The comparison of survival between active surveillance or watchful waiting and focal therapy for low-risk prostate cancer: a real-world study from the SEER database / 亚洲男科学杂志(英文版)

To reduce treatment-related side effects in low-risk prostate cancer (PCa), both focal therapy and deferred treatments, including active surveillance (AS) and watchful waiting (WW), are worth considering over radical prostatectomy (RP). Therefore, this study aimed to compare long-term survival outcomes between focal therapy and AS/WW. Data were obtained and analyzed from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with low-risk PCa who received focal therapy or AS/WW from 2010 to 2016 were included. Focal therapy included cryotherapy and laser ablation. Multivariate Cox proportional hazards models were used to compare overall mortality (OM) and cancer-specific mortality (CSM) between AS/WW and focal therapy, and propensity score matching (PSM) was performed to reduce the influence of bias and unmeasured confounders. A total of 19 292 patients with low-risk PCa were included in this study. In multivariate Cox proportional hazards model analysis, the risk of OM was higher in patients receiving focal therapy than those receiving AS/WW (hazard ratio [HR] = 1.35, 95% confidence interval [CI]: 1.02-1.79, P = 0.037), whereas no significant difference was found in CSM (HR = 0.98, 95% CI: 0.23-4.11, P = 0.977). After PSM, the OM and CSM of focal therapy and AS/WW showed no significant differences (HR = 1.26, 95% CI: 0.92-1.74, P = 0.149; and HR = 1.26, 95% CI: 0.24-6.51, P = 0.782, respectively). For patients with low-risk PCa, focal therapy was no match for AS/WW in decreasing OM, suggesting that AS/WW could bring more overall survival benefits.

Clinical characteristics of IgE-mediated cow's milk protein allergy in children / 中华儿科杂志

Objective: To analyze the clinical features of IgE-mediated cow's milk protein allergy (CMPA) in children aged 0-5 years. Methods: This cross-sectional study collected the data on children diagnosed with CMPA in the Department of Allergy at the Children's Hospital of the Capital Institute of Pediatrics from October 2019 to November 2020 and improved peripheral blood routine,total IgE defection, milk specific IgE (sIgE) defection,SPT and milk component defection,diagnosis of severe anaphylaxis based on clinical manifestations. Rank-sum test and chi-square test are used for statistical analysis of clinical characteristics between groups. Results: A total of 106 children (67 boys and 39 girls) were enrolled with the age of 15 (8, 34) months, including 42 cases (≤ 1 year of age), 39 cases (>1-<3 years of age) and 25 cases(≥3 years of age), the onset age of 6 (5, 8) months. Among them, 95 cases (89.6%) were reacted after consuming milk or its products, 42 cases (39.6%) had reaction due to skin contact and 11 cases (10.4%) reacted after exclusive breastfeeding. The onset time of milk product consumption was 45 (1, 120) min, skin contact pathway was 10 (5, 30) min and symptoms in breastfeeding pathway was 121 (61, 180) min. There was statistical difference among the time of symptoms (χ2=77.01, P<0.001).The cutaneous reaction was most common (100 cases, 94.3%), followed by digestive (20 cases, 18.9%) and respiratory (16 cases, 15.1%), and the nervous symptoms (1 case, 0.9%) were uncommon and 24 cases (22.6%) had at least one episode of anaphylaxis. There were 87 cases (82.1%) also diagnosed with other food allergies, 94 cases (88.7%) with previous eczema, 57 cases (53.8%) with history of rhinitis, and 23 cases (21.7%) with history of wheezing. The total IgE level was 191.01 (64.71, 506.80) kU/L, and the cow's milk sIgE level was 3.03 (1.11, 15.24) kU/L. The maximum diameter of the wheal in SPT was 8.2 (4.0, 12.0) mm. Component resolved diagnosis showed that 77 cases (81.9%) were sensitized to at least one out of 4 main components, including casein, α lactalbumin, β lactoglobulin and bovine serum albumin.The possibility of anaphylaxis in children with milk sIgE grade Ⅳ-Ⅵ was higher than that in children with grade 0-Ⅲ (57.7% (15/26) vs. 12.5% (10/80), OR=9.545, 95%CI 3.435-26.523). Children with milk SPT ≥+++ had a higher probability of anaphylaxis than those with milk SPT ≤++ (34.4% (11/32) vs. 11.5% (3/26), OR=4.016, 95%CI 0.983-16.400). Anaphylaxis were more common in α lactalbumin positive children than in negative children (34.3% (13/38) vs. 14.2% (8/56), χ2=1.23，P=0.042). Conclusions: CMPA in children has early onset and diversified clinical manifestations, which are mainly cutaneous symptoms. Most children are sensitized to at least one allergen component. Serum sIgE level, SPT reaction and allergen components play important roles in the diagnosis and evaluation of CMPA, and higher milk sIgE level may predict a higher risk of anaphylaxis.

