Study on transfusion-related acute lung injury caused by HLA-Ⅱ antibody / 中国输血杂志

【Objective】 To explore the risk factors of transfusion-related acute lung injury (TRALI). 【Methods】 The clinical symptoms, signs, imaging examinations, and laboratory test results of two patients with TRALI after blood transfusion were retrospectively analyzed, and human leukocyte antigen (HLA) genotyping of the patient and HLA antibodies typing of the plasma donors were performed. 【Results】 The clinical manifestations and laboratory parameters of two patients were consistent with those of TRALI after blood transfusion. After timely clinical respiratory support treatment, all patients were improved. Blood donors produced high titers of HLA-Ⅱ antibodies after pregnancy, including antibodies that specifically recognize the patient′s HLA antigen. 【Conclusion】 Two patients developed TRALI after platelet transfusion from a female blood donor, which was caused by HLA-Ⅱ antibodies.

Novel Variants in the FIG4 Gene Associated With Chinese Sporadic Amyotrophic Lateral Sclerosis With Slow Progression

Background@#and Purpose Mutations in the FIG4 gene have been linked to amyotrophic lateral sclerosis (ALS) type 11 in Caucasian populations. The purpose of this study was to identify FIG4 variants in a cohort of 15 familial ALS (FALS) indexes and 275 sporadic ALS (SALS) patients of Han Chinese origin. @*Methods@#All 23 exons of FIG4 were sequenced using targeted next-generation sequencing.An extensive literature review was performed to detect genotype-phenotype associations of FIG4 mutations. @*Results@#No FIG4 variants were identified in the FALS patients. One novel heterozygous missense variant (c.352G>T [p.D118Y]) and one novel heterozygous nonsense variant (c.2158G>T [p.E720X]) in FIG4 were identified in two SALS patients. The p.E720X variant is interpreted as likely pathogenic while the p.D118Y variant is a variant of uncertain significance. The patient carrying the p.E720X mutation developed lower-limb-onset slowly progressive ALS, and survived for 11.5 years. The patient harboring the FIG4 p.D118Y variant also presented with progressive ALS, with the score on the ALS Functional Rating Scale–Revised (ALSFRS-R) decreasing by 0.4 per month. The rate of decrease in the ALSFRS-R scores from symptom onset to diagnosis seemed to be lower in the patients carrying FIG4 variants than the no-FIG4-mutation ALS patients in this study. @*Conclusions@#Our findings suggest that ALS patients carrying FIG4 mutations are not common in the Chinese population and are more likely to exhibit slow progression.

Differences in non-suicidal self-injury behaviors between only-child and non-only-child adolescents with mood disorders: a cross-sectional study / 中国当代儿科杂志

OBJECTIVES@#To investigate the differences in non-suicidal self-injury (NSSI) behaviors between only-child and non-only-child adolescents with mood disorders.@*METHODS@#A three-stage sampling method was used to perform a cross-sectional survey of 529 adolescents, aged 12-18 years, who had mood disorders and NSSI behaviors. These adolescents were sampled from the outpatient service of 20 mental hospitals in 9 provinces of China from August to November 2020. A self-made questionnaire was used to collect general demographic data. The Functional Assessment of Self-Mutilation, Beck Scale for Suicide Ideation, Kessler Psychological Distress Scale, Stress Mindset Measure-General, Multidimensional Scale of Perceived Social Support, Multidimensional Students' Life Satisfaction Scales, and Rosenberg Self-Esteem Scale were used to collect the information on self-injury behaviors and psychological factors in these adolescents.@*RESULTS@#A total of 529 adolescents with mood disorders and NSSI behaviors were surveyed, among whom 375 were only-child adolescents and 154 were non-only-child adolescents. Compared with the non-only-child group, the only-child group had a significantly higher total score of Functional Assessment of Self-Mutilation (P<0.05) .The type and frequency of self-injury in the only-child group were significantly higher than those in the non-only-child group (P<0.05). Psychological analysis showed that compared with the non-only-child group, the only-child group had a significantly lower score of self-esteem (P<0.05) and significantly higher scores of psychological distress and depressive symptoms (P<0.05). The multiple linear regression analysis showed that the score of suicidal ideation was positively correlated with the frequency of NSSI behaviors in both only-child and non-only-child adolescents with mood disorders (P<0.05); in the only-child adolescents, the level of self-esteem was negatively correlated with the frequency of NSSI behaviors (P<0.05), and the score of stress perception was positively correlated with the frequency of NSSI behaviors (P<0.05); in the non-only-child adolescents, the score of anxious emotion was positively correlated with the frequency of NSSI behaviors (P<0.05).@*CONCLUSIONS@#Among the adolescents with mood disorders and NSSI behaviors, the only-child adolescents tend to have a higher frequency of self-injury and poorer mental health, and therefore, the only-child adolescents with mood disorders and NSSI behaviors need more attention.

