Analysis of the relationship between MRI imaging characteristics and clinical symptoms and therapeutic efficacy in adenomyosis patients / 中华妇产科杂志

Objective: To investigate the relationship between magnetic resonance imaging (MRI) imaging characteristics and clinical symptoms and therapeutic efficacy in adenomyosis patients. Methods: The clinical characteristics of the adenomyosis questionnaire was self-designed. This was a retrospective study. From September 2015 to September 2020, totally 459 patients were diagnosed with adenomyosis and underwent pelvic MRI examination at Peking University Third Hospital. Clinical characteristics and treatment were collected, MRI was used to determine the lesion location, and to measure the maximum lesion thickness, the maximum myometrium thickness, uterine cavity length, uterine volume, the minimum distance between the lesion and serosa or endometrium, and whether combined with ovarian endometrioma. The difference of MRI imaging characteristics in patients with adenomyosis and its relationship with clinical symptoms and therapeutic efficacy were analyzed. Results: (1) Among the 459 patients, the age was (39.1±6.4) years. There were 376 patients (81.9%, 376/459) with dysmenorrhea. Whether patients had dysmenorrhea were related to uterine cavity length, uterine volume, ratio of the maximum lesion thickness to the maximum myometrium thickness, and whether patients had ovarian endometrioma (all P<0.001). Multivariate analysis suggested that ovarian endometrioma was the risk factor for dysmenorrhea (OR=0.438, 95%CI: 0.226-0.850, P=0.015). There were 195 patients (42.5%, 195/459) with menorrhagia. Whether patients had menorrhagia were related to age, whether patients had ovarian endometrioma, uterine cavity length, the minimum distance between lesion and endometrium or serosa, uterine volume, ratio of the maximum lesion thickness to the maximum myometrium thickness (all P<0.001). Multivariate analysis suggested that ratio of the maximum lesion thickness to the maximum myometrium thickness was the risk factor for menorrhagia (OR=774.791, 95%CI: 3.500-1.715×105, P=0.016). There were 145 patients (31.6%, 145/459) with infertility. Whether the patients had infertility were related to age, the minimum distance between lesion and endometrium or serosa, and whether patients had ovarian endometrioma (all P<0.01). Multivariate analysis suggested that young and large uterine volume were risk factors for infertility (OR=0.845, 95%CI: 0.809-0.882, P<0.001; OR=1.001, 95%CI: 1.000-1.002, P=0.009). (2) The success rate of in vitro fertilization-embryo transfer (IVF-ET) was 39.2% (20/51). Dysmenorrhea, high maximum visual analogue scale score and large uterine volume affected the success rate of IVF-ET (all P<0.05). The smaller the maximum lesion thickness, the smaller the distance between the lesion and serosa, the larger the distance between the lesion and endometrium, the smaller the uterine volume, and the smaller the ratio of the maximum lesion thickness to the maximum myometrium thickness, the better the therapeutic efficacy of progesterones (all P<0.05). Conclusions: Concomitant ovarian endometrioma increases the risk of dysmenorrhea in patients with adenomyosis. The ratio of the maximum lesion thickness to the maximum myometrium thickness is an independent risk factor for menorrhagia. Young and large uterine volume may increase the risk of infertility. Severe dysmenorrhea and large uterine volume affect the success rate of IVF-ET. The therapeutic efficacy of progesterones is relatively better when the lesion is small and far away from the endometrium.

Application of ulnar nerve diameter changes examined by HRUS in patients with cubital tunnel syndrome / 中国骨伤

OBJECTIVE@#To evaluate the value of high-resolution ultrasound the diagnosis and prognosis of cubital tunnel syndrome.@*METHODS@#From January 2018 to June 2019, 47 patients with cubital tunnel syndrome were treated with ulnar nerve release and anterior subcutaneous transposition. There were 41 males and 6 females, aged from 27 to 73 years old. There were 31 cases on the right, 15 cases on the left, and 1 case on both sides. The diameter of ulnar nerve was measured by high-resolution ultrasound pre-and post-operatively, and measured directly during the operation. The recovery status of the patients was evaluated by the trial standard of ulnar nerve function assessment, and the satisfaction of the patients was assessed.@*RESULTS@#All the 47 cases were followed up for an average of 12 months and the incisions healed well. The diameter of ulnar nerve at the compression level was (0.16±0.04) cm pre-operatively, and the diameter of ulnar nerve was (0.23±0.04) cm post-operatively. The evaluation of ulnar nerve function:excellent in 16 cases, good in 18 cases and fair in 13 cases. Twelve months post-operatively, 28 patients were satisfied, 10 patients were general and 9 patients were dissatisfied.@*CONCLUSION@#The preoperative examination of ulnar nerve by high-resolution ultrasound is consistent with the intuitive measurement during operation, and the result of postoperative examination of ulnar nerve by high-resolution ultrasound is consistent with follow-up results. High-resolution ultrasound is an effective auxiliary method for the diagnosis and treatment of cubital tunnel syndrome.

