptosis of SKOV3 cells.
 Results: UC-MSCs targeted SKOV3 cells in vitro. MTT assay showed that UC-MSCs conditioned medium significantly inhibited the proliferation of SKOV3 cells (P<0.01). Annexin V-FITC/PI double staining showed that the apoptotic rate in the 75% conditioned medium group was significantly higher than that in the control group (P<0.05). Real-time PCR showed that the expression of proliferation-related gene Ki-67 decreased significantly (P<0.01). The apoptosis-related gene Bcl-2 expression was decreased dramatically (P<0.01), and Bax expression was increased significantly (P<0.01).
 Conclusion: UC-MSCs can target ovarian cancer cells in vitro, inhibit the proliferation of SKOV3 cells by regulating the expression of Ki-67, and promote the apoptosis of SKOV3 cells by regulating the expression of Bcl-2 and Bax.

Three noninvasive liver fibrosis evaluation methods in diagnosis of early cirrhosis for chronic HBV infected patients with mild abnormal liver function / 中华临床感染病杂志

Objective To compare FibroTouch, serum hepatic fibrosis index and aspartate aminotransferase-to-platelet ratio index (APRI) in diagnosis of liver fibrosis and early cirrhosis for patients with chronic HBV infection with mild abnormal liver function.Methods One hundred and seven chronic HBV infected patients with alanine transaminase (ALT)≤80 U／L who underwent liver biopsy in Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2014 to January 2017 were enrolled in the study.According to the liver biopsy pathology , the patients were divided into mild liver fibrosis group (S1, n＝26 ), significant fibrosis group ( S2-3, n ＝34 ) and early cirrhosis group ( S4, n ＝47 ).The differentiations of liver stiffness measurement (LSM), Laminin(LN), Collagen Type ⅢN-peptide(PⅢP N-P), Collagen Type IV(CⅣ), Hyaluronic acid ( HA) and APRI were compared among the three groups , and their correlations with fibrosis were analyzed with Spearman rank correlation analysis .Logistic regression analysis was performed to establish a multi-index model for predicting the degree of liver fibrosis , and the receiver operating characteristic (ROC) curves were drawn to compare and analyze the predictive value for different stages of liver fibrosis.Results The LSM in the significant fibrosis group was higher than that in the mild liver fibrosis group (Z＝-2.611, P＜0.01).The levels of PⅢP N-P,CIV,LN and HA in early cirrhosis group were higher than those in mild liver fibrosis group (Z＝-4.026,-4.205,-2.938 and-3.156, all P＜0.01).LSM and APRI in early liver cirrhosis group was higher than that in mild liver fibrosis group(Z＝-5.789 and -4.308, both P＜0.01) and significant liver fibrosis group (Z＝-3.460 and -3.498, both P＜0.01).PLT in early liver cirrhosis group was lower than that in mild liver fibrosis group and significant liver fibrosis group (Z＝-4.533 and -3.206, both P＜0.01).The correlation analysis showed that the values of LSM , CIV, PⅢP N-P and APRI were positively correlated with the stage of liver fibrosis (r＝0.606, 0.418, 0.396 and 0.470, respectively; all P＜0.01).There was no significant difference in the efficacy of each single index in predicting hepatic fibrosis S≥2 and S＝4 (all P＞0.05). The prediction of liver fibrosis models were established with Logistic regression analysis .The model 1 Logit (P)＝-3.810+0.385×LSM+0.052×CIV was used for predicting liver fibrosis S≥2; the area under the receiver operating characteristic curve ( AUC) was 0.839, with specificity of 96.0%, and the diagnostic efficacy was superior to PⅢP N-P, CⅣand APRI(Z＝2.579, 2.145 and 2.219, all P＜0.05), but there was no significant difference compared with LSM ( Z ＝1.001, P ＞0.05).The model 2 Logit ( P)＝-4.291+0.105×LSM+0.028×CIV+2.682×APRI was used for predicting liver fibrosis S ＝4; its AUC was 0.865 with sensitivity of 82.9%and specificity of 81.8%, and the diagnostic efficacy was superior to LSM, PⅢP N-P, CⅣand APRI (Z＝2.309, 2.485, 2.403 and 2.103, all P＜0.05).Conclusions For chronic HBV infected patients with mild abnormal liver function , FibroTouch can be selected as a noninvasive method to predict liver fibrosis S≥2.The diagnostic efficacy of the prediction model 2, based on the combination of LSM, CIV and APRI is superior to each single index , which can improve the prediction level of early cirrhosis.

