Effect of enteral nutrition support on hematological complications in children with malignant solid tumor during chemotherapy / 中华全科医师杂志

Objective:To investigate the effect of enteral nutrition on hematological complications in children with malignant solid tumors during chemotherapy.Methods:A total of 103 children with malignant solid tumor admitted to our hospital from March 2020 to December 2020 were enrolled in the study. The children were randomly divided into enteral nutrition group ( n=51) and control group ( n=52). Children in enteral nutrition group were given enteral nutrition support on the basis of routine diet, while children in control group were only given routine diet. The levels of leukocytes, neutrophils, hemoglobin and platelets in peripheral blood of children during chemotherapy were analyzed. The incidence of infection and the transfusion of red blood cells and platelets after chemotherapy were documented and compared between two groups. Results:The levels of white blood cells, neutrophils, hemoglobin and platelets before chemotherapy were significantly higher than those after chemotherapy both in enteral nutrition group ( Z=-5.91, -5.59, -5.54, -5.66, all P<0.05) and in control group ( Z=-6.14, -5.84, -5.75, -4.75, all P<0.05). The overall hemoglobin levels in enteral nutrition group before and after chemotherapy was significantly higher than those in control group ( t=5.68, 5.62, P<0.05), and there were no significant differences in the levels of white blood cells, neutrophils and platelets between the two groups before chemotherapy ( Z=-0.71, -0.12, -1.29, all P>0.05) and after chemotherapy ( Z=-0.39, -0.86, -0.94, all P>0.05). Compared with the control group, the degree of anemia during chemotherapy was significantly improved in enteral nutrition group (χ2=10.45,6.12, all P<0.05), but there was no significant difference in the reduction degree of white blood cells, neutrophils and platelets between the two groups (before chemotherapy: χ2=1.17, 0.10, 0.49; after chemotherapy: χ2=0.18, 1.10, 0.97, all P>0.05). The number of children receiving red blood cell transfusion in enteral nutrition group was significantly lower than that in control group (χ2=14.06, P<0.05), and there was no significant difference in the number of children with infection and platelet transfusion between the two groups (χ2=1.20, 0.29, all P>0.05).There was no significant difference in the duration of neutrophil deficiency between enteral nutrition group and control group ( t=-1.75, P>0.05). Conclusion:Enteral nutrition support can significantly improve the hemoglobin level in children during chemotherapy, effectively alleviate the severity of anemia, and reduce the incidence of red blood cell transfusion after chemotherapy, which has high clinical application value.

Protective effect of amifostine in the chemotherapy of malignant solid tumor in children / 肿瘤研究与临床

Objective:To explore the cellular protective effect and adverse reactions of amifostine in the chemotherapy of malignant solid tumor in children.Methods:A total of 62 children with malignant solid tumors receiving 253 times of chemotherapy who were admitted to the Pediatrics Single Center of Beijing Tongren Hospital from April 2018 to April 2020 were selected and divided into the experimental group (amifostine was used before chemotherapy, 113 times in total) and the control group (amifostine was not used before chemotherapy, 140 times in total) according to stratified random sampling. The self-control method was used to compare the therapeutic effects and adverse effects of the use of amifostine or not in the same child under the same chemotherapy regimen.Results:Compared with the control group, the duration of agranulocytosis [(6.7±3.0) d vs. (9.5±4.3) d, t = 3.788, P < 0.05], the duration of platelet reduction (<20×10 9/L) [(3.6±1.3) d vs. (5.4±3.2) d, t = 2.037, P < 0.05], the time of receiving recombinant human granulocyte colony-stimulating factor (rhG-CSF) treatment [(6.5±3.5) d vs. (10.0±2.8) d, t = 3.049, P < 0.05] and the time of antibiotic treatment during infection [(5.0±2.5) d vs. (8.2±2.5) d, t = 3.558, P < 0.05] in the experimental group were all shorter; the amount of platelet input required [(0.7±0.5) U vs. (1.5±0.8) U, t = 2.873, P < 0.05] was less than that of the control group. Oral mucosal ulceration occurred in only 4 (3.5%) times in the experimental group, which was lower than that in the control group [12 (8.6%) times] ( χ2 = 4.634, P = 0.033). Regardless of the cost of amifostine itself, there was a statistically significant difference in treatment cost between the experimental group and the control group ( P = 0.034), and the length of hospital stay in experimental group was relatively short ( P = 0.012). The patients were more prone to nausea and vomiting and hypocalcemia when treated with amifostine. Conclusions:Amifostine can effectively protect normal tissue cells in chemotherapy of children with malignant solid tumor and its adverse reactions are mild.