Qualitative and quantitative study of flavonoids in Notoginseng Radix et Rhizoma based on UPLC-Q-TOF-MS and HPLC-DAD / 中国中药杂志

The flavonoids in Panax notoginseng were qualitatively analyzed by ultra-high performance liquid chromatography-quadrupole-time of flight mass spectrometry(UPLC-Q-TOF-MS), and the content of three main flavonoids in P. notoginseng of different specifications and grades collected from different habitats was determined by HPLC-DAD. Flavonoids and anthocyanins were analyzed by UPLC-Q-TOF-MS/MS in the positive and negative ion modes, respectively. Twelve flavonoid glycosides and one anthocyanin glycoside in P. notoginseng were identified, but no flavonoid aglycones were detected. Among them, 12 compounds were identified in the underground part of P. notoginseng for the first time and eight compounds were first reported in this plant. Moreover, six and four compounds were identified in the Panax genus and the Araliaceae family for the first time, respectively. A method for simultaneous determination of three flavonoids in P. notoginseng was established by HPLC-DAD. The content of flavonoids in 721 P. notoginseng samples of 124 specifications and grades collected from 20 different habitats was simultaneously determined. Among three flavonoids determined, the content of quercetin-3-O-(2″-β-D-xylosyl)-β-D-galactoside was the highest with the average content in the tested samples of 161.0 μg·g~(-1). The content of compounds quercetin-3-O-hexosyl-hexoside and kaempferol-3-O-pentosyl-hexoside was relatively low, with the average content of 18.5 μg·g~(-1)(calculated as quercetin-3-O-sophoroside) and 49.4 μg·g~(-1)(calculated as kaempferol-3-O-sangbu diglycoside). There were significant differences in flavonoids content of samples from different production area. The content of flavonoids in spring P. notoginseng was significantly lower than that in winter P. notoginseng when the other influencing factors such as production areas, germplasm resources, and cultivation conditions were fixed. As for P. notoginseng of different specifications, the flavonoid content in the part connecting the taproot and the aboveground stem was significantly higher than that in other parts. The results of large-scale data showed that the flavonoid content gradually increased with the increase in the number of heads. There were significant differences between the flavonoid content in most specifications and grades, especially the 20-head P. notoginseng and countless head P. notoginseng, whose content was significantly lower and significantly higher than that of other specifications and grades, respectively. This study provides a scientific basis for the study of the effective components and quality control of P. notoginseng from the perspective of flavonoids.

Water migration and kinetics of Arecae Semen during moistening process / 中国中药杂志

In this study, low-field nuclear magnetic resonance(LF-NMR) and magnetic resonance imaging(MRI) were employed to analyze the water distribution, status, and migration in the moistening process of Arecae Semen. Peleg model was adopted to study the water absorption kinetics of Arecae Semen moistened at different water temperatures(10, 30, and 50 ℃). The Arecae Semen samples soaked at different water temperatures all contained four water states: binding water T_(21), non-flowing water T_(22), free water T_(23), and unbound water T_(24). Non-flowing water had the largest increase in peak area during the moistening process, followed by free water. The peak areas of non-flowing water, free water, and total water were correlated with the water content(P<0.01). Therefore, LF-NMR can quickly and non-destructively predict the water content of Arecae Semen during moistening. The peak area of non-flowing water and the content of free water were correlated with the content of arecoline in the soaking solution(P<0.01), which indicated that the faster flow of non-flowing water and more free water corresponded to more arecoline dissolved. The MRI images showed that the water migration pathway varied at different soaking temperatures, and the moistening degree obtained by this means was consistent with that obtained based on traditional experience. The rate constant K_1 fitted by Peleg model decreased with the increase in water temperature, while the capacity constant K_2 showed an opposite trend. The Arrhenius equation fitting of K_1 with temperature showed that the activation energy of Arecae Semen in the moistening process was 32.98 kJ·mol~(-1). LF-NMR/MRI can be used to analyze the water status and content and determine the end moisturing point of Arecae Semen. Peleg model can accurately describe the water absorption properties of Arecae Semen in the moistening process. The findings of this study can guide the moistening optimization and mechanism research of other seed Chinese medicinal materials.

CRISPR Screens Identify Essential Cell Growth Mediators in BRAF Inhibitor-resistant Melanoma / 基因组蛋白质组与生物信息学报·英文版

BRAF is a serine/threonine kinase that harbors activating mutations in ∼7% of human malignancies and ∼60% of melanomas. Despite initial clinical responses to BRAF inhibitors, patients frequently develop drug resistance. To identify candidate therapeutic targets for BRAF inhibitor resistant melanoma, we conduct CRISPR screens in melanoma cells harboring an activating BRAF mutation that had also acquired resistance to BRAF inhibitors. To investigate the mechanisms and pathways enabling resistance to BRAF inhibitors in melanomas, we integrate expression, ATAC-seq, and CRISPR screen data. We identify the JUN family transcription factors and the ETS family transcription factor ETV5 as key regulators of CDK6, which together enable resistance to BRAF inhibitors in melanoma cells. Our findings reveal genes contributing to resistance to a selective BRAF inhibitor PLX4720, providing new insights into gene regulation in BRAF inhibitor resistant melanoma cells.

