Determination and analysis of monitoring period and measuring duration of personal internal exposure dose / 中国辐射卫生

Objective To develop a reasonable plan of monitoring personal internal exposure dose. Methods This paper introduced the methods of monitoring the individual dose and direct measurement of three representative radionuclides. Results The maximum monitoring periods were determined according to the radionuclide retention characteristics and the reporting standards and requirements, which were m(1)/m(T/2) ≤ 3 and m(T/2)/m(T) ≤ 3. The lower detection limit of the instrument was derived from the monitoring periods and the annual radionuclide intake limit, which should be lower than the derived method detection limit of the corresponding radionuclide. Then the measuring duration of the instrument that meets the corresponding conditions was derived from the derived method detection limit of the instrument and the maximum monitoring period. Conclusion Our results provide a reference for the formulation of a plan of monitoring personal internal exposure dose.

LASS2/TMSG1 overexpression inhibits proliferation and promotes apoptosis of human lung cancer A549 cells possibly by upregulating ceramide and p38 MAPK to activate a signaling cascade / 南方医科大学学报

OBJECTIVE@#To investigate the effects of LASS2/TMSG1 gene overexpression on proliferation and apoptosis of human lung cancer A549 cells and explore the possible mechanism.@*METHODS@#We examined LASS2/TMSG1 expression level in a previously constructed A549 cell line overexpressing LASS2/TMSG1 using Western blotting. The proliferation and apoptosis of the cells were detected using colony-forming assay, CCK-8 assay, Hoechst/PI double staining and flow cytometry. Fourteen nude mice were randomized into 2 groups (n=7) to receive subcutaneous injection of A549 cells with or without LASS2/TMSG1 overexpression on the back of the neck, and the cell proliferation in vivo was observed. The expression levels of p38 MAPK protein and p-p38 MAPK protein in the xenografts were detected with Western blotting. ELISA was used to detect the levels of ceramide and p38 MAPK protein in cultured A549 cell supernatants and the xenografts in nude mice.@*RESULTS@#Compared with the negative control cells, A549 cells with LASS2/TMSG1 overexpression had significantly lowered proliferation ability in vitro with increased early apoptosis rate (P < 0.05), and showed obvious growth inhibition after inoculation in nude mice(P < 0.05). Western blotting showed that in both cultured A549 cells and the xenografts in nude mice, LASS2/TMSG1 gene overexpression significantly increased the expression levels of p38 MAPK protein and p-p38 MAPK protein (P < 0.05); the results of ELISA also revealed significantly increased levels of ceramide and p38 MAPK protein in the cell supernatant andxenografts as well (P < 0.05).@*CONCLUSION@#Overexpression of LASS2/TMSG1 gene can significantly inhibit the proliferation and promote early apoptosis of human lung cancer A549 cells both in vitro and in vivo possibly by upregulating the expressions of ceramide and p38 MAPK protein to activate a signal transduction cascade.

Effects of comprehensive geriatric assessment and intervention on treatment outcomes of elderly patients with type 2 diabetes mellitus and emotional disorders / 中华老年医学杂志

Objective:To investigate the effects of comprehensive geriatric assessment(CGA)and intervention on treatment outcomes of type 2 diabetes and concurrent emotional disorders in the elderly.Methods:108 type 2 diabetes cases with emotional disorders were enrolled from March 2020 to March 2021 in the First Affiliated Hospital of Zhengzhou University and randomly divided into the conventional treatment group and the CGA group(54 cases each). The control group was given standard drug treatment and psychological counseling, whereas the CGA group was additionally given individualized treatment based on CGA guidelines.After observation for 8 weeks, clinical effects in the two groups were examined.Changes in cognitive status, nutritional status, fall risk and results on other indicators in patients were comprehensively assessed and statistically analyzed.Results:Compared with pre-treatment data, 8 weeks of treatment for both the control group and the CGA group resulted in decreased FPG levels[control group(10.16±0.90)mmol/L, (8.70±2.98)mmol/L, t=2.58, P=0.011; CGA group: (9.94±0.82)mmol/L, (7.12±2.25)mmol/L, t=8.65, P=0.000], 2hPG levels[control group: (11.83±3.92)mmol/L, (10.53±2.70)mmol/L, t=2.01, P=0.047; CGA group: (10.64±2.99)mmol/L, (9.26±1.89)mmol/L, t=2.87, P=0.005], HbA 1C(%)[control group: (9.76±1.09)%, (8.66±2.64)%, t=2.83, P=0.006; CGA group: (9.38±2.92)%, (7.81±1.78)%, t=3.37, P=0.001], HAMD-24 scores[control group(25.69±4.70), (24.20±2.48), t=2.06, P=0.042; CGA group(24.03±4.00), (22.11±1.38), t=3.33, P=0.001], and HAMD-14 scores[control group(19.66±2.84), (18.41±2.34), t=2.50, P=0.014; CGA group(18.77±2.48), (17.39±2.36), t=2.96, P=0.004], respectively, with more marked changes in all measures in the CGA group than in the control group(all P<0.05). Conclusions:Early CGA can effectively improve blood glucose levels and relieve mood disorders in elderly type 2 diabetes with emotional disorders.

