Influencing Factors and Prediction Model of Performance of Needle Visualization in Fine Needle Aspiration of Thyroid Nodules / 中国医学科学院学报

Objective To investigate the influencing factors and establish a model predicting the performance of needle visualization in fine-needle aspiration (FNA) of thyroid nodules. Methods This study prospectively included 175 patients who underwent FNA of thyroid nodules in the Department of Ultrasound in China-Japan Friendship Hospital and compared the display of the needle tips in the examination of 199 thyroid nodules before and after the application of needle visualization.We recorded the location,the positional relationship with thyroid capsule,ultrasonic characteristics,and the distribution of the soft tissue strip structure at the puncture site of the nodules with unclear needle tips display before using needle visualization.Furthermore,according to the thyroid imaging reporting and data system proposed by the American College of Radiology,we graded the risk of the nodules.Lasso-Logistic regression was employed to screen out the factors influencing the performance of needle visualization and establish a nomogram for prediction. Results The needle tips were not clearly displayed in the examination of 135 (67.8%) and 53 (26.6%) nodules before and after the application of needle visualization,respectively,which showed a significant difference (P<0.001).Based on the positional relationship between the nodule and capsule,anteroposterior/transverse diameter (A/T) ratio,blood supply,and the distribution of subcutaneous strip structure at the puncture site,a nomogram was established to predict the probability of unclear display of the needle tips after application of needle visualization.The C-index of the prediction model was 0.75 (95%CI=0.67-0.84) and the area under the receiver operating characteristic curve was 0.72.The calibration curve confirmed the appreciable reliability of the prediction model,with the C-index of 0.70 in internal validation. Conclusions Needle visualization can improve the display of the needle tip in ultrasound-guided FNA of thyroid nodules.The nomogram established based on ultrasound features such as the positional relationship between the nodule and capsule,A/T ratio,blood supply,and the distribution of subcutaneous strip structure at the puncture site can predict whether needle visualization is suitable for the examination of nodules.

In vitro evaluation, cellular uptake and anti-acute myocardial ischemia effect of puerarin PEG-PLGA micelles / 中国中药杂志

PUE@PEG-PLGA micelles has excellent characteristics such as small particle size, high drug loading and slow drug release. The results of TEM electron microscopy showed that PUE@PEG-PLGA micelles had obvious core-shell structure. The critical micelle concentration(CMC) of PEG-PLGA micelles determined by pyrene assay was about 4.8 mg·L~(-1). Laser confocal experiments showed that PEG-PLGA micelles can enhance the cellular uptake of coumarin-6 and aggregate around the mitochondria; quantitative results of extracellular drug residues also indirectly confirmed that PEG-PLGA micelles can promote cellular uptake of the drug. Acute ischemic myocardial model rats were prepared by coronary artery ligation, and then the model rats were randomly divided into six groups: Sham operation group, model group, puerarin(PUE) group, as well as low-, mid-, and high-dose PUE@PEG-PLGA micelles groups. Drugs were given by iv administration 5 min after the ligation. The ST segment changes in the electrocardiogram were monitored; serum creatine kinase(CK), lactate dehydrogenase(LDH), aspartate aminotransferase(AST), and malondialdehyde(MDA) levels were detected and myocardial infarct size was also measured. Both PUE and PUE@PEG-PLGA micelles can reduce the elevated ST segment, reduce serum CK, LDH, AST and MDA levels, and reduce myocardial infarct size. The efficacy of PUE@PEG-PLGA medium and high dose groups was significantly better than that in the PUE group, and the efficacy in PUE@PEG-PLGA low dose group was basically equivalent to that in the PUE group. PUE@PEG-PLGA micelles can greatly improve the cardiomyocytes uptake of PUE, enhance the anti-acute myocardial ischemia effect of drugs, and reduce its dosage.