Effect of ergosterol peroxide derivatives on the proliferation ，migration and invasion of human triple negative breast cancer cell / 中国药房

OBJECT IVE To study the effects of ergosterol peroxide derivatives EP-3P on the proliferation ，migration and invasion of human tripe negative breast cancer cell MDA-MB- 231，and to provide reference for the development of breast cancer related drugs. METHODS MTT assay was adopted to detect the proliferation of MDA-MB- 231 cells after treated with 0（blank control），1.25，2.5，5，10，20，40 μmol/L EP-3P for 24，48 and 72 h. Wound healing assay and Transwell chamber method were adopted to detect the migration and invasion ability of MDA-MB- 231 cells after treated with 0（blank control ），5，10，20 EP-3P for 24 h. The apoptosis and cell cycle distribution were detected by flow cytometry. Western blot assay was used to detect the expressions of B-cell lympho ma-2（Bcl-2），Bcl-2 associated X protein （Bax），caspase-3，cleaved-caspase-3，cytochrome C （Cyt-C），matrix metalloproteinase- 2（MMP-2）and MMP- 9. RESULTS Compared with blank control group ，2.5，5，10，20，40 μmol/L EP-3P could significantly increase the inhibitory rate of cell proliferation （P＜0.05 or P＜0.01）in a dose and time- dependent manner. After 24 h treatment of EP- 3P（10，20 μmol/L），the rate of cell migration and the number of invasive cells were decreased significantly （P＜0.01），and cell was arrested at G 2/M stage （P＜0.05 or P＜0.01）；the apoptotic rate was increased significantly （P＜0.05）；the protein expressions of Bax ，Cyt-C and cleaved-caspase- 3 were upregulated significantly ， while those of Bcl- 2，caspase-3，MMP-2 and MMP- 9 were downregulated significantly （P＜0.01）. CONCLUSIONS EP-3P can inhibit the proliferation ，migration and invasion of human tripe negative breast cancer cells MDA-MB- 231 through mitochondrial mediated endogenous caspase pathway ，and induce the apoptosis of cells .

Influence of three combined exercise programs on improving sleep quality among college students with sleep disorders / 中国学校卫生

Objective@#To explore the improvement influence of three combined exercise programs on sleep quality among college students with sleep disorders, so as to provide reference for the construction of exercise intervention programs for sleep disorder.@*Methods@#A total of 35 college students with sleep disorders were randomly divided into AR group ( n =10), AM group ( n =8), RM group ( n =9) and CG group ( n =8). The three exercise groups were provided with exercise intervention for 8 weeks, 3 times/week , 60 min/time, and the CG group maintained previous lifestyle.Before and after the intervention,evaluation of subjective sleep quality and reduction rate of sleep disorder by PSQI, and Actigraph GT3X+ was used to monitor the changes in the objective sleep quality.@*Results@#After the intervention,the total score of PSQI ( t =3.49, 2.31, 2.73), sleep quality score ( t =2.71, 3.00 , 5.29),sleep duration of AR group ( t =2.74), daytime dysfunction of AM group ( t =2.64) and sleep duration of RM group ( t = 2.29) significantly decreased ( P ＜0.05); The scores of sleep duration in AM group were significantly lower than those in AR group, and the scores of PSQI,sleep quality and daytime dysfunction in AM group were significantly lower than those in CG group (P<0.05). After intervention,TST ( t =-4.41, -8.37, -6.79) and SE ( t =-4.40, -5.86, -4.91) of AR group, AM group and RM group significantly increased( P <0.05), SOL ( t =4.18, 9.93), WASO ( t =2.91, 3.46) and NA ( t =4.80, 3.37) of AM group and RM group significantly decreased ( P <0.05). The changes of TST,SE and WASO in RM group were significantly higher than those in CG group, and SOL was significantly lower than those in CG group ( P <0.05).@*Conclusion@#The three kinds of combined exercise programs can improve the subjective and objective sleep quality of college students with sleep disorders, and reduce the incidence of sleep disorders; different combined exercise programs have different influence on the improvement of sleep quality of college students with sleep disorders, aerobic combined meditative movement exercise program has a prominent influence on the improvement of subjective sleep quality, and resistance combined meditative movement exercise program has a prominent influence on the improvement of objective sleep quality.