Complete androgen blockade vs. medical castration alone as adjuvant androgen deprivation therapy for prostate cancer patients following radical prostatectomy: a retrospective cohort study / 中华医学杂志(英文版)

BACKGROUND@#Till date, the optimal treatment strategy for delivering adjuvant androgen deprivation therapy (ADT) in localized and locally advanced prostate cancer (PCa), as a lower stage in PCa progression compared with metastatic PCa, is still unclear. This study compares the efficacy of castration alone with complete androgen blockade (CAB) as adjuvant ADT in patients with localized and locally advanced PCa undergoing radical prostatectomy (RP).@*METHODS@#Patients diagnosed with PCa, without lymph node or distant metastasis, who received RP in West China Hospital between January 2009 and April 2019, were enrolled in this study. We performed survival, multivariable Cox proportional hazard regression, and subgroup analyses.@*RESULTS@#A total of 262 patients were enrolled, including 107 patients who received castration alone and 155 patients who received CAB. The survival analysis revealed that there was no significant difference between the two groups (hazard ratios [HR] = 1.07, 95% confidence intervals [95% CI] = 0.60-1.90, P = 0.8195). Moreover, the multivariable Cox model provided similarly negative results before and after adjustment for potential covariant. Similarly, there was no significant difference in the clinical recurrence between the two groups in both non-adjusted and adjusted models. Furthermore, our subgroup analysis showed that CAB achieved better biochemical recurrence (BCR) outcomes than medical castration alone as adjuvant ADT for locally advanced PCa (P for interaction = 0.0247, HR = 0.37, 95% CI = 0.14-1.00, P = 0.0497).@*CONCLUSION@#Combined androgen blockade achieved better BCR outcomes compared with medical castration alone as adjuvant ADT for locally advanced PCa without lymph node metastasis.

Abuse of Pharmaceutical Drugs and Its Prevention / 法医学杂志

Abuse of pharmaceutical drugs is a major public health and social problem worldwide. Mostly abused drugs mainly include opioids such as morphine, tramadol, methadone and fentanyl, sedative-hypnotics such as benzodiazepines and non-benzodiazepines, and central stimulants such as Ritalin (methylphenidate), Adderall (amphetamine and dextroamphetamine) and modafinil. Abuse of pharmaceutical drugs not only causes direct damage to multiple systems of the body, but also significantly increases risks of mental and physical diseases, imposing a heavy burden on individuals, families and society. Therefore, the prevention and control of pharmaceutical drug abuse are of vital importance. The Chinese government has taken strict administration measures for pharmaceutical drugs with abuse risk. However, confronting endless new drugs and changing abuse trends, it is necessary to further strengthen management and prevention of pharmaceutical drugs, monitor the trend of abuse, establish rapid response mechanisms, popularize relevant knowledge, and develop specific therapeutic drugs and intervention means, in order to promote prevention and treatment of pharmaceutical drug abuse.

Historical evolution of Salviae Miltiorrhizae Radix et Rhizoma processing methods / 中国中药杂志

China has a long history of Salviae Miltiorrhizae Radix et Rhizoma processing with multiple methods available. The pre-sent study collated and summarized the Salviae Miltiorrhizae Radix et Rhizoma processing methods recorded in 23 related herbal medicine books, all editions of Chinese Pharmacopoeia, the 1988 edition of National Regulations for Processing of Chinese Medicine, and 20 current local processing specifications and standards. The results demonstrated various processing methods of Salviae Miltiorrhizae Radix et Rhizoma, such as removing residual part of stem, plantlet, or soil, smashing, filing, cutting, decocting, washing with wine, soaking in wine, and stir-frying with wine or blood from pig heart, while raw and wine-processed products are mainly used in modern times. Due to the lack of unified standards, the phenomena of multiple methods adopted in one place and different methods in different places have led to uneven quality of Salviae Miltiorrhizae Radix et Rhizoma pieces, even affecting the safety and effectiveness of its clinical medication. This study is expected to provide a reference for the development of Salviae Miltiorrhizae Radix et Rhizoma processing and its rational medication.

