Effect of continuous positive airway pressure on nocturnal blood pressure in patients complicated with obstructive sleep apnea-hypopnea syndrome and different circadian rhythms of hypertension / 中华健康管理学杂志

Objectives:To analysis the effect of continuous positive airway pressure (CPAP) on nocturnal blood pressure in patients complicated with obstructive sleep apnea-hypopnea syndrome (OSAHS) and different circadian rhythms of hypertension.Methods:A total of 61 eligible patients were monitored by overnight polysomnography (PSG) at the Sleep Center of the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University between January 2020 and April 2021. During the period of PSG monitoring, continuous non-invasive blood pressure (BP) and heart rate variability (HRV) were monitored simultaneously. Frequency domain analysis was used to measure HRV and low/high frequency was used to indirectly reflect sympathetic activity. According to the nighttime systolic BP decrease rate, patients were divided into three groups: dipper pattern (descent rate ≥10%), non-dipper pattern (descent rate was less than 10% but higher than 0) and reverse dipper pattern (descent rate≤0). The PSG parameters, BP data as well as sympathetic activity etc. were compared within and among groups before and after CPAP treatment. Multiple linear regression analyses were used to explore the influencing factors of antihypertensive effect of CPAP.Results:There were no significant differences in awake systolic BP (SBP) values, the severity of OSAHS, ESS scores, awake sympathetic activity and the other baseline data among the three groups. After CPAP treatment, the mean value of asleep BP in entire group showed a modest decline as compared to the baseline values [SBP decreased 4.6 mmHg (1 mmHg=0.133 kPa); diastolic blood pressure (DBP) decreased 2.4 mmHg, both P<0.001]. Subgroup analysis showed a significant reduction in asleep SBP of 11.1 mmHg and DBP of 4.9 mmHg (both P<0.001) in reverse dipper group, respectively, compared with the baseline values. While in dipper and non-dipper group, there were no significant differences before and after CPAP treatment in terms of BP (both P>0.05). In addition, there was no difference in awake sympathetic activity among three groups, while sleep sympathetic activity showed a gradual increasing trend. Sleep sympathetic activity decreased significantly from baseline after CPAP treatment in reverse dipper group ( P<0.001), while no differences were found in the other two groups before and after treatment. After controlling for baseline data such as age etc., the line regression model showed that the antihypertensive effect of CPAP was correlated with reverse dipper (SBP: β=0.548, P=0.002; DBP: β=0.454, P=0.013) and the improvement of nocturnal MpO 2 (SBP: β=0.410, P=0.046), but not with the severity of OSAHS, daytime sleepiness, or baseline BP values. Conclusion:For patients with moderate to severe OSAHS and hypertension, reverse dipper is an effective indicator to predict the antihypertensive effect of CPAP therapy.

Clinical study of biofeedback combined with oral Liumo Decoction in the treatment of functional constipation and qi constipation syndrome / 国际中医中药杂志

Objective:To explore the curative effect of biofeedback combined with oral Liumo Decoction on functional constipation (FC) and qi constipation syndrome.Methods:According to random number table method, 120 patients with FC of qi constipation meeting inclusion criteria in Beijing Rectum Hospital were divided into two groups between January 2018 and December 2019, 60 in each group. The control group was treated with biofeedback, while the observation group was additionally treated with oral Liumo Decoction. All were treated for 4 weeks. Before and after treatment, TCM syndromes were scored and recorded. The resting anal pressure (RAP) was detected. The anal maximal contraction pressure (AMCP) was detected by forced systolic anus. In relaxation status, gas was injected into rectal balloon to record the rectal sensation threshold (RST) and rectal maximum tolerance (RMT). The levels of serum substance P and NO were detected by double-antibody sandwich ELISA and immunoturbidimetry. The adverse events were recorded, and clinical curative effect was evaluated.Results:The differences in total response rate between the observation group and the control group was statistically significant [89.3% (50/56) vs. 64.4% (38/59)] ( χ 2=9.90, P=0.002). After treatment, scores of TCM syndromes in observation group was significantly lower than that of the control group ( t=-15.36, P<0.01). After treatment, the RAP [(48.31±4.15) mmHg vs. (53.64±5.46) mmHg, t=-5.88], RST [(30.14±3.17) ml vs. (35.42±3.12) ml, t=-9.00] and RMT [(154.21±15.27) ml vs. (160.61±16.38)ml, t=-2.16] in observation group were significantly lower than those in the control group ( P<0.05), while AMCP [(156.67 ± 15.62) mmHg vs. (132.26 ± 13.21) mmHg, t=9.07] was significantly higher than that of the control group ( P<0.01). After treatment, the substance P in observation group was significantly higher than that of the control group ( t=9.08, P<0.01), while NO was significantly lower than that of the control group ( t=-6.58, P<0.01). There were no serious adverse events during treatment in either group. Conclusion:Biofeedback combined with oral Liumo Decoction can alleviate clinical symptoms, improve anorectal dynamics indexes and regulate levels of enteric neurotransmitters in patients with FC of qi constipation with safety.