Alpha-lipoic acid alleviates the 6-OHDA-induced SH-SY5Y cell damage by inhibiting autophagy via AMPK/mTOR pathway / 中华老年医学杂志

Objective To investigate the effects of α-lipoic acid(ALA)on 6-hydroxydopamine(6-OHDA)-induced autophagy in human neuroblastoma(SH-SYSY)cells and its possible mechanisms.Methods SH-SYSY cells were divided into 5 groups:blank control group (group A),ALA group (group B),6-OHDA group(group C),ALA+6-OHDA group(group D),and rapamycin(RAPA)group (group E).The cell viability,cell apoptosis,and oxidative stress were assayed and analyzed in A-D group.The expression of autophagy-related proteins LC3-Ⅱ,AMP-activated protein kinase(AMP-K),phosphorylated AMPK (p-AMPK),the mammalian target of rapamycin (mTOR) and p-mTOR were detected by Western blot in A-E group.Results Compared with the blank control group,the 6-OHDA group significantly reduced the cell viability(P ＜ 0.01) and p-mTOR protein expression (P ＜0.05),and increased the cellular apoptosis rate(P＜0.01),oxidative stress level(P ＜0.01),LC3-Ⅱ protein expression(P＜0.05,with the highest level at 6 h after treatment),and p-AMPK protein expression(P＜＜0.05).There was no significant difference in these indices between ALA group and the blank control group.Compared with 6-OHDA group,ALA+ 6-OHDA group showed that the cell viability(P ＜ 0.01) and p-mTOR protein expression (P ＜ 0.05) were increased,while the cellular apoptosis rate(P＜0.01),oxidative stress level(P＜0.01),LC3-Ⅱ protein expression(P ＜0.05),and p-AMPK protein expression (P ＜ 0.05)were decreased.Conclusions The 6-OHDA can induce oxidative stress and autophagy in SH-SY5Y cells and decrease the cell viability.ALA can alleviate the 6-OHDA-induced cell injury possibly by inhibiting autophagy via AMPK/mTOR pathway.

Study on the effects of different concentrations of propofol target controlled infusion on postoperative cognitive function in patients undergoing coronary artery bypass grafting / 中国生化药物杂志

Objective To investigate the effects of different concentration propofol target controlled infusion on postoperative cognitive function in patients undergoing coronary artery bypass grafting.Methods182 cases with coronary heart disease undergoing off-pump coronary artery bypass grafting were randomly divided into groupA and groupB from January 2014 to December 2016 in our hospital, 91cases in each group.GroupA were given a small dose propofol target controlled infusion anesthesia;groupB were given high dose propofol target controlled infusion anesthesia.The total dose of propofol induction and effect compartment concentration in the two groups were observed, and the Mini Mental State Examination(MMSE) in the two groups was evaluated preoperative, postoperative 24h, 48h, 72h.Concentration of S100β was determined at suture, postoperative 24h, 72h.ResultsThe total dose of propofol induction in the groupA was significantly lower than that in the groupB (P<0.05), effect compartment concentration between the two groups had no statistically significant difference.MMSE scores in the group A at postoperation 24h, 48h, were higher than those in the group B (P<0.05).Concentration of S100β in the group A was lower than those in the group B at suture, postoperative 24h, 72h.MMSE and concentration of S100β in the two groups were not statistically significant at post operation 72h.ConclusionLow dose propofol target controlled infusion can reduce postoperative cognitive dysfunction in patients undergoing coronary artery bypass grafting, which is worthy of clinical application.

