Analysis of risk factors for the occurrence and in-hospital prognosis in patients with peripartum cardiomyopathy / 中国医师进修杂志

Objective:To investigate the risk factors for the occurrence and poor in-hospital prognosis in patients with peripartum cardiomyopathy (PPCM).Methods:The clinical data of 35 patients with PPCM and 35 healthy pregnant women in Xuanwu Hospital, Capital Medical University and Beijing Friendship Hospital Affiliated to Capital Medical University from January 2003 to January 2022 were retrospectively analyzed. The personal histories, laboratory examination, imaging examination, cardiac function outcome, etc were collected. According to the left ventricular ejection fraction (LVEF) at discharge, the patients with PPCM were divided into in-hospital recovery group (LVEF≥50%, 18 cases) and prolonged disease group (LVEF<50%, 17 cases). Multivariate Logistic regression analysis was used to analyze independent risk factors of poor in-hospital prognosis in patients with PPCM.Results:Among 35 patients with PPCM, the age was (29.81 ± 5.37) years old, 17 cases (48.57%) complicated with gestational hypertension, 6 cases (17.14%) complicated with gestational diabetes mellitus, 24 cases (68.57%) of New York Heart Association (NYHA) cardiac function classification was Ⅲ to Ⅳ class, and 4 cases died (11.43%). The gestational age in patients with PPCM was significantly shorter than that in healthy pregnant women: (36.26 ± 4.27) weeks vs. (38.54 ± 4.59) weeks, the rates of multiple pregnancy and gestational hypertension were significantly higher than those in healthy pregnant women: 17.14% (6/35) vs. 2.86% (1/35) and 48.57% (17/35) vs. 11.43% (4/35), and there were statistical differences ( P<0.05 or <0.01). Compared with hospital recovery group, the patients in protracted disease group had shorter gestational age, larger left ventricular end-diastolic diameter, higher serum creatinine, C-reactive protein and amino-terminal pro-brain natriuretic peptide (NT-proBNP), worse NYHA cardiac function classification, and there were statistical differences ( P<0.05 or <0.01); but there were no statistical difference in LVEF at the first diagnosis and troponin I between two groups ( P>0.05). Multivariate Logistic regression analysis result showed that elevated creatinine was an independent risk factor for poor in-hospital prognosis in patients with PPCM ( OR = 4.554, 95% CI 1.536 to 13.684, P = 0.018). Conclusions:The gestational hypertension may be a risk factor for PPCM. The gestational hypertension, earlier onset time, enlarged left ventricular end-diastolic diameter, high NT-proBNP, high C-reactive protein, high creatinine and high cardiac function NYHA classification may be risk factors for poor in-hospital prognosis in patients with PPCM; and elevated creatinine is an independent risk factor for poor in-hospital prognosis in patients with PPCM.

A mendelian randomization study of the causal association between gastroesophageal reflux and atrial fibrillation / 公共卫生与预防医学

Objective In this study，we performed two sampie Mendelian Randomization to infer a causal association between Gastroesophageal reflux(GERD) and Atrial fibrillation(AF)，it can effectively avoid the problems such as reverse causation and confounds in traditional epidemiology. Methods We used the Summary data of GERD and AF from published Genome wide association study(GWAS) of European Individuals. Single Nucleotide Polymorphisms (SNPs) were extracted as Instrumental Variables (IVs).The main MR methods include Inverse Variance [] Weighted(IVW)，Weighted Median(WME)，MR-Egger，Simple Mode，and Weighted Mode.In addition，we used the sensitivity analysis such as MR-PRESSO，Cochran's Q test etc. Results The IVW shows a causal association between GERD and AF(P<0.0001，OR=1.16，95%CI:1.10-1.23).The WME shows P＜0.0001，OR=1.20，95%CI:1.11-1.30；Simple Mode shows P=0.01，OR=1.34，95%CI:1.07-1.69；Weighted Mode shows P=0.02，OR=1.33，95%CI:1.06-1.66. Conclusion This study based on genetic data supports the causal association between GERD and AF. The occurrence of GERD could increase the risk of AF.

