Related factors of relapse based on positive and negative syndrome scale among schizophrenics in Shanghai communities / 上海预防医学

ObjectiveTo explore the relapse status based on the positive and negative syndrome scale （PANSS Scale） and related factors of schizophrenics in Shanghai communities， and to analyze the association between socio demographic characteristics， lifestyles， clinical characteristics and relapse. MethodsA dynamic cohort prospective study design was used in this study. From March 2018 to February 2019， a total of 189 schizophrenics in Xuhui， Hongkou， Changning， Jiading， Songjiang and Baoshan districts were enrolled successively. Baseline questionnaires were conducted through face-to-face interviews at baseline， which contained social demographic information， lifestyle information and clinical information. A follow-up was conducted every 2 weeks for a measurement of PANSS Scale for a total of 6 months. Relapse was assessed by a PANSS score increase of ≥25% from baseline （or an increase of 10 points or more if the baseline score was ≤40 points）. Univariate and multivariate Cox regression models were used to analyze the associations between relapse status （assessed by PANSS Scale） and socio demographic characteristics， lifestyles， and clinical characteristics， respectively. ResultsA total of 165 community schizophrenics completed baseline and follow-up surveys， with a loss to follow-up rate of about 12.7%. After exclusion of sociodemographic and clinical information deficits， 132 patients were included in the analysis totally， with an average age of 48.18±12.67 years， among whom 41.67% were male. Totally 33 patients relapsed during the 6-month follow-up period， with a relapse rate of 25.0%. After adjusting for gender， family history， age， employment， education， marital status， smoking， drinking， exercise frequency， medication compliance， insight， social function， violence history， stress recent events， adverse drug reactions and baseline scores of PANSS Scale， risk factors of relapse included the following four factors： age below 40 years （HR=4.47， 95%CI： 1.15-17.40）， primary school or below （HR=7.11， 95%CI： 1.54-32.83）， unemployed （HR=8.34， 95%CI： 1.78-38.98）， and adverse drug reactions （HR=5.02， 95%CI： 1.75-14.37）. ConclusionWe should pay attention to the risk factors such as age， education， employment and adverse drug reactions， in order to identify high-risk patients and to conduct timely interventions during the relapse management of schizophrenics in Shanghai community.

Development and validation of risk prediction model for new-onset cardiovascular diseases among breast cancer patients: Based on regional medical data of Inner Mongolia / 北京大学学报(医学版)

OBJECTIVE@#To develop and validate a three-year risk prediction model for new-onset cardiovascular diseases (CVD) among female patients with breast cancer.@*METHODS@#Based on the data from Inner Mongolia Regional Healthcare Information Platform, female breast cancer patients over 18 years old who had received anti-tumor treatments were included. The candidate predictors were selected by Lasso regression after being included according to the results of the multivariate Fine & Gray model. Cox proportional hazard model, Logistic regression model, Fine & Gray model, random forest model, and XGBoost model were trained on the training set, and the model performance was evaluated on the testing set. The discrimination was evaluated by the area under the curve (AUC) of the receiver operator characteristic curve (ROC), and the calibration was evaluated by the calibration curve.@*RESULTS@#A total of 19 325 breast cancer patients were identified, with an average age of (52.76±10.44) years. The median follow-up was 1.18 [interquartile range (IQR): 2.71] years. In the study, 7 856 patients (40.65%) developed CVD within 3 years after the diagnosis of breast cancer. The final selected variables included age at diagnosis of breast cancer, gross domestic product (GDP) of residence, tumor stage, history of hypertension, ischemic heart disease, and cerebrovascular disease, type of surgery, type of chemotherapy and radiotherapy. In terms of model discrimination, when not considering survival time, the AUC of the XGBoost model was significantly higher than that of the random forest model [0.660 (95%CI: 0.644-0.675) vs. 0.608 (95%CI: 0.591-0.624), P < 0.001] and Logistic regression model [0.609 (95%CI: 0.593-0.625), P < 0.001]. The Logistic regression model and the XGBoost model showed better calibration. When considering survival time, Cox proportional hazard model and Fine & Gray model showed no significant difference for AUC [0.600 (95%CI: 0.584-0.616) vs. 0.615 (95%CI: 0.599-0.631), P=0.188], but Fine & Gray model showed better calibration.@*CONCLUSION@#It is feasible to develop a risk prediction model for new-onset CVD of breast cancer based on regional medical data in China. When not considering survival time, the XGBoost model and the Logistic regression model both showed better performance; Fine & Gray model showed better performance in consideration of survival time.