A high-efficiency and versatile CRISPR/Cas9-mediated HDR-based biallelic editing system / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Clustered regulatory interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 nuclease (Cas9), the third-generation genome editing tool, has been favored because of its high efficiency and clear system composition. In this technology, the introduced double-strand breaks (DSBs) are mainly repaired by non-homologous end joining (NHEJ) or homology-directed repair (HDR) pathways. The high-fidelity HDR pathway is used for genome modification, which can introduce artificially controllable insertions, deletions, or substitutions carried by the donor templates. Although high-level knock-out can be easily achieved by NHEJ, accurate HDR-mediated knock-in remains a technical challenge. In most circumstances, although both alleles are broken by endonucleases, only one can be repaired by HDR, and the other one is usually recombined by NHEJ. For gene function studies or disease model establishment, biallelic editing to generate homozygous cell lines and homozygotes is needed to ensure consistent phenotypes. Thus, there is an urgent need for an efficient biallelic editing system. Here, we developed three pairs of integrated selection systems, where each of the two selection cassettes contained one drug-screening gene and one fluorescent marker. Flanked by homologous arms containing the mutated sequences, the selection cassettes were integrated into the target site, mediated by CRISPR/Cas9-induced HDR. Positively targeted cell clones were massively enriched by fluorescent microscopy after screening for drug resistance. We tested this novel method on the amyloid precursor protein (APP) and presenilin 1 (PSEN1) loci and demonstrated up to 82.0% biallelic editing efficiency after optimization. Our results indicate that this strategy can provide a new efficient approach for biallelic editing and lay a foundation for establishment of an easier and more efficient disease model.

Ethyl Acetate Fraction of Dicliptera chinensis (L.) Juss. Ameliorates Liver Fibrosis by Inducing Autophagy via PI3K/AKT/mTOR/p70S6K Signaling Pathway / 中国结合医学杂志

OBJECTIVE@#To investigate the molecular mechanism underlying the anti-hepatic fibrosis activity of ethyl acetate fraction Dicliptera chinensis (L.) Juss. (EDC) in human hepatic stellate cells (HSCs) in vitro and in a carbon tetrachloride (CCl4)-induced hepatic fibrosis mouse model in vivo.@*METHODS@#For in vitro study, HSCs were pre-treated with platelet-derived growth factor (10 ng/mL) for 2 h to ensure activation and treated with EDC for 24 h and 48 h, respectively. The effect of EDC on HSCs was assessed using cell counting kit-8 assay, EdU staining, transmission electron microscopy, immunofluorescence staining, and Western blot, respectively. For in vivo experiments, mice were intraperitoneally injected with CCl4 (2 ° L/g, adjusted to a 25% concentration in olive oil), 3 times per week for 6 weeks, to develop a hepatic fibrosis model. Forty 8-week-old male C57BL/6 mice were divided into 4 groups using a random number table (n=10), including control, model, positive control and EDC treatment groups. Mice in the EDC and colchicine groups were intragastrically administered EDC (0.5 g/kg) or colchicine (0.2 mg/kg) once per day for 6 weeks. Mice in the control and model groups received an equal volume of saline. Biochemical assays and histological examinations were used to assess liver damage. Protein expression levels of α -smooth muscle actin (α -SMA) and microtubule-associated protein light chain 3B (LC3B) were measured by Western blot.@*RESULTS@#EDC reduced pathological damage associated with liver fibrosis, downregulated the expression of α -SMA and upregulated the expression of LC3B (P<0.05), both in HSCs and the CCl4-induced liver fibrosis mouse model. The intervention of bafilomycin A1 and rapamycin in HSCs strongly supported the notion that inhibition of autophagy enhanced α -SMA protein expression levels (P<0.01). The results also found that the levels of phosphoinositide (PI3K), p-PI3K, AKT, p-AKT, mammalian target of rapamycin (mTOR), p-mTOR, and p-p70S6K all decreased after EDC treatment (P<0.05).@*CONCLUSIONS@#EDC has anti-hepatic fibrosis activity by inducing autophagy and might be a potential drug to be further developed for human liver fibrosis therapy.