Clinical features and transfusion effectiveness of patients with hematological diseases underwent acute transfusion reactions / 中国输血杂志

【Objective】 To demonstrate the real incidence and clinical features of acute transfusion reactions (ATRs) and analyze its association with transfusion effectiveness. 【Methods】 The blood transfusion process of patients in the Hematology Department in our hospital from March 16, 2018 to March 16, 2019 was observed and followed up. The vital signs and clinical features were recorded, the clinical data and relevant laboratory examination results were collected, and the correlation between ATRs, clinical features and transfusion effectiveness was statistically analyzed. 【Results】 A total of 2500 transfusions were observed in the Hematology Department, out of which 138 patients developed 242 ATRs. The overall incidence of ATRs was 9.68% (95% CI, 8.52%~10.94%) and the incidence of ATRs during platelets transfusion was the highest. The clinical features of most ATRs were mild and no fatal consequences occurred. No significant difference was found in the association between transfusion effectiveness with ATRs in platelets and red blood cells transfusion (P>0.05). 【Conclusion】 None of the ATRs observed in this study resulted in serious consequences or had effect on the transfusion effectiveness. The characteristics presented in these reactions may provide certain references for clinical practice.

Simultaneous Determination of 8 Components Contents in Shenqi Jianwei Granules by UPLC-Q-Exactive Qua- drupole Electrostatic Field Orbital Hydrazine High Resolution Mass Spectrometry / 中国药房

OBJECTIVE：To develo p a method for simultaneous determination of chlorogenic acid ，paeoniflorin，hesperidin， ammonium glycyrrhizate ，limonin，nobiletin，tangeretin and lobetyolin in Shenqi jianwei granules. METHODS ：UPLC-Q-Exactive quadrupole electrostatic field orbital hydrazine high resolution mass spectrometry method was adopted. The determination was performed on Hypersil Gold C 18 column with a mobile phase consisted of acetonile- 0.1％ formic acid （gradient elution ）at the flow rate of 0.4 mL/min. The column temperature was set at 35 ℃，the sample size was 1 μL. High resolution full scan experiments was performed over the range of m/z 100-1 000 in heating electro-spray lonization and positive mode to extract the accurate mass of analytes. The contents of 8 components were determined in 3 batches of samples from 2 manufacturers. RESULTS ：The linear range of chlorogenic acid ，paeoniflorin，hesperidin，ammonium glycyrrhizate ，limonin，nobiletin，tangeretin and lobetyolin were 0.12-1.46，3.51-42.15，2.71-32.55，1.76-21.10，0.04-0.46，0.04-0.24，0.02-0.21 and 0.01-0.25 μg/mL，respectively（all r≥0.999 0）. The limits of quantitation were 6.06，0.04，0.03，0.02，7.60，0.05，0.02，6.25 ng/mL，respectively. The limits of detection were 3.03，0.01，0.01，0.01，3.80，0.01，0.01，2.50 ng/mL，respectively. RSDs of precision ，reproducibility and stability （24 h）tests were all lower than 5％（n＝6）. Average recoveries were 93.16％-97.78％（RSD≤5％，n＝6）. The contents of 8 components in 3 batches of samples were 12.62-13.20，265.01-472.26，234.20-278.90，173.10-255.74，2.32-2.83，2.37-3.58，0.79-1.22，0.91-1.78 μg/g，respectively. CONCLUSIONS ：The established method is simple ，convenient，rapid，accurate，highly reproducible and sensitive，which can be used for quality control of Shenqi jianwei granules.

