Molecular mechanism and treatment strategy of colorectal cancer peritoneal metastasis / 中华胃肠外科杂志

Peritoneal metastatic colorectal cancer (pmCRC) is common and has been considered as the terminal stage. The theory of "seed and soil" and "oligometastasis" are the acknowledged hypotheses of pathogenesis of pmCRC. In recent years, the molecular mechanism related to pmCRC has been deeply researched. We realize that the formation of peritoneal metastasis, from detachment of cells from primary tumor to mesothelial adhesion and invasion, depends on the interplay of multiple molecules. Various components of tumor microenvironment also work as regulators in this process. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been widely used in clinical practice as an established treatment for pmCRC. Besides systemic chemotherapy, targeted and immunotherapeutic drugs are also increasingly used to improve prognosis. This article reviews the molecular mechanisms and treatment strategies related to pmCRC.

Two new prenylated 2-arylbenzofurans from roots of Artocarpus heterophyllus and their anti-respiratory burst activities / 中国中药杂志

Two prenylated 2-arylbenzofurans were isolated from roots of Artocarpus heterophyllus, with a combination of various chromatographic approaches, including ODS, MCI, Sephadex LH-20, and semipreparative high performance liquid chromatography(HPLC). They were identified as 5-[6-hydroxy-4-methoxy-5,7-bis(3-methylbut-2-enyl)benzofuran-2-yl]-1,3-benzenediol(1) and 5-[2H,9H-2,2,9,9-tetramethyl-furo[2,3-f]pyrano[2,3-h][1]benzopyran-6-yl]-1,3-benzenediol(2) with spectroscopic methods, such as HR-ESI-MS, IR, 1D NMR, and 2D NMR, and named artoheterins B(1) and C(2), respectively. The anti-respiratory burst activities of the two compounds were evaluated with rat polymorphonuclear neutrophils(PMNs) stimulated by phorbol 12-myristate 13-acetate(PMA). The results showed that 1 and 2 exhibited significant inhibitory effect on respiratory burst of PMNs with IC_(50) values of 0.27 and 1.53 μmol·L~(-1), respectively.

Traditional Chinese Medicine Syndromes and Influencing Factors of Protein Energy Wasting in Chronic Kidney Disease Patients Undergoing Maintenance Hemodialysis：a Cross-sectional Study / 中医杂志

ObjectiveTo investigate the distribution of traditional Chinese medicine （TCM） syndrome types and influencing factors of protein-energy wasting （PEW） in chronic kidney disease （CKD） undergoing maintenance hemodialysis （MHD）. MethodsAccording to diagnostic criteria， 164 patients with MHD were divided into PEW group and non-PEW group. The clinical data of all patients were collected， including general information such as gender， age， height and weight， disease characteristics such as course， cormobidity， and haemodialysis duration， laboratory indicators such as blood routine， liver function， renal function， electrolyte， blood lipid， grip strength， and the four examinations. Logistic regression analysis was used to find the influencing factors of PEW by taking the clinical indicators with significant differences between the two groups （P＜0.05） as the independent variables， diagnosis of PEW as the dependent variable， and normal values as the reference. ResultsOut of 164 patients with MHD， there were 96 （58.5%） cases in PEW group and 68 cases （41.5%） in non-PEW group. Compared to the non-PEW group，PEW group had increased age， ratios of bedrest， deep vein preservation， edema， and low grip strength， percentages of comorbidities type 2 diabetes， cardiovascular and cerebrovascular diseases，infections and anemia， and levels of alanine aminotransferase and permine amin aminotransferase， as well as decreased body mass index， self-care ratio，internal arteriovenous fistula， red blood cell count， hemoglobin， serum total protein， serum albumin levels （P＜0.05）. The PEW group had significantly higher frequency of poor appetite and digestion， abdominal distension， fear of cold and preference of warmth， weak breathing and fatigue， poor appetite， oliguria， nausea and vomiting than non-PEW group （P＜0.05）. The incidence of both yin and yang deficiency syndrome and damp-turbidity syndrome were significantly higher in the PEW group than the non-PEW group， while that of liver-kidney yin deficiency syndrome and stirring of wind syndrome were lower （P＜0.05）. Logistic regression analysis showed that low BMI （＜22 kg/m2）， inability to take care of oneself， low grip strength，low serum albumin （＜38 g/L）， infection， older age， fear of cold and cold limbs，and poor appetite were the risk factors of PEW in patients undergoing MHD （P＜0.05）. ConclusionThe root syndrome of MHD-PEW patients is both yin and yang deficiency， concurrent with damp-turbidity syndrome. Low BMI， low serum albumin， infection and older age may be the influencing factors of PEW in patients undergoing MHD.

