Research status of Bovis Calculus and relevant Chinese patent medicines based on bibliometric analysis / 中国中药杂志

With scarce resources, natural Bovis Calculus is expensive and hard to meet clinical demand. At the moment, four kinds of Bovis Calculus are available on the market: the natural product, in vitro cultured product, synthesized product, and the product formed in cow after manual intervention. In this study, papers on the four kinds of Bovis Calculus products and relevant Chinese patent medicines were searched from Web of Science, PubMed, and China National Knowledge Infrastructure(CNKI). CiteSpace, citexs AI, and CNKI were employed for bibliometric analysis and knowledge map analysis. On this basis, the status, trend, and focuses of research on Bovis Calculus and relevant Chinese patent medicines were summarized. The results suggested overall slow development in the research on Bovis Calculus and relevant Chinese patent medicines with three typical growth stages. It is consistent with the development of Bovis Calculus substitutes and the national policy for the development of traditional Chinese medicine. At the moment, the research on Bovis Calculus and relevant Chinese patent medicines has been on the rise. In recent years, there has been an explosion of research on them, particularly the quality control of Bovis Calculus and the Chinese patent medicines, the pharmacological efficacy of Chinese patent medicines, such as Angong Niuhuang Pills, and the comparison of the quality of various Bovis Calculus products. However, there is a paucity of research on the pharmacological efficacy and the mechanism of Bovis Calculus. This medicinal and the relevant Chinese patent medicines have been studied from diverse perspectives and China becomes outstanding in this research field. However, it is still necessary to reveal the chemical composition, pharmacological efficacy, and mechanism through multi-dimensional deep research.

DNA methylation diversity analysis of Lycium barbarum samples from different cultivation areas based on MSAP / 中国中药杂志

Obvious epigenetic differentiation occurred on Lycium barbarum in different cultivation areas in China. To investigate the difference and change rule of DNA methylation level and pattern of L. barbarum from different cultivation areas in China, the present study employed fluorescence-assisted methylation-sensitive amplified polymorphism(MSAP) to analyze the methylation level and polymorphism of 53 genomic DNA samples from Yinchuan Plain in Ningxia, Bayannur city in Inner Mongolia, Jingyuan county and Yumen city in Gansu, Delingha city in Qinghai, and Jinghe county in Xinjiang. The MSAP technical system suitable for the methylation analysis of L. barbarum genomic DNA was established and ten pairs of selective primers were selected. Among amplified 5'-CCGG-3' methylated sites, there were 35.85% full-methylated sites and 39.88% hemi-methylated sites, showing a high degree of epigenetic differentiation. Stoichiometric analysis showed that the ecological environment was the main factor affecting the epigenetic characteristics of L. barbarum, followed by cultivated varieties. Precipitation, air temperature, and soil pH were the main ecological factors affecting DNA methylation in different areas. This study provided a theoretical basis for the analysis of the epigenetic mechanism of L. barbarum to adapt to the diffe-rent ecological environments and research ideas for the introduction, cultivation, and germplasm traceability of L. barbarum.

Repeatability of OPD-Scan Ⅲ and its consistency with Pentacam in measuring keratometry and astigmatism / 中华实验眼科杂志

