Application of a low copper diet guidance based on food exchange portions in children with hepatolenticular degeneration / 中国当代儿科杂志

OBJECTIVES@#To study the efficacy of a low-copper diet guidance based on food exchange portions in children with hepatolenticular degeneration.@*METHODS@#A self-controlled study was conducted from July 2021 to June 2022, including 30 children under the age of 18 who were diagnosed with hepatolenticular degeneration and poorly controlled with a low-copper diet. During the medical visit, personalized low-copper diet guidance was provided to the children and their parents using a copper-containing food exchange table and a copper food exchange chart. During home care, compliance with the low-copper diet of the children was improved by recording dietary diaries and conducting regular follow-ups. The changes in 24-hour urine copper level, liver function indicators, and the low-copper diet knowledge of the children's parents were observed before and after the intervention, with no change in the original drug treatment.@*RESULTS@#After 8, 16, and 24 weeks of intervention, the 24-hour urine copper level decreased significantly compared to before intervention (P<0.05). When compared to 8-week intervention, the urine copper level decreased significantly after 16 and 24 weeks of intervention. The 24-hour urine copper level after 24 weeks of intervention decreased significantly compared to 16 weeks of intervention (P<0.05).After 24 weeks of intervention, the alanine aminotransferase and aspartate aminotransferase levels decreased significantly compared to before intervention (P<0.05). Additionally, in 16 of the cases (53%), alanine aminotransferase and aspartate aminotransferase returned to normal levels. Following 8 weeks of intervention, the low-copper diet knowledge of the children's parents increased significantly (P<0.05).@*CONCLUSIONS@#A low-copper diet guidance based on food exchange portions can effectively decrease the urine copper level and improve liver function in children with hepatolenticular degeneration. Furthermore, it can increase the low-copper diet knowledge of the children's parents.

Comparison between endoscopic submucosal dissection and gastrectomy in clinical benefit for metachronous early gastric cancer in the remnant stomach / 中华消化内镜杂志

Objective:To compare the histopathological features and treatment efficacy of different methods for metachronous early gastric cancer (MEGC) in the remnant stomach.Methods:A total of 66 patients [38 endoscopic submucosal dissection (ESD) and 28 gastrectomy] with MEGC in the remnant stomach from January 2014 to December 2020 in Drum Tower Hospital were divided into the ESD group and the gastrectomy group. The baseline characteristics, histopathological features, treatment efficacy, and cost differences of the two groups were analyzed.Results:The MEGC in the remnant stomach mostly occurred in elderly male patients, with the mean age of 69.7±8.5 years. The mean interval of the occurrence of MEGC in the remnant stomach was 6 years. As for the tumor location, the gastric body (31.6%) was the main location in the ESD group and gastric cardia (53.6%) in the gastrectomy group with significant difference ( χ2=11.07, P=0.026). The mean operation time, hospital stay, postoperative fasting time, and total treatment cost were 80.0 min, 6.0 d, 1.5 d, ￥19 436 in the ESD group and 215.0 min, 19.0 d, 6.5 d, and ￥68 665 in the gastrectomy group, respectively, with significant differences between the two groups ( P<0.05). The overall survival rate during follow-up was 76.3% in the ESD group and 71.4% in the gastrectomy group with no significant difference between the two groups ( χ2=0.736, P=0.778). In terms of postoperative complications, the incidences of bleeding and infection were 7.9% and 5.3% in the ESD group, and those of obstruction and infection were both 14.3% in the gastrectomy group. There was significant difference in the incidences of postoperative obstruction between the two groups ( P<0.05). Conclusion:ESD is safe and effective for MEGC in the remnant stomach and is better than gastrectomy in terms of the treatment cost and operation time, but the long-term efficacy still needs to be validated by large-scale prospective studies.

Consensus of experts on the oral health management and medical risk prevention for the patients with chronic airway diseases (2022 edition) / 中华口腔医学杂志

Today, there is greater awareness on the association between oral diseases and respiration diseases after the outbreak of COVID-19. However, confusion regarding the oral health management and medical risk prevention for patients with chronic airway diseases has been remained among dental clinicians. Therefore, the dental experts of the Fifth General Dentistry Special Committee, Chinese Stomatological Association, combined with the experts of respiratory and critical care medicine, undertook the formation of consensus on the oral health management of patients with chronic airway diseases in order to help dental clinicians to evaluate medical risks and make better treatment decision in clinical practice. In the present consensus report, the relationship of oral diseases and chronic airway diseases, the oral health management and the treatment recommendations of patients with chronic airway diseases are provided.