Application of control charts in hospital data quality management / 中华医院管理杂志

Objective:To study the feasibility of control charts in the quality management of hospital statistical data as a reference for improving such management.Methods:Main business indicators of the main campus and some business indicators of the affiliated campus of a tertiary general hospital from January to May 2022 were selected. K-S test and chi-square goodness of fit test were used to test data in its statistical daily report, analyzing whether the data conform to the specific distributions. Then appropriat control chart were used according to the data type and distribution type. Minitab 21.1 software was used to draw the hospital data quality control chart, and data quality was monitored by analyzing the distribution of data points in the control chart.Results:The test found that the number of admissions, ultrasound examinations and emergency department visits in the main campus, and CT examinations in the affiliated campus, conformed to normal distribution, and single value control charts were applied. The number of ambulance trips in the main campus and the affiliated campus conform to Poisson distribution, and the defect number control chart was applied. The number of inpatient deaths in the main campus conform to a geometric distribution, and a rare event control chart was applied. The volume of admissions and ultrasound examinations in the main campus were mostly influenced by other factors, and the single-value selective control chart was used to further determine the cause of abnormal data distribution. The results of the control chart analysis showed that, there were no abnormal points in the data distribution of admissions, color ultrasound volume and in-hospital deaths in the main campus, two abnormal points in the CT examination volume in the affiliated campus. The control charts for the number of emergency department visits in the main campus and the number of ambulance trips in the main and affiliated campuses each had one outlier. It was verified that one anomaly in the volume of CT examinations in the affiliated campus and one anomaly in the number of ambulance trips in the affiliated campus were caused by data errors, while the other data were correct.Conclusions:It is feasible to use control charts to monitor the quality of hospital data, which can be used as a quality management tool to assist the quality management of hospital data.

Preventive and therapeutic effects and mechanism of Xiaoer Feike Granules on chronic bronchitis induced by lipopolysaccharide in rats / 中国中药杂志

The aim of this paper was to investigate the preventive and therapeutic effects of Xiaoer Feike Granules(XEFK) on chronic bronchitis in rats and its mechanism. Except for 10 rats in the blank group, the remaining 50 of the 60 SD rats were used to establish a model of chronic bronchitis induced by LPS. On the 22 nd day, the model rats were randomly divided into 5 groups according to their body weight, and administrated with purified water, Keteling Capsules 0.11 g·kg~(-1), XEFK 3.2, 1.6 and 0.8 g·kg~(-1)(the dosing concentrations were 0.32, 0.16, 0.08 g·mL~(-1), respectively). These rats took the corresponding drug orally once a day, for consecutive 21 days. The rats were anesthetized 1 hour after the last administration, and the lavage bronchus and alveoli were collected. Then, after the fixation of the smear, neutrophils were counted microscopically, and the contents of glutathione peroxidase(GSH-Px), superoxide dismutase(SOD) and malondialdehyde(MDA) in the bronchoalveolar lavage fluid(BALF) were detected by colorimetric method. Flow cytometry was used to detect the content changes of T cell subsets CD4~+, CD8~+, CD4~+/CD8~(+ )in serum. Hemorheology related indexes were detected by automatic hemorheology. Enzyme-linked immunosorbent assay(ELISA) was used to detect the contents of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), IL-2, IL-6 and IL-10 in serum. The expression of TNF-α and IL-10 mRNA in lung was detected by Real-time quantitative PCR(RT-qPCR). HE staining was used to observe the pathological changes in the bronchitis tissues. Compared with the model group, XEFK high and medium dose groups could significantly reduce the contents of neutrophils and MDA in bronchial lavage fluid, and increase the activities of GSH-Px and SOD in BALF, and repair the chronic inflammatory cell infiltration and lymphoid tissue hyperplasia in the bronchial mucosal layer and submucosal layer. The high-dose group could reduce the plasma viscosity of rats, but there was no statistical difference in other hemorheological indexes. CD4~+, CD8~+, CD4~+/CD8~+, IL-2 and IL-10 contents in each dose group were significantly increased, and TNF-α, IL-1β and IL-6 contents were significantly decreased in serum. Each dose group could significantly down-regulate the expression level of TNF-α mRNA in the lung and increase the expression of IL-10 mRNA. XEFK could reduce lipid peroxidation, increase the content of peripheral blood T cell subsets, regulate the release and secretion of inflammatory factors, and repair the morphological and pathological changes of bronchial tissue. Its mechanism might be related to the improvement of inflammatory response and the enhancement of immune function.

