Combination immunotherapy of glioblastoma with dendritic cell cancer vaccines,anti-PD-1 and poly I:C / 药物分析学报

Glioblastoma(GBM)is a lethal cancer with limited therapeutic options.Dendritic cell(DC)-based cancer vaccines provide a promising approach for GBM treatment.Clinical studies suggest that other immu-notherapeutic agents may be combined with DC vaccines to further enhance antitumor activity.Here,we report a GBM case with combination immunotherapy consisting of DC vaccines,anti-programmed death-1(anti-PD-1)and poly I:C as well as the chemotherapeutic agent cyclophosphamide that was integrated with standard chemoradiation therapy,and the patient remained disease-free for 69 months.The patient received DC vaccines loaded with multiple forms of tumor antigens,including mRNA-tumor associated antigens(TAA),mRNA-neoantigens,and hypochlorous acid(HOCl)-oxidized tumor lysates.Furthermore,mRNA-TAAAs were modified with a novel TriVac technology that fuses TAAs with a destabilization domain and inserts TAAs into full-length lysosomal associated membrane protein-1 to enhance major histo-compatibility complex(MHC)class Ⅰ and Ⅱ antigen presentation.The treatment consisted of 42 DC cancer vaccine infusions,26 anti-PD-1 antibody nivolumab administrations and 126 poly I:C injections for DC infusions.The patient also received 28 doses of cyclophosphamide for depletion of regulatory T cells.No immunotherapy-related adverse events were observed during the treatment.Robust antitumor CD4+and CD8+T-cell responses were detected.The patient remains free of disease progression.This is the first case report on the combination of the above three agents to treat glioblastoma patients.Our results suggest that integrated combination immunotherapy is safe and feasible for long-term treatment in this patient.A large-scale trial to validate these findings is warranted.

Advances in research on vascular assessment of lower extremity chronic total occlusion for interventional therapy / 西安交通大学学报(医学版)

Lower extremity chronic total occlusion (CTO) is the most severe manifestation of peripheral artery disease (PAD), with high amputation and mortality rates. As a minimal invasive reconstruction therapy, endovascular therapy (EVT) plays an important role in limb salvage for CTO in current clinical practice. The complexity of CTO lesions leads to a high risk for complications and a low success rate of EVT. Therefore, establishing a grading or scoring system to predict the success rate of revascularization strategy will be helpful in developing appropriate treatment strategies and assessing benefits and risks. This paper summarizes the most popular CTO scoring systems, such as PACSS grading, PARC grading, TAC grading, CTOP classification, Infrapop-CTO scoring, and J-BTK CTO scoring. PACSS grading and PARC grading are suitable for evaluating the severity of vascular calcification including iliofemoral segment, femoral-popliteal segment, and below-the-knee artery segment. TAC grading is suitable for grading calcification below the knee lesions; with low intervention success rate in a high calcification grading. CTOP classification was developed by analyzing the effect of morphological characteristics of proximal and distal fibrous caps of lower extremity CTO lesions on the outcome of EVT. The success rate of antegrade intervention is lower in type IV. The Infrapop-CTO score and J-BTK CTO score can predict successful anterograde crossing of infrapopliteal CTO lesions, with low intervention success rate in high score. Both scoring systems use three variables, namely, shape of proximal stump, calcification, and occlusion length.

A Novel Trajectory of C7 Laminar Screws Determined Using Three-Dimensional Computed Tomography and Surgical Simulation Software: Comparison with a Pre-existing Trajectory

Methods@#Computed tomographic scans of a total of 50 male and 50 female patients were utilized. The placement of C7 laminar screws was activated employing the new and old trajectories. The success rate, the causes of failure, and the maximum allowable length of each trajectory were compared. @*Results@#Employing the new trajectory, the success rates of the unilaminar and bilaminar screws were 93% and 83%, respectively, which were significantly better than the old trajectory (80%, p<0.0001 and 70%, p=0.0003). The most prevalent cause of failure was laminar cortical breach followed by facet joint violation. The new trajectory also offered significantly longer maximum allowable screw length in unilaminar (32.5±4.3 mm vs. 26.5±2.6 mm, p<0.001), bilaminar cephalic (29.5±3.8 mm vs. 25.9±2.6 mm, p<0.0001) and bilaminar caudal (33.1±2.6 mm vs. 25.8±3.1 mm, p<0.001) screws than the old trajectory. With the new and old trajectories, 70% vs. 6% of unilaminar, 60% vs. 2% of bilaminar caudal, and 32% vs. 4% of bilaminar cephalic screws could be protracted perfectly into the corresponding lateral mass without any laminar cortical or facet joint violation (p<0.0001). @*Conclusions@#The novel trajectory possesses a substantially higher success rate, longer maximum allowable screw length, and higher chance to be extended into the lateral mass (a condition known as a lamino-lateral mass screw) than the old trajectory.

