Fruit variation and geographical distribution of citron / 中国中药杂志

The ripe dried fruit of citron(Citrus medica) is one of the important sources of Chinese herb Citri Fructus. At the same time, it is also grown for edible and ornamental uses. There are many species and abundant genetic variation. To clarify the intraspecific variation and resource distribution of citron, this study investigated the variation in 11 citron fruits, basically covering the main species in China, including Xiaoguo citron(C. medica var. ethrog), Goucheng(C. medica var. yunnanensis), Muli citron(C.medica var. muliensis), Dehong citron(C.medica×Citrus spp.), Fuzhou citron(C.medica×C.grandis?), Mawu(C.medica×C.grandis?), Cangyuan citron, Binchuan citron, Sweet citron, Big citron, and Small citron. The natural communities of citron were proved to be mainly distributed in the southwestern and western Yunnan and southeastern Tibet of China, with Yunnan, Sichuan, Guangxi, Chongqing, Hubei, and Zhejiang identified as the main production areas. Citron has also been widely grown in India, the Mediterranean region, and the Caribbean coast countries. The field investigation revealed the large-scale intraspecific variation of citron fruits. Most of the fruits are oval-like or sphere-like in shape. The fruits are green when raw and yellow when ripe, with oil cell dots on the skin, stripe-likes running from top to bottom, and bulge at the top. Usually, in the smaller citron fruits, the pulp and juice vesicles are better developed and the central columella is tighter. By contrast, the juice vesicles and central columella in larger fruits became more vacant, with carpels visible, and the apex segregation and development of the carpels is one of the reasons for variation. These variations should be given top priority in the future variety selection and breeding, and the quality differences of different citron species and their mechanisms should be further studied. In particular, variety selection and classification management according to their medicinal or edible purposes will provide scientific and technological supports for the orderly, safe, and effective production of citron products consumed as food and medicine.

Fulminant type 1 diabetes mellitus in pregnancy

Fulminant type 1 diabetes mellitus (FT1DM) has received clinical attention for its low incidence and poor prognosis. Currently, few cases of FT1DM are associated with pregnancy in clinical practice, but it poses a great threat to the life of mothers and infants. Here, we present two cases of FT1DM in pregnancy. In Case 1, the patient was a 26-year-old woman who was admitted to the hospital with reduced fetal movement. She was diagnosed with FT1DM and delivered a dead female fetus. Lispro and lantus were administered to control blood glucose, and lipoic acid for antioxidant therapy. In Case 2, the patient was a 28-year-old woman who developed nausea, vomiting, diarrhea, and polydipsia, which later proved to be FT1DM. An abortion was induced and blood glucose levels were controlled using an insulin pump. All physicians should be aware of this disease in order to provide prompt diagnosis and emergency treatment, thus improving maternal prognosis. We suggest that plasma glucose/hemoglobin A1C ratio be adopted as a new clinical parameter in predicting FT1DM.

The effect of regions-of-interest and elasticity modulus selection on differentiating benign and malignant cervical lymph nodes with shear wave elastography

OBJECTIVE: Imaging diagnosis of cervical lymphadenopathy has conventionally used ultrasonography. Shear wave elastography (SWE) is a recent ultrasound technological advancement that has shown promise in the important medical problem of differentiating between benign and malignant cervical lymph nodes based on quantitative measurements of elasticity modulus. However, widely varying elasticity modulus metrics and regions-of-interest (ROIs) were used in existing studies, leading to inconsistent findings and results that are hard to compare with each other. METHODS: Using a large dataset of 264 cervical lymph nodes from 200 patients, we designed a study comparing three elasticity modulus metrics (Emax, Emean, and standard deviation-SD) with three different ROIs to evaluate the effect of such selections. The metric values were compared between the benign and malignant node groups. The different ROI and metric selections were also compared through receiver operating characteristics curve analysis. RESULTS: For all ROIs, all metric values were significantly different between the two groups, indicting their diagnostic potential. This was confirmed by the ≥0.80 area under the curve (AUC) values achieved with these metrics. Different ROIs had no effect on Emax, whereas all ROIs achieved high performance at 0.88 AUC. For Emean, the smallest ROI focusing on the area of the highest elasticity achieved the best diagnostic performance. In contrast, the larger ROIs achieved higher performances for SD. CONCLUSIONS: This study illustrated the effect of elasticity modulus and ROI selection on the diagnostic performance of SWE on cervical lymphadenopathy. These new findings help guide relevant future studies and clinical applications of this important quantitative imaging modality.