Effect of MCUR1 on proliferation,cell cycle and apoptosis of K562 cells / 军事医学

Objective To investigate the effect of mitochondrial calcium uniporter(MCU)regulator 1(MCUR1)on proliferation,cell cycle and apoptosis of K562 cells and the possible molecular mechanism.Methods Recombinant plasmid vectors containing short hairpin RNAs(shRNAs)targeting MCUR1 were transfected into K562 cells,before the K562 cells stably expressing low MCUR1 were selected with G418.The expression of MCUR1 mRNA was detected by quantitative real-time polymerase chain reaction(qRT-PCR)assays.Western blotting(WB)assays were used to detect the expressions of MCUR1,P53,BAX and BCL2.The proliferation,cell cycle and apoptosis of K562 cells were detected by cell counting kit-8(CCK-8)assays and flow cytometry, respectively.Results The results of qRT-PCR and WB assays revealed that MCUR1 was stably down-regulated at mRNA and protein levels in the K562 cells transfected with shRNAs targeting MCUR1.Knockdown of MCUR1 significantly inhibited the cell proliferation, induced the cell apoptosis, but did not influence the cells cycle.Meanwhile, knockdown of MCUR1 increased the expression of P53 protein and the ratio of protein BAX/BCL2 in K562 cells.Conclusion MCUR1 promotes cell proliferation and inhibits cell apoptosis in K 562 cells.

Analysis on current situation and the stakeholder's attitude of PBM pilot in China :A case in Wuhu city of Anhui province / 中国卫生政策研究

Objective:To understand the present situation, operation mode, stakeholder's attitude, preliminary results and problems in Pharmacy Benefit Management (PBM) from pilot areas in China, and put forward corresponding suggestions. Methods :In this paper, we carried out an analysis of introduced PBM model after reviewing the existing literature, conducting interviews with key person in the pilot areas and process observation. Moreover, we combined all of the methods and techniques with quantitative analysis in order to find promising results. Results :We constructed a PBM model based on the information provided by the analysis mainly carried out in the piloting community health service centers. After launching the model, the number of drugs increased, the number of outpatients doubled, and the program was widely praised by the patients who joined it. To a certain extent, with the introduction of PBM model, patients with chronic diseases returned to the grassroots level and promoted the development of basic public health services. On the contrast, stakeholders showed different attitudes towards the program, and this inconsistency greatly affected its development through many factors. PBM promoted the management of chronic diseases and tiered care system in pilot areas, but some problems are still there. Conclusions :To a certain limit, PBM can improve the accessibility of drugs in primary health service centers and promote the management of chronic disease and separation of clinics from pharmacies. With the gradual elimination of drug-supporting medical system and the deepening of health insurance reform, PBM may play its positive role in improving service quality and controlling medical expenses. However, its long-term effect requires more follow-up studies,

Clinicopathologic features and clinical significance of endometrial carcinoma with mismatch repair deficiency / 天津医药

Objective To investigate the clinicopathologic features and clinical significance in mismatch repair (MMR) of deficient endometrial carcinoma. Methods A total of 108 endometrial carcinoma cases younger than 50 years of age who were underwent routine laparotomy in our hospital were included in this study. Immunohistochemistry staining was used for 4 MMR proteins (MLH1, MSH2, MSH6 and PMS2). Patients were divided into two groups (MMR deficiency group and MMR normal group) based on the results of immunohistochemistry staining. Results Thirty-three percent of cases (36 patients) showed at least one deletion of MMR protein expression. The clinicopathological features of 36 cases with deletion of MMR protein expression were analyzed. The 31% showed deep myometrium invasion and 25% were with intense lymphocyte infiltration around tumor cells. Thirty-five percent of endometrial carcinomas associated with mucinous, clear cell or other differentiations, and 14% with heterogeneity. Background endometrium of majority of the cases displayed proliferative endometrium. There were 20% cases complicated with ovarian carcinoma. Features included deep myometrium invasion, lymphocyte infiltration around tumor cells, multiple differentiations and complicated with ovarian carcinoma. There were significant differences in background endometrium between endometrial carcinoma combined with ovarian cancer group and control group. Conclusion MMR deficient endometrial carcinoma has characteristic features, which are different from both type I and type II endometrial carcinoma.