National Trends in Smoking Cessation Medication Prescriptions for Smokers With Chronic Obstructive Pulmonary Disease in the United States, 2007-2012 / 예방의학회지

OBJECTIVES: Smoking cessation decreases morbidity and mortality due to chronic obstructive pulmonary disease (COPD). Pharmacotherapy for smoking cessation is highly effective. However, the optimal prescription rate of smoking cessation medications among smokers with COPD has not been systemically studied. The purpose of this study was to estimate the national prescription rates of smoking cessation medications among smokers with COPD and to examine any disparities therein. METHODS: We conducted a retrospective study using National Ambulatory Medical Care Survey data from 2007 to 2012. We estimated the national prescription rate for any smoking cessation medication (varenicline, bupropion, and nicotine replacement therapy) each year. Multiple survey logistic regression was performed to characterize the effects of demographic variables and comorbidities on prescriptions. RESULTS: The average prescription rate of any smoking cessation medication over 5 years was 3.64%. The prescription rate declined each year, except for a slight increase in 2012: 9.91% in 2007, 4.47% in 2008, 2.42% in 2009, 1.88% in 2010, 1.46% in 2011, and 3.67% in 2012. Hispanic race and depression were associated with higher prescription rates (odds ratio [OR], 5.15; 95% confidence interval [CI], 1.59 to 16.67 and OR, 2.64; 95% CI, 1.26 to 5.51, respectively). There were no significant differences according to insurance, location of the physician, or other comorbidities. The high OR among Hispanic population and those with depression was driven by the high prescription rate of bupropion. CONCLUSIONS: The prescription rate of smoking cessation medications among smokers with COPD remained low throughout the study period. Further studies are necessary to identify barriers and to develop strategies to overcome them.

Olfactory functional magnetic resonance imaging in patients with mild cognitive impairment / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the activation of brain regions associated with olfactory in patients with mild cognitive impairment (MCI) by olfactory functional magnetic resonance imaging (fMRI). @*Methods@#Twenty six patients with MCI were compared with twenty six controls in the dementia center of Tianjin HuanHu hospital in terms of olfactory function T&T testing, the differences between the activation of the whole brain and region of interest associated with olfactory (bilateral primary olfactory cortex(POC), bilateral hippocampus, bilateral orbital frontal gyrus) by olfactory stimulator using event correlation design for olfactory fMRI scanning. To analyze the correlation between the number of activator in POC and the threshold of olfactory discriminate as well as the severity of cognitive impairment.SPSS 19.0 software was used for the statistical analysis. @*Results@#T&T olfactory testing revealed that MCI patients had higher scores than controls (3.57±1.29 (±s) vs 1.02±0.35, t=4.372, P<0.05). The activation range of whole brain in MCI patients was less than controls (pleasant odor (po) 147.36±21.45 vs 323.11±39.76, unpleasant odor (upo) 201.86±24.93 vs 447.73±57.22, tpo=4.241, tupo=5.365, both P<0.05). The activation range of whole brain in inhaling unpleasant odor was more than pleasant odor in controls (447.73±57.22 vs 323.11±39.76, t=3.936, P<0.05). The number of activator in ROIawo in MCI patients was less than controls (pleasant odor (po) 51.0[8.0, 109.0](M[P25, P75]) vs 135.0[21.0, 321.5], unpleasant odor (upo) 65.0[6.0, 158.0]vs 205.0[36.5, 491.0], Zpo=-2.199, Zupo=-2.216, both P<0.05). The number of activator in POC in MCI patients was less than controls (pleasant odor (po) 19.0[4.0, 35.5]vs 46.0[9.0, 118.5], unpleasant odor (upo) 26.0[2.0, 51.0]vs 79.0[17.5, 189.0], Zpo=-1.898, Zupo=-2.167, both P<0.05). The number of activator in POC was negatively correlated with olfactory discriminate threshold in MCI patients (rpo=-0.415, rupo=-0.409, both P<0.05). The number of activator in POC was positively correlated with MoCA in MCI patients (rpo=0.289, rupo=0.296, both P<0.05). @*Conclusion@#Olfactory fMRI can objectively assess the olfactory function in MCI, it is a imaging indicator with neuropsychological tests for detection in MCI, the number of activator in POC can reflect the severity of MCI.

