Value of conventional ultrasonography combined with cervical compression in the diagnosis of orbital venous malformation / 中华超声影像学杂志

Objective:To explore the value of conventional ultrasonography combined with cervical compression in the diagnosis of orbital venous malformation (OVM).Methods:A total of 43 patients with suspected OVM were admitted in sequentially from January 2019 to July 2022 in the Third Medical Center of PLA General Hospital. All patients were examined by ultrasonography combined with cervical compression and demonstrated by operation or digital subtraction angiography (DSA). The conventional ultrasound features of OVM were summarized, and the value of conventional ultrasonography combined with cervical compression in the diagnosis of OVM was discussed.Results:The features of the conventional ultrasound combined with cervical compression for diagnosis of OVM were as follows: the interior of lesion was mainly tubular structure, and the compression test was positive. After cervical compression, the lesion enlarged and the inner diameter of the internal tubular structure widened. Doppler flow imaging showed that the interior of lesion was mainly venous blood flow. Compared with the results of postoperative pathology or DSA, the sensitivity, specificity, accuracy and positive predictive value of ultrasonography combined with cervical compression were 0.952, 1.000, 95.3% and 100%, respectively. The results of Fisher exact diagnosis showed that there was no significant difference between ultrasonography and operation or DSA of OVM( P>0.05). Conclusions:Conventional ultrasound combined with cervical compression can be used as an effective method for the diagnosis of OVM.

Value of 5G remote ultrasonic robot in diagnosing high altitude pulmonary edema / 中华超声影像学杂志

Objective:To explore the value of 5G robotic remote ultrasound in the diagnosis of plateau pulmonary edema(HAPE).Methods:A total of 27 patients who quickly entered Nagqu, Tibet at an altitude of 4 600 m-5 600 m from March to December 2021 and developed one of the clinical symptoms of HAPE were collected. All patients were examined by 5G remote robotic ultrasound and lung CT respectively. Kappa test was used to analyze the consistency of the two diagnostic results, and McNemar test was used to compare the difference in diagnostic results. The ROC curve was used to analyze the sensitivity and specificity of remote lung ultrasound scores in the diagnosis of HAPE.Results:Among the 27 patients, 16 showed thickening of pleural line, increasing of B line, lung consolidation, pleural effusion, etc. Meanwhile, 11 showed no abnormality. Additionally, 8 cases had diffuse pulmonary fluid in both lungs, and 8 cases had localized pulmonary fluid. ROC curve showed that the area under the curve of lung ultrasound score for the diagnosis of HAPE was 0.947 (95% CI=0.78-0.99, P<0.001). The sensitivity and specificity were 0.933 and 0.917, respectively. Lung CT diagnosis was positive in 15 cases. Lung CT showed thickening of lung texture, ground glass, small nodular shadow, fine reticulate shadow, etc. The diagnostic results of the two techniques were in good agreement (Kappa=0.924, P<0.001), and there was no significant difference between the two methods ( P>0.05). Conclusions:5G remote robotic ultrasound has high consistency with CT in the diagnosis of HAPE and is an alternative early diagnosis method for HAPE. It may have clinical application value in scattered medical resources and remote plateau areas.

Screening of neonatal congenital heart diseases based on heart sound acquisition system / 上海预防医学

ObjectiveTo investigate the value of remote consultation of heart sound acquisition in screening and referral of neonates with congenital heart diseases （CHD） in primary hospitals. MethodsA total of 4 030 neonates with non-critical diseases were selected. They were born in Shanghai Pudong New Area Maternal and Child Health Hospital from November 5， 2019 to March 31， 2021. After birth， routine cardiac auscultation was performed and remote consultation of heart sound collection were performed at the same time in combination with percutaneous oxygen saturation measurement to screen CHD. The children with any positive screening index were advised to verify the diagnosis by cardiac ultrasound examination in Shanghai Children's Medical Center. The diagnostic value of different screening methods was compared. ResultsA total of 110 cases were detected positive by routine screening. Among them， 16 cases were lost to follow-up， and 46 cases were confirmed by cardiac ultrasound examination， with a positive diagnosis rate of 48.94% （46/94）. A total of 51 cases were detected positive by routine screening and remote consultation of heart sound collection simultaneously. Among them， 42 cases were confirmed by cardiac ultrasound examination， with a positive diagnosis rate of 82.35% （42/51）. The difference between the two positive diagnosis rates was statistically significant （P<0.001）. ConclusionRemote consultation of heart sound acquisition on the basis of routine neonatal CHD screening can effectively improve the positive diagnosis rate of CHD screening in primary hospitals， and reduce unnecessary referrals. This method is simple and feasible. It has practical value in primary hospitals that lack professional technicians for the diagnosis and treatment of CHD.