Risk factors for venoarterial-extracorporeal membrane oxygenation related nosocomial infection in children after cardiac surgery / 中南大学学报(医学版)

OBJECTIVES@#Extracorporeal membrane oxygenation (ECMO) is an extracorporeal life support strategy for the treatment of critically ill children with reversible heart and lung failure, increasingly being used in patients with low cardiac output after cardiac surgery. However, the mortality of patients is closely related to the complications of ECMO, especially bleeding, thrombosis, and infection, ECMO-related nosocomial infection has become a challenge to the success of ECMO. This study aims to analyze the incidence and risk factors for venoarterial-ECMO (VA-ECMO)-related nosocomial infections in children after cardiac surgery.@*METHODS@#We retrospectively collected the data of patients who underwent VA-ECMO treatment after pediatric cardiac surgery in the Second Xiangya Hospital of Central South University from July 2015 to March 2021, and divided them into an infected group and a non-infected group. The clinical characteristics of the 2 groups of patients, VA-ECMO-related nosocomial infection factors, pathogenic microorganisms, and patient mortality were compared. Logistic regression was used to analyze the risk factors for nosocomial infection related to VA-ECMO after cardiac surgery.@*RESULTS@#Of the 38 pediatric patients, 18 patients (47.37%) had VA-ECMO related nosocomial infection, served as the infected group, including 7 patients with blood infections and 11 respiratory tract infections. Gram-negative pathogens (16 strains, 88.9%) were the main bacteria, such as Acinetobacter baumannii (6 strains), Klebsiella pneumoniae (3 strains), and Stenotrophomonas maltophilia (3 strains). Compared with the non-infected group (n=20), the infection group had longer time of cardiopulmonary bypass, time of myocardial block, and time of VA-ECMO assistance (All P<0.05). Multivariate logistic regression analysis showed that time of cardiopulmonary bypass (OR=1.012, 95% CI 1.002 to 1.022; P=0.021) was an independent risk factor for ECMO-related nosocomial infection. The number of surviving discharges in the infected group was less than that in the non-infected group (1 vs 11, P<0.05).@*CONCLUSIONS@#Cardiopulmonary bypass time is an independent risk factor for VA-ECMO-related nosocomial infection in children after cardiac surgery. Shortening the duration of extracorporeal circulation may reduce the incidence of VA-EMCO-related nosocomial infections in children after cardic surgery. The occurrence of VA-ECMO-related nosocomial infections affects the number of patient's discharge alive.

Retrospective Analysis of Hematological Phenotypes in Patients with Gene Mutation and Deletion α-Thalassemia / 中国实验血液学杂志

OBJECTIVE@#To explore the differences between hematological phenotypes of patients with different genotypes in gene mutations and deletion α- thalassemia.@*METHODS@#By screening the α- thalassemia gene test results in the First Affiliated Hospital, Sun Yat-Sen University from January 2015 to April 2020, the patients with mutation and deletion α- thalassemia were obtained, then the differences between hematological phenotypes of patients with different genotypes were analyzed.@*RESULTS@#There were 96 patients with mutation combined with deletion α- thalassemia from the results of 24 054 α- thalassemia patients screened out, including 79 patients with non-deletion Hb H disease (α@*CONCLUSION@#The hematological phenotype changes caused by α

Composition and histopathological features of prostatic calculi in patients with benign prostatic hyperplasia / 中华男科学杂志

Objective@#To analyze the composition of prostatic calculus in patients with BPH and explore its pathogenic factors and histopathological characteristics.@*METHODS@#Strictly following the inclusion and exclusion criteria, we included in this retrospective study 580 cases of bipolar transurethral plasma kinetic prostatectomy (TUPKP) performed in our hospital from May 2015 to May 2019, analyzed the histopathological and calculus-composition features of the patients with BPH complicated by prostatic calculi (the BPH+PC group) and the histopathological data of those with BPH only (the BPH group). We compared the related factors between the two groups of patients and performed uni- and multivariate logistic regression analyses of the data on those in the BPH+PC group.@*RESULTS@#The incidence rate of chronic inflammation was significantly higher in the BPH+PC than in the BPH group (83.1% vs 61.1%, P 0.05). Logistic regression analyses showed that prostatic calculus was significantly correlated with chronic inflammation of the prostate, the patient's age and IPSS (P 0.05).@*CONCLUSIONS@#Prostatic calculus has a high incidence in BPH patients and varies widely in composition, chiefly consisting of calcium oxalate and carbonate apatite. The major factors contributing to prostatic calculi include chronic inflammation of the prostate (primarily the severe type), age and BPH. Prostate calculi may aggravate lower urinary tract symptoms, especially urinary storage symptoms, in patients with BPH, but not significantly affect the PSA level.？.