Comparison of safety and efficacy of laparoscopy and laparotomy for 5-10 cm intermediate-risk primary gastric stromal tumors / 中华消化内镜杂志

Objective:To compare the safety and efficacy of laparoscopy and laparotomy for 5-10 cm intermediate-risk gastric stromal tumor, and to evaluate whether there was evident benefits of postoperative adjuvant treatment with imatinib.Methods:A retrospective study was conducted on 72 patients with moderate risk gastric stromal tumors (5-10 cm in diameter) who received operation in Nanjing Drum Tower Hospital from January 2010 to July 2020. There were 28 cases in the laparoscopy group and 44 cases in the laparotomy group. The clinical features, pathological data, perioperative results and hospitalization costs were compared between the two groups. The survival rates of postoperative adjuvant therapy with or without imatinib were analyzed and compared.Results:There was no significant difference in clinicopathological features between the two groups ( P>0.05). The incidences of postoperative complications in the laparoscopy group and the laparotomy group were 32.1% (9/28) and 52.3% (23/44) respectively, showing no significant difference ( P=0.094). Compared with the laparotomy group, both the hospital stay (12.5±3.2 days VS 15.0±3.5 days, P=0.004) and the median postoperative hospital stay (7.5 days VS 9.0 days, P=0.006) in the laparoscopy group were significantly shorter, and the first exhaust time was significantly shorter ( P=0.003). During the median follow-up period of 58 months (13-129 months), there was no tumor-related death. Two cases died of breast cancer and heart disease in the laparotomy group, and 1 case died irrelevant to gastric stromal tumor in the laparoscopy group. Of the 72 patients, 40 received postoperative imatinib adjuvant therapy, 22 cases (50.0%) in the laparotomy group and 18 cases (64.3%) in the laparoscopy group, with no significant difference in the proportion ( χ2=1.414, P=0.234). There was significant difference in the overall survival rate between the group treated with imatinib and the group without imatinib ( P=0.015). Conclusion:Laparoscopic resection is safe and effective for intermediate-risk gastric stromal tumor of 5-10 cm. Taking imatinib adjuvant treatment does not increase overall survival rate of patients with intermediate-risk gastric stromal tumors (5-10 cm), and there is no tumor-related death, recurrence or metastasis for those who did not accept imatinib adjuvant treatment after R0 resection.

Measurement and evaluation of the quadriceps muscle mass in young men based on magnetic resonance imaging / 北京大学学报(医学版)

OBJECTIVE@#To investigate the correlation between the quadriceps cross-sectional area (CSA) and quadriceps muscle volume (QMV) at different horizontal levels from the upper edge of the patella, and to determine the best observation position.@*METHODS@#Thigh magnetic resonance imaging (MRI) images of 22 Chinese young men [age: (29±6) years] with anterior cruciate ligament (ACL) rupture were examined. The CSA was measured at 18, 15, and 12 cm above the upper edge of the pate-lla (denoted by CSA-18, CSA-15 and CSA-12 respectively), and the QMV and CSA were determined by semiautomatic segmentation. A curve model was established to estimate QMV. Bland-Altman analysis was performed to determine the confidence limits of the volumes.@*RESULTS@#On the unaffected side, the mean QMV was (1 944.45±323.77) cm3. The quadriceps CSA at the upper edge of the patella at 18, 15, and 12 cm was (80.80±12.16) cm2, (77.53±12.03) cm2, and (72.68±10.51) cm2, respectively. The coefficients of determination (R2), ascertained using curve estimation models, for the 3 positions were 0.819, 0.755, and 0.684 (P < 0.001), and the standard deviations of the volume estimated value (SEE) were 7.4%, 8.7%, and 9.8%. The fitting equations of the three horizontal positions were all good, but the fitting degree of CSA-18 was the highest. The Bland-Altman scatter plot showed that the arithmetic means of the QMV at 18, 15 and 12 cm from the upper edge of the patella 0.8 cm3, -1.1 cm3, and 0.9 cm3 and 95% limits of agreement (LoA) were (-268.8, 270.5), (-315.2, 313.1), and (-355.7, 357.5), respectively. The estimated QMV was in good agreement with the measured value. The difference between the estimated CSA-18 and measured values was the smallest. The results on the affected side were consistent.@*CONCLUSION@#The correlation between QMV and CSA in the young men with the upper edge of patella as baseline was reliable and consistent. Among them, CSA-18 had the highest correlation with the QMV. However, different observation sites could be selected for different injuries of the quadriceps.