New psychoactive substances abuse among patients with access to methadone maintenance treatment in Jiangsu province: a case-control study / 中华流行病学杂志

Objective To explore the reasons and factors associated with new psychoactive substances abuse among patients with access to methadone maintenance treatment (MMT).Methods A well-developed questionnaire and urine tests were used to collect information about demographic characteristics,condition of MMT and drug abuse,family and social support of MMT clients.A 1 ∶ 1 matched case-control study was conducted,and conditional logistic regression model was used to identify factors associated with new psychoactive substances abuse.Results A total of 212 (106 pairs) clients receiving MMT were recruited,and most of them were males (78.3％,166/212),married or cohabitant (48.6％,103/212) and unemployed (63.2％,134/212).The average age of the clients was (45.1 ± 7.2) years.The main types of abused new psychoactive substances were benzodiazepine (62.3％,66/106) and methamphetamine (39.6％,42/106).The proportion of abusing multi new psychoactive substances was 8.5％ (9/106).Results from multivariate conditional logistic regression analysis indicated that using opioid drug during the past 6 months of MMT treatment might increase the risk of abusing new psychoactive substances (OR=3.25,95％CI:1.35-7.79),benzodiazepine (OR=3.25,95％CI:1.11-9.47) and methamphetamine (OR =13.31,95 ％ CI:1.12-158.01).Moreover,MMT for more than 9 years reduced the risk of abuse of new psychoactive substances (OR=0.03,95％ CI:0.01-0.21),benzodiazepine (OR=0.02,95％ CI:0.00-0.36) and methamphetamine (OR=0.02,95％ CI:0.00-0.69).Conclusion Less new psychoactive substances abuse might be associated with longer duration of MMT treatment.And inappropriate support from family and friends might increase the risk of abusing new psychoactive substances in MMT clients,especially in clients who used opioid.

Current situation on new psychoactive substances abuse among methadone maintenance treatment patients in China / 中华流行病学杂志

Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China.However,the features on drug abuse changed in the past decades,and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT.This paper concised the information on research and surveys of this issue that targeting on the current situation,characteristics,related factors and relevant public health problem on new psychoactive substances abuse,among patients who have been on MMT,in China.

New psychoactive substances abuse among patients with access to methadone maintenance treatment in Jiangsu province: a case-control study / 中华流行病学杂志

Objective To explore the reasons and factors associated with new psychoactive substances abuse among patients with access to methadone maintenance treatment (MMT).Methods A well-developed questionnaire and urine tests were used to collect information about demographic characteristics,condition of MMT and drug abuse,family and social support of MMT clients.A 1 ∶ 1 matched case-control study was conducted,and conditional logistic regression model was used to identify factors associated with new psychoactive substances abuse.Results A total of 212 (106 pairs) clients receiving MMT were recruited,and most of them were males (78.3％,166/212),married or cohabitant (48.6％,103/212) and unemployed (63.2％,134/212).The average age of the clients was (45.1 ± 7.2) years.The main types of abused new psychoactive substances were benzodiazepine (62.3％,66/106) and methamphetamine (39.6％,42/106).The proportion of abusing multi new psychoactive substances was 8.5％ (9/106).Results from multivariate conditional logistic regression analysis indicated that using opioid drug during the past 6 months of MMT treatment might increase the risk of abusing new psychoactive substances (OR=3.25,95％CI:1.35-7.79),benzodiazepine (OR=3.25,95％CI:1.11-9.47) and methamphetamine (OR =13.31,95 ％ CI:1.12-158.01).Moreover,MMT for more than 9 years reduced the risk of abuse of new psychoactive substances (OR=0.03,95％ CI:0.01-0.21),benzodiazepine (OR=0.02,95％ CI:0.00-0.36) and methamphetamine (OR=0.02,95％ CI:0.00-0.69).Conclusion Less new psychoactive substances abuse might be associated with longer duration of MMT treatment.And inappropriate support from family and friends might increase the risk of abusing new psychoactive substances in MMT clients,especially in clients who used opioid.