Clinical characteristics and prognosis analysis of 217 infant patients with retinoblastoma / 中华实用儿科临床杂志

Objective:To investigate the clinical characteristics and prognosis of infants with retinoblastoma (RB).Methods:The clinical data of 217 (335 affected eyes) infantile RB patients admitted to the Department of Pediatrics, Beijing Tongren Hospital, Capital Medical University from July 1, 2009 to June 30, 2019 were collected for analyzing the clinical efficacy and prognosis after comprehensive treatment.Results:(1) Clinical characteristics: 217 infantile RB patients included 129 males and 88 females, with the ratio of male to female being 1.47∶1.00; the median age was 6.06 months; there was monocular disease in 99 cases, and binocular disease in 118 cases, with the incidence ratio of binocular to monocular disease being 1.19∶1.00; all the 5 cases with family history of RB had binocular disease; the first symptoms included white pupils and yellow-white reflections in pupils (183 cases, 84.3%), followed by strabismus (18 cases, 8.3%). There were 335 affected eyes, of which 304 counts were in the intraocular stage (90.7%), most commonly in stage D (146 counts, 43.6%); 26 counts (7.7%) in the extraocular stage, mainly invading the optic nerve and/or optic nerve stump; 5 counts (1.5%) in the metastasis stage.(2) Survival analysis: the medical follow-up continued to March 31, 2020, with a median follow-up time of 67 months.There were 2 cases with a loss of follow-up, 21 relapsed cases, and 19 death cases, with the overall survival rate being 91.2%.According to Kaplan-Meier survival analysis, the expected 5-year survival rate was 91.1%; the survival rate was 96.2% in the intraocular stage and 73.1% in the extraocular stage.All 5 cases died during the distant metastasis stage, and the difference was statistically significant ( χ2=7.492, P<0.001); there was also a statistical difference in the survival rate between the monocular disease (95.9%) and binocular disease (87.3%) ( χ2=4.335, P=0.023). (3) Eyeball removal and eye protection: the eye protection rate of 217 children was 68.9%, 100.0% in stage A, B and C, 80.1% in stage D and 35.1% in stage E, which showed significant differences ( χ2=6.573, P=0.004). There were 35 children who underwent eye extraction before chemotherapy and 67 cases after chemotherapy, among which the difference was statistically significant ( χ2=6.076, P=0.012) in eye removal rates before and after chemotherapy in stage D and E(6 and 11 cases before chemotherapy, 22 and 36 cases after chemotherapy). (4) Adverse reactions: according to the World Health Organization′s classification of adverse reactions to chemotherapy, there were 26 cases in grade 0 (12.0%), 98 cases in grade Ⅰ (45.1%), 59 cases in grade Ⅱ (27.2%), 23 cases in grade Ⅲ (10.6%), and 11 cases in grade Ⅳ (5.1%), mainly manifested as bone marrow suppression after chemotherapy (132 cases). No second tumors appeared, and only 4 cases had transient hearing abnormalities, which returned to the normal state in the subsequent review. Conclusions:Infantile RB has its own characteristics.Such factors as different eye types and different clinical stages can affect the prognosis of children.The survival rate of such children can be improved significantly and the rate of eyeball removal can be reduced after treatment.

Clinical features and prognosis of 21 children with medulloblastoma / 国际儿科学杂志

Objective:To investigate the clinical features and adjuvant chemotherapy of children with medulloblastoma(MB).Methods:Clinical data of 21 pathologically confirmed MB children admitted to the department of pediatrics of Beijing Tongren Hospital affiliated to Capital Medical University from May 2012 to November 2017 were collected to analyze the clinical efficacy and prognosis of multidisciplinary combined treatment.Results:There were 21 children enrolled in the study(15 males and 6 females; median age: 6 years and 3 months). The majority of tumors were from the fourth ventricle(66.7%, 14/21 cases). The most common type of pathological tissue was classic medulloblastoma(61.9%, 13/21 cases). Most of the molecular types was type 4(47.6%, 10/21 cases). There were 15 cases(71.4%)in the high-risk group and the remaining 6 cases(28.6%)in the low-risk group without metastasis(M0 stage). Total tumor resection was performed in 16 cases(76.2%). The patients were followed up to December 2019(median follow-up time was 29 months). After comprehensive treatment, 11 patients died and 6 patients relapsed.The 2-year survival rate was 61.5%, and the 5-year survival rate was 51.1%.Cox regression multivariate analysis showed that the survival rate of children with no tumor spread, short time interval between radiotherapy and surgery was higher( P<0.05). Conclusion:The incidence of MB in boys is higher than that in girls.Whether the tumor is disseminated or not, the time interval between radiotherapy and surgery are independent risk factor affecting the prognosis.Multidisciplinary combination therapy can effectively improve the long-term prognosis.