Application of 18F-FDG PET/CT in early detection of therapy-associated cardiotoxicity in patients with lymphoma / 中华核医学与分子影像杂志

Objective:To explore the role of 18F-fluorodeoxyglucose (FDG) PET/CT in early detection of therapy-associated cardiotoxicity (TACT) in lymphoma patients and to analyze the diagnostic efficacy of different evaluation criteria. Methods:Consecutive patients between November 2009 to October 2018 in Peking University Cancer Hospital were retrospectively enrolled. All patients underwent standard chemotherapy. Myocardial uptake of 18F-FDG pre- and post-treatment were analyzed by visual interpretation and semi-quantitative (maximum standardized uptake value, SUV max) methods. The value of pre-treatment SUV max-heart -post-treatment SUV max-heart (ΔSUV max), %ΔSUV max, and post-treatment SUV max-heart/SUV max-mediastinum, SUV max-heart/SUV max-liver and SUV max-heart/SUV max-background(left gluteal muscle) ratios were calculated. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal cut-off values of those PET/CT imaging criteria for evaluating early TACT of lymphoma, taking electrocardiogram (ECG) positive as the end point. Independent-sample t test and χ2 test were performed. Results:A total of 274 patients (median age was 36-year old), with the male-to-female ratio of 1.85∶1, were included, and 78.1%(214/274) of them had non-Hodgkin′s lymphoma (NHL). After treatment, 55.1%(151/274)of the patients had high myocardial uptake of 18F-FDG (compared with liver uptake), 20.4%(56/274) of them had moderate myocardial uptake (between liver uptake and blood-pool uptake), and 24.5%(67/274) were with equal uptake (less than blood-pool uptake). There were significant differences in myocardial uptake between ECG-positive group ( n=71) and ECG-negative group ( n=203) ( SUV max: 7.77±4.06 vs 5.91±3.04; t=4.045, P<0.01). ROC curves showed that optimal thresholds of post-treatment SUV max-heart, Δ SUV max-heart, %ΔSUV max-heart, and post-treatment SUV max-heart/SUV max-mediastinum, SUV max-heart/SUV max-liver and SUV max-heart/SUV max-background ratios were 9.4, 4.8, 1.4, 5.0, 2.3, 7.0 respectively. The corresponding areas under the curves (AUC) were 0.653, 0.637, 0.612, 0.655, 0.649 and 0.650, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of post-treatment SUV max-heart/SUV max-background ratio were 40.85%(29/71), 82.76%(168/203), 45.31%(29/64), 80.00%(168/210) and 71.90%(197/274). Conclusion:18F-FDG PET/CT can early detect TACT in patients with lymphoma, and if using 7.0 as the threshold of post-treatment SUV max-heart/SUV max- background ratio, the specificity and negative predictive value of 18F-FDG PET/CT for early prediction of TACT are up to 80%.

Diagnosis and clinical characteristics analysis in elderly patients with severe pneumonia caused by Chlamydia psittaci / 中华老年医学杂志

