Advances in the treatment of Meige's syndrome with blepharospasm / 国际眼科杂志(Guoji Yanke Zazhi)

Meige's syndrome is a segmental craniocervical dystonia extrapyramidal disorder, which belongs to a type of adult attention deficit and hyperactivity disorder(ADHD). The cause is unknown and is commonly seen in middle-aged and elder women, and is often associated with depression, trauma, drugs, surgery and other risk factors. Blepharospasm is the earliest and most common clinical symptom of Meige's syndrome, although there is a possibility of spontaneous remission, the risk of blindness still exists. Clinically, treatment is often delayed and the prognosis is influenced due to insufficient understanding of Meige's syndrome. As the incidence of Meige syndrome increases, particularly blepharospasm in ophthalmology, a comprehensive understanding of Meige's syndrome is needed to improve the ability of ophthalmologists to treat the condition and to guide the appropriate use of clinical medication. In this paper, we review advances in the treatment of Meige's syndrome with blepharospasm and summarize the pros and cons of pharmacotherapy, surgery and traditional Chinese medicine, with a view to improving the diagnosis and treatment of this disease by ophthalmologists.

Three new anthraquinones from Prismatomeris tetrandra (Roxb.) K. Schum and their protective effects in neuroblastoma cells / 药学学报

Three new anthraquinones were isolated from the 80% ethanol extract of Prismatomeris tetrandra by silica gel, MCI, ODS column chromatography and high performance preparative liquid chromatography (HPLC). The structures of the new compounds were identified by mass spectrometry, nuclear magnetic resonance and other spectroscopic methods as 6-hydroxy-1,2,3-trimethoxy-7-methylanthracene-9,10-dione (1), 6-(hydroxymethyl)-1,2,3-trimethoxyanthracene-9,10-dione (2) and 7-hydroxy-6-(hydroxymethyl)-1,2-dimethoxyanthracene-9,10-dione (3). Compounds 1, 2 and 3 showed protective effects against monosodium glutamate-induced damage in SH-SY5Y neuroblastoma cells, with the cell survival rates elevated 18.45%, 4.31%, and 7.65%, respectively.

Research progress of anti-pulmonary fibrosis drugs targeting autotaxin-lysophosphatidic acid axis / 药学学报

Pulmonary fibrosis is an interstitial lung disease characterized by inflammatory injury and tissue structure destruction. Currently, there is a lack of effective therapeutic drugs for pulmonary fibrosis, and the mechanism is still unknown. Therefore, it is urgent to seek new targets for effective drugs. In pulmonary fibrosis, the level of autotaxin (ATX) in bronchoalveolar lavage fluid increases and stimulates the production of lysophosphatidic acid (LPA). The involvement of LPA receptors in activating a variety of G-protein-mediated signal transduction pathways leads to a range of related physiological effects, including pro-inflammatory signaling in epithelial cells, activation of transforming growth factor signaling, and stimulation of fibroblast accumulation. LPA receptor antagonists and ATX inhibitors have been concerned as new targets for pulmonary fiber therapy, and currently related drugs have entered clinical trials. In this paper, the pathophysiological effects of LPA and ATX in pulmonary fibrosis disease and related drug development progress were reviewed to provide reference information of new drug development for pulmonary fibrosis based on the ATX-LPA axis.

Sulfasalazine increases the radiosensitivity of colorectal cancer cells by promoting ferroptosis / 中华放射肿瘤学杂志

Objective:To investigate the radiosensitization effect of low-dose sulfasalazine (SAS) on colorectal cancer (CRC) cells.Methods:Proliferation inhibition effect of SAS on CRC cells was detected by CCK-8 assay, and the concentration of SAS in vitro assays was based on its IC10 value. CRC cells were treated with SAS alone or combined with inhibitors of apoptosis, autophagy, ferroptosis and necroptosis, then cell viability was detected by CCK-8 assay. Trypan blue staining, clone formation assay and cell growth curves were used to verify the radiosensitization effect of SAS on CRC cells in vitro. CRC cells were treated with SAS and radiotherapy, then the intracellular contents of lipid peroxidation and the protein levels of GPX4, PTGS2, cleaved PARP and active caspase 3 were evaluated, respectively. Subcutaneous xenograft tumor mouse model was established to further verify the radiosensitization effect of SAS in vivo. Results:High dose (lethal dose) of SAS could induce apoptosis and ferroptosis in CRC cells. Low dose (non-lethal dose) of SAS enhanced the radiosensitivity of CRC cells in vitro, and the radiosensitivity effect of SAS could only be abolished by ferroptosis inhibitor (Fer-1). Low dose of SAS combined with radiotherapy significantly down-regulated the expression of GPX4, whereas increased the intracellular lipid peroxidation levels and the expression of PTGS2. SAS also showed significant radiosensitization effect in subcutaneous xenograft tumor model. Conclusion:Our findings suggest that low-dose SAS could increase the radiosensitivity of CRC cells by promoting ferroptosis.