The impact of different infarction regions on functional connectivity in motor execution network / 中华行为医学与脑科学杂志

Objective@#To explore the influence of the location of the infarction lesion on the resting-state functional connectivity (rsFC) of the motor execution network.@*Methods@#A total of 144 patients with infarction of the motor pathway were involved in the study, including 97 patients with capsule stroke (CS) and 47 patients with pontine stroke (PS).50 age-matched healthy subjects were enrolled.After acquiring the structural images and the resting-state functional MRI data of all the subjects by 3.0-Tesla MR scanner, the functional connectivity was calculated in different regions of interest and the differences of the rsFC within the motor execution network among patients with different infarction location were compared.@*Results@#Left CS patients exhibited increased rsFC in L_PMd (MNI x, y, z: -22, -13, 57) -R_M1 (MNI x, y, z: 38, -22, 56) (F=3.951, P=0.022), the increased rsFC than healthy controls (P=0.031); Left CS patients exhibited increased rsFC in R_PMv (MNI x, y, z: 53, 0, 25)-L_SPL (MNI x, y, z: -22, -64, 54) than healthy controls (F=4.017, P=0.021), left CS patients exhibited decreased rsFC in R_PCG (MNI x, y, z: 37, -34, 53) -R_PMv (MNI x, y, z: 53, 0, 25) than healthy controls(F=-3.788, P=0.025). Right CS patients exhibited increased rsFC than healthy controls in R_PMd(MNI x, y, z: 28, -10, 54)-L_M1(MNI x, y, z: -38, -22, 56) (F=4.438, P=0.014), right CS patients exhibited increased rsFC than healthy controls in R_PMv(MNI x, y, z: 53, 0, 25)-R_PCG(MNI x, y, z: 37, -34, 53)(F=4.830, P=0.010), right CS patients exhibited decreased rsFC in L_M1(MNI x, y, z: -38, -22, 56)-L_SMA(MNI x, y, z: -5, -4, 57) than healthy controls (F=-5.102, P=0.007). And the left PS patients showed increased rsFC than healthy controls in R_DN -L_SMA (F=4.939, P=0.009), left PS patients exhibited increased rsFC than healthy controls in L_DN-R_SMA (F=3.431, P=0.036), left PS patients exhibited reduced rsFC than healthy controls in R_AICb -R_PMd (F=-4.114, P=0.019). Right PS patients showed increased rsFC compared with healthy controls in L_DN-R_M1(F=3.075, P=0.049), and increased rsFC compared with healthy controls in L_AICb-R_SCb (F=3.725, P=0.027).@*Conclusion@#The infarction location poses influence on the FC alteration of the motor network after stroke.

Studies on flavonoids from Scutellaria moniliorrhiza / 中国中药杂志

By means of preparative HPTLC and column chromatography over silica gel and Sephadex LH-20, nineteen flavonoids were isolated and purified from the whole plants of Scutellaria moniliorrhiza. Based on the physico-chemical properties and spectral data, their structures were identified as： apigenin (1), luteolin (2), wogonin (3), oroxylin A (4), 6-methoxynaringein (5), 5,7,4'-trihydroxy-6,8-dimethoxyflavone (6), 5,7,8-trimethoxyflavone (7), 3,5,6,7-tetramethoxyflavone (8), 7-hydroxy-4',5,6,8-tetramethoxyflavone (9), 5,7,2'-trihydroxy-6-methoxyflavanone (10), 5,7,4'-trihydroxy-6-methoxyflavone (11), 5,7-dihydroxy-6,8-dimethoxy -flavone (12), 5,2',6'-trihydroxy-7,8-dimethoxyflavone (13), 5,7,2'-trihydroxy-8-methoxyflavone (14), 5,2'-dihydroxy-7,8-dimethoxyflavanone (15), 2'-hydroxy-5,7,8-trimethoxyflavone (16), 5-hydroxy-7,8-dimethoxyflavone (17), 5,2'-dihydroxy-7,8-dimethoxyflavone (18), and 5-hydroxy-6,7,8-trimethoxyflavone (19). For the first time, compounds 1-19 were isolated from S. moniliorrhiza, and compounds 6, 8, 9, 12, 19 were isolated from the Scutellaria genus.

Imaging diagnosis of 95 cases of moderate and severe acute carbon monoxide poisoning / 中华劳动卫生职业病杂志