Objective:To investigate the diagnosis and clinical characteristics of five elderly patients with Chlamydia psittaci-caused severe pneumonia.Methods:Through retrospective analysis, diagnosis and treatment process and clinical characteristics of five elderly inpatients with severe pneumonia caused by Chlamydia psittaci were summarized in the Department of Critical Care Medicine, Quanzhou First Hospital East Street Branch Area, affiliated to Fujian Medical University between January to June 2021.Results:Five patients with severe pneumonia caused by Chlamydia psittaci were aged from 64 to 74 years, with various underlying diseases such as coronary heart disease, chronic heart failure, chronic obstructive pulmonary disease, etc.All patients had an established history of poultry exposure.These cases had high fever, cough, spitting, and dyspnea as the main clinical manifestations.Some of them also had systemic symptoms or weakness of the limbs as the prodromal symptoms.The disease progressed rapidly, with severe respiratory failure, acute kidney injury, and shock appearing soon, accompanied by different degrees of muscle injury, and damage to the heart, liver, blood coagulation, and immune systems at the same time.Laboratory examination showed that levels of inflammatory indicators were increased: at 3, 5, 7 d after admission, the level of C reactive protein was 214.6(153.9-256.3)mg/L, 199.2(115.8-333.8)mg/L, 151.0(11.19-173.7)mg/L, respectively; and interleukin 6 level was 1 241.0(912.1-6822.0)ng/L, 779.1(451.2-7122.0)ng/L, 631.2(7.0-4 321.0)ng/L, respectively.And monitoring results of nutritional index indicated a high metabolic state.The imaging examinations showed that consolidation and ground-glass shadows spreaded to both lungs, may accompany the miliary and nodular shadows, and may also involve pleural which caused pleural effusion.After the clinical use of metagenomic next-generation sequencing(mNGS), mNGS has been confirmed as an important method for the diagnosis of Chlamydia psittaci infection.The disease course and prognosis were related to the severity of the disease, advanced age, underlying diseases, and timely diagnosis and effective treatment.Conclusions:The progression of Chlamydia psittaci pneumonia to severe disease may be related to advanced age, more basic diseases such as chronic cardiopulmonary disease, smoking, and timely diagnosis and treatment.Generally, laboratory and imaging examinations have no diagnostic specificity, but mNGS is of great significance for early diagnosis, transition to target treatment and improvement of prognosis.

Analysis of the effect of modified cervical cerclage in the treatment of cervical insufficiency / 中华妇产科杂志

Objective:To discuss the surgical effect of modified cervical cerclage for the treatment of pregnant women with cervical insufficiency.Methods:The clinical data of 225 pregnant women who underwent modified cervical cerclage in Qilu Hospital (Qingdao) were selected for retrospective analysis from April 2014 to June 2020. Surgical success rate, full-term birth rate, preterm birth rate, prolonged pregnancy weeks and newborn birth weight were compared between singleton and twin pregnancies, preventive cerclage and emergency cerclage, surgery before and after 18 weeks, naturally and in vitro fertilization and embryo transfer (IVF-ET) conceived pregnant women respectively.Results:Among the 225 pregnant women, the gestational weeks of surgery were 14-24 +5 weeks, mean gestational weeks of delivery were 38 +2 weeks (35 +5-39 +3 weeks), the number of prolonged gestation were (20.3±5.2) weeks, and the newborn birth weight was (3 065±735) g; the overall surgical success rate was 92.9% (209/225), and the miscarriage rate was 7.1% (16/225); among the surviving newborns, the full-term birth rate was 73.7% (154/209), and the preterm birth rate was 26.3% (55/209). All cases had no intraoperative complications. Among the 225 pregnant women, 202 (89.8%, 202/225) cases were singleton pregnancies, and 23 (10.2%, 23/225) cases were twin pregnancies; 201 (89.3%, 201/225) cases underwent preventive cervical cerclage, and 24 (10.7%, 24/225) cases underwent emergency cervical cerclage; 190 (84.4%, 190/225) cases underwent the surgery before 18 weeks, and 35 (15.6%, 35/225) cases underwent the surgery after 18 weeks; 49 (21.8%, 49/225) cases were conceived by IVF-ET. There was no statistically significant difference in the overall surgical success rate of single and twin group ( P>0.05). The full-term birth rate, newborn birth weight and prolonged pregnancy weeks of single group were higher than those of twin group ( P<0.05). There were no statistical differences between preventive and emergency cerclage in overall surgical success rate, full-term birth rate, preterm birth rate, and newborn birth weight (all P>0.05). The pregnancy prolonged weeks of preventive cerclage was higher than that of emergency cerclage ( P<0.05). There were no statistically significant differences in the overall surgical success rate, full-term birth rate, preterm birth rate and birth weight of newborns at different surgical timings (all P>0.05). The pregnancy prolonged week for those who underwent surgery before 18 weeks was higher than that of surgery after 18 weeks ( P<0.05). The premature birth rate of IVF-ET was higher than that of naturally conceived pregnant women ( P<0.05). Conclusion:The modified cervical cerclage could effectively prolong the gestational weeks of delivery, reduce the rate of preterm birth, and the operation is simple and easy to promote. It could be used as a surgical option for patients with cervical insufficiency.