Effect of Cinobufacin injection combined with chemotherapy on serum tumor markers and immune function in elderly patients with colorectal cancer / 中国医师进修杂志

Objective:To investigate the short-term effect of Cinobufacin injection combined with chemotherapy on elderly patients with colorectal cancer and its influence on tumor markers and immune function.Methods:Sixty-two elderly patients with colorectal cancer admitted to Xinchang Branch of Zhejiang Hospital of Traditional Chinese Medicine from January 2015 to December 2017 were randomly divided into observation group (31 cases) and control group (31 cases). Patients in the control group were treated with chemotherapy, while those in the observation group were treated with Cinobufacin injection on the basis of the control group. Two treatment of 21 d was as a cycle, continuous chemotherapy 2-4 cycles. The short-term therapeutic effect, Karnofsky function state score (KPS score), serum tumor markers, immune function and side effects of the two groups were compared before and after treatment.Results:After treatment, the total effective rate of the observation group was 77.42%(24/31), and was higher than that of the control group 48.39%(15/31), there was significant difference ( χ2=5.599, P<0.05). The KPS scores of the observation group was higher than that of the control group [(87.48 ± 6.57) scores vs. (80.20 ± 6.12) scores], there was significant difference ( t=4.514, P<0.05). The levels of serum cancer antigen 19-9(CA19-9), carbohydrate antigen 724(CA724) and carcino-embryonic antigen (CEA) in the observation group were lower than those in the control group [(3.59 ± 1.02) kU/L vs. (6.98 ± 1.37) kU/L, (7.38 ± 1.87) μg/L vs.(9.82 ± 1.42) μg/L, (12.27 ± 2.36) μg/L vs.(16.57 ± 3.24) μg/L], there were significant differences ( t=11.051, 9.042, 10.624, P<0.05). The levels of CD 3+, CD 4+ and CD 4+/CD 8+ in the observation group were higher than those in the control group [(58.97 ± 3.72)% vs. (47.31 ± 2.98)%, (38.85 ± 3.25)% vs. (30.19 ± 2.71)%, 1.59 ± 0.18 vs. 0.89 ± 0.14], there were significant differences ( t=13.620, 11.394, 17.091, P<0.05). The incidence of side effects in the observation group was lower than that in the control group ( P<0.05). Conclusions:Cinobufacin injection combined with chemotherapy can improve the quality of life of elderly patients with colorectal cancer in the near future, reduce the levels of serum CA19-9, CA724 and CEA, improve the immune function of patients, and have fewer side effects.

Clinical Efficacy of Dahuang Zhuyu Decoction for Oral Administration and Enema on Severe Acute Pancreatitis with Syndromes of Blood Stasis, Toxin and Its Effect on Serum Inflammatory Factors / 中国实验方剂学杂志

Objective::To observe the clinical efficacy of Dahuang Zhuyu decoction for oral administration and enema on severe acute pancreatitis with syndromes of blood stasis and toxin and its effect on serum inflammatory factors. Method::Sixty eight patients with severe acute pancreatitis with syndromes of blood stasis and toxin who were admitted in Henan Provincial People's Hospital from September 2017 to December 2018 were randomly divided into treatment group (34 cases) and control group (34 cases). The control group was treated with western medicine. The treatment group was treated with Dahuang Zhuyu decoction for oral administattion and enema in addition to the therapy of the control group. Both groups were treated for 7 days. Before and after treatment, abdominal pain, bloating, nausea and vomiting were scored separately, serum amylase (AMS), lipase (LPS), interleukin-6 (IL-6), interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) were detected, and abdominal pain disappearance time, bloating disappearance time and exhaust recovery time were recorded. Result::After treatment, the abdominal pain score, abdominal distension score, nausea and vomiting score, serum AMS, LPS, IL-6 and TNF-α were lower than those before treatment (P<0.05), and those in treatment group was lower than those in control group (P<0.05). After treatment, IL-10 level in both groups was higher than those before treatment (P<0.05), and that in treatment group was higher than that in control group (P<0.05). The disappearance time of abdominal pain, the disappearance time of abdominal distension and the recovery time of exhaust were shorter in treatment group than in control group (P<0.05). The total effective rate of the treatment group was higher than that of the control group (P<0.05). Conclusion::Dahuang Zhuyu decoction for oral administration and enema for severe acute pancreatitis with syndromes of blood stasis and toxin can alleviate clinical symptoms, reduce amylase and lipase levels, inhibit the expression of pro-inflammatory factors, promote the expression of anti-inflammatory factors, restore intestinal function, and improve clinical efficacy.