PX-12 Promoting Apoptosis of Multiple Myeloma Cell Line H929 Induced by Bortezomib / 中国实验血液学杂志

OBJECTIVE@#To study the effect of PX-12 on apoptosis of multiple myeloma (MM) cell line induced by bortezomib.@*METHODS@#MM cell line H929 cells were divided into PX-12 group, bortezomib group, combination group, and control group. 5.0 μmol/L PX-12, 20 nmol/L bortezomib, combination of the two drugs, and DMSO were given to the above mentioned group, respectively. After culture for 24, 48, and 72 hours, the changes of cell viability were observed, the MM cell activity was detected by MTT method, and the cell cycle distribution and apoptosis of each group was detected by flow cytometry. The intracellular ROS level was measured by H@*RESULTS@#MTT assay showed that after culture for 72 hours, the activity of H929 cells in PX-12 group (P<0.05) and bortezomib group (P<0.01) was significantly lower than that in the control group, while that in the combination group was decreased most significantly (P<0.01). After culture for 48 hours, cells in G1 phase in PX-12 group was decreased to 40%, while cells in S phase and G@*CONCLUSION@#PX-12 can increase the apoptosis of MM cell line H929 induced by bortezomib, which may be caused by increasing of ROS level.

Clinical value of PCR-flow Fluorescence Hybridization in Prenatal Genetic Diagnosis of Thalassemia / 中国实验血液学杂志

OBJECTIVE@#To explore the value of PCR-flow fluorenscence immunmicrobeads assay in prenatal gene diagnosis of thalassemia.@*METHODS@#A total of 1001 pregnant women and their couples checked in the First Affiliated Hospital of Sun Yat-Sen University from January 2016 to August 2019 were selected. Both pregnant women and their spouses were the carriers of thalassemia gene. Samples such as amniotic fluid, were used to extract genomic DNA at the right time. Parallel detection of α- and β- thalassemia genes to samples should be carried out by PCR-flow cytometric fluorescence hybridization and traditional multiple Gap-PCR and PCR-RDB techniques. The consistency of two methods in gene diagnosis of thalassemia was evaluated by analyzing the results of detection.@*RESULTS@#389 normal genotypes (38.86%, 389/1001) and 59 abnormal genotypes (61.14%, 612/1001) was cheked out by the two methods, including 416 cases of α-thalassemia, 162 cases of β-thalassemia and 34 cases of αβ- complex thalassemia. The main genotypes of α-thalassemia were --@*CONCLUSION@#Guangzhou is a area with high incidence of thalassemia, and the genetic types of thalassemia are complex and diverse. Prenatal diagnosis is the final barrier to the prevention of thalassemia. PCR flow-cytometric fluorescence hybridization, as a simple and fast technique, combined with traditional techniques in parallel contributed to the accuracy of prenatal gene diagnosis of thalassemia.

Rituximab combined with ABVD regimen in treatment of Hodgkin lymphoma with autoimmune hemolytic anemia: report of one case and review of literature / 白血病·淋巴瘤

Objective:To explore the efficacy of rituximab combined with ABVD (epirubicin+ bleomycin+ vindesine +dacarbazine) regimen in treatment of Hodgkin lymphoma (HL) complicated with autoimmune hemolytic anemia (AIHA).Methods:The clinical data of 1 HL patient complicated with AIHA in November 2019 in Henan Cancer Hospital were retrospectively analyzed, and literatures were reviewed.Results:The patient received left cervical lymph node biopsy and bone marrow biopsy, and then lymphoma-related gene mutations and whole genetic genome detection were performed. The patient was diagnosed as HL (tuberous sclerosis in stage Ⅳ) complicated with AIHA. After 6 cycles of rituximab combined with ABVD regimen, the efficacy was evaluated. This patient's anemia was recovered, and HL also achieved complete remission.Conclusions:Rituximab combined with ABVD regimen is effective in treatment of HL patients complicated with AIHA.