Neoadjuvant chemoradiotherapy combined with surgery versus direct surgery in the treatment of Siewert type II and III adenocarcinomas of the esophagogastric junction: long-term prognostic analysis of a prospective randomized controlled trial / 中华胃肠外科杂志

Objective: To investigate the effectiveness, safety, and prognosis of neoadjuvant chemoradiotherapy (nCRT) for Siewert type II and III adenocarcinomas of the esophagogastric junction (AEG). Methods: This study is a prospective randomized controlled clinical study (NCT01962246). AEG patients who were treated at the Third Department of Surgery of the Fourth Hospital of Hebei Medical University from February 2012 to June 2016 were included. All of the enrolled patients were diagnosed with type II or III locally advanced AEG gastric cancer (T2-4N0-3M0 or T1N1-3M0) by gastroscopy and CT before operation; the longitudinal axis of the lesion was ≤ 8 cm; no anti-tumor treatment was previously given and no contraindications of chemotherapy and surgery were found. Case exclusion criteria: serious diseases accompanied by liver and kidney, cardiovascular system and other vital organs; allergy to capecitabine or oxaliplatin drugs or excipients; receiving any form of chemotherapy or other research drugs; pregnant or lactating women; patients with diseases resulting in difficulty to take capecitabine or with concurrent tumors. Based on sample size estimation, a total of 150 AEG patients were enrolled. Using the random number table method, the enrolled patients were divided into the nCRT group and the direct operation group with 75 cases in each group. The nCRT group received XELOX chemotherapy (capecitabine+ oxaliplatin) before surgery and concurrent radiotherapy (45 Gy, 25 times, 1.8 Gy/d, 5 times/week). Clinical efficacy of the nCRT group was evaluated by the solid tumor efficacy evaluation standard (RECIST1.1) and the tumor volume reduction rate was measured on CT. After completing the preoperative examination in the direct operation group, and 8-10 weeks after the end of nCRT in the nCRT group, surgery was performed. Laparoscopic exploration was initially performed. According to the Japanese "Regulations for the Treatment of Gastric Cancer", a transabdominal radical total gastrectomy combined with perigastric lymph node dissection was performed. The primary outcome was the 3-year overall survival (OS) and disease-free survival rate (DFS); the secondary outcomes were R0 resection rate, the toxicity of chemotherapy, and surgical complications. The follow-up ended on December 31, 2019. The postoperative recurrence, metastasis and survival time of the two groups were collected. Results: After excluding patients with incomplete clinical data, patients or family members requesting to withdraw informed consent, and those failing to follow the treatment plan, 63 cases in the nCRT group and 69 cases in the direct operation group were finally enrolled in the study. There were no statistically significant differences in baseline characteristics of the two groups (all P>0.05). Sixty-three patients in the nCRT group were evaluated by RECIST1.1 after treatment, the image based effective rate was 42.9% (27/63), and the stable disease rate was 98.4% (62/63); the tumor volume before and after nCRT measured on CT was (58.8±24.4) cm(3) and (46.6±25.7) cm(3), respectively, the effective rate of tumor volume reduction measured by CT was 47.6% (30/63). Incidences of neutrophilopenia [65.1% (41/63) vs. 40.6% (28/69), χ(2)=7.923, P=0.005], nausea [81.0% (51/63) vs. 56.5% (39/69), χ(2)=9.060, P=0.003] and fatigue [74.6% (47/63) vs. 42.0% (29/69), χ(2)=14.306, P=0.001] in the nCRT group were significantly higher than those in the direct surgery group. Radiation gastritis/esophagitis and radiation pneumonia were unique adverse reactions in the nCRT group, with incidences of 52.4% (33/63) and 15.9%(10/63), respectively. The classification of tumor regression of 63 patients in nCRT group presented as 11 cases of grade 0 (17.5%), 20 cases of grade 1 (31.7%), 28 cases of grade 2 (44.4%), and 5 cases of grade 3 (7.9%). Eleven (17.5%) patients achieved pathologic complete response. Sixty-one (96.8%) patients in the nCRT group underwent R0 resection, which was higher than 87.0% (60/69) in the direct surgery group (χ(2)=4.199, P=0.040). The mean number of harvested lymph nodes in the specimens in the nCRT group and the direct operation group was 27.6±12.4 and 26.8±14.6, respectively, and the difference was not statistically significant (t=-0.015, P=0.976). The pathological lymph node metastasis rate and lymph node ratio in the two groups were 44.4% (28/63) vs. 76.8% (53/69), and 4.0% (70/1 739) vs. 21.9% (404/1 847), respectively with statistically significant differences (χ(2)=14.552, P<0.001, and χ(2)=248.736, P<0.001, respectively). During a median follow-up of 52 (27-77) months, the 3-year DFS rate in the nCRT group and the direct surgery group was 52.4% and 39.1% (P=0.049), and the 3-year OS rate was 63.4% and 52.2% (P=0.019), respectively. According to whether the tumor volume reduction rate measured by CT was ≥ 12.5%, 63 patients in the nCRT group were divided into the effective group (n=30) and the ineffective group (n=33). The 3-year DFS rate of these two subgracps was 56.6% and 45.5%, respectively without significant difference (P=0.098). The 3-year OS rate was 73.3% and 51.5%,respectively with significant difference (P=0.038). The 3-year DFS rate of patients with the tumor regression grades 0, 1, 2 and 3 was 81.8%, 70.0%, 44.4%, and 20.0%, repectively (P=0.024); the 3-year OS rate was 81.8%, 75.0%, 48.1% and 40.0%, repectively (P=0.048). Conclusion: nCRT improves treatment efficacy of Siewert type II and III AEG patients, and the long-term prognosis is good.