Effects of CXC-chemokine Receptor 7 Expression in Endothelial Progenitor Cells on Angiogenesis after Cerebral Ischemia-reperfusion Injury / 中国康复理论与实践

Objective:To explore the effect of upregulating CXC-chemokine receptor 7 (CXCR7) in endothelial progenitor cells (EPCs) on angiogenesis after cerebral ischemia-reperfusion injury. Methods:EPCs were isolated and cultured from human umbilical cord blood and identified. Then, the EPCs were transfected with CXCR7 overexpression lentiviral vector, and the expression of CXCR7 was identified with real-time PCR and Western blotting. The tube-like structure formation and apoptosis of EPCs under oxidized low density lipoprotein (ox-LDL) were detected with tube-like structure formation test and Annexin V/PI staining. Cerebral ischemia-reperfusion injury model in rats was established, and the qualified model rats were randomly divided into three groups after 24 hours reperfusion: PBS group (n = 12) was injected with phosphate buffers through tail vein, control group (n = 12) was injected the EPCs infected with control lentiviral vector, and CXCR7 group (n = 12) was injected with EPCs infected with CXCR7 overexpression lentiviral vector. Neurological function scores were determined seven and 14 days after transplantation. The cerebral infarct volume was measured, the number of GFP-positive cells in the ischemic site and the density of capillary were observed. Results:The expression of CXCR7 in EPCs increased after transfection (P < 0.01). Overexpression of CXCR7 improved tube formation and reduced apoptosis of EPCs under ox-LDL (P < 0.05). Compared with PBS and control groups , neurological function improved in CXCR7 group, with less infarct volume, more GFP-positive cells and density of capillary (P < 0.05). Conclusion:Up-regulating CXCR7 can improve the survival and angiogenesis of EPCs, and improve the repair of cerebral ischemia-reperfusion injury.

Anti-tumor effect and mechanisms of shikonin on gliomas / 国际肿瘤学杂志

Shikonin has anti-tumor activity,and it not only can inhibit the proliferation,migration and infiltration of glioma cells,but also induce necroptosis of glioma cells via promoting the production of reactive oxygen species.Shikonin combined with endoplasmic reticulum stress inhibitors or regulatory tactics of microRNA expression may further enhance its killing effect on gliomas.Shikonin armed by nanoparticles shows increased targetability to gliomas.Shikonin combined with tumor-targeted therapeutic drugs or chemotherapeutic drugs is expected to overcome the drug resistance of glioma cells.

Efficacy and Safety of Different Bisphosphonates for Bone Loss Prevention in Kidney Transplant Recipients: A Network Meta-Analysis of Randomized Controlled Trials / 中华医学杂志(英文版)

<p><b>Background</b>Mineral and bone disorder is one of the severe complications in kidney transplant recipients (KTRs). Previous studies showed that bisphosphonates had favorable effects on bone mineral density (BMD). We sought to compare different bisphosphonate regimens and rank their strategies.</p><p><b>Methods</b>We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to April 01, 2017, for randomized controlled trials (RCTs) comparing bisphosphonate treatments in adult KTRs. The primary outcome was BMD change. We executed the tool recommended by the Cochrane Collaboration to evaluate the risk of bias. We performed pairwise meta-analyses using random effects models and network meta-analysis (NMA) using Bayesian models and assessed the quality of evidence.</p><p><b>Results</b>A total of 21 RCTs (1332 participants) comparing 6 bisphosphonate regimens were included. All bisphosphonates showed a significantly increased percentage change in BMD at the lumbar spine compared to calcium except clodronate. Pamidronate with calcium and Vitamin D analogs showed improved BMD in comparison to clodronate with calcium (mean difference [MD], 9.84; 95% credibility interval [CrI], 1.06-19.70). The combination of calcium and Vitamin D analogs had a significantly lower influence than adding either pamidronate or alendronate (MD, 6.34; 95% CrI, 2.59-11.01 and MD, 6.16; 95% CrI, 0.54-13.24, respectively). In terms of percentage BMD change at the femoral neck, both pamidronate and ibandronate combined with calcium demonstrated a remarkable gain compared with calcium (MD, 7.02; 95% CrI, 0.30-13.29 and MD, 7.30; 95% CrI, 0.32-14.22, respectively). The combination of ibandronate with calcium displayed a significant increase in absolute BMD compared to any other treatments and was ranked best.</p><p><b>Conclusions</b>Our NMA suggested that new-generation bisphosphonates such as ibandronate were more favorable in KTRs to improve BMD. However, the conclusion should be treated with caution due to indirect comparisons.</p>