Research updates of diagnosis and treatment of COVID-19 / 解放军医学杂志

From December 2019, the outbreak of corona virus disease 2019 (COVID-19) hits Hubei Province of China. It causes severe acute respiratory syndrome in some patients and notable number of cases died of multiple organ failures. SARS-CoV-2 mainly spread by respiratory droplets and close contact. It is highly infectious and has been found in many countries and regions around the world. So far, no specific vaccine and specific drugs against SARS-CoV-2 have been developed for clinical use. This article reviews the virological characteristics, clinical symptoms, infection mechanism, epidemiology, research progress and clinical effect of COVID-19. It could provide new insights for clinical prevention of COVID-19.

Obstructive Ileocolitis in Patients With Obstructed Colorectal Cancer – A Matched Case Control Study

PURPOSE: Obstructive ileocolitis is an ulcero-inflammatory condition which typically occurs in the ileum or colon proximal to an obstructing colorectal lesion. If left unresolved, it often leads to intestinal perforation. We present a matched case control study of patients with obstructive ileocolitis caused by colorectal cancer to determine if any factors can predict this condition. METHODS: This is a retrospective review of 21 patients with obstructive colorectal cancer and histologically proven obstructive ileocolitis from 2005 to 2015 matched for age and sex with 21 controls with obstructing colorectal cancer without obstructive ileocolitis. RESULTS: The 21 patients with obstructive ileocolitis had a median age of 71 years (range, 52–86 years). The most common presenting symptom was abdominal pain (n = 16, 76.2%), followed by vomiting/nausea (n = 14, 66.7%) and abdominal distension (n = 12, 57.1%). Interestingly, the radiological feature of pneumatosis intestinalis was noted in only 1 case. No significant differences were observed in baseline comorbidities, clinical presentations, or tumor characteristics between the 2 groups. Patients with obstructive ileocolitis were found to have a significantly higher total leucocyte count (17.1 ± 9.4×109/L vs. 12.0 ± 6.8×109/L, P = 0.016), lower pCO2 (32.3 ± 8.2 mmHg vs. 34.8 ± 4.9 mmHg, P = 0.013), lower HCO3 (18.8 ± 4.5 mmol/L vs. 23.6 ± 2.7 mmol/L, P < 0.001), lower base excess (-6.53 ± 5.32 mmol/L vs. -0.57 ± 2.99 mmol/L, P < 0.001) and higher serum lactate levels (3.14 ± 2.19 mmol/L vs. 1.19 ± 0.91 mmol/L, P = 0.007) compared to controls. No radiological features were predictive of obstructive ileocolitis. CONCLUSION: Patients with obstructive ileocolitis tend to present with metabolic acidosis with respiratory compensation, raised lactate, and worse leucocytosis. Radiological features are not useful for predicting this condition.

Treatment and prognosis analysis of 56 cases of childhood hepatoblastoma in advanced stage with pulmonary metastasis / 中华实用儿科临床杂志

Objective To explore the treatment and prognosis of advanced stage childhood hepatoblastoma with pulmonary metastasis.Methods Fifty-six cases of advanced stage hepatoblastoma with pulmonary metastasis diagnosed through pathology from April 2006 to June 2014 in Department of Pediatrics,Beijing Tongren Hospital Affilia-ted to Capital Medical University were enrolled,among them 33 cases were males and 23 cases were females,and the median age was 2.33 years old(1 month-15 years and 1 month old).The clinical effects of multidisciplinary therapy were analyzed.Results (1)Follow-up studies were conducted till December 2016,in which 21 cases of 56 children achieved complete remission,the complete remission rate was 37.5%(21/56 cases),while 12 cases were partial re-mission and 14 cases were deceased,and the effective rate reached 58.9%(33/56 cases).The follow-up period of 41 children were over 24 months,in which the 2-year free event survival(EFS)rate was 37.5%,2-year overall survi-val(OS)rate was 75.0%,5-year survival rate was 42.4%,and the 95% average survival confidence interval was 35.7-55.9 months.(2)The OS rate of children with small age(≤3 years old)was 88.1%(36/42 cases),the ove-rall prognosis was better than that of >3 years old children(35.7%,5/14 cases)(P=0.003).The survival rate of children with complete tumor resection[OS rate was 89.2%(33/37 cases)]was significantly higher than that of the incomplete excision[OS rate was 47.4%(9/19 cases)],and the difference was statistically significant(P=0.001). The prognosis of epithelial type cases was better than that of other types,and the difference was statistically significant (P<0.05),while the fetal type prognosis was the best,and the difference was statistically significant(χ2=8.56,P=0.014).The growth of alpha fetoprotein was negatively correlated with the clinical efficacy and prognosis(r=-0.468, P=0.023).Conclusions Lung is the most common metastatic site of hepatoblastoma,and the marginal lung metasta-sis is more common.With insidious onset and poor prognosis.Therefore,it should be treated with early diagnosis and multidisciplinary therapy to improve prognosis.