Effect of the focal adhesion kinase inhibitor TAE226 on the epithelial-mesenchymal transition in human oral squamous cell carcinoma cell line / 华西口腔医学杂志

OBJECTIVE@#To study the effect of the focal adhesion kinase inhibitor TAE226 on epithelial-mesenchymal transition (EMT) in human oral squamous cell carcinoma (OSCC) cell line.@*METHODS@#HSC-3 and HSC-4 cells were cultured with TAE226 under different concentrations (0, 1, 5, and 10 μmol·L⁻¹) for 24, 48, and 72 h. Real-time quantitative polymerase chain reaction was performed to detect the mRNA expressions of E-cadherin and Vimentin. The protein expressions of E-cadherin and Vimentin were determined by Western blot assay after 48 h of TAE226 treatment.@*RESULTS@#Real-time quantitative polymerase chain reaction showed that increasing the TAE226 dose and reaction time resulted in increased and decreased E-cadherin and Vimentin mRNA expressions, respectively (P<0.05). Western blot assays showed that increasing the TAE226 dose resulted in increased and decreased E-cadherin and Vimentin protein expressions, respectively (P<0.05).@*CONCLUSIONS@#TAE226, which is expected to be an effective drug for OSCC treatment, can effectively inhibit the EMT of the OSCC cell line.

Fetal growth, fetal development, and placental features in women with polycystic ovary syndrome: analysis based on fetal and placental magnetic resonance imaging / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

OBJECTIVE@#Polycystic ovary syndrome (PCOS), a common endocrine-metabolic dysfunction in reproductive-aged women, may be involved in compromised pregnancy and offspring outcomes. This study aimed to investigate whether maternal PCOS affects fetal growth, fetal development, and placental features.@*METHODS@#This retrospective case-control study included 60 pregnant women with PCOS (PCOS group) and 120 healthy pregnant women without PCOS (control group). Fetal magnetic resonance imaging (MRI) was performed followed by an ultrasound examination and indications for imaging, including known or suspected fetal pathology, history of fetal abnormality in previous pregnancy or in a family member, and concern for placenta accreta. Fetal MRI images were analyzed for head circumference (HC), abdomen circumference (AC), lung-to-liver signal intensity ratio (LLSIR, a prenatal marker of fetal lung maturity), lengths of liver and kidney diameters in fetuses, and placental relative signal intensity on T2-weighted single-shot fast spin echo (SSFSE) imaging (rSI@*RESULTS@#Compared to the control group, the PCOS group showed the following characteristics: (1) smaller biparietal diameter and femur length in fetuses (P=0.026 and P=0.005, respectively), (2) smaller HC in fetuses (evident after 32 weeks; P=0.044), (3) lower LLSIR and smaller dorsoventral length of liver in fetuses (evident before 32 weeks; P=0.005 and P=0.019, respectively), and (4) smaller placental thickness (evident before 32 weeks; P=0.017). No significant differences in placental rSI@*CONCLUSIONS@#There exist alterations of fetal growth, fetal development, and placental features from women with PCOS.

Mediating effect of resilience on nursing occupational risk and job performance in nurses / 中华劳动卫生职业病杂志

Objective@#To analyze Nursing Occupational Risk, the relationship between resilience and job performance, and investigate the mediating effects of resilience on Nursing Occupational Risk and job performance.@*Methods@#406 nurses from33 clinical departments of Chengdu first-class hospital were recruited by randomsampling method. Thier Nursing Occupational Risk, resilience and job performance were interviewed by nursing occupational risk assessment questionnaire, the Scale of medical staff resilience and the job performance questionnaire, and analyze the relationship between variables.@*Results@#The clinical nurses＇ resilience is 82.98±10.05, the clinical nurses' job performance is 145.79±23.55; here was a positive correlation between clinical nurses' resilience and job performance (P<0.05) ; three variable of resilience can explain 33.2% of the variation of clinical nurses job performance; in the highest the Nursing Occupational risk, resilience served to mediate the relationship between Nursing Occupational Risk and job performance, which was 56.77% of the total effect respective.@*Conclusion@#resilience are closely related to job performance. Resilience plays mediating role in the relationships between Nursing Occupational Risk and job performance, three dimensions of resilience can predict nurses' job performance. Improving the resilience of nurses can effectively improve their job performance.