Current situation on new psychoactive substances abuse among methadone maintenance treatment patients in China / 中华流行病学杂志

Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China.However,the features on drug abuse changed in the past decades,and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT.This paper concised the information on research and surveys of this issue that targeting on the current situation,characteristics,related factors and relevant public health problem on new psychoactive substances abuse,among patients who have been on MMT,in China.

Analysis of Clinical Characteristics in 31 Acute Myeloid Leukemia Patients with Chromosome 21 Aberrations / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics of 31 acute myeloid leukemia (AML) patients with chromosome 21 aberrations.</p><p><b>METHODS</b>Karyotypes of 168 newly diagnosed AML patients in Second Xiangya Hospital from Jan 2014 to July 2016 were reviewed for the presence of chromosome 21 aberrations (accounting for 18.45%). Clinical manifestation, as well as prognostic gene mutations distribution and immune classification were analyzed.</p><p><b>RESULTS</b>Out of 168 AML newly diagnosed patients, 31 cases with chromosome 21 aberrations including t(8;21) accounting for 67.74% (21/31), and trisomy 21 (16.13%,5/31), 2 variants were found as t(1; 21) and t(1; 21; 8); 77 cases had normal karyotype, and 60 cases possessed other chromosomes aberrations. Statistically significant differences did not exist among age, sex and white blood cell count (P>0.05). However, the 21 cases in chromosome aberrations group were predisposed to lower hemoglobin and platelet count(P<0.05). 5 cases of Trisomy 21 were characterized by M5 2 cases, M1 one case, M2 one case M4 one case. And the rate of C-kit/D816V mutation was higher in t(8;21) aberrations group when 7 prognostic genes including FLT3/ITD, C-kit/D816V, NPM1, DNMT3A, TET2 were analyzed, and the immune classification of t(8; 21) aberration group inclined to CD19, CD34but CD33, CD64. And trisomy 21 displayed a trend to CD34and CD7.</p><p><b>CONCLUSION</b>Chromosome 21 is easily involved in acute myeloid leukemia. The patients with involvement of this aberration have characteristic clinic changes.</p>

Gene Analysis of A Chinese Family with Hereditary Hemorrhagic Telangiectasia and its Curative Effect of Thalidomide / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyze a hereditary hemorrhagic telangiectasia(HHT) family Activin receptor-like kinase 1(ACVRL1), Endoglin (ENG) and Mothers against decapentaplegic homolog 4 (MADH4, SMAD4) gene mutation, meanwhile, to observe the curative effect of thalidomide in treatment of HHT patients.</p><p><b>METHODS</b>The clinical feature of the HHT family was analyzed, the polymerase chain reaction (PCR) combined with Sanger sequencing of ACVRL1, ENG and SMAD4 were used to investigate the proband. The suspicious mutations were further detected in the other 7 family members. Proband was treated with thalidomide (100 mg/day) for 6 months, and the frequency and quantity of bleeding and blood transfusion frequency were assayed to evaluate the curative efficacy.</p><p><b>RESULTS</b>One ACVRL1 mutation (c.1231C>T) was identified in proband(II-1) and the other 4 family members(II-2, III-1, III-2, III-3), which was reported as a pathogenic gene and revealed cosegregation with HHT clinical phenotype. One ENG mutation (c.1096G>C) was previously reported as gene polymorphism, which was identified in some family members(II-1, II-3, III-1, III-2) without cosegregation with clinical phenotype. No gene mutation was found in SMAD4. After thalidomide treatment, the frequency and quantity of bleeding and blood transfusion frequncy in the proband were reduced, hemoglobin concentration and serum iron level were increased.</p><p><b>CONCLUSION</b>There is phenotypic heterogeneity in hereditary hemorrhagic telangiectasia and the features are age-dependent, the pathogenic gene of this pedigree is ACVRL1 mutation (c.1231C>T;p. R 411 W). Thalidomide is effective for the treatment of hemorrhage in hereditary hemorrhagic telangiectasia.</p>

