Value of Head and Neck CT Angiography in the Clinical Evaluation of Intraoperative Bleeding Volume of Carotid Body Tumours / 中国医学科学院学报

To investigate the value of head and neck CT angiography(CTA)in the evaluation of intraoperative hemorrhage of carotid body tumours. Head and neck CTA images of 36 patients with carotid body tumours confirmed by pathology were retrospectively analyzed.Patients were divided into two groups based on the intraoperative bleeding volume:<500 ml and≥500 ml groups.The patient's age,sex,Shamblin classification,size of the lesion,number of blood supply arteries,course of the disease,plain scan,and enhanced CT value between two groups were compared and analyzed.Logistics regression equation was established based on the CTA parameters with significant differences between the two intraoperative bleeding volume groups,and combined parameter was acquired.The receiver operating characteristic curve was established based on CTA single and combined parameters. The bleeding volume during the operation of carotid body tumors was significantly correlated with the age of patients(=0.019),the maximum diameter of tumours on axial images(=0.003),the maximum upper and lower diameters(=0.004),Shamblin classification(=0.012),and number of blood supply arteries(<0.001).The area under the receiver operating characteristic curve of the number of feeding arteries,the maximum diameter of axial images,maximum upper and lower diameters,Shamblin classification,and combined parameters were 0.865,0.781,0.806,0.766,and 0.927,respectively.When the optimal critical value was 0.408,the Youden index was 0.794,and the corresponding accuracy,sensitivity,and specificity were 0.919,0.909,and 0.923,respectively. Preoperative head and neck CTA can be used to evaluate the intraoperative blood loss.Combined parameters has the best diagnostic performance compared with single parameters.

Programmed cell death induced by drought stress in sprout tumble of Pinellia ternata / 中国中药杂志

To further study the mechanism of sprout tumble caused by drought,drought stress was simulating with 30% PEG 6000,physiological,and then the morphological changes of Pinellia ternata cells at different treatment time were detected. The results indicated that,along with the period of drought stress continued,the contents of chlorophyll and water potential were decreased,relative electrical conductivity,contents of soluble sugar and MDA increased. Sprout tumble of P. ternata first occurred on the fourth day during drought stress,large scale of sprout tumble appeared on the eighth day with about 73% of tumble rate. The nuclei exposed to drought stress for 2 days were flattened,lobed,invalidated or irregular in shape and significant showed the apoptotic morphological characteristics. Adenylate transferase( ANT) gene expressions were inhibited by drought,with the rapid increase of Caspase-3 enzyme activity,the cell death rate increased. All this proves that the essence of sprout tumble caused by drought is programmed cell death,which may be a self dormancy protection mechanism of P. ternata against adverse environment.

The relationship between different tourniquet pressures in total knee arthroplasty and the pain and swelling of the affected limb after surgery / 医学研究生学报

Objective The use of tourniquets in total knee arthroplasty has been controversial. Many studies have focused only on the different time courses and neglected the effects of pressures. Currently,there is no study explaining the mechanism of tourniquet-induced injury. The aim of this study was to explore the effects of different tourniquet pressures on pain and swelling after total knee arthroplasty and to explore the mechanism of injury. Methods Ninety-six patients who underwent total knee arthroplasty at Nanjing General Hospital from June 2017 to December 2017 were randomly as-signed to 240 mmHg group (low pressure),270 mmHg group (medi- um pressure),and 300 mmHg group (high pressure). The patient's pain and thigh circumference were measured before and 1-2 days after surgery. Blood samples were taken before and 3,8,and 24 hours after surgery. Superoxide dismutase 1 (SOD1),prostaglandin E2 (PGE2) and myoglobin were detected,analysed and compared. Results In the perspective of the pain and swelling of affected limb after surgery,the 300 mmHg group (73.24±10.51) was significantly different from the 240 mmHg group (58.18±9.66) and the 270mmHg group (63.06±10.06). In the perspective of the SOD1 level in serum,the 300mmHg group (97.77±13.82) was significant-ly different from the 240mmHg group (63.72±15.02) and the 270 mmHg group (70.58±5.85) at 3h after surgery,and then the diver-gence was gradually decreased. In the perspective of the PGE2 level in serum,the 300 mmHg group (478.05±35.80) was significantly different from the 240mmHg group (334.42±33.12) and the 270mmHg group (391.85±19.41) at 3h after surgery,and the divergence was started to decrease after 8 h. In the perspective of the myoglobin level in serum,the 300 mmHg group (30.43±9.79) was also sig-nificantly different from the 240 mmHg group (17.58±1.93) and the 270 mmHg group (22.28±4.21) at 8 h after operation,the diver-gence was started to decrease after 24 h. which began to decrease after 24 h. Correlation analysis showed that there was a significant cor-relation between pain (correlation coefficient 0.518,P<0.001),swelling (correlation coefficient 0.345,P<0.05) and stress after sur-gery. Conclusion The pain and swelling of the affected limb is positively correlated with the pressure of the tourniquet during the operation. Muscle necrosis is the main mechanism of the injury. Oxidative stress occurs in the ischemic phase and inflammation occurs in the reperfusion phase.

A review of research on Schmallenberg virus / 病毒学报

Schmallenberg virus (SBV), a novel orthobunyavirus, was first isolated in 2011. SBV preferentially infects the central nervous system of cattle and sheep and causes fever, diarrhea, a drop in milk yields, congenital malformations and stillbirths. Until June 2014, more than 200 scientific publications regarding SBV have been published. Although more than 20 articles on SVB were published in China, most of these articles provided only a brief introduction of the disease without fully discussing the associated disease characteristics. As a new disease, it has been made a focus of the National Research Center for Exotic Animal Diseases at the China Animal Health and Epidemiology Center. In this review, in order to provide a reference for research into SBV in China, we have reviewed the state of current research progress on the etiology, diagnosis and epidemiology of SBV, and vaccine development.