Diagnosis of myeloid neoplasms for three patients with erythroblast more than 50 ％ of bone marrow nucleated cells / 临床检验杂志

Objective To further understand the diagnosis,clinical features and prognosis of myeloid neoplasms with erythroblast more than 50％ of bone marrow(BM) nucleated cells in the WHO Classification(2016) by analyzing the clinical data,diagnosis and prognosis of 3 patients with myeloid leukemia.Methods The ages,medical histories,symptoms and signs,and laboratory examinations from 3 patients with myeloid neoplasms whose erythroblast cells were more than 50％ of BM nucleated cells when newly diagnosed were collected.Then,they were diagnosed with the WHO Classification criteria(2008) and the WHO Classification criteria(2016),respectively,and their prognosis was evaluated with the revised International Prognostic Scoring System(IPSS-R).Results According to the WHO Classification criteria(2008),all of 3 patients were diagnosed as acute erythroid leukemia(AEL).However,according to the WHO Classification criteria(2016),2 patients were diagnosed as myelodysplastic syndrome with excess blasts-2(MDS-EB-2),and 1 was diagnosed as acute myeloid leukemia(AML) with maturation.Moreover,their prognostic scores were also different.The former two patients were older men with significant dysplasia and complex genetic abnormalities,and had poor prognosis,while the latter was a middle-aged woman with no obvious dysplasia and genetic abnormalities,and had medium prognosis.Conclusion The WHO Classification(2016) is more reasonable than the WHO Classification(2008),which tends to focus more on the different biological characteristics of diseases,and may better distinguish two types of diseases with different clinical features and prognosis.

Effect of traditional Chinese medicine on the expression of proteinuria and inflammatory factors in diabetic kidney disease rats / 国际中医中药杂志

Objective To observe the effect of traditional Chinese medicine on proteinuria and inflammatory factors on the model of diabetic kidney disease rats. Methods The male SD rats were divided into the blank group, model group, treatment group, control group. The diabetic kidney disease model was induced by using the left inferior abdominal cavity. After eight weeks, we observed the changes of the rat's weight/kidney weight, blood sugar, IL-6, urine microalbumin, MCP-1 and TGF-β. Results Compared with the model group,the blood glucose(9.96 ±3.73 mmol/L vs.17.16 ±5.75 mmol/L)and Proteinuria(11.73 ±4.01 mg/L vs.19.57 ± 8.38 mg/L,P<0.05) of the treatment group significantly decreased (P<0.05). Compared with the model group,the level of IL-6(58.87 ±14.69 ng/L vs.85.22 ±12.16 ng/L)and the MCP-1(1.52 ±0.86 ng/L vs.3.17 ± 1.26 ng/L)of the treatment group were significantly lower (P<0.05). Conclusions The Chinese medicine can reduce the FPG, proteinuria and the removal of serum inflammatory factors in diabetic kidney disease.

Development and clinical application of automatic chest X-ray protective device / 医疗卫生装备

Objective To develop an automatic chest X-ray protective device to decrease the harm to the patient during Xray examination.Methods Mobile lead plate was involved in to protect the non-target organs and tissues.The device had the frame made of 304 stainless steel,and the core protective part of lead plate with 5 mm-thickness,whose components included noiseless motor,transmission system and lithium battery.Results The device decreased the exposure field and radiation dosage,and thus contributed to the patient protection effectively.Conclusion The device reduces the exposure dosage greatly,and is of great value for enhancing efficacy.

Clinical and electrophysiological value of sensory tricks in cervical dystonia / 中华神经科杂志