Expert Consensus on the Treatment of Antiangiogenic Agents for Radiation Brain Necrosis / 中国肺癌杂志

Vascular damage is followed by vascular endothelial growth factor (VEGF) expression at high levels, which is an important mechanism for cerebral radiation necrosis (CRN) development. Antiangiogenic agents (Bevacizumab) alleviates brain edema symptoms caused by CRN through inhibiting VEGF and acting on vascular tissue around the brain necrosis area. Many studies have confirmed that Bevacizumab effectively relieves symptoms caused by brain necrosis, improves patients' performance status and brain necrosis imaging. Considering that the efficacy of antiangiogenic therapy is mainly related to the duration of drug action, low-dose antiangiogenic agents can achieve favorable efficacy. Prevention is the best treatment. The occurrence of CRN is associated with tumor-related factors and treatment-related factors. By controlling these factors, CRN can be effectively prevented.
.

Radiotherapy and prognostic analysis of breast cancer patients with isolated regional recurrence after mastectomy / 中华放射肿瘤学杂志

Objective:To analyze the prognosis of patients with isolated regional recurrence (RR) after mastectomy, and evaluate the efficacy of radiotherapy and identify the optimal radiation target volumes.Methods:Clinical data of 144 patients with first isolated RR after mastectomy between 2001 and 2018 were retrospectively analyzed. All patients had not received post-mastectomy radiotherapy. The primary endpoints consisted of the subsequent locoregional recurrence (sLRR), distant metastasis (DM), progression-free survival (PFS) and overall survival (OS).Results:With a median follow-up of 82.5 months after RR, the 5-year sLRR, DM, PFS and OS rates for the entire group were 42.1%, 71.9%, 22.9% and 62.6%, respectively. Local plus systemic therapy was an independent favorable prognostic factor for sLRR ( P<0.001) and PFS ( P=0.013). The sLRR rate in the surgery plus radiotherapy group was the lowest ( P<0.001). Surgery plus radiotherapy significantly reduced the 5-year risk of recurrence within the initially involved nodal regions ( P<0.001). Patients with chest wall irradiation obtained the 5-year subsequent chest wall recurrence rate of 12.1% compared to 14.8%( P=0.873) for those without chest wall irradiation. The subsequent supraclavicular recurrence rate was lower in patients with prophylactic supraclavicular irradiation than that without prophylactic supraclavicular irradiation (9.9% vs. 23.8%, P=0.206). The incidence rates of initially uninvolved axillary and internal mammary nodal recurrence were below 10% regardless of prophylactic irradiation or not. Conclusions:Patients with RR alone have an optimistic 5-year OS in the contemporary era. Comprehensive locoregional treatment including surgery and radiotherapy combined with systemic therapy is recommended. The chest wall, axillary and internal mammary nodal prophylactic irradiation should not be routinely performed for all patients with RR. The value of supraclavicular prophylactic irradiation remains to be evaluated.

Radiotherapy for and prognosis of breast cancer patients with isolated chest wall recurrence after mastectomy / 中华放射肿瘤学杂志

Objective:To investigate the radiation field and dose selection of patients with isolated chest wall recurrence (ICWR) after modified radical mastectomy, and analyze the prognostic factors related to subsequent chest wall recurrence.Methods:Clinical data of 201 patients with ICWR after mastectomy admitted to the Fifth Medical Center, Chinese PLA General Hospital from 1998 to 2018 were retrospectively analyzed. None of the patients received postoperative adjuvant radiotherapy. After ICWR, 48 patients (73.6%) underwent surgery and 155 patients (77.1%) received radiotherapy. Kaplan-Meier method was used to calculate the post-recurrence progression-free survival (PFS) rates and the difference was compared by log-rank test. Multivariate analysis was performed using Cox regression model. Competing risk model was adopted to estimate the subsequent local recurrence (sLR) rates after ICWR and the difference was compared with Gray test. Multivariate analysis was conducted using F&G analysis. Results:With a median follow up of 92.8 months after ICWR, the 5-year PFS rate was 23.2%, and the 5-year sLR rate was 35.7%. Multivariate analysis showed that patients with surgery plus radiotherapy and recurrence interval o F>12 months had a lower sLR rate. Patients with recurrence interval o F>48 months, local plus systemic treatment and surgery plus radiotherapy had a higher PFS rate. Among the 155 patients who received chest wall radiotherapy after ICWR, total chest wall irradiation plus local boost could improve the 5-year PFS rate compared with total chest wall irradiation alone (34.0% vs. 15.4%, P=0.004). Chest wall radiation dose (≤60 Gy vs.>60 Gy) exerted no significant effect upon the sLR and PFS rates (both P>0.05). In the 53 patients without surgery, the 5-year PFS rates were 9.1% and 20.5%( P=0.061) with tumor bed dose ≤60 Gy and>60 Gy, respectively. Conclusions:Local radiotherapy is recommended for patients with ICWR after modified radical mastectomy of breast cancer, including total chest wall radiation plus local boost. The radiation dose for recurrence should be increased to 60 Gy, and it should be above 60 Gy for those who have not undergone surgical resection. In addition, patients with ICWR still have a high risk of sLR, and more effective treatments need to be explored.