Result analysis of percutaneous core needle biopsy for bone tumors in upper limbs with pathological fracture / 中国骨伤

OBJECTIVE@#To analyze the results of percutaneous core needle biopsy for bone tumors in upper limbs with pathologic fracture and to find the possible factors that could impact the results.@*METHODS@#The including criteria for this study was the patients who had received percutaneous core needle biopsy and definitive surgery, whose tumor was located at upper limb with pathologic fracture. From January 2015 to December 2019, seventy-seven patients were enrolled. There were 55 males and 22 females. The median age was 27 years old (range:5 to 88 years old). The tumor located at humerus in 67 cases, radius in 8 cases and ulna in 2 cases. If the pathologic diagnosis of core needle biopsy was the same with the definitive surgery, it was defined as "correct". If the pathologic diagnosis of biopsy for benign or malignant was right but the exact diagnostic name was not the same with definitive surgery, it was defined as "supportive". If the pathologic diagnosis of biopsy for benign or malignant was not correct, it was defined as "wrong". We retrospectively analyzed the accuracy and impact factors for core needle biopsy.@*RESULTS@#The result was "correct" in 63 cases(81.8%), "supportive" in 14 cases(18.2%), and "wrong" in 0 cases. We analyzed the gender, age, location, fracture displacement, the destroyed type for bone tumor, soft tissue mass, fluid area in the tumor as the factors. The results showed the rate for "correct" was significantly higher when the tumor had soft tissue mass (@*CONCLUSION@#The accuracy of percutaneous core needle biopsy for upper limb bone tumor with pathologic is high and acceptable. The biopsy chosen the soft tissue mass area can increase the accuracy.

Application of temporal kurtosis index in assessing hearing loss caused by complex noise / 中国职业医学

Complex noise with impulse or impact property is common in workplace, and its damage on the auditory system is greater than that of steady-state noise. At present, the noise exposure measurement and evaluation indicators widely used in the world mainly include the equivalent continuous sound level and the cumulative noise exposure, both are based on the equal energy hypothesis(EEH). EEH only considered the damage of noise energy on the auditory system, but ignored the effect of temporal characteristics of noise, and underestimated the degree of hearing loss associated with complex noise. This paper first introduced the limitations of current noise exposure assessment standards at home and abroad, then introduced the definition of temporal kurtosis and the calculation method of its related energy indexes(such as cumulative noise exposure and equivalent continuous A-weighted sound pressure level), and further summarized the effectiveness of temporal kurtosis as an auxiliary parameter of noise energy in assessing the risk of hearing loss caused by complex noise, providing a rationale to supplement the existing noise assessment standards.

Anti-anaphylactic potential of benzoylpaeoniflorin through inhibiting HDC and MAPKs from Paeonia lactiflora / 中国天然药物

Guided by cell-based anti-anaphylactic assay, eighteen cage-like monoterpenoid glycosides (1-18) were obtained from the bioactive fraction of P. lactiflora extract. Among these, compounds 1, 5, 6, 11, 12, 15, and 17 significantly reduced the release rate of β-HEX and HIS without or with less cytotoxicity. Furthermore, the most potent inhibitor benzoylpaeoniflorin (5) was selected as the prioritized compound for the study of action of mechanism, and its anti-anaphylactic activity was medicated by dual-inhibiting HDC and MAPK signal pathway. Moreover, molecular docking simulation explained that benzoylpaeoniflorin (5) blocked the conversion of L-histidine to HIS by occupying the HDC active site. Finally, in vivo on PCA using BALB/c mice, benzoylpaeoniflorin (5) suppressed the IgE-mediated PCA reaction in antigen-challenged mice. These findings indicated that cage-like monoterpenoid glycosides, especially benzoylpaeoniflorin (5), mainly contribute to the anti-anaphylactic activity of P. lactiflora by dual-inhibiting HDC and MAPK signal pathway. Therefore, benzoylpaeoniflorin (5) may be considered as a novel drug candidate for the treatment of anaphylactic diseases.

