Comparative analysis of clinical diagnosis application of two intrauterine adhesion scoring criteria / 中华妇产科杂志

Objective:To explore the similarities and differences of China Society of Gynecology Endoscopy (CSGE) and American Fertility Society (AFS) intrauterine adhesion (IUA) scoring criteria on IUA grading and their predictive value of reproductive prognosis.Methods:From January 2016 to January 2019, a total of 1 249 patients were diagnosed with IUA by hysteroscopy at Beijing Obstetrics and Gynecology Hospital. Totally, 378 patients with complete clinical data were enrolled, and the results diagnosed by CSGT and AFS scoring criteria were compared and analyzed.And follow-up for 2 years, the pregnancy rate and live birth rate were statistical analysis.Results:(1) The grade of IUA according to AFS and CSGE scoring criteria was less consistent ( κ=0.295, P<0.001). Compared with AFS, the proportion of severe IUA cases diagnosed by CSGE was significantly lower [45.8% (173/378) vs 15.1% (57/378); RR=0.22, 95% CI: 0.15-0.30, P<0.01); the proportions of both mild and moderate IUA cases were significantly higher ( RR=4.16, 95% CI: 2.38-7.14; RR=2.38, 95% CI: 1.75-3.23; both P<0.01). (2) The pregnancy rates of mild, moderate and severe IUA diagnosed according to CSGE were 11/13, 64.5% (147/228), 31.8% (7/22), live birth rates were 11/13, 54.8% (125/228) and 22.7% (5/22), respectively; there were statistically significant differences between the groups (all P<0.01). The pregnancy rates of mild, moderate and severe IUA diagnosed based on AFS were 3/3, 66.9% (97/145) and 56.5% (65/115), respectively, with no statistically significant difference between the groups ( P>0.05). (3) IUA grades based on both CSGE and AFS criteria were significantly negatively correlated with pregnancy rates and live birth rates (CSGE: r=-0.210, r=-0.226; AFS: r=-0.130, r=-0.147; all P<0.05). Univariate logistic regression analysis showed that CSGE had higher OR for both pregnancy rates and live birth rates compared to AFS (3.889 vs 1.657, 3.983 vs 1.554, respectrvely). Conclusions:Compared with AFS, the IUA grade based on CSGE is better related with reproductive prognosis, suggesting that the CSGE standard might be more objective and comprehensive and has better predictive value for reproductive prognosis, thus avoiding overdiagnosis and overtreatment.

The epidemiological features and relational factors of accidental death among children under 5 years of age in rural Shaanxi Province / 西安交通大学学报(医学版)

【Objective】 To explore the epidemiological features and relational factors of accidental death among children under 5 years of age in rural area of Shaanxi Province. 【Methods】 A case-control study was conducted in the research, and children under 5 years old in nine National surveillance counties of Shaanxi were collected. The questionnaire of national survey of accidental injuries among children under 5 years of age was used to investigate the basic information of children, socio-demographic characteristics, child care status, injury occurrence condition. The mean, standard deviation and percentage were used to describe the basic situation and main characteristics of accidental death. The Chi-square test and Logistic regression methods were performed to explore the relational factors of accidental death of children. 【Results】 Of the 25 cases of accidental death of children under the age of five years old, 5 were traffic accidents (20.0%), 9 cases were falling (36.0%), and 11 were suffocation (44.0%). Age distribution showed that children of accidental suffocation were younger, with 90.9% (10 cases) of them under the age of 1 years old. Gender distribution showed that traffic accident deaths occurred to boys. Area distribution showed that falling and suffocation death mainly happened in Hanzhong, while traffic accidents death mainly in Weinan. When the accident happened, 8 caregivers were not on the scene. What was worse, among 17 caregivers who were on the scene of accident, only 4 kept an eye on children. Compared with 25 children in control group, 16 in case group had received health examination, and the difference showed statistical significance (χ2=8.672, P=0.003). Meanwhile, 9 main caregivers were mothers in the case group, compared with 14 in the control group. The Logistic regression analysis showed that compared with fathers, mothers as the children’ main caregivers could positively reduce accidental death of children (OR=0.016, 95% CI: 0.000 3-0.997, P=0.049). 【Conclusion】 To decrease the incidence rate and mortality of accidental death of children under the age of five years old, parenting behavior guidance, health examination, and targeted health education should be taken in Maternal and Child Health Care System as a routine work.

Real-world research of vonoprazan and amoxicillin dual therapy for Helicobacter pylori eradication / 中国药房

OBJECTIVE To explore the efficacy， safety and economics of a dual therapy consisting of conventional dose of vonoprazan combined with conventional dose of amoxicillin in patients with primary treatment of Helicobacter pylori （HP） infection. METHODS Using a prospective cohort study， the patients diagnosed with HP infection and receiving initial treatment in Chengdu Xinhua Hospital from July 2021 to July 2022 were collected according to inclusion and exclusion criteria. The patients were given vonoprazan/amoxicillin dual therapy （i.e. VA group， Vonoprazan fumarate tablets 20 mg， once a day+Amoxicillin capsules 1.0 g， twice a day， 14 days） and bismuth-containing quadruple therapy （i.e. LJAF group， Rabeprazole sodium enteric- coated tablets 20 mg， twice a day+Colloidal bismuth pectin capsules 200 mg， twice a day+Amoxicillin capsules 1.0 g， twice a day+ Furazolidone tablets 100 mg， twice a day， for 14 days） according to the patient’s medication willingness. Four weeks after the end of the treatment， HP eradication rates of the two groups were compared by using intention-to-treat （ITT）， modified intention-to- treat （MITT） and per-protocol （PP） analysis. The occurrence of adverse drug reactions （ADR） was recorded， and an economic evaluation was performed for them. RESULTS Among the 58 patients in VA group， 55 completed the trial， 2 were lost to follow- up and one withdrew due to rash； among the 62 patients in LJAF group， 57 completed the trial， 3 were lost to follow-up and 2 withdrew due to rash. Results of ITT， MITT and PP analysis showed that HP eradication rates of VA group were 86.2%， 89.3% and 90.9%， and those of LJAF group were 87.1%，91.5% and 94.7%， respectively； there was no statistical significance among different groups （P＞0.05）. The incidences of ADR in VA group and LJAF group were 6.9% and 14.5%，which were not significantly different （P＞0.05）. The result of cost minimization analysis showed that the treatment cost of VA group was 340.9 yuan， which was lower than 373.5 yuan of LJAF group. CONCLUSIONS In patients with primary treatment of HP infection， the efficacy and safety of dual therapy of conventional dose of vonoprazan combined with conventional dose of amoxicillin is equivalent to the bismuth-containing quadruplex therapy with low cost.

The role of adipose-derived exosomes in the pathological progression of atherosclerosis / 生理学报

Atherosclerosis is a chronic inflammatory disease of vascular walls with a complex etiology. In recent years, the incidence of atherosclerosis continues to increase with obesity and diabetes as major risk factors. As an important metabolic organ in the body, adipose tissue also has a powerful endocrine function. In the case of obesity and diabetes, various cytokines and exosomes derived from adipose tissue mediate organ-organ/cell-cell crosstalk, and are involved in the occurrence and development of various diseases. As an important intercellular communicator, exosomes regulate the pathological process of various cardiovascular diseases and are closely related to atherosclerosis. In this paper, we reviewed the mechanism of adipose-derived exosomes in atherosclerosis with focus on endothelial dysfunction, inflammatory response, lipid metabolism disorder and insulin resistance, hoping to provide reference for the research, diagnosis and treatment of atherosclerosis.

Investigation on medical practice of overseas acupuncturists based on the top 5 general hospitals in the United States of America and the inspiration / 国际中医中药杂志

This study selected the top five general hospitals in the United States of America, collected the practice information of acupuncturists through the official website, and analyzed the professional department, expertise, professional title, education background, residency, fellowship, board certification, etc. of these acupuncturists to understand the practice situation of acupuncturists in the hospitals. The results of the study showed the practice of acupuncturists in the United States of America is improving. With further localization, locally trained acupuncturists have gradually become the main body of acupuncturists; acupuncture treatment is still mainly for analgesia, but the scope of treatment continues to expand, and departments that accept acupuncturists are gradually increasing. However, the group of licensed acupuncturists is still a minority in the group of acupuncturists in the United States of America. Native American physicians still use acupuncture as an alternative option and neglect to obtain a license. The entry barrier for acupuncturists still needs to be raised.

Overwork Affects Extracellular Matrix of Arterial Vessel Wall in Rats / 中国医学科学院学报

Objective To explore the effect of overwork (OW) on extracellular matrix of arterial vessel wall in rats. Methods Random number grouping method was employed to assign 18 Sprague-Dawley rats into three groups(n=6):the control group(no special treatment),group OW(forced swimming twice a day for 15 days),and sleep deficiency(SD)+OW group(in addition to forced swimming twice a day,the rats were put on the platforms in water to limit sleep for 15 days).On the 16th day,the abdominal aorta and common carotid artery were collected after blood sampling from heart under deep anesthesia.A part of the abdominal aorta sample was taken for Masson staining of collagen fiber,and Verhoeff-Van Gieson staining was carried out for the elastic fiber of common carotid artery.Image J was employed for the quantitative analysis of collagen fiber and elastic fiber content.The expression of collagen 1(Col-1) protein was quantified by immunohistochemistry and the ultrastructure of vascular matrix was examined by transmission electron microscopy.The other part of the abdominal aorta sample was used to determine the mRNA levels of matrix metalloproteinase(MMP)-1,MMP-2,MMP-9,tissue inhibitor of metalloproteinases-1(TIMP-1),and Col-1 by quantitative real-time polymerase chain reaction. Results Compared with that in control group,the content of collagen fiber in groups OW and SD+OW had no significant change(all P>0.05);the content of elastic fiber in groups OW and SD+OW decreased(all P<0.001) and had no significant difference between each other(P>0.05).The vascular vessel wall of group OW showed slight fiber breakage,while that of group SD+OW presented wormhole-like or spongy fiber fragmentation.The mRNA levels of MMP-1 and MMP-2 in groups OW and SD+OW had no significant difference between each other(P>0.05) but were higher than that in control group(all P<0.001).The mRNA levels of MMP-9 and TIMP-1 had no significant difference among the three groups(all P>0.05).Groups OW and SD+OW had lower mRNA level(all P<0.001) and protein level(all P<0.001) of Col-1 than control group,while the mRNA and protein levels of Col-1 had no significant difference between groups OW and SD+OW(P>0.05). Conclusion OW can reduce the content of Col-1 and elastic fibers in the extracellular matrix of arterial vessels,destroy the elastic lamina of vascular wall,up-regulate the expression of MMP-1 and MMP-2,thereby injuring arterial vessels.

Prevalence of anxiety among healthcare professionals during the COVID-19 pandemic: a meta-analysis / 预防医学

Objective@#To systematically investigate the prevalence of anxiety among healthcare professionals during the COVID-19 pandemic, so as to provide the development of evidence-based psychological interventions among healthcare professionals.@*Methods@#The publications pertaining to the prevalence of anxiety among healthcare professionals during the COVID-19 pandemic were retrieved in national and international electronic databases from January 1, 2020 through November 30, 2021, including CNKI, Wanfang Data, VIP, SinoMed, PubMed and Web of Science. The quality of publications was evaluated using the United States Healthcare Research and Quality (AHRQ) quality assessment of included cross-sectional studies, and the pooled prevalence of anxiety was estimated among healthcare professionals using the software Open Meta Analyst version 3.0. The publication bias were evaluated with funnel plots and Begg rank correlation test.@*Results@#Totally 598 publications were retrieved, and 36 eligible publications were enrolled in the final analysis, including 33 Chinese publications and 3 English publications. There were 5 high-quality, 29 moderate-quality and 2 low-quality publications. All investigations pertaining to the prevalence of anxiety among healthcare professionals were conducted in 2020. Totally 19 872 healthcare professionals were investigated, and the prevalence of anxiety was 28.8% (95%CI: 24.0%-33.6%). Subgroup analysis showed that the prevalence of anxiety was 31.9% (95%CI: 17.6%-46.2%) among healthcare professionals from western China, 29.6% (95%CI: (17.8%-41.4%) from central China, and 25.3% (95%CI: 20.2%-30.3%) from eastern China. The prevalence of anxiety was 4.9% (95%CI: 3.3%-6.4%) among male healthcare professionals and 22.9% (95%CI: 17.7%-28.0%) among male healthcare professionals, and the prevalence of anxiety was 21.6% (95%CI: 13.2%-29.9%) among nurses, 5.2% (95%CI: 2.8%-7.5%) among doctors and 4.8% (95%CI: 2.2%-7.4%) among other healthcare professionals. The prevalence of mild, moderate and severe anxiety was 18.6% (95%CI: 14.0%-23.2%), 5.5% (95%CI: 4.1%-6.8%) and 1.9% (95%CI: 1.3%-2.5%), respectively. No publication bias was detected as revealed by funnel plots and Begg rank correlation test, and stable meta-analysis results and heterogeneity test were observed.@*Conclusions@#The prevalence of anxiety is 28.8% among healthcare professionals during the COVID-19 pandemic, and mild anxiety is predominant. A high prevalence rate of anxiety is seen female healthcare professionals and nurses, who should be given a high priority and timely psychological interventions

Clinicopathological and immunophenotypic analysis of 24 cases of transformed mycosis fungoides / 中华皮肤科杂志

Objective:To investigate clinicopathological features and prognosis of transformed mycosis fungoides (TMF) .Methods:A retrospective analysis was performed on clinicopathological data collected from 24 patients with TMF, as well as on flow cytometry results of 16 peripheral blood samples obtained from 11 of the 24 patients, who visited Hospital of Dermatology, Chinese Academy of Medical Sciences between 2014 and 2020.Results:Among the 24 patients, 11 were males and 13 were females. Their average age at diagnosis of TMF was 50.0 years (range: 18 - 77 years), and patients with early-stage TMF (9 cases) and tumor-stage TMF (15 cases) were aged 44.8 and 52.6 years on average, respectively. The average time interval from diagnosis of MF to large cell transformation was 3.7 years, and 8 patients were diagnosed with TMF at the initial visit. Histopathologically, large cells infiltrated in a diffuse pattern in 20 cases, as well as in a multifocal pattern in 4, and the proportion of large cells in 7 cases was greater than 75%. Immunohistochemically, 18 patients showed positive staining for CD30, and the proportion of CD30-positive large cells was greater than 75% in 9; negative staining for CD30 was observed in 6. Flow cytometry of 16 peripheral blood samples showed the presence of cell subsets expressing clonal T cell receptor (TCR) -vβ in 2 of 4 patients with early-stage TMF and 10 of 12 with tumor-stage TMF, and tumor cells with higher forward scatter than normal lymphocytes were detected in 16 samples. During the follow-up, among the patients with early-stage TMF, 3 progressed to tumor-stage TMF 3.3 years on average after large cell transformation, 1 progressed to erythrodermic MF in stage IIIA, and the other 4 still showed an indolent course; among the patients with tumor-stage TMF, 1 progressed to stage-IV TMF, and 5 died 3.3 (1.5 - 6) years after large cell transformation.Conclusion:Large cell transformation may occur in patients with MF in any stage, some patients have poor prognosis, so close follow-up is needed for patients with TMF.

Research progress on the molecular regulatory mechanism of exosome biogenesis / 中华危重病急救医学

Exosomes are small vesicles with a diameter of about 40-160 nm actively secreted by cells. They participate in a variety of pathophysiological processes and are closely related to the occurrence and development of diseases. As a newly carrier of intercellular communication and circulating biomarkers of disease diagnosis and prognosis, exosomes have attracted great attention for their potential clinical applications. However, many aspects such as exosome biogenesis, targeted transport, and mechanism of action are still unclear. This paper focuses on the exosome biogenesis, summarizes the exosome biogenesis pathways, and describes relevant molecular modulation mechanisms of importance. And this review provides a theoretical basis for disease treatment based on regulating exosome production.

Generation of αGal-enhanced bifunctional tumor vaccine

Hepatocellular carcinoma (HCC) is a common malignant tumor with poor prognosis and high mortality. In this study, we demonstrated a novel vaccine targeting HCC and tumor neovascular endothelial cells by fusing recombinant MHCC97H cells expressing porcine α-1,3-galactose epitopes (αGal) and endorphin extracellular domains (END) with dendritic cells (DCs) from healthy volunteers. END+/Gal+-MHCC97H/DC fusion cells induced cytotoxic T lymphocytes (CTLs) and secretion of interferon-gamma (IFN-γ). CTLs targeted cells expressing αGal and END and tumor angiogenesis. The fused cell vaccine can effectively inhibit tumor growth and prolong the survival time of human hepatoma mice, indicating the high clinical potential of this new cell based vaccine.

Role of flow cytometric analysis of peripheral blood in the diagnosis of lymphoma-associated erythroderma / 中华皮肤科杂志

Objective:To investigate the value of flow cytometric analysis of peripheral blood in the diagnosis of erythroderma.Methods:A total of 29 patients with erythroderma were collected from Hospital of Dermatology, Chinese Academy of Medical Sciences from September 2017 to December 2020, including 6 with erythrodermic mycosis fungoides (EMF) , 5 with Sézary syndrome (SS) , 18 with inflammatory erythroderma (IE) with different etiologies. Four healthy volunteers served as healthy controls. Flow cytometry was performed to detect peripheral blood lymphocyte subsets, immunophenotypes and clonality, and their differences were analyzed between inflammatory erythroderma and lymphoma-related erythroderma. One-way analysis of variance and least significant difference- t test were used for comparisons between groups. Results:The proportions of T cells, B cells, NK cells and CD4 -CD8 - cells significantly differed among the EMF group, SS group, IE group and control group (all P < 0.001) . The proportion of T cells was significantly higher in the SS group (93.8% ± 3.4%) than in the EMF group (42.7% ± 6.4%) and IE group (46.0% ± 6.8%, t = 12.8, 14.4, respectively, both P < 0.001) , and the proportion of CD4 -CD8 - cells was significantly lower in the IE group (0.37% ± 0.40%) than in the EMF group (2.93% ± 0.84%) and SS group (2.38% ± 0.74%, t = 9.2, 6.7, respectively, both P < 0.05) . The expression of clonal T-cell receptor β-chain variable region (TCR-vβ) was not detected in healthy controls or IE patients; the T cell subsets expressing clonal TCR-vβ were detected in 3 cases of EMF and all cases of SS, and they were all identified to be cells with a CD4 +CD7 -CD26 - phenotype. There were significant differences among the above 4 groups of subjects in the proportions of CD4 + T lymphocytes expressing chemokine receptors CCR4, CXCR3, CCR5, cutaneous lymphocyte antigen (CLA) or programmed death receptor-1 (PD-1) on the cell surface (all P < 0.001) . Compared with the SS group and EMF group, the IE group showed significant decreased proportions of CD4 + T lymphocytes expressing CCR4, CLA or PD-1 (all P < 0.001) , but significantly increased proportions of CD4 + T lymphocytes expressing CXCR3 or CCR5 (all P < 0.001) . Conclusion:Flow cytometric analysis of peripheral blood lymphocyte subsets, immunophenotypes and clonality can provide a reference for the etiological diagnosis of erythroderma, and is helpful for the differential diagnosis between lymphoma-associated erythroderma and inflammatory erythroderma.

Research progress on accelerated partial breast irradiation for early breast cancer after breast-conserving surgery / 中华放射肿瘤学杂志

Currently, whole breast radiotherapy (WBRT) is the standard treatment for early breast cancer after breast-conserving surgery, which effectively reduces the recurrence rate. Accelerated partial breast irradiation (APBI), a special radiotherapy that only targets the limited volume of tissues surrounding the primary lesion, has attracted more and more attention because of the high proportion of tumor recurrence adjacent to the tumor resection cavity. In recent years, a number of prospective randomized controlled trails have demonstrated its safety and effectiveness, which is a feasible choice for specific low-risk patients after breast-conserving surgery. Compared with WBRT, APBI shortens the treatment time, reduces the treatment cost and improves the cosmetic effect. At the same time, more and more APBI technologies have been developed, which enhance the accessibility and possess unique advantages for partial patients undergoing breast-conserving surgery. Nevertheless, the efficacy and side effects of APBI technologies still differ, which need to be treated differently. In this paper, multiple APBI technologies, research progresses at home and abroad and applicable population were reviewed. The unresolved problems were proposed and development prospect was predicted, aiming to provide reference for clinical application.

Application value of 256-layer spiral CT left atrial pulmonary vein dual phase scanning imaging in radiofrequency ablation of nonvalvular atrial fibrillation / 中国医师进修杂志

Objective:To explore the application value of 256-layer spiral CT left atrial pulmonary vein dual phase scanning imaging (called simply CT dual phase scanning imaging) in radiofrequency ablation of nonvalvular atrial fibrillation.Methods:The clinical data of 74 patients with nonvalvular atrial fibrillation from October 2018 to September 2020 in Tiantan Hospital, Capital Medical University were retrospectively analyzed. All patients were examined by CT dual phase scanning imaging and transesophageal echocardiography (TEE). The result of TEE was as "gold standard", the value of CT dual phase scanning imaging in the diagnosis of left atrial pre-thrombotic state (PTS) and thrombus were assessed, and the variation of the pulmonary vein was observed.Results:CT dual phase scanning imaging in diagnosis of left atrial PTS had a sensitivity of 52.94% (9/17), a specificity of 92.45%(49/53), a negative predictive value of 85.96%(49/57), and a positive predictive value of 69.23%(9/13); it in diagnosis of left atrial thrombus had a sensitivity of 100.00% (4/4), a specificity of 90.74%(49/54), a negative predictive value of 100.00%(49/49), and a positive predictive value of 44.44%(4/9). The variation rate of the pulmonary vein was 21.62%(16/74).Conclusions:CT dual phase scanning imaging has relatively high values of sensitivity, specificity and negative predictive value in detecting left atrial PTS and thrombus. It can also evaluate the abnormal anatomical characteristics of the pulmonary vein, and find pulmonary vein variation. It provides a reliable basis for radiofrequency ablation of nonvalvular atrial fibrillation.

Expression of polycomb group proteins in common cutaneous T-cell lymphomas and lymphoproliferative disorders / 中华皮肤科杂志

Objective:To investigate the expression of epigenetic inhibitor polycomb group proteins such as enhancer of zeste homolog 1/2 (EZH1/EZH2), embryonic ectoderm development protein (EED) and suppressor of zeste 12 (SUZ12) in common cutaneous T-cell lymphomas and lymphoproliferative disorders (CTCL/LPD) .Methods:Totally, 93 paraffin-embedded skin samples of CTCL/LPD and 8 of lichen planus were collected from Hospital for Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College between 2012 and 2019, and subjected to immunohistochemical staining to determine the protein expression of EZH2, EED, SUZ12 and EZH1. Statistical analysis was carried out with SPSS 25.0 software by using chi-square test and Spearman correlation analysis.Results:The 93 cases of CTCL/LPD included 44 cases of mycosis fungoides (MF), 17 natural killer/T cell lymphoma (NK/TCL), 8 primary cutaneous anaplastic large cell lymphoma (PC-ALCL), 8 lymphomatoid papulosis (LyP), 8 hydroa vacciniforme-like lymphoproliferative disorder (HV-like LPD) and 8 cases of subcutaneous panniculitis-like T cell lymphoma (SPTCL). Among the 93 CTCL/LPD cases, 83 (89.2%) were positive for EZH2, 81 (87.1%) for EED, 78 (83.9%) for SUZ12 and 37 (39.8%) for EZH1; among the 8 cases of lichen planus, 1 was positive for EZH2, all were positive for EZH1, and all were negative for EED and SUZ12. The expression of EZH2, EED, SUZ12 and EZH1 in lichen planus samples significantly differed from all the CTCL/LPD samples ( χ2 = 41.75, 39.74, 39.36, 32.83, respectively, all P < 0.001), and from MF, NK/TCL, PC-ALCL, LyP, HV-like LPD and SPTCL samples separately (α = 0.008 3, all P < 0.001). Meanwhile, the score of EZH2 expression was negatively correlated with that of EZH1 expression in the MF, NK/TCL, PC-ALCL, LyP, HV-like LPD and SPTCL tissues ( rs = -0.60, -0.68, -0.89, -0.74, -0.93, -0.80, respectively, all P < 0.05) . Conclusion:Polycomb group proteins EZH2, EED, SUZ12 and EZH1 are abnormally expressed in CTCL/LPD lesions.

Histone methyltransferase EZH2 in the pathogenesis of lymphoma / 中华皮肤科杂志

Epigenetic modification is one of the important causes for the occurrence and development of cancers.Enhancer of zeste homolog 2 (EZH2),as an important member of the epigenetic suppressor polycomb group (PcG),can tri-methylate lysine at amino acid position 27 of histone H3 gene,and participates in the regulation of cell cycle,cell aging and cell differentiation.Recently,overexpression or mutation of EZH2 has been detected in a variety of solid tumors and B-cell lymphomas.However,the expression status and action mechanism of EZH2 in some T-cell lymphomas are still unclear,and its action mechanisms in different tumors are not completely consistent,which need further study.

Histone methyltransferase EZH2 in the pathogenesis of lymphoma / 中华皮肤科杂志

Epigenetic modification is one of the important causes for the occurrence and development of cancers. Enhancer of zeste homolog 2 (EZH2) , as an important member of the epigenetic suppressor polycomb group (PcG) , can tri-methylate lysine at amino acid position 27 of histone H3 gene, and participates in the regulation of cell cycle, cell aging and cell differentiation. Recently, overexpression or mutation of EZH2 has been detected in a variety of solid tumors and B-cell lymphomas. However, the expression status and action mechanism of EZH2 in some T-cell lymphomas are still unclear, and its action mechanisms in different tumors are not completely consistent, which need further study.

Characterization of myelin oligodendrocyte glycoprotein (MOG)35-55-specific CD8+ T cells in experimental autoimmune encephalomyelitis / 中华医学杂志(英文版)

BACKGROUND@#The pathogenesis of multiple sclerosis (MS) is mediated primarily by T cells, but most studies of MS and its animal model, experimental autoimmune encephalomyelitis (EAE), have focused on CD4 T cells. The aims of the current study were to determine the pathological interrelationship between CD4 and CD8 autoreactive T cells in MS/EAE.@*METHODS@#Female C57BL/6 mice (n = 20) were induced by myelin oligodendrocyte glycoprotein (MOG)35-55 peptide. At 14 days after immunization, T cells were isolated from the spleen and purified as CD4 and CD8 T cells by using CD4 and CD8 isolation kits, and then the purity was determined by flow cytometric analysis. These cells were stimulated by MOG35-55 peptide and applied to proliferation assays. The interferon-gamma (IFN-γ) and interleukin (IL)-4 secretion of supernatant of cultured CD4 and CD8 T cells were measured by enzyme-linked immunosorbent assays (ELISA). For adoptive transfer, recipient mice were injected with MOG35-55-specific CD8 or CD4 T cells. EAE clinical course was measured by EAE score at 0-5 scale and spinal cord was examined by staining with hematoxylin and eosin and Luxol fast blue staining.@*RESULTS@#CD8CD3 and CD4CD3 cells were 86% and 94% pure of total CD3 cells after CD8/CD4 bead enrichment, respectively. These cells were stimulated by MOG35-55 peptide and applied to proliferation assays. Although the CD8 T cells had a generally lower response to MOG35-55 than CD4 T cells, the response of CD8 T cells was not always dependent on CD4. CD8 T cell secreted less IFN-γ and IL-4 compared with CD4 T cells. EAE was induced in wildtype B6 naïve mice by adoptive transfer of MOG35-55-specific T cells from B6 active-induced EAE (aEAE) mice. A similar EAE score and slight inflammation and demyelination were found in naive B6 mice after transferring of CD8 T cells from immunized B6 mice compared with transfer of CD4 T cells.@*CONCLUSION@#Our data suggest that CD8 autoreactive T cells in EAE have a lower encephalitogenic function but are unique and independent on pathogenic of EAE rather than their CD4 counterparts.

Interocular aberration profiles in different severities of hyperopic anisometropic amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the interocular aberration root mean squares(RMS)characteristics among different severities of hyperopic anisometropic amblyopia.<p>METHODS: Sixty hyperopic anisometropic amblyopia were enrolled and divided into mild, moderate and severe groups. Each group was then divided into amblyopic eye(AE)and fellow eye(FE)subgroups according to the corrected visual acuity of each subject. All patients underwent wavefront analysis with iDesign^© wavefront aberration system(AMO, USA)in mydriasis condition. Paired <i>t</i>-test was used to compare interocular differences of aberration parameters within groups. <p>RESULTS: Paired<i> t</i>-test showed that significant differences in defocus equivalent(DE), BCVA between AE and FE in mild, moderate and severe anisometropic amblyopia(all <i>P</i><0.01). No significant interocular difference was noticed in mild group except for forth-order aberration RMS(<i>P</i><0.01). And No significant interocular differences were noticed in moderate and severe group except for total aberration RMS(both <i>P</i><0.01). One-way ANOVA showed that significant interocular differences were noticed in third-order aberration RMS among the groups(<i>P</i><0.01). LSD showed that interocular difference of third-order aberration RMS in moderate group was significant lower than that in mild and moderate groups(both <i>P</i><0.05). <p>CONCLUSION: In mydriasis condition, mild anisometropic amblyopia showed higher forth-order aberration RMS in AE than that in FE, moderate and sever amblyopia showed higher total aberration RMS in AE than that in FE. Moderate anisometropic amblyopia manifested lower interocular differences of third-order aberrations RMS than mild and severe amblyopia, but no significant interocular differences observed between mild and severe amblyopia.

Clinical efficacy of Da Vinci robot-assisted radical resection for right colon cancer / 中华消化外科杂志

Objective To investigate the clinical efficacy of Da Vinci robot-assisted radical resection for right colon cancer.Methods The retrospective cross-sectional study was conducted.The clinical data of 85 patients with right colon cancer who were admitted to the First Hospital Affiliated to Army Medical University from August 2013 to February 2019 were collected.There were 56 males and 29 females,aged from 29 to 84 years,with an average age of 60 years.All patients underwent Da Vinci robot-assisted radical resection of right colon cancer,named right hemicolon D3 + complete mesocolic excision,and received infection prevention and total parenteral nutrition treatment after surgery.According to clinical pathological staging of guideline issued by National Comprehensive Cancer Network,patients underwent postoperative chemotherapy within 1 year after surgery.Observation indicators:(1) treatment status;(2) postoperative pathological examination;(3) follow-up.Follow-up was conducted using outpatient examination,telephone interview and mail every 3 months within 1 year after surgery,every 6 months from 1 to 3 years after surgery,and once a year from 3 to 5 years after surgery up to March 2019.The postoperative tumor metastasis and survival of patients were obtained.Measurement data with normal distribution were represented as Mean±SD,and measurement data with skewed distribution were described as M (range).Count data were expressed as absolute number.Survival rates were calculated using life-table method.Results (1) Treatment status:85 patients underwent Da Vinci robot-assisted right hemicolon D3 + complete mesocolic excision successfully.The operation time,volume of intraoperative blood loss,time for postoperative outof-bed activities,time to recovery of gastrointestinal function,time to liquid diet intake were (178±28) minutes,(85±33) mL,(2.9± 1.8) days,(3.1 ± 2.7) days,(3.9± 1.9) days,respectively.There was no perioperative death.Eleven patients had postoperative complications including 5 of anastomotic leakage,2 of anastomotic bleeding,2 of pulmonary infection,1 of gastric emptying disorder and 1 of incomplete intestinal obstruction;they were cured and discharged after conservative treatment.All the 85 patients received postoperative infection prevention and total parenteral nutrition support,including 64 receiving systemic intravenous chemotherapy with 6 -8 cycles of FOLFOX or XELOX,7 receiving 6-8 cycles of oral capecitabine,and 14 receiving no chemotherapy.(2) Postoperative pathological examination:the number of harvested lymph nodes was 20± 11 and 25 had lymph node metastasis.The length of proximal and distal cutting edge of the specimens was (16±5) cm and (9±5)cm,respectively.There was no cancerous cell on the cutting edge.High-differentiated adenocarcinoma,moderatedifferentiated adenocarcinoma,moderate-differentiated tubular adenocarcinoma,low-differentiated adenocarcinoma,mucinous adenocarcinoma,tubular combined with mucinous adenocarcinoma were detected in 2,40,14,16,9,4 patients,respectively.There were 8,28,24,5,12,8 patients in Ⅰ stage,Ⅱ A stage,Ⅱ B stage,Ⅱ C stage,ⅢB stage,Ⅲ C stage of TNM staging,respectively.(3) Follow-up:85 patients were followed up for 1-67 months,with a median follow-up time of 19 months.During the follow-up,1 of 85 patients had liver metastasis at 14 months after surgery and had survived after radiofrequency ablation treatment up to the end of follow-up.Three cases died of abdominal tumor metastases,1 of which in Ⅱ C stage died at 32 months after surgery,1 in Ⅲ B stage died at 4 months after surgery and 1 in Ⅲ B stage died at 16 months after surgery.The 1-,3-year overall survival rates were 97.1％ and 94.0％,respectively.Conclusion Da Vinci robot-assisted radical resection of right colon cancer is safe and feasible,with good short-and long-term outcomes.

Weight Gain during Neoadjuvant Chemotherapy is Associated with Worse Outcome among the Patients with Operable Breast Cancer / 한국유방암학회지

PURPOSE: This study was aimed at identifying the influence of initial weight and weight change during neoadjuvant chemotherapy (NAC) on pathologic complete response (pCR) and long-term survival in Chinese patients with operable breast cancer. METHODS: We conducted a retrospective study using data from 409 female patients who received NAC for stage II or III breast cancer and had complete record of body mass index (BMI) before and after NAC. BMI of 2 kg/m² following NAC was considered to be significant, else was considered stable. The study end points included pCR rates, disease-free survival (DFS), and overall survival (OS). RESULTS: The median follow-up time was 43.2 (8.9–93.6) months. The average BMI was 23.40 ± 3.04 kg/m² before NAC and 23.66 ± 3.02 kg/m² after NAC (t = −3.604, p < 0.001). The pCR rate was 25.3% in the NW/UW group and 24.1% in the OW/OB group (p = 0.811), and was similar between the BMI-gain (23.3%) and the BMI-stable/loss (25.1%) groups (p = 0.787). Initial BMI was an independent prognostic factor for DFS (hazard ratio, 1.69; 95% confidence interval [CI], 1.13–2.53; p = 0.011) but not for OS, while BMI-gain was an independent prognostic factor for both DFS (hazard ratio, 2.09; 95% CI, 1.28–3.42; p = 0.003) and OS (hazard ratio, 1.97; 95% CI, 1.04–3.74; p = 0.039). CONCLUSION: BMI increased after NAC in Chinese breast cancer patients. Initial BMI and BMI change during NAC were not associated with pCR but were reversely associated with survival.