Resveratrol up regulates the expression of SIRT1 and mediates protective effect on radiation-induced myocardial injury / 中华放射肿瘤学杂志

Objective:To evaluate the effect of resveratrol on radiation-induced myocardial injury in mice.Methods:A total of 80 C57BL/6 mice were randomly divided into the control group, resveratrol (Res) group, radiation (RT) group and radiation+resveratrol (RT+Res) group. In the RT group, mice were given with heart radiation and mice in the Res group were given with resveratrol by gavage for 3 months. Cardiac ultrasound was used to evaluate cardiac function at 3 months after cardiac radiation. The hearts of mice were collected for HE staining, immunofluorescence, TUNEL staining, Masson staining and Western blot to evaluate the expression of silent information regulator 1 (SIRT1), the level of oxidative stress, inflammatory response, apoptosis and the degree of fibrosis in myocardial tissues. Experimental data were expressed as Mean ± SD. Continous data were statistically analyzed by t-test. Results:After 3 months of irradiation, compared with the control group, the ejection fraction (EF) and fractional shortening (FS) of cardiac function were decreased, and myocardial degeneration and disorder, reactive oxygen species (ROS) and inflammatory levels (interleukin-1β, interleukin-6, tumor necrosis factor-α), myocardial apoptosis (TUNEL positive cell rate) and fibrosis were increased in the RT group. In the RT+Res group, the cardiac function was improved, the expression of SIRT1 was increased, and the levels of oxidative stress, inflammation, myocardial apoptosis and fibrosis were decreased.Conclusions:Resveratrol can reduce oxidative stress, inflammatory infiltration, apoptosis and fibrosis of myocardium in mice with radiation-induced myocardial injury, thereby improving cardiac structural abnormalities and cardiac dysfunction. This protective effect can be mediated by upregulation of SIRT1 expression.

p21 gene knockout aggravates radiation-induced heart disease in vivo / 中华放射肿瘤学杂志

Objective:To investigate the role of p21 gene in the radiation-induced heart disease (RIHD) and to evaluate the effect on p21 gene knockout on RIHD phenotype in mouse models.Methods:p21 -/-mice were utilized in the experimental group, and p21 + /-mice were allocated in the control group. RIHD mouse models were established by exposure to 10 Gy whole heart irradiation by using a small animal radiation research platform. The heart samples were collected at 6 weeks after irradiation, the gross specimens were measured and subject to HE staining. The wall thickness and left ventricular ejection fraction of the mice were detected by the Vevo2100 ultrasound imaging system. The hypoxia in cardiac tissues was detected by the hypoxia probe method. The apoptosis of cardiac cells was determined by Tunel method. Results:Compared with the p21 + /-mice, the survival of p21 -/-mice was significantly shortened ( P=0.004), the interventricular septum was significantly thinned during the diastolic and systolic phases ( P=0.049, P=0.006), the left ventricular posterior wall was remarkably thickened ( P<0.001) and the left ventricular ejection fraction was significantly decreased ( P=0.004). The gross heart tissue was enlarged in the p21 -/-mice. HE staining showed the aggregation of inflammatory cells in cardiac tissues and disordered arrangement of myocardial cells. Significant hypoxia and apoptosis could be observed in the p21 -/-mouse heart tissues. Conclusions:p21 -/-mice are prone to more severe RIHD after irradiation, manifested with shortened cardiac survival, weakened cardiac function, abnormal cardiac structure, hypoxia and apoptosis of cardiac tissues. p21 plays an important role in the repair after cardiac irradiation.

Research Progress of Immune Checkpoint Inhibitor-associated Myocarditis / 中国肺癌杂志

Immune checkpoint inhibitors (ICIs) is a negative regulatory factor antibody, which activates T cells to play an anti-tumor effect in immunotherapy, and can also cause immune-related adverse responses, thereby inducing a series of immune related adverse events (irAEs). Among these irAEs, although the incidence of ICIs-related myocarditis is very low, the fatality rate is significantly higher than other adverse reactions, close to 50%. Clinicians should be vigilant when applying ICIs, but the pathogenesis of ICIs-related myocarditis is still unclear. This article combines the recent research results of ICIs to summarize the mechanism and clinical manifestations of ICIs-related myocarditis, so as to improve clinicians' understanding of the adverse reactions.
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Management of Drug Therapy for Leptomeningeal Metastasis of Sensitive Driver Gene Positive Non-small Cell Lung Cancer / 中国肺癌杂志

Leptomeningeal metastasis (LM) is one of the serious complications of advanced non-small cell lung cancer (NSCLC), although the incidence is not high, the clinical symptoms are severe and the prognosis is poor. LM is prone to occur in patients with positive driver gene than negative. At present, the treatment of LM mainly includes molecular targeted therapy, systemic chemotherapy, whole brain radiotherapy, intrathecal chemotherapy and immunotherapy. Although there are many treatments, the efficacy of LM is still unsatisfactory. This article reviews the drug therapy of sensitive driver gene positive NSCLC LM.