Objective:To analyze the repeatability of keratometry and astigmatism values measured by the OPD-Scan Ⅲ and the agreement of the parameters measured by OPD-Scan Ⅲ and Pentacam.Methods:A diagnostic test study design was adopted.Fifty patients (100 eyes) with refractive errors, aged from 21 to 35 years old, were selected from Second Affiliated Hospital of Nantong University and Lixiang Eye Hospital of Soochow University during August 2018.Spherical equivalent, astigmatim degree and axis were measured by Autorefraction.Corneal biometric measurements were measured three times continuously with the above two instruments.Keratometry values at the flat axis (K1), keratometry values at the steep axis (K2), astigmatim degree, axis, vector parameters J0 (Jackson cross cylinder at 0°or 180°) and J45 (Jackson cross cylinder at 45°) were recorded.Intraclass correlation coefficient (ICC) was used for repeatability analysis.Wilcoxon signed rank test, Spearman correlation analysis and Bland-Altman graphs were employed to analyze the comparability.This study adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Lixiang Eye Hospital of Soochow University (No.SLER2018112). Written informed consent was obtained from each patient prior to any examination.Results:The ICC of K1, K2, astigmatism, astigmatic axis, J0 and J45 measured by OPD-Scan Ⅲ were all greater than 0.900; the ICC of the astigmatism measured by Pentacam was 0.896, and the ICC of the other parameters measured by Pentacam were greater than 0.900; The values of K2, astigmatism, J0 and J45 measured by OPD-Scan Ⅲ were greater than those measured by Pentacam, and the differences were statistically significant (all at P<0.05). The values of K1, K2, astigmatism degree, axis, J0 and J45 measured by OPD-Scan Ⅲ were positively correlated with those measured by Pentacam (r s=0.981, 0.982, 0.900, 0.737, 0.921, 0.703, all at P<0.01). The 95% agreement of limits (LOA) of K1, K2, astigmatism, axis, J0 and J45 measurement difference between OPD-Scan Ⅲ and Pentacam were -0.52-0.50 D, -0.39-0.59 D, -0.37-0.48 D, -17.29°-20.38°, -0.12-0.24 D and -0.22-0.28 D, respectively. Conclusions:OPD-Scan Ⅲ has high credibility in measuring corneal refractive power and astigmatism degree, but its 95% LOA of astigmatism axis is too large to be accepted clinically.

Analysis of water-soluble nutrients in Lycium barbarum leaves and differences between different producing areas / 中国中药杂志

This study is to clarify the composition and content differences of water-soluble nutrients in Lycium barbarum leaves(LBLs) from different areas. The total polysaccharides, free monosaccharides and oligosaccharides, nucleosides and amino acids in 35 batches of LBLs were analyzed with use of spectrophotometry, HPLC-ELSD and UPLC-MS/MS. The results showed that LBLs contained abundant polysaccharides, fructose, glucose, sucrose and maltose, with an average contents of 39.07, 12.69, 8.99, 17.44, 8.32 mg·g~(-1), respectively. Besides, eight nucleosides and twelve amino acids were detected in LBLs, and their average total contents were 54.95, 336.9 μg·g~(-1). Principal component analysis(PCA) and partial least squares discrimination analysis(PLS-DA) of carbohydrate, nucleoside and amino acid showed that the water-soluble nutrients of the samples from Qinghai Province were significantly different from those from other areas mainly in asparagine, proline, glutamine, sucrose, adenine and guanosine. In this study, the compositions and contents of water-soluble nutrients in LBLs were preliminarily clarified, which provided basis for further development and utilization of LBLs resoures.

Regionalization of production of medicinal and edible fruit of Lycium barbarum associated with ecological factors and chemical constituents / 药学学报

The fruit of Lycium barbarum L. (FLB) is a food and medicinal herb. Identifying suitable production regions for this plant would be beneficial to its cultivation and production. In this study, the Maxent model was used to identify ecologically suitable regions for the growth of L. barbarum L. In addition, based on its chemical composition, the suitable regions for production were identified by literature analysis and chemometrics. The results show that suitable regions for L. barbarum L. culture are mainly distributed in the northwest of China; suitable regions for the production of medicinal FLB were mainly concentrated in the district of Ningxia, Baiyin, Jiuquan and Zhangye of Gansu, and parts district in west of Inner Mongolia. All are the traditional production regions for FLB, which is consistent with the good quality of FLB produced in Ganzhou in ancient times, and the genuine medicinal materials of FLB produced in Zhongning of Ningxia today. The suitable regions for edible FLB were mainly distributed in northwest of Qinghai, Jiuquan and Zhangye of Gansu, as well as Aksu and Kizi sukirgiz of Xinjiang. The fruit type index of FLB in these regions is large, and the content of fructose and glucose in the fruit is high, which satisfies the edible commodity property. The study results lay a foundation for realizing the regional distribution and development of L. barbarum based on its different uses.