Analysis of phacovitrectomy with internal limiting membrane peeling to treat foveoschisis without macular hole in ultra-high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the results of phacovitrectomy with internal limiting membrane(ILM) peeling to treat foveoschisis in ultra-high myopia.METHODS: Totally 32 eyes of 32 ultra-high myopia patients with foveoschisis were selected retrospectively.The preoperative refractive errors ranged from-12.00D to-20.00D with the mean of-15.78±2.16D.The best corrected visiual acuity(BCVA) were converted to LogMAR acuity, and the average BCVA was 4.1±0.4.Conventional phacovitrectomy with ILM peeling by ICG dying were performed.Gas tamponade were performed to end the operation.The BCVA and the foveoschisis cavity were observed by 1-9mo after the surgery, with the mean of 4.5mo.RESULTS: The foveoschisis cavity of 30 eyes were healed with BCVA increased and visual distortion alleviated distinctly (94%)(t=-7.91, P<0.05).CONCLUSION: Phacovitrectomy with ILM peeling is useful in treating foveoschisis in ultra-high myopia with visual function preserving.

New triterpenoid saponins from the leaves of Panax notoginseng / 药学学报

Five triterpene saponins were isolated from the aqueous extract of the leaves of Panax notoginseng (Burk.) F.H.Chen via various chromatographic approaches, including HPD-100 macroporous resin, silica gel, reverse phase C18 and so on. Spectroscopic and chemical methods were used to elucidated their structures, which were determined to be 3-O-β-D-glucopyranosyl-(1→2)-β-D-glucopyranosyl-12β,23(R)-epoxydammara-24-ene-3β,6α,20(S)-triol 20-O-α-L-arabinofuranosyl-(1→6)-β-D-glucopyranoside (1), 3-O-β-D-glucopyranosyl-(1→2)-β-D-glucopyranosyl-12β,23(R)-epoxydammara-24-ene-3β,6α,20(S)-triol 20-O-α-L-arabinopyranosyl-(1→6)-β-D-glucopyranoside (2), notoginsenoside FP2 (3), gypenoside Ⅸ (4), ginsenoside Rg1 (5). Compounds 1 and 2 are new compounds and named as notoginsenoside Fh8 and notoginsenoside Fh9.

Skeletal Muscle Magnetic Resonance Imaging of the Lower Limbs in Late-onset Lipid Storage Myopathy with Electron Transfer Flavoprotein Dehydrogenase Gene Mutations / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Lipid storage myopathy (LSM) is a genetically heterogeneous group with variable clinical phenotypes. Late-onset multiple acyl-coenzyme A dehydrogenation deficiency (MADD) is a rather common form of LSM in China. Diagnosis and clinical management of it remain challenging, especially without robust muscle biopsy result and genetic detection. As the noninvasion and convenience, muscle magnetic resonance imaging (MRI) is a helpful assistant, diagnostic tool for neuromuscular disorders. However, the disease-specific MRI patterns of muscle involved and its diagnostic value in late-onset MADD have not been systematic analyzed.</p><p><b>METHODS</b>We assessed the MRI pattern and fat infiltration degree of the lower limb muscles in 28 late-onset MADD patients, combined with detailed clinical features and gene spectrum. Fat infiltration degree of the thigh muscle was scored while that of gluteus was described as obvious or not. Associated muscular atrophy was defined as obvious muscle bulk reduction.</p><p><b>RESULTS</b>The mean scores were significantly different among the anterior, medial, and posterior thigh muscle groups. The mean of fat infiltration scores on posterior thigh muscle group was significantly higher than either anterior or medial thigh muscle group (P < 0.001). Moreover, the mean score on medial thigh muscle group was significantly higher than that of anterior thigh muscle group (P < 0.01). About half of the patients displayed fat infiltration and atrophy in gluteus muscles. Of 28 patients, 12 exhibited atrophy in medial and/or posterior thigh muscle groups, especially in posterior thigh muscle group. Muscle edema pattern was not found in all the patients.</p><p><b>CONCLUSIONS</b>Late-onset MADD patients show a typical muscular imaging pattern of fat infiltration and atrophy on anterior, posterior, and medial thigh muscle groups, with major involvement of posterior thigh muscle group and gluteus muscles and a sparing involvement of anterior thigh compartment. Our findings also suggest that muscle MRI of lower limbs is a helpful tool in guiding clinical evaluation on late-onset MADD.</p>