Therapeutic effect of rehabilitative exercise on angina pectoris and its impact on cardiac autonomic nervous function,IL-6 and BNP level / 心血管康复医学杂志

Objective:To study therapeutic effect of rehabilitative exercise on angina pectoris and its impact on cardiac au-tonomic nervous function,levels of interleukin (IL)-6 and brain natriuretic peptide (BNP).Methods:A total of 128 pa- tients with angina pectoris,who were treated in our hospital from Jan 2013 to Dec 2016,were enrolled as rehabilitative ex-ercise group (received routine treatment and rehabilitative exercise ) and treated for six months.Another 128 healthy sub-jects were regarded as healthy control group.Blood lipid levels,indexes of heart rate variability (HRV),levels of IL-6 and BNP were observed and compared between two groups before and after treatment.Results:1.Comparison of blood lipids and BNP (table 2,4):(1) Before vs.after treatment in rehabilitative exercise group:after six-month treatment,there were significant reductions in levels of TG,TC,LDL-C,IL-6 and BNP,and significant rise in HDL-C level,P＝0.001 all;(2) Comparison between two groups after treatment:Compared with healthy control group after treatment,there were significant rise in levels of TG [ (1.56 ± 0.17) mmol/L vs.(2.15 ± 0.22) mmol/L],TC [ (1.53 ± 0.20) mmol/L vs.(4.01 ± 0.43) mmol/L],LDL-C [ (2.79 ± 0.29) mmol/L vs.(3.21 ± 0.25) mmol/L],IL-6 [ (12.21 ± 1.34) pg/ml vs.(20.18 ± 2.19) pg/ml] and BNP [ (89.96 ± 9.21) ng/L vs.(410.69 ± 42.76) ng/L],and significant reduction in HDL-C level [ (1.16 ± 0.19) mmol/L vs.(0.98 ± 0.11) mmol/L] in rehabilitative exercise group,P＝0.001 all.2.HRV index comparison (table 3):(1) Healthy control group (resting vs.after exercise):after exercise there were signif-icant reductions in lnVLF,lnLF,lnHF and lnTP,and significant rise in ln (LF/HF),P＝0.001 all;(2) Rehabilitative exercise group before treatment (resting vs.after exercise):after exercise only lnVLF significantly reduced,P＝0.005;(3) Healthy control group vs.rehabilitative exercise group before treatment,no matter resting or after exercise,there were significant reductions in lnVLF,lnLF,lnHF and lnTP,and significant rise in ln (LF/HF) in rehabilitative exercise group,P＝0.001 all;(4) Rehabilitative exercise group after treatment (resting vs.after exercise):after exercise there were significant reductions in lnVLF,lnLF,lnHF,lnTP and ln (LF/HF),P＝ 0.001 all;(5) Rehabilitative exercise group resting (before vs.after treatment):after treatment there were significant rise in lnVLF,lnLF,lnHF and lnTP,P＝0.001 all;(6) Rehabilitative exercise group after exercise (before vs.after treatment):after treatment there were sig-nificant rise in lnLF and lnHF,and significant reduction in ln (LF/HF),P＜0.01 all.Conclusion:Rehabilitation exercise can significantly improve blood lipid levels,relieve inflammation,improve cardiac autonomic nervous function with signifi-cant therapeutic effect in patients with angina pectoris,and it＇s safe and reliable.