Research progress on the exposure pathway and toxic effect of microplastics / 中国职业医学

Global plastics production has been increasing year by year. Due to the large quantity of plastics and the difficulty of their degradation, plastics are continuously accumulated in the environment. Therefore, plastic waste has become one of the most serious threats to the global environment. Microplastics can be absorbed into organisms through the mouth, respiratory tract and skin, causing organ(intestine, liver) toxicity, reproductive and developmental toxicity, and neurotoxicity. Moreover, microplastics can also take up other pollutants distributed in the surrounding environment, such as heavy metals and organic pollutants, jointly exerting combined toxic effects. The extracts of microplastics, including microplastics unstable polymers and additives, also have toxic effects. The molecular mechanisms involved in the toxic effects induced by microplastics include oxidative stress, inflammation, disturbance of intestinal flora, disturbance of gene expression, and others.

Feasibility of fundus imaging in cataractous eyes by Retinal Health Assessment System / 中华实验眼科杂志

Objective:To study the ability of the Retinal Health Assessment (RHA) system to obtain fundus images in patients with different types and degrees of cataracts.Methods:A cross-sectional study was performed.Forty-five eyes of 41 patients with cataract were enrolled in First People's Hospital, Shanghai Jiaotong University from December 2016 to January 2017.Lens opacity grading and RHA fundus imaging were performed after pupil dilation.Forty-five eyes were divided into 4 groups according to the degree of lens opacity: cortical cataract group 18 eyes, nucleus cataract group 21 eyes, posterior subcapsular cataract group 2 eyes, hybrid cataract group 4 eyes.Fundus images were obtained by FullSpectrum mode of RHA2020, and the clearness of fundus images was evaluated.Scores of fundus images clarity were compared between the cortical cataract group and nucleus cataract group.This study was approved by the Ethics Committee of First People's Hospital, Shanghai Jiaotong University.Written informed consent was obtained from each patient prior to any medical examination.Results:In all 45 eyes, the phacoscotasmus classification ranged from mildest (C0N2P0, 1 eye) to very serious (C2N5P2 and C4N2P4, 2 eyes). The grade Ⅳ nuclear opacity, grade Ⅲ cortical opacity, and grade Ⅲ posterior subcapsular opacity reduced the quality of RHA images significantly, especially for images with red and green light.In cortical cataract group, images showed peripapillary vessels and retinal vessels at 580 nm and 590 nm, while retinal and choroidal vessels, as well as choroidal pigmentation, were visible at 810 nm.The clarity scores at 580, 590 and 810 nm were 2.0 (1.0, 3.0), 2.0 (2.0, 3.0) and 2.0 (2.0, 3.0), which were lower than that with red and green light (620 nm + 550 nm) (3.0[2.0, 3.0]), with statistically significant differences (all at P<0.05). In nucleus cataract group, the quality of fundus images from the eyes with grade Ⅲ nucleus cataracts was good, the image quality decreased when the nucleus opacity was grade Ⅳ, retinal vessels were occasionally observed at 580 nm and 590 nm.Additionally, retinal and choroidal vessels and choroidal pigment were visible at 810 nm and 850 nm.The clarity scores at 580, 590, 810 and 850 nm were 1.0 (1.0, 3.0), 2.0 (1.0, 3.0) and 2.0 (1.0, 3.0), which were lower than that with red and green light (620 nm + 550 nm) (3.0[1.5, 3.0]), with statistically significant differences (all at P<0.05). In posterior subcapsular cataract group, the retinal vessels were visible at 580 nm, meanwhile retinal and choroidal vessels and choroidal pigment could be observed at 810 nm and 850 nm.In hybrid cataract group, running lines of retinal vessels could be seen at 850 nm, while the central reflection was absent.Focal choroidal vessels were observed. Conclusions:Except for severe cases, RHA system can produce good quality fundus images in cataract eyes at 580, 590, 810 and 850 nm, facilitating the evaluation of fundus disease before surgery and prediction of visual outcomes after surgery.