Application of three-dimensional visualization technique in anatomical variation of peripancreatic vessels in patients with pancreatic occupancy / 中华肝胆外科杂志

Objective:To explore the application value of three-dimensional visualization technology in the analysis of anatomic variation of peripancreatic vessels in patients with pancreatic space occupation.Methods:A total of 98 cases in Yijishan Hospital of Wannan Medical College, the First Affiliated Hospital of University of Science and Technology of China, the First Affiliated Hospital of Anhui Medical University, the Second Affiliated Hospital of Anhui Medical University, the First Affiliated Hospital of Bengbu Medical College, Fuyang People's Hospital from June 2018 to December 2019 were retrospectively analyzed. Of 94 patients were enrolled, including 56 males and 38 females, aged (61.2±7.2) years. Abdominal organs and blood vessels were reconstructed by 3D visualization technology, and anatomic variation of peripancreatic vessels was analyzed, including abdominal trunk, hepatic artery system, portal vein system and dorsal pancreatic artery.Results:The three-dimensional reconstruction rate of celiac trunk vessels was 100.0% (94/94). The 60 cases of abnormal celiac trunk were as follows: liver and spleen trunk in 5 cases (5.3%), stomach and spleen trunk in 1 case (1.1%), liver, stomach and spleen mesentery trunk in 3 cases (3.2%), liver, stomach and spleen mesentery trunk in 17 cases (18.1%), celiac trunk with one or more inferior phrenic arteries in 34 cases (36.2%). There were 69 cases (73.4%) of Michels type Ⅰ, 2 cases (2.1%) of Michels type Ⅲ, 1 case (1.1%) of Michels Ⅴ, 2 cases (2.1%) of Ⅷ, and 1 case (1.1%) of type Ⅸ of hepatic artery system. There were 17 cases (18.1%) of accessory left hepatic artery from celiac trunk which did not belong to Michels classification. Left accessory hepatic artery originated from left gastric artery and left hepatic artery originated from superior mesenteric artery in 1 case (1.1%), right accessory hepatic artery originated from celiac trunk combined with proper hepatic artery and right anterior hepatic artery combined with gastroduodenal artery originated from right posterior hepatic artery in 1 case (1.1%). Abnormal walking of dorsal pancreatic artery in 3 cases. The inferior mesenteric vein flowed into the superior mesenteric vein in 38 cases (40.4%), and the inferior mesenteric vein flowed into the splenic vein and superior mesenteric vein in 4 cases (4.3%).Conclusion:Three-dimensional visualization technique is helpful to determine the variation of peripancreatic vessels, and has certain significance for accurate preoperative evaluation and surgical guidance of patients with pancreatic space occupation.

Twenty years in the 21st century: temporal and spatial evolution of Chinese medicinal processing equipment / 中国中药杂志

Against the backdrop of "Internet+" and Made in China 2025, Chinese medicinal processing equipment embraces various opportunities and develops to an unprecedented level. In the 20 years of the new century, the processing equipment has gradually developed in the direction of high efficiency, energy saving, environmental protection, integration, and automation, and this field has tended to highlight the establishment and application of the linkage production line for the processing of Chinese medicinal decoction pieces. Integrating automation control technology, online detection technique, and the internet of things technology, the online detection system of Chinese medicinal processing equipment and the computer information management system of Chinese medicinal proces-sing are the mainstream development trends of Chinese medicinal processing equipment. Standard Chinese medicine processing equipment is the prerequisite for the standardization of processing parameters. A standard system for processing equipment and processing parameters is the key to the modernization of Chinese medicinal decoction pieces. This paper summarized the research and application of Chinese medicinal processing equipment in the 20 years of the 21 st century and predicted the development trend, which is expected to serve as a reference for the technological innovation and development of the processing equipment.