Effects of wearing a mask on oxygenation of subjects with spontaneous breathing during supplementary oxygen through facemask / 生物医学工程学杂志

During the COVID-19 epidemic, our national guidelines have suggested that surgical patients should wear a mask to decrease the potential transmission of COVID-19 in the operating room, as long as the condition allows. However, so far, there is no study to discuss the influence of wearing a mask on the ventilation and blood oxygenation status in patients of spontaneous breathing with supplementary oxygen through an anesthetic facemask. This is a before-after study in the same patient, and 10 healthy volunteers were recruited, by testing the arterial blood gas parameters at key time points before and after oxygen inhalation to evaluate the effects of two different supplementary oxygen methods ('disposable medical mask + anesthetic facemask' and 'anesthetic facemask only') on the oxygenation of subjects. Our data demonstrated whether wearing a disposable medical mask or not could effectively increase the oxygen supply of the subjects compared with the basic value before oxygen inhalation; however, compared with the group without mask, the arterial oxygen partial (PaO

Prognostic significance of 18F-fluorodeoxyglucose positron emission tomography in patients with diffuse large B cell lymphoma undergoing autologous stem cell transplantation / 中华血液学杂志

Objective@#To evaluate the prognostic value of 18F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B cell lymphoma (DLBCL) undergoing autologous hematopoietic stem cell transplantation (auto-HSCT).@*Methods@#Forty-eight patients with DLBCL treated at Peking University Cancer Hospital between November 2010 and December 2014 were assessed. All patients underwent PET/CT scanning prior to or after auto-HSCT. Correlation analysis was done based upon patients characteristics, PET/CT scan results and survival.@*Results@#①Among 48 patients, 27 was male, 21 female, median age was 43 (17-59) years old. ② Patients with negative pre-auto-HSCT PET/CT assessment demonstrated significantly better 3-year progression free survival (PFS) (87.1% vs 53.3%, χ2=7.02, P=0.019) and overall survival (OS) (90.3% vs 60.0%, χ2=6.51,P=0.022) than patients with positive pre-auto-HSCT PET/CT assessment. Three-year PFS (94.1% vs 30.0%, χ2=22.75, P=0.001) and OS (97.1% vs 40.0%, χ2=21.09, P=0.002) were also significantly different between patients with negative and positive post-auto-HSCT PET/CT assessment. ③ Multivariate analysis indicated a significant association of PFS (HR=13.176, P=0.005) and OS (HR=20.221, P=0.007) with post-auto-HSCT PET/CT assessment. Number of prior treatment regimens was associated with PFS (HR=10.039, P=0.040). ④ Harrell’s C index revealed that the value of combined use of number of prior treatment regimens and post-auto-HSCT PET/CT assessment was superior to either one used alone in PFS (Harrell’s C values were 0.976, 0.869 and 0.927 in combined use, number of prior treatment regimens and post-auto-HSCT PET/CT assessment, respectively), and the combined use of ECOG performance status and post-auto-HSCT PET/CT assessment significantly increased the Harrell’s C index in OS (Harrell’s C values were 0.973, 0.711 and 0.919 in combined use, ECOG performance status and post-auto-HSCT PET/CT assessment, respectively).@*Conclusions@#Post-auto-HSCT PET/CT assessment is the main predictor of outcomes in DLBCL patients receiving auto-HSCT. Combined use of post-auto-HSCT PET/CT assessment and number of prior treatment regimens and ECOG performance status is a better prognostic tool in patients with DLBCL undergoing transplantation.

Role of autophagic response in glutamine treatment attenuating inflammation in rats after traumatic brain injury / 中华临床营养杂志