Spectrum of thalassemia mutations in fetuses of Han and Li ethinicities in Hainan province, China

To analyze the frequency and spectrum of thalassemia mutations in amniotic fluid samples collected from Han and Li people in Hainan province of China. Methods: We carried out a retrospective analysis on prenatal diagnosis of amniotic fluid samples collected from pregnant women who may have next generation with high risks of medium or severe thalassemia between 2005 and 2016. Diverse fetal thalassemia genotypes and mutated alleles in Han and Li people were analyzed and cmpared. Results: We examined 536 amniotic fluid samples from Han people and 588 from Li people, among which 406 Han and 500 Li samples were found to carry at least one thalassemia gene mutation, with a detection rate of 75.75% and 85.03%, respectively. Among all - and β-thalassemia mutant alleles detected, the most frequently found mutations in Han and Li samples were SEA-type of -thalassemia and 41/42 (-CTTT) of β-thalassemia, respectively. A total of 75 severe thalassemia cases were identified in Han samples and 53 in Li samples. In most of these severe cases, parents chose to terminate pregnancy after being informed of thalassemia-related risks. Conclusions: The thalassemia mutations shows ethnic and area specificity, and that prenatal diagnosis for high-risk thalassemia carrier pregnant women is an efficient approach to prevent and control the occurrence of severe thalassemia in the high-prevalence areas.

Review on correction methods related to the pleiotropic effect in Mendelian randomization / 中华流行病学杂志

Mendelian randomization is an approach using the genetic variants as instrumental variable to estimate and assess the casual relationship between exposure of interest and outcomes. As a valid instrument, genetic variants have to meet the assumptions of strong correlation with exposure but without pleiotropic effect with the outcomes. However, pleiotropy of the variants is usually inevitable, owing to the existence of complex biological effects. Thus, correction methods related to pleiotropic bias are introduced in this paper regarding the selection of instrumental variables, testing of invalid instrumental variables, construction of pleiotropic effect correction models and sensitivity analysis of the robust results. For practical application, investigators should take consideration on the following areas including the types of data, sample size and other relative aspects, thereby selecting the suitable method for the inference of consistent and robust casual estimation.

Childhood obesity and coronary artery disease: a Mendelian randomization study / 中华流行病学杂志

Objective@#To assess the casual effect of childhood obesity on adulthood coronary artery disease (CAD) using Mendelian randomization (MR) method.@*Methods@#Data on BMI of children aged 2-10 years in 2015 were downloaded from Early Growth Genetics Consortium and Genetic Investigation of Anthropometric Traits Consortium. Twenty-seven genetic variants related to children’s BMI were selected as instrumental variables (IVs), and the associations between IVs and CAD were extracted from a Meta-analysis of the genome-wide association study of CAD cases published in UK Biobank 2015. We used MR-Egger regression to test whether there was the pleiotropy of the selected SNPs. In the present MR methods, we conducted MR analyses by using mode-based estimate method as primary method for summary-level of associations to estimate the causal association between childhood obesity and CAD.@*Results@#The intercept term estimated for CAD from MR-Egger method suggested that the selected SNPs don’t exert pleiotropy with a 95%CI including the null (-0.008-0.018). In addition, we found evidence that support the effect of childhood obesity on CAD risk: a 1 s increase in children BMI (kg/m2), and the risk of suffering from CAD in adulthood increased by an average of 37% (OR=1.37, 95%CI: 1.09-1.72).@*Conclusion@#This study provides a causal association between childhood obesity and CAD risk.

Effect of phacoemulsification combined with intraocular lens implantation on inflammatory factors, oxidative stress response and hemorheology in diabetic cataract patients

Objective: To investigate the change on phacoemulsification combined with intraocular lens implantation on inflammatory factors IL-2, IL-6, hs-CRP, TNF- alpha; oxidative stress response indexes MDA, CAT, SOD, GSH-Px; peripheral blood hemorheologic index WHV, WMV,PV, PCV, FIB in diabetic cataract patients. Study Design: An observational study. Place and Duration of Study: Department of Ophthalmology, the Second Hospital of Shandong University, Jinan, China, from January 2015 to July 2017

Methodology: One hundred anf fifty-two diabetic cataract patients [160 eyes] were randomly divided into observation group and control group, each with 76 cases [80 eyes]. The control group was treated with conventional therapy, while the observation group was treated with phacoemulsification combined with intraocular lens implantation on the basis of conventional treatment. After one month of treatment, the patients were tested for IL-2, IL-6, hs-CRP, TNF- alpha, MDA, CAT, SOD, GSH-Px, WHV, WMV, PV, PCV, FIB