Mechanism of Shaofu Zhuyu Decoction in treatment of EMT induced dysmenorrhea based on network pharmacology and molecular docking / 中国中药杂志

Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP) and Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine(BATMAN-TCM) were searched for the effective components and targets of Shaofu Zhuyu Decoction. The relevant targets for endometriosis(EMT) and dysmenorrhea were retrieved from the Comparative Toxicogenomics Database(CTD), Therapeutic Target Database(TTD), GeneCards, and DisGeNET with the terms of "endometriosis" and "dysmenorrhea". Cytoscape 3.8.0 was employed to construct the drug-active component-therapeutic target network. A protein-protein interaction(PPI) network was established by STRING 11.0. Analyze Network, the plug-in in the Cytoscape 3.8.0, was used to calculate the topological parameters of the nodes and screen out the critical proteins in the network. The potential therapeutic targets were imported into RStudio and subjected to Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses with clusterProfiler package. Finally, the AutoDock Vina(Vina) platform was used for molecular docking to predict the binding degree of the main active components of Shaofu Zhuyu Decoction to key targets. As revealed by the screening results, 136 active components and 380 targets of Shaofu Zhuyu Decoction were obtained. Additionally, there were 1 627 targets related to EMT and 142 targets related to dysmenorrhea with 107 common targets, and 42 potential therapeutic targets of Shaofu Zhuyu Decoction for the treatment of EMT-induced dysmenorrhea. The targets such as interleukin 6(IL6) and prostaglandi-nendoperoxide synthase-2(PTGS2) were pivotal in the biological network of Shaofu Zhuyu Decoction intervention in EMT-induced dysmenorrhea, which involved multiple signaling pathways, including inflammation, hormones, and those promoted cell proliferation [e.g., mitogen-activated protein kinase(MAPK) and phosphatidylinositol-3 kinase(PI3 K)-protein kinase B(AKT)]. The results of molecular docking showed that the active components of Shaofu Zhuyu Decoction had good binding capacities to key targets such as IL6 and PTGS2. The findings of this study demonstrated that Shaofu Zhuyu Decoction could treat EMT-induced dysmenorrhea through multiple targets and multiple pathways, which could provide new ideas for investigating the underlying mechanism of Shaofu Zhuyu Decoction in the treatment of EMT-induced dysmenorrhea.

Gentiopicroside Ameliorates the Progression from Hepatic Steatosis to Fibrosis Induced by Chronic Alcohol Intake

In current study, we aimed to investigate whether the gentiopicroside (GPS) derived from Gentiana manshurica Kitagawa could block the progression of alcoholic hepatic steatosis to fibrosis induced by chronic ethanol intake. C57BL/6 mice were fed an ethanol- containing Lieber-DeCarli diet for 4 weeks. LX-2 human hepatic stellate cells were treated with GPS 1 h prior to transforming growth factor-β (TGF-β) stimulation, and murine hepatocyte AML12 cells were pretreated by GPS 1 h prior to ethanol treatment. GPS inhibited the expression of type I collagen (collagen I), α-smooth muscle actin (α-SMA) and tissue inhibitor of metal protease 1 in ethanol-fed mouse livers with mild fibrosis. In addition, the imbalanced lipid metabolism induced by chronic ethanol-feeding was ameliorated by GPS pretreatment, characterized by the modulation of lipid accumulation. Consistently, GPS inhibited the expression of collagen I and α-SMA in LX-2 cells stimulated by TGF-β. Inhibition of lipid synthesis and promotion of oxidation by GPS were also confirmed in ethanol-treated AML12 cells. GPS could prevent hepatic steatosis advancing to the inception of a mild fibrosis caused by chronic alcohol exposure, suggesting GPS might be a promising therapy for targeting the early stage of alcoholic liver disease.