Preimplantation genetic diagnosis for carriers of thalassemia and chromosomal abnormality / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To provide preimplantation genetic diagnosis(PGD) for two couples carrying thalassemia mutations and chromosomal abnormalities.</p><p><b>METHODS</b>Couple 1 were both carriers of β 41/42 thalassemia mutations, while the husband has carried a reciprocal translocation with a karyotype of 46,XY,inv(9)(p11;q13),t(11;22)(q25;q13). Couple 2 were both carriers of α (-SEA) thalassemia mutation. Their chromosome karyotypes were both normal, but had two spontaneous abortions. The couples had received 1 and 3 blastocysts respectively through in vitro fertilization(IVF) cycles. Following the biopsy, the cells underwent whole genome amplification, and the amplified DNA from each embryo was subjected to genetic testing and a 23-chromosome single nucleotide polymorphism(SNP) microarray assay.</p><p><b>RESULTS</b>The embryo of couple 1 was diagnosed as carrier of β 41/42 thalassemia with euploid chromosomes. The embryo was transferred and resulted in intrauterine pregnancy. Similarly, an embryo of couple 2 was verified as carrier of α (-SEA) thalassemia with euploid chromosomes.</p><p><b>CONCLUSION</b>PGD for aneuploidy coupled with testing for single gene disorders via trophectoderm biopsy and whole genome amplification is feasible. The approach can attain diagnosis with minimal damage with sound clinical outcome.</p>

Preliminary results after metal-on-metal hip resurfacing arthroplasty / 中华骨科杂志

Objective To introduce the technique of metal-on-metal hip resurfacing arthroplasty,evaluate its preliminary clinical results and review the factors which affect the results.Methods From January 2006 to October 2010,104 patients (116 hips) with osteonecrosis of the femoral head,hip osteoarthritis,hip dyplasia,or ankylosing spondylitis were treated with the total hip resurfacing arthroplasty.Among them,59 patients (66 hips) were male,and 45 patients (50 hips) were female,with an average age of 39.7 years (range,16-67 years).Standard operation technique was performed for all patients with Conserve Plus prosthesis.Each patient was followed up at 1 month,3 months,6 months,1 year postoperatively.Results Three patients (4 hips) were lost,so 101 patients (112 hips) were followed up for an average period of 33 months (range,9-66 months).The average Harris hip score was improved significantly from 37.6±6.3 preoperatively to 91.3±5.3 at final follow-up; 104 hips were excellent,7 hips were good,1 hip was poor,and the excellent and good rate was 99.1％.At final follow-up,the average abduction angle of the acetabutar cup was 42.7°(range,36°-55°); the average femoral prothesis stem-shaft angle was 138.5° (range,132°-146°).Two patients presented with heterotopic ossification (Brook Ⅲ and Brook Ⅱ ).One patient presented with prothesis dislocation,which healed after being treated with manual reduction.There was no femoral neck fracture,infection,or prosthesis loosening.Conclusion With strict patient selection criteria and optimized technique,the short-term results of metal-on-metal hip resurfacing arthroplasty are satisfactory.

Role of preoperative C-reactive protein and erythrocyte sedimentation rate in predicting postoper-ative infections following multiple fractures / 中华创伤杂志

Objective To discuss the value of preoperative C-reactive protein (CRP) and eryth-rocyte sedimentation rate (ESR) in predicting postoperative infections following multiple fractures. Methods A study was conducted in 78 patients with multiple fractures (complicated with pelvic frac-ture, ISS > 18) treated in our department from December 2006 to March 2009. CRP and ESR levels be-fore second damage control operation as well as postoperative infections were recorded. Meanwhile, the optimal cut-off value was determined by receiver operating characteristic curve and analyzed. Results There were 11 patients with postoperative infection. The preoperative optimal cut-off value of CRP was 50 mg/L, with a sensitivity of 0.909 and a specificity of 0.821. The preoperative optimal cut-off value of ESR was 27.5 mm/h, with a sensitivity of 0.818 and a specificity of 0.791. The combination tests showed the sensitivity and specificity of 0.875 and 0.900 respectively. Conclusion CRP (50 mg/L) can be a sensitive predictive index for postoperative infection in the multiple fractures (complicated with pelvic fractures). Combination test of CRP and ESR can benefit diagnosis of postoperative infection.