Thyroid function of twin-pregnant women in early pregnancy / 中华医学杂志(英文版)

Background@#Serum human chorionic gonadotrophin (hCG) is higher in twin than that in singleton pregnancies. As hCG stimulates the thyroid to produce more free thyroxine (FT4), which may lead to decreased thyroid-stimulating hormone (TSH) levels, the reference ranges of thyroid-related indicators may differ between singleton and twin pregnancies in the first trimester. This study aimed to establish reference ranges for thyroid-related indicators in early twin pregnancies and to compare them with singleton pregnancies.@*Methods@#Data of 820 twin-pregnant women were extracted from the established database of all pregnant women who delivered at Peking University First Hospital from October 2013 to May 2018; 160 who met National Academy of Clinical Biochemistry criteria were included to establish TSH and FT4 reference ranges. We screened 480 (3:1 paired) women with singleton pregnancies from the same database as controls. The Mann-Whitney test for TSH and FT4 levels was applied for comparisons between singleton and twin pregnancies.@*Results@#First-trimester reference ranges (4–12 gestational weeks) for twin pregnancies were: TSH 0.69 (0.01–3.35) mIU/L and FT4 16.38 (12.45–23.34) pmol/L. Median TSH was significantly lower at 7 to 12 gestational weeks than that at 4 to 6 gestational weeks (0.62 vs. 0.96 mIU/L, Z = -1.964, P = 0.049); FT4 was not significantly different between the two groups. Compared to singleton pregnancies, median TSH was significantly lower (0.69 vs. 1.27 mIU/L, Z = -6.538, P = 0.000), and FT4 was significantly higher (16.38 vs. 14.85 pmol/L, Z = -7.399, P = 0.000) in twin pregnancies in the first trimester.@*Conclusions@#Specific reference ranges for thyroid-related indicators for twin pregnancies are needed to avoid a misdiagnosis of thyroid dysfunction. Moreover, establishment of separate reference ranges for 4 to 6 and 7 to 12 gestational weeks in twin pregnancies may be considered.

Changes of ganglion cell-inner plexiform layer and retinal thickness in macular region after ICL implantation / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the changes of ganglion cell-inner plexiform layer and retina thickness in myopic eyes after intraocular collamer lens(ICL)implantation using quantitative optical coherence tomography(OCT).<p>METHODS:A prospective study enrolled 41 myopic eyes of 26 patients which underwent ICL implantation(average age: 28.19±6.28 years). Aaxial length(AL), uncorrected visual acuity(UCVA), refractive diopter(RD), best corrected visual acuity(BCVA), intraocular pressure(IOP)and OCT were measured and compared in all patients before and after surgery. Optical coherence tomography(OCT)was used to image central retinal thickness(CRT)and ganglion cell-inner plexiform layer thickness(GCT). The changes between pre-and postoperative were analyzed by repeated measures analysis of variance(ANOVA). Least significant difference test was used to compare the specific time points after operation with those before operation.<p>RESULTS: Compared with the preoperative data, all the patients showed significant improvements in the postoperative UCVA and BCVA(<i>P</i><0.05). However, there was no statistical significance in IOP. CRT were 273.20 ±25.48, 274.07±27.64, 277.85 ±25.49, and 275.99 ±24.68μm before and after surgery, respectively, while GCT were 85.31 ±5.19, 88.95±6.87, 87.73±4.23, and 87.45±4.59μm, respectively, with statistically significant changes(all <i>P</i> <0.05). Among them, CRT increased in one month after operation, with statistical significance(<i>P</i><0.01). GCT increased in 1wk, 1mo and 3mo after operation, with statistical significance(<i>P</i><0.05). The changes of GCT in 1wk after operation was positively correlated with AL(<i>r</i>s=0.529, <i>P</i>=0.001).<p>CONCLUSION:ICL implantation for myopic eyes has good efficacy and safety, but macular area changes will occur after surgery, which need to be paid attention to.

Thyroid function of twin-pregnant women in early pregnancy / 中华医学杂志(英文版)

