Pulmonary Bulla and Bilateral Diffusely-distributed Nodules: Report of One Case and Literature Review / 中国医学科学院学报

Lung cancer is mostly characterized by a pulmonary solid mass on CT. In rare cases,patients do not have these typical manifestation but present with diffusely-distributed small nodules and pulmonary bullae,which can easily be misdiagnosed. A special case of lung adenocarcinoma was managed in our hospital from September 24th to December 19th in 2016. Under high-resolution CT,multiple nodules were seen in both lungs,mostly in the upper lungs,involving the pleura and interlobular fissures. Some nodules had cystic changes. A large bulla was seen in the left upper lung. Its wall was thickened with multiple nodules. Lung adenocarcinoma was pathologically confirmed.

Asthma and Obstructive Sleep Apnea / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To get a comprehensive understanding about the relationship between obstructive sleep apnea (OSA) and asthma by reviewing the epidemiology, pathophysiology, and clinical manifestation and then summarizing the latest progress on diagnosis and treatment.</p><p><b>DATA SOURCES</b>Articles referred in this review were mainly collected from a comprehensive search of the PubMed published in English from 1990 to 2015 with the terms "OSA" and "asthma" as the main keywords. Highly regarded older publications were also included.</p><p><b>STUDY SELECTION</b>Information about the features of the two diseases in common, the pathophysiologic association between them and their current treatments from the literature search were identified, retrieved, and summarized.</p><p><b>RESULTS</b>Both OSA and asthma are very prevalent conditions. The incidences of them have kept on rising in recent years. Asthma is often accompanied by snoring and apnea, and OSA often combines with asthma, as well. They have many predisposing and aggravating factors in common. Possible shared direct mechanistic links between them include mechanical effects, intermittent hypoxia, nerve reflex, inflammation, leptin, etc. Indirect mechanistic links include medication, nose diseases, smoking, obesity, and gastroesophageal reflux disease. Since OSA presents many similar features with nocturnal asthma, some scholars termed them as a sole syndrome - "alternative overlap syndrome," and proved that asthma symptoms in those patients could be improved through the treatment of continuous positive airway pressure.</p><p><b>CONCLUSIONS</b>OSA and asthma are closely associated in pathogenesis, symptoms, and therapies. With the growing awareness of the relationship between them, we should raise our vigilance on the coexistence of OSA in those difficult-to-control asthmatic patients. Further studies are still needed to guide the clinical works.</p>

Establishment and application of HPLC-QAMS for quality evaluation of Chuanxiong Rhizoma / 药学学报

A quantitative analysis method of multi-components with a single marker (QAMS) for simultaneous determination of six marker compounds (one from phenolic acids and five from phthalides) in Chuanxiong Rhizoma was established by applying HPLC and using butylidenephthalide as the internal reference substance. And also the feasibility and accuracy of the established method for quality evaluation and application of Chuanxiong Rhizoma were investigated and validated. The analysis was performed with the mobile phase consisting of acetonitrile - 0.2% aqueous formic acid. The flow rate was 1.0 mL . min-1 and the column temperature was maintained at 30 °C. The detection wavelengths were set at 252 nm (for ferulic acid, Z-ligustilide, and butylidenephthalide) and 266 nm (for senkyunolide I, senkyunolide A, and coniferyl ferulate), separately, and 20 µL was injected for analysis with gradient elution. The results showed that there were no significant differences observed between the HPLC-QAMS method and the external standard method (RSD <5%). The relative correction factors were credible (RSD < 5%) in changed chromatographic conditions. The established HPLC-QAMS method can be accurately used for simultaneously evaluating and controlling the quality of Chuanxiong Rhizoma with multi-components.