The mechanism of "Trichosanthis Fructus-Allii Macrostemonis Bulbus" on phlegm and blood stasis syndrome-related cardiovascular diseases based on network pharmacology and experimental verification / 药学学报

This study aimed to investigate the mechanism of "Trichosanthis Fructus-Allii Macrostemonis Bulbus" (GX) on phlegm and blood stasis syndrome (PBSS) rats combining the methods of network pharmacology and experimental verification. Animal experiment ethical requirements were approved by the Ethical Committee Experimental Animal Center of Anhui University of Chinese Medicine (grant number: AHUCM-rats-2021070). Based on the HPLC-Q-TOF-MS analysis and database, 69 chemical constituents of GX and 163 targets of GX for the treatment of phlegm and blood stasis-related cardiovascular diseases were obtained. Then, key targets such as serine/threonine kinase 1 (Akt1), tumor necrosis factor (TNF), interleukin 6 (IL6), vascular endothelial growth factor A (VEGFA), cellular tumor antigen p53 (Tp53) were screened. Pathway analysis showed that the targets of GX in the treatment of phlegm and blood stasis-relate cardiovascular diseases were mainly involved in PI3K/Akt signaling pathway, sphingolipid metabolism, platelet activation, hypoxia inducible factor-1 (HIF-1), ras-proximate-1 (rap1) and other signaling pathways. In addition, molecular docking analysis showed that apigenin, cucurbitacin D, linolenic acid and kaempferol and other key components had potential binding ability with Akt1, TNF, IL6, VEGFA and Tp53. In the animal experiments, compared to the phlegm and blood stasis syndrome group, GX could significantly improve the traditional Chinese medicine syndrome score, blood lipid, vascular endothelial structure disorders and reduce serum endothelin-1 (ET-1) level, increase serum nitric oxide (NO) and endothelial nitric oxide synthase (eNOS) levels, which could restore aortic endothelial function. In addition, the expression of intercellular cell adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in aorta could be significantly reduced, which could improve the vascular endothelial injury of aorta. Western blot revealed that GX could significantly decrease the phosphorylation levels of phosphoinositide 3-kinase (PI3K) and Akt in aorta. This study revealed the mechanism of GX in treatment of phlegm and blood stasis-relate cardiovascular diseases is consistent with the characteristics of multiple ingredients, multiple targets and multiple pathways. In addition, this study also clarified that the reversal of pathological of phlegm and blood stasis syndrome rats may be related to GX inhibiting PI3K/Akt signaling pathway, which could improve vascular inflammation and vascular endothelial function injury.

Implementation and influencing factors analysis of nursing evidence of perioperative deep vein thrombosis prevention for patients with brain neoplasms based on the Ottawa model of research use / 中国实用护理杂志

Objective:To evaluate the clinical status, and analyz obstacles and facilitators for perioperative deep vein thrombosis prevention of brain neoplasms based on the Ottawa model of research use (OMRU).Methods:A total of 93 patients with brain tumors who were admitted to the Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University from April to May 2021 and 33 nurses in the neurosurgery ward and operating room neurosurgery special group were selected as the baseline review subjects by convenience sampling. Based on the framework of evidence-based continued quality improvement of Fudan University, we searched BMJ Best Practice, UpToDate, The Joanna Briggs Institute Library, International Guideline Library, American Guideline Network, Scottish Intercollegiate Guideline Network, National Institutes for Health and Clinical Technology Optimization, Medline, Medlive, China National Knowledge Infrastructure, VIP, Wanfang and SinoMed according to the '6S' evidence pyramid from inception to January 1, 2021 for all clinical decisions, recommended practices, best practice information, evidence summary, guidelines and expert consensus on venous thrombosis assessment, prevention, screening, nursing and health education. The best evidence was summarized, and the final review indicators were formulated through two rounds of expert correspondence. According to the results of baseline review, barriers and facilitators were analyzed, and countermeasures were developed guided by OMRU.Results:A total of 19 best evidences were included, and 34 review indicators were developed in this study. Among them, only 4 indicators had a compliance rate of 100%, 18 ones had a compliance rate of 0, and the other 12 ones had a compliance rate of 6.5%-97.8%. A multi-factor analysis of the review results showed that the main obstacles of evidence implementation were the feasibility and comprehensibility at evidence level, the lack of knowledge and heavy workloads at the potential practitioner level, insufficient education materials, trainings and preventive equipment at system level. Furthermore, the reliable sources of evidence at evidence level, supports from practitioners at the potential practitioner level and system resources (such as training, national and hospital policies, etc.) at system level may contribute to the clinical application of evidence.Conclusions:There was still a huge gap between the best evidence and clinical practice. The obstacles and facilitating factors in evidence transformation should be evaluated scientifically and comprehensively, and corresponding countermeasures should be given to promote the application of evidence in clinical practice.