Objective@#To explore the difference of radiological imaging features of delayed encephalopathy after carbon monoxide poisoning (DECMP) and acute carbon monoxide poisoning (ACMP) , and the correlation between the imaging findings and clinical prognosis of the disease.@*Methods@#The correlation between imaging findings and clinical manifestations and prognosis of 95 patients with moderate and severe acute carbon monoxide poisoning were retrospectively analyzed. In the above 95 cases, there were 62 cases of ACMP and 33 cases of DEACMP. All patients underwent conventional CT, MRI and magnetic resonance diffusion tensor imaging (DTI) . Circular regions of interest (ROI) measurement was used for analysis of average diffusion coefficient (ADC) value and fractional anisotropy (FA) value of the MRI and DTI imaging manifestations in different brain regions.@*Results@#The main clinical manifestation of moderate acute carbon monoxide poisoning was consciousness disorder and fatigue; Severe poisoning patients showed deep coma as the main clinical manifestations; The most prominent clinical manifestations of DEACMP were mental disorders and neurological impairment in the extrapyramidal system. A total of 95 cases with moderate or severe CO poisoning showed unilateral or bilateral cerebral cortex, bilateral basal ganglia (white ball) , cerebral white matter around bilateral ventricles or bilateral centrum semiovale, around bilateral ventricles cerebral white matter around bilateral ventricles and bilateral centrum semiovale, cerebral cortex and subcortical involvement. CT showed normal or low density shadow.MRI showed that the lesion T1WI presented slightly low or equal signal, T2WI and FLAIR sequences showed equal, a slightly higher or high signal; DWI sequence showed slightly higher or high signal. ADC value and FA value in different brain white matter regions of DEACMP group was significantly lower than those of ACMP group (P<0.05) , especially for those around semi oval center and lateral ventricles of the brain white matter (P<0.01) ; The ADC values increased significantly, FA value decreased significantly in the nerve nucleus (P<0.05) , especially for ADC values in globus pallidus (P<0.01) .@*Conclusion@#DTI can evaluate the brain tissue damage in patients with DEACMP more early and more accurately.

Olfactory bulb volume in patients with posttraumatic olfactory dysfunction / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the correlation between olfactory bulb(OB) volume and olfactory function in patients with posttraumatic olfactory dysfunction.@*Methods@#Forty patients with posttraumatic olfactory dysfunction were compared with forty controls in terms of olfactory function T&T testing, OB volume assessed with magnetic resonance imaging (MRI). SPSS 17.0 software was used to analyze the data.@*Results@#T&T olfactory testing revealed that patients with posttraumatic olfactory dysfunction had higher scores than controls(3.47±0.63 vs.1.39±0.19, t=4.317, P<0.05). Both men and women with posttraumatic olfactory dysfunction were affected by the same extent of olfactory loss(3.52±0.66 vs.3.43±0.61, t=0.896, P>0.05). Both men and women as controls were affected by the same extent of olfactory loss(1.41±0.20 vs.1.38±0.17, t=1.073, P>0.05). OB volume of left side in patients with posttraumatic olfactory dysfunction were (36.15±3.16)mm3, right side were (39.28±3.76)mm3, average OB volume were (37.55±3.42)mm3; OB volume of left side in controls were (81.74±5.87)mm3, right side were (83.58±6.13)mm3, average OB volume were (82.59±5.99)mm3; OB volumes were lower in patients with posttraumatic olfactory dysfunction as compared with controls(t value were 4.815, 4.837 and 4.825, all P<0.01). Average olfactory discriminate threshold was negatively correlated with average OB volume in posttraumatic olfactory dysfunction and controls(r value was-0.582, -0.564, both P<0.05). Average olfactory discriminate threshold was positively correlated with impairment degree in patients with posttraumatic olfactory dysfunction(r value was 0.472, P<0.05), average OB volume was negatively correlated with impairment degree in patients with posttraumatic olfactory dysfunction(r value was -0.397, P<0.05)@*Conclusions@#The OB volumes are lower in patients with posttraumatic olfactory dysfunction as compared with controls. The OB volume is correlated with olfactory function. Impairment degree in patients with posttraumatic olfactory dysfunction is accordance with olfactory function lowering degree. Megnetic resonance imaging can be used as a supplementary diagnostic tool for patients with posttraumatic olfactory dysfunction.

Dynamic susceptibility contrast enhanced MRI in differential diagnosis of glioblastoma, solitary cerebral metastasis and cerebral lymphoma / 中国医学影像技术

Objective To investigate the value of the dynamic susceptibility contrast enhanced MRI (DSC-MRI) in differential diagnosis of glioblastoma,solitary cerebral metastatic tumors and cerebral lymphoma.Methods Seventeen patients with glioblastoma,15 cases with solitary cerebral metastatic tumor and 17 cases with cerebral lymphoma were analyzed retrospectively.All patients underwent conventional MR imaging,contrast enhancement and DSC-MRI preoperatively.Pseudo color pictures of cerebral blood volume (CBV) and the time signal intensity curve were obtained from the raw data of DSC MRI.The relative CBV (rCBV)were measured from regions of enhanced solid parts of the tumors,peritumoral region and contralateral normal white matter regions respectively.The percentage of signal intensity recovery (PSR) of enhanced solid parts of the tumors were measured.ROC curve analysis was performed to determine optimum indicator in differential diagnosis of three types of tumors,and the sensitivity and specificity were calculated.Results Three types of tumors all showed enhancement of solid area with obvious peritumoral edema.Besides the no difference between glioblastoma and metastasis in rCBV of solid parts of the tumors,there were statistically significant differences in comparisons of two types of tumors (all P＜0.05).Besides the no difference between single brain metastases and lymphoma in rCBV of peritumoral regions,there were statistically significant differences in comparisons of two types of tumors (all P＜0.05).The PSR of the solid parts of the tumors had no difference between glioblastoma and single brain metastases,while there were statistically significant differences in comparisons of two types of tumors (all P＜0.05).ROC curve analysis showed sensitivity and specificity of the PSR values of solid parts of the tumors in differentiating lymphoma and non lymphoma were 100 ％and 81.3 ％.The rCBV of peritumoral regions was the optimum indicator for differentiating glioblastoma and solitary brain metastasis,the sensitivity and specificity were respectively 94.1％ and 86.7％.Conclusion The combination of rCBV and PSR can improve the efficiency for diagnosing the three types of brain tumors.