Risk factors for postpartum glycometabolism in patients with gestational diabetes mellitus: a prospective study / 中国基层医药

Objective:To investigate the risk factors for postpartum glycometabolism in patients with gestational diabetes mellitus (GDM), providing a new idea for clinical prevention of type 2 diabetes mellitus.Methods:Pregnant women who underwent regular prenatal examination in Cixi People's Hospital, China between February 2019 and January 2020 were included in this prospective cohort study. The clinical data before and during pregnancy were collected. These pregnant women were followed up for 6 weeks and 6 months postpartum. Oral glucose tolerance test (OGTT) with 75 g of glucose was performed. The clinical end point was abnormal glucose metabolism. Kaplan-Meier (KM) univariate analysis and multivariate Cox regression analyses were used to analyze the risk factors for abnormal glucose metabolism postpartum in patients with GDM.Results:A total of 252 eligible patients were included in this study. Among them, 212 patients finished 6-week follow-up, and 149 patients finished 6-month follow-up. Among the 212 patients who finished 6-week follow-up postpartum, 87 (41.04%) patients had abnormal glucose metabolism, 3 (1.42%) patients had impaired fasting glucose, 66 (31.13%) had impaired glucose tolerance, and 18 (8.49%) patients had type 2 diabetes mellitus. Among the 149 patients who finished 6-month follow-up postpartum, there were 2 new patients with impaired fasting glucose, 11 new patients with impaired glucose tolerance, and 3 new patients with type 2 diabetes mellitus. Overweight before pregnancy [body mass index (BMI) ≥ 24 kg/m 2] and1-hour OGTT (≥ 10.1 mmol/L) were the independent risk factors for abnormal glucose metabolism postpartum in pregnant patients with GDM ( OR = 2.273, 2.462; P = 0.039, 0.023; 95% CI = 1.495-3.051, 1.684-3.240). The Matsuda indexes and 60-minute insulinogenic index in the normal glucose metabolism group were significantly higher than in the abnormal glucose metabolism group ( t = 7.184 and 2.011, both P < 0.05). Conclusion:The incidence of abnormal glucose metabolism in patients with GDM at 6 months postpartum remains high. Overweight before pregnancy [body mass index ≥ 24 kg/m 2] and 1-hour OGTT (≥ 10.1 mmol/L) are the independent risk factors for abnormal glucose metabolism postpartum in pregnant patients with GDM.

Research Progress on Application of Sports Beverage to Post-exercise Fluid Restoration / 中国医学科学院学报

A good hydration status is important to the exercise performance and cognitive function of exercisers.The effective restoration of fluid balance after exercise is helpful to prevent dehydration,maintain body fluid balance,accelerate fatigue recovery,and enhance exercise performance.As the most effective sports nutrition supplement,sports beverage has different ingredients and formulas,and also has various effects.To provide clues for the development of sports beverage,this article reviews the types,components,effects,and mechanisms of sports beverage currently used in post-exercise fluid restoration.

Effect of the Seasonal Adaptability on Carbohydrate-electrolyte Beverage Efforts on Post-exercise Rehydration in Healthy Young Men / 中国医学科学院学报

Objective To compare the effects of carbohydrate-electrolyte beverage on post-exercise rehydration of healthy young men in different seasons,and to explore the influence of seasonal adaptability on fluid and electrolyte balance.Methods Fifteen healthy men,aged(24.4±0.5)years,completed 2 trails in a random crossover design both in summer and winter.During recovery,they consumed a drink volume equivalent to 100% of their sweat loss with plain boiled water(the water group)or carbohydrate-electrolyte beverage(the beverage group).Recovery was monitored for further 180 minutes by the collection of blood and urine samples.Results The dehydration time in summer was significantly shorter by about 20 minutes than that in winter(

Baicalein Regulates Colony Formation of Triple-negative Breast Cancer Cells by Inhibiting YAP Entry into Nucleus / 中国实验方剂学杂志