Risk factors for hemostatic failure in emergency gastroscopic sclerotherapy combined with tissue adhesive injection for esophagogastric variceal bleeding with portal vein embolus / 临床肝胆病杂志

ObjectiveTo investigate the risk factors for failure in emergency endoscopic injection sclerotherapy (EIS) combined with sequential histoacryl injection (HI) for esophagogastric variceal bleeding (EGVB) with portal vein embolus (PVE). MethodsA total of 109 EGVB patients with PVE who underwent emergency gastroscopy in Beijing Shijitan Hospital, Capital Medical University, and The Fifth Medical Center of Chinese PLA General Hospital from January 2018 to December 2019 were enrolled, and according to the outcome of hemostatic treatment under emergency gastroscopy, the patients were divided into hemostatic failure group with 28 patients and hemostatic success group with 81 patients. The two groups were compared in terms of general information, varices and bleeding manifestations under gastroscopy, blood biochemical parameters, Child-Pugh class, and Model for End-Stage Liver Disease (MELD) score, and the risk factors for hemostatic failure were analyzed. The t-test or the Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; a logistic regression analysis was used for multivariate analysis. ResultsCompared with the hemostatic success group, the hemostatic failure group had significantly higher peripheral white blood cell count (WBC), total bilirubin (TBil), Child-Pugh class, and MELD score (Z=3.794, Z=4.751, χ2=40.104, Z=6.412, all P＜0001) and significantly lower prothrombin time activity (PTA), albumin (Alb), and cholinesterase (CHE) (t=9.653, Z=3.093, Z=4.092, P＜0.001, P=0.002, and P＜0.001). WBC (odds ratio ［OR］=28.543, 95% confidence interval ［CI］: 1.285-634.113, P＜0.05), PTA(OR=0.194, 95%CI: 0.045-0.835, P＜0.05), TBil (OR=2.197, 95%CI: 1.004-4.810, P＜0.05), Alb (OR=0448, 95%CI: 0.209-0.961, P＜0.05), and Child-Pugh class (OR=5.164, 95%CI: 1.307-20.406, P＜0.05) were independent risk factors for hemostatic failure. ConclusionWBC, PTA, TBil, Alb, and Child-Pugh class are independent risk factors for failure in emergency EIS combined with sequential HI in the treatment of EGVB with PVE, and adequate preoperative evaluation and correction may help to improve the success rate of hemostasis.

Comparison of Liver Transplantation and Liver Resection for Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombus Type I and Type II

Purpose@#The aim of this study was to compare the efficacy of liver transplantation (LT) and liver resection (LR) for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) and to investigate risk factors affecting prognosis. @*Materials and Methods@#A total of 94 HCC patients with PVTT type I (segmental PVTT) and PVTT type II (lobar PVTT) were involved and divided into LR (n=47) and LT groups (n=47). Recurrence-free survival (RFS) and overall survival (OS) were compared before and after inverse probability of treatment weighting (IPTW). Prognostic factors for RFS and OS were explored. @*Results@#Two treatment groups were well-balanced using IPTW. In the entire cohort, LT provided a better prognosis than LR. Among patients with PVTT type I, RFS was better with LT (p=0.039); OS was not different significantly between LT and LR (p=0.093). In subgroup analysis of PVTT type I patients with α-fetoprotein (AFP) levels >200 ng/mL, LT elicited significantly longer median RFS (18.0 months vs. 2.1 months, p=0.022) and relatively longer median OS time (23.6 months vs. 9.8 months, p=0.065). Among patients with PVTT type II, no significant differences in RFS and OS were found between LT and LR (p=0.115 and 0.335, respectively). Multivariate analyses showed treatment allocation (LR), tumor size (>5 cm), AFP and aspartate aminotransferase (AST) levels to be risk factors of RFS and treatment allocation (LR), AFP and AST as risk factors for OS. @*Conclusion@#LT appeared to afford a better prognosis for HCC with PVTT type I than LR, especially in patients with AFP levels >200 ng/mL.

Progress of diagnosis and treatment of cholangiocarcinoma / 国际外科学杂志

Due to the high degree of malignancy and low surgical resection rate of cholangiocarcinoma, as well as the immaturity of postoperative adjuvant chemotherapy and targeted therapy drugs, the mortality rate of patients with cholangiocarcinoma is high and the long-term prognosis is poor. With the improvement of clinical diagnosis and treatment, preoperative evaluation and surgical technique, the diagnosis and treatment of cholangiocarcinoma have made some progress. The early stage of cholangiocarcinoma is lack of specific manifestations, so the patient has lost the opportunity of R0 resection when diagnosed. Early diagnosis can improve the patient′s R0 resection and long-term survival after surgery. The diagnostic accuracy can be improved by contrast enhanced ultrasound, enhanced magnetic resonance, positron emission tomography PET, etc. Dominated by comprehensive therapy in the treatment of bile duct carcinoma, strive for R0 resection for resectable cholangiocarcinoma, distant metastasis occurred after bile duct carcinoma can be combined with new adjuvant chemotherapy according to the review situation decides whether it is feasible to surgery, postoperative chemotherapy, molecular targeted therapy, body directional radiation therapy, and other comprehensive solutions in order to improve the long-term survival rate. This article reviews the recent progress in the pathogenesis, diagnosis and treatment of cholangiocarcinoma.