Research progress on the relationship between miRNA and diagnosis and treatment of gastric cancer / 中国医师杂志

Gastric cancer is one of the most common malignant tumors in China, and its pathogenesis is complex. At present, there is no good method for the diagnosis and treatment of gastric cancer. However, studies have shown that microRNA (miRNA) has abnormal expression in gastric cancer, which participates in the regulation of gastric cancer related genes, and has an impact on the occurrence, development, diagnosis and treatment of gastric cancer. This paper aims to review the relationship between miRNA and the diagnosis and treatment of gastric cancer, as well as the drug resistance in the treatment, so as to lay the foundation for the follow-up research and clinical diagnosis and treatment.

Effect of glucosamine combined with sodium hyaluronate on serum IL-1β and TNF-α levels in patients with Kashin-Beck disease / 中华地方病学杂志

Objective:To study the effect of glucosamine combined with sodium hyaluronate on serum interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) levels in patients with Kashin-Beck disease (KBD).Methods:In a prospective design, patients with KBD admitted to South Hospital of Yantaishan Hospital from January 2017 to January 2019 were selected and divided into control, observation, and replacement groups. The control group was treated with glucosamine sulfate, the observation group was treated with intra-articular injection of sodium hyaluronate on the basis of the control group, and the replacement group was treated with artificial knee arthroplasty. The clinical efficacy, visual analogue scale (VAS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) of the three groups were compared before treatment, 6 weeks and 6 months after treatment. Blood samples were collected from the patients, and the serum levels of IL-1β and TNF-α were measured by enzyme-linked immunosorbent assay (ELISA) to compare the serum levels of IL-1β and TNF-α in the three groups before treatment, 6 weeks and 6 months after treatment.Results:The age of patients in the control group was (53.76 ± 7.33) years old, including 19 males and 23 females. The age of patients in the observation group was (54.18 ± 7.06) years old, including 20 males and 22 females. The age of the replacement group was (55.17 ± 6.43) years old, including 17 males and 13 females. The total effective rate in observation group (92.86%, 39/42) was significantly higher than that of the control group (76.19%, 32/42, χ 2 = 4.459, P < 0.05). At 6 weeks and 6 months after treatment, the VAS scores in the observation group [(4.10 ± 1.21), (3.16 ± 0.95) points] were significantly lower than those in the control group [(5.48 ± 1.17), (4.06 ± 0.74) points, P < 0.05]; at 6 weeks after treatment, the VAS score in the replacement group [(3.28 ± 0.89) points] was significantly lower than that in the observation group ( P < 0.05). At 6 weeks and 6 months after treatment, the WOMAC scores in the observation group [(40.72 ± 4.19, 25.86 ± 3.02) points] were significantly lower than those in the control group [(48.29 ± 2.16), (36.81 ± 3.13) points, P < 0.05]; the WOMAC scores in the replacement group [(29.68 ± 4.22), (23.57 ± 3.86) points] were significantly lower than those of the observation group ( P < 0.05). The serum levels of IL-1β [(9.28 ± 2.74), (6.85 ± 2.27) pg/ml] and TNF-α [(12.66 ± 4.54), (10.34 ± 3.48) pg/ml] in the observation group were significantly lower than those in the control group [(12.78 ± 2.79), (10.36 ± 2.63), (15.51 ± 4.63), (14.64 ± 4.27) pg/ml, P < 0.05], the serum levels of IL-1β [(6.12 ± 3.55), (5.39 ± 2.23) pg/ml], TNF-α [(10.42 ± 3.13) , (8.19 ± 3.15) pg/ml] in the replacement group were significantly lower than those in the observation group at 6 weeks and 6 months after treatment ( P < 0.05). Conclusion:Glucosamine combined with intra-articular injection of sodium hyaluronate can relieve inflammation, improve pain and promote joint function recovery in patients with KBD, but there is still a certain gap compared with knee arthroplasty.