A Historical Cohort Study on the Efficacy of Glucocorticoids and Riboflavin Among Patients with Late-onset Multiple Acyl-CoA Dehydrogenase Deficiency / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Late-onset multiple acyl-CoA dehydrogenase deficiency (MADD) is the most common type of lipid storage myopathies in China. Most patients with late-onset MADD are well responsive to riboflavin. Up to now, these patients are often treated with glucocorticoids as the first-line drug because they are misdiagnosed as polymyositis without muscle biopsy or gene analysis. Although glucocorticoids seem to improve the fatty acid metabolism of late-onset MADD, the objective evaluation of their rationalization on this disorder and comparison with riboflavin treatment are unknown.</p><p><b>METHODS</b>We performed a historical cohort study on the efficacy of the two drugs among 45 patients with late-onset MADD, who were divided into glucocorticoids group and riboflavin group. Detailed clinical information of baseline and 1-month follow-up were collected.</p><p><b>RESULTS</b>After 1-month treatment, a dramatic improvement of muscle strength was found in riboflavin group (P < 0.05). There was no significant difference in muscle enzymes between the two groups. Significantly, the number of patients with full recovery in glucocorticoids group was less than the number in riboflavin group (P < 0.05). On the other hand, almost half of the patients in riboflavin group still presented high-level muscle enzymes and weak muscle strength after 1-month riboflavin treatment, meaning that 1-month treatment duration maybe insufficient and patients should keep on riboflavin supplement for a longer time.</p><p><b>CONCLUSIONS</b>Our results provide credible evidences that the overall efficacy of riboflavin is superior to glucocorticoids, and a longer duration of riboflavin treatment is necessary for patients with late-onset MADD.</p>

Tissue distribution of PEGylated puerarin in acute myocardial ischemia mode rats / 药学学报

The aim of this study is to explore the tissue distribution of PEGylated puerarin in acute myocardial ischemia model rats. Healthy male SD rats were randomly divided into two groups (30 each). Both were given PEGylated puerarin at a dose of 488 mg x kg(-1). After 5 min of medication, one group was normal rats, another group with acute myocardial ischemia was established by peritoneal injection of 50 mg x kg(-1) isoprenaline. After administration, the animals were executed at 30, 60, 90, 120, 150 and 180 min, then heart, liver, spleen, lung, kidney were extracted. The content of puerarin in organ tissue was determined by HPLC. The results showed that the AUC of tissue distribution of PEGylated puerarin in normal rats was liver > kidney > heart ≈ spleen > lung > brain. While the AUC of tissue distribution of PEGylated puerarin in acute myocardial ischemia model rats was liver ≈ heart > kidney > lung ≈ spleen > brain. AUC(heart) of PEGylated puerarin in acute myocardial ischemia model rats was 1.7 times than that of the normal rats, and there was significant difference (P < 0.05). Thus, PEGylated puerarin had a good heart-targeting property in early myocardial infarction area, drugs could accumulate in the ischemic myocardium. It provided important information for further study and clinic use of PEGylated puerarin.

Alleviation of PEGylated Puerarin on Erythrocyte Hemolysis Induced by Puerarin in Glucose-6-phosphate Dehydrogenase-deficient Rats / 中草药·英文版