Port-externalized overexpansion with huge expanders and its use in extensive skin lesion / 中华医学美学美容杂志

Objective To study port-externalized tissue expansion technique and to provide a safe,simple and effective skin tissue expansion for extensive skin lesion reconstruction.Methods A lot of 247 patients with extensive skin lesion were chosen for the study.400-1000 ml tissue expanders were used for overexpansion and repeated expansion.Expanders were inserted into subcutaneous pockets through mini-invasive incisions and intermittent injection was carried out 4 days after first stage operation.After expansion finished,expanded skin flaps were transplanted for skin lesion reconstruction.During inflation period,complications and expander failures were observed.Results In 741 expanders of 247 patients,complication rate was 16.5 ％ with total 122 cases of complications.Expansion success rate was 98.9 ％ with 8 expander failures.Expanders were inflated successfully between 64-113 days,with average 92.7 days.The inflated saline volume was 2.38 times of marked expander capacity.In this group of 733 expanded skin flaps,721 flaps were well survived with 98.4％ success rate.276 expanded flaps of 116 patients were followed up for one to five years post-operation.The width of incision scar was between 0.3-1.2 mm.Conclusions The port-externalized overexpansion with giant expanders is a safe,simple and feasible technique,which is worthy of further clinical application.

Comparative study on neuropsychological tests for typical Alzheimer's disease, frontal variant of Alzheimer's disease and behavioral variant of frontotemporal dementia / 中华老年医学杂志

Objective To compare the neuropsychological features and other clinical and imaging characteristics among patients with typical Alzheimer's disease (TAD),frontal variant Alzheimer's disease (fvAD) and behavioral variant frontotemporal dementia (bvFTD).Methods Neuropsychological scales were used to evaluate the cognitive function and neuropsychiatric symptoms of nine patients with fvAD,30 patients with bvFTD and 32 patients with typical AD (TAD).The apolipoprotein E (ApoE) ε4 allele and brain imaging techniques,including the magnetic resonance imaging (MRI),11 C-Pittsburgh compound B positron emission tomography (PIB-PET),and 18F-deoxyglucose positron emission tomography (FDG-PET),were used for the differential diagnosis of fvAD and bvFTD.Results There were no significant differences in general cognitive function or daily activity in patients among the three groups.However,the cognitive subscale scores of Montreal Cognitive Assessment (MoCA) scale,including visual acuity and executive function,delayed recall,and orientation,were significantly different among the groups (Z =7.891,P =0.035;Z =7.412,P =0.031;Z=6.437,P=0.043,respectively).The clock drawing test (CDT) score of TAD group was higher than that in the bvFTD and fvAD groups (Z=8.673,P=0.020),while the neuropsychological questionnaire (NPI) scores of the bvFTD and fvAD groups were higher than those of the TAD group (Z=7.577,P =0.023).Meanwhile,the incidences of agitation,disinhibition and abnormal behavior of NPI in the bvFTD and fvAD groups were higher than those in the TAD group (x2 =11.139,P =0.004;x2 =6.481,P =0.039;x2 =6.812,P =0.033,respectively).The frequencies of the ApoE ε4 allele were 44.4％ in the fvAD group and 33.3％ in the bvFTD group,which were not significant different from that in the TAD group (40.6％).Furthermore,patients in the fvAD group were associated with decreased regional cerebral glucose metabolism and amyloid deposition in the temporalparietal cortex evaluated by FDG-PET and PIP-PET.Conclusions Neuropsychological evaluation is valuable for the differential diagnosis of TAD,fvAD and bvFTD.The frequencies of the ApoEε4 allele are similar among the three groups.FDG-PET and PIB-PET imaging plays an important role in the diagnosis of variant types of Alzheimer's disease.

neo-Clerodane diterpenoids from Scutellaria galericulata / 中国中药杂志

By means of preparative HPTLC and column chromatography over silica gel and Sephadex LH-20, fourteen diterpenoids were isolated and purified from the whole plants of Scutellaria galericulata. Based on the physico-chemical properties and spectral data, their structures were elucidated and identified as：scutebarbatine D(1), scutolide A(2), scutolide K(3), scutebata J(4), scutebata I(5), 6-O-acetylscutehenanine A(6), barbatin C(7), scutolide E(8), barbatine C(9), scutebarbatine Y(10), scutebarbatine B(11), scutestrigillosin A(12), scutebata O(13), scutolide B(14). Compounds 1-14 were isolated from S. galericulata for the first time.