Objective:This study aims to observe the effect of baicalein on the clonal formation of triple negative breast cancer MDA-MB-231 and MDA-MB-468 cells， and to explore the mediation role of Yes- related protein （YAP） in it. Method:MDA-MB-231 and MDA-MB-468 cells were treated with baicalein. Thiazole blue （MTT） colorimetric method was used to detect cell proliferation ability. Plate cloning experiments was used to detect the colony forming ability. Immunofluorescence method was used to detect the nuclear distribution of YAP， and Western blot test was used to detect the protein expression levels of YAP large tumor suppressor factor 1 （LATS1）， YAP， phosphorylated Yes- related protein（p-YAP） and phosphorylated YAP large tumor suppressor factor 1 （p-LATS1）. Result:Compared with the blank group， baicalein （40， 80， 160 μmol·L^-1） significantly inhibited the proliferation ability of MDA-MB-468 and MDA-MB-231 cells （<italic>P</italic><0.05， <italic>P</italic><0.01）， and the inhibitory effect was dose-dependent. The half inhibit concentration（IC₅₀） of baicalein against MDA-MB-468 and MDA-MB-231 cells were （80.3±7.2），（70.4±6.5） μmol·L^-1， respectively. Compared with blank group， baicalein （5， 10， 20 μmol·L^-1） had no significant effect on the proliferation of MDA-MB-468 and MDA-MB-231 cells， and the difference was not statistically significant. Compared with the blank group， baicalein （5， 10， 20 μmol·L^-1） significantly dose-dependently reduced the cell colony formation rates of MDA-MB-468 and MDA-MB-231 cells （<italic>P</italic><0.05， <italic>P</italic><0.01）， and baicalein （10， 20 μmol·L^-1） significantly inhibited the nuclear expression of YAP in MDA-MB-468 and MDA-MB-231 cells in a dose-dependent manner（<italic>P</italic><0.01）. Also， baicalin （5， 10， 20 μmol·L^-1） significantly up-regulated p-YAP and p-LATS1 protein expressions in MDA-MB-468 cells in a dose-dependent manner （<italic>P</italic><0.05， <italic>P</italic><0.01）. Baicalein （10， 20 μmol·L^-1） significantly up-regulated p-YAP and p-LATS1 protein expressions in MDA-MB-231 cells in a dose-dependent manner （<italic>P</italic><0.01）. Conclusion:Baicalein can inhibit colony formation of triple negative breast cancer MDA-MB-468 and MDA-MB-231 cells by mediating the reduction of YAP entry into the nucleus.

The mediating role of illness perception and illness distress on glycemic control and depression among people with type 2 diabetes / 中华行为医学与脑科学杂志

Objective:To investigate the status of depression and physiological, psychological and social factors among people with type 2 diabetes(T2DM), as well as the mediating effects of illness perception and diabetes distress on glycemic control and depression.Methods:A total of 511 patients with type 2 diabetes were recruited and investigated using general demographic questionnaire, self-rating depression scale(SDS), brief illness perception questionnaire(BIPQ) and diabetes distress scale(DDS). Body mass index (BMI) and hemoglobin a1c (HbA1c) were detected in laboratory.Results:The mean score of SDS was (57.48±9.94). The distribution of depression condition were 138(27.0%)without depression, 179(35%)with mild depression, 174(34.1%)with moderate depression and 20(3.9%)with severe depression.SDS score was significantly positively correlated with poor glycemic control ( r=0.157, P<0.01), illness perception( r=0.359, P<0.01) and four dimensions of diabetes distress( r=0.177-0.354, P<0.01). Partially mediating effect of illness perception( B=0.216, 95% CI=0.112-0.372) was found in glycemic control and depression, the proportion of effect was 25.9%.The chain mediating effect ( B=0.086, 95% CI=0.042-0.149) of illness perception and diabetes distress was also found between glycemic control and depression, whose indirect effect size was 10.3%. Conclusion:Glycemic control is significantly related with depression.Illness perception and diabetes distress are partly mediating the effect between glycemic control and depression.

Clinical and CT manifestations of coronavirus disease 2019 / 西安交通大学学报(医学版)

Objective To evaluate the clinical and CT manifestations of coronavirus disease 2019 (COVID-19). Methods Serial clinical and CT data of 11 patients with confirmed COVID-19 were retrospectively analyzed. These data were collected in The Second Affiliated Hospital of Xi'an Jiaotong University from January 24 to February 9, 2020. There were 6 males and 5 females, aged from 17 to 64 years old, with the mean age of 42.27±15.67. Results A majority of the patients fell into mild type and only one was of severe type. Clinical manifestations were mainly fever, fatigue, and dry cough. For laboratory tests, the patients' lymphocyte and eosinophil counts decreased, while their C-reactive protein concentration increased. In terms of CT findings, 7 patients showed bilateral subpleural involvement. The ground glass opacity (GGO) was common in CT findings. Typical crazy paving sign, air bronchogram and halo sign were also found. During the progression of the disease, GGO might be associated with pulmonary consolidation. No enlarged lymph nodes or pleural effusion were seen in all the patients. Conclusion Patients with COVID-19 have distinctly characteristic chest CT manifestations and laboratory examination findings, which play a vital role in diagnosis and prognosis of the disease.