Clinical characteristics and prognosis of children aged five or above with stage 3/4 neuroblastoma / 中华全科医师杂志

Objective To study the clinical characteristics and prognosis of children aged 5 or above with stage 3/4 neuroblastoma ( NB).Method Among 180 children with NB admitted from March 2007 to June 2015, 54 were aged 5 or above with stage 3 or 4.The clinical characteristics , therapeutic efficacy and prognosis of above 54 cases were analyzed.Results There were 36 boys and 18 girls with a male to female ratio of 2∶1.The most common of primary site was retroperitoneum (41/54, 75.5%), followed by mediastinum (10/54,18.5%), spine and pelvic cavity (3/545,6%).After treated by average 9 cycles of chemotherapy , 34 cases ( 63%) achieved complete remission ( CR ) , 13 ( 24.1%) achieved partial remission (PR), 5 (9.3%) presented disease progression (DP), and 2 died (3.7%).Patients were followed up for median 30 months ( 8 -99 months ) , 24 cases died and 30 survived with a overall survival (OS) rate of 55.6%.In 30 survival cases, there were 23 cases (76.7%) of event-free survival (EFS) ,and 6 cases (20.0%) of PR and 1 case (3.3%) of DP.There were significant differences in prognosis among patients with different responses to first therapy (χ2 =8.963, P =0.003 ).Among 20 children with stage 4 NB treated by autologous peripheral blood stem cell transplantation ( APBSCT ) , 13 cases died and 7 survived with an average survival time of (73.55 ±8.89)months.Among 29 cases without APBSCT, 11 cases died and 18 survived with an average survival time of(40.19 ±5.52)months.There was no significant difference in survival between APBSCT and no-APBSCT.Conclusion Children aged 5 or above with NB tend to have advanced stage , relapse and long treatment cycle , but the survival still can be improved with the appropriate treatment .

Clinical features and outcomes of neuroblastoma patients aged above 5 years / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features and outcomes of neuroblastoma (NB) children aged above 5 years, and to provide a theoretical basis for improving prognosis.</p><p><b>METHODS</b>A retrospective analysis was performed for the clinical data of 54 previously untreated NB children, and their clinical features and outcome were analyzed. The Kaplan-Meier method was used for survival analysis.</p><p><b>RESULTS</b>Among the 54 children, there were 36 boys and 18 girls, and all of them had stage 3 or 4 NB. Of all the children, 41 (41/54, 76%) had retroperitoneal space-occupying lesions, 10 (10/54, 18%) had mediastinal space-occupying lesions, 2 (2/54, 4%) had intraspinal space-occupying lesions, and 1 (1/54, 2%) had pelvic space-occupying lesions. At the end of the follow-up, 30 children (30/54, 56%) survived, among whom 23 (77%) achieved disease-free survival (9 achieved complete remission after chemotherapy for recurrence), 6 (20%) achieved partial remission of tumor (all of them received chemotherapy again due to recurrence), and 1 (3%) experienced progression (with progression after chemotherapy again due to recurrence); 24 children (44%) died, among whom 22 died after chemotherapy again due to recurrence and 2 died of multiple organ failure during the first treatment. According to the Kaplan-Meier survival analysis, the mean survival time was 53.8 months, and the children with stage 3 NB had a significantly higher overall survival rate than those with stage 4 NB (80% vs 53%; p<0.01). The children with recurrence had a significantly lower mean survival time than those without recurrence (51.68 months vs 62.57 months; p<0.01).</p><p><b>CONCLUSIONS</b>Older children often have late-stage NB, but standard treatment can improve their outcomes.</p>

Preliminary analysis on the treatment of ventilator-associated pneumonia caused by pandrug-resistant Acinetobacter baumannii / 中国医学科学院学报

<p><b>OBJECTIVE</b>To analyze the clinical features of pandrug-resistant Acinetobacter baumannii (PDR-Ab) in the Chinese PLA General Hospital and compare the efficacies of different antibiotic treatments in aged patients with ventilator-associative pneumonia (VAP) caused by PDR-Ab.</p><p><b>METHODS</b>Data were collected from all isolated PDR-Ab strains in our hospital from April 2009 to April 2010. The clinical features, treatment, and outcomes were retrospectively reviewed.</p><p><b>RESULTS</b>PDR-Ab was found to be the dominant pathogen in 42 of 126 aged VAP patients. Cefoperazone/sulbactam plus minocycline showed good efficacy in 20 patients with PDR-Ab VAP, showing a clinical cure rate of 65% (13/20) and a bacterial eradication rate of 40% (8/20). Another 22 patients were treated with other antimicrobial drugs, achieving a clinical cure rate of 22.7% (5/22) and a bacterial eradication rate of 13.6% (3/22). The factors influencing bacterial clearance were prolonged length of hospital stay and mechanical ventilation prior to positive culture (all P<0.01).</p><p><b>CONCLUSION</b>Cefoperazone/sulbactam plus minocycline can be an effective treatment for VAP caused by PDR-Ab.</p>