BACKGROUND@#Serum human chorionic gonadotrophin (hCG) is higher in twin than that in singleton pregnancies. As hCG stimulates the thyroid to produce more free thyroxine (FT4), which may lead to decreased thyroid-stimulating hormone (TSH) levels, the reference ranges of thyroid-related indicators may differ between singleton and twin pregnancies in the first trimester. This study aimed to establish reference ranges for thyroid-related indicators in early twin pregnancies and to compare them with singleton pregnancies.@*METHODS@#Data of 820 twin-pregnant women were extracted from the established database of all pregnant women who delivered at Peking University First Hospital from October 2013 to May 2018; 160 who met National Academy of Clinical Biochemistry criteria were included to establish TSH and FT4 reference ranges. We screened 480 (3:1 paired) women with singleton pregnancies from the same database as controls. The Mann-Whitney test for TSH and FT4 levels was applied for comparisons between singleton and twin pregnancies.@*RESULTS@#First-trimester reference ranges (4-12 gestational weeks) for twin pregnancies were: TSH 0.69 (0.01-3.35) mIU/L and FT4 16.38 (12.45-23.34) pmol/L. Median TSH was significantly lower at 7 to 12 gestational weeks than that at 4 to 6 gestational weeks (0.62 vs. 0.96 mIU/L, Z = -1.964, P = 0.049); FT4 was not significantly different between the two groups. Compared to singleton pregnancies, median TSH was significantly lower (0.69 vs. 1.27 mIU/L, Z = -6.538, P = 0.000), and FT4 was significantly higher (16.38 vs. 14.85 pmol/L, Z = -7.399, P = 0.000) in twin pregnancies in the first trimester.@*CONCLUSIONS@#Specific reference ranges for thyroid-related indicators for twin pregnancies are needed to avoid a misdiagnosis of thyroid dysfunction. Moreover, establishment of separate reference ranges for 4 to 6 and 7 to 12 gestational weeks in twin pregnancies may be considered.

Ecology suitability study of Trollius chinensis / 中国中药杂志

Based on the distribution information of 110 samples and 55 environmental factors, Maxent model was used to predict the ecology suitability regions of Trollius chinensis. The study aims at providing theory basis for the cultivation of T. chinensis. The results showed that the Maxent model prediction result was good (AUC>0.9) and the main factors effecting the ecology suitability regions of T. chinensis were precipitation in July, standard deviation of seasonal variation of temperature, annual mean temperature, precipitation in August and altitude. The ecology suitable regions of T. chinensis mainly concentrated in Shanxi, Hebei, east of Inner Mongolia, west of Jilin and Liaoning, north of Shaanxi, south of Ningxia, east and south of Gansu, and east of Qinghai. The results indicated that except for traditional distribution regions, north of Shaanxi, south of Ningxia, east and south of Gansu, and east of Qinghai could selected as the regions for cultivation of T. chinensis. It provides theory basis for selecting suitable regions to cultivate T. chinensis.

Production regionalization study of Isatidis Radix / 中国中药杂志

In this research, we collected information of eighty nine sampling points of Isatidis Radix nationwide through data query and field survey, and the medicinal component contents of samples were determined by HPLC. By using Maxent Model and ArcGIS, along with ecological factor data, the national habitat suitability distribution of Isatidis Radix was predicted. R-language was adopted to establish a model of the relationship between the medicinal component contents and ecological factors. The medicinal quality was divided by ArcGIS grid computing. The results indicated that the three main ecological factors affecting the distribution of Isatidis Radix were precipitation in the driest season, mean annual temperature and mean temperature in the wet season. The suitable cultivation region of Isatidis Radix is mainly distributed in the north of China, but the medicinal quality is quite different, Isatidis Radix in Xinjiang province has higher medicinal quality. This study provides a reference for rational selection of planting areas of Isatidis Radix.

Ecology suitability study of Ephedra intermedia / 中国中药杂志

The study aims at predicting ecological suitability of Ephedra intermedia in China by using maximum entropy Maxent model combined with GIS, and finding the main ecological factors affecting the distribution of E. intermedia suitability in appropriate growth area. Thirty-eight collected samples of E. intermedia and E. intermedia and 116 distribution information from CVH information using ArcGIS technology were analyzed. MaxEnt model was applied to forecast the E. intermedia in our country's ecology. E. intermedia MaxEnt ROC curve model training data and testing data sets the AUC value was 0.986 and 0.958, respectively, which were greater than 0.9, tending to be 1.The calculated E. intermedia habitat suitability by the model showed a high accuracy and credibility, which indicated that MaxEnt model could well predict the potential distribution area of E. intermedia in China.