Improvement of continence with preservation of pelvic stabilized structure in patients undergoing robot-assisted laparoscopic radical prostatectomy / 中华泌尿外科杂志

Objective To investigate the effect of pelvic floor stabilized structure preservation (PPSS) during robot-assisted laparoscopic radical prostatectomy (RARP)on postoperative continence recovery.Methods From October 2017 to April 2018,86 patients with prostatic cancer who underwent traditional RARP and RARP plus PPSS were included.There were 31 patients in non-PPSS group and 55 patients in PPSS group.In non-PPSS group,patients age was (68.48 ± 7.79) years old,BMI was (24.79 ± 3.05) kg/m2,median prostate volume was 63.54 (53.00-99.36) cm3,clinic T-stage T1-T2,T3,T4 accounted for 49.39％,22.58％,6.45％ and ISUP grade 1,2,3,4,5 accounted for 22.58％,22.81％,12.90％,12.90％,19.35％ respectively.In PPSS group,patients age was (69.53 ± 6.81)years old,BMI was (23.95 ± 3.03) kg/m2,median prostate volume was 73.39 (54.88-94.23) cm3,clinic T-stage T1-T2,T3,T4 accounted for 72.73％,7.27％,3.64％ and ISUP grade 1,2,3,4,5 accounted for 21.82％,18.18％,23.64％,18.18％,10.91％ respectively.The preoperative PSA,BMI,clinical T-stage,ISUP grade,and postoperative hospital days had no significant differences (P ＞ 0.05)between the two groups.Both groups were operated via transperitoneal approach.In the non PPSS group,endo-pelvic fascia and pubic prostate ligament was cut,and dorsal vessel complex was ligated.In PPSS group,the partial endo-pelvic fascia was bluntly pushed to the pelvic wall to preserve tendon arch,and pubic prostate ligament also was preserved without suturing and ligating dorsal vascular complex.The catheter was removed 7 d after RARP.The continence recovery were compared between the two groups,including pad number on the day of I,7,14,30,90 and ICI-Q-SF scores on the day of 30 and 90 after catheter removal.Results There was no significant difference in pad numbers used between the two groups on the day of 1,7,14,30 after catheter removal.On the 90th day,the proportions of using pad ≥4 in PPSS group were significantly lower than those in non-PPSS group (1.89％ vs.20.69％,P =0.004).No significant difference was found in ICI-Q-SF scores on the 30th and 90th day between the two groups.Univariate analysis showed that PPSS group used less pads than non-PPSS group on the 90th day [OR =0.07(95％ CI 0.01-0.65),P =0.019];T3 patients used more pads than T1-T2 patients [OR =9.19 (95％ CI 1.32-63.87),P =0.025].After adjusting for age,ISUP grading,T staging,and PSA,multivariate regression analysis showed that the risk of using pad ≥ 4 in PPSS group compared with non-PPSS group was 0.46,0.34,0.27,0.25,and 0.03 on the day of 1,7,14,30 and 90 after catheter removal,respectively.The PPSS approach didn't increase the risk of positive surgical margin.Conclusions Preservation of pelvic stabilized structure in RARP is very efficient in term of continence rate after RARP,and it does not increase the risk of positive surgical margin.