Feasibility of low-dose radiation CT scanning for liver 3D modeling printing / 医学研究生学报

Objective In the wide clinical practice of liver 3D printing, its related high-dose CT radiation has been somehow neglected and resulted in unnecessary radiation injury to the patients. This study was to explore the feasibility of liver 3D modeling printing with the low-dose radiation CT scanning technique.　Methods　This retrospective study included 40 patients undergoing liver 3D modeling printing from January 2016 to June 2018, who were equally randomized into a low-dose radiation group (100 kVp, by automated tube current modulation [ATCM] and adaptive statistical iterative reconstruction [ASIR]) and a normal-dose radiation group (120 kVp, 250 mA by filter back projection [FBP]), both with contrast agent Iohexol at 300 mgI/m1. We obtained the values of three-phase enhanced CT scanning of the abdominal aorta, portal vein and liver parenchyma, background noise (BN), volume CT dose index (CTDI), dose length product (DLP), contrast noise ratio (CNR) and effective radiation dose (ED). We input the CT DICOM data into the 3D printer for liver modeling printing and subjectively assessed the results. Results There were statistically significant differences between the low-dose and normal-dose radiation groups in the CTDI, DLP and ED (P 0.05). The ED was decreased about 35.8% in the low-dose group as compared with that in the normal-dose group ([2.58 ± 0.79] vs [4.02 ± 0.26] mSv, P 0.05). Conclusion Low-dose radiation CT scanning technology can meet the clinical requirement of liver 3D modeling printing and significantly reduce the patient’s exposure to CT radiation.

Effects on vibration perception threshold and the quality of life in the patients of high-risk diabetic foot treated with the pestle needling therapy / 中国针灸

OBJECTIVE@#To evaluate the effects of the pestle needling therapy on the vibration perception threshold (VPT) and the quality of life (QOL) in the patients of high-risk diabetic foot.@*METHODS@#A total of 132 patients of high risk diabetic foot were randomized into an observation group and a control group, 66 cases in each one. In the control group, the routine treatment and nursing for diabetes were applied. In the observation group, on the base of the treatment as the control group, the pestle needling therapy was used at , , , Zusanli (ST 36), Yongquan (KI 1), Sanyinjiao (SP 6) and Taixi (KI 3). The intervention with the pestle needling therapy was given once every day, consecutively for 4 weeks. The follow-up visit was conducted in 3 months and 6 months after the intervention. Vibration perception threshold (VPT) was observed before and after intervention in the two groups. Separately, before intervention, at the end of intervention, 3 months after intervention and 6 months after intervention, the type 2 diabetes mellitus quality life scale (DMQLS), the revised edition was adopted to compare the QOL between the two groups. The effects were evaluated in the two groups.@*RESULTS@#After intervention, the VPT and QOL were all improved in the two groups (<0.01, <0.05). In the observation group, after intervention, VPT at the first toes and the dorsum of the feet was lower than the control group at the same time point (all <0.01). In the observation group, the total scores and the score of each dimension item in the DMQLS of the revised edition were all lower than the control group correspondently at the end of intervention, 3 months after intervention and 6 months after intervention (<0.01, <0.05). The repeated ANOVA results showed that the differences were significant in the total scores and the score of each dimension in the aspects of time, inter-group and interaction effect (<0.01, <0.05). The total scores and score of each dimension item in the DMQLS were lower than those the earlier time point (<0.01, <0.05). The total effective rate was 100.0% in the observation group, which was superior to 95.1% (59/62) in the control group (<0.05).@*CONCLUSION@#The pestle needling therapy reduces the foot VPT and improves the sensory nerve function of the foot and the QOL in the patients of high-risk diabetic foot.

Comparative hearing outcomes of tympanostomy tubes and combined with adenoidectomy for pediatric otitis media effusion treatment:a Meta-analysis / 实用医学杂志

Objective To investigate the hearing outcome efficiency of tympanostomy tubes and when combined with adenoidectomy for otitis media with effusion treatment. Methods A systematic literature review of tympanostomy tubes and tympanostomy tubes combined with adenoidectomy were performed using PubMed, EMBASE,the Cochrane Library,MEDLINE,all of the included studies were randomized controlled trial. The quality of included studies was evaluated according to the Risk of Bias Table of the Cochrane Handbook. Data were analyzed with Review Manager 5.02 software. Heterogeneity was examined,and forest plot was drawn. Results All of the included 4 studies were randomized controlled trials. At 6 month follow-up patients,the tym-panostomy tubes and tympanostomy tubes combined with adenoidectomy had no difference in hearing improvement (WMD = 1.06,95%CI-0.18 ~ 2.29,P = 0.09). At 12 month follow-up patients,the tympanostomy tubes com-bined with adenoidectomy were better than tympanostomy tubes alone(WMD = 3.03,95%CI 0.91 ~ 5.14,P =0.005). Conclusions The meta analysis result reveals that tympanostomy tubes combined with adenoidectomy have an advantage in long term follow up time for hearing improvement in children's otitis media with effusion treatment.