A multicenter, randomized, double-blind, placebo-controlled safety study to evaluate the clinical effects and quality of life of paclitaxel-carboplatin (PC) alone or combined with endostar for advanced non-small cell lung cancer (NSCLC) / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the efficacy and quality of life and safety for paclitaxel and carboplatin (TC) and TC combined with endostar in the treatment of advanced non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>This is a prospective, multicenter, randomized, double-blind, placebo-controlled clinical study. A total of 126 cases of untreated advanced NSCLC were enrolled in this study. There were 63 patients in the TC control arm and TC combined endostar arm, respectively. All enrolled patients were continuously followed-up for disease progression and death.</p><p><b>RESULTS</b>The objective response rate (ORR) of TC combined with endostar arm was 39.3%, and that of TC control arm was 23.0%, P = 0.078. The progression-free survival rates for TC combined with endostar arm and TC control arm were 78.3% and 58.8%, respectively, in 24 weeks (P = 0.017). The hazard ratio for the risk of disease progression was 0.35 (95%CI 0.13 to 0.90, P = 0.030). The median time to progression (TTP) of the TC combined with endostar arm was 7.1 months and TC arm 6.3 months (P > 0.05). The follow-up results showed that the median survival time (mOS) of the TC + Endostar arm was 17.6 months; (95%CI 13.4 to 21.7 months), and the TC + placebo arm 15.8 months (95%CI 9.4 to 22.9 months) (P > 0.05). The quality of life scores (LCSS patient scale) after treatment of the TC combined with endostar arm was improved, and that of the TC group was improved after completion of two cycles and three cycles of treatment. The quality of life scores compared with baseline after the completion of one cycle treatment was significantly improved for both the TC combined with endostar arm (P = 0.028 and), and TC arm (P = 0.036). It Indicated that TC combined with endostar treatment improved the patient's quality of life in the early treatment. The difference of adverse and serious adverse event rates between the two groups was not significant (P > 0.05).</p><p><b>CONCLUSIONS</b>Compared with TC alone treatmrnt, TC combined with endostar treatment can reduce the risk of disease progression at early time (24 weeks), increase the ORR, and can be used as first-line treatment for advanced NSCLC. The TC combined with endostar treatment has good safety and tolerability, improves the quality of life, and not increases serious adverse effects and toxicity for patients with advanced NSCLC.</p>

Prevalence and its impacting factors of non-motor symptoms in Parkinson's disease / 中华老年医学杂志

Objective To explore the incidence rate, total incidence numbers and possible impacting factors of non-motor symptoms (NMSs) in Parkinson's disease (PD). Methods The NMS questionnaire (NMS Quest) was used to investigate 131 out-patients diagnosed with PD, and the prevalence of each item, the total NMS numbers and their relationships with clinical features were assessed. Results All of the patients, who were distributed in every stage of PD, had NMSs and each case with 11 items on average. Autonomic symptoms such as nocturia and constipation were the most frequent ones. The patients over 65 versus less than 65 years old had a higher prevalence in a number of items such as olfactory disturbance, dysphagia and constipation. At the same time, the rigidity subtype patients had a higher prevalence in depression items than the tremor subtype ones.The total number of NMS was positively correlated with course of disease, age, UPDRS score and Hoehn & Yahr (H&Y) stage. Conclusions NMSs are common among PD patients. While the prevalence of each item may vary with different clinical features, the total number of NMS is increased with the severity of PD. More attention should be paid to the diagnosis and rational treatment of the NMSs.

Depression in patients with Parkinson's disease and the associated features / 华中科技大学学报（医学）（英德文版）

The study was aimed to examine the prevalence of depression in patients with Parkinson's disease (PD) and identify its features. A total of 131 out-patients, diagnosed as having idiopathic PD in accordance with the United Kingdom Parkinson's Disease Society Brain Bank criteria, were interviewed with questionnaire and evaluated by Mini-Mental State Examination (MMSE), Unified Parkinson's Disease Rating Scale (UPDRS), Hohen &Yahr staging (H&Y staging) and Hamilton Rating Scale for Depression (HRSD). Patients were divided into three groups in terms of HRSD score: depression group, sub-threshold depression group and non-depression group. The clinical variables and symptom profiles were obtained and compared among the three groups. The results showed that 27 patients (20.6%) fell into the depression group, 71 (54.2%) into the sub-threshold depression group, and 33 (25.2%) into the non-depression group. There were no differences in age, gender or tremor score among the groups (P>0.05). Significant differences were found in duration of PD, UPDRS score, rigidity score and H&Y stage between the sub-threshold depression group (or the depression group) and the non-depression group (P<0.05). Moreover, the clinical variables in the subthreshold depression group had the trend of increasing with the severity of PD and their values were similar to those in the depression group. Anhedonia, feeling of incapability, sleep disturbance, gastrointestinal symptoms and depressive moods were most common in the depression group. And these symptoms also were more common in the other two groups. It is concluded that depression and sub-threshold depression are common in PD and share similar clinical features. Furthermore, subthreshold depression might be the prodrome of depression and may develop into depression as the condition progresses.