Clinical effect of mouth floor approach intubation in jaw fracture combined with brain injury / 口腔疾病防治

Objective @#To explore the effects of mouth floor approach intubation in the treatment of jaw fracture combined with skull base injury.@*Methods @#From Jan. 2014 to Oct. 2015, 7 cases of jaw fracture combined with skull base injury were selected from Medical center of Stomatology, Foshan Hospital of Traditional Chinese Medicine (FSTCM). All cases were treated with mouth floor approach intubation, because they were not suitable to be given the oral or nasal intubation anesthesia. @*Results @#All the patients healed well after operation, and there was no tube accident or other complications.@*Conclusions@# For patients of jaw fracture combined with skull base injury, the mouth floor approach intubation could be recommended as a supplementary choice for traditional intubation methods.

Ecology suitability study of Chinese materia medica Gentianae Macrophyllae Radix / 中国中药杂志

This paper is aimed to predict ecology suitability distribution of Gentianae Macrophyllae Radix and search the main ecological factors affecting the suitability distribution. The 313 distribution information about G. macrophylla, 186 distribution information about G. straminea, 343 distribution information about G. dauricaand 131 distribution information about G. crasicaulis were collected though investigation and network sharing platform data . The ecology suitable distribution factors for production Gentianae Macrophyllae Radix was analyzed respectively by the software of ArcGIS and MaxEnt with 55 environmental factors. The result of MaxEnt prediction was very well (AUC was above 0.9). The results of predominant factors analysis showed that precipitation and altitude were all the major factors impacting the ecology suitable of Getiana Macrophylla Radix production. G. macrophylla ecology suitable region was mainly concentrated in south of Gansu, Shanxi, central of Shaanxi and east of Qinghai provinces. G. straminea ecology suitable region was mainly concentrated in southwest of Gansu, east of Qinghai, north and northwest of Sichuan, east of Xizang province. G. daurica ecology suitable region was mainly concentrated in south and southwest of Gansu, east of Qinghai, Shanxi and north of Shaanxi province. G. crasicaulis ecology suitable region was mainly concentrated in Sichuan and north of Yunnan, east of Xizang, south of Gansu and east of Qinghai province. The ecological suitability distribution result of Gentianae Macrophyllae Radix was consistent with each species actual distribution. The study could provide reference for the collection and protection of wild resources, meanwhile, provide the basis for the selection of cultivation area of Gentiana Macrophylla Radix.

Analysis of commercial specifications and grades of wild and cultivated Gentianae Macrophyllae Radix based on multi-indicative constituents / 中国中药杂志

The study is aimed to analyze the commercial specifications and grades of wild and cultivated Gentianae Macrophllae Radix based on multi-indicative constituents. The seven kinds of main chemical components containing in Gentianae Macrophyllae Radix were determined by UPLC, and then the quality levels of chemical component of Gentianae Macrophyllae Radix were clustered and classified by modern statistical methods (canonical correspondence analysis, Fisher discriminant analysis and so on). The quality indices were selected and their correlations were analyzed. Lastly, comprehensively quantitative grade division for quality under different commodity-specifications and different grades of same commodity-specifications of wild and planting were divided. The results provide a basis for a reasonable division of specification and grade of the commodity of Gentianae Macrophyllae Radix. The range of quality evaluation of main index components (gentiopicrin, loganin acid and swertiamarin) was proposed, and the Herbal Quality Index (HQI) was introduced. The rank discriminant function was established based on the quality by Fisher discriminant analysis. According to the analysis, the quality of wild and cultivated Luobojiao, one of the commercial specification of Gentianae Macrophyllae Radix was the best, Mahuajiao, the other commercial specification, was average , Xiaoqinjiao was inferior. Among grades, the quality of first-class cultivated Luobojiao was the worst, of second class secondary, and the third class the best; The quality of the first-class of wild Luobojiao was secondary, and the second-class the best; The quality of the second-class of Mahuajiao was secondary, and the first-class was the best; the quality of first-class Xiaoqinjiao was secondary, and the second-class was the better one between the two grades, but not obvious significantly. The method provides a new idea and method for evaluation of comprehensively quantitative on the quality of Gentianae Macrophyllae Radix.