Analysis of tuberculosis epidemiological characteristics and drug resistance among the floating population in Beijing in 2019 / 中华流行病学杂志

Objective: To analyze the epidemic characteristics and drug resistance of pulmonary tuberculosis among the floating population in Beijing and to provide a scientific basis for formulating strategies for the prevention and control of tuberculosis among the floating population. Methods: Data of tuberculosis patients who were positive for Mycobacterium tuberculosis culture was collected from 16 districts and one municipal institution of tuberculosis control and prevention in Beijing in 2019. The strain samples were tested for drug sensitivity by the proportional method. According to household registration location, patients were divided into the floating population and Beijing registration. SPSS 19.0 software analyzed tuberculosis patients' epidemic characteristics and drug resistance in the floating population. Results: In 2019, there were 1 171 culture-positive tuberculosis patients in Beijing, among the floating population, 593 (50.64%) patients were identified, with a male-to-female sex ratio of 2.2∶1 (409∶184). Compared to patients under household registration as Beijing residents, a higher proportion of young adults aged 20-39 years (65.09%,386/593) were noticed, with 55.65% (330/593) reported from the urban areas and 96.80% (574/593) were reported the first time. The differences were statistically significant (all P<0.05). After completing the drug sensitivity test, 37 cases were with multiple drug-resistant tuberculosis, accounting for 6.24% (37/593). The rates of isoniazid resistance (42.11%,8/19) and multidrug resistance (21.05%,4/19) in floating population patients after retreatment were significantly higher than those in newly treated patients (11.67%, 67/574 and 5.75%, 33/574), and the differences were statistically significant (all P<0.05). Conclusions: Most patients with tuberculosis in the floating population in Beijing in 2019 were young males aged 20-39 years. The reporting areas were urban areas and the newly treated patients mainly. The patients with tuberculosis in the re-treated floating population were more likely to suffer from multidrug and drug resistance, which should be taken as the key population for prevention and control.

"Trichosanthis Fructus-Allii Macrostemonis Bulbus" combination inhibits NLRP3 inflammasome activation and reduces inflammatory response in RAW264.7 macrophage by inducing autophagy / 中国中药杂志

This study aims to explore the effect of "Trichosanthis Fructus-Allii Macrostemonis" combination(GX) on the activation of NOD-, LRR-, and pyrin domain-containing protein 3(NLRP3) inflammasome, the release of inflammatory cytokines, and the level of autophagy in RAW264.7 macrophage damaged by lipopolysaccharide(LPS), and the mechanism of GX against inflammatory response in macrophages. To be specific, LPS was used to induce the injury of RAW264.7 cells. Cell Counting Kit-8(CCK-8) assay was employed to measure the survival rate of cells, and Western blot to detect the protein expression of NLRP3, apoptosis-associated speck-like protein(ASC), cysteine-aspartic acid protease(caspase)-1, interleukin(IL)-18, IL-1β, microtubule-associated protein light chain 3(LC3)-Ⅱ, and selective autophagy junction protein p62/sequestosome 1 in RAW264.7 macrophages. ELISA was used to measure the levels of IL-18 and IL-1β in RAW264.7 cells. Transmission electron microscopy was applied to observe the number of autophagosomes in RAW264.7 cells. Immunofulourescence staining was used to detect the expression of LC3-Ⅱ and p62 in RAW264.7 cells. The result showed that GX significantly reduced the protein expression of NLRP3, ASC, and caspase-1 in RAW264.7 cells, significantly increased the protein expression of LC3Ⅱ, decreased the expression of p62, significantly inhibited the secretion of IL-18 and IL-1β, significantly increased the number of autophagosomes, significantly enhanced the immunofluorescence of LC3Ⅱ, and reduced the immunofluorescence of p62. Furthermore, 3-methyladenine(3-MA) could reverse the inhibitory effect of GX on NLRP3, ASC, and caspase-1 and reduce the release of IL-18 and IL-1β. In summary, GX can increase of the autophagy activity of RAW264.7 and inhibit the activation of NLRP3 inflammasome, thereby reducing the release of inflammatory cytokines and suppressing inflammatory response in macrophages.