Progress on the treatment of adolescent idiopathic scoliosis / 中国骨伤

Adolescent idiopathic scoliosis (AIS) is a common disease with the age of 10 to 18 years, the Cobb angle more than 10 ° on the coronal plane and combined with the rotation of the vertebral body without other organic lesions. The disease can lead to deformity, pain and even damage of cardiopulmonary function, which seriously affects the physical and mental health and quality of life of patients. For mild to moderate AIS patients, regular observation, braces and other conservative treatment methods can effectively delay the progress of scoliosis. For AIS patients whose conservative treatment is ineffective and reaches the surgical threshold, surgery is recommended. Currently, the prevalent surgical method is posterior vertebral body fusion represented by the pedicle screw internal fixation system, which can often achieve good clinical efficacy. In recent years, Physical Therapeutic Scoliosis Specific Exercise (PSSE) has become more and more popular because of its safety and effectiveness. At present, the specific indications for the treatment of AIS patients are gradually improving, the concept and technology of treatment are constantly updated, and the clinical efficacy is constantly improved. This article will start from two aspects of conservative treatment and surgical treatment, mainly describes the commonly used treatment methods in clinical progress and application as well as the problems faced, in order to provide a reference for the selection of clinical treatment.

Nutritional support in children with pneumonia on mechanical ventilation by short-peptide enteral nutrition formula / 中国当代儿科杂志

OBJECTIVE@#To observe the incidence of malnutrition and nutritional risk in children with pneumonia on mechanical ventilation in the pediatric intensive care unit (PICU), and to explore the nutritional support effect of short-peptide enteral nutrition formula.@*METHODS@#A total of 68 children with severe pneumonia who were hospitalized in the PICU from October 2017 to October 2018 and required mechanical ventilation were enrolled for a prospective randomized controlled study. The children were randomly divided into a control group and an experimental group. Through the nasogastric feeding tube, the experimental group received the short-peptide enteral nutrition formula, and the control group received the intact-protein enteral nutrition formula. The weight-for-age Z score, STRONGkids nutritional risk score, and pediatric critical illness score of the two groups were evaluated. The serum levels of total protein, albumin, and prealbumin (PA) on admission and before discharge were measured. The gastrointestinal tolerance and clinical outcome indicators of the two groups were observed.@*RESULTS@#Among the 68 mechanically ventilated children, 26 (38%) had malnutrition, including moderate malnutrition (10 cases, 15%) and severe malnutrition (16 cases, 24%); 10 cases (15%) had malnutrition at discharge. Sixty-three children (93%) had nutritional risk, including moderate nutritional risk in 21 cases and high nutritional risk in 42 cases. The moderate and high nutritional risk rates of the critical and extreme critical groups were significantly higher than those of the non-critical group (P0.05).@*CONCLUSIONS@#The detection rates of malnutrition and nutritional risk in children with pneumonia on mechanical ventilation are relatively high. Short-peptide enteral nutrition formula can help improve their treatment outcome and are more suitable for nutritional support in critically ill children on mechanical ventilation.

Nutritional assessment and clinical application of nutritional risk screening tools in critically ill children / 中国当代儿科杂志

OBJECTIVE@#To investigate the nutritional status of critically ill hospitalized children and to explore the value of nutritional risk screening tools in the nutritional risk assessment.@*METHODS@#The clinical data of 211 critically ill children who were admitted to the pediatric intensive care unit from November 2017 to April 2018 were collected to evaluate their nutritional status on admission and at discharge. Two nutritional risk screening tools, STRONGkids and PYMS, were used for nutritional risk screening in the 211 children.@*RESULTS@#Among the 211 patients, 68 (32.2%) were found to have malnutrition on admission, with 34 cases each of moderate and severe malnutrition. Moderate or high nutritional risk was found in 154 cases (73.0%) with STRONGkids and 165 cases (78.2%) with PYMS. Using weight-for-age Z-score as the gold standard to evaluate the efficacy of the two nutritional risk screening tools, the areas under the receiver operating characteristic curves of STRONGkids and PYMS were 0.822 and 0.759 respectively. Both tools had a significant clinical value in screening for malnutrition (P0.05). With the optimal cut-off value of 3 points, the sensitivities of STRONGkids and PYMS for screening of malnutrition were 92.1% and 76.2% respectively. The children with moderate or high nutritional risk on admission had a significantly poorer prognosis than those with low nutritional risk (P=0.014 and 0.001 respectively). The children with severe malnutrition had a significantly poorer prognosis than those with normal nutrition (P=0.0009).@*CONCLUSIONS@#The detection rates of malnutrition and nutritional risk are high in critically ill children. Malnutrition/high nutritional risk is related to a poor prognosis. Both STRONGkids and PYMS have a clinical value for nutritional risk screening in critically ill children, and they have similar clinical efficacy; however, STRONGkids is more sensitive.