Objective To investigate demography of sensory tricks in cervical dystonia (CD),and to discuss the relationship between sensory tricks and the function of sensorimotor integration of cerebral cortex,meanwhile to explore potential worthiness using sensory tricks in the management of CD.Methods We recruited 75 patients (23 male,52 female,male female ratio:1:2.26;aged 19-72 years,mean (42.45 ± 13.09) years) admitted to the Dystonia Clinic Center of the First Affiliated Hospital of Dalian Medical University from March 2016 to April 2013.Standardized questionnaire on sensory tricks was used to investigate the sensory tricks first recognized in 75 patients retrospectively.Median nerve somatosensory evoked potential via multipoint recording was measured in 43 CD patients who manifested as simple rotation of neck.Bilateral amplitudes of P22/N30 derived from F (3,4) were compared.Results Frequency of sensory tricks in CD was 85.53％ (64/75) in our research.As disease progressed,the type of sensory tricks used by patients may transform from one to another or even disappear.No statistically significant differences were found in ages among patients using classic sensory tricks,forcible tricks and patients without sensory tricks,whereas the complexity of the disease showed increased tendency among the three groups.Bilateral P22/N30 amplitudes of patients with classic sensory tricks showed no significant differences.P22/N30 amplitudes contralateral to the head turn were significantly higher than ipsilateral in patients using forcible tricks ((3.16 ± 1.71) μV vs (2.47 ± 1.28) μV,t =2.243,P=0.038) and patients without sensory tricks ((3.62 ±1.58) μV vs (2.73 ±1.14) μV,t=2.893,P=0.023).Tsui scores among patients using classic sensory tricks (9.36 ± 3.52) and forcible tricks (12.67 ± 5.00) or patients without sensory tricks (15.18 ± 4.07) had statistically significant differences (classic sensory tricks vs forcible tricks,t =-3.020,P =0.004;classic sensory tricks vs patients without sensory tricks,t =-4.452,P =0.000).Conclusions Types of sensory tricks used by patients are associated with severity of the disease.Different types of sensory tricks may reflect status of adaptive compensatory mechanism of the cerebral cortex.

Value of diffusion weighted imaging on predicting radiotherapy and concurrent chemoradiotherapy response in patients with advanced non-small cell lung cancer / 中华放射学杂志

Objective To investigate the value of DWI using 3.0 T MRI to predict response to radiotherapy(RT) and concurrent chemoradiotherapy(CCRT) in patients with advanced non-small cell lung cancer (NSCLC).Methods From January 2014 to May 2015, 40 patients with stageⅢ(Ⅲa orⅢb) NSCLC underwent DWI using 3.0 T MRI before RT/CCRT were enrolled. The imaging quality of diffusion-weighted images were evaluated on 3-level grades as good, moderate and non-diagnostic.The patients with good or moderate image quality were underwent DWI at 2 weeks after starting therapy(total dose of 20 Gy), and at the end of therapy (total dose of 60 Gy). Apparent diffusion coefficient(ADC) of lung cancer with good and moderate image quality were calculated by Funtool. The following quantitative parameters were recorded and calculated: the mean pretreatment ADC value(ADCpre), the mean mid-treatment ADC value (ADCmid), the mean post-treatment ADC value(ADCpost), the rate of changes inmean ADC value at 2 weeks post therapy (ΔADCmid) and the rate of changes inmean ADC value at the end of therapy(ΔADCpost). The patients were classified into response group and non-response group according to the tumor response, which was assessed with revised response evaluation criteria in solid tumors (RECIST1.1) after CCRT. The Mann-Whitney U test was used to compare parameters between the two groups.The relationship between these obtained parameters and tumor response was evaluated by Spearman correlation analysis. The value of parameters on predicting tumor response was calculated by receiver operating characteristic curve.Results 96.4%(80/83) DW images were graded as good or moderate image quality. The responders had lower median ADCpre[1.32 (0.77—1.96) × 10- 3 mm2/s] than non-responders[1.60(1.12—2.33) × 10- 3 mm2/s], which had statistically significant difference (Z=-2.934,P=0.003).Tumor regression rate after treatment had negative correlation with ADCpre(r=-0.386, P=0.018).The responders had increased ADC [ΔADCmid: 38.9%(12.8%—139.0%),ΔADCpost: 48.3% (25.6%—148.1%)] than non-responders [ΔADCmid: -2.5% (-15%—29.4%), ΔADCpost:14.2% (- 28.1% —71.3% )], which had statistically significant difference (Z=- 2.847, - 2.221, respectively;P<0.05). Tumor regression rate after treatment had positive correlation with ΔADCmid(r=0.637, P=0.001) and ΔADCpost(r=0.631, P=0.005).From ROC analysis,when setting threshold on pretreatment ADCpre=1.38 × 10-3 mm2/s, ΔADCmid=21.6%, ΔADCpost=38.8%, the area under curve was 0.782, 0.838 and 0.813.Conclusion The mean ADC value before RT/CCRT and its changes during treatment is likely to be a valuabletool for predicting the response after RT/CCRT in advanced NSCLC, which may be helpful to clinical decision on individualized therapy.