Research Models of the Nanoparticle-Mediated Drug Delivery across the Blood–Brain Barrier

Brain diseases and damages come in many forms such as neurodegenerative diseases, tumors, and stroke. Millions of people currently suffer from neurological diseases worldwide. While Challenges of current diagnosis and treatment for neurological diseases are the drug delivery to the central nervous system. The Blood–Brain Barrier (BBB) limits the drug from reaching the targeted site thus showing poor effects. Nanoparticles that have advantage of the assembly at the nanoscale of available biomaterials can provide a delivery platform with potential to raising brain levels of either imaging therapeutic drugs or imaging. Therefore, successful modeling of the BBB is another crucial factor for the development of nanodrugs. In this review, we analyze the in vitro and in vivo findings achieved in various models, and outlook future development of nanodrugs for the successful treatment of brain diseases and damages.

Anti-inflammatory effect of non-thermal atmospheric pressure plasma for periodontitis treatment: in vitro pilot study

Purpose@#The purpose of this study was to evaluate the anti-inflammatory effects of non-thermal atmospheric pressure plasma (NTP) on human gingival fibroblasts (HGFs) for clinical application of periodontal treatment. @*Materials and Methods@#HGFs were treated with Porphyromonas gingivalis (Pg) lipopolysaccharide (LPS). Customized NTP device was developed for periodontal in vitro study. Cell viability was evaluated with cell counting kit-8. The levels of inflammatory cytokines, including interleukin (IL)-8 and 6, were determined by enzyme-linked immunosorbent assay. @*Results@#When NTP was applied, the cell viability did not change significantly, and there was no difference for 6 h and 24h. When Pg LPS was treated to HGFs, the secretion of IL-8 and IL-6 was increased compared to the control group. But when the NTP was applied, the secretion of them was significantly decreased. @*Conclusion@#NTP did not affect cell viability of HGFs. And it inhibited the LPS-induced production of IL-8 and IL-6.

Selective fetal reduction for monochorionic and dichorionic triplet / 中华围产医学杂志

Monochorionic triplet and dichorionic triplet pregnancies result in a higher risk of complications than trichorionic triplet due to its monochorionic part, and often lead to adverse pregnancy outcomes. We discuss the impact of different fetal reduction numbers, object and surgical methods on the outcome of monochorionic triplet and dichorionic triplet pregnancies. Compared with expectant management, several common fetal reduction strategies can reduce the risk of premature birth, prolong gestational weeks, and increase fetal birth weight. Reduction of the fetus with a separate placenta does not avoid the complications of monochorionic twins, and reducing one of the monochorionic pairs might cause the death of the remaining fetus, thereby requiring skilled surgeons. So, reduction of the monochorionic pair was preferred. More study are needed to evaluate the reduction strategy of monochorionic triplet.

Application of mixed reality technology and situational awareness in clinical teaching of cardiac macrovascular surgery / 中华医学教育探索杂志

Mixed reality technology can achieve a 3D reconstruction of the patient's imaging data and organically combine the real scene. This allows to simulate a real medical operation in clinical teaching. Combined with large data analysis, mixed reality technology allows to build situational awareness data models, thus providing data support for teaching interaction and disease simulations. In the present work, the application of mixed reality technology and situational awareness in clinical teaching of cardiac macrovascular surgery is explored innovatively. These technologies open a new avenue for teaching, solving the issue that stymies traditional teaching approaches and improving the teaching efficiency. It is thus important to explore and promote the applications of this innovative teaching methodology particularly in clinical teaching.