Depressive males have higher odds of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a retrospective cohort study based on propensity score matching / 亚洲男科学杂志(英文版)

Lower urinary tract symptoms suggestive of benign prostate hyperplasia (LUTS/BPH) and depression are both increasing in Chinese aging males. However, the relationship still remains unknown. To explore their relationship, a retrospective cohort study based on propensity score matching (PSM) was conducted by analyzing the China Health and Retirement Longitudinal Study dataset. After data cleaning, a total of 5125 participants were enrolled and subjected to PSM; 1351 pairs were matched and followed for 2 years. Further logistic regression and restricted cubic spline (RCS) were performed to evaluate, model and visualize the relationship between depression and LUTS/BPH. Moreover, subgroup analyses and sensitivity analyses were adopted to verify the robustness of the conclusions. Before PSM, depressive patients showed higher odds of LUTS/BPH in all three models adjusting for different covariates (P < 0.001). After PSM, univariate logistic regression revealed that depressive patients had higher risks for LUTS/BPH than participants in the control group (odds ratio [OR] = 2.10, P < 0.001). The RCS results indicated a nonlinear (P < 0.05) and inverted U-shaped relationship between depression and LUTS/BPH. In the subgroup analyses, no increased risks were found among participants who were not married or cohabitating, received an education, had an abnormal body mass index (<18.5 kg m

Finite element analysis of the effect of local posterior sclera collagen cross-linking on eyeball shape / 生物医学工程学杂志

China is the country with high incidence of high myopia in the world. High myopia can cause severe vision impairment. So far, there is no effective treatment for high myopia in clinic. Scleral collagen cross-linking surgery has been proven to be effective in preventing animal eye axial elongation

Clinical significance of external wall of femoral intertrochanteric fracture and the treatment of internal fixation / 中国组织工程研究

BACKGROUND: The concept of the lateral wall as a hot area has emerged in recent years, and has great guiding significance for the treatment of intertrochanteric fractures. OBJECTIVE: To review the definition, scope, thickness of the lateral wall and its important role in the surgical treatment of intertrochanteric fractures. METHODS: The authors searched Wanfang, CNKI, PubMed, and Web of Science. The search terms were “intertrochanteric fracture, lateral wall, fracture fixation” in Chinese and English. The retrieved documents were sorted, analyzed and summarized. RESULTS AND CONCLUSION: (1) The definition, scope, thickness and measurement method of the lateral wall and its clinical significance were sorted out. (2) Classification criteria based on lateral intertrochanteric fractures of the femur were summarized. (3) In terms of treatment, four kinds of treatment methods: Extramedullary fixation, intramedullary fixation, artificial joint replacement and other treatment methods were listed. Causes and treatment of fracture of lateral wall during and after operation were analyzed. (4) The results showed that the integrity of the lateral wall directly affected the stability of the internal fixation, even the success of the internal fixation. The complete lateral wall can prevent the distal femur from moving inward and the head pin from withdrawing, and prevent the coxa varus deformity. Clinicians should make use of detailed imaging examination, analyze fracture types, comprehensively consider various factors, and select appropriate repair methods.