Development of the personalized criteria for microscopic review following four different series of hematology analyzer in a Chinese large scale hospital / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A generally accepted guideline ("41 rules") published by the International Consensus Group for Hematology Review (ICGHR) can not be suitable for all the laboratories because the facility type, laboratory requirements, sample volume, review rate, turn around time, instrument model and characters etc. are quite different from each other, which may cause a higher workload for microscopy review or lead to false or misleading results. Therefore, we decided to develop the personalized review criteria for 4 series of hematology analyzers in the same hospital, and describe all the implement procedures in detail.</p><p><b>METHODS</b>The total 1770 blood samples were collected from Peking Union Medical College Hospital. Referring to the suggested criteria by international consensus group for hematology review ("41 rules"), the personalized review criteria for 4 series of hematology analyzers including Siemens Advia 2120, Sysmex XE-2100, Sysmex XT-1800i and Sysmex XS-800i were established and validated by adjusting the rules in order to reduce the false positive rate and keep the false negative acceptable by clinical.</p><p><b>RESULTS</b>Using the "41 rules", high review rates of 37.94%, 35.56%, 33.44% and 37.94% were got respectively in Siemens Advia 2120, Sysmex XE-2100, Sysmex XT-1800i and Sysmex XS-800i. Three false positive rules mainly were observed in all of 4 analyzers: white blood cell < 3 × 10(9)/L or >30 × 10(9)/L, platelet < 100 × 10(9)/L or > 1000 × 10(9)/L and immature granulocyte. Specialized rules were observed in different series of analyzers, atypical/variant lymphs flag were found mainly in Sysmex XE-2100, Aniso-RBC were found mainly in Sysmex XT-1800i, flag of "immature granulocyte" mainly in Sysmex XS-800i, Micro-RBC, Macro-RBC and Aniso-RBC mainly in Siemens Advia 2120. Rules of immature granulocyte, blast, and NRBC flag would be mainly triggered by hematology malignant tumor. We could not delete these rules due to the risk of false negative of serious disease, other rules were deleted or revised. After continually optimizing to the rules, we finalized the criteria suitable for Siemens Advia 2120, Sysmex XE-2100, Sysmex XT-1800i and Sysmex XS-800i in our laboratory. The false negative rates were 2.94%, 2.86%, 3.10% and 2.78%, the review rates were 31.07%, 30.00%, 30.01% and 30.09%, and there was no hematology malignant tumor missed. Validated by 547 samples, the false negative rates of our optimized rules were 0.37%, 0.55%, 0.55%, and 0.91% respectively.</p><p><b>CONCLUSION</b>The criteria can be based on the criteria established by International Consensus Group for Hematology Review but must be optimized according to the different requirements.</p>

Fibrous dysplasia: molecular clonality analysis of 21 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the neoplastic nature of fibrous dysplasia by molecular clonality approaches.</p><p><b>METHODS</b>Twenty-one cases of fibrous dysplasia were examined by clonality assays based on X-chromosomal inactivation mosiacism. Lesional and non-lesional tissues were microdissected from paraffin sections followed by DNA extraction. The DNA was predigested by HpaII or HhaI, and then amplified by nested PCR targeting phosphoglycerate kinase (PGK) and androgen receptor (AR) genes. Single nucleotide polymorphism (SNP) at the PGK locus was identified by incubation of the PCR products with Bst XI and agarose gel electrophoresis, and CAG repeat length polymorphism at AR locus was determined by denaturing polyacrylamide gel electrophoresis and visualized by silver staining.</p><p><b>RESULTS</b>Microscopically, all 21 cases showed characteristic features of fibrous dysplasia, including spindle fibrous cell proliferation and immature bone trabeculae at various proportions. DNA polymorphisms at AR locus and SNP of PGK gene were found in 15 of 21, and 4 of 21 cases, respectively. All 19 cases were monoclonal in nature. Two cases showed no polymorphism at either AR or PGK gene locus.</p><p><b>CONCLUSIONS</b>Fibrous dysplasia is likely a clonal, neoplastic process. Additional studies of larger number of cases are needed for a definitive conclusion.</p>

Two-year observation of the clinical efficacy in treating chronic hepatitis B Patients with Ganxian recipe and lamivudine / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of Ganxian recipe (GXR) and lamivudine (LVD) in a two-year treatment of chronic hepatitis B (CHB).</p><p><b>METHODS</b>One hundred and twenty patients with CHB were randomly divided into the combinedly treated group (combined group) of 40 CHB patients who were treated with GXR combined with LVD. Another 40 CHB patients were treated with LVD alone (WM group), and still another 40 CHB patients were treated with GXR alone (TCM group). All these cases were randomly controlled and observed for two years.</p><p><b>RESULTS</b>Comprehensive efficacy: Total effective rate of the combined group (complete response and partial response) was 92.5%, while that of the WM group was 67.5% and TCM group 57.5%, respectively, with the difference between them was significant (P < 0.01); after treatment, the hepatic functions (AST, ALT, SB) of the three groups were all reduced, and the reduction in the combined group was particularly significant in comparison with the WM group or TCM group, P < 0.05 or P < 0.01 respectively, suggesting that the effect in the combined group was better than that in the other two groups; the rate of tyrosine-methionine-aspartate-aspartate (YMDD) virus mutation: it was 7.5% in the combined group, 40.0% in the WM group, and 5.0% in the TCM group; liver fibrosis improvement parameter: after treatment, the results in the combined group got better than those in the other two groups.</p><p><b>CONCLUSION</b>GXR could inhibit the appearance of YMDD after long-term application of LVD, and combined use has marked synergism.</p>