In Vitro Fatigue Test of Lung Volume Reduction Loop / 中国医疗器械杂志

Lung volume reduction loop uses bronchoscopic lung volume reduction(BLVR) technology to compress and collapse the necrotic emphysema tissue and exhaust the internal gas to achieve the purpose of lung volume reduction to treat emphysema. After the lung volume reduction loop is implanted into the human body, the compressed part of the lung tissue tends to expand with breathing, which makes the lung volume reduction loop expand into a linear trend periodically. Fatigue resistance is one of the most important performance indexes of the lung volume reduction loop. In the paper, Z-direction vibration fatigue machine was used to simulate the changes of human respiratory cycle movement to test the fatigue performance of lung volume reduction loop, which can provide some reference for the test method of in vitro fatigue performance of lung volume reduction related products in the future.

Application of nanoparticles in wound healing of diabetes / 中国药科大学学报

@#Due to oxidative stress, infection, vascular disease, inflammation and neuropathy caused by metabolic disorders induced by hyperglycemia, Diabetes mellitus (DM) patients often suffer from poor wound healing and develop diabetic foot ulcers (DFUs), which may even lead to amputation in severe cases.Through the deep understanding of the diabetic wound healing process and its pathophysiology, effective strategies for the treatment of wound injury can be obtained.Nano-preparation has been widely used in accelerating wound healing in recent years.On the one hand, nanoparticles are beneficial for diabetic wound healing; on the other hand, they can be used to deliver one or more therapeutic agents such as growth factors, nucleic acids, antibiotics and antioxidants, which can be continuously released within the target tissue.This paper reviews the application and mechanism of various nano-preparation in promoting diabetic wound healing.

Prenatal pyrethroid pesticides exposure and neurodevelopment of 2-year-old children: a birth cohort study / 中华预防医学杂志

Objective: To investigate the influence and critical windows of prenatal exposure to pyrethroid pesticides (PYRs) on neurodevelopment of 2-year-old children. Methods: The subjects of this study were derived from the Xuanwei Birth Cohort. A total of 482 pregnant women who participated in the rural district of Xuanwei birth cohort from January 2016 to December 2018 were included. Maternal urinary concentrations of PYRs metabolites during 8-12 gestational weeks, 20-23 gestational weeks and 32-35 gestational weeks were measured with ultra high performance liquid chromatography system coupled with a tandem mass spectrometry detector. Child neurodevelopment was evaluated with the Bayley Scales of Infant and Toddler Development-Third Edition at 2 years of age. Multivariate linear regression models and binary logistic regression models were used to assess the association between PYRs exposure during pregnancy and children's neurodevelopment. Results: A total of 360 mother-child pairs had complete data on maternal urinary PYRs metabolites detection and children's neurodevelopment assessment. The detection rate of any one PYRs metabolites during the first, second and third trimester were 93.6% (337/360), 90.8% (327/360) and 94.2% (339/360), respectively. The neurodevelopmental scores of Cognitive, Language, Motor, Social-Emotional, and Adaptive Behavior of 2-year-old children were (102.3±18.9), (100.2±16.3), (102.0±20.3), (107.8±23.3) and (85.8±18.6) points, respectively. After controlling for confounding factors, 4-fluoro-3-phenoxybenzoic acid (4F3PBA, one of PYRs metabolites) exposure in the first trimester reduced Motor (β=-5.02, 95%CI: -9.08, -0.97) and Adaptive Behavior (β=-4.12, 95%CI:-7.92, -0.32) scores of 2-year-old children, and increased risk of developmental delay of adaptive behavior (OR=2.07, 95%CI:1.13-3.82). Conclusion: PYRs exposure during the first trimester of pregnancy may affect neurodevelopment of 2-year-old children, and the first trimester may be the critical window.

Surgical resection for synchronous multiple pulmonary nodules identified difficultly in clinics / 中国胸心血管外科临床杂志

@#Objective 　To evaluate the role of surgical resection on synchronous multiple pulmonary nodules identified difficultly in clinics. Methods 　The clinical data of 97 patients with synchronous multiple pulmonary nodules who received surgical resection between 2012 and 2019 in Hunan Cancer Hospital were retrospectively analyzed. There were 72 males and 25 females, aged 58.1卤9.0 years. Among these patients, there were 78 patients with ipsilateral and 19 patients with bilateral pulmonary nodules. Clinicopathological parameters between main nodules and secondary nodules were evaluated. Perioperative morbidity was also assessed. Results 　The operation was successfully completed on all patients for the ipsilateral and bilateral lesions. Totally, 71.1% of mian lesions was mostly removed by lobectomy, and the completion rate of video-assisted thoracoscopic surgery (VATS) was 69.1% (67/97); 80.4% of secondary lesions were mostly removed by wedge resection, and the completion rate of VATS was 71.1% (69/97). The incidence of grade 3 or higher complications after unilateral or bilateral surgery was 12.8% and 5.3%, respectively. Postoperative pathology confirmed that the main lesions were malignant in 65 patients (67.0%), mainly adenocarcinoma (63.1%), of which 43.1%were in the stage Ⅰ; 32 patients were benign, mainly tuberculoma (56.3%). There were 29 patients of malignant secondary lesions, 67 benign, and 1 both benign and malignant; the pathological agreement rate of primary and secondary lesions was 54.6% (lung cancer metastases in the lung and all the benign). When the primary lesion was malignant with its diameters of <3 cm, 3-<5 cm, 5-7 cm, >7 cm, the metastatic rate of secondary lesions was 42.5%, 15.8%, 20.0%, 0, respectively. When the primary lesion was malignant with lymph node metastasis, the probability of the secondary lesion being a metastatic tumor was higher than that without lymph node metastasis (46.7% vs. 30.0%, P>0.05). When the primary lesion was malignant and the primary and secondary lesions were located in the same lobe, the secondary lesions were more likely to metastasize (54.5%), while when they were located on different lobes on the same side or different sides, the secondary lesions were more likely to be benign (58.1%, 72.7%), and the possibility of metastasis was small ( 32.6%, 9.1%). When the primary lesion was benign and clinical differential diagnosis was difficult, the secondary lesion was benign. Conclusion    For synchronous multