T cell immunotherapy mediated by dual-affinity aptamer targeted liposome / 药学学报

Redirecting immune cells to the tumor cells and enhancing its anti-tumor immune response is a very promising cancer treatment strategy. AS1411 aptamers have high affinity for malignant tumors with high nucleolin expression, and cytotoxic T lymphocyte associated protein 4 (CTLA-4) aptamers can specifically bind to CTLA-4, which is expressed by T cells. In this study, a dual-affinity aptamer targeted liposome (Dat. Lipo) was constructed based on AS1411 aptamer and CTLA-4 aptamer, and its immunotherapeutic effect on T cells was studied. After the aptamer was modified with cholesterol, Dat. Lipo was prepared by instillation method; its effect of redirecting T cells was determined by confocal micrographs; its T cell immunotherapy effect was evaluated by cell counting kit-8 (CCK8) and T cell penetration was evaluated by tumor spheroids. The results showed that compared with liposomes loaded with one type aptamer, Dat. Lipo could effectively promote the redirection of T cells to tumor cells; Dat. Lipo had good biosafety and immunotherapeutic effect on MCF-7 and HepG2 cells in a concentration-dependent manner; Dat. Lipo could also promote T cells to infiltrate into the tumor spheroids and enhance the immunotherapy effect of T cells in different dimensions. In summary, Dat. Lipo can use the high affinity of aptamers to redirect T cells to tumor cells, enhance the effect of immunotherapy, and has a promising application prospect in tumor therapy. This study was approved by the Examination Committee of Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Cancer Hospital.

Effect of multi-glycosides of Tripterygium wilfordii on renal injury in diabetic kidney disease rats through NLRP3/caspase-1/GSDMD pyroptosis pathway / 中国中药杂志

This study investigated the effect of multi-glycosides of Tripterygium wilfordii(GTW) on renal injury in diabetic kidney disease(DKD) rats through Nod-like receptor protein 3(NLRP3)/cysteine-aspartic acid protease-1(caspase-1)/gsdermin D(GSDMD) pyroptosis pathway and the mechanism. To be specific, a total of 40 male SD rats were randomized into the normal group(n=8) and modeling group(n=34). In the modeling group, a high-sugar and high-fat diet and one-time intraperitoneal injection of streptozotocin(STZ) were used to induce DKD in rats. After successful modeling, they were randomly classified into model group, valsartan(Diovan) group, and GTW group. Normal group and model group were given normal saline, and the valsartan group and GTW group received(ig) valsartan and GTW, respectively, for 6 weeks. Blood urea nitrogen(BUN), serum creatinine(Scr), alanine ami-notransferase(ALT), albumin(ALB), and 24 hours urinary total protein(24 h-UTP) were determined by biochemical tests. The pathological changes of renal tissue were observed based on hematoxylin and eosin(HE) staining. Serum levels of interleukin-1β(IL-1β) and interleukin-18(IL-18) were detected by enzyme-linked immunosorbent assay(ELISA). Western blot was used to detect the expression of pyroptosis pathway-related proteins in renal tissue, and RT-PCR to determine the expression of pyroptosis pathway-related genes in renal tissue. Compared with the normal group, the model group showed high levels of BUN, Scr, ALT, and 24 h-UTP and serum levels of IL-1β and IL-18(P<0.01), low level of ALB(P<0.01), severe pathological damage to kidney, and high protein and mRNA levels of NLRP3, caspase-1, and GSDMD in renal tissue(P<0.01). Compared with the model group, valsartan group and GTW group had low levels of BUN, Scr, ALT, and 24 h-UTP and serum levels of IL-1β and IL-18(P<0.01), high level of ALB(P<0.01), alleviation of the pathological damage to the kidney, and low protein and mRNA levels of NLRP3, caspase-1, and GSDMD in renal tissue(P<0.01 or P<0.05). GTW may inhibit pyroptosis by decreasing the expression of NLRP3/caspase-1/GSDMD in renal tissue, thereby relieving the inflammatory response of DKD rats and the pathological injury of kidney.

Clinical features and prognosis of childhood B-lineage acute lymphoblastic leukemia expressing the PRAME gene / 中国当代儿科杂志

OBJECTIVES@#To study the clinical and prognostic significance of the preferentially expressed antigen of melanoma (PRAME) gene in the absence of specific fusion gene expression in children with B-lineage acute lymphoblastic leukemia (B-ALL).@*METHODS@#A total of 167 children newly diagnosed with B-ALL were enrolled, among whom 70 were positive for the PRAME gene and 97 were negative. None of the children were positive for MLL-r, BCR/ABL, E2A/PBX1, or ETV6/RUNX1. The PRAME positive and negative groups were analyzed in terms of clinical features, prognosis, and related prognostic factors.@*RESULTS@#Compared with the PRAME negative group, the PRAME positive group had a significantly higher proportion of children with the liver extending >6 cm below the costal margin (P<0.05). There was a significant reduction in the PRAME copy number after induction chemotherapy (P<0.05). In the minimal residual disease (MRD) positive group after induction chemotherapy, the PRAME copy number was not correlated with the MRD level (P>0.05). In the MRD negative group, there was also no correlation between them (P>0.05). The PRAME positive group had a significantly higher 4-year event-free survival rate than the PRAME negative group (87.5%±4.6% vs 73.5%±4.6%, P<0.05), while there was no significant difference between the two groups in the 4-year overall survival rate (88.0%±4.4% vs 85.3%±3.8%, P>0.05). The Cox proportional-hazards regression model analysis showed that positive PRAME expression was a protective factor for event-free survival rate in children with B-ALL (P<0.05).@*CONCLUSIONS@#Although the PRAME gene cannot be monitored as MRD, overexpression of PRAME suggests a good prognosis in B-ALL.

Efficiency of spectral CT iodine concentration value related parameters in diagnosis of regional lymph node metastasis of gastric adenocarcinoma / 中华放射学杂志

Objective:To analyze the efficacy of quantitative parameters related to spectral CT iodine concentration (IC) values in evaluating regional lymph node metastasis in patients with gastric adenocarcinoma.Methods:The clinical data and CT images of 55 patients with gastric adenocarcinoma diagnosed by pathology from June 2021 to June 2022 were collected retrospectively at Shengjing Hospital of China Medical University. Patients were divided into lymph node metastatic lesion group (32 cases) and lymph node non-metastatic lesion group (23 cases) according to whether there were metastatic lymph nodes in all the lymph nodes examined in the pathological results. Then lymph nodes were taken as the research object, and all lymph nodes were divided into the metastatic lymph node group (25 lymph nodes) and the non-metastatic lymph node group (27 lymph nodes) according to the nature of lymph nodes recorded in the pathological report. The IC values and normalized IC (nIC) values of gastric cancer lesions and lymph nodes in the arterial and venous phases (ICa and ICp, nICa and nICp) were obtained. The difference of IC and nIC values between arterial and venous phases (?IC and ?nIC) were calculated, and the arterial enhancement fraction (AEF, ratio of ICa and ICp of lymph nodes ) was calculated. Student′s t test or Mann-Whitney U test was used to compare the differences of quantitative parameters between the two groups. The parameters with statistical differences were analyzed by the receiver operating characteristic curve to obtain the diagnostic efficacy of each parameter in evaluating lymph node metastasis of gastric cancer, and the Z test was used to compare the area under the curve (AUC) of each parameter. Results:The ICp, nICp, ?IC and ?nIC of the lymph node metastatic lesion group were higher than those of the lymph node non-metastatic lesion group (all P<0.05). The AUC were 0.738, 0.746, 0.811 and 0.821. The short diameter, ICa, nICa and AEF values of lymph nodes in the metastatic lymph node group were higher than those in the non-metastatic lymph node group (all P<0.05). The AUC were 0.821, 0.832, 0.734 and 0.863. There were significant differences in AUC between ICp and ?IC, ?nIC ( Z=2.41, 3.29, P=0.016, 0.001), and between nICp and ?IC, ?nIC ( Z=2.10, 3.09, P=0.036, 0.002) in gastric cancer lesions. There were statistically significant differences in AUC between nICa and ICa, AEF ( Z=2.09, 2.41, P=0.037, 0.016) in lymph nodes. Conclusions:The quantitative parameters related to IC values of spectral CT can be applied to evaluate the properties of regional lymph nodes in patients with gastric adenocarcinoma, where ?IC, ?nIC of lesions and AEF of lymph nodes have the best efficacy.

Cardiometabolic disease patterns among elderly patients with colorectal cancer in China / 中华肿瘤杂志

Objective: To explore the distribution patterns of cardiometabolic diseases (CMD) in elderly patients with colorectal cancer, and provide a reference for the prevention and treatment of cardiovascular metabolic diseases in these patients. Methods: Clinical data of 3 894 elderly patients with colorectal cancer from January 2008 to March 2018 admitted in the Chinese PLA General Hospital were recruited and the incidence rate of CMD was retrospectively analyzed. The influence factors of elderly patients with colorectal cancer combined with CMD were analyzed by multivariate Logistic regression model. Results: The morbidity rate of CMD in elderly patients with colorectal cancer is 33.4% (1 301/3 894), among them, the morbidity rate of the male was 31.9% (768/2 409), and that of the female was 35.9% (533/1 485). There was not significant difference between these two sex (P=0.074). The morbidity rates of CMD in patients of 65-74 years, 75-84 years and ≥85 years were 30.6% (754/2 462), 37.0% (479/1 294) and 49.3% (68/138), respectively, with significant differences (P<0.001). Multiple Logistic regression analysis revealed that female (OR=1.213, 95%CI: 1.056-1.394), age (75-84 years group: OR=1.344, 95%CI: 1.164-1.552; ≥85 years group: OR=2.345, 95%CI: 1.651-3.331) and body mass index (BMI 18.5-24.9 kg/m(2) group: OR=1.319, 95%CI: 1.065-1.638; ≥25 kg/m(2) group: OR=2.041, 95%CI: 1.627-2.561) were independent risk factors for elderly colorectal cancer patients with CMD. Conclusion: The morbidity rate of CMD in elderly patients with colorectal cancer increases with age and it is urgent to strengthen multidisciplinary cooperation and develop reasonable treatment plans to extend the survival and life quality of these patients.

The role of FGF21 in the pathogenesis of cardiovascular disease / 中华医学杂志(英文版)

The morbidity and mortality of cardiovascular diseases (CVDs) are increasing worldwide and seriously threaten human life and health. Fibroblast growth factor 21 (FGF21), a metabolic regulator, regulates glucose and lipid metabolism and may exert beneficial effects on the cardiovascular system. In recent years, FGF21 has been found to act directly on the cardiovascular system and may be used as an early biomarker of CVDs. The present review highlights the recent progress in understanding the relationship between FGF21 and CVDs including coronary heart disease, myocardial ischemia, cardiomyopathy, and heart failure and also explores the related mechanism of the cardioprotective effect of FGF21. FGF21 plays an important role in the prediction, treatment, and improvement of prognosis in CVDs. This cardioprotective effect of FGF21 may be achieved by preventing endothelial dysfunction and lipid accumulating, inhibiting cardiomyocyte apoptosis and regulating the associated oxidative stress, inflammation and autophagy. In conclusion, FGF21 is a promising target for the treatment of CVDs, however, its clinical application requires further clarification of the precise role of FGF21 in CVDs.

The Impact of Induction Treatment Response on the Prognosis of Pediatric Core Binding Factor-Acute Myeloid Leukemia Patients / 中国实验血液学杂志

OBJECTIVE@#To explore the impact of induction treatment response on the prognosis of pediatric core binding factor-acute myeloid leukemia (CBF-AML).@*METHODS@#The result of induce reaction and survival data of 157 pediatric CBF-AML patients in our hospital from September 2008 to December 2018 were retrospectively analyzed．The survival rate of the patients with different degrees of morphological remission after induction chemotherapy was comparative analyzed.@*RESULTS@#Among the 157 children with CBF-AML, 113 (72.4%) patients achieved morphologic leukemia-free state (MLFS) after the first course of induction chemotherapy, 153 (98.1%) patients achieved MLFS after the second course of induction chemotherapy. The 5-year event-free survival (EFS) rate and 5-year overall survival (OS) rate of patients with non-remission (NR) status after the first course of induction of chemotherapy was significantly lower than the patients achieved MLFS and the patients achieved partial remission (PR). The 5-year EFS rate and 5-year OS rate of the patients with PR status after the second course of induction chemotherapy were lower than the patients achieved MLFS, but the difference was not statistically significant. Multivariable analyze showed that NR after the first course of induction chemotherapy and myeloid sarcoma were the independent risk factors affecting EFS of the patients. There were six patients with NR status after the first course of induction chemotherapy, in which all of them harbored t(8;21), three of them with sex chromosome deletion, two of them with myeloid sarcoma.@*CONCLUSION@#NR status after the first course of induction chemotherapy was the independent risk factor affecting EFS and OS of CBF-AML patients, it can be taken as an indicator for higher risk stratification. PR status after the first course of induction chemotherapy may not be used as a diagnostic criterion for primary drug resistance.

Advances in anesthesia research of modified electroconvulsive therapy / 上海交通大学学报（医学版）

Modified electroconvulsive therapy (MECT) is a fast and effective physical therapy method currently widely used in psychiatry. The anesthesia target of this treatment is to calm the patients, relax the muscles and maintain stability in histodynamics during treatment, meanwhile avoiding affecting efficacy, because too deep anesthesia can inhibit discharge of the cerebral cortex. However, current anesthetic drugs in MECT, including muscle relaxants, intravenous anaesthetics, inhalation anaesthetics, analgesics, etc., lack the best compatibility of anesthesia induction. This review discusses the application and compatibility of these drugs in MECT in recent years, in order to provide reference for the best anesthesia induction protocol for MECT.

Clinical characteristics and prognostic analysis of pediatric pro-B cell acute lymphoblastic leukemia / 中国当代儿科杂志

OBJECTIVE@#To explore the clinical-biological characteristics and prognosis of pediatric pro-B cell acute lymphoblastic leukemia (pro-B-ALL).@*METHODS@#A total of 64 patients aged less than 18 years old with pro-BALL were enrolled. Clinical characteristics, therapeutic effect and prognostic factors were retrospectively analyzed.@*RESULTS@#Pro-B-ALL occurred in 6.23% (64/1 028) of pediatric ALL. Among the 64 patients, 35 were male and 29 were female. The median age was 7.0 years (range 0.4-16.0 years) at diagnosis, of which 39% and 6% were ≥ 10 years old and < 1 year old respectively. The median WBC count was 25.5×10@*CONCLUSIONS@#Pediatric pro-B ALL is a heterogeneous disease with clinical and biological diversity. Biological characteristics, such as immunological markers, genetic alterations, and MRD at 3 months after chemotherapy may be important factors for the long-term prognosis.

Influence of dasatinib treatment on body height in children with acute myeloid leukemia / 中国当代儿科杂志

OBJECTIVE@#To study the influence of dasatinib treatment on body height in children with acute myeloid leukemia (AML).@*METHODS@#A retrospective analysis was performed for the clinical data of 86 AML children aged <17 years. According to the treatment regimen, these children were divided into a conventional chemotherapy group and a dasatinib chemotherapy group. The 57 children in the conventional chemotherapy group were given conventional chemotherapy drugs without tyrosine kinase inhibitor, and the 29 children in the dasatinib chemotherapy group were given conventional chemotherapy drugs and dasatinib. The two groups were compared in terms of height standard deviation score (HtSDS) at the beginning of treatment and after treatment, as well as the change in HtSDS after 1 and 2 years of treatment.@*RESULTS@#There was no significant difference in HtSDS between the conventional and dasatinib chemotherapy groups before treatment. Within the first two years of treatment, the dasatinib chemotherapy group had a similar change trend of HtSDS as the conventional chemotherapy group. Four children in the dasatinib chemotherapy group reached the final adult height during follow-up, which was significantly lower than the target height (P=0.044). In the conventional chemotherapy group, there was no significant difference between final adult height and target height. In the dasatinib chemotherapy group, the children in adolescence had a significant change in HtSDS after treatment (P=0.032).@*CONCLUSIONS@#Dasatinib treatment may affect the final height of children with AML, and the use of dasatinib after the beginning of adolescence may lead to growth disorder, but dasatinib treatment has little effect on body height in the short-term treatment.

Mutation of CTLA-4 causes primary immunodeficiency disease: One case report / 中国免疫学杂志

The main biological function of cytotoxic T cell-associated protein 4 (CTLA-4) is to suppress the T cell response and suppress the immune response, and its mutation will cause a series of immune related abnormalities. This case reports a rare case of onset of lymphocytosis, immune hemolysis, repeated infection, and other similar symptoms of autoimmune lymphoproliferative syndrome which caused by CTLA4 Exon2 c. 151 C＞T mutation. Sequencing validation was performed to clarify the source of gene mutation. We review the pathogenesis of CTLA4 and new progress in treatment in this case, and the follow-up treatment for the patient was prospected.

Real world study on characteristics of Maixuekang Capsules combined with traditional Chinese medicines in treating nephrotic syndrome / 中国中药杂志

To analyze the clinical characteristics of Maixuekang Capsules combined with traditional Chinese medicines in the treatment of patients with nephrotic syndrome,and provide references for improving rationality of clinical drug use. Based on the database of hospital information system(HIS) in 15 hospitals in China,the electrical medical records of the patients diagnosed as nephrotic syndrome and treated with Maixuekang Capsules were collected. Their diagnostic information and characteristics of combined traditional Chinese medicines were analyzed by using association rules. The results showed that 1 588 patients of nephrotic syndrome who used Maixuekang Capsules were often complicated with hypertension(863 cases,accounting for 7. 54%),anemia(551 cases,accounting for 4. 81%),and coronary heart disease(349 cases,accounting for 3. 05%). Maixuekang Capsules were mainly combined with Tabellae Rhei et Natrii Bicarbonatis,Baining Capsules,tanshinone,Ganmao Qingre Granule,Shuxuening Injection in treating nephrotic syndrome. The results indicated that in the real world,Maixuekang Capsules was mainly used in combination with traditional Chinese medicines such as blood-activating and stasis-removing agents,pathogens eliminating and supporting healthy Qi agents,digestants,anti-bacterial and anti-inflammatory agents,wind-dispersing and antipyretic agents for patients with nephropathy. By the pharmacological effect,it was suitable for nephropathy patients based on combined diagnosis. The association rules of combination were specific,and can provide reference for subsequent studies and rational clinical medication of traditional Chinese medicines.

Effect of Naoshuming decoction on expression of NF-κB, TNF-α, and IL-1β in focal cerebral ischemia rats / 中南大学学报(医学版)

To explore the effect of Naoshuming decoction on cerebral ischemic rats.
 Methods: The model of cerebral ischemia in rats was established via middle cerebral artery occlusion (MCAO). The MCAO model rats were randomly divided into a model group (n=36), a Naoshuming decoction at high dose group (n=36), a Naoshuming decoction at middle dose group (n=36) and a Naoshuming decoction at low dose group (n=36). In addition, a normal group (n=12) and a sham operation group (n=12) were included. Rats in each group were killed on the 3rd, 7th, and 14th day to detect relevant indicators. The Ayelet Levy 14 method was used to score the neurological function. Immunohistochemical method was used to detect the protein expression of nuclear factor kappa-B (NF-κB)/p50, NF-κB/p65, tumor necrosis factor-α (TNF-α), and IL-1β. The quantitative real-time PCR were used to detect the mRNA expression of NF-κB, TNF-α and IL-1β. 
 Results: Compared with the sham group, at each time point, the inflammation indexes in the model group and different dose of Naoshuming decoction groups were significantly enhanced, and all of them showed neurological dysfunction. But the inflammatory indexes and neurological function scores would were gradually improved with the pass of time. Compared with the model group, the neurological dysfunction, the protein levels of NF-κB/p50, NF-κB/p65, TNF-α and IL-1β, and the mRNA of NF-κB, TNF-α and IL-1β in the high, middle and low dose of Naoshuming decoction groups were reduced at 3, 7 and 14 d, with statistical difference (all P<0.05 or P<0.01). 
 Conclusion: Naoshuming decoction can alleviate the cerebral ischemic injury in rats.

Interaction of amoxicillin and nifedipine mediated by intestinal flora / 药学学报

In this study, the change of intestinal microflora in rat fecal samples after amoxicillin administration was observed. In vitro incubation experiments combined with LC-MS/MS assay were used to test the role of intestinal flora in the metabolism of nifedipine. The effect of changes of intestinal flora was determined after amoxicillin administration on the metabolism of nifedipine. We found that the number and types of intestinal flora decreased after taking amoxicillin. After incubation for 12 h, the results showed that the remaining amounts of nifedipine in the N1 group (nifedipine) and N2 group (amoxicillin + nifedipine) were 0.057 6 and 0.064 8 μmol·L-1, respectively, while the remaining amounts of nifedipine after 24 h of incubation were 0.039 6 and 0.050 4 μmol·L-1, respectively. These results show that the intestinal flora is involved in the metabolism of nifedipine. After administration of amoxicillin, the metabolism of nifedipine was slowed down, the AUC0-t was increased by 39.10%, tmax was advanced by 0.45 h, and the CL was reduced 34.71%. The data suggest that the combination may enhance the therapeutic effect of nifedipine. Therefore, drug-drug interactions mediated by gut microbiota cannot be ignored when combined with antibiotics and nifedipine, one of the important factors affecting drug efficacy.

Comparison of flower buds and leaves of Tussilago farfara L. by UHPLC-Q Extractive Hybrid Quadrupole Orbitrap MS / 药学学报

The flower bud of Tussilago farfara L. has been commonly used in the treatment of cough, bronchitis and asthmatic disorders in the Traditional Chinese Medicine. In Europe, the leaves were also used as herbal drugs with similar pharmacological activities. In order to utilize the leaves, it is important to conduct the chemical comparison between the flower buds and the leaves. In this study, ultra high liquid chromatography (UHPLC) coupled with Q Exactive high resolution mass spectrometry (HR-MS) was used to compare the chemical composition of the flower buds and leaves of T. farfara L. forty three metabolites were identified by the combination of targeted and untargeted approach. The results suggest that the sesquiterpenes, such as tussilagone and 7β-(3'-ethyl-cis-crotonoyloxy)-1α-(2'-methylbutyryloxy)-3(14)-dehydro-Z-notonipetranone were higher in the flower buds. While the phenylpropanoids, such as cholorgenic acid and isochlorogenic acid were higher in the leaves. The flavonoids, such as hyperin and quercetin exhibited no difference between the flower buds and leaves, while the rutin and kaempferol were higher in the flower buds. The leaves and flower buds had similar chemical components, and the phenylpropanoids, which were closely related with the antitussive and expectorant activities, were found at higher concentrations in the leaves. The results presented here laid the basis for the rational utilization of the leaves of T. farfara L.

IncRNA EVADR promotes proliferation and migration of human colorectal cancer cell lines / 基础医学与临床

Objective To explore the effect and mechanism of IncRNA EVADR on the proliferation and migration in human colorectal cancer cell lines HCT116 and LOVO. Methods HCT116 and LOVO cell lines were transfected with IncRNA EVADR by overexpressing lentivirus system. CCK8 assay was performed to measure the growth of HCT116 and LOVO cells after overexpression of EVADR. Transwell migration was performed to determine if EVADR promote HCT116 and LOVO cells migration. Finally, the expression of Ecadherin and transcription factor Snail, Slug, ZEB1 and ZEB2 were detected by Western blot and realtime quantitative PCR respectively. Results We successfully established colorectal cancer cells strains HCT116, LOVO which can stably overexpress IncRNA EVADR and the capacity of proliferation and migration in overexpression group was significantly improved (P＜0.05). The expression of Ecadherin was decreased while mesenchymal markers Snail, Slug, ZEB1 and ZEB2 were increased in EVADR overexpression HCT116 and LOVO cells. Conclusions Overexpression of IncRNA EVADR in HCT116 and LOVO cells can significantly promote the proliferation and migration of HCT116 and LOVO cells which may play an important role in regulating epithelial-mesenchymal transition in colorectal cancer cells.

Advances of studies on effect of drug transporter under hypoxia / 中国药理学通报

Plateau environment has the characteristic of low ox-ygen and low pressure, which leads to a series of physiological changes and affects the process of drug metabolism in the body. Many factors affect the pharmacokinetic parameters, including gastric emptying, blood rheology, cardiopulmonary function, hepatorenal function, cytochrome P450 enzyme and so on. The present study focuses on drug metabolic enzymes, since drug transporter is the key factor that mediates drugs in their entrance to the body through the cell membrane, producing the curative effect. In order to provide the reference to further research on the effect of plateau hypoxia on pharmacokinetics and guide the rational use of drugs, we review in this paper the classification of the transporter, mediated drug substrates, the influence of hypoxia on expression levels of drug transporter substrates and the regulatory mechanism of drug transporter under the condition of hypoxia.