Production suitability regionalization study of Pinus massoniana / 中国中药杂志

The distribution, yield and sample information data of Pinus massoniana was obtained by document literature and sample investigation. Based on sample data from 12 provinces including 414 sample plots and environment factors in China,the distribution regionalization of P. massoniana was predicted by using Maxent and spatial analysis function of ArcGIS. The results showed that the northernmost distribution of P. massoniana was 33.5 degrees north latitude, and it mainly distributed in the southeast in China. Based on plant age, plant height, yield per plant and other growth index from 414 sample plots, combined vegetation form and other data, the growth regionalization of P. massoniana was carried out by using SPSS and related functions of ArcGIS. The results showed that Fujian, Guizhou and Guangxi had a lager distribution area of P. massoniana, meanwhile, it had a relatively higher yield of fresh pine needles. The relational model between environmental factors and shikimic acid,and procyanidin, and the total lignans was constructed by using SPSS regression analysis method. Then the spatial calculation function of ArcGIS was used tocarry out the quality regionalization of P. massoniana based on the relational model. The results showed that east of Sichuan, Guizhou, Chongqing had a good pine needles quality. Based on the distribution, growth and quality regionalization, the production suitability regionalization of P. massoniana was carried out. The results showed that the optimal planting base region mainly distributed in east of Sichuan, middle and east of Guizhou, and east of Guangxi.

Quality regionalization study on Gentianae Macrophyllae Radix / 中国中药杂志

The 79 samples of Gentianae Macrophyllae Radix were collected based on the distributed information by document literature. Based on sample information, and using the regression model of Gentianae Macrophyllae Radix index component and environmental factors, and combined with the prediction results of ecological suitability by MaxEnt and principal component analysis results of index component, the space distribution of Gentianae Macrophyllae Radix was estimated with the spatial analysis function of ArcGIS. The results showed that it had a higher comprehensive quality in south of Shaanxi, south of Gansu, middle of Sichuan and southeast of Xizang. The study results were coinciding with the producing regions of Gentianae Macrophyllae Radix. It can provide reference for Gentianae Macrophyllae Radix resource conservation, development and utilization.

Glycosylation of recombinant human thyroid peroxidase ectodomain of insect cell origin has little effect on recognition by serum thyroid peroxidase antibody / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Thyroid peroxidase (TPO) is an important autoantigen in Hashimoto's thyroiditis (HT), and almost all epitopes are located in TPO ectodomain. The glycosylation of TPO might contribute to breaking self-tolerance, therefore, purified glycosylated recombinant TPO ectodomain is prerequisite of elucidating its role in the pathogenesis of HT. The aim of our study was to investigate whether the glycosylation has influence on the antigenic determinants of recombinant TPO.</p><p><b>METHODS</b>Bac-to-Bac baculovirus expression system was used to generate recombinant human TPO ectodomain. The antigenicity was analyzed by antigen specific enzyme-linked immunosorbant assays (ELISAs). The glycosylation of recombinant human TPO ectodomain of High Five insect cell origin was detected by lectin-ELISAs.</p><p><b>RESULTS</b>TPO ectodomain was recovered from the culture media as a soluble protein, and it was fused with a hexahistidine tag which allowed purification by nickel-affinity chromatography. The recombinant TPO ectodomain could be recognized by all the 54 HT patients and three TPO monoclonal antibodies. Fucose, sialic acid and galactose were all detected on the recombinant TPO ectodomain. Sera TPOAb binding decreased slightly after non-specific deglycosylation of TPO by periodic acid.</p><p><b>CONCLUSIONS</b>High Five insect cells derived recombinant human TPO ectodomain had N-glycosylation sites, which might have little effect on recognition by serum TPOAb.</p>

Does urothelial cancer of bladder behave differently in young patients? / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Bladder urothelial cancer has been diagnosed at an increasing rate among young adults in China while the clinical outcomes remain highly controversial. To optimize the management of young patients with bladder cancer, we examined whether bladder urothelial cancer in young patients behaved differently from that in the elder patients.</p><p><b>METHODS</b>From 1994 to 2008, a database of bladder urothelial cancer patients at a major tertiary medical center was retrospectively reviewed. The clinical and pathological parameters of patients who were less than 40 years of age and a series of patients older than 40 years of age as the control group during the same period were compared. A survival analysis was performed using the Kaplan-Meier method and log-rank test, and Cox regression was performed to identify clinical parameters that affected the clinic outcomes.</p><p><b>RESULTS</b>Young bladder cancer patients had a lower male-to-female ratio and were less likely to have advanced stages and high-grade cancers at the initial diagnosis. Tumors in young bladder cancer patients tended to be less multifocal at diagnosis. In addition, young patients had a lower recurrence rate and longer recurrence interval than older patients. The Kaplan-Meier curve and Log-rank test showed that young patients had significantly better cancer specific survival than old patients. The univariate and multivariate Cox regression analysis revealed that tumor grade is the sole predictor for tumor recurrence in young patients.</p><p><b>CONCLUSIONS</b>Young patients with bladder cancer have favorable pathological features and clinical outcomes than older patients. These findings argue for more conservative management approaches for young patients with bladder cancer.</p>