Clinical efficacy and prognosis with advanced Wilms' tumor in children / 中华实用儿科临床杂志

Objective To analyze the clinical data of 12 children with advanced Wlims' tumor in children from Feb.2009 to Jun.2012.All cases were diagnosed by pathology and to analysis the clinic efficacy and treatment experience were analyzed.Methods Of 12 patients,10 cases were male and 2 cases were female.The medium age of 12 patients was 2.54 years old(9 months-15 years old).According to pathological stage and clinical stage of The National Wilms' Tumor Study Group(NWTSG),5 cases belonged to stage lⅢ,and 7 cases stage Ⅳ.Six cases were well-differentiated tissue type,and 6 cases were poorly differentiated tissue type according to NWTSG.In all patients,different ways of chemotherapy and radiotherapy were selected according to clinical stage and tissue type differentiation.If a patient had repeated recurrence after common surgery and chemotherapy,would treated by antologous peripheral blood stem cell transplantation(APBSCT).Statistic analysis was used to analyze the clinical characters and efficacy and prognosis for 12 patients.Results 1.Initial symptoms:in 12 cases,8 cases presented abdominal mass (66.6％),2 cases with abdominal pain and fever(12.7％),and 2 cases with hematuria(12.7％).2.Eleven cases followed up to Jan.2013,the medium time was 31.5 months(8-131 months).Of 12 cases,1 case give up therapy and follow-up and 11 cases were followed up.Of those 11 cases followed-up,4 cases had complete remission(CR),and 1 case had remission in part(PR),the conditions of 5 cases were progressively worse,1 case replapsed,and 4 patients died.Total survival rate was 63.63％ (7/11 cases),and mortality was 36.37％ (4/11 cases),and free survival rate was 36.37％ (4/11 cases),of that,1 patient of stage Ⅳ,relapsed 3 times after common radiotherapy and chemotherapy,achieved complete remission after high dose chemotherapy (Melphalan + Carboplatin + Etoposide,CEM) and APBSCT.The estimated 3-yearsurvival rate was 51.4％.Conclusions The prognosis of advanced Wilms' tumor is poor,and the mortality is still high.High dose chemotherapy with APBSCT may be a valuable method for advanced cases.

Effect of simulated microgravity and its associated mechanism on pulmonary circulation in rats / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the effect of Simulated Microgravity and its Associated Mechanism on Pulmonary Circulation in Rats).</p><p><b>METHODS</b>Rat tail-suspension model was used to simulate the physiological effects of microgravity and changes in pulmonary blood vessel morphology, pulmonary arterial and venous blood pressure, pulmonary vascular resistance, pulmonary vasomotoricity, as well as the regulation of pulmonary circulation by cytokines produced and released by the lung of rats were measured.</p><p><b>RESULTS</b>The walls of pulmonary blood vessels of rats were thickened, and the pulmonary artery was reconstructed with increased pulmonary vascular resistance. The pulmonary blood vessels of rats became more prone to dilation as contractions increased. Rat epithelial Adrenomedulin gene transcription and protein expression were upregulated. The level of basic fibroblast growth Factor of rat was also elevated.</p><p><b>CONCLUSION</b>Findings from the present study on rats revealed that the microgravity can affect pulmonary blood vessel structure, pulmonary arterial pressure, and pulmonary blood vessel self-regulation and cytokine production.</p>