Investigation on overlapping HIV/HBV infection in Yining City and its prevention and control / 公共卫生与预防医学

Objective To investigate the superinfection of human immunodeficiency virus (HIV) / hepatitis B virus (HBV) in Yining City, and to study on its prevention and control measures. Methods A total of 21 cases of HIV / HBV superinfection recorded by Yining CDC from January 2017 to October 2019 were investigated. Results In this group, the proportion of male (66.67%) was higher than that of female (33.33%), 36-60 years old and 17-35 years old (42.86% and 33.33%), junior high school and primary school and below (57.14% and 28.57%), sex workers and migrant workers (42.86% and 28.57%) were higher. The common clinical manifestations of this group were long-term fever, emaciation, general pain and so on. HIV was mainly sexually transmitted (61.90%). HBV was mainly transmitted by blood and sex (47.62% and 9.52%). The proportion of big three Yang was the highest (42.86%), followed by simple HBsAg (23.81%), small three yang (19.05%), HBsAg / anti HBC (14.29%). Conclusion In Yining City, 36-60 years old of male, junior high school and below, sex workers and migrant workers account for a relatively high proportion, and their clinical manifestations were complex, with clear features. Therefore, prevention and management should be strengthened.

Evaluation of total elbow arthroplasty for bone tumor around the elbow / 中华骨科杂志

Objective:To investigate the oncological efficacy and functional evaluation of total elbow arthroplasty (TEA) for the reconstruction of tumor around elbow joint.Methods:A retrospective case series study was made on the clinical data of 26 patients who underwent total elbow joint replacement after tumor resection in Beijing Jishuitan Hospital from June 1988 to June 2019. According to the inclusion and exclusion criteria, 23 patients were enrolled in the final study, there were 14 males and 9 females, the mean and median age was 37.6±19.9 and 35.0 years respectively. 23 patients included 3 cases of giant cell tumor, 4 cases of metastatic cancer, 4 cases of Ewing's sarcoma, 2 cases of osteosarcoma, 2 cases of aneurysmal bone cyst, 1 angiosarcoma, 1 primary malignacy in giant cell tumor, 1 low-grade central osteosarcoma, 1 parosteosarcoma, 1 synovial sarcoma, 1 plasma cell myeloma, 1 tendon sheath giant cell tumor and 1 case of mixed tumor. There were 6 cases of benign tumor, 4 cases of low grade sarcoma and 13 cases of high grade malignancy. With 19 cases of distal humerus, 3 cases of proximal ulna and 1 case of elbow. Each patient underwent tumor resection followed by restrictive tumor prosthesis and semi-restrictive of coonrad-morrey prosthesis were used for reconstruction.The duration of the operation, the amount of blood loss, epidemiological data, reconstruction length, oncology parameter, complications and functional evaluation were enrolled and statistical analyzed.Results:The mean length of the osteotomy followed by reconstruction was 12.5±3.9 cm, the mean operative time was 154.1±50.1 minutes, and the mean bleeding was 262.2±100.9 ml. Thirteen patients were treated with customized tumor limited prosthesis while 10 patients with Coonrad-Morrey semi-limited prosthesis. The 5-year survival rates of 23 patients was 64.3%, benign tumors, low-grade and high-grade malignancies were 100%, 100% and 39.7%, respectively. Three cases of lung cancer and three cases of Ewing's sarcoma died during the follow-up period (6/23, 26.1%), one case of giant cell tumor and one case of synovial sarcoma developed local recurrence (2/23, 8.7%). The median range of motion for the elbow increased from 35 to 85 degrees ( t=-13.787, P<0.05), the median NRS score decreased from 5.0 to 0.5 ( t=14.391, P<0.05). Postoperative complications occurred in 9 cases (9/23, 39.1%), the recent complications were nerve injury in 4 cases and infection in 1 case, late complications were prosthesis loosening and failure in 4 cases, the 5 year survival rate of prosthesis was 82.0%. The mean and median MSTS 93 score was 84.5%±11.0% and 88.3% respectively. Conclusion:The local control around the elbow is satisfactory after tumor resection. Total elbow arthroplasty can relieve pain and significantly improve function.

Evaluation on the rationality of "Sandwich principle teaching mode" for internal medicine / 中华医学教育探索杂志