Application of Magnetization-prepared True Fast Imaging with Steady-state Precession Sequence in Brain Tumor Enhancement / 中国医学科学院学报

Objective To evaluate the application of two-dimensional magnetization-prepared true fast imaging with steady-state precession(2D-MP-TrueFISP)sequence in brain tumor enhancement.Methods In this study,60 cases of brain tumor patients who underwent enhanced magnetic resonance imaging of brain were scanned with 2D-MP-TrueFISP/two-dimensional spoiled gradient-recalled echo(2D-SPGR)before and after enhancement.The scores of lesions on the images of 2D-MP-TrueFISP/2D-SPGR were compared.At the same level of 2D-SPGE and 2D-MP-TrueFISP,the signal intensities(SIs)of lesions,white matter,and cerebrospinal fluid were measured before and after enhancement,and the contrast ratios(CRs)of lesions were calculated.The CRs before and after 2D-SPGR/2D-MP-TrueFISP enhancement and those between 2D-SPGR and 2D-MP-TrueFISP after enhancement were compared.Results The scores of lesions after 2D-MP-TrueFISP/2D-SPGR T1WI enhancement were 9.0(9.0,9.0)and 7.0(6.0,7.0),respectively,with significant difference(

The impact of obstructive sleep apnea hypopnea syndrome on the perioperative and long-term outcome in patients with Stanford type A aortic dissection / 中华耳鼻咽喉头颈外科杂志

Objective: To confirm the impact of obstructive sleep apnea hypopnea syndrome (OSAHS) on perioperative and long-term outcome in patients with Stanford type A aortic dissection. Methods: From June 2010 to July 2017, the clinical data of 91 patients with Stanford type A aortic dissection were analyzed. Among them, 51 patients with OSAHS were included in the study group and 40 patients without OSAHS were included in the control group. After 36 months follow-up, all-cause death was regarded as the end event. The clinical baseline data, perioperative period and 36 months survival rate of the two groups were compared. Kanplan-Meier method was used to describe the 36 month survival curve of the two groups. Cox proportional risk model was used to evaluate the risk ratio (HR) and 95%CI of 36 month survival rate. Results: The mortality rate during hospitalization was 5.9% (3 cases) in the study group and 5.0% (2 cases) in the control group, and the difference was not statistically significant (χ~2=0.03, P>0.05). The actual follow-up was (36.2±1.5) months, 88 cases were followed up and 3 cases were lost. The all cause mortality rate of 36 months was 27.5% (14/51)in the study group and 10.0%(4/40) in the control group, the difference was statistically significant (χ~2=4.30, P<0.05).By Cox proportional risk model analysis, 36 months after operation, the study group was compared with the control group after adjusting for age, male, bicuspid of aortic valve, chronic obstructive pulmonary disease, anemia, preoperative pericardial tamponade, postoperative organ dysfunction, preoperative LVEF, emergency operation, Sun's operation, coronary artery bypass grafting, hypertension, cardiac arrhythmia, and advanced avulsion of distal aortic dissection The survival rate was lower, the difference was statistically significant (P<0.05).In addition to OSAHS, coronary artery bypass grafting and preoperative pericardial tamponade were also risk factors for the increase of 36 month mortality rate (HR=11.28,95%CI: 1.98-46.25, P=0.009; HR=9.08, 95%CI: 2.22-41.3, P=0.032). Conclusions: There was no significant difference in mortality during hospitalization in patients with Stanford A aortic dissection combined with OSAHS. The survival rate of 36 months after operation was lower than that of the control group.

Association between microRNA-137 Gene Polymorphisms and Ischemic Post-stroke Depression / 中国康复理论与实践

Objective:To analyze the relationship between microRNA-137 gene polymorphisms and ischemic post-stroke depression (PSD). Methods:January, 2017 to January, 2019, the single nucleotide polymorphism (SNP) of rs1625579 in microRNA-137 was genotyped in 250 ischemic PSD patients and 250 healthy controls with SNaPshot. The expression of microRNA-137 was measured with quantitative real-time polymerase chain reaction in the mononuclear cells, and the association of the SNP rs1625579 with microRNA-137 expression was analyzed. Results:The allele T was more in the patients than in the controls (OR = 2.033, 95%CI 1.255 to 3.294, P = 0.003), as well as the genotype TT (OR = 2.139, 95%CI 1.272~3.595, P = 0.004). The microRNA-137 expression was less in the patients than in the controls (t = 28.23, P < 0.001). For the controls, the microRNA-137 expression was also less in those with genotype of TT than with GT and GG (t = 3.764, P < 0.001). Conclusion:The genotype TT of SNP rs1625579 in microRNA-137 is a risk factor of susceptibility to ischemic PSD, which may associate with the decrease of expression of microRNA-137.