Efficacy of Small Dose HAG Regimen Combined with Decitabine in Treatment of Elderly Patients with Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To study the efficacy of small dose HAG combined with decitabine regimen in the treatment of elderly patients with acute myeloid leukemia (AML).@*METHODS@#134 elderly AML patients treated in our hospital from March 2015 to December 2018 were selected, and the patients were divided into CAG group and combined treatment group. The AML patients in CAG group was treated with CAG regimen, while the AML patients in combined treatment group was treated with small dose HAG regimen combined with decitabine. Efficacy was evaluated after treatment.@*RESULTS@#After treatment, the OR rate of the patients in combined treatment group was significantly higher than that in CAG group (χ=5.311, P=0.021). The nausea and vomiting rate, infection rate, myelosuppression rate, bleeding rate and intestinal discomfort rate showed no significant difference between the two groups (P＞0.05). The CD3, CD4 and CD8 levels of patients in combined treatment group were significantly lower than those in CAG group (P＜0.05). The result of followed-up for 2 years, showed that the overall survival rate of patients in combined treatment group was significantly higher than that in CAG group [(76.2±6.3)% vs (45.7±7.6)%] (χ=4.214, P＜0.05), while the disease free survival rate of patients in combined treatment group were (57.4±7.7)%, which was significantly higher than that in CAG group (30.3±7.9)% (χ=5.250, P＜0.05).@*CONCLUSION@#Small dose HAG regimen combined with decitabine for elderly patients with acute myeloid leukemia has a certain curative efficacy.

Analysis of correlation between underweight and pulmonary function in healthy adults / 公共卫生与预防医学

Objective To investigate the relationship between underweight and pulmonary function in the general population. Methods A total of 2 350 patients who underwent a pulmonary function examination at Chongqing Three Gorges Central Hospital from January to June 2019 were selected as the study subjects. The subjects were divided into three groups based on their BMI value including underweight (2), normal weight (BMI between 18.5 kg/m2 and 25 kg/m2), and overweight and obese (≥25 kg/m2). Results Subjects in the overweight group had significantly worse biochemical indicators compared with underweight and normal weight subjects, but the frequency of strenuous exercise of the underweight subjects was significantly lower than that of the other two groups (P<0.001). Compared to the normal weight and overweight groups, the underweight group had lower level of forced expiratory volume in first second (FEV1), predicted FEV1(%), forced vital capacity (FVC), predicted FVC(%), and peak expiratory flow (PEF) (P<0.001), but higher level of FEV1/FVC, as well as predicted FEV1 (%)<80% and predicted FVC (%)<80%. Multivariate logistic regression model analysis showed that after adjusting for multiple confounding factors, the risk of reduced lung function in underweight group increased significantly, and the odd ratios were 2.10 (95%CI 1.98–2.21) and 4.90 (95%CI 4.62–5.18) for FEV1(%)<80% and FVC%<80%, respectively. Conclusion This study demonstrated that in the general population, the underweight was significantly associated with reduced lung function.

Genetic diversity of endophytic fungi strains Fusarium proliferatum isolated from Belamcanda chinensis using ISSR and SRAP markers / 中草药

Objective: In order to understand the genetic diversity of endophytic fungi strain Fusarium proliferatum isolated from Belamcanda chinensis. Methods: A total of 52 ISSR primers and 90 SRAP primers were used to detect the genetic diversity among 17 F. proliferatum strains. Results: The results indicated that 27 ISSR primers and 38 SRAP primers were screened out for the genetic diversity analysis. 178 bands were amplified from 27 ISSR primers, among which 131 (63%) allelic variations were detected. However, 357 bands were amplified by 38 SRAP primers, among which 323 (91%) allelic variations were detected. The value of allelic polymorphism information content (PIC) of ISSR primers ranged from 0.19 to 0.91, with the average of 0.70 per primer. The value of PIC of SRAP primers ranged from 0.00 to 0.93, with the average of 0.72 per primer. The value of Nei's genetic similarity (GS) indexes of 17 strains based on ISSR, SRAP and ISSR + SRAP genetic locus varied from 0.73-0.99, 0.72-0.95 and 0.73-0.95, and with the average of 0.84, 0.85 and 0.85, separately. Cluster analysis showed that the 17 strains in this study could be clustered into three groups, three strains from the roots were clustered together, and F. proliferatum strains isolated from stems and leaves were gathered in other two groups. Cluster analysis revealed that genetic similarity of 17 strains were high, this suggested that the 17 strains had a near relationship, in accordance with the traditional morphology identification. Conclusion: The results show that the ISSR and SRAP technology is more efficient than traditional morphology identification. It is also found that ISSR and SRAP markers could more really reflect the genetic diversity of endophytic fungi strain F. proliferatum from B. chinensis, which can provide the basis for the application of molecular biotechnology in endophytic fungi of F. proliferatum from B. chinensis.