Implication of serum steroid receptor coactivator-3 level for lumbar bone mineral density and bone turnover in postmenopausal women / 中国组织工程研究

BACKGROUND: Steroid receptor coactivator-3 (SRC-3) is a member of the steroid receptor coactivator family,and it can promote proliferation and differentiation in human osteoblasts by modulating estrogen receptor activity. Previous studies have reported that allelic variation at the SRC-3 locus is significantly positively correlated with the lumbar bone mineral density in Caucasian men, but the relationship between SRC-3 and bone metabolism in postmenopausal women remains unknown.OBJECTIVE: To investigate the level of serum SRC-3 in postmenopausal women and its association with bone mineral density and bone turnover markers.METHODS: Fifty-five women with postmenopausal osteoporosis and 35 healthy postmenopausal women were recruited, and their serum levels of SRC-3, 25-hydroxyvitamin D, osteocalcin and procollagen I N-terminal peptide, beta C-terminal telopeptide of type I collagen were detected. The bone mineral density of L1-4 vertebrae and femoral neck were measured by dual-energy X-ray absorptiometry.RESULTS AND CONCLUSION: Serum SRC-3 level in postmenopausal women with osteoporosis was remarkably lower than that in healthy individuals. In addition, the serum SRC-3 level was positively correlated with lumbar bone mineral density, and negatively correlated with procollagen I N-terminal peptide and osteocalcin in postmenopausal women with osteoporosis. These results indicate that low serum SRC-3 level may be involved in the pathogenesis of postmenopausal osteoporosis and play a pivotal role in bone turnover.

Effects of aspirin and clopidogrel on the risk of upper gastrointestinal bleeding in patients with cardiovascular and cerebrovascular diseases / 中国生化药物杂志

Objective To investigate the effects of aspirin and clopidogrel on the risk of upper gastrointestinal bleeding in patients with cardiovascular and cerebrovascular diseases. Methods 116 cases of patients with upper gastrointestinal bleeding and cardiovascular disease as research subjects. 86 cases of patients used antiplatelet drugs (drug group), 30 cases didn't use antiplatelet drugs (non-drug group). In the drug group, 30 patients with aspirin alone (group A), 24 patients with clopidogrel alone (group B) and 32 patients with aspirin and clopidogrel (group C) . Compared the upper gastrointestinal bleeding in each group of patients. Results The incidence of abdominal pain in the drug group was significantly lower than non-drug group (P<0.05). However, there was no significant difference in the incidence of bloating, nausea, vomiting, acid reflux compared with non - drug group. There were no significant differences in the endoscopic manifestations of gastrointestinal bleeding between the drug group and the non-drug group. The incidence of severe gastrointestinal bleeding in the drug group was 47.67%, significantly higher than that in the non-drug group (26.67%)(P<0.05). A, B, C three groups of patients with severe gastrointestinal bleeding rate and bleeding patterns were no significant difference. There was no significant difference in the total effective rate of gastrointestinal bleeding between the drug group and the non-drug group. Conclusion Antiplatelet drugs may increase the risk of upper gastrointestinal bleeding in patients with cardiovascular and cerebrovascular diseases, but aspirin and clopidogrel alone or in combination had no significant effect on the degree of gastrointestinal bleeding.

Effects of aspirin and clopidogrel on the risk of upper gastrointestinal bleeding in patients with cardiovascular and cerebrovascular diseases / 中国生化药物杂志

Objective To investigate the effects of aspirin and clopidogrel on the risk of upper gastrointestinal bleeding in patients with cardiovascular and cerebrovascular diseases. Methods 116 cases of patients with upper gastrointestinal bleeding and cardiovascular disease as research subjects. 86 cases of patients used antiplatelet drugs (drug group), 30 cases didn't use antiplatelet drugs (non-drug group). In the drug group, 30 patients with aspirin alone (group A), 24 patients with clopidogrel alone (group B) and 32 patients with aspirin and clopidogrel (group C) . Compared the upper gastrointestinal bleeding in each group of patients. Results The incidence of abdominal pain in the drug group was significantly lower than non-drug group (P<0.05). However, there was no significant difference in the incidence of bloating, nausea, vomiting, acid reflux compared with non - drug group. There were no significant differences in the endoscopic manifestations of gastrointestinal bleeding between the drug group and the non-drug group. The incidence of severe gastrointestinal bleeding in the drug group was 47.67%, significantly higher than that in the non-drug group (26.67%)(P<0.05). A, B, C three groups of patients with severe gastrointestinal bleeding rate and bleeding patterns were no significant difference. There was no significant difference in the total effective rate of gastrointestinal bleeding between the drug group and the non-drug group. Conclusion Antiplatelet drugs may increase the risk of upper gastrointestinal bleeding in patients with cardiovascular and cerebrovascular diseases, but aspirin and clopidogrel alone or in combination had no significant effect on the degree of gastrointestinal bleeding.