Expression of PD-L1 and Gal-9 in human adipose-derived stem cells and its influencing factors / 中华整形外科杂志

Objective@#To explore whether human adipose-derived stem cells (ADSCs) express PD-L1 and Gal-9 and its potential influence factors.@*Methods@#ADSCs isolated from 28 healthy female donors who underwent liposuction of the abdomen or breast tissue were cultured and characterized. The expression of PD-L1 and Gal-9 were detected using flow cytometry. The impact of donor age, body mass index (BMI), donor site and interferon-γ (IFN-γ) on the expression of PD-L1 and Gal-9 was analyzed using multivariate linear regression analysis.@*Results@#The cultured cells fulfilled the criteria for defining MSCs according to the international standards and expressed PD-L1 and Gal-9. Breast-derived ADSCs had higher expression levels of PD-L1 (37.24%±8.20%) and Gal-9 ( 4.41%±2.65%) than those in abdomen-derived ADSCs (28.80%±8.59% and 2.51%±1.39%, respectively) (P=0.018, P=0.039). Multivariate linear regression analysis showed that donor age and site were independent risk factors affecting PD-L1 expression (P=0.009, P=0.006). The expression of PD-L1 decreased by 0.385% for every one year of age increase, and it was 8.58% higher in the breast-derived ADSCs than in the abdomen-derived ADSCs. Donor site was an independent risk factor for Gal-9 expression (P=0.041). Gal-9 positive expression rate in the breast-derived ADSCs was 1.898% higher than that in the abdomen-derived ADSCs. BMI was not a risk factor affecting PD-L1 or Gal-9 expression on ADSCs. The expression of PD-L1 and Gal-9 on ADSCs were significantly upregulated after 48 hours stimulation with 20 ng/ml IFN-γ in vitro.@*Conclusions@#Human ADSCs expressed PD-L1 and Gal-9. Donor age, site and IFN-γ treatment were independent risk factors affecting the expression of PD-L1 and Gal-9 on ADSCs.

Dynamic changes of pH2AX expression in the reversibility of mouse testicular reproductive function impaired by single heat stress / 中华男科学杂志

Objective@#To investigate the role of pH2AX in the reversibility of mouse testicular reproductive function impaired by single heat stress.@*METHODS@#Twenty-four C57 male mice were randomly divided into heat stress and control groups and immersed in water at 43℃ and 25℃, respectively, for 15 minutes. At 1, 7, and 14 days of heat exposure, all the mice were sacrificed and their testis tissues collected for determining the apoptosis of the germ cells by TUNEL and measuring the expression level of the pH2AX protein by immunohistochemistry and Western blot.@*RESULTS@#The highest percentage of apoptotic cells were found in the seminiferous tubules of the mice in the heat stress group on the 1st day of the exposure and almost no apoptosis was observed at 7 and 14 days. The pH2AX protein was expressed in the nuclei of the basement membrane of adjacent seminiferous tubules. Compared with the control group, the expression of pH2AX was significantly increased on the 1st day of exposure (0.47 ± 0.02 vs 1.61 ± 0.04, P <0.01), then decreased at 7 days (0.85 ± 0.03) in comparison with that on the 1st day (P <0.01), and again elevated at 14 days (1.72 ± 0.02) as compared with either those at 1 and 7 days (P <0.01) or that of the control (P <0.01).@*CONCLUSIONS@#Heat stress causes dynamic changes of the pH2AX expression in the testis of the mouse, which are associated with heat stress-induced proliferation and division of the testicular spermatogenic cells.