Safety and efficacy of the second generation biodegradable polymer Cobalt-Chromium sirolimus-eluting stent (EXCEL 2) stent in diabetic patients:A Subgroup analysis of the CREDIT Ⅱ and CREDIT Ⅲ trials / 中国介入心脏病学杂志

Objective To invesgate the safety and efficacy of the second generation biodegradable polymer Cobalt-Chromium sirolimus-eluting stent (EXCEL2) stent in diabetic patients by a subgroup analysis of of the CREDITⅡand CREDIT Ⅲ trials. Methods All patients who were implanted with the EXCEL2 stent were enrolled in the CREDITⅡand CREDIT Ⅲ trials. The primary endpoint was target lesion failure at 24-month, defi ned as a composite of cardiac death, target vessel myocardial infarction (TV-MI) and target lesion revascularization(TLR). The secondary endpoint was endpoints including all-cause death, all myocardial infarction (MI) or any revascularization.Results A total of 828 patients were included from the patients who were implanted with the EXCEL2 stent in the CREDIT II and CREDIT Ⅲ trials. 24-month follow-up rate was 99.5%. There was no significant difference in the primary endpoint (P>0.05) and event rates of the secondary endpoints(P>0.05) between the diabetic and non-diabetic group, which included all-cause death[diabetics (2.5%)vs.non-diabetics(1.4%),P>0.05],myocardial infarction(MI)(7.5% vs.5.0%,P>0.05),all from of revascularization(5.0% vs.3.9%,P>0.05),and stent thrombosis(0.6% vs.0.4%,P>0.05).Conclusions EXCEL 2 stent met the objective performance goal on effcacy and safety, which can reduce make stent restenosis, target vessel revascularization ,with 160 diabetic cases among them, and stent thrombosis in diabetic patients.

Electroconvulsive treatment for geriatric depression: a systematic review of randomized clinical trials / 上海交通大学学报（医学版）

Objective·To explore the clinical effectiveness and safety of electroconvulsive therapy (ECT) in elderly patients with depression.Methods·Searches were made in PubMed,EMBase,Web of Knowledge,CNKI,Wanfang,VIE CBMDisc databases and etc.CONSORT (Consolidated Standards of Reporting Trials) statement were used to assess the methodological quality of the studies.RevMan and STATA were used to do meta analysis.Results·Ten studies were included in this systematic review.The studies which used Hamilton depression rating scale (HAMD,n=5) and Montgomery-(A)sberg depression rating scale (MADRS,n=3) to access depressed symptom were analyzed.Sample size was 306 and 290 before and after treatment,respectively.The depressive symptoms were significantly improved after ECT treatment estimated by either HAMD (Z=6.39,SMD=3.64,P=0.000) or MADRS (Z=15.47,SMD=2.12,P=0.000).There was no difference of Mini-mental State Examination (MMSE) scores before and after the treatment (Z=1.47,P=0.140).The incidence of adverse events of headache,confusion,drowsiness,nausea and vomiting was more than 5％.Conclusion·Depressed symptoms are significantly improved in geriatric depression after ECT.The overall cognitive impairment is not obvious,but headache and disturbance of consciousness are common.

A study on common bile duct primary suture after laparoscopic choledocholithotomy with bile duct decompression tube / 中华普通外科杂志

Objective To evaluate intraoperative placement of bile duct decompression drainage tube in CBD primary suture after laparoscopic choledocholithotomy.Methods 152 patients undergoing laparoscopic choledocholithotomy were divided into group A (placement of bile duct decompression drainage tube during operation,82 cases) and group B (no decompression drainage tube placement,70 casas).Results There was no significant difference in operative time and intraoperative bleeding between the two groups (P ＞ 0.05).In group B patients the abdominal drainage tube indwelling time,abdominal drainage volume,peritoneal drainage fluid bilirubin value,postoperative hospitalization time were significantly longer than group A,the difference was statistically significant (P ＜ 0.05).No recurrence of choledocholithiasis and biliary stricture were found in either groups.Conclusions Placement of bile duct decompression drainage tube in laparoscopic choledocholithotomy and CBD primary suture after laparoscopic choledochotomy can significantly reduce the incidence of biliary leakage and shorten the postoperative hospital stay.