Results: After one month of treatment, the levels of IL-2, IL-6, hs-CRP and TNF- alpha were lower in the observation group [p<0.001]; the levels of SOD, GSH-Px and CAT were higher in the observation group [p<0.001], while MDA level was higher in the control group [p<0.001]; the levels of WHV, WMV, PV were lower in the observation group [p<0.001], and there was no significant difference in the levels of PCV and FIB between the two groups [p = 0.794 and 0.838, respectively]

Conclusion: Phacoemulsification combined with intraocular lens implantation can improve the level of aqueous inflammatory factors and oxidative stress response indexes in diabetic cataract patients and improve their level of hemorheological indexest

Effect of phacoemulsification combined with intraocular lens implantation on inflammatory factors, oxidative stress response and hemorheology in diabetic cataract patients

Objective: To investigate the change on phacoemulsification combined with intraocular lens implantation on inflammatory factors IL-2, IL-6, hs-CRP,TNF-Alpha; oxidative stress response indexes MDA, CAT, SOD, GSH-Px; peripheral blood hemorheologic index WHV, WMV,PV, PCV, FIB in diabetic cataract patients

Study Design: An observational study

Place and Duration of Study: Department of Ophthalmology, the Second Hospital of Shandong University, Jinan, China, from January 2015 to July 2017

Methodology: One hundred anf fifty-two diabetic cataract patients [160 eyes] were randomly divided into observation group and control group, each with 76 cases [80 eyes]. The control group was treated with conventional therapy, while the observation group was treated with phacoemulsification combined with intraocular lens implantation on the basis of conventional treatment. After one month of treatment, the patients were tested for IL-2, IL-6, hs-CRP, TNF-Alpha, MDA, CAT, SOD, GSH-Px, WHV, WMV, PV, PCV, FIB

Results: After one month of treatment, the levels of IL-2, IL-6, hs-CRP and TNF-Alpha were lower in the observation group [p <0.001]; the levels of SOD, GSH-Px and CAT were higher in the observation group [p <0.001], while MDA level was higher in the control group [p <0.001]; the levels of WHV, WMV, PV were lower in the observation group [p <0.001], and there was no significant difference in the levels of PCV and FIB between the two groups [p = 0.794 and 0.838, respectively]

Conclusion: Phacoemulsification combined with intraocular lens implantation can improve the level of aqueous inflammatory factors and oxidative stress response indexes in diabetic cataract patients and improve their level of hemorheological indexest

Synchronous lymphoma and carcinoma-clinical analyses of 17 patients / 中华血液学杂志

Objective@#To explore the clinical features of patients with synchronous lymphoma and carcinoma.@*Methods@#The clinical data of 17 patients with Synchronous lymphoma and carcinoma from February 2012 to October 2017 were analyzed retrospectively.@*Results@#Among 17 patients of lymphoma, 1 case HL, 2 cases B-NHL, 6 cases MZBL, 3 cases DLBCL, 1 case mantle cell lymphoma (MCL) , 3 cases NK/T- cell lymphoma, 1 case anaplastic large cell lymphoma(ALCL). In terms of 17 patients with carcinoma, 3 cases esophageal carcinoma, 3 cases gastric carcinoma, 2 cases colorectal carcinoma, 7 cases thyroid carcinoma, 1 case hepatocellular carcinoma and lung cancer. Up to 15 patients received operation, and some of them combined with chemotherapy, radiotherapy and autologous transplant. Follow-up analysis showed that 3 cases was undergoing treatment, 2 cases lost follow-up, 4 cases died, 3 cases achieved CR, 3 cases remained to be at SD, and 2 cases assessed for progression or recurrence.@*Conclusion@#The relationship between lymphoma and carcinoma was under discussion, patients with synchronous lymphoma and carcinoma were not unusual. We herein should raise awareness to avoid misdiagnosis.