HMGB1/TLR4/NF-κB signaling pathway and role of vitamin D in asthmatic mice / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the changes in the mRNA and protein expression of high-mobility group box 1 (HMGB1), Toll-like receptor 4 (TLR4), and nuclear factor-kappa B (NF-κB) in lung tissues of asthmatic mice and the interventional effect of vitamin D.</p><p><b>METHODS</b>A total of 48 BALB/c mice were randomly divided into control group, asthma group, and 1,25-(OH)Dintervention group, with 16 mice in each group. An animal model of asthma was established, and lung tissue samples were taken in each group at weeks 1 and 2 of ovalbumin challenging. Conventional hematoxylin-eosin staining was used to measure airway wall thickness. Immunohistochemical staining was used to observe the expression of HMGB1, TLR4, and NF-κB in lung tissues. Quantitative real-time PCR and Western blot were used to investigate the changes in the mRNA and protein expression of HMGB1, TLR4, and NF-κB.</p><p><b>RESULTS</b>At weeks 1 and 2 of ovalbumin challenging, compared with the control group, the asthma group had a significant increase in airway wall thickness and the intervention group had a significant reduction compared with the asthma group (P<0.05). The asthma group had significantly higher mRNA expression of HMGB1, TLR4, and NF-κB in lung tissues than the control group, and the intervention group had significantly lower mRNA expression of TLR4 and NF-κB than the asthma group (P<0.05). At week 1 of ovalbumin challenging, there was no significant difference in the mRNA expression of HMGB1 between the intervention group and the asthma group (P>0.05). At week 2, the intervention group had a significant reduction in the mRNA expression of HMGB1 compared with the asthma group (P<0.05). At weeks 1 and 2 of ovalbumin challenging, the asthma group had significantly higher protein expression of HMGB1, TLR4, and NF-κB in lung tissues than the control group, and the intervention group had significantly lower expression than the asthma group (P<0.05). Airway wall thickness was positively correlated with the mRNA expression of HMGB1, TLR4, and NF-κB in lung tissues (r=0.804, 0.895, and 0.834; P<0.05).</p><p><b>CONCLUSIONS</b>The HMGB1/TLR4/NF-κB signaling pathway plays an important role in the pathogenesis of asthma, and an appropriate amount of 1,25-(OH)Dhas a regulatory effect on this pathway and may prevent the progression of asthma. Therefore, 1,25-(OH)Dis expected to become a new choice for the treatment of asthma.</p>

A Meta analysis of the efficacy of high-frequency oscillatory ventilation versus conventional mechanical ventilation for treating pediatric acute respiratory distress syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To systematically assess the clinical efficacy of high-frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) for treating pediatric acute respiratory distress syndrome (ARDS).</p><p><b>METHODS</b>Data from randomized controlled trials comparing HFOV and CMV in the treatment of pediatric ARDS published before July 2016 were collected from the Cochrane Library, PubMed, Medline, CNKI, and Wanfang Data. Literature screening, data extraction, and quality assessment were performed by two independent reviewers according to the inclusion and exclusion criteria. The selected studies were then subjected to a Meta analysis using the RevMan 5.3 software.</p><p><b>RESULTS</b>A total of 6 studies involving 246 patients were included. The results of the Meta analysis showed that there were no significant differences between the HFOV and CMV groups in the in-hospital or 30-day mortality rate, incidence of barotrauma, mean ventilation time, and oxygenation index (P>0.05). However, compared with CMV, HFOV increased the PaO/FiOratio by 17%, 24%, and 31% at 24, 48, and 72 hours after treatment respectively, and improved oxygenation in patients.</p><p><b>CONCLUSIONS</b>Although the mortality rate is not reduced by HFOV in children with ARDS, this treatment can result in significant improvement in oxygenation compared with CMV. Further large-sample, multicenter, randomized clinical trials will be required to draw a definitive conclusion.</p>

Ameliorative effect of metformin on insulin resistance induced by olanzapine gavage in rats / 上海交通大学学报（医学版）

Objective · To investigate the effect of metformin on insulin resistance (IR)-related metabolic parameters in olanzapine-bearing rats.Methods · Thirty female SD rats were randomly divided into metformin intervention group, olanzapine group and control group. During the first 6 weeks,5 mg /(kg·d) olanzapine was given to the two test groups . The control group was given the same amount of saline. From the 7th week, the intervention group began to combine with metformin 500 mg / (kg·d), while the olanzapine group combined with the same amount of saline, continuing for 4 weeks.At the end of 6th week and 10th week, intraperitoneal glucose tolerance and homeostasis model assessment IR index were assessed. Results · The area under the glucose tolerance curve (P=0.040) and the IR index (P=0.000) were significantly higher for the intervention group and the olanzapine group than the control group at the end of 6th week. At the 10th weekend, the glucose tolerance (P=0.015) and IR index in the intervention group were significantly lower than those in the olanzapine group (P=0.001). Conclusion · Metformin may rectify the impaired glucose tolerance and improve IR induced by olanzapine partly.