Efficacy and tolerability of exenatide monotherapy in obese patients with newly diagnosed type 2 diabetes: a randomized, 26 weeks metformin-controlled, parallel-group study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Incretin-based therapies provide additional options for treating type 2 diabetes. We aimed to evaluate the efficacy and tolerability of exenatide monotherapy in obese patients with type 2 diabetes.</p><p><b>METHODS</b>A 26-week, metformin controlled, parallel-group study was conducted among antidiabetic drug-naive obese patients aged > 18 years, and with type 2 diabetes. Participating patients were randomly assigned to receive exenatide or metformin treatments.</p><p><b>RESULTS</b>Fifty-nine patients (age (50.5 ± 8.6) years, body mass index (BMI) (30.2 ± 1.6) kg/m(2), and hemoglobin A1C (HbA(1C) (8.2 ± 1.2)%) were enrolled in the study. Glucose control and weight reduction improved in both groups receiving treatment. HbA(1C) and oral glucose tolerance test (OGTT) 2 hour glycemia reduction with exenatide was superior to that obtained with metformin ((-2.10 ± 1.79)% vs. (-1.66 ± 1.38)%, (-5.11 ± 2.68) mmol/L vs. (-2.80 ± 2.70) mmol/L, P < 0.05). Fast plasma glucose (FPG) reduction was not significantly different between the two groups ((-1.8 ± 2.0) mmol/L vs. (-1.6 ± 1.7) mmol/L, P > 0.05). Patients treated with exenatide achieved HbA(1C) of < 7% (97% of patients) and < 6.5% (79%) at end-point, vs. 93% and 73% with metformin (P > 0.05). Greater weight reduction was also achieved with exenatide ((-5.80 ± 3.66) kg) than with metformin ((-3.81 ± 1.38) kg, P < 0.01). Homeostasis model assessment of beta-cell function (HOMA-B) was not significantly increased, but the insulinogenic index and HOMA for insulin sensitivity (HOMA-S) were greatly improved in the exenatide group (P < 0.05). Nausea was the most common adverse effect in exenatide treatment (30% vs. 8%; P < 0.05), but most cases were of mild to moderate intensity. One case in the exenatide group was withdrawn early because of severe nausea. Hypoglycemia events were often observed during the first 4 weeks, with 12% of patients in the exenatide and 3.2% in metformin groups, respectively (P < 0.05). No incidents of severe hypoglycemia were reported.</p><p><b>CONCLUSIONS</b>Exenatide demonstrated more beneficial effects on HbA(1C), weight reduction and insulin resistance during 26 weeks of treatment, but there were more hypoglycemic events and mild-to-moderate nausea compared with metformin. These results suggested that exenatide monotherapy may provide a viable treatment option in newly developed type 2 diabetes.</p>

A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma / 国际口腔科学杂志·英文版

Oral squamous cell carcinoma (OSCC) has a high incidence of cervical micrometastases and sometimes metastasizes contralaterally because of the rich lymphatic intercommunications relative to submucosal plexus of oral cavity that freely communicate across the midline, and it can facilitate the spread of neoplastic cells to any area of the neck consequently. Clinical and histopathologic factors continue to provide predictive information to contralateral neck metastases (CLNM) in OSCC, which determine prophylactic and adjuvant treatments for an individual patient. This review describes the predictive value of clinical-histopathologic factors, which relate to primary tumor and cervical lymph nodes, and surgical dissection and adjuvant treatments. In addition, the indications for elective contralateral neck dissection and adjuvant radiotherapy (aRT) and strategies for follow-up are offered, which is strongly focused by clinicians to prevent later CLNM and poor prognosis subsequently.