Association between bilirubin levels and diabetic retinopathy in type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective:To investigate the correlation between serum bilirubin level and the risk of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus of different sexes.Methods:A total of 1 304 patients with type 2 diabetes mellitus were included in this study. The clinical data were collected and fundus examination was performed. According to the results of fundus examination, the patients were divided into DR group and Non-DR (NDR) group. The correlation between the levels of serum total bilirubin, direct bilirubin, indirect bilirubin, and the occurrence of DR was analyzed.Results:The levels of total bilirubin, direct bilirubin, and indirect bilirubin in DR group were significantly lower than those in NDR group. Univariate analysis showed that the levels of total bilirubin and indirect bilirubin were negatively correlated with the occurrence of DR ( P<0.01). There was no significant correlation between the level of direct bilirubin and the occurrence of DR. Smooth curve fitting showed that there was a U-shaped relationship between the levels of total bilirubin and indirect bilirubin and the risk of DR in women, while a negative correlation between total bilirubin, indirect bilirubin and the risk of DR in men. The results of multiple regression analysis showed that in men total bilirubin increased by 1 μmol/L, the risk of DR decreased by 8% ( OR=0.92, 95% CI 0.88-0.98, P<0.01). Indirect bilirubin increased by 1 μmol/L, and the risk of DR decreased by 9% ( OR=0.91, 95% CI 0.84-0.96, P<0.01). In women, when total bilirubin<12.8 μmol/L, for every 1 μmol/L increase in total bilirubin, the risk of DR decreased by 17%( OR=0.83, 95% CI 0.72-0.95, P<0.01); When total bilirubin≥12.8 umol/L, for every 1 μmol/L increase in total bilirubin, the risk of DR increased by 10%( OR=1.10, 95% CI 1.01-1.20, P<0.05); When indirect bilirubin<9.8 μmol/L, for every 1 μmol/L increase in indirect bilirubin, the risk of DR decreased by 20%( OR=0.80, 95% CI 0.68-0.94, P<0.01); When indirect bilirubin≥9.8 μmol/L, for every 1 μmol/L increase in indirect bilirubin, the risk of DR increased by 13%( OR=1.13, 95% CI 1.01-1.25, P<0.05). Conclusion:This study shows that there is a U-shaped relationship between the levels of total bilirubin and indirect bilirubin and the risk of DR in female patients with type 2 diabetes mellitus, and there is a negative correlation between total bilirubin, indirect bilirubin and the risk of DR in male patients. However, there was no significant correlation between direct bilirubin and DR risk.

Correlation between the oxygen desaturation rate and blood pressure among patients with severe obstructive sleep apnea syndrome and the possible mechanism / 中华健康管理学杂志

Objective:To investigate the association between oxygen desaturation rate and blood pressure (BP) among severe obstructive sleep apnea syndrome (OSAS) and the possible mechanism.Methods:Patients with snoring were enrolled from the Department of Sleep Medicine Center, the Affiliated Huaian No.1 People′s Hospital of Nanjing Medical University form March 2018 to January 2019 and underwent polysomnography (PSG). Noninvasive BP and Heart rate variability were full-night monitored continuously and synchronized with PSG. Based on the PSG results and exclusion criteria, a total of 86 severe OSAS patients were enrolled in this study and divided into two groups according to the ambulatory BP measurements: hypertensive group ( n=44) and normotensive group ( n=42). Oxygen desaturation rate was expressed as the change in the percentage of pulse oxyhemoglobin saturation (SpO 2) per second during desaturation events after the obstructive apnea events occurred. The PSG parameters were compared between the two group and the multiple regression analyses were used to explore the association between oxygen desaturation rate and BP and its possible mechanism. Results:The apnea-hyperpnoea index (AHI) and respiratory event-related arousals (RERAs) were significantly higher in hypertensive group than those in normotensive group [(69.8±18.2) vs. (56.5±13.9) event/h; (40.5±17.4) vs. (30.2±14.6) event/h, both P<0.01]. In addition, hypoxia exposure conditions in the hypertensive group were more severe than those in the normotensive group, especially oxygen desaturation rate [(0.45±0.14)%/s vs. (0.33±0.10)%/s, P<0.001]. After adjusting for age, sex, neck circumference, waist circumference, smoking, drinking, the regression analyses showed that only the oxygen desaturation rate was significantly associated with both awake and asleep BP in OSAS patients ( β=0.473, 0.478, both P<0.01) and the correlation analyses suggested that the oxygen desaturation rate was related to the both awake and asleep sympathetic-parasympathetic imbalance ( r=0.367, 0.337, both P<0.01). Conclusion:Oxygen desaturation rate is closely related to BP levels in patients with severe OSAS, and the underlying mechanism is associated with the increased sympathetic activity.