Cloning and expression analysis of tocopherol cyclase gene in Carthamus tinctorius / 中国中药杂志

The tocopherol cyclase was one of the key enzymes in plant vitamin E biosynthesis pathway. According to the study of Carthamus tinctorius transcriptome data,the Tocopherol cyclase gene was obtained using RT-PCR techniques and named CtTC . Bioinformatics analysis showed theopen reading frame （ORF）of CtTC was 1 524 bp. The putative protein contained 507 amino acids with a predicted molecular mass of 62.9 kDa and theoretically isoelectric point was 5.01.Signal peptide analysis showed that it was a non secretory protein, and there was no signal peptide. The subcellular localization showed that the CtTC protein was located in the chloroplast. The expression of CtTC gene in safflower seeds at different development stages was determined by quantitative real-time PCR, it was found that the highest expression level of CtTC gene was detected in 50 DAF.Quantitative RT-PCR analysis suggested that expression of CtTC is induced and strengthened by drought stresses. This research provided a candidate gene for metabolic engineering of vitamin E and resisting stress.

A systematic review on efficacy and safety of gasless laparoscopy in the management of uterine leiomyoma / 华中科技大学学报（医学）（英德文版）

Uterine leiomyoma causes considerable morbidity in women. This study systematically reviewed the efficacy and safety of gasless laparoscopic myomectomy (GLM) in the management of uterine leiomyoma by comparing GLM with other minimally invasive procedures. Cochrane Library, Pub- Med, EMBASE, Web of Science, WANFANG database and China National Knowledge Infrastructure (CNKI) were searched for studies published in English or Chinese between January 1995 and May 2015, and related references were traced. Study outcomes from randomized controlled trials and retrospective cohort studies were presented as mean difference (MD) or odds ratio (OR) with a 95% confidence interval (CI). Seventeen studies (including 1862 patients) meeting the inclusion criteria, including 934 treated with GLM and 928 treated with other minimally invasive procedures were reviewed. The results of meta-analysis revealed that GLM resulted in significantly shorter operating time [MD=-10.34, 95% CI (-18.12,-2.56), P<0.00001], shorter hospital stay [MD=-0.47, 95% CI (-0.88,-0.06)], less time to flatus [MD=-2.04, 95% CI (-2.59,-1.48)], less postoperative complications [OR=0.20, 95% CI (0.06, 0.62)] and less blood loss [MD =-30.74, 95% CI (-47.50,-13.98)]. On the other hand, there were no significant differences in duration of post-operative fever [MD=-0.52, 95% CI (-1.46, 0.42)] between the two groups. Additionally, GLM was associated with lower febrile morbidity, lower postoperative abdominal pain, and higher postoperative hemoglobin than other minimally invasive procedures for the treatment of uterine leiomyoma. In conclusion, GLM and other minimally invasive procedures are feasible, safe, and reliable for uterine leiomyoma treatment. However, available studies show that GLM is more effective and safer than other minimally invasive approaches.

A systematic review on efficacy and safety of gasless laparoscopy in the management of uterine leiomyoma / 华中科技大学学报（医学）（英德文版）

Uterine leiomyoma causes considerable morbidity in women. This study systematically reviewed the efficacy and safety of gasless laparoscopic myomectomy (GLM) in the management of uterine leiomyoma by comparing GLM with other minimally invasive procedures. Cochrane Library, Pub- Med, EMBASE, Web of Science, WANFANG database and China National Knowledge Infrastructure (CNKI) were searched for studies published in English or Chinese between January 1995 and May 2015, and related references were traced. Study outcomes from randomized controlled trials and retrospective cohort studies were presented as mean difference (MD) or odds ratio (OR) with a 95% confidence interval (CI). Seventeen studies (including 1862 patients) meeting the inclusion criteria, including 934 treated with GLM and 928 treated with other minimally invasive procedures were reviewed. The results of meta-analysis revealed that GLM resulted in significantly shorter operating time [MD=-10.34, 95% CI (-18.12,-2.56), P<0.00001], shorter hospital stay [MD=-0.47, 95% CI (-0.88,-0.06)], less time to flatus [MD=-2.04, 95% CI (-2.59,-1.48)], less postoperative complications [OR=0.20, 95% CI (0.06, 0.62)] and less blood loss [MD =-30.74, 95% CI (-47.50,-13.98)]. On the other hand, there were no significant differences in duration of post-operative fever [MD=-0.52, 95% CI (-1.46, 0.42)] between the two groups. Additionally, GLM was associated with lower febrile morbidity, lower postoperative abdominal pain, and higher postoperative hemoglobin than other minimally invasive procedures for the treatment of uterine leiomyoma. In conclusion, GLM and other minimally invasive procedures are feasible, safe, and reliable for uterine leiomyoma treatment. However, available studies show that GLM is more effective and safer than other minimally invasive approaches.