Breakthrough bleeding in adult patients with severe hemophilia A receiving low- and intermediate-dose FVIII for tertiary prophylaxis: characteristics and influencing factors / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the characteristics of breakthrough bleeding in adult patients with severe hemophilia A (SHA) receiving low- and intermediate-dose FVIII for tertiary prophylaxis and explore the factors affecting the outcomes of the treatment.</p><p><b>METHODS</b>Forty-nine patients (mean age 31.53∓7.33 years) with SHA receiving tertiary prophylaxis FVIII treatment were divided into low-dose group (n=15) and intermediate-dose group (n=34). The data including clinical bleeding phenotype (Pre?AJBR), 72 h FVIII trough activity, and Functional Independence Score in Hemophilia (FISH) were recorded in all the patients, and Hemophilia Steward APP was used to record the bleeding episode and the treatment data. All the patients were followed up for at least 6 months.</p><p><b>RESULTS</b>In the low-dose and intermediate-dose groups, the number of joint bleeding (AJBR) episodes were 18.79∓13.03 and 9.28∓7.02 per year (P=0.016), and the proportions of spontaneous bleeding were 75.0% and 47.7%, respectively. The proportions of patients with target joint were 80% and 44%, target joint bleeding occurred in 59% and 41%, and cataract bleeding after 0-12 h of prophylactic injection occurred in 4.86% and 5.18% of the patients with a median breakthrough bleeding time of 40.08 h and 46.08 h (P=0.008), respectively. The proportions of patients with 72 h FVIII trough activity <1% were 44.4% and 34.8% in the two groups, respectively. AJBR was negatively correlated with the preventive dose consumed (r=-0.57, P=0.000, n=49) and FISH, but positively correlated with Pre-AJBR in the two groups (P<0.05).</p><p><b>CONCLUSION</b>Tertiary prophylaxis with low- and intermediate-dose FVIII is not sufficient to achieve the goal of preventing progression of joint disease in Chinese adult patients with SHA. Although the prophylactic dose is the most important factor to affect the treatment efficacy, other non-factor approaches may also help to improve the efficacy of the treatment.</p>

Effect and Mechanism of Exercise for Patients with Cardiovascular Diseases (review) / 中国康复理论与实践

Exercise is one of the important techniques of cardiovascular rehabilitation. Exercise can reduce inflammatory response to improve endothelial function, and improve mitochondrial function to increase myocardial cell activity. For cardiovascular risk factors, exer-cise can promote the activity of lipoprotein, increase the level of high-density lipoprotein;improve the function of insulin receptor to reduce insulin resistance, reduce platelet aggregation and improve endothelial function to reduce blood pressure. For the respiratory system, aerobic exercise can improve the function of respiratory muscle, thus relieve the dyspnea. Exercise can promote the activation of immune factor and increase metabolism, to increase immune function and anti-aging. Resistance exercise can improve mitochondrial function and promote fi-ber type conversion, to improve the function of skeletal muscle system.

Caffeic acid phenethyl ester against cellular injuries in the rotenone-induced Parkinson’s disease model / 中国组织工程研究

BACKGROUND:Caffeic acid phenethyl ester (CAPE) can inhibit lipid peroxidation after rat brain injury. However, the trend of 5-lipoxygenaseis (5-LOX) and cysteinyl leukotrienes (CysLTs) in model of Parkinson’s disease, and whether CAPE protects against rotenone-induced cel ular injuries by inhibiting the levels of 5-LOX and CysLTs stil need further research. OBJECTIVE:To investigate the protective effect of CAPE on the rotenone-induced Parkinson-like injury, and to determine whether 5-LOX involved. METHODS:(1) PC12 cel s in good-growth were col ected and divided into five groups cultured with different concentrations of rotenone (0, 0.01, 0.1, 1, 10μmol/L). 24 and 48 hours later, changes of cel ular morphology and activity were observed to single out the optimum concentration of rotenone;at 24 hours, the levels of 5-LOX and CysLTs were detected by western blotting and ELISA, respectively. (2) PC12 cel s were pretreated with different concentrations of CAPE (0, 0.01, 0.1, 1, 10 μmol/L) for 30 minutes, and 1 μmol/L rotenone was then added. The other cel s received no intervention as blank control group. Subsequently, the cel activity was detected, and the CysLTs production was detected by ELISA at 24 hours. RESULTS AND CONCLUSION:(1) Rotenone (0.1-10μmol/L) could induce PC12 cel injury with overt morphological and cel activity changes at 24 hours, especial y the 1 μmol/L rotenone. (2) Rotenone also significantly increased the 5-LOX expression and CysLTs production in a concentration-dependant manner. (3) CAPE (1-10μmo/L) significantly attenuated rotenone-induced CysLTs production and cel viability reduction in a concentration-dependant manner. (4) These results suggest that CAPE protects against PC12 cel injuries in the model rat with Parkinson’s disease induced by rotenone involving 5-Lox.