Follistatin Like 5 (FSTL5) inhibits epithelial to mesenchymal transition in hepatocellular carcinoma / 中华医学杂志(英文版)

BACKGROUND@#Epithelial to mesenchymal transition (EMT) is a key process in determining distant metastasis and intra-hepatic dissemination of hepatocellular carcinoma (HCC). Follistatin (FST) family members are considered to be an attractive therapeutic targets and prognostic indicators in cancers. As a derivative of FST, Follistatin Like 5 (FSTL5) may play a similar role in HCC cells. This study aimed to investigate the expression and function of FSTL5 in HCC and its role in EMT.@*METHODS@#FSTL5, E-cadherin and vimentin in HCC, and paracancerous tissues were detected by immunohistochemistry. Correlation of FSTL5 expression with overall survival was assessed. The proliferation and invasion of HCC cell lines SK-Hep1 and MHCC-LM3 were analyzed by cell counting kit-8 and Transwell assays. The expression of FSTL5, E-cadherin, and vimentin in HCC cells was examined by polymerase chain reaction and Western blot analysis. T-test was used to analyze the difference in proliferation and invasion ability between groups. The Spearman rank correlation test was used to detect the correlation between the expression of FSTL5 and E-cadherin or vimentin.@*RESULTS@#The expression of FSTL5 in HCC was lower than that in paracancerous tissues (9.97% vs. 82.55%, χ = 340.15, P < 0.001). Patients with high FSTL5 expression had a better prognosis (χ = 8.22, P = 0.004) and smaller tumor diameter (χ = 45.52, P < 0.001), less lymph node metastasis (χ = 5.58, P = 0.02), earlier tumor node metastasis stage (χ = 11.29, P = 0.001), a reduced number of tumors (χ = 5.05, P = 0.02), lower alpha-fetoprotein value (χ = 24.36, P < 0.001), more probability of hepatitis carrying (χ = 40.9, P < 0.001), and better liver function grade (χ = 5.21, P = 0.02). Immunohistochemistry showed that FSTL5 expression in HCC tissues was positively correlated with E-cadherin expression (r = 0.38, P < 0.001) and negatively correlated with vimentin expression (r = -0.385, P < 0.001). Furthermore, over-expression of FSTL5 up-regulated the expression of E-cadherin and down-regulated the expression of vimentin in SK-Hep1 (negative control [NC] vs. FSTL5-interfering group [Lv-FSTL5]: E-cadherin [t = 45.03, P < 0.001], vimentin [t = 67, P < 0.001]) and MHCC-LM3 (NC vs. Lv-FSTL5: E-cadherin [t = 50, P < 0.001], vimentin [t = 72.75, P < 0.001]) cells at mRNA level. The same as protein level. In addition, the over-expression of FSTL5 inhibited the proliferation (NC vs. Lv-FSTL5: SK-Hep1, 3 d [t = 7.324, P = 0.018], 4 d [t = 6.23, P = 0.021], 5 d [t = 10.21, P = 0.003]; MHCC-LM3, 3 d [t = 4.32, P = 0.037], 4 d [t = 7.49, P = 0.012], 5 d [t = 9.3661, P = 0.009]) and invasion (NC vs. Lv-FSTL5: SK-Hep1, t = 21.57, P < 0.001; MHCC-LM3, t = 18.04, P < 0.001) of HCC cells.@*CONCLUSIONS@#Down-regulation of FSTL5 may contribute to EMT of HCC, and FSTL5 is a potential target in the treatment of HCC.

Ziprasidone Injection for Agitation in Schizophrenic Patients：A Meta-Regression Analysis / 中山大学学报(医学科学版)

@#【Objective】To evaluate the efficacy of ziprasidone injection and the related influencing factors for treating agitation in schizophrenic patients based on published literature in English or Chinese. 【Methods】We searched PubMed， EMBASE， Web of Knowledge， Cochrane Library， Wanfang data， Chinese Journal Full- Text Database（CJFD），Chinese Biomedical Literature Database（CBMdisc）and VIP Chinese Technology Periodical Database（VIP）. The Consolidated Standards of Reporting Trials（CONSORT）statement was used as a criterion for screening and assessing the literature. Meta-analysis and meta-regression were conducted by using STATA. With the effect size as the dependent variable and sex，age，baseline PANSS scale total score and oral antipsychotics as the covariates ，the meta- regression model was analyzed. 【Results】The Grades of Recommendation ，Assessment ，Development and Evaluation（GRADE） approach was employed to rate the overall quality of evidence. A total of 14 studies（5 in English and 9 in Chinese）were included in meta analysis and meta regression. The samples were ，respectively，1 197 and 1 149 at baseline and after treatment. Random effect Meta analysis showed that ziprasidone injection had significant efficacy in the treatment of agitation symptoms［SMD=2.04，95%CI（1.47，2.61），P = 0.000］. Meta regression revealed that the efficacy was related to baseline PANSS scores（t = 5.57 ，P = 0.011）and oral antipsychotics（t = 4.07 ，P = 0.027），but irrelevant to age（t = 0.74，P = 0.539）and language published（t = -0.57，P = 0.625）. The efficacy was better in female patients than that in male patients （t = -2.95 ，P = 0.060）. 【Conclusion】 Ziprasidone injection has significant efficacy in schizophrenia patients with agitation symptoms and the efficacy may be enhanced in those patients with higher baseline PANSS score and added with oral antipsychotics.