Effect of blue light on proliferation of human retinal pigment epithelial cells / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the influence and mechanism of blue light on the proliferation of human retinal pigment epithelial cells.METHODS: Cells were divided into two groups,including blue light group and control group.The 35W white light lamp with blue filter was used to establish damaged RPE cell model in vitro.Blue ray wavelength ranged between 470nm and 520nm.And the light intensity was about 2000Lx.After exposure to blue light,we tested the proliferation of human retinal pigment epithelial cells by CCK-8 kit.And then expression of miR-103 was measured by the real-time PCR.RESULTS: Exposure to blue light inhibited the proliferation of human retinal pigment epithelial cells and increased the expression of miR-103.Moreover,up-regulation of miR-103 inhibited the proliferation of human retinal pigment epithelial cells,and down-regulates miR-103 promoted the proliferation of human retinal pigment epithelial cells.CONCLUSION: Blue light inhibits the proliferation of human retinal pigment epithelial cells by the up-regulation of miR-103.

Quality of Schisandrae Chinensis Fructus regionalization based on GIS technology / 中国中药杂志

This paper is aims to clarify the spatial distribution of high quality medicinal materials Schisandrae Chinensis Fructus. Based on investigation and field investigation, the samples and distribution information of Schisandrae Chinensis Fructus were collected. Based on the data of four kinds of lignin chemical constituents, ecological environment factors and spatial distribution data of Schisandrae Chinensis Fructus, using GIS technology, maximum information entropy model and SPSS statistical analysis method for regionalizing the quality of Schisandrae Chinensis Fructus. The results showed that Schisandrae Chinensis Fructus was mainly distributed in the northeast of Liaoning, east of Jilin, east of Heilongjiang. The content of schisandrin was higher in the samples from northeastern part of Jilin province and the northeastern part of Liaoning province, The content of deoxyschizandrin was higher in the samples from middle of Jilin province and northeastern Hebei province, where the content of schisandrin B was higher in the samples from Jilin area, The higher schisantherin A sample were from southeast of Jilin and northeast of Liaoning. Considering the content of four components in Schisandrae Chinensis Fructus, the quality of Schisandrae Chinensis Fructus was concentrated in the southeast of Jilin and the northeastern part of Liaoning.

Olanzapine May Inhibit Colonic Motility Associated with the 5-HT Receptor and Myosin Light Chain Kinase

OBJECTIVE: To study whether the effects of olanzapine on gastrointestinal motility is related to the serotonin antagonism and myosin light chain kinase. METHODS: Male Sprague-Dawley rats were randomly divided into four groups. Olanzapine gavage was performed for each treatment group during the course of 30 continuous days, while the same volume of saline was given to the rats in the control group. Defecation of the rats was observed on days 7 and 30 after olanzapine gavage. The effects of olanzapine on contraction of colonic smooth muscles were observed in ex vivo experiments. A Western blot was used to evaluate expression levels of the serotonin transporter (SERT) and MLCK in colon segments of the rats. RESULTS: ResultsaaCompared to the control group, 5-160 µM of olanzapine could inhibit dose-dependently the contraction of colonic smooth muscle ex vivo experiments. The maximum smooth muscle contraction effects of 5-HT and acetylcholine significantly decreased after treatment with 40-160 µM of olanzapine. Constipation was found in the olanzapine-treated rats on day 7 and have sustained day 30 after gavage. Expression of MLCK in olanzapine-treated rats was significantly decreased, whereas the expression of SERT significantly increased on the day 7, then significantly decreased on the day 30 after olanzapine gavage. CONCLUSION: SERT and MLCK may involve in the inhibition of colonic contraction induced by olanzapine.