Natural alkaloids: basic aspects, biological roles, and future perspectives / 中国天然药物

Natural products have gained popularity worldwide for promoting healthcare, as well as disease prevention. Alkaloids are important chemical compounds that serve as a rich reservoir for drug discovery. Several alkaloids isolated from natural herbs exhibit antiproliferation, antibacterial, antiviral, insecticidal, and antimetastatic effects on various types of cancers both in vitro and in vivo. This paper focuses on the naturally-derived alkaloids such as berberine, matrine, piperine, fritillarine, and rhynchophylline, etc., and summarizes the action mechanisms of these compounds. Based on the information in the literature that is summarized in this paper, the use of alkaloids as drugs is very promising, but more research and clinical trials are necessary before final recommendations on specific alkaloids can be made. Following this, it is hoped that as a result of this review, there will be a greater awareness of the excellent promise that natural alkaloids show for use in the therapy of diseases.

Mutation analysis and prenatal diagnosis of FBN1 gene mutations for four patients with Marfan syndrome / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To screen for mutations of fibrillin-1 (FBN1) gene in 4 patients with Marfan syndrome in order to provide prenatal diagnosis and genetic counseling.</p><p><b>METHODS</b>Potential mutations of the FBN1 gene in the probands were detected with PCR and DNA sequencing. Subsequently, genomic DNA was extracted from amniotic fluid sampled between 18 to 20 weeks gestation. The mutations were confirmed with denaturing high-performance liquid chromatography - robust microsatellite instability (DHPLC-MSI) analysis with maternal DNA as reference. The products were further analyzed by direct sequencing and BLAST search of NCBI database.</p><p><b>RESULTS</b>An IVS46+1G>A substitution was identified in patient A at +1 position of intron 46 of the FBN1 gene. Two novel missense mutations were respectively discovered at positions +4453 of intron 35 in patient B (Cys1485Gly) and position +2585 of intron 21 in patient C (Cys862Tyr). In patient D, a novel deletion (c.3536 delA) was found at position +3536 of intron 28. In all of the 4 cases, the same mutations have been identified in the fetuses.</p><p><b>CONCLUSION</b>FBN1 gene analysis can provide accurate diagnosis of Marfan syndrome, which can facilitate both prenatal diagnosis and genetic counseling.</p>

Ultrasound targeted microbubble destruction-mediated gene delivery system: application to therapy for ocular disease.

Background: Ocular disorders have greatest potential for benefit from gene therapy. The major obstacle in the clinical application of gene therapy is not due to the lack of an ideal gene, but rather the lack of a clinically safe and efficient gene transfer method. Ultrasound (US) targeted microbubble destruction (UTMD)-mediated gene delivery system as a noninvasive gene transfer method is now widely used in gene therapy of cardiovascular disease, muscular tissue, and tumor, and proved to effectively enhance gene transfer in various studies in vitro and in vivo. However, it is just the beginning of application for ophthalmological disease. Objective: Review the latest advancements in UTMD-mediated ocular gene transfection and discuss mechanisms of UTMD involved in gene transfection, obstacles, and limitations to the use of this technology, as well as the perspectives for future applications of UTMD-mediated gene delivery system. Methods: Summarize published literature concerning UTMD-mediated ocular gene transfection. Results: UTMD is an effective and safe gene delivery method of therapy for ocular diseases. Considerable progress has been made in US or UTMD-mediated viral and nonviral ocular gene delivery to retina, like recombinant adeno-associated virus (rAAV) and nanoparticles as nonviral gene carriers. In addition, UTMD has potential for producing the blood-retinal barrier opening and serves as a promising method for intravenous ocular gene delivery. Conclusion: UTMD-mediated gene delivery system could effectively enhance gene transfer into ocular tissue. Though several problems remain to be solved, UTMD is a promising technology for the targeted gene therapy of ocular disease.