Volumetric Assessment of Fusion Mass and Its Clinical Correlations in Posterior Lumbar Interbody Fusion Depending on the Type of Bone Graft

Objectives@#This study was conducted to analyze associations between the volume of the fusion mass and clinical outcomes 1 year after posterior lumbar interbody fusion (PLIF).Summary of Literature Review: No study has investigated associations between the size of the fusion mass and clinical outcomes after PLIF. @*Materials and Methods@#The volume of the fusion mass and its clinical correlations after PLIF were analyzed in all patients and in subgroups. When a sufficient amount of local bone was available for grafting, only local bone without a graft extender was used (LbG group, n=20). If an inadequate amount of local bone was present for grafting, a local bone graft with porous hydroxyapatite bone chips was used (LbHa group, n=20). The same amount of demineralized bone matrix was used in both groups. The primary outcome was the relationship between the size of the fusion mass and clinical outcomes in all patients 1 year after surgery. The secondary outcome was a comparison of the size of the fusion mass and clinical outcomes by group. @*Results@#The volume of the fusion mass was not correlated with any clinical outcomes 1 year after surgery, either in the overall group of patients or in the subgroup analysis. @*Conclusions@#The volume of the interbody fusion mass was not related to any clinical outcomes 1 year after surgery. Furthermore, in cases with an insufficient amount of local bone for grafting, porous hydroxyapatite could be a relatively good alternative as a graft extender.

Research and application of artificial cervical disc / 中国组织工程研究

BACKGROUND: For patients with cervical spondylosis who fail to receive conservative treatment, cervical anterior decompression and fusion has always been the gold standard for surgical treatment. Since its use, it has been widely recognized by clinicians for its simple and convenient intraoperative operation and significant relief of pathological segmental symptoms after surgery. As time goes by, the problem of degeneration of surgery adjacent segments and loss of mobility of the replacement segments is gradually exposed. At the same time, the patient's requirements for postoperative rehabilitation and quality of life are constantly improving, and surgical technology continues to develop rapidly. This type of surgery cannot meet the clinical needs. Therefore, total cervical disc replacement surgery comes into being, which can solve the related problems caused by anterior cervical decompression and fusion, and the clinical effect is better than previous one. OBJECTIVE: To review the research status of artificial cervical intervertebral discs, to focus on its clinical effects and structure, and to prospect its improvement and development direction of artificial development direction. METHODS: A compute-based retrieval of CNKI, WanFang and PubMed databases was conducted for articles published between January 1995 and August 2019. The keywords were "non-fusion technique, artificial intervertebral disc, clinical efficacy, structure" in Chinese and English, respectively. The articles related to artificial cervical intervertebral disc were selected, and the latest experimental and clinical researches were preferred. RESULTS AND CONCLUSION: (1) Through analyzing the main artificial cervical discs on the market, the research of artificial cervical discs will focus on materials, structures, implantation devices and surgical approaches of prosthesis. The domestic cervical disc will be designed based on the anatomical features of the Chinese cervical spine. (2) It is believed that the future cervical disc replacement surgery will achieve a satisfactory clinical effect, and its postoperative complications will be significantly reduced, which can meet the requirements of Chinese people.

Predictive value of CT texture analysis for early enlargement of hypertensive intracerebral hemorrhage / 实用放射学杂志