Progress of diagnosis and treatment of cholangiocarcinoma / 国际外科学杂志

Due to the high degree of malignancy and low surgical resection rate of cholangiocarcinoma,as well as the immaturity of postoperative adjuvant chemotherapy and targeted therapy drugs,the mortality rate of patients with cholangiocarcinoma is high and the long-term prognosis is poor.With the improvement of clinical diagnosis and treatment,preoperative evaluation and surgical technique,the diagnosis and treatment of cholangiocarcinoma have made some progress.The early stage of cholangiocarcinoma is lack of specific manifestations,so the patient has lost the opportunity of R0 resection when diagnosed.Early diagnosis can improve the patient's R0 resection and long-term survival after surgery.The diagnostic accuracy can be improved by contrast enhanced ultrasound,enhanced magnetic resonance,positron emission tomography PET,etc.Dominated by comprehensive therapy in the treatment of bile duct carcinoma,strive for R0 resection for resectable cholangiocarcinoma,distant metastasis occurred after bile duct carcinoma can be combined with new adjuvant chemotherapy according to the review situation decides whether it is feasible to surgery,postoperative chemotherapy,molecular targeted therapy,body directional radiation therapy,and other comprehensive solutions in order to improve the long-term survival rate.This article reviews the recent progress in the pathogenesis,diagnosis and treatment of cholangiocarcinoma.

Clinical observation of dynamic scalp acupuncture combined with task-oriented mirror therapy for upper limbs function impairment in patients with hemiplegia after ischemic stroke / 中国针灸

OBJECTIVE@#To explore the effect of dynamic scalp acupuncture combined with task-oriented mirror therapy (TOMT) for upper limb motor function and activity ability of daily living in patients with hemiplegia after ischemic stroke.@*METHODS@#Seventy-eight patients with hemiplegia after ischemic stroke were randomly divided into a dynamic scalp acupuncture group, a TOMT group, and a scalp acupuncture group, 26 cases in each group (1 case dropped off in the TOMT group and the scalp acupuncture group respectively). All three groups received routine rehabilitation training and medication treatment. The TOMT group was treated with TOMT for 40 min a day, 5 days a week for 8 weeks. The scalp acupuncture group was treated with TOMT after the scalp acupuncture, and the dynamic scalp acupuncture group was treated with TOMT during the scalp acupuncture treatment. The scalp acupuncture treatment was applied at ipsilateral up 1/5 and mid 2/5 of and , and the needles were retained for 40 min. The scalp acupuncture treatment was given once a day, 5 days a week for 8 weeks. Before treatment and after 4 weeks and 8 weeks of treatment, the functions of upper limb and hand were evaluated by simplified Fugl-Meyer assessment (FMA) scale upper limb part and functional test for the hemiplegic upper extremity-Hong Kong version (FTHUE-HK) grade, the muscle tension of the upper extremity flexor elbow muscle group was assessed by modified Ashworth scale (MAS) and the activity ability of daily living was assessed by modified Barthel index (MBI).@*RESULTS@#After 4 weeks and 8 weeks of treatment, the FMA scores, FTHUE-HK grades and MBI scores in the three groups were better than those before treatment (<0.01, <0.05), and MAS scores after 4 weeks of treatment in the three groups were better than those before treatment (<0.05). After 4 weeks and 8 weeks of treatment, the FMA scores, FTHUE-HK grades and MBI scores in the dynamic scalp acupuncture group were better than those in the TOMT group and the scalp acupuncture group (<0.05), and these items in the scalp acupuncture group were better than those in the TOMT group (<0.05).@*CONCLUSION@#The dynamic scalp acupuncture combined with TOMT treatment can effectively improve the upper limb function and the activities ability of daily living in patients with hemiplegia after ischemic stroke, which is better than TOMT after scalp acupuncture and simple TOMT treatment.