Laparoscopic diagnosis and treatment of rectum telangiectasia: report of a rare form of lower gastrointestinal hemorrhage / 南方医科大学学报

We report a case of rectum telangiectasia, a rare form of lower gastrointestinal hemorrhage caused by vascular malformation. The patient underwent laparoscopic assisted abdomino-perineal resection of the sigmoid colon-rectum telangiectasia. The extent and degree of pathological changes were observed directly from the intestinal wall during laparoscopic surgery, and after collection of biopsy evidence, concomitant definitive surgery was performed to achieve a minimally invasive effect.

Observation of clinical curative effect in the patients with internal endometriosis by interventional therapy / 中国医师进修杂志

ObjectiveTo explore the curative effect in the patients with internal endometriosis by interventional therapy.MethodsUsing Seldinger technique,34 cases with internal endometriosis wereperformed bilateral uterine artery embolization.Observed postoperative menstrual quantity,dysmenrrhea degree,anemia and the change of the volume of uterine lesions.ResultsAll the patients were followed up for 1-3 years,menstrual quantity average decreasd of 59.1％P ＜ 0.05 ),the symptoms of dysmenorrhea was significantly eased in 28 cases (82.4％,28/34).All the patients of anemia haemoglobin were back to normal,volume of uterus average reduced 43.8％P ＜ 0.05 ),lesion was obviously smaller or disappear.Ultrasonography showed myometrium and blood flow signal of lesion was was obviously reduced.Conclusion Internalendometriosis by interventional therapy can get good results,symptoms improve significantly.

The role of (18)F-FDG DHC SPECT-CT in the diagnosis and staging for lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate and compare the clinical significance of (18)F-FDG single-photon emission computed tomography and computed tomography (SPECT-CT) in the diagnosis and staging of lung cancer.</p><p><b>METHODS</b>From July 2005 to July 2007, 71 patients with suspected lung cancer received conventional CT and SPECT-CT examination. Fifty-seven of the 71 patients had definite pathological or cytological diagnosis, consisting of 52 malignant lung tumors and 5 benign pulmonary nodules. Forty-three patients underwent surgical resection with different modes. Thirty-seven of the 43 surgically treated patients had available complete data of CT, SPECT-CT and pathological results.</p><p><b>RESULTS</b>Taking the pathological diagnosis as gold standard, the sensitivity, specificity and accuracy of diagnosing pulmonary lesions suspected as lung cancer were 84.6% (44/52), 80.0% (4/5), 84.2% (48/57) for conventional CT and 92.3% (48/52), 80.0% (4/5), 91.2% (52/57) for SPECT-CT, respectively. If taking the pathological TNM staging results as gold standard, the concordance rates of TNM staging with pathological TNM staging results was 59.5% (22/37) for CT and 67.6% (25/37) for SPECT-CT. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of staging hilar and mediastinal lymph nodes were 76.9%, 79.2%, 78.4%, 66.6%, 86.4% for conventional CT versus 61.5%, 75.0%, 70.3%, 57.1%, 78.3% for SPECT-CT (P > 0.05), respectively. There was no statistically significant difference between conventional CT and SPECT-CT in the accuracy of diagnosing and staging for the suspected pulmonary lesions (P > 0.05).</p><p><b>CONCLUSION</b>SPECT-CT is likely superior to conventional CT in the diagnosing and staging for lung cancer. It can be used as a non-invasive supplementary tool for differential diagnosis between malignant and benign pulmonary lesions and in diagnosis of lymph node > 1 cm in diameter.</p>