Objective To explore the predictive value of CT image texture analysis for early enlargement of hypertensive intracerebral hemorrhage.Methods One hundred and eight patients with hypertensive intracerebral hemorrhage were divided into enlarged hematoma group (positive group)and non-enlarged hematoma group (negative group),according to whether the volume of hematoma on 24 h follow up CT scan was more than 30% or 6 mL of the baseline CT.Phillis Radiomics Tool V93 software was used to segment the hematoma on CT plain scan images of two groups,four features of first-order and three of gray-level co-occurrence matrix (GLCM),thirteen of gray-level size zone matricx (GLSZM)and eleven of gray-level run-length matricx (GLRLM)were obtained.The differences of thirty-one texture features between the two groups were compared.The ROC curves of the features with statistical differences were analyzed.The independent predictors of early enlargement of intracerebral hemorrhage were screened by Logistic multivariate regression model.Results Among the one hundred and eight patients,twenty-eight were positive group and eighty were negative group.Skewness and long run low gray-level emphasis (LRLGE)in positive group were significantly higher than those in negative group (P＜0.05).There was no significant difference in the remaining twenty-nine features between the two groups (P＞0.05).ROC curve analysis showed that the AUC of Skewness,LRLGE and their combined diagnosis were 0.634,0.814 and 0.828,respectively.The independent variables were screened by stepwise regression analysis.The LRLGE (OR＝1.238,95%CI＝1.009－1.51 9,P＜0.05)was selected as the regression model, suggesting that LRLGE was an independent predictor of the early enlargement of intracerebral hemorrhage.Conclusion Texture analysis of CT images is helpful to predict the early enlargement of hypertensive intracerebral hemorrhage,and LRLGE based on GLRLM algorithm can be used as an independent predictor.

Reducing the incidence of healthcare-associated infection in department of critical care medicine by risk assessment method / 中国感染控制杂志

Objective To explore the effect of risk assessment method on the incidence of healthcare-associated infection (HAI) in high-risk departments.Methods A hospital was selected as the research object, risk assessment of HAI management at the hospital and department level was carried out, high-risk departments and high-risk links were screened out, targeted intervention was performed. Patients hospitalized in April-June 2017 were as control group and those hospitalized in July-September 2017 were as intervention group, incidence of HAI between two groups was compared.Results Through risk assessment at the hospital level, department of critical care medicine was the department with the highest risk, risk assessment at the department level showed that without wearing isolation clothes when contacting isolated patients during diagnosis and treatment, without using sterile sheeting when catheterization, and low correct rate of hand hygiene were high-risk links in department of critical care medicine. Targeted intervention was performed, isolation clothing allocation rate for contacting isolated patients increased from 0 to 100％, compliance rate to wearing isolation clothing among medical staff increased from 0 to 97.62％, implementation rate of using sterile sheet for deep vein catheterization increased from 72.50％ to 100％; hand hygiene correct rate increased from 85.00％ to 96.59％. Incidence of HAI decreased from 5.90％ to 2.64％, difference was statistically significant (P＜0.05).Conclusion Implementing risk assessment management of HAI in medical institutions can effectively guide the prevention and control of HAI in high-risk departments, and improve the level of HAI management.

Research progress on exosomes in promoting bone regeneration / 基础医学与临床

Exosomes, small vesicles of endocytic origin, have attracted attention in bone regeneration field. The vesicles travel between cells and deliver functional cargoes like proteins and RNAs, thereby regulating targeted cells dif-ferentiation, commitment, function, and proliferation. Exosomes directly regulate MSCs into the osteoblastic lineage, stimulate bone regeneration by directly regulating osteoblast proliferation and activity, regulate osteoclast maturation and activity and stimulate bone growth and regeneration by increasing vessel formation. Meantime, exosomes resolves toxicity and immunogenicity problems caused by biomaterial treatment. Furthermore, compared with living cell trans-plantation, exosomes present a lower risk for severe complication(such as tumors, emboli formation).

Preparation and quality evalution of direct-fill isophenylcyclopentylamine hydrochloride capsules / 国际药学研究杂志

Objective To prepare isophenylcyclopentylamine hydrochloride capsules and evaluate its quality. Methods The suitable excipients were selected by the drug-excipient compatibility test,and after the formulation and preparation process design and screening,the micromeritic property and hygroscopicity of contents of capsules as well as the basic performance and stability of is-ophenylcyclopentylamine hydrochloride capsules were evaluate. Results The selected formulation was composed of isophenylcyclo-pentylamine hydrochloride 10 mg,anhydrous dibasic calcium phosphate 128.7 mg,mannitol 128.7 mg and aerosil 2.7 mg.The angle of repose of intermediate powders was(30.71±1.09)°,aerated and packed bulk densities were(0.76±0.01)and(0.90±0.02)g/ml re-spectively,Hausner value was 1.19±0.01,Carr′s index was(15.86±1.05)%,indicating good flowability and filling property as well as relatively low humidity.The contents,uniformity of contents and dissolution of capsules fulfilled the requirements.The quality of ca-pusles kept well in the 6-month accelerated and long-term stability test.Conclusion The formulation is simple and reasonable,and the preparation process showed a good reproducibility,which might be suitable for industrialization.