Cognitive function in patients with early onset and adult onset schizophrenia / 中国心理卫生杂志

Objective:To explore the characteristics of cognitive function in patients with early onset and adult onset schizophrenia.Methods:In this cross-sectional study, 546 patients with schizophrenia who met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) were selected.Among them, 62 cases were defined as early onset schizophrenia (EOS, age of onset＜18 years) and 175 patients were defined as adult onset schizophrenia (AOS, age of onset≥25 years).Patients underwent clinical assessments with the Positive and Negative Symptom Scale (PANSS) and the Personal and Social Performance Scale (PSP), and comprehensive neuropsychological assessments.Results:The EOS patients got lower scores in motor function-PEGDOM T score [ (26±12) vs. (30±11), P＜0.01], working memory-average T score of PASAT and WMSSP[ (34±12) vs. (38±10), P＜0.05]and executive function (inhibition) -Stroop T score [ (35±12) vs. (39±10), P＜0.05]than AOS patients.No differences were fund in processing speed, verbal memory and learning, visual memory and learning (Ps＞0.05) between the two groups.Conclusion:It suggests that the EOS patients have worse motor function, working memory and inhibition.

Effectiveness of Integrative Medicine Therapy on Coronary Artery Disease Prognosis: A Real-World Study / 中国结合医学杂志

OBJECTIVE@#To evaluate the effectiveness of integrative medicine (IM) on patients with coronary artery disease (CAD) and investigate the prognostic factors of CAD in a real-world setting.@*METHODS@#A total of 1,087 hospitalized patients with CAD from four hospitals in Beijing, China were consecutively selected between August 2011 and February 2012. The patients were assigned to two groups based on the treatment: Chinese medicine (CM) plus conventional treatment, i.e., IM therapy (IM group); or conventional treatment alone (CT group). The endpoint was major adverse cardiac events [MACE; including cardiac death, myocardial infarction (MI), and revascularization].@*RESULTS@#A total of 1,040 patients finished the 2-year follow-up. Of them, 49.4% (514/1,040) received IM therapy. During the 2-year follow-up, the total incidence of MACE was 11.3%. Most of the events involved revascularization (9.3%). Cardiac death/MI occurred in 3.0% of cases. For revascularization, logistic stepwise regression analysis revealed that age ⩾ 65 years [odds ratio (OR), 2.224], MI (OR, 2.561), diabetes mellitus (OR, 1.650), multi-vessel lesions (OR, 2.554), baseline high sensitivity C-reactive protein level ⩾ 3 mg/L (OR, 1.678), and moderate or severe anxiety/depression (OR, 1.849) were negative predictors (P<0.05); while anti-platelet agents (OR, 0.422), β-blockers (OR, 0.626), statins (OR, 0.318), and IM therapy (OR, 0.583) were protective predictors (P<0.05). For cardiac death/MI, age ⩾ 65 years (OR, 6.389) and heart failure (OR, 7.969) were negative predictors (P<0.05), while statin use (OR, 0.323) was a protective predictor (P<0.05) and IM therapy showed a beneficial tendency (OR, 0.587), although the difference was not statistically significant (P=0.218).@*CONCLUSION@#In a real-world setting, for patients with CAD, IM therapy was associated with a decreased incidence of revascularization and showed a potential benefit in reducing the incidence of cardiac death or MI.

Effects of preoperative percutaneous transhepatic biliary drainage on surgical treatment of type Ⅲ and Ⅳ hilar cholangiocarcinoma / 中华外科杂志