Effects of different doses of 1,25-(OH)2D3 on expression of HMGB1 and IL-17 in the lungs of asthmatic mice / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effects of 1,25-(OH)(2)D(3) on airway remodeling and expression of high mobility group box 1 (HMGB1) and IL-17 in asthmatic mice.</p><p><b>METHODS</b>Fifty female mice were randomly divided into 5 groups: control, asthma, low-dose, middle-dose, and high-dose intervention groups (n=10 each). Asthma was induced by intraperitoneal injections of ovalbumin (OVA) and aerosol inhalation of OVA solution. The low-dose, middle-dose, and high-dose intervention groups were administered with 1,25-(OH)(2)D(3) solution at the dosage of 1, 4 and 10 μg/kg respectively by intraperitoneal injections before asthma challenge. The airway structural changes were assessed by hematoxylin and eosin staining. mRNA expression levels of HMGB1 and IL-17 in the lung tissues were evaluated by RT-PCR. The protein levels of HMGB1 and IL-17 in the lung tissues were observed by immunohistochemistry.</p><p><b>RESULTS</b>The airway wall thickness, protein and mRNA expression levels of HMGB1 and IL-17 were higher in the untreated asthma group than in the control group (P<0.05). The airway wall thickness, protein and mRNA expression levels of HMGB1 and IL-17 were lower in the middle-dose and low-dose intervention groups than in the untreated asthma group, and the middle-dose intervention group demonstrated lower airway wall thickness, protein and mRNA expression levels of HMGB1 and IL-17 than in the low-dose intervention group (P<0.05). However, the airway wall thickness, protein and mRNA expression levels of HMGB1 and IL-17 in the high-dose intervention group were higher than in the untreated asthma group (P<0.05).</p><p><b>CONCLUSIONS</b>HMGB1 and IL-17 may be involved in the airway remodeling process in asthmatic mice. A moderate amount of HMGB1 and IL-17 may be involved in the airway remodeling process in asthmatic mice. A moderate amount of 1,25-(OH)(2)D(3) can improve the airway remodeling, but a higher dose of 1,25-(OH)(2)D(3) may affect adversely the airway remodeling process.</p>

Expression and Clinical Significance of Soluble E?cadherin before and after Operation in Breast Cancer Patients / 中国医科大学学报

Objective To detect the expression of serum soluble E?cadherin(sEC)before and after operation in breast cancer patients,and to ex?plore its clinical significance. Methods The levels of sEC in 42 patients with breast cancer and 18 patients with benign breast diseases were tested by enzyme?linked immunosorbent assay(ELISA)before and after operation as well as in 30 healthy controls. Its correlation with clinical and patho?logical characteristics was analyzed. Results The levels of sEC in breast cancer patients before operation were significantly higher than patients with benign breast diseases and controls,which declined significantly after operation. Moreover,the levels of sEC in those with high clinical grading and lymphatic metastasis were also higher than in the ones with low grading and negative lymphatic metastasis(P<0.05). Conclusion The levels of sEC in breast cancer patients before operation are specific and closely related with pathological grade and lymphatic metastasis,which may be a pre?dictive factor for prognosis of breast cancer.

18F-FDG PET/CT in Differential Diagnosis of Incidental Benign or Malignant Thyroid Focal Hypermetabolic Lesions / 中国医学影像学杂志

Purpose To investigate the significance of PET/CT in differential diagnosis of incidental thyroid benign or malignant lesions with high fluorodeoxyglucose (FDG) uptake.Materials and Methods Forty cases with focal high FDG uptake lesion in thyroid accidently detected by PET/CT were retrospectively collected. The subjects were dived into physiological uptake group (n=18), benign lesion group (n=16) and malignant lesion group (n=6) according to the pathology or follow-up examinations. The average SUVmax of different groups was analyzed, and ROC curve was used todetect benign or malignant lesions.Results The average SUVmax was 3.7±1.1 in physiological uptake group, 4.9±2.3 in benign lesion group and 9.5±4.8 in malignant lesion group. Significant difference was noticed among the three groups. The average SUVmax in malignant lesion group was higher than that of the other two groups with statistical difference (P0.05). ROC analysis showed that the sensitivity and specificity for thyroid malignant tumor were 100.0% and 87.2% at SUVmax of 8.5.Conclusion18F-FDG PET/CT plays an important role in differentiating benign lesions of thyroid from malignance, but it is not helpful to identify benign lesions from physiologic uptake.

P-VEP games aided combined treatment of amblyopia in children / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the efficacy of combined therapy for amblyopia in children by making use of pattern visual evoked potential ( P-VEP) game. METHODS: This was a prospective case control study. These asthenopic children were divided into two groups. The control group ( 66 eyes of 49 patients ): occlusive therapy with glasses, cover, precision work, red light treatment and so on, later the stereo vision training was added. The experimental group (72 eyes of 52 patients):conventional methods mentioned above with P - VEP games. RESULTS: The total effective rate and cure rate of experimental group in 6mo were higher than those of control group. The overall effective rate was 94. 4% in the experimental group and 83. 3% in the control group. There was a statistically significant difference between them (P CONCLUSION: The comprehensive therapy by making use of P-VEP game is an individualized effective new way in treating amblyopia.