Coexistence of Amyotrophic Lateral Sclerosis in the Proband of an X-Linked Charcot-Marie-Tooth Disease Type 1 Pedigree in China

No abstract available.

Magnetic resonance imaging for pelvic tumors during pregnancy: manifestations and clinical application / 中华围产医学杂志

Objective To investigate the manifestations and clinical application of magnetic resonance imaging (MRI) in the diagnosis of pelvic tumors during pregnancy.Methods Clinical data and MRI manifestations of 161 patients attending Women's Hospital,School of Medicine,Zhejiang University with pelvic tumors during pregnancy between March 2013 and July 2016 were retrospectively analyzed.MRI manifestations and clinical treatments of different tumors in pregnancy were summarized.All data were analyzed by descriptive statistics.Results (1) The gestational ages at initial diagnosis of the 161 patients ranged between 8-39 weeks and the average gestational age was (29±-4) weeks.Of all patients,147 (91.3％) had benign tumor,while the other 14(8.7％) were diagnosed as malignanices.The sensitivity,specificity and accuracy of MRI in the diagnosis of malignancy during pregnancy were 92.8％ (13/14),97.3％ (143/147) and 96.7％ (156/161).Uterine neoplasm,ovarian tumor,intestinal tumor and pelvic peripheral nerve schwannoma respectively accounted for 67.1％ (108/161),29.8％ (48/161),1.9％ (3/161) and 1.2％ (2/161) of all cases.(2) Among the 108 gravidas with uterine neoplasm,104 cases of leiomyoma continued to term pregnancy,among which 71 underwent myomectomy after vaginal delivery and 33 had myomectomy during cesarean section;the other four cases of cervical cancer terminated their pregnancy.(3) Among the 48 gravidas with ovarian tumor,38 were diagnosed as having benign tumor by MRI and continued to term pregnancy;five were diagnosed with tumor pedicle torsion and treated with emergency operation because of acute abdominal disease;two patients who were both in their second trimester (16 and 20 gestational weeks) were diagnosed with ovarian cancer complicated with peritoneal metastasis by MRI and decided to terminate pregnancy;another two patients with uncertain preoperative diagnosis of ovarian cancer were followed up closely to term and the tumor was removed during cesarean section;one patient with ovarian malignant tumor,which was diagnosed by MRI at the 32nd gestational week,received cesarean section and cytoreductive surgery.(4) In the three gravidas with intestinal tumor,one was complicated with sigmoid colon cancer and underwent cesarean section,radical resection of sigmoid colon tumor,colostomy and enterodialysis at 28+3 weeks of gestation;one with appendiceal mucinous adenocarcinoma was monitored closely until full-term pregnancy and received right hemicolectomy during cesarean section;the third case with malignant stromal tumor of the small intestine underwent cesarean section at 30+5 weeks of gestation as well as the completer resection of tumor.(5) One gravida with pelvic peripheral nerve schwannomas was diagnosed with pelvic schwannoma and underwent cesarean section and tumor extirpation at term.The other one underwent tumor extirpation prior to delivery due to the larger size of tumor and had a vaginal delivery at term.Conclusions MRI can provide more precise information for prenatal diagnosis of pelvic tumors during pregnancy.