Establishment of high-fat diet-induced obesity and insulin resistance model in rats / 北京大学学报(医学版)

OBJECTIVE@#To investigate the appropriate conditions and duration for establishing a high-fat diet-induced obesity and insulin resistance model in rats.@*METHODS@#Forty-five 6-week-old male Sprague-Dawley (SD) rats were randomly assigned into 2 groups: (1) control group (CON), (2) high-fat diet group (HFD). HFD was fed with a high-fat diet (45% kcal from fat) while CON with chow diet. After four-weeks of high-fat diet feeding, the rats of obesity resistance (OR) were eliminated according to body weight sorting, whereas obese (OB) rats were continued feeding a high-fat diet until 12 weeks. Body weight and food intake were recorded weekly. Glucose tolerance was evaluated by oral glucose tolerance test (OGTT) in 4 weeks, 8 weeks and 12 weeks. At the end of 12 weeks, insulin releasing test and visceral fat mass were measured and HE staining of the liver, adipose tissue and pancreatic tissue were conducted.@*RESULTS@#After 4 weeks of a high-fat diet, the body weight of HFD was 17.8% higher than that of CON (P=0.001), and the rate of obesity was 67.6%-78.4%. Glucose tolerance of OB rats was impaired with a higher blood glucose concentration at 120 min (P<0.001) and a higher area under the curve (AUC, P=0.037) in OGTT compared with CON. The rate of obesity and insulin-resistance rats was 79.3%. After 8 weeks of feeding, the body weight in OB was 30.4% higher than CON (P<0.001). In OGTT, blood glucose levels at 60 min and 120 min were 35.6% and 36.4% higher than those in CON (both P<0.001), and AUC was 21.7% (P<0.001) higher than that of CON. The rate of obesity and insulin-resistance rats was 100.0%. After 12 weeks of feeding, the body weight in OB was 36.9% higher than that in CON (P<0.001). In OGTT, the blood glucose levels at 60 min and 120 min were 24.8% (P=0.001) and 34.6% (P<0.001) higher than those in CON, and AUC was 16.1% (P=0.019) higher than that of CON. The rate of obesity and insulin-resistance rats was 93.3%. The insulin releasing test showed that serum insulin concentration at each time point (0, 30, 60, 120 min) was higher than that in CON, with a 6.3-times higher than that in CON at 120 min (P=0.008). Pathological changes were observed in islets and liver in the OB rats.@*CONCLUSION@#After 4 weeks of a high-fat diet (45% kcal from fat) feeding in six-weeks SD rats, the rats of OR were eliminated. Impaired glucose tolerance was found in OB rats after 4 weeks of feeding, and the rate was higher after 8-12 weeks of high-fat diet feeding.

Effects of chlorogenic acid on glucose tolerance and its curve characteristics in high-fat diet-induced obesity rats / 北京大学学报(医学版)

OBJECTIVE@#To observe the effect of chlorogenic acid (chlorogenic acid, CGA) on the glucose tolerance and its curve characteristics in high fat diet-induced obesity (diet-induced-obesity, DIO) rats, so as to provide scientific grounds for the development and utilization of CGA in early prevention and reversal of prediabetes.@*METHODS@#Eight of forty-six male Sprague-Dawley rats were randomly selected as the normal diet group (CON group), and the rest were fed with high-fat diet. After 4 weeks, 24 high-fat-induced obese rats were screened according to the criteria and then randomly divided into high fat diet group (HFD group), 50% CGA group and 98% CGA group. The CGA groups received intragastric administrations of 50% CGA and 98% CGA orally via a gavage needle once a day for 8 weeks, respectively, while the CON and HFD groups received a carrier solution (phosphate buffer saline, PBS). Their body weights were measured weekly and oral glucose tolerance test (OGTT) was performed every 4 weeks. Fasting insulin and insulin release were measured at the end of the study. Meanwhile, HOMA-IR and visceral fat percentage were calculated. Histopathological examination by hematoxylin and eosin staining method were evaluated in the pancreatic tissues.@*RESULTS@#Before the intervention of chlorogenic acid, blood glucose levels 120 min after glucose loading (P<0.05) and AUC-G (P<0.05) were increased in the HFD group when compared with the CON group, and the time to glucose peak was delayed after 4 weeks of chlorogenic acid intervention (P<0.05). After 8 weeks of intervention, the HOMA-IR index, the insulin levels at 0 min, 30 min, 60 min, and 120 min after glucose loading and AUC-I increased (P<0.05), and the histopathological examination showed obvious hyperplasia of pancreatic islets (P<0.05). Compared with the HFD group, there was no significant change in glucose tolerance and glucose peak time in 50%CGA and 98%CGA groups at the end of 4 weeks of intervention. However, after 8 weeks of intervention, OGTT-60min,OGTT-120min blood glucose (P<0.05) were lower, HOMA-IR index and OGTT-0min, OGTT-120min serum insulin level decreased (P<0.05), the time to glucose peak shifted to an earlier timepoint (P<0.05), abnormal islet hyperplasia attenuated (P<0.05) in 50% CGA and 98% CGA groups. Also, the OGTT-30min serum insulin level was decreased (P<0.05) in 50% CGA group.@*CONCLUSION@#Delay in time to glucose peak during the OGTT was one of the manifestations of impaired glucose tolerance in DIO rats, and 50% and 98% CGA could improve the glucose tolerance and delay in glucose peak time.