Effect and mechanism of baicaIin and geniposide on excitotoxicity of acute cerebral ischemia / 中国药理学与毒理学杂志

OBJECTIVE Based on the methods of microdialysis,HPLC-MS/MS and gene chip tech-nology,the mechanism of Baicalin and Geniposide(BC/GP)against excitatory amino acid toxicity in ce-rebral ischemia was studied. This will provide guidance for the clinical application of BC/GP and the study of excitatory amino acid toxicity in cerebral ischemia.METHODS (1)Microdialysis technique and HPLC-MS/MS was performed to study the pharmacodynamics of BC/GP against cerebral ischemia. ①18 SD rats with body weight of(280±20)g were randomly divided into control group,treatment groups with BC/CP at low dose,medium dose and high dose(equal to the dosage of crude drugs for 30 mg·kg-1, 45 mg·kg-1and 60 mg·kg-1respectively).Rats in each group were given intragastric administration for seven days to establish cerebral ischemia model. Then, microdialysis probe was applied to collect cerebrospinal fluid from hippocampus before and after cerebral ischemia. ② First, we established the HPLC-MS/MS method for measuring drugs and excitatory amino acids.Then we detected the microdi-alysis samples and observed their changes in animals.(2)The mechanism of BC/GP against excitatory toxicity of cerebral ischemia were observed at gene level by chip technique. ① 16 SD rats with body weight of 240±20 g were randomly divided into sham group, model group, treatment group of BC(60 mg·kg-1),treatment group of GP(60 mg·kg-1)and treatment group of BC/GP(7:3)(60 mg·kg-1).Rats in eachgroup were given intragastric administration for seven days to establish cerebral ischemia model. Then the rats were sacrificed,and the hippocampus were rapidly harvested and stored at-80℃for further detection. ②After the quality inspection of the hippocampal,the qualified samples were subjected to detect the levels of neurotransmitter receptor gene in the ischemic of rats by gene chip technology.Finally,the results were analyzed by the method of Δ ΔCt.RESULTS (1)Only three compounds includ-ed GP,glutamic acid and aspartic acid were detected in microdialysis samples by HPLC-MS/MS.The concentration of GP increased and lasted for 120 min with a significant dose-dependent after cerebral ischemia.Compared with low dose group,the AUC(0-t),MRT(0-∞),Cmaxand t1/2zin high-dose group showed significant difference(P<0.01).Compared with the model group,the levels of glutamic acid and aspartic acid in the treatment groups decreased significantly,especially in the middle and high dose groups.(2) 89 genes in the neurotransmitter receptor gene signaling pathway were detected by gene chip technol-ogy. There were 22 genes with |Fold Regulation|>1.5 in the model group, compared with the sham group.Five of the 22 genes showed statistically significant differences,including Grin2c(2.9026),Chrna7 (-1.5877), and Tacr2 (-1.7695). Htr3a (-1.8172) and Grm6 (-2.3527). There were 5 genes with |Fold Regulation|>1.5 in the BC group, compared with the model group, Two of them exhibited statistically significant differences,including Brs3(1.797)and Grin2c(-1.7979).There were 14 genes with|Fold Reg-ulation|>1.5 in the GP group, compared with the model group. Three of them displayed statistically significant differences,including Hcrtr2 (-1.6584), Sctr (-3.8524) and Grin2c (-4.8408). Compared with model group, the genes of |Fold Regulation|>1.5 in BC/GP (7:3) group are 5, and only one of them showed a significant differences. CONCLUSION (1)After administration of BC and GP,GP can cross the blood-brain barrier and reduce the release of excitatory amino acids in the hippocampus. (2) BC/GP can inhibit the interaction between excitatory amino acids and excitatory amino acid receptors and attenuate the toxicity of excitatory amino acids by down-regulating the expression of glutamic acid receptor Grin2c gene.(3)BC/GP may exert their brain protection effect by reducing the release of excit-atory amino acids and inhibiting the expression of excitatory amino acid receptors.

Effects of high?fat diet feeding time on the establishment of a rat model of type 2 diabetic nephropathy / 中国实验动物学报