Analysis of adverse events of transport in critical patients with extracorporeal membrane oxygenation / 中国实用护理杂志

Objective:To discuss how to avoid the occurrence of adverse events and provides basis for improving the extracorporeal membrane oxygenation (ECMO) transport safety management to formulate the corresponding preventive measures through analyzing the causes and characteristics of adverse events in transport of ECMO.Methods:By using a self-designed ECMO transport observation table to collect data, with a retrospective study of adverse events in patients with ECMO transport in ECMO center of Beijing Chaoyang Hospital from January 2013 to June 2017, carrying out classification and analysis according to the causes of adverse events and the potential risks of the patients, thus put forward the feasible preventive measures.Results:There were 53 cases of ECMO transport in study period, with 18 cases (33.96%) of adverse events, among which the incidence of adverse events in inner-hospital transport was 34.21% (13/38) and that in inter-hospital transport was 33.33% (5/15). There was no patient died in ECMO transport. In the adverse events of ECMO transport, the main causes were related to transport staff, transport equipment and patient, which accounting for 1/3 of each. Among them, the most prominent was 4 cases (22.22%) of equipment lacking and 3 cases of battery and power supply (16.67%). In classification according to the risk degree of patients, 6 cases (33.33%) of third grade risk were found.Conclusions:It is safe and feasible to carry out ECMO transport in inner-hospital transport and inter-hospital transport based on ECMO transport team and transport process of this hospital. However the unexpected events of high risk or crisis of life is inevitable in ECMO transport. Through standardized training for ECMO team, with full assessment before transport, by the use of ECMO checklist and strict implementation of various transport processes and specifications, the incidence of adverse events in ECMO transport may be reduced.

Comparison of soil hydraulic properties in wild and cultivated areas of Notopterygium incisum / 中国中药杂志

To clarify the difference of soil moisture characteristics between mixed broad leaf-conifer forest soil and artificial cultivation of Notopterygium incisum, the HYPROP system and the dew point potential meter were used to determine soil water retention curves(SWRC) for samples of two horizons(i.e. 2-7 cm, 10-15 cm). The basic physical and chemical properties of soil and its water characteristic parameters were also determined. The result showed as fllows:①The bulk density of mixed coniferous-broad leaf forest soil was between 0.33 and 0.52 g·cm~(-3), significantly lower than the corresponding value of field soil(1.01-1.18 g·cm~(-3))(P<0.05), While the organic matter content was significantly higher than the corresponding value of field soil(P<0.05). ②The saturated water content(θ_s), field water holding capacity(θ_(FC)) and Water that can be effectively utilized by plants(θ_(PAC)) of mixed coniferous-broadleaved forest soil were significantly higher than the corresponding value of field soil(P<0.05), while the retained water content(θ_r) value that cannot be effectively utilized by plants was significantly lower than that of field soil(P<0.05). ③The values of structural porosity(0.13-0.24 cm~3·cm~(-3)) and Matrix porosity(0.34-0.44 cm~3·cm~(-3)) of mixed coniferous-broadleaved forest soil were higher than the corresponding values of field soil. Therefore, with low bulk density and high content of organic matter, mixed coniferous-broadleaved forest soil can store more water in soil in the form of effective water to meet the needs of plants for water, thus possibly forming high quality medicinal materials of Notopterygii Rhizoma et Radix. In conclusion, the results of this study can provide theoretical basis guidance for soil structure improvement and water management to form high quality medicinal materials in the artificial cultivation of N. incisum.