Central opioid peptide-containing neurons mediates therapeutic effect of short-pulse gastric electrical stimulation on dyspepsia-like symptoms in dogs / 华中科技大学学报（医学）（英德文版）

This study investigated whether the curative effect of short-pulse gastric electrical stimulation (GES) on the vasopressin-induced dyspeptic symptoms was mediated by central opioid peptide-producing neurons. Five female beagle dogs implanted with 1 pair of electrodes in gastric serosa were used in a two-experiment study. In experiment one, the brain was scanned by positron emission tomography in 3 dogs with and without short-pulse GES, and the radioactivity in nuclei of solitary tract (NST) and hypothalamus was detected. Experiment two was composed of 4 sessions. In session one, the dogs were injected with vasopressin in the absence of short-pulse GES. With session two, the short-pulse GES was simultaneously given via the electrodes with the injection of vasopressin. In sessions three and four, naloxone and naloxone methiodide was administered respectively in the presence of short-pulse GES. Motion sickness-like symptoms were scored and compared among the different sessions. The results showed that the short-pulse GES significantly increased the radioactivity in NST and hypothalamic nuclei (P<0.05, vs control). The short-pulse GES could ameliorate the vasopressin-induced motion sickness-like symptoms in dogs. Naloxone, but not naloxone methiodide could attenuate the curative effects of short-pulse GES. It is concluded that NST and hypothalamic nuclei may participate in the mediation of the curative effects of short-pulse GES on dyspepsia-like symptoms. Central opioid peptide-containing neurons presumably mediate the therapeutic effect on dyspeptic symptoms of short-pulse GES.

Clinical investigation of mild cognitive impairment in patients with Parkinson's disease / 中华神经科杂志

Objective To describe the prevalence and neuropsychological character of mild cognitive impairment (MCI) associated with Parkinson' s disease(PD-MCI). Methods One hundred and three PD patients and a control group of 32 healthy old subjects were chosen. Psychometric assessment included the Mini Mental State Examination, the Dementia Rating Scale and a series of neuropsychol ogicaltests. The Hamilton Rating Scale of Depression was used to assess depression in PD patients. Results (1)Twenty-one (20.4%) PD patients was diagnosed with dementia, 45 (43.7%) had a MCI and only 37(35.9%) had no cognitive impairment; (2) Subjects with PD-MCI were older, had a later onset of the PD,and displayed more severe motor symptoms compared with those without cognitive impairment; (3) The prevalence and neuropsychological profile of PD-MCI were thought to correlate with the dominating side and subtype of Parkinsonian symptoms, for patients with left-sided dominant symptoms had a significantly higher chance of suffering MCI than those with right-sided dominant symptoms, the ratio being 74.2% vs 42.2%,χ<'2 =7. 589,P <0.05; The tremor-dominant group took less time than the mixed group for Stroop word test measurement ((80.8±39.9) s vs (94.4±30.0) s,t=3.332,P<0.01). Conclusion Identification of MCI is of important clinical significance, which helps to treat patients differently and thus predict the prognosis.

Effect of short pulse gastric electrical stimulation on the c-fos expression in nucleus tractus solitarius and hypothalamus and its possible mechanism / 中华消化杂志

Objective To investigate whether enteric nervous system(ENS)involve in mediating the effect of short pulse gastric electrical stimulation on c-fos expression in nucleus tractus solitarius (NTS)and hypothalamus.Methods Fifteen Wistar rats were divided into control group,gastric electrical stimulation(GES)group and ENS free group with 5 rats each.A pair of electrodes was implanted on the gastric serosa.In ENS free group,0.5%benzalkonii chloridum was applied on the serosa during the surgery.A set of short pulse GES with frequency of 20 cpm,pulse width of 300 μs and amplitude of 2 mA was applied via the electrodes for 30 rain in the stimulation group and ENS free group.The c-fos expression in NTS/hypothalamus was detected 1 h after the stimulation.Results The number of neuron with c-fos expression was(71.6±7.4)/HP in NTS group and(63.4±10.8)/HP in ENS free group,both were significantly higher than those in control group(36.4±8.6/HP,P＜0.05).The number of neuron with c-fos expression in hypothalamus was higher in GES[(224.2±47.3)/HP]and ENS free groups[(249.1±44.0)/HP]compared with control group[(90.2±47.3)/HP,P＜0.05].There was no significant difference in c-fos expression in NTS/hypothalamus between GES group and ENS free group(P＞0.05).Conclusions Short pulse gastric electrical stimulation significantly increases c-fos expression in NTS/hypothalamus,which suggests that NTS/hypothalamus may participate in mediating the effect of GES on gastric function.This effect may be not mediated by ENS.