Objective To investigate the effect of glutamine (GLN) treatment on neurobehavioral outcome,brain edema and inflammatory response in rats after traumatic brain injury (TBI),and to find out the role played by autophagic response in this effect.Methods Rat models with TBI in this study were established using Feeney's method.One hundred healthy male SD rats were randomly divided into five groups (n =20) to receive sham operation (group Sham),TBI (group TBI),TBI and glutamine treatment (group TBI+GLN),TBI amd autophagy inhibitor 3-methyladenine (group TBI+ 3-MA),and TBI,GLN and autophagy inhibitor (group TBI+GLN+3-MA).We measured the rats' behavioral outcomes by modified neurologic severity score (mNSS) tests at day 1,3,7 and 14 after intervention.Brain water content was measured with wet-dry weight method.The serum levels of tumor necrosis factor-α (TNF-ct),interleukin (IL)-1 and IL-4 were tested using enzyme linked immunosorbent assay.The expressions of autophagy-related factors (LC3-Ⅱ,Beclin-1) in TBI cerebral cortex were tested with Western blot.Results Compared with the Sham group,the other four groups had significantly increased levels of brain edema,mNSS,serum inflammatory factors and cerebral LC3-Ⅱ and Beclin-1 (P=0.00).Compared with the TBI group,the TBI+GLN group had less severe brain edema and improved mNSS,lower levels of TNF-α [(57.71 ±9.69) pg/ml vs.(83.37± 12.81) pg/ml,P=0.01] and IL-1 [(39.46±8.60) pg/ml vs.(69.04± 10.48) pg/ml,P=0.00],higher levels of IL-4 [(68.72± 11.18) pg/ml vs.(35.75 ± 8.40) pg/ml,P =0.04],and upregulated expressions of LC3-Ⅱ and Beclin-1 (P=0.01).Compared with the TBI+GLN group,the TBI+GLN+3-MA group had severer neurofunctional impairment,brain edema and inflammation (P＜ 0.05).Conclusions Treatment with GLN markedly reduced brain edema and improved neurobehavioral outcomes in rats with TBI by inhibiting inflammatory response in the central nervous system.The mechanism might have been the activation of the autophagic response.

MiRNA-374 Inhibits Glioma Cell Growth, Invasion Via Direct Targeting Pituitary Tumor Transforming Gene / 中山大学学报(医学科学版)

[Objective] To investigate the possible effect of microRNA-374 (miR-374) expression on tumor cells' proliferation and invasion and particular mechanism.[Methods] MiR-374 overexpression lentiviral vector (Lv-miR-374) and a control lentiviral empty vector (LEV) were stably transfected into human glioma U251 and U87 cells,to evaluate the effect of miR-374 on cell proliferation and invasion ability.Target relationship between miR-374 and PTTG were researched by dual luciferase report gene assay.Expression level of correlative signaling pathways of the downstream gene protein was analyzed by Western blot.[Results] We revealed that the overexpression of miR-374 dramatically suppressed glioma cell growth and invasion in vitro.Target relationship between miR-374 and PTTG was confirmed by dual luciferase report gene assay.And decreased protein expression of PTTG,bFGF,AKT,MMP2,and p70S6K was consistent with the effect of miR-374 overexpression.[Conclusion] Decreased miRNA-374 is an unfavorable prognosis marker and promotes glioma cell growth and invasion via direct targeting PTTG.Our findings provide new insights into the role of miR-374 in the development of gliomas,and implicate the potential application of miR-374 in cancer therapy.

Effect of Zhuang Medicine Acupuncture on Brainstem Auditory Evoked Potential in Patients with Posterior Circulation Ischemic Vertigo / 上海针灸杂志

Objective To investigate the effect of Zhuang medicine acupuncture on brainstem auditory evoked potential (BAEP) in patients with posterior circulation ischemic vertigo (PCIV).Methods Eighty-five PCIV patients were randomly allocated to a treatment group of 45 cases and a control group of 40 cases. The control group received conventional basic therapy and the treatment group, Zhuang medicine acupuncture in addition. The peak latencies (Pg) of BAEP waveⅠ ,Ⅰ andⅠ and the interpeak latencies (IPg) of waveⅠ-Ⅰ,Ⅰ-Ⅰ andⅠ-Ⅰ were compared between the two groups after treatment.Results There were statistically significant post-treatment differences in waveⅠ andⅠ Pg and waveⅠ-Ⅰ andⅠ-Ⅰ IPg between the treatment and control groups (P<0.05).Conclusions Zhuang medicine acupuncture plus medication is an effective way to treat PCIV. It can improve BAEP indicators in the patients.

Application of interim 18 F-FDG PET-CT in lymphoma / 国际肿瘤学杂志

Interim fluorine 1 8 fluorodeoxyglucose (1 8 F-FDG)positron emission tomography (PET) integrated with computed tomography (CT) provides both metabolic and morphologic information,which becomes one of the most sensitive tools to evaluate the efficacy of the therapy and predict the prognosis of patients with lymphoma.Meanwhile,it is the basis for guiding trial design and changing clinical practice.How-ever,it is still a controversial issue in the ideal utilization of interim 1 8 F-FDG PET-CT imaging for the patients with lymphoma.