Objective To investigate the effects of different high-fat diet feeding time durations on blood glucose (BG), insulin resistance index(HOMA-IR), and urinary albumin excretion rate(UAER)in rats with high fat diet-induced type 2 diabetic nephropathy(DN). Methods Unilateral renal artery ligation, high-fat diet(throughout the ex-periment period),and low dose streptozotocin(STZ)intraperitoneal injection were used to establish a type 2 DN rat mod-el. After the operation,rats in the DN1 and DN2 groups received an intraperitoneal injection of STZ 30 mg/kg after 4 and 8 weeks of high-fat diet feeding,respectively. UAERs of the DN1 and DN2 groups were compared at 4 weeks after the STZ injection and the end of study(EOS). BG,body weight,HOMA-IR,kidney index,and pathological changes of the kidney were observed. Results UAER was increased in both groups at 4 weeks after the STZ injection,but significantly higher in the group DN2 than in the DN1 group(P<0.01). At the end of study(the 12th week),the renal tissues showed patho-logical changes,including glomerular capillary loop hypertrophy,increased mesangial matrix,and decreased capsule space in both groups. Compared with the DN1 group,the body weight was significantly higher(P<0.01),kidney index was sig-nificantly lower(P<0.01),while BG,serum insulin level,HOMA-IR,and UAER were no significantly changed in the DM2 group(P>0.05,respectively). Conclusions The results show that extending the feeding time of high-fat diet can aggravate the kidney damages in diabetic rats,but it can also delay the start of any planned intervention. Therefore,the ex-perimental protocol should be carefully designed based on the study objective.

Analysis of risk factors of postoperative pancreatic fistula after pancreaticoduodenectomy / 中华消化外科杂志

Objective To investigate the risk factors of postoperative pancreatic fistula after pancreaticoduodenectomy (PD).Methods The retrospective case-control study was adopted.The clinicopathological data of 196 patients with PD who were admitted to First Affiliated Hospital of Dalian Medical University from September 2014 to July 2016 were collected.All the patients underwent PD.Observation indicators:(1) intra-and postoperative situations;(2) follow-up;(3) analysis of risk factors of pancreatic fistula after PD.All patients were followed up by outpatient examination and telephone interview to detect pancreatic fistula and peritoneal fluid collection up to March 2017.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed by t test.Measurement data with skewed distribution were represented as median (range).Count data and univariate analysis were done using the chi-square test.Logistic regression model was used for multivariate analysis.Results (1) Intra-and post-operative situations:all the 196 patients underwent surgeries successfully.The operation time,volume of intraoperative blood loss,number of intraoperative blood transfusion and non intraoperative blood transfusion were (439± 136) minutes,(686±280) mL,45 and 151 cases,respectively.Time to initial anal exsufflation,time of initial defecation and time for first diet after operation were (4.1 ±2.1) days,(5.1± 2.9) days and (3.1 ± 2.0) days.Of 76 patients,the content of diastase in the i ntraperitoneal drainage was 614 U/L (31-30 215 U/L) at postoperative day 1 and level of serum procalciton in was (0.7±0.4) ng/mL at postoperative day 3.Time for drainage tube removal of 196 patients was (14.6±7.1)days.Fifty four of 196 patients with postoperative complications were improved by symptomatic treatment,including 15 with intestinal obstruction,12 with delayed gastric emptying,11 with abdominal infection,9 with incision infection,7 with bleeding.Duration of postoperative hospital stay was (17.1 ±4.2)days.Results of pathological diagnosis of 196 patients showed 121 cases of pancreatic cancer,50 of intraductal papillary mucinous tumors of the pancreas,7ampullary carcinoma,15 of carcinoma of the lower end of the bile duct,and 3 of duodenum cancer.Pancreatic findings:pancreatic texture:95 cases were with soft pancreas and 101 with hard pancreas.Diameter of main pancreatic duct duct:101 cases had diameter of pancreatic duct duct ≥3 mm and 95 cases ＜3 mm.(2)Followup:all the 196 patients were followed up for 4-30 months,with a median follow-up time of 18 months.During follow-up time,the grade B/or C pancreatic fistula occurred in 37 cases.Of 16 patients with pancreatic fistularalated ascites,10 had readmission and were improved by symptomatic treatment.(3) Analysis of risk factors of pancreatic fistula after PD:the results of univariate analysis showed that the content of diastase in the intraperitoneal drainage at postoperative day 1,level of serum procalcitonin at postoperative day 3 and pancreatic texture were related factors affecting the pancreatic fistula after PD (x2 =6.569,5.902,13.517,P＜0.05).The results of multivariate analysis showed that the content of diastase in the intraperitoneal drainage at postoperative day 1 ≥600 U/L was an independent risk factor affecting the pancreatic fistula after PD (OR =9.135,95％confidence interval:2.247-37.130,P＜0.05).Conclusion The content of diastase in the intraperitoneal drainage at postoperative day 1 ≥ 600 U/L is an independent risk factor affecting the pancreatic fistula after PD.