Objective@#To investigate the effects of preoperative percutaneous transhepatic biliary drainage on surgical treatment of type Ⅲ and Ⅳ hilar cholangiocarcinoma.@*Methods@#Clinical data of 72 patients with hilar cholangiocarcinoma of the Bismuth-Corlette type Ⅲ and Ⅳ treated at Department of General Surgery,First Affiliated Hospital of Bengbu Medical College from January 2010 to December 2017 were analyzed retrospectively.Patients were divided into two groups based on whether PTBD was performed:a drained group and an undrained group.In the drained group,there were 31 patients,20 males and 11 females,aged (59.9±9.7)years (range: 39-73 years).Among them,14 patients underwent hepatectomy with half or more than half of the liver removed (extended hepatectomy)and 17 patients underwent non-anatomical hepatectomy in the hilar region (limited hepatectomy).In the undrained group,there were 41 patients, 26 males and 15 females, aged (60.8±7.8)years(range: 45-75 years).Among them, 17 patients underwent hepatectomy with half or more than half of the liver removed (extended hepatectomy)and 24 patients underwent non-anatomical hepatectomy in the hilar region (limited hepatectomy).Percutaneous transhepatic biliary drainage(PTBD)was used in the drained group.Under the guidance of ultrasound,one or more hepatobiliary ducts could be sufficiently drained,which had good effect and was not restricted by the obstruction location of hilar cholangiocarcinoma.The analysis of the measurement data was performed using t test,and the analysis of the count data was performed using χ2 test,and the survival curve was plotted using Kaplan-meier method.@*Results@#In total, 72 jaundiced patients with hilar cholangiocarcinoma underwent surgical treatment: 31 had PTBD prior to operation while 41 did not had PTBD.There were significant differences in ALT((93.2±21.4)U/L vs.(207.4±65.1)U/L),AST((87.6±18.1)U/L vs.(188.9±56.6)U/L)and total bilirubin((68.8±12.6)μmol/L vs.(227.5±87.7)μmol/L)between the patients after treatment and those before treatment(t=10.958, P=0.000; t=10.845, P=0.000; t=10.386, P=0.000).Compared with those in the undrained group, the operation time was shorter, the amount of intraoperative bleeding and the incidence of complications were lower in the drained group(t=-2.840, P=0.006; t=-3.698, P=0.000; χ2=4.108, P=0.043).There were no perioperative death cases in drained group and 2 perioperative death cases in undrained group.There was no significant difference in R0 resection rate between the two groups(χ2=0.778,P=0.378).The 1-,3-,5-year survival rate of patients in the drained group and the undrained group was 72.7%,34.2%, 13.7% and 72.8%, 31.5%, 11.8%, respectively.The difference was not statistically significant(all P>0.05).@*Conclusions@#The preoperative percutaneous transhepatic biliary drainage in patients with hilar cholangiocarcinoma of Bismuth-Corlette type Ⅲ and Ⅳ could effectively shorten operative time, reduce amount of intraoperative bleeding and incidence of postoperative complications,but have no significant effect on the R0 resection rate and survival rate.

Therapeutic effect of different dose of simvastatin on hypertension complicated hyperlipidemia and its safety / 心血管康复医学杂志

Objective :To analyze therapeutic effect of different dose of simvastatin on hypertension complicated hy‐perlipidemia and its safety .Methods :A total of 90 patients with hypertension complicated hyperlipidemia treated in our hospital were randomly and equally divided into simvastatin routine dose group (20mg／d simvastatin) and high dose group (40mg／d simvastatin) ,both groups were treated for six months .Therapeutic effect ,levels of blood pressure (BP) and blood lipids before and after treatment ,and incidence of adverse reactions were compared between two groups .Results :Compared with routine dose group after treatment , there were significant rise in total effective rates of hypertension (75.56% vs.93.33%) and hyperlipidemia (71.11% vs.95.56%) in high dose group ,P＝0.020 ,0.002 ;Compared with routine dose group after treatment ,there were significant reductions in levels of serum TC [ (5.68 ± 0.68) mmol／L vs. (4.07 ± 0.62) mmol／L] ,TG [(1.89 ± 0.37) mmol／L vs.(1.03 ± 0.31) mmol／L] ,LDL‐C [ (3.59 ± 0.74) mmol／L vs. (2.12 ± 0.69) mmol／L] and blood pressure [ (134.84 ± 11.92)／(90.96 ± 8.79) mmHg vs.(120.09 ± 11.43)／(81.78 ± 8.57) mmHg] ,and significant rise in serum HDL‐C level [ (1.28 ± 0.41) mmol／L vs.(1.48 ± 0.46) mmol／L] in high dose group , P＜0.05 or ＜0.01. There was no significant difference in incidence rate of adverse reactions between two groups (P＝0.535).Conclusion :High dose simvastatin possesses more significant therapeutic effect on hypertension compli‐cated hyperlipidemia .It can significantly reduce BP and blood lipids with good safety .

Effect of Kuanxiong Aerosol () on Patients with Angina Pectoris: A Non-inferiority Multi-center Randomized Controlled Trial / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the effect and safety of Kuanxiong Aerosol (, KA) on patients with angina pectoris.</p><p><b>METHODS</b>Block randomization was performed to randomly allocate 750 patients into KA (376 cases) and control groups (374 cases). During an angina attack, the KA group received 3 consecutive sublingual sprays of KA (0.6 mL per spray). The control group received 1 sublingual nitroglycerin tablet (NT, 0.5 mg/tablet). Log-rank tests and Kaplan-Meier estimations were used to estimate the angina remission rates at 6 time-points after treatment (1, 2, 3, 4, 5, and >5 min). Logistic regression analysis was performed to observe the factors inflfluencing the rate of effective angina remission, and the remission rates and incidences of adverse reactions were compared for different Canadian Cardiovascular Society (CCS) classes of angina.</p><p><b>RESULTS</b>The 5-min remission rates in the KA and control groups were not signifificantly different (94.41% vs. 90.64%, P>0.05). The angina CCS class signifificantly inflfluenced the rate of remission (95% confidence interval = 0.483-0.740, P<0.01). In the CCS subgroup analysis, the 3-and 5-min remission rates for KA and NT were similar in the CCSII and III subgroups (P>0.05), while they were signifificantly better for KA in the CCSI and II subgroups (P<0.05 or P<0.01). Furthermore, the incidence of adverse reactions was signifificantly lower in the KA group than in the control group for the CCSII and III subgroups (9.29% vs. 26.22%, 10.13% vs. 20.88%, P<0.05 or P<0.01).</p><p><b>CONCLUSIONS</b>KA is not inferior to NT in the remission of angina. Furthermore, in CCSII and III patients, KA is superior to NT, with a lower incidence of adverse reactions. (Registration No. ChiCTRIPR-15007204).</p>