Phosphorylated TDP-43 Staging of Primary Age-Related Tauopathy / 神经科学通报·英文版

Primary age-related tauopathy (PART) is characterized by tau neurofibrillary tangles (NFTs) in the absence of amyloid plaque pathology. In the present study, we analyzed the distribution patterns of phosphorylated 43-kDa TAR DNA-binding protein (pTDP-43) in the brains of patients with PART. Immunohistochemistry and immunofluorescence double-labeling in multiple brain regions was performed on brain tissues from PART, Alzheimer's disease (AD), and aging control cases. We examined the regional distribution patterns of pTDP-43 intraneuronal inclusions in PART with Braak NFT stages > 0 and ≤ IV, and a Thal phase of 0 (no beta-amyloid present). We found four stages which indicated potentially sequential dissemination of pTDP-43 in PART. Stage I was characterized by the presence of pTDP-43 lesions in the amygdala, stage II by such lesions in the hippocampus, stage III by spread of pTDP-43 to the neocortex, and stage IV by pTDP-43 lesions in the putamen, pallidum, and insular cortex. In general, the distribution pattern of pTDP-43 pathology in PART cases was similar to the early TDP-43 stages reported in AD, but tended to be more restricted to the limbic system. However, there were some differences in the distribution patterns of pTDP-43 between PART and AD, especially in the dentate gyrus of the hippocampus. Positive correlations were found in PART between the Braak NFT stage and the pTDP-43 stage and density.

Comparison of cryoballoon ablation for atrial fibrillation guided by real-time three-dimensional transesophageal echocardiography vs. contrast agent injection / 中华医学杂志(英文版)

BACKGROUND@#Pulmonary vein (PV) occlusion generally depends on repetitive contrast agent injection when cryoballoon ablation for atrial fibrillation (AF). The present study was to compare the effect of cryoballoon ablation for AF guided by transesophageal echocardiography (TEE) vs. contrast agent injection.@*METHODS@#Eighty patients with paroxysmal AF (PAF) were enrolled in the study. About 40 patients underwent cryoballoon ablation without TEE (non-TEE group) and the other 40 underwent cryoballoon ablation with TEE for PV occlusion (TEE group). In the TEE group during the procedure, PVs were displayed in 3-dimensional images to guide the balloon to achieve PV occlusion. The patients were followed up at regularly scheduled visits every 2 months.@*RESULTS@#No differences were identified between the groups in regard to the procedure time and cryoablation time for each PV. The fluoroscopy time (6.7 ± 4.2 min vs. 17.9 ± 5.9 min, P < 0.05) and the amount of contrast agent (3.0 ± 5.1 mL vs.18.1 ± 3.4 mL, P < 0.05) in the TEE group were both less than the non-TEE group. At a mean of 13.0 ± 3.3 mon follow-up, success rates were similar between the TEE group and non-TEE group (77.5% vs. 80.0%, P = 0.88).@*CONCLUSIONS@#Cryoballoon ablation with TEE for occlusion of the PV is both safe and effective. Less fluoroscopy time and a lower contrast agent load can be achieved with the help of TEE for PV occlusion during procedure.

Genetic mutations among Chinese patients with non-small cell lung cancer and targeted therapy / 中华医学遗传学杂志

OBJECTIVE@#To provide mutational analysis and targeted therapy for Chinese patients with non-small cell lung cancer (NSCLCs).@*METHODS@#Mutation of 13 genes including EGFR, ALK, KRAS were detected among 102 patients with NSCLCs by next-generation sequencing, and the correlation between mutations and clinical characteristics and response to targeted therapy was analyzed.@*RESULTS@#In total 42 EGFR mutations (40.8%), 3 ALK fusions (3.9%), 6 KRAS mutations (5.8%), 3 PIK3CA mutations and amplifications (2.9%), 1 MET exon 14-skipping (1%) and 1 RET fusion (1%) were detected. The occurrence of mutations have varied with sample types and pathological types. Seventeen out of 20 EGFR tyrosine kinase inhibitor (TKI)-treated patients with EGFR mutations have shown remission.@*CONCLUSION@#The mutational frequency of NSCLCs among Chinese patients slightly differed from the western populations, in particular the frequency of ALK fusion. The mutations have well correlated with clinical response to targeted therapy.

Evaluation of menopause and treatment choice of breast cancer patients before endocrine therapy / 中华肿瘤杂志

Aromatase inhibitors (AIs) directly applies to postmenopausal breast cancer patients. Patients underwent bilateral ovariectomy or ≥60 years were acknowledged as postmenopausal.Alternatively, for <60 years breast cancer patients, sex hormone detection to evaluate menopause is recommended by National Comprehensive Cancer Network (NCCN) guideline, textbooks, and AIs clinical trials.However, series of clinical trial found that, a broad overlap region of follicle stimulating hormone and estradiol appeared between premenopausal and postmenopausal patients, which unable to determine the menopause even with sensitivity promotion of detection equipment or manners.We have abandon this detection in clinical treatment, and decision making was only according to the relapse risk and disease status. We recommend bilateral ovariectomy resection accompanied with AIs for breast cancer patients with high recurrence risk (e.g. T3-4 or LNM≥4) or patients with advanced metastatic disease.However, patients with low or moderate recurrence risk can be treated with tamoxifen.