Experience from the U.S.military and civilian integration management of drugs for military special needs / 军事医学

Drugs for military special needs are important strategic materials for supporting military operational needs and maintaining national security,and are highly valued by Armed Forces in each country in the world.The U.S.military has accumulated much experience through the long-term management of drugs for military special needs.Here,The U.S.military and civilian integration management of drugs for military special needs between the U.S.DOD and FDA was analyzed in terms of research,purchase,use and storage,the secrets of success were summarized,and problems were identified.Finally,recommendations on military and civilian integration management of drugs for military special needs in China were proposed.

Clinical features of 11 cases of primary bone lymphoma / 中华血液学杂志

Objective@#To analyze the clinical features, treatment and outcomes of primary lymphoma of bone (PLB) .@*Methods@#The clinical data of 11 PLB patients were retrospectively analyzed.@*Results@#11 patients were enrolled in our study including 7 females and 4 males. The median age of the patients was 45 years old. The main histologic type was diffuse large B cell lymphoma and anaplastic large cell lymphoma. Of the 11 PLB cases, 3 cases were at stage ⅠE, 2 at stage ⅡE, 6 at stage ⅣE respectively. 6 cases were treated with chemotherapy and radiotherapy, 2 cases with total joint arthroplasty and chemotherapy, and 3 cases chemotherapy alone respectively. 5 cases got complete remission, 4 cases partial remission and 2 cases stable disease respectively. The median progression free survival was 17 (5-58) months after a median follow up of 21 (6-58) months.@*Conclusions@#Most of PLB patients were clinically in late stage lacking of clinical and imagine features. The optimal treatment for PLB was radiotherapy combined with chemotherapy, and its prognosis was relatively good.

Study on the efficacy of CD34 + cells combined with sarpogrelate hydrochlotride tablets for the re-construction of the blood supply of thromboangiitis obliterans / 中国医师杂志

Objective To investigate the effect of autologous peripheral blood stem cell transplanta-tion combined with CD34 + cells and oral sarpogrelate hydrochloride for the treatment of vascular reconstruc-tion and blood supply on the thromboangiitis obliterans. Methods Thromboangiitis obliterans ( TAO) of 262 patients with 262 lower limbs were divided into stem cells CD34 + cells transplantation combined with sarpogrelate hydrochloride group ( group A) with 100 lower limbs, CD34 + stem cell transplantation group ( group B) with 91 lower limbs, and sarpogrelate hydrochloride oral group ( group C) with 71 lower limbs. The degree of lower limb local blood flow variability were calculated at the three levels of skin, blood vessels and blood by preoperative and postoperative use of multi-function monitoring instrument, Doppler detector, transcutaneous oxygen pressure monitor, and digital subtraction angiography ( DSA) , respectively. Results⑴ The degree of shank, foot cyanosis, cool skin, and pain was relieved significantly in groups A and B than in group C for 1 month after the treatment (P<0. 05). ⑵Intermittent claudication distance, the skin temperature of the lower leg and foot to patients in the groups A and B than in group C, with a significant difference (F=7. 01, F=7. 04, P<0. 05) for 3 months after the treatment. ⑶ Among the patients with amputation, 10 cases were in group A, 16 cases in group B, and 31 cases in group C for 6 months after the treatment. ⑷ Transcutaneous oxygen pressure was increased from ( 30. 43 ± 4. 31 ) mmHg to ( 37. 21 ± 9. 01)mmHg (F=5. 69, P<0. 05), ankle brachial index from (0. 32 ±0. 23) to (0. 91 ± 0. 16) (F=6. 71, P<0. 05), the volume of blood flow index from the photoelectric (0. 22 ± 0. 04) to (0. 83 ± 0. 13 (F=5. 69, P<0. 05), oxygen saturation from (42. 41 ±9. 61)％ to (79. 61 ±20. 34)％ (F=5. 74, P<0. 05), and DSA score (0. 23 ± 0. 03) increased to (1. 35 ± 0. 23) (F=7. 14, P<0. 05), which was sig-nificantly higher than group B and group C ( F=7. 01, F=7. 04, F=7. 12, F=7. 08, F=7. 15, P<0. 05) for one year after treatment. Conclusions Treatment of peripheral blood stem cells CD34 + cell transplantation combined with oral sarpogrelate hydrochloride can significantly improve the vascular regener-ation and its blood supply in TAO lower extremity limb.