Deep Common Iliac Region Lymphadenectomy by Laparoscopic Surgery and Its Clinical Value in Uterine Malignancy / 中山大学学报(医学科学版)

[Objective]To investigate the value of deep common iliac region lymphadenectomy in treatment of uterine malignancies.[Methods]88 patients with deep common iliac region lymphadenectomy in Third affiliated hospital of sun yat-sen university from March 2016 to June 2017 were enrolled in this study. The number of removed lymph nodes、metastatic lymph nodes、operative complication and so on were analyzed.[Results]The number of pelvic lymph nodes resection is from 18 to 52,the average is 26;the number of deep common iliac region lymph nodes resection is from 2 to 16,the average is 5. The number of pelvic lymph node metastasis is 11 and the rate is 12.5%;the number of deep common iliac region lymph node metastasis is 3,accounting for 27.3% of the total number of pelvic lymph node metasta-sis,which alone deep common iliac region lymph node positive in 1 case,9.0% of the total number of pelvic lymph node metastasis.The average operation time of single pelvic lymph node resection was 43 min and that of single deep common iliac region lymph nodes was 10 min.There was no severe complication.[Conclusion]Deep common iliac region lymphad-enectomy is feasibility and safety,27%of patients with pelvic lymph node metastasis has positive deep common iliac region lymph nodes,and we believe that the promotion and application of deep common iliac region lymphadenectomy can further improve the therapeutic effect of uterine malignancy.

Effect of electroacupuncture on expressions of acetylcholine and mucin 5AC in the lungs of rats with chronic obstructive pulmonary disease / 针灸推拿医学（英文版）

Objective:To observe the effect of electroacupuncture (EA) on the expressions of acetylcholine (ACh) and mucin 5AC (MUC5AC) in the lungs of rats with chronic obstructive pulmonary disease (COPD),and explore the mechanism of EA in treating COPD.Methods:Thirty Sprague-Dawley (SD) rats were randomly divided into a control group,a COPD group,and an EA group,with 10 rats in each group.The control group was a group of normal rats.The COPD rat model was induced by cigarette smoke combined with lipopolysaccharide (LPS).The COPD rats were treated with EA at bilateral Feishu (BL 13) and Zusanli (ST 36) in the EA group,30 min each time,once a day,successively for 14 d.The lung function was tested.The contents of ACh and MUC5AC in lungs and bronchoalveolar lavage fluid (BALF) were detected by enzyme-linked immunosorbent assay (ELISA).Pearson method was used to analyze the correlation between pulmonary function and the content of MUC5AC in lungs.The mRNA and protein expressions of MUC5AC in lung tissues were detected by real-time polymerase chain reaction (RT-PCR) and Western blot (WB),respectively.The immune response of MUC5AC was observed by immunohistochemistry.Results:Eight rats were left in each group,and the other two died.Compared with the control group,the total airway resistance (Raw) increased significantly and dynamic compliance (Cdyn) decreased significantly in the COPD group (P＜0.01);compared with the COPD group,the Raw level declined significantly and Cdyn increased significantly in the EA group (P＜0.01).The contents of ACh and MUC5AC in the lungs and BALF were remarkably higher in the COPD group compared with those in the control group (P＜0.01,P＜0.001);compared with the COPD group,the contents of ACh and MUC5AC were significantly lower in the EA group (P＜0.05,P＜0.001).There was a negative correlation between MUC5AC content and lung function (P＜0.001).The mRNA and protein expressions of MUC5AC in the lungs were significantly higher in the COPD group than in the control group (P＜0.001);compared with the COPD group,the expressions were significantly lower in the EA group (P＜0.01).Compared with the control group,the immune response of MUC5AC in the airway epithelium significantly increased in the COPD group (P＜0.001);the immune response of MUC5AC was significantly lower in the EA group compared with that in the COPD group (P＜0.001).Conclusion:EA treatment can improve the lung function of COPD rats,which may be related to its effect in the down-regulation of ACh and MUC5AC contents in the lungs as well as the inhibition of mucus hypersecretion.