Safety and efficacy of three-dimensional shaping of titanium plate in subtemporal repair of skull defects: study protocol for a data analysis of 38 patients / 中国组织工程研究

BACKGROUND: Skull damage is necessary after decompressive craniectomy. Previously used autologous bone, allogeneic bone, and organic material are associated with the risk of an unsatisfactory cosmetic outcome and infection. Titanium mesh is an ideal material for cranioplasty. Digital three-dimensional shaping of titanium mesh allows it to perfectly match the skull defect and can restore the anatomic appearance of the defective area.OBJECTIVE: To explore the safety and effectiveness of the three-dimensional shaping of titanium plate in subtemporal repair of skull defects.METHODS: We retrospectively analyzed the surgical and follow-up data of 38 patients with skull defects who underwent subtemporal repair using three-dimensional shaping of a titanium plate at the Department of Neurosurgery, Wujiang Hospital (The First People's Hospital of Wujiang District), Nantong University, China, from January 2015 to December 2016. The primary outcome measure was the incidence of complications within postoperative 12 months. The secondary outcome measures were the Glasgow outcome scale score, Karnofsky performance scale score, National Institutes of Health stroke scale score, and skull computed tomography scan results at 1, 6, 12, 18, and 24 months after repair. This trial was registered in the Chinese Clinical Trial Registry (identifier: ChiCTR-IOC-17012947) at October 11th, 2017. RESULTS AND CONCLUSION: Partial results have been obtained from 38 patients who have been followed up for 6 to 24 months. No complications or adverse reactions occurred. Skull computed tomography scan results revealed that the titanium mesh and nail were well fixed, the skull shape was symmetrical, and no subcutaneous effusion or intracranial hemorrhage occurred. Complications, neurological function, and imaging findings in patients with frontotemporal skull defects provide an experimental basis for three-dimensional shaping of titanium plates in subtemporal repair of frontotemporal defects.

Effects of kangnao liquid on the expressions of LC3 and Beclin 1 in hippocampus after cerebral ischemia-reperfusion in rats / 天津医药

Objective To observe the effect of kangnao liquid on the expressions of LC3 and Beclin 1 in hippocampus after cerebral ischemia-reperfusion in rats, and to discuss the mechanism. Methods A total of 48 male SD rats were randomly divided into four groups:sham-operation group, model group, kangnao liqiud group [14.30 g/(kg·d)] and edaravone group [10.00 mg/(kg·d)], 12 rats in each group. The rats in kangnao liqiud group and edaravone group were administrated by intragastric administration. The rats in sham-operation group and model group were administrated with equal volume of normal saline. After treating for 7 days, except for the sham-operation group, the middle cerebral artery occlusion (MCAO) model was made by suture method in the other three groups. After 2 h of ischemia, the rats were reperfused for 24 h. Six rats in each group were randomly selected for observing the neurological function. TTC staining was used to observe the morphology of the brain tissue and calculate the percentage of infarction. The morphology of the cerebral cortex and hippocampus was observed by HE staining in the remaining animals, and the expressions of LC3 and Beclin 1 in the hippocampus were detected by immunohistochemical staining. Results Compared with the sham-operation group, model group showed an obvious neurological deficit, and the percentage of cerebral infarction increased significantly. At the same time, nerve cells of cerebral cortex and hippocampus revealed degeneration and necrosis, stroma edema, and the expressions of LC3 and Beclin 1 in hippocampus significantly increased (P<0.05). Compared with the model group, the neurological deficit symptoms and the percentage of cerebral infarction significantly reduced, changes of neuron morphology were lighter, and the expressions of LC3 and Beclin 1 decreased significantly in kangnao liqiud group and edaravone group (P<0.05).Conclusion Kangnao liquid shows protective effects on cerebral ischemia-reperfusion, which may be related with the decreased expressions of LC3 and Beclin 1 in hippocampus after cerebral ischemia-reperfusion in rats.

Curative effect and safety of romethamine combined with dexamethasone on the postpartum hemorrhage for patients with high risk pregnancy / 药物评价研究