Significance of trypsinogen activation peptides and interleukin-6 in experimental acute pancreatitis / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the feasibility of using plasma trypsinogen activation peptides (TAP) and serum interleukin-6(IL-6) as early markers for predicting the severity of experimental acute pancreatitis.</p><p><b>METHODS</b>Ninety male adult Sprague-Dawley rats were equally randomized into five groups: edema pancreatitis group, treated with retrograde ductal infusion of 3% sodium taurocholate solution; necrosis pancreatitis group, treated with retrograde ductal infusion of 5% sodium taurocholate solution; treatment pancreatitis group, treated with retrograde ductal infusion of 3% sodium taurocholate solution and ulinastatin intravenous infusion half an hour later; control pancreatitis group, treated with 0.9% normal saline retrograde ductal infusion; and sham operation group, treated with sham operation. Rats in each group were equally randomized into three subgroups, which were killed by exsanguination 3, 6, or 24 hours after infusion, and blood specimens were obtained. Serum amylase, plasma TAP, and serum IL-6 were determined. The severity of pancreatitis was scored by two blinded pathologists under microscope.</p><p><b>RESULTS</b>At 3 and 6 hours after infusion, plasma TAP concentration of necrosis pancreatitis group [(4.798±0.169) and (3.999±0.299)nmol/L, respectively]were significantly higher than those of edema pancreatitis group [(2.416±0.148) and (3.356±0.211)nmol/L, respectively] (P<0.01); at 6 hours after infusion, serum IL-6 level of necrosis pancreatitis group [(1339.51±56.43)pg/ml]was significantly higher than that of edema pancreatitis group [(619.07±42.25)pg/ml] (P<0.01).</p><p><b>CONCLUSIONS</b>In this acute pancreatitis model, the peak levels of plasma TAP and serum IL-6 may appear earlier in rats with severer disease. Serum TAP level may be used as a marker for the accurate early prediction of the severity of acute pancreatitis.</p>

Salidroside inhibits clinorotation-induced apoptosis in pulmonary microvascular endothelial cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the inhibitory effect of salidroside (Sal) on pulmonary microvascular endothelial cell (HPMEC) apoptosis induced by simulated microgravity and its mechanism.</p><p><b>METHODS</b>Human pulmonary microvascular endothelial cells cultured in vitro were divided into control group, clinorotation group and clinorotation+Sal pretreatment groups. Microgravity was simulated by clinorotation. The apoptotic rate of HPMECs was detected by flow cytometry using Annexin V-FITC staining, and the expressions of bcl-2, bax, and caspase-3 at the mRNA and protein levels were determined by real-time PCR and Western blotting, respectively.</p><p><b>RESULTS</b>A 72-h clinorotation significantly induced apoptosis in HPMECs. Real-time PCR results demonstrated a significantly lowered bcl-2 but increased bax and caspase-3 mRNA expressions in clinorotation group as compared with those in the control group. Western blotting showed that clinorotation inhibited the protein expressions of PI3K and p-AKT and increased caspase-3 protein expression. Salidroside significantly inhibited the cell apoptosis, reversed the expressions of Bcl-2 and Bax, and attenuated the decrease in the protein expression of PI3K and phosphorylation level of AKT. Salidroside also antagonized the activation of caspase-3.</p><p><b>CONCLUSION</b>PI3K/AKT pathway and caspase 3 are involved in the apoptosis of HPMVECs induced by clinorotation, and the effect of clinorotation can be reversed by salidroside, suggesting the potential value of salidroside for application in spaceflight.</p>

Clinical data analysis and chest radiographic features of Wegener's granulomatosis with pulmonary involvement / 南方医科大学学报

<p><b>OBJECTIVE</b>To improve the diagnostic accuracy of Wegener's granulomatosis (WG) with pulmonary involvement by analyzing the clinical data and chest radiographic features.</p><p><b>METHODS</b>The clinical data and chest radiographic features of 43 WG cases with pulmonary involvement were retrospectively analyzed.</p><p><b>RESULTS</b>Clinically, the patients frequently presented with multi-system involvement, with the incidence of pulmonary involvement of 72.8%. The patients with WG presented with such symptoms in the respiratory system as coughing, expectoration, hemoptysis, and dyspnea. The radiographic manifestations varied among the cases. Nodules and cavitations in the lungs were the signs most frequently found, and patchy infiltration and bronchial narrowing were also observed, which often led to misdiagnosis of WG as other pulmonary diseases.</p><p><b>CONCLUSION</b>WG often has multi-organ involvement, and the lung is one of the most commonly involved organs. The clinical symptoms and radiographic manifestations of WG have no specificity, and the disease can be easily misdiagnosed. Biopsy and ANCA assay can be important means for WG diagnosis.</p>

Repair of occipital and nuchal wounds with inferior trapezius myocutaneous flaps in patients after high voltage electrical burn / 中华烧伤杂志