Application value of manganese-loaded caramelized carbonaceous nanospheres for synchronized breast cancer MRI and photothermal therapy / 中华放射学杂志

Objective To investigate the application value of pH sensitive manganese-loaded caramelized carbonaceous nanospheres (Mn-CNS) in the synchronous MRI and photothermal therapy for breast cancer. Methods Anhydrous glucose was used as carbon source to prepare caramelized carbonaceous nanospheres(CNS).Mn2 +was absorbed and bonded to its surface to obtain the Mn-CNS.The MR signal values of aqueous solutions of Mn-CNS under different pH(pH=7.4,6.0,5.0)with different Mn2+concentrations(0,0.14,0.28,0.57,1.14 and 2.28 mmol/L)were measured to obtain the relaxation rate.The cell counting kit-8(CCK-8)assay was used to determine the effect of Mn-CNS on the viability of 4T1 cells. Pathological examination was used to evaluate the systemic toxicity. Inductively coupled plasma mass spectrometry (ICP-MS) was used to analyze Mn uptake by different cell lines (human breast cancer cells MCF-7, human normal mammary epithelial cells MCF-10A and human macrophages cells). The 4T1 tumor-bearing BALB/c mice were divided randomly into four groups (6 mice per group): (1) normal saline (intratumoral injection)plus near infrared laser(NIR);(2)normal saline(intravenous injection)plus NIR;(3) Mn-CNS(intratumoral injection)plus NIR;(4)Mn-CNS(intravenous injection)plus NIR.After intratumoral injection for 30 min and intravenous injection for 12 h,the tumors were continuously irradiated with 808 nm laser for 10 min,the temperature changes and relative tumor volume were recorded.The MRI was obtained at different time point(pre-injection and post-injection at 15 min,30 min,1 h,4 h,8 h,12 h,24 h,48 h,4 d, respectively)with the dose of Mn-CNS(4 mg Mn/kg)by intravenous injection.The changes of Mn2+content before and after Mn-CNS incubation and the tumor volume differences among each group were compared by t test.Results The values of r1were 0.18 L·mmol-1·s-1(pH 5.0),3.48 L·mmol-1·s-1(pH 6.0)and 5.42 L· mmol- 1·s- 1(pH 7.4), respectively. The cells viability of 4T1 were all above 90 % when the cells were incubated with Mn-CNS at different concentrations (25, 50, 100 and 200 μg/ml). MCF-7 and human macrophages cells were ingested Mn2+.The Mn2+amount before and after uptake were significant difference(P<0.05).The MCF-10A had a slight uptake of Mn2+which was not statistically significant(P>0.05).After 10 minutes of the laser exposure (2 w/cm2), the change of temperature with tumor among different groups were shown as follow:Mn-CNS(intratumoral injection)>Mn-CNS(intravenous injection)>normal saline(intravenous injection)>normal saline (intratumoral injection). After photothermal therapy, the relative tumor volumes of Mn-CNS (intratumoral injection)and normal saline(intratumoral injection)were statistically different(t=-2.724,P<0.05). Meanwhile,the relative tumor volumes also showsd significant difference among Mn-CNS(intravenous injection) and normal saline (inject intravenous injection) groups (t=-5.193,P<0.05). After intravenous injection of Mn-CNS in 4T1 tumor-bearing mice, the signal intensity of T1gradually increased and reached the peak of enhancement at 4 h after which the signal intensity remained stable and decreased slightly at 12 h,then gradually decreased to normal. The T1signal intensity of kidney was consistent with that of the tumor and higher. Meanwhile, the degree of liver tissue enhancement was the lowest. Conclusions Mn-CNS is highly biocompatible and self-degradable,it can targeted MRI and achieve precise photothermal therapy simultaneously, which is of great value in the integrated diagnosis and treatment of breast cancer.

Comparisons and Thoughts on the Development of Medical Simulation Between China and Foreign Countries / 中国医院管理

Medical simulation is an educational subject,which will become the main trend of the clinical skill training in the future.Medical simulation is just at the beginning stage in China;however,it has come a long way in foreign developed countries.The article compares the development of medical simulation between China and foreign countries,in terms of specialized courses,fellowship training,theoretical research,academic communities and academic exchange.Based on this,that advanced foreign experience needs to be learnt is proposed,innovation is needed,academic system should be perfected,more academic exchange platforms be established,and the theoretical connotation and denotation be enlarged to develop medical simulation with Chinese characteristics

Differences of CT features for different subtypes of pulmonary neuroendocrine tumors / 实用放射学杂志