Objective To explore the curative effect and safety of romethamine combined with dexamethasone on the postpartum hemorrhage for patients with high risk pregnancy.Methods 80 patients with high risk pregnancy were enrolled in our hospital from June 2014 to June 2016,of which patients divided into two group randomly,Group A (n =40) accepted romethamine for hemostasis treatment,and Group B (n =40) adopted romethamine combined with dexamethasone treatment.The clinical effect and hemorrhage of patients with postpartum hemorrhage were compared,and the adverse reactions were recorded and analyzed in the period of treatment.Results After treatment,the difference of total effective rate for postpartum hemorrhage from two groups was no significance.After given medicines 0.5 h respectively in delivery process,the SBP,DBP and HR of all parturient women were rising compared with before medicine administration remarkably (P ＜ 0.05),but the difference of those between two groups was no significance.Within 24 h after delivery,the hemorrhage of Group B was lower significantly than those patients in Group A (P ＜ 0.05).The difference of shock index (SI) from Group A and Group B was no significance.The incidence of nausea and vomiting in Group B was lower than those Group A significantly (P ＜ 0.05),and the case of total adverse reactions in group B was fewer significantly than those Group A (P ＜ 0.05).Conclusions The romethamine combined with dexamethasone for the postpartum hemorrhage in patients with high risk pregnancy deserved popularization in clinic,of which not only possessed remarkably clinical effect and well safety,but also controlled the postpartum hemorrhage effectively and decreased the incidence of the adverse reactions in the period of treatment.

Acute Effect of Carotid Artery Stenting on Hemodynamics / 中国循环杂志

Objective: To investigate the acute effect of carotid artery stenting (CAS) on hemodynamics. Methods: We retrospectively analyzed 170 consecutive patients who received CAS in our hospital from 2014-09 to 2015-09. The acute effects of proximal internal CAS on blood pressure (BP) and heart rate (HR) were studied, the patients were followed-up for a month to observe the relationship between CAS and peri-operative adverse events occurrence. Results: ① Compared with pre-operative condition, the all day mean systolic blood pressure (SBP) from (126.6±15.1, 93-175) mmHg decreased to (117.7±13.7, 87-158) mmHg, P<0.01, all day mean DBP from (72.8±11.5, 49-100) mmHg decreased to (67.3±10.3, 48-90) mmHg, P<0.01, and all day HR from (66.3±6.8, 49-84) bpm decreased to (62.6±7.2, 49-88) bpm, P<0.01. ② The incidence of hemodynamic instability (HI) was 51.8％ (88/170) and the occurrence rates of thypertension, hypotension and bradycardia were 3.5％ (6/170), 39.4 ％ (67/170) and 22.4％ (38/170) respectively. Multivariate regression analysis showed that HI was closely related to gender, history of hypertension, bilateral CAS and carotid bifurcation lesions. Upon HI onset, BP and HR could be restored to normal via intravenous infusion of vasoactive drugs and 6 (3.5％) patients having the medication time more than 24 hours. ③ Peri-operative adverse events happened in 8 (4.7％) patients including 4 transient ischemic attack, 2 minor stroke and 2 major stroke (1 patient died). The ratio of adverse events was 2.4％ (2/82) in Non-HI group and 6.8％ (6/88) in HI group, P=0.32. In HI group, the incidences of hypertension, hypotension, bradycardia and hypotension combining bradycardia were 16.7％ (1/6), 6.8％ (3/44), 0％ (0/15) and 8.7％ (2/23) respectively, compared with the overall patients' group, P=0.669, P=0.723, P=0.793 and P=0.658 respectively. Conclusion: HI incidence was relatively high in peri-operative period of CAS; gender, history of hypertension, bilateral CAS and carotid bifurcation lesions were the independent predictors for CAS occurrence. It is important to reasonably use vasoactive drugs in time for preventing and reducing HI related adverse events.

Synthesis and anti-hepatocellular carcinoma activity of novel O-vinyl diazeniumdiolate-based nitric oxide-releasing derivatives of oleanolic acid / 中国天然药物

Considering that high levels of nitric oxide (NO) exert anti-cancer effect and the derivatives of oleanolic acid (OA) have shown potent anti-cancer activity, new O-vinyl diazeniumdiolate-based NO releasing derivatives (5a-l, 11a-l) of OA were designed, synthesized, and biologically evaluated in the present study. These derivatives could release different amounts of NO in liver cells. Among them, 5d, 5i, 5j, 11g, 11h, and 11j released more NO in SMMC-7721 cells and displayed stronger proliferative inhibition against SMMC-7721 and HepG2 cells than OA and other tested compounds. The most active compound 5j showed almost 20-fold better solubility than OA in aqueous solution, released larger amounts of NO in liver cancer cells than that in normal ones, and exhibited potent anti-hepatocellular carcinoma activity but little effect on the normal liver cells. The inhibitory activity against the cancer cells was significantly diminished upon addition of an NO scavenger, suggesting that NO may contribute, at least in part, to the activity of 5j.