Objective:To evaluate the rationality of the "Sandwich Principle teaching mode" adopted in our teaching of internal medicine and verify the necessity of its "Intergroup intersecting discussion".Methods:33 students majoring in traditional Chinese medicine were divided into control group (taught by standard process of sandwich principle) and experiment group (taught by simplified process of sandwich principle). The Dundee Ready Education Environment Measure (DREEM) was used to evaluate students' feelings toward the two teaching modes.Results:The total score of DREEM in the control group was higher than that in the experiment group, with statistically significant difference; the total score in the academic perception subscale in the control group was higher than that in the experiment group, among which the scores of "I have faith in passing the exam this year" and other 2 items were better than that in the experiment group, with statistically significant difference ( P<0.05); there were no statistical difference in the total scores of other perception subscales between the two groups( P>0.05), but the scores of the 9 items including "the atmosphere is very harmonious in the clinical teaching process" in the control group were significantly better than those in the experiment group, with statistically significant difference( P<0.05). Conclusion:The teaching mode of Sandwich Principle can create a positive and effective learning environment for supporting students. "Intergroup intersecting discussion" can encourage students to actively participate in the teaching process, and help increase their academic confidence and sense of achievement in learning. It is also helpful to build a harmonious teacher-student relationship and create a relaxing and pleasant learning environment so that students can gain a better learning experience. Therefore, "Intergroup intersecting discussion" is indispensable in medical teaching.

Current status and dilemmas for early fluid resuscitation strategy in treating acute pancreatitis: a perspective from the integrated Chinese and Western medicine / 中华胰腺病杂志

Fluid resuscitation is an important support for the early treatment of acute pancreatitis. However, the timing, volume and type of fluid, the goal of fluid resuscitation and other related issues remain unanswered. A dilemma on under- and over-resuscitation is often encountered in clinical practice. This paper summarized the recent advances on early fluid resuscitation in acute pancreatitis and proposed an early fluid resuscitation strategy of " three stages and two steps" for acute pancreatitis from a perspective of the relationship and the corresponding changes between Qi and Xue based on the Qi-Xue-Jin-Ye theory of traditional Chinese medicine by integrating the Chinese and Western medicine thoughts, which could provide some insights into optimizing the current strategy.

Clinical evaluation of outcome of amniotic membrane transplantation combine with interferon eye drops for primary pterygium / 中华实验眼科杂志

Objective:To observe the clinical effect of the biological amniotic membrane transplantation combined with interferon α2b eye drops (interferon eye drops) in the treatment of primary pterygium.Methods:A randomized controlled clinical trial was used, 49 patients (55 eyes) of primary pterygium were selected in Beijing Tongren eye center from June to December, 2018, and all the subjects finished the follow up on time.The patients were randomly divided into two groups by random number table method, with 25 eyes of 23 patients in the experimental group and 30 eyes of 26 patients in the control group.The experimental group was treated with pterygium resection combined with amniotic membrane transplantation and interferon eye drops, while the control group was treated with pterygium resection combined with conjunctival autograft transplantation.Meanwhile the experimental group was treated with interferon eye drops on the 3rd day after surgery for 3 months.Follow up was done on the 3rd day, 7th day, 1st month, 3rd month and half a year after the surgery.The best corrected visual acuity (BCVA), heal of corneal epithelial defect and pterygium recurrence rate were observed.Written informed consent was obtained from each subject prior to entering the study cohort.The study protocol was approved by the Ethics Committee of Beijing Tongren Hospital (No.TRECKY2018-043).Results:At 6 months after surgery, there was no significant difference in number of eyes with decrease, stable or increase of BCVA between the two groups ( P=0.259); Cornea epithelium of one eye in each group was healed within 14 days, and the cornea epithelia were healed within 7 days in all rest cases of the two groups, and there was no significant difference in the healing time of corneal epithelium between the two groups ( P=1.000); At 6 months after the surgery, there was no true recurrence in the two groups, and there was no significant difference between the two groups of grade 1, 2 and 3 patients with conjunctival hyperplasia ( Z=0.461, P=0.497). There were three eyes (3/25, 12.0%) and two eyes (2/30, 6.7%) had fibrovascular tissue hyperplasia in the experimental group and control group, respectively, but fibrovasular tissue hyperplasia was only appeared at the junction of conjunctiva and graft, and did not reach the center of the and graft or the limbus of cornea. Conclusions:Compared with the traditional conjunctival autograft transplantation, amniotic membrane transplantation combined with interferon eye drops has no higher recurrence rate for the treatment of primary pterygium, while it is getting less damage to the healthy conjunctival tissue.