The prognosis value of early and interim ¹⁸F-FDG-PET/CT scans in patients with diffuse large B-cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the prognosis value of early and interim ¹⁸F-FDG-PET/CT scan in patients with diffuse large B- cell lymphoma （DLBCL） to establish the suitable criteria for evaluating posttherapeutic lesions in scans.</p><p><b>METHODS</b>Fifty- six newly diagnosed DLBCL patients were enrolled in the study, and underwent baseline, early and interim ¹⁸F- FDG PET/CT scans. Five- point and % ΔSUVmax criteria were used separately to interpret ¹⁸F- FDG PET/CT images. Interobserver reproducibility was assessed with the kappa test（κ）, and thresholds of %ΔSUVmax were calculated via receiver operating characteristic curve（ROC）. Survival curves were obtained using Kaplan-Meier curves and log-rank test. Cox regression analysis was used for multi-factor analysis.</p><p><b>RESULTS</b>Median follow-up was 24 months（6 to 42 months）. The kappa value of the five- point scale was above 0.600 with the reference background set in the liver（Score≥4）. The optimal threshold of %ΔSUVmax was 81% for early PET/CT and 74% for interim PET/CT. Survival analysis showed both early and interim PET/CT scans could predict the outcome of 56 patients with DLBCL, and 3-year PFS and OS of PET-negative patients were significantly higher than those of PET-positive ones（P<0.05）. Five-score criteria were more accurate in evaluating 3- year PFS of DLBCL patients in the interim PET/CT scan（76.79%）. %ΔSUVmax criteria were better for interpreting 3-year OS（76.79% and 83.93%）. Multi-factor analysis demonstrated that early and interim PET/CT were solid predicting factors for DLBCL patients.</p><p><b>CONCLUSION</b>Early and interim PET/CT scans could predict the outcome of patients with DLBCL, treated with R-CHOP/CHOP. Three-year OS was more accurate in early and interim PET/CT using 66 %ΔSUVmax criteria as an interpretation, while 3-year PFS was more accurate in interim PET/CT by five scores criteria.</p>

Prognostic value of 18F-FDG PET-CT in Hodgkin lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To determine the predictive value of interim and end-of-treatment ¹⁸F-FDG PET-CT after first-line treatment in patients with Hodgkin lymphoma (HL).</p><p><b>METHODS</b>The clinical data of 50 newly diagnosed HL patients were retrospectively analyzed. Baseline, interim and end-of-treatment PET-CT were performed, and then imaging results were analyzed for the survival of patients via software SPSS 13.0.</p><p><b>RESULTS</b>Fifty patients received first-line treatment with ABVD (doxorubicin + bleomycin + vincristine + dacarbazine) or BEACOPP (bleomycin + etoposide + doxorubicin + cyclophosphamide + vincristine + procarbazine+ prednisone) regimen. Interim PET-CT of 35 patients were performed after 2-4 cycles of treatment, 46 patients received PET-CT scans at the end of treatment. After a median follow-up of 29.4 months (12.2-52.4 months), the 3-year progression-free survival (PFS) rates were 100% and 70% for the interim PET-CT negative (n=25) and positive (n=10) patients, respectively (P=0.004). The 3-year PFS rates were 100% and 60% for the post-treatment PET-CT negative (n=36) and positive (n=10) patients, respectively (P<0.01).</p><p><b>CONCLUSION</b>Interim and end-of-treatment PET-CT were correlated with 3-year PFS rates for HL patients. They may play an important role in predicting the outcome of HL. The relationship with OS can not be determined because of the short follow-up time.</p>

Structural flexibility and functional interaction of Mediator Cdk8 module

Mediator is a highly conserved large protein complex (25 proteins, >1000 kDa) and preeminently responsible for eukaryotic transcription, which contains a dissociable 'Cdk8 module'. Although increasing evidence demonstrates that Cdk8 module plays both positive and negative roles in transcription regulation, the detailed structure, and subunit organization, molecular mechanism how it regulates transcription remain elusive. Here we used single-particle electron microscopy to characterize the structure and subunit organization of the Cdk8 module and illuminated the substantial mobility of the Med13 subunit results in the structural flexibility. The Cdk8 module interaction with core Mediator is concurrent with active transcription in vivo. An interaction with the Cdk8 module induces core Mediator into very extended conformation in vitro, which is presumed to be an active functional state of Mediator. Taken together, our results illuminated the detailed architecture of Cdk8 module, and suggested the Cdk8 module could positively regulate transcription by modulating Mediator conformation.