Clinical study of S-1 alone compared to gemcitabine combined with S-1 in treatment of patients with advanced pancreatic cancer / 肿瘤研究与临床

Objective To value the clinical efficacy and toxicity of S-1 compared to gemcitabine combined with S-1 in treatment of patients with advanced pancreatic cancer.Methods From January 2011 to December 2013,the data of 46 patients with advanced pancreatic cancer were analyzed retrospectively,including 24 patients receiving S-1 alone (group A) and 22 patients who received gemcitabine combined with S-1 (group B).The results were evaluated by objective response rate (ORR),disease control rate (DCR),survival time and safety.Results In group A the ORR was 20.8 ％ (5/24),DCR was 66.7 ％ (16/24),median progression-free survival was 4.8 months,median overall survival was 9.6 months,and 1 year survival was 12.5 ％.In group B the ORR was 27.3 ％ (6/22),DCR was 72.7 ％ (16/22),median progression-free survival was 5.9 months,median overall survival was 10.3 months,and 1 year survival was 22.7 ％.There was no significant difference between the two groups (P ＞ 0.05).The incidence rates of leukopenia,neutropenia and thrombopenia in group A were significantly lower than those in group B (P ＜ 0.05).Conclusion S-1 alone and gemcitabine combined with S-1 have similar effects in the treatment of advanced pancreatic cancer,but the toxicity of S-1 is mild and tolerable.

Effect of CTP guided thrombolytic therapy in the treatment of acute cerebral infarction / 天津医药

Objective To investigate the effect of CT perfusion (CTP) imaging guidance in the treatment of acute cere?bral infarction. Methods Patients (n=200) with acute cerebral infarction who visited our clinic within 6 hours underwent CTP examination and were divided into two groups:penumbra group and non-penumbra group according to their CTP imag?ing (presence of penumbra or not). Recombinant tissue plasminogen activator (rt- PA) was administrated for intravenous thrombolysis in both groups. NIHSS (The NIH Stroke Scale), BI (Barthel Index), mRS (modified Rankin Scores) and hemor?rhagic transformation events of two groups were determined before and after thrombolysis to evaluate its effect and prognosis in these two group. Results Compared with non penumbra group, NIHSS was reduced in penumbra group from 7 days after rt-PA (6.67±3.46 vs 4.76±2.04), and this decrease became obvious at 4 weeks after rt-PA (6.67±3.46 vs 3.68±1.93). Effi?ciency rate at 4 week (60.3%) and good prognosis rate at 3 months(71.7%)were both significantly improved in penumbra group than those in non penumbra group(34.7%,56.8%). Conclusion rt-PA under CTP guidance is effective and safe in the treatment of acute cerebral infarction. The thrombolytic therapy window can be enlarged according to the presence of pen?umbra or not and the bleeding conversion rate remains at low level.

Repairment of sciatic nerve defect by Schwann cell of adult rat combined with acellular nerve grafts / 器官移植

Objective To investigate clinical efficacy of tissue-engineered artificial nerve grafts constructed by acellular nerve grafts combined with adult rat Schwann cell (SC)in the treatment of peripheral nerve injury.Methods SCs were isolated and cultured from the distal nerves of adult Sprague Dawley (SD) rats with 1-week Wallerian degeneration and then combined with acellular nerve grafts to construct tissue-engineered artificial nerve.All rats were divided into acellular nerve graft containing SCs (SC group)and nerve graft containing no cells groups (control group),five animals in each group.At 2-,4-and 8-week after surgery,sciatic function index (SFI)of the affected side was compared between two groups.At postoperative 8 weeks,nerve conduction of sciatic nerve of the injured side,recovery rate of triceps surae wet weight and other relevant parameters were equally compared between two groups.Results In the SC group,SFI of the affected side at 2-,4-and 8-week after surgery,nerve conduction of sciatic nerve at the injured side and recovery rate of triceps surae wet weight at postoperative 8 weeks were significantly better compared with those in the control group (all in P <0.05).Conclusions Combined use of adult rat SCs and acellular nerve grafts effectively repairs peripheral nerve defects and accelerates functional recovery of injured nerves.