Olfactory bulb volume and depth of olfactory sulcus in olfactory dysfunction patients after upper respiratory tract infection / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the correlation between olfactory bulb (OB) volume, depth of olfactory sulcus (OS) and olfactory function in patients with olfactory dysfunction after upper respiratory tract infection.</p><p><b>METHODS</b>One hundred patients with olfactory dysfunction after upper respiratory tract infection (patient group) were compared with one hundred normal controls in terms of olfactory function T&T testing, OB volume and depth of OS assessed with magnetic resonance imaging (MRI). T&T testing and MRI were performed again after a year in patient group and the results were compared. SPSS 13.0 software was used to analyze the data.</p><p><b>RESULTS</b>T&T olfactory testing revealed that the patient group had higher scores than controls (t = 4.014, P < 0.05). Both men and women in patient group were affected by the same extent of olfactory loss (t value was 0.892, P > 0.05). Both men and women in control group were affected by the same extent of olfactory loss (t value was 1.011, P > 0.05). OB volume of left side in patient group was (38.14 ± 4.31) mm³, right side was (38.72 ± 4.22) mm³, average OB volume was (38.47 ± 4.27) mm³; OB volume of left side in controls was (51.65 ± 6.30) mm³, right side was (51.98 ± 6.34) mm³, average OB volume was (51.81 ± 6.32) mm³; OB volume was lower in patient group as compared with controls (t value were 4.233, 4.267 and 4.249, all P < 0.01). OS depth study revealed no statistical difference between patient group and control group (t value were 0.901, 0.948 and 0.927, all P > 0.05). Olfactory discriminate threshold was negatively correlated with OB volume in patient group and control group (r value were -0.598, -0.512, both P < 0.05) Olfactory discriminate threshold was not correlated with the depth of OS (r value were -0.152, -0.174, both P > 0.05). Olfactory discriminate threshold and OB volume were not correlated with the persistent time of the dysosmia in patient group (r value were -0.121, 0.139, both P > 0.05). Among 100 olfactory dysfunction patients after upper respiratory tract infection, when followed-up, 24 showed increased in OB volume and olfactory function after a year, but no statistical difference was found with the first time (t value were 0.894, 0.914, 0.942 and 0.931, all P > 0.05). The other 76 patients showed no significant changes of OB volume and olfactory function.</p><p><b>CONCLUSIONS</b>The OB volume was lower in patient group as compared with normal controls, the depth of OS showed no significant changes in patient group. The OB volume was correlated with olfactory function, the depth of OS was not correlated with olfactory function; Olfactory function had not correlated with the persistent time of the dysosmia in patient group.</p>

A correlation study on olfactory bulb volumes with ages and olfactory function in healthy adults / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the correlation between olfactory bulb (OB) volumes and ages, as well as OB volumes and olfactory function in healthy adults.</p><p><b>METHODS</b>One hundred healthy subjects, without any diseases which might cause smell dysfunction were selected to participate in this study. The ages of the subjects ranged from 20 to 70, with the mean age of 42.6 ± 4.8. These subjects were scaned for olfactory function by T&T testing, OB volumes assessed with Magnetic resonance imaging (MRI). The correlation between OB volumes and ages as well as OB volumes and olfactory function in healthy adults was analyzed. SPSS 13.0 software was used to analyze the data.</p><p><b>RESULTS</b>The left and right OB volumes of men were (84.65 ± 7.11) mm(3) and (87.79 ± 7.57) mm(3), average OB volume was (86.14 ± 7.37) mm(3). The left and right OB volumes of women were (69.58 ± 4.72) mm(3) and (71.43 ± 5.29) mm(3), average OB volume was (70.22 ± 5.02) mm(3). OB volume study revealed no statistical difference between the left and right OB volumes of men (t = 1.024, P > 0.05). OB volume study revealed no statistical difference between the left and right OB volumes of women (t = 0.987, P > 0.05). OB volumes were lower in women as compared with men (t value were 3.742, 3.869 and 3.814, all P < 0.01). OB volumes were negatively correlated with ages in the subjects (r value were -0.588, -0.523, both P < 0.01). Olfactory discriminate threshold was negatively correlated with OB volumes in the subjects (r value were -0.624, -0.587, both P < 0.01).</p><p><b>CONCLUSIONS</b>This study revealed no statistical difference between the left and right OB volumes in healthy adults. OB volumes were lower in women as compared with men. As age went up, OB volume would become smaller. As olfactory function went down, OB volume would become smaller. OB volumes were expected to be a gauge of olfactory function.</p>