Objective To investigate the differences of CT features for different subtypes of pulmonary neuroendocrine tumors (PNETs).Methods CT imaging data of 41 patients with PNETs and 5 patients of lung cancer with neuroendocrine differentiation confirmed by pathology were analyzed retrospectively,and the differences in CT features among pathological subtypes were explored. Results Among the pathological subtypes of 41 PNETs,the statistical differences in the CT features including vascular invasion,the metastatic lymphadenopathy in the hilus and mediastinum were found(P<0.05).However,no differences were found in other imaging findings (lesion location,spiculation,bronchial invasion,atelectasis and obstructive pneumonia,and pleural effusion or thickening)among the subtypes (P>0.05).Among those subtypes PNETs and lung cancer with neuroendocrine differentiation,the differences in tumor size,vascular invasion,and metastatic lymphadenopathy in the hilus and mediastinum were also found (P<0.05).However,no differences were found in other imaging findings (P>0.05).In addition,there were differences in tumor size among different enhancement types and different metastastic presences in the lung or outside of the chest (P<0.05).Conclusion CT shows certain differences among the different subtypes of PNETs,which may be helpful for the differential diagnosis but not specific.

Expression of PD1/PD-L1 in gastric carcinoma and its correlation with clinicopathological characteristics and prognosis / 临床与实验病理学杂志

Purpose To investigate the expression of pro-grammed death1 (PD-1), programmed death-ligand1 ( PD-L1) in gastric carcinoma and its correlation with clinicopathological characteristics and prognosis. Method Immunohistochemistry was used to dectect the expression of PD-1/PD-L1 in 75 cases of gastric cancer and adjacent tissues of cancer, without chemother-apy and radiotherapy from 2011 to 2016 in The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University. To analyzed the relationship between expression of PD-1/PD-L1 in gastric carci-noma and clinicopathologic characteristics, and analyzed rela-tionship of overall survival time in all patients. Result The tumor cells expressed 37. 3% (28/75) PD-L1 positive rate in 75 cases, which associated with age, tumor diameter and differ-entiation. PD-1 positive rate in the tumor infiltrating lympho-cytes was 46. 7% (35/75), which associated with pTNM stag-ing. The positively rate of PD-L1 expression in tumor cells and PD-1 expression in the tumor infiltrating lymphocytes were sig-nificantly higher than that in the adjacent tissues of carcinoma (P＜0. 001). Kaplan-Meier and Long-rank results showed the overall survival time was significantly related with tumor diame-ter, differentiation, invasion depth, metastasis and pTNM stag-ing ( P ＜0. 05), but unrelated with PD-1 and PD-L1 expres-sion. But if the follow-up time was 14 months, the prognosis of PD-L1 positive patients were significantly lower than that of the negative ones. Conclusion Expression of PD-1/PD-L1 in cancer cells are significantly higher than that in para-carcinoma tissue. Positive expression of PD-L1 in tumor cells may contrib-ute to evaluation of short-term prognosis, and has nothing to do with the overall survival rate.

Monomorphic epitheliotropic intestinal T-cell lymphoma: A clinic-pathologic study of 3 cases and literature review / 解放军医学杂志

Objective To summarize the clinicopathological features of monomorphic epitheliotropic intestinal T cell lymphoma (MEITL),and provide the experiences and lessons for diagnosis and treatment.Methods The clinical manifestations,histopathological and immunohistochemical characteristics,diagnosis,treatment and prognosis of 3 cases of MEITL were analyzed retrospectively.Meanwhile,the other cases published in the literatures were reviewed and summarized.Results Two cases of middle aged and aged men and one young woman were reported in present paper.These lesions of all the 3 patients were at the small intestine,of which the female patients had skin and mammary gland involvement.The clinical manifestations were abdominal distention,mulligrubs and intestinal perforation,and the main pathological feature was the diffuse infiltration of the homogeneous tumor cells in the whole layer intestinal wall.Immunohistochemical examination showed that tumor cells expressed all T cell markers CD3,CD8,CD56,T cell cytoplasmic antigen (TIA-1),CD4 and CD5,and Ki-67 proliferation index was 50％-70％.As to the treatment,case 1 received CHOP and GDP regimens successively,and died 2 years after final diagnosis.Case 2 received CHOP regimen for 1 course of chemotherapy and died of giving up treatment.Case 3 gave up treatment,voluntary discharged and then lost.It is clear according to the previous literatures and our experiences that the MEITL possesses high invasiveness and low incidence,and makes the diagnosis difficult;the patient's response to the current treatment is poor.Conclusions MEITL is prone to be in the small intestine.The diagnosis of MEITL should be based on clinical manifestations,pathological features and immunohistochemical detection results.MEITL is rare,the course of disease progresses rapidly,and the patients have the tendency to have intestinal perforation and poor prognosis.Early diagnosis and positive chemotherapy may lead to a better prognosis.