Genotoxicity and Embryotoxicity Study of Bicyclol Methyl Ether, Main Impurity in Bicyclol / 中国结合医学杂志

OBJECTIVE@#To assess the genotoxicity and embryotoxicity of bicyclol methyl ether (BME), the main impurity in bicyclol.@*METHODS@#Five concentrations of BME (0.5, 5, 50, 500 and 5000 μg/plate) were used in the Ames test to detect gene mutation. In the chromosome aberration test, Chinese hamster lung cells were used to detect chromosomal aberration of BME (15, 30, 60, 120 μg/mL) with or without S9 mixture. Embryotoxicity test was also conducted to determine any embryotoxicity of BME (7.5, 22.5, 67.5 μg/L) using zebrafish embryos.@*RESULTS@#No significant differences were observed in the Ames test and the chromosome aberration test in the BME groups compared with the vehicle control group. The zebrafish embryos toxicity test also showed no embryo development toxicity of BME, including hatching rate, body length, pericardial area and yolk sac area.@*CONCLUSIONS@#Bicyclol methyl ether has no genotoxicity in vitro and embryotoxicity in zebrafish embryos, and the impurity in bicyclol is qualified.

Exosome-mediated Let-7a inhibits malignant biological behaviors of triple-negative breast cancer cells by down-regulating MYC expression / 中国肿瘤生物治疗杂志

@#Objective: To investigate the role of exosome (EXO) transporting Let-7a to regulate MYC gene in the malignant biological behaviors of triple negative breast cancer (TNBC) cell, and to explore the underlying mechanism. Methods: After the completion of cell culture, the gene and protein expressions of MYC and Let-7a in TNBC MDA-MB-231cells were detected by qPCR and WB, respectively. Recombinant lenti-virus vector carrying Let-7a and Crisper/Cas-9 system with MYC knockdown were transfected into MDA-MB-231 cells; MTT assay, Transwell assay and Scratch healing assay were performed to examine the proliferation, invasion and migration of MDA-MB-231 cells. Luciferase activity assay was performed to validate the binding between MYC and Let-7a. EXO was isolated and identified by transmission electron microscopy and WB assay in wild-type and Let-7a over-expressed MDA-MB-231 cells, respectively. After co-incubation of two types of EXO and MDA-MB-231 cells, the effects of Let-7a on biological behaviors of MDAMB-231 cells via EXO were detected by qPCR, WB, MTT and Transwell etc. Results: Let-7a was negatively correlated with MYC in breast cancer tissues and cell lines (all P<0.05); MYC promoted while Let-7a inhibited the proliferation, migration and invasion of breast cancer cells (all P<0.01); Let-7a silenced MYC by acting on 3'UTR of MYC gene, thereby reducing the expression of MYC protein (P<0.05); Let-7a was enveloped by EXO and transported to cancer cells, there by inhibiting the proliferation, migration and invasion of MDA-MB-231 cells. Conclusion: EXO some mediated Let-7a silences MYC gene by acting on its 3'UTR region, thus inhibiting the proliferation, migration and invasion of MDA-MB-231 cells.

Advantages of Chinese Medicine for Patients with Acquired Immunodeficiency Syndrome in Rural Central China / 中国结合医学杂志

OBJECTIVE@#To analyze the effect of Chinese medicine (CM) on mortality and quality of life (QOL) of acquired immunodefificiency syndrome (AIDS) patients treated with combined antiretroviral therapy (cART).@*METHODS@#A random sample of AIDS patients enrolled in the National Chinese Medicine Treatment Trial Program (NCMTP) that met the inclusion criteria was included in this study. NCMTP patients were included as the CM+cART group, and those not in the NCMTP were included as the cART group. Survival from September 2004 to September 2012 was analyzed by retrospective cohort study. QOL was analyzed by cross-sectional study.@*RESULTS@#The retrospective cohort study included 528 AIDS patients, 322 in the CM+cART group and 206 in the cART group. After 8 years, the mortality in the CM+cART group was 3.3/100 person-years, which was lower than the cART group of 5.3/100 person-years (P<0.05). The hazard ratio (HR) for mortality in the cART group was 1.6 times that of the CM+cART group by Cox proportional hazard model analysis. After controlling for gender, age, marital status, education, and CD4 T-cell count, the HR was 1.9 times higher in the cART group compared with the CM+cART group (P<0.05). The cross-sectional study investigated 275 AIDS patients. The mean scores of all QOL domains except spirituality/personal beliefs were higher in the CM+cART group than in the cART group (P<0.05).@*CONCLUSIONS@#For AIDS patients, CM could help to prolong life, decrease mortality, and improve QOL. However, there were limitations in the study, so prospective studies should be carried out to confifirm our primary results.