Intrastriatal gene transfer of vascular endothelial growth factor rescues dopaminergic neurons in a rat Parkinson's disease model / 华中科技大学学报（医学）（英德文版）

To examine the ability of intrastriatal gene transfer of vascular endothelial growth factor 165 mediated by adenoviral vector to rescue dopaminergic neurons in a rat model of Parkinson's disease (PD), we constructed recombinant replication-deficent adenoviral vectors carrying the gene of VEGF165 (Ad-VEGF), and injected Ad-VEGF (or Ad-LacZ and PBS as controls) into the striatum of rats 7 days after the lesion by 6-hydroxydopamine. The rat rotational behavior analysis and tyrosine hydroxylase (TH) immunohistochemistry were performed to assess the change of dopaminergic neurons. Our results showed that the rats receiving Ad-VEGF injection displayed a significant improvement in apomorphine-induced rotational behavior and a significant preservation of TH-positive neurons and fibers compared with control animals. It is concluded that intrastriatal gene transfer by Ad-VEGF may rescue the dopaminergic neurons from degeneration in a rat model of PD.

Intrastriatal Gene Transfer of Vascular Endothelial Growth Factor Rescues Dopaminergic Neurons in a Rat Parkinson's Disease Model / 华中科技大学学报（医学）（英德文版）

To examine the ability of intrastriatal gene transfer of vascular endothelial growth factor 165 mediated by adenoviral vector to rescue dopaminergic neurons in a rat model of Parkinson's disease (PD), we constructed recombinant replication-deficent adenoviral vectors carrying the gene of VEGF165 (Ad-VEGF), and injected Ad-VEGF (or Ad-LacZ and PBS as controls) into the striatum of rats 7 days after the lesion by 6-hydroxydopamine. The rat rotational behavior analysis and tyrosine hydroxylase (TH) immunohistochemistry were performed to assess the change of dopaminergic neurons. Our results showed that the rats receiving Ad-VEGF injection displayed a significant improvement in apomorphine-induced rotational behavior and a significant preservation of TH-positive neurons and fibers compared with control animals. It is concluded that intrastriatal gene transfer by Ad-VEGF may rescue the dopaminergic neurons from degeneration in a rat model of PD.

alpha-Synuclein redistributed and aggregated in rotenone-induced Parkinson's disease rats / 神经科学通报·英文版

Objective To observe the influence of rotenone on the distribution of alpha-synuclein (ASN) in rat model of Parkinson's disease (PD). Methods Wistar rats were randomly divided into two groups and received 2 mg/kg rotenone (s.c.) or sunflower oil (as control group) for about 4 weeks. The hippocampus, substantia nigra and striatum of brain were observed. Hematoxylin and eosin stain were used to observe the Lewy body like inclusion. The expression of tyrosine hydroxylase (TH) or ASN protein was determined by anti-TH or anti-alpha-synuclein immunohistochemistry, respectively. Results In control rats, ASN protein distributed widely in brain, especially in hippocampus, cortex and striatum. Rotenone obviously increased TH positive neurons and fibers loss in substantia nigra and striatum (P < 0.05). In rotenone treated rats, ASN positive cells increased in global brain but not distributed in an even manner. In substantia nigra, ASN positive stuff was found aggregate in both cytoplasm and nucleus, and some formed spherical inclusion; in striatum, ASN positive neurites end aggregated and agglomerated around neurons; and in hippocampus, few dot-like ASN were aggregated in cell body, and no notable change was found in nucleus. Conclusion In rotenone administrated PD rats, ASN protein aggregated in several brain regions but most obviously in striatum and substantia nigra, and the distribution region of ASN was changed from peri-synapse to the cytoplasm and nucleus of dopaminergic neuron.

Preparation of micro-biosensor and its application in monitoring in vivo change of dopamine / 华中科技大学学报（医学）（英德文版）

The self-made high sensitivity and selectivity micro-biosensor was applied to monitor the change of dopamine in cerebral nucleus in rats in vivo. The micro-biosensor was prepared and used to detect dopamine level in vitro and monitor the dynamic change of dopamine in different cerebral nucleus in vivo. The results showed the lowest concentration of dopamine that could be detected by the biosensor was 32.5 nmol/L. Its positive peak was significantly different from that of AA, 5-HTP and E. The biosensor could keep working for monitoring the dopamine concentration in the cerebral tissue for more than 10 h. It was concluded that the microsensor has high sensitivity and selectivity to dopamine and can be used to dynamically monitor the change of dopamine in vivo.