<p><b>OBJECTIVE</b>To explore the methods and effects of repair of occipital and nuchal wounds with inferior trapezius myocutaneous flap after deep electrical bum.</p><p><b>METHODS</b>Twelve patients with high-voltage electrical burn in occipital and nuchal regions were hospitalized to our ward from March 2003 to September 2007. They were repaired with improved inferior trapezius myocutaneous flaps after debridement. Flaps were of two types: (1) blood supply from cutaneous and perforator branches of the original segment of the superficial descending branch of transverse cervical artery. (2) combined blood supply from both superficial and deep descending branches of transverse cervical artery C, i.e., dorsal scapular artery). All flaps carried segmental and limited trapezius muscle cuff surrounding the vascular pedicle of the flap similar to a perforator flap.</p><p><b>RESULTS</b>Flaps survived completely primarily in eight cases. In two patients, infection developed in flaps adjacent to wounds with lignification; they healed after dress change. Necrosis appeared in distal end of flap (one case), it healed after re-operation. One patient with surviving flaps died of sepsis and multiple organ failure 21 days after operation. The flaps which survived were not swollen ; the donor sites at scapular region looked normal without pterygoid or pendulous scapula deformities.</p><p><b>CONCLUSION</b>Inferior trapezius myocutaneous flaps can be used to repair occipital and nuchal wounds, with the advantages of constant blood vessels, reliable blood supply, convenience for application.</p>

Early reconstruction of the periorbital injuries / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics and the treatment of periorbital injuries.</p><p><b>METHODS</b>61 cases were treated, including 30 cases orbitozygomatic fracture, 6 cases of frontal-orbital fracture, 8 cases of naso-ethmoid-orbital fracture, 7 cases of blow -out fracture and 10 cases of complicated fracture. The patients were diagnosed after physical examination and other examination, like CT. Through bicoronal or local mini incision at the end of eyebrow, combined with subciliary incision and local wound approach, the fractured sites were exposed completely. Then the fractured fragments were repositioned and fixed rigidly. The orbital wall was reconstructed with titanium net and Medpor.</p><p><b>RESULTS</b>The wounds healed primarily. Good cosmetic and functional results achieved in most of the patients. 4 cases underwent second-stage ophthalmectomy. 2 patients had diplopia after operation, but improved gradually. 3 cases of blepharoptosis needed further treatment.</p><p><b>CONCLUSIONS</b>Early diagnosis and treatment is very important for periorbital injuries. Fracture reposition and orbital wall reconstruction should he performed at early period.</p>

Periradicular compound betamethasone injection therapy for lumbar radicular pain performed under CT guidance / 介入放射学杂志

Objective To evaluate the clinical efficacy of periradicular compound betamethasone injections into the periganglionic space in the treatment of radicular pain.Methods Periganglionic compound betamethasone infiltrations were performed in 76 patients with lumbar radicular pain under MSCT guidance.All patients were divided into two groups including group 1(31 cases of lumbar disc herniation)and group 2(45 cases of lumbar degenerative disorders).The total and two groups scores of VAS were compared after the therapeutic procedure with evaluation of the efficacy.Results 88%(69/76)of patients showed significant pain reduction,with the score of VAS 6.5?2.0(before therapy)dropping to 3.4?1.8(after 1 week)and 3.8?1.9(after 3 month).Differences in improvements before and after the therapy were statistically significant.Differences between one-week and three-month follow-up were not statistically significant.Differences between the two groups demonstrated no statistical significance.Conclusion Periradicular compound betamethasone injection under CT guidance is safe and useful in the treatment of lumbar radicular pain.

Serious response during tilt-table test in elderly and its prophylactic management / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To evaluate the serious response during tilt-table test (TTT) and its prophylactic management.</p><p><b>METHOD</b>Seventy-six elderly patients were tested at a tilt angle of 70 degrees for a maximum of 45 min and then subjected to isoproterenol-provocative tilt testing. ECG and blood pressure were monitored during the test and patients were kept at normal saline condition through a peripheral intravenous duct.</p><p><b>RESULTS</b>Fifty-one of 76 patients were defined as positive including 23 having serious response; 6 of the 23 patients had arteriosclerosis involving internal carotid arteries and 7 cases had bradycardia, two of which were associated with II degrees -I A-V block and the others with chronic atrial fibrillation. The serious response consisted of cardiac arrest for more than 5 s (6 cases), or serious bradycardia for more than 1 min (7 cases) or serious hypotension for more than 1 min (10 cases). Those with serious response were managed by returning to supine position, thus driving up legs and intravenous atropine, CPR (2 cases with cardiac arrest) and needing oxygen supplementation (11 cases). Only 2 hypotension patients recovered gradually by 10 min after emergency management, while others recovered rapidly with no complications.</p><p><b>CONCLUSION</b>Although non-invasive, TTT may result in serious response, especially in elderly. Therefore proper patient selection, control of isoproterenol infusion and close observation of vital signs are decisive for a safe consequence.</p>