Repairment of 1 cm sciatic nerve defect by bone marrow mesenchymal stem cell of adult rat combined with tissue-engineered artificial nerve / 器官移植

Objective To discuss the effect of bone marrow mesenchymal stem cell (BMSC)as the seed cell transplantation of tissue-engineered artificial nerve in the treatment of peripheral nerve injury. Methods BMSC was obtained from the bone marrow of adult rat through isolation and culture and combined with acellular nerve scaffold to construct ‘tissue-engineered artificial nerve’.After transplantation,rats were divided into two groups,the BMSC +acellular nerve conduit group(BMSC treatment group)and the empty cell conduit group(negative control group)with 5 rats in each group.Sciatic functional index (SFI)of the affected side of rats was compared between two groups at 2 weeks,4 weeks and 8 weeks after the surgery.Moreover,the sciatic conduction,recovery rate of tricipital muscle wet weight and other repair effects of the affected side were compared between two groups at 8 weeks after the surgery.Results The indicators of BMSC treatment group, including SFI assessed at 2 weeks,4 weeks and 8 weeks after the surgery as well as the sciatic conduction and recovery rate of tricipital muscle wet weight assessed at 8 weeks after the surgery,were better than those of the negative control group(all in P <0.05).Conclusions BMSC combined with tissue-engineered artificial nerve of acellular nerve scaffold can effectively promote nerve regeneration and function recovery.

Induction of Schwann cell-like differentiation in bone mesenchymal stem cell of adult rat in vitro / 器官移植

[Abstract ] Objective To explore the effective method of induction of Schwann cell-like differentiation in bone mesenchymal stem cell (BMSC)of adult rat in vitro.Methods Primary culture of Schwann cell and isolated culture of BMSC were separately conducted.According to different induction methods,the cells were divided into chemical induction group and co-culture induction group.The growth of Schwann cell and BMSC was observed under light microscope.These two kinds of cells were identified by immunofluorescence staining [detecting Schwann cell marker proteins:glial fibrillary acidic protein (GFAP) antibody and S-100 antibody] and flow cytometry.The shape and growth of cells in two groups were dynamically observed by light microscope.The induced differentiation was evaluated with immunofluorescence staining at 3 rd day after co-culture induction in the co-culture induction group and at 4 h and 1 st day after chemical induction in the chemical induction group.Results In the chemical induction group,the BMSC appeared typical Schwann cell-like morphology.The positive expression of GFAP antibody appeared at 4 h after preliminary induction.Meanwhile,the positive expression rate of GFAP and S-100 antibody was (80.9 ± 3.5)% and (59.0 ±1.1 )% at 1 st day after induction.The induced BMSC began to die at 2nd day after chemical induction and most of the induced BMSC had died at 3 rd day after chemical induction.At 3 rd day after co-culture induction,few induced BMSC showed obvious morphological changes like those in chemical induction group.The positive expression rate of GFAP and S-100 antibody was (89.8 ±2.4)% and (80.9 ±1.7)%. The positive expression rate of GFAP and S-100 antibody in the co-culture induction group was higher than those in the chemical induction group and the difference had statistical significance (all in P <0.01).Conclusions The co-culture induction not only has obvious effect on Schwann cell-like differentiation in BMSC,but also promotes the survival and proliferation of BMSC.Thus,co-culture induction is more safe and effective than chemical induction.

Application of DR in diagnosis of lumbar instability / 医疗卫生装备

Objective To apply DR to the diagnosis of lumbar instability.Methods Totally 198 patients suspected with lumbar instability underwent routine lateral side DR radiograph and examination of flexion-extension position to analyze the forward and backward displacements of the lumbar.Results Totally 35 patients with lumbar instability were determined based on the method proposed by White and Panjabi.Conclusion Film of flexion-extension position gains advantages over films of lateral position and oblique position in lumbar instability and malfunction, and thus helps for clinical diagnosis and efficacy observation.