Preparation of Micro-biosensor and Its Application in Monitoring in vivo Change of Dopamine / 华中科技大学学报（医学）（英德文版）

The self-made high sensitivity and selectivity micro-biosensor was applied to monitor the change of dopamine in cerebral nucleus in rats in vivo. The micro-biosensor was prepared and used to detect dopamine level in vitro and monitor the dynamic change of dopamine in different cerebral nucleus in vivo. The results showed the lowest concentration of dopamine that could be detected by the biosensor was 32.5 nmol/L. Its positive peak was significantly different from that of AA, 5-HTP and E. The biosensor could keep working for monitoring the dopamine concentration in the cerebral tissue for more than 10 h. It was concluded that the microsensor has high sensitivity and selectivity to dopamine and can be used to dynamically monitor the change of dopamine in vivo.

Comparative study on safety and immunogenicity between influenza subunit vaccine and split vaccine / 中华流行病学杂志

<p><b>OBJECTIVE</b>To compare the reactogenicity and serology between influenza subunit vaccine and split vaccine.</p><p><b>METHODS</b>A randomized, double-blind study was carried out among children (age 6 - 12 years) in order to compare the safety and immunogenicity of an influenza inactivated subunit vaccine (Agrippal, Chiron Vaccines) with that of a split vaccine (Flurix, GSK).</p><p><b>RESULTS</b>A total of 499 subjects were vaccinated and included in the safety analysis. A total of 249 subjects received Agrippal and 250 received Flurix. All subjects were kept under medical observation for 30 minutes in order to check the evidence of having any immediate local and systemic reaction. Daily observation records were collected during the 3-day follow-up after vaccination. 6.4% of the cases with fever >or= 37.5 degrees C was reported in the Flurix group, but 2.4% in Agrippal group which was significantly less than the former group (P > 0.05). Blood samples (the D0 pre- and D23 post-vaccination sera) were collected from 224 of Agrippal group and 223 of Flurix group and analysed by the haemagglutination inhibition (HI) assay. Agrippal and Flurix induced similar seroprotection (HI titer >or= 1:40, H1N1 99.6% vs 100.0%; H3N2 99.1% vs 99.1%) and seroconversion (4-fold increase, 95.1% vs 97.8%; H3N2 74.5% vs 79.8%) rates and geometric mean titer (GMT) increase (16.0 vs 21.0; 5.4 vs 6.4) against the two A subtypes. A similar seroprotection rate (94.2% vs 96.4%) and GMT increase (21.2 vs 18.2) against the influenza B strain were also noticed in both vaccines. No significant difference was found in the results of immunological assay between the two vaccines (P < 0.05). A lower seroconversion rate against B strain was observed in Agrippal group than in Flurix group (91.1% vs 97.3%).</p><p><b>CONCLUSION</b>In terms of safety, both vaccines were generally well tolerated. The fever reaction was less frequently seen in the Agrippal group. Both vaccines induced an effective immune response in the vaccines.</p>

Exercise based on traditional Chinese medicine for patients with stable chronic obstructive pulmonary disease / 中华物理医学与康复杂志

Objective To make up an exercise prescription based on traditional Chinese medical training (EP-TCMT) for patients with stable chronic obstructive pulmonary disease (COPD).Methods Eighty-five pa- tients with stable COPD were randomly divided into a control group (CG group),a traditional Chinese medicine group ( TC group) and an exercise prescription group ( EP group).The patients in the TC and EP groups were giv- en intensive training for 8 weeks.Their 6 rain walk distance (6MWD) and Borg scale scores were assessed before and after the treatment.Results The 6MWD in the TC group increased from 337.68?59.18 m to 386.14?76.71 m,while those in the EP group improved from 348.00?55.94 m to 425.17?53.22 m.The Borg scale scores in the TC group decreased from 3.14?1.94 to 2.32?1.25,while those in the EP group declined from 3.45?1.84 to 1.72?0.70.Conclusion Making up EP-TCMTs is feasible.Additional treatment was found to improve exercise tolerance and decrease dyspnea in COPD patients.Exercise therapy based on traditional Chinese methods is easy and safe.