Clinical Efficacy of Modified Shenling Baizhu San in Treatment of Hashimoto's Thyroiditis / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of modified Shenling Baizhu San combined with thyroxine tablets in the treatment of Hashimoto's thyroiditis (HT). Method:The 68 patients with HT were randomly divided into treatment group and control group, with 34 patients in each group. Control group was treated with thyroxine tablets alone, while treatment group was treated with modified Shenling Baizhu San in addition to the therapy of control group. Free triiodothyronine (FT3), free Thyroxine (FT4), thyroid stimulating hormone (TSH), serum thyroid peroxidase antibody (TPOAb) and thyroglobulin were observed before and after treatment in the two groups of HT patients. The changes of thyroglobulin antibody (TgAb) and traditional Chinese medicine (TCM) syndrome score, and the safety of TCM prescription were observed. Result:After 3 months of treatment, the effective rate of treatment group was 91.2%, which was significantly higher than 70.6% of control group, with statistically significant difference (PPP3 and FT4 in treatment group and control group increased significantly after 3 months of treatment (PPPPConclusion:Modified Shenling Baizhu San combined with thyroxine tablets in the treatment of HT is more effective than simple thyroxine tablets, which is worthy of further clinical and experimental study.

Effect of Puerarin Combined with Tanshinone ⅡA on t-PA, PAI-1 and Oxidative Stress in DM Rats with Vascular Lesions / 中国实验方剂学杂志

Objective:To observe the protective effect and mechanism of combination of puerarin combined with tanshinone ⅡA on diabetes mellitus (DM) rats with vascular lesions. Method:The SD rats (fed with high-fat diet) were administrated with streptozotocin(STZ) through intravenous injection to make the model of diabetic vascular lesions. The successfully modeled rats were randomly divided into the model control group, the high-dose group (0.5 g·kg-1+1.0 g·kg-1), the middle-dose group (0.25 g·kg-1+0.5 g·kg-1), the low-dose group (0.05 g·kg-1+0.1 g·kg-1), the puerarin group (0.25 g·kg-1), the tanshinone ⅡA group (0.5 g·kg-1) and the positive control group (Metformin, 0.09 g·kg-1). Each group was administrated with drugs respectively by gavage for 70 days. After intervention in each group, the general conditions and body weight of the rats were observed. The contents of blood grucose and blood lipids were determined by automatic biochemical analyzer. The contents of insulin, advanced glycation end products (AGEs), superoxide dismutase(SOD), glutathione peroxidase (GSH-Px) in serum, the contents of tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and thromboxane B2 (TXB2) in plasma, as well as the contents of AGEs and oxidized low-density lipoprotein(ox-LDL) in aorta homogenate were detected by enzyme-linked immunosorbent assay(ELISA). The content of malondialdehyde(MDA) in serum was determined by chemical colorimetry. Pathological changes of coronary tissue were observed by htoxylin eosin(HE) staining. The expression of PAI-1 protein of aorta was observed by immunohistochemistry. Result:Compared with the normal control group, in the model group, the levels of blood grucose and blood lipids (PPPP2 in plasma (PPPPPPPPP2 in plasma (PPPPPPPConclusion:Puerarin combined with Tanshinone ⅡA could relieve vascular lesions of DM rats. The mechanisms may be related to the reduction of oxidative stress and the regulation of coagulation-fibrinolysis system.

Comparation of Clinical Efficacy between Two Regimens of Preexcitation Chemotherapy for MDS-RAEB Patients / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy and safely of DAC and CAG/HAG preexcitation chemotherapy regimens for the treatment of patients with MDS-RAEB (refractory anemia with excess blasts, RAEB).@*METHODS@#The clinical data of 86 MDS-RAEB patients were analyzed retrospectively from February 2014 to February 2018. According to therapeutic regimem, the 86 patients were divided into 2 groups: group A (41 patients) with DAC preexcitation chemotherapy regimen, and group B (45 patients) with CAG/HAG preexcitation chemotherapy regimen; and the disease control effect, effective treatment course, median survival time and incidence of adverse reactions were compared between these 2 groups.@*RESULTS@#The CR rate and ORR rate were not significantly different between these 2 groups (P＞0.05). The mCR rate in group A was significantly higher than that in group B (P＜0.05). The numbers of cases obtained therapeutic efficacy at 2 rd and 3 rd conrse in group A significantly more than those in group B (P＜0.05), but the number of cases obtained efficacy at 1 st course in group B was significantly higher than that in group A (P＜0.05). The median OS time was not significanly different between 2 groups (P＞0.05). The duration of neutrophils deficiency in group A was significantly shorter than that in group B (P＜0.05). The transfusion volume of red blood cells and platelets in group A was significantly less than that of group B (P＜0.05). The incidence of neutropenia, anemia and thrombocytopenia of III-IV grade at different treatment courses of group A were significantly lower than that in group B (P＜0.05). The incidence of infection of III-IV grade in group A at 3rd treatment course was significantly lower than that in group B (P＜0.05).@*CONCLUSION@#Preexcitation chemotherapy regimens of DAC and CAG/HAG for the treatment of MDS-RAEB possess the same effects for disease control; application of DAC regimen can efficiently reduce the risk of adverse reaction, but CAG/HAG regimen can be helpful to accelerate the effective process of treatment.