Objective: To explore and analyze the reducing hemolytic effects of PEGylated puerarin (PEG-PUE) on erythrocytes induced by PUE in glucose-6-phosphate dehydrogenase (G6PD)-deficient rats. Methods: The rat model with G6PD-deficiency was established via sc injecting 1% acetylphenyl-hydrazine. Then the G6PD-deficient erythrocyte suspension obtained from this rat model was used to evaluate the hemolytic effects of PUE and the reducing hemolytic effects of PEG-PUE via hemolytic activity and erythrocyte osmotic fragility assay. Results: It was found that PUE could cause a serious hemolysis to the erythrocyte suspension with the increase of drug concentration and the prolongation of drug incubation time, the hemolytic rate of PUE was up to 40%, while the addition of PEG-PUE to the erythrocyte suspension revealed no significant hemolysis. Additionally, the result of erythrocyte osmotic fragility indicated that PEG-PUE exerted a slight effect on the erythrocyte membranes, and the NaCl concentration that induced 50% hemolysis (32 mmol/L) was about one-third PUE. Conclusion: These results demonstrate that PEG-PUE could play a significant role in reducing the side effect of hemolysis induced by PUE. The low hemolytic activity of PEG-PUE makes it a favorable candidate for in vivo tests and PEG-PUE could also provide the useful insight for the further formulation development as an innovative drug. © 2013 Tianjin Press of Chinese Herbal Medicines.

Protective effect of yixinshu capsule on myocardial ischemia reperfusion injury in rats / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the protective effect of Yixinshu capsule on myocardial ischemia reperfusion injury (MIRI) in SD rats.</p><p><b>METHOD</b>Sixty healthy SD rats were randomized into six groups: sham group, MIRI model group, Xinsuning capsule group, low, middle or high dose Yixinshu capsule. Acute MIRI rat models were created by reperfusion for 120 min after anterior interventricular branch of the left coronary artery for 30 min. The serum creatine kinase (CK), lactic dehydrogenase (LDH), aspartate aminotransferase (AST) and malondialdehyde(MDA), blood viscosity, and infarction area of myocardium were determined.</p><p><b>RESULT</b>Yixinshu capsule could reduce serum CK, LDH, AST and LDH activity, improve the blood viscosity, and reduced the myocardial infarct size.</p><p><b>CONCLUSION</b>Yixinshu capsule can protect against MIRI in rats.</p>

Stability of PEGylated puerarin under different storage conditions / 中国中药杂志

<p><b>OBJECTIVE</b>To detect the stability of PEGylated puerarin (PEG-PUE), in order to provide experimental basis for storage conditions of PEGylated puerarin.</p><p><b>METHOD</b>First, a method for determining the content of PEG-PUE was established. Next, a system study was conducted for the stability of PEG-PUE affected by different factors such as temperature, humidity, light and light avoidance.</p><p><b>RESULT</b>PEG-PUE was severely degraded under the conditions of high temperature, high humidity and light. It was also seriously degraded under high temperature.</p><p><b>CONCLUSION</b>PEG-PUE shall be stored under low temperature and in a dark and dry environment.</p>

In vitro dissolution of forsythin in Forsythia suspensa powder of different particle diameter / 中国中药杂志

<p><b>OBJECTIVE</b>To examine the in vitro dissolution of forsythin in Forsythia suspensa powder of different particle diameter, in order to give guidance to the grinding process.</p><p><b>METHOD</b>HPLC was used to determine the in vitro dissolution quantity and dissolution velocity of forsythin coarse powder, fine powder and ultramicroscopic powder.</p><p><b>RESULT</b>The dissolution curves of Forsythia suspensa coarse powder, fine powder and ultramicroscopic powder were basically inconformity to Weibull distribution. Specifically, T50 was 11.8, 10.5 and 6.8 min, respectively, and Q45 was 78.22%, 81.91% and 90.76%, respectively.</p><p><b>CONCLUSION</b>The superfine milling process can significantly increase the dissolution quantity and dissolution velocity of forsythin.</p>

Optimization of synthetic process of PEGylated puerarin by orthogonal test with multi-index / 中草药

Objective: To optimize the synthesis of PEGylated puerarin (PEG-PUE) by orthogonal test with multi-index evaluation. Methods: The research has focused on the optimized interacting factors of the synthetic process of PEG-PUE by HPLC, such as ratio of PEG and PUE, catalyst DMAP dosage, and reaction time, using the purity, drug loading, and yield of PEG-PUE as evaluation indexes. Results: The optimum synthesis conditions of PEG-PUE were as follows, PEG-EDC-PUE-DMAP (1 : 1.2 : 1.2 : 0.3) and reaction time 12 h. Conclusion: The optimum synthesis condition of PEG-PUE is reasonable, as well as feasible.