The Acquirement of Endocrinology Information at Home and Abroad on Internet / 医学信息学杂志

The paper introduces the acquirement of endocrinology information at home and abroad on Internet from six aspects, inclu-ding major research institutions and its periodicals, main -stream publications, teaching materials, clinical experience materials, major search engine and search skills for medical resources, in order to provide reference for medical staffs finding endocrinology resources.

Pre-clinical study on tumor vasoactive intestinal peptide receptor scintigraphy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To develop a tumor imaging agent for vasoactive intestinal peptide (VPAC) receptor and evaluate its biological activity and pharmacokinetics of radiolabeled peptide.</p><p><b>METHODS</b>VIP(28) was modified at the carboxyl terminal by the addition of His-tag which was the chelating site of (99m)Tc(I) and the general purification tag for immobilized metal ion affinity chromatography. Biological activity of the modified VIP(28) analogue MY34 was examined in vitro by radiological cell-binding assay, rabbit internal anal sphincter (IAS) smooth muscle relaxing assay and immunocytochemical stain. The pharmacokinetics of this labeled peptide was examined in C57 mice.</p><p><b>RESULTS</b>MY34 could relax the IAS smooth muscle and bind VPAC receptors on tumor cell membranes. (99m)Tc- MY34, with a yield of about 90%, was stable enough for practical use. Both MY34 and VIP(28) could inhibit the binding between the labeled peptide and VPAC receptor. The pharmacokinetics of [(99m)Tc(H(2)O)(3)(CO)(3)]-MY34 was studied in mice conformed well with the two-compartment model (Wi = 1/C(2)), with a t(1)/(2alpha) of 16.35 min and a t(1)/(2beta) of 1013.56 min.</p><p><b>CONCLUSION</b>MY34 possesses physiological activities and specific receptor binding characteristics similar to those of natural VIP(28).</p>

Sentinel lymph node biopsy for breast cancer patients after neoadjuvant chemotherapy / 中国普通外科杂志

Objective To evaluate the clinical significance of sentinel lymph nodes biopsy (SLNB) in breast cancer patients after neoadjuvant chemotherapy. Methods SLNB was performed in sixty primary breast cancer patients after neoadjuvant chemotherapy using a combination of 99mTc- Rituximab and patent blue. SLN was examined by routine pathologic examination and immunohistochemistry. Routine axillary lymph node resection was performed after SLNB. Results The successful rate of SLNB was 95% (57/60). Twenty-three cases of SLN (40% ) were metastasis positive, including 18 positive cases detected by HE staining and 5 by immunohistochemistry. SLN was the only metastasis lymph nodes in 14 out of 23 cases. One case was of false negative metastasis by SLN. The sensitivity and accuracy of SLNB were 96% (23/24) and 98% (56/57), respectively. The specificity was 100% (33/33) , the false negative rate was 4. 3% (1/23) with the negative predictive value being 97% (36/37). The positive predictive value was 100% (24/24). Internal mammary sentinel lymph node lymphoscintigraphy were positive in 11 cases but all the cases were negative in metastases by pathologic examination. Conclusion The combination of isotope imaging agent and patent blue is suitable for primary breast carcinoma after neoadjuvant chemotherapy. Internal mammary sentinel lymph node biopsy is less clinically important.

Ways of and experience in strengthening ward rounds by attending doctors / 中华医院管理杂志

The general clinical abilities of attending doctors are closely linked with the overall quality of patient care in a hospital. A set of quality standards for ward rounds by attending doctors were formulated in the author's hospital and an intensive evaluation was conducted by the experts team of the results of inspection and assessment. It is suggested that the hospital should tighten the quality control of ward rounds by attending doctors and pay serious attention to various problems that may occur. In particular, the hospital should set strict assessment standards for post qualification for attending doctors and strive to cultivate their clinical abilities after their post assumption. In addition, it should bring their talent into full play on the basis of vigorous management and assessment and discover and correct their shortcomings in ward rounds in a timely manner.

Ethics Problems in Administration of ICU / 中国医学伦理学

ICU is a special department for critically ill person.For the reasons of the closed-type of administration and the peculiar psychological state of patient,some ethics issues came out.The patients and their relative can't receive the due respect and humanism care,and the ethics issue hasn't drawn enough attention.The author holds that to solve the ethical problems in the administration,we should pay attention to the basic principle of ethics of life,reinforce the humanistic morals of the medical personnel in ICU,and apply the principle of people first in clinic.