Case-control study on malignant transformation of fibrous dysplasia / 中国肿瘤临床

Objective: To elucidate the biological behavior of malignant transformation (MT) of fibrous dysplasia (FD) and investigate its risk factors for diagnostic identification. Methods: A retrospective analysis of 394 FD cases from March 2006 to March 2017 in Beijing Ji Shui Tan Hospital was performed. Seven cases had been histopathologically confirmed as malignant (study group). According to age, location, and other epidemiological data, we performed a 1:2 case-matched comparison between the patients with malignant FD and 14 patients with benign disease (control group). Clinical features, visual analog scale (VAS) score, tumor volume, imaging characteris-tics, alkaline phosphatase (AKP) levels, lactate dehydrogenase (LDH) levels, oncologic results, and function data were analyzed. Re-sults: The 7 MT cases included 3 males and 4 females. Mean follow-up time was 175 (3-396) months, and mean and median follow-up time were 25 (3-51) months after MT. Mean and median age were 45.6 and 47 (24-60) years, respectively. Among the 7 cases, 6 in-volved the femur and 1 involved the tibia. Two cases involved a single lesion whereas the remaining 5 involved multiple lesions. There were 5 recurrent cases and 2 initial cases. The mean MT period from initial surgery were 207 (37-377) months. VAS scores in the study group were significantly higher than that in the control group (Z=-3.317, P=0.001); the VAS scores decreased significantly after opera-tion (Z=-2.384, P=0.017). Preoperative AKP levels were different between the study and control group; the levels were significantly higher in the former group than in the latter (Z=2.314, P=0.021). However, postoperative AKP levels were similar in both groups (Z=0.821, P=0.821). LDH levels were not significantly different between the two groups, either preoperatively (Z=1.269, P=0.205) or post-operatively (Z=0.075, P=0.940). As for the study group, AKP levels decreased significantly after surgery (Z=-2.366, P=0.018); LDH levels were also lower after surgery than before (Z=-2.028, P=0.043). CT enhancement values were higher in the study group than in the con-trol group (Z=-3.659, P<0.001). Univariate analysis indicated that preoperative VAS score, AKP level, cortical damage, presence of soft tissue mass, and CT enhancement value were clinical risk factors for determination of MT of FD. Histopathological analysis revealed 4 cases of osteosarcoma, 2 of low-grade spindle cell sarcoma, and 1 of undifferentiated pleomorphic sarcoma. Three patients had re-ceived adjuvant chemotherapy, 2 cases involved pulmonary metastasis, and 1 patient had died. The mean Musculoskeletal Tumor Soci-ety (MSTS) scores for the study and control groups were (95.0±3.9)% and (86.0±10.9)%, respectively (F=5.689, P=0.029). Conclusions:Malignant transformation of fibrous dysplasia is rare. The preoperative VAS score, AKP level, cortical damage, presence of soft tissue mass, and CT enhancement value may be helpful for clinical screening of malignant transformation. An adequate surgical margin is re-quired for treatment of this lesion.

siRNA-mediated antizyme inhibitor down-regulates the expression of ornithine decarboxylase of prostate cancer cell PC3 / 基础医学与临床

Objective To evaluate whether down-regulating antizyme inhibitor(AZIN) can regulate the expression of ornithine decarboxylase(ODC) and the proliferation of prostate cancer cell PC3 or not.Methods siRNA-AZIN transfected prostate cancer cell PC3,the level of antizyme(AZ),AZIN and ODC were measured by RT-PCR and westernblot. MTT was used to measure the proliferation of cells. Results The mRNA level of AZIN declined(P<0.01);the protein level of AZIN and ODC declined(P<0.05). Knockdown of AZIN significantly inhibited the proliferation of PC3(P<0.05). Conclusions Transfecting siRNA-AZIN can decrease the level of AZIN, then the decline level of ODC inhibits the proliferation of PC3.