The primary research for the influence of immobilization baseplate of carbon fiber on dose distribution of radiation field of radiotherapy / 中国医学装备

Objective:To analyze the attenuation of immobilization baseplate of carbon fiber for ray and the change of dose verification results for enhanced radiation field of MatriXX. And to primarily research the influence of this immobilization baseplate for the dose distribution of radiation field of radiotherapy.Methods: 20 patients with cervical cancer were enrolled in the research. The angle of gantry was 180°in the enhanced plan of immobilization field, and the corresponding verification plans were designed. When the verification plan was implemented on the Varian Clinac iX of accelerator, the two-dimensional ionization chamber array (MatriXX) was used to measure dose distributions of the plan. The immobilization baseplate of carbon fiber (ORFIT AIO) was used in the research. The situations of no baseplate (A group), one baseplate (B group), two baseplates (C group)and three baseplates (D group)between the handpiece of accelerator and Matri XX were researched, respectively. The data of the 4 groups were obtained by using software (OminiPro I'mRT), and the largest dose point and passing rate of Gamma in plane of radiation field were counted and analyzed.Results: Compared with A group, the average attenuation factors for ray on the largest dose point of B, C and D group in the plane of radiation field were (1.73±0.11)％, (3.44±0.36)％, and (5.48±0.44)％, respectively. The passing rates of Gamma in the 4 groups were (94.87±2.31)％, (99.18±0.61)％, (99.79±0.27)％ and (96.24±1.99)％, respectively. And the differences of passing rate between each group and A group were statistical significance (t=9.788,t=9.261,t=2.256,P<0.05).Conclusion:The immobilization baseplate of carbon fiber has influence for the attenuation of high-energy X-rays and it can affect the dose distribution of radiation field which has passed baseplate in some degrees. And when physicists calculates the dose, they should consider the effect of immobilization baseplate of carbon fiber for dose distribution of radiation field.

Methodological validation: a method for Determination of Iodine in Serum-As3+-Ce4+ Catalytic Spectrophotometry / 中华地方病学杂志

Objective To carry out a methodological validation of a new standard method "Determination of Iodine in Serum-As3+-Ce4+ Catalytic Spectrophotometry".Methods In accordance with the requirements of "Guide for Establishing Occupational Health Standards-Part 5:Determination Methods of Chemicals in Biological Materials (GB/T 210.5-2008)",the methodological validation was tested in 3 standard development and 3 verification laboratories,calculated the linear relation and range of standard curve and the lowest linmit of detection,precision,accuracy and anti-interference ability,sample stability of sample determination.Results The linear range of iodine mass concentration of the standard curve was 0 to 300 μg/L in 6 laboratories.The linear correlation coefficients of the standard curve obtained from each laboratory were 0.999 1 to 1.000 0.The detection limits of serum iodine were 1.8 to 6.9 μg/L (the.sample amount was 0.10 ml) in 5 laboratories.Precision:15 different serum samples from 5 laboratories with a total iodine concentration range of 48.8 to 273.2 μg/L were repeatedly tested for six times,the relative standard deviations (RSD) were 0.7％ to 3.8％ (the average was 1.7％).Accuracy:a total recovery of samples with iodine concentrations ranging from 26.3 to 253.3 μg/L were performed in 5 laboratories,the recoveries were 96.2％ to 105.2％ (the average was 99.8％).One laboratory carried out the standard method and the inductively coupled plasma mass spectrometry (ICP-MS) method for serum iodine determination.The recovery rates of the two methods were 96.4％ ～ 107.8％,which met the measurement requirements.Anti-interference:15 kinds of chemical reagents were added for interference test in 3 laboratories,and the results showed no deviation,indicating that the standard method had strong anti-interference.Stability:The samples could be stored for 7 days at room temperature,for 2 months at 4 ℃,and for 3 months after freezing when the assay results were not affected.Reaction temperature and time:the appropriate pairing budget for temperature and time was consistent with the standard method.Conclusion The verification of the standard method for serum iodine determination further proves that the standard method has the advantages of simple reagents preparation,wide linear range,better correlation coefficient,lower detection limit,higher precision and accuracy,stronger antiinterference ability,convenient batch testing,and wide applicability.