Short-Term Therapeutic Efficacy, Survival Time and Side Effects in Treatment of Newly Diagnosed Multiple Myeloma Patients with Different Chemotherapeutic Regimens / 中国实验血液学杂志

OBJECTIVE@#To investigate the short-term therapeutic efficacy, survival time and side effects in newly diagnosed multiple myeloma patients treated with TCD regimen consisted of thalidomide, cyclophosphiamide and dexamethasone, and BCD reginen consisted of bortezomib, cyclophsphamide and dexamethasone.@*METHODS@#The clinical data of newly diagnosed MM patients admitted in our hospital from January 2011 to January 2018 were collected and analyzed retrospectively. According to chemotherapectic regimen, 106 patients were divided into 2 groups: 53 cases in one group were treated with TCD regimen (TCD group), and 53 cases in another group were treaded with BCD regimen (BCD group). The therapeutic efficacy, median PFS and OS time and incidence of side effects in 2 groups were compared, at the same time the relationship of the remission degree and the factors in different subgroups with the therapeutic efficacy was analyzed in 2 groups.@*RESULTS@#There was no significant difference in the ≥MR rate between 2 groups (P＞0.05). The ≥PR rate, ≥VGPR rate and CR rate of BCD group were significantly higher than TCD group (P＜0.05). The median PFS time of patients in BCD group were significantly longer than that in TCD group (P＜0.05). There was no significant difference in the median OS time of patients between 2 groups (P＜0.05). The median OS time of ≥MR patients in TCD group was significantly longer than that of ＜MR patients (P＜0.05). The median OS time of ≥PR patients in TCD group were significantly longer than that of ＜PR patients (P＜0.05). The median OS time of ≥VGPR patients in BCD group was significantly longer than that of ＜VGPR patients (P＜0.05). There was no significant difference in the median OS time of ≥PR and ＜PR patients in BCD group (P＞0.05). The ORR of ≥VGPR patients in BCD group was significantly higher than that in TCD group (P＜0.05). There was no significant difference in the incidence of infection, fatigue, gastrointestinal reactions and bone marrow suppression between 2 groups (P＜0.05). The incidence of numbness in distal extremities and herpes zoster in BCD group was significantly higher than that in TCD group (P＜0.05).@*CONCLUSION@#TCD and BCD in the treatment of patients with NDMM possess the same disease control effects; BCD regimen application can efficiently improve remission degree and prolong PFS time; but TCD regimen application have the advantages in reducing the side effects risk and improving treatment tolerance.

Clinical Feature Analysis for Respiratory Disease and/or Hypoxia Related Pulmonary Hypertension in 31 Patients / 中国循环杂志

Objective: To investigate the clinical features in patients with respiratory disease and/or hypoxia related severe pulmonary hypertension. Methods: Our research included in 2 groups: Hypoxia related pulmonary hypertension group, the patients with respiratory disease and/or hypoxia combining severe pulmonary hypertension, n=31 and Severe idiopathic pulmonary hypertension group, n=41. The diagnosis was confirmed by right heart catheterization; the patients treated in our hospital from 2016-01 to 2017-01 were consecutively enrolled and studied. Clinical features and treatment were compared between 2 groups. Results: Compared with Severe idiopathic pulmonary hypertension group, the patients' mean age, BMI and blood pressure were higher in Hypoxia related pulmonary hypertension group, while the majority clinical features were similar between 2 groups. In Hypoxia related pulmonary hypertension group, more patients had obstructive sleep apnea-hypopnea syndrome (OSAHS) with the higher AHI and the lower mean blood oxygen pressure at night, increased diameters of left atria and ventricle, elevated NT-proBNP level and reduced 6 minutes walking distance; some patients tried target drug therapy, calcium channel blocker therapy or continuous positive airway pressure therapy. Conclusion: Respiratory disease especially OSAHS should be screened from the patients with severe pulmonary hypertension. In addition to basic respiratory and hypoxia medication, further investigation is needed to confirm whether the prognosis could be improved by calcium channel blocker therapy and target drug therapy.