Association between hemoglobin levels and diabetic retinopathy risk in type 2 diabetes mellitus / 中华内分泌代谢杂志

Objective The aim of this study was to evaluate the relationship between hemoglobin ( Hb ) levels and diabetic retinopathy( DR) risk in Chinese patients with type 2 diabetes mellitus( T2DM) . Methods A total of 629 patients who were hospitalized and diagnosed as T2DM were enrolled in the study. The clinical data were collected;All participants underwent an ophthalmic examination, including fundus photographs. They were divided into DR and non-diabetic retinopathy( NDR) groups based on the results of fundus examination. Anemia was defined according to Chinese anemia criteria. The analyses were performed to evaluate the relationships between Hb levels and DR risks. Results The patients with DR had lower hemoglobin levels and a higher prevalence of anemia compared to those without DR. A univariate analysis displayed a significant negative correlation between Hb levels and the rates of DR( P<0.01) . In multivariate linear regression, a 29％ decrease in DR risk was found with a 1 g/dl increase in Hb level(OR=0.713, 95％CI 0.598-0.850, P<0.01). Presence of anemia increased the risk of DR with OR=4.123(95％CI 1.793-9.478, P<0.01) times compared to those who did not have anemia. Conclusion The study indicates a negatire relationship letween Hb levels and DR risk, and a higher Hb levels may reduce the development of DR in T2DM.

Effects of soil water content on growth and accumulation of active ingredients of Notopterygium incisum / 中国中药杂志

To investigate the adaptive mechanism of Notopterygium incisum to water changes, one-year-old seedlings were used as test materials. The characteristics of growth, physiology, and active ingredients of N. incisum were studied at different soil water content by pot experiments. The result showed that: ①The water content at 100% field capacity is conducive to the growth and accumulation of biomass of N. incisum. The leaf length, petiole length, petiole diameter, root diameter, root length and biomass of underground dry of N. incisum were all significantly increased at the 100% field capacity, and they slightly declined at 70% field capacity. 20% field capacity could not provide the necessary water to growth of N. incisum, all N. incisum withered and died. ②With the extension of moisture treatment time, the relative content of chlorophyll (SPAD) in leaves and the activity of peroxidase (POD) in rhizome showed a trend of increasing firstly, decreasing then; the tendency of activity of superoxide dismutase (SOD) in rhizome increased; the content of malondialdehyde (MDA) in rhizome decreased firstly and increased then;. For the late test, the SPAD value, the activity of POD and SOD in N. incisum at the 40% field capacity were lower than 70% field capacity and 100 field capacity, while the content of MDA in rhizome were higher than 70% field capacity and 100% field capacity. ③ At 70% field capacity, the active ingredients accumulated most in the N. incisum. At the 70% field capacity, the notopterol and isoimperatorinwerehigher than100 field capacity and 40 field capacity. In summary, the soil water content at 70%-100% field capacity would contribute to the growth and accumulation of active ingredients of N. incisum.

Clinical Study on Herbal Cake Moxibustion plus Acupuncture for Treatment of Post-stroke Urinary Incontinence / 上海针灸杂志

Objective To investigate the clinical efficacy of herbal cake moxibustion plus acupuncture in treating post-stroke urinary incontinence.Methods Fifty patients with post-stroke urinary incontinence were randomized to a treatment group (26 cases) and a control groups (24 cases). The treatment group received herbal cake moxibustion plus acupuncture and the control group, acupuncture alone. Twenty-four-hour urine void number, incontinence severity and the clinical symptom score were recorded in the two groups before and after treatment.Results There were statistically significant pre-/post-treatment differences in twenty-four-hour urine void number and the clinical symptom score in the two groups (P<0.05). There were statistically significant differences in pre-/post-treatment twenty-four- hour urine void number difference value and clinical symptom score difference value between the treatment and control groups (P<0.05). There was a statistically significant pre-/post-treatment difference in incontinence severity in the two groups (P<0.05). There was a statistically significant post-treatment difference in incontinence severity between the treatment and control groups (P<0.05).Conclusion Herbal cake moxibustion plus acupuncture is an effective way to treat post-stroke urinary incontinence.