Clinical Features in Pulmonary Hypertension Patients Combining Obstructive Sleep Apnea / 中国循环杂志

Objective: To observe clinical features in pulmonary hypertension (PH) patients combining obstructive sleep apnea (OSA). Methods: Sleep apnea monitoring was conducted in 65 PH patients with right cardiac catheterization in our hospital from 2016-04 to 2016-08. General clinical tests and the parameters of sleep respiration and right cardiac catheterization were recorded. OSA was diagnosed by apnea hypopnea index (AHI)≥5, different parameters were compared between PH patients with and without OSA. Results: The average patients' age was (41.98±15.26) years including 72.31% (47/65) female, 26 (40%) patients combining OSA with the mean AHI at (18.12±13.40). Compared to those without OSA, PH with OSA patients had the elder age, more male and higher proportions of chronic thromboembolic PH, lung diseases or hypoxia; increased AHI, apnea index (AI), obstructive AI (oAI); more patients with nocturnal hypoxia>10% and SaO2<90%, increased BMI, more NYHA Ⅲ and elevated NT-proBNP; while decreased mean oxygen saturation, minimum oxygen saturation, PaO2, 6 minute walk distance and cardiac index, all P<0.05. Drug therapy was similar between 2 groups. Conclusion: Nocturnal hypoxia and OSA were common in PH patients, elder age and male gender were the risk factors for PH combining OSA; the patients had lower partial pressure of oxygen especially at night, longer time of hypoxia and severer cardiac function damage. It is necessary to conduct sleep apnea monitoring to alert sleep apnea and hypoxia in relevant patients.

Chemical constituents from the leaves of Cyclocarya paliurus / 中成药

AIM To study the chemical constituents from the leaves of Cyclocarya paliurus (Batal.) lljinskaja.METHODS The ethyl acetate fraction of methanol extract from C.paliurus leaves was isolated and purified by silica,ODS and semi-preparative HPLC,then the structures of obtained compounds were identified by spectral data.RESULTS Eleven compounds were isolated and identified as (6S,7R,8R)-7α-[(β-glucopyranosyl) oxy] lyoniresinol (1),lyoniside (2),(-)-lyoniresinol 3 α-O-β-D-xylopyranoside (3),dihydrodehydrodiconiferyl alcohol 4'-O-β-D-glucoside (4),kaempferol-3-O-α-L-rhamnoside (5),kaempferol-3-O-α-L-(4"-Z-p-cumaroyl)-rhamnoside (6),naringenin (7),4'-hydroxywogonin (8),1-(3',4'-dihydroxyphenyl)-7-(4"-hydroxyphenyl)-4-hepten-3-one (9),grasshopper ketone (10),p-hydroxybenzoic acid (11).CONCLUSION Except for compounds 5,11,all the compounds are isolated from this plant for the first time.

Peri-operative Management and Result of Pulmonary Endarterectomy in 56 Patients / 中国循环杂志

Objective: To summarize the peri-operative management experience of pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods: A total of 56 CTEPH patients received PEA in our hospital from 2015-01 to 2016-11 were retrospectively analyzed. Our study was focused on the medication in respiratory and circulatory system during ICU stay, peri-operative application of vasoactive drug and target drug to pulmonary hypertension (HP), usage of ventilators, mechanical assisted devices and other management experiences. Results: No peri-operative death occurred. There were 2/56 (3.6%) patients with lung reperfusion, 2 (3.6%) with PH crisis. Compared with pre-operation, the post-operative pulmonary artery hemodynamics parameters were improved as right heart catheter measured pulmonary artery systolic pressure (PASP) decreased from (85.05±22.40) mmHg to (36.83 ±17.21) mmHg and pulmonary vascular resistance decreased from (773.84±342.95) dyn·s·cm-5 to (293.59±214.95) dyn·s·cm-5. Post-operative oxygen saturation was maintained at (95-100) % in all patients. Echocardiography found that PASP from pre-operation (85.03±25.78) mmHg decreased to (39.44±19.24) mmHg at follow-up period, P<0.01.Conclusion: A comprehensive peri-operative management of PEA was helpful to improve pulmonary hemodynamics in CTEPH patients; meanwhile, effective prevention and treatment of severe complication could obviously reduce peri-operative mortality.

Effective study in the real-world study of intravitreal anti-VEGF drugs injection in the treatment of fundus diseases / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To understand the clinic effect of intravitreal anti-vascular endothelial growth factor(VEGF) drugs injection in the treatment of fundus disease in the real-world study (RWS).METHODS:The clinical cases treated with anti-VEGF drugs in our department from September 2012 to June 2015 were enrolled in this study.Retrospective investigation was reviewed to the kinds of diseases, frequency, usage, efficacy, adverse reaction, and the effects on visual acuity, fundus and macular thickness which were treated with intravitreal anti-VEGF drugs injection.RESULTS:In 305 patients (340 eyes) treated with anti-VEGF drugs, 53 patients (60 eyes, 17.6%) were wet age-related macular degeneration (AMD), polypoidal choroidal vasculopathy (PCV) 16 cases (18 eyes, 5.3%), diabetic macular edema (DME) 120 cases (134 eyes, 39.4%), branch retinal vein occlusion (BRVO) secondary macular edema 61 cases (68 eyes, 20.0%), central retinal vein occlusion (CRVO) secondary macular edema 29 cases (32 eyes, 9.4%), idiopathic choroidal neovascularization (ICNV) 16 cases (18 eyes, 5.3%), high myopia with choroid neovascularization 4 cases (4 eyes, 1.2%), neovascular glaucoma 4 cases (4 eyes, 1.2%), retinal angiomatous proliferation (RAP) 1 cases (1 eyes, 0.2%) and optic papillary neovascularization 1 cases (1 eyes, 0.2%).The minimum age was 16 years old, and the maximum age 90 years old.There were 247 cases (275 eyes, 80.9%) were treated with intravitreal ranibizumab injection, 58 cases (65 eyes, 19.1%) intravitreal conbercept injection.The time number of all patients accepted anti-VEGF drugs treatment was 465, with an average of 1.7 times per eye.Which, the 3 + PRN treatment method in 98 patients (109 eyes, 32.1%), 1 + PRN treatment in 207 patients (231 eyes, 67.9%).69 cases (77 eyes, 22.6%) were used alone to receive anti-VEGF drugs therapy, 10 cases (11 eyes, 3.2%) combined with intravitreal triamcinolone injection(TA), 35 cases (39 eyes, 11.5%) combined with vitrectomy, 26 cases (29 eyes, 8.5%) combined with photodynamic treatment (PDT), 165 cases (184 eyes, 54.1%) combined with simple laser treatment.After anti-VEGF drug treatment, majority of patients' the best corrected visual acuity (BCVA), fundus and central macular thickness(CMT) were significantly improved, compared with the pre-treatment, the difference is significant (P<0.05).So that anti-VEGF drugs can effectively improve visual function and ocular fundus for fundus diseses.There were no serious adverse reactions except 3 patients appearling skin redness, itching, rash, 1 patient low low-grade fever and 1 patient acute cerebral infarction during the treatment.CONCLUSION:Intravitreal anti-VEGF drugs injection can significantly improve the visual function and ocular fundus for patients with fundus diseases, but there are still some adverse events, which should be attached great importance to medical workers.

Analysis of visual acuity and macular edema in patients with diabetic retinopathy after laser treatment / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To analyze curative effect of laser treatment for diabetic retinopathy (DR).METHODS:A total of 100 patients (136 eyes) with DR who were admitted to our hospital during January 2015 to December 2016 were enrolled in the study.All patients were given 532nm laser treatment.Changes of visual acuity and the incidence of complications were statistically analyzed after treatment, and the macula central fovea retinal thickness and hemodynamic changes of affected eyes were compared before and after treatment.The effects of laser treatment were compared among patients with different types of diabetes, patients in different DR stages and patients with different glycosylated hemoglobin (HbAlc) levels.RESULTS:After treatment, the macula central fovea retinal thickness, end diastolic velocity (EDV), pulsatility index (PI) and central retinal artery (CRA), mean flow velocity (Vm) significantly decreased (P<0.05).After treatment, there were 2 cases (2 eyes) of bleeding and 2 cases (2 eyes) of tractional retinal detachment.The effective improvement rate of visual acuity was 83.1%.There were significant differences in the improvement rate of visual acuity among patients with different types of diabetes [type 1 (60.0%) vs type 2 (84.9%)], patients in different DR stages [preproliferative diabetic retinopathy (NPDR) 92.3%, early proliferative stage (PDR) 85.1%, high-risk PDR 54.2%] and patients with different HbAlc levels (< 8% 91.8% vs ≥8% 73.0%) (P<0.05).CONCLUSION:The 532nm laser treatment is effective for DR.It can significantly improve the retinal hemodynamics and visual acuity and relieve macular edema.Types of diabetes mellitus, stages of DR and blood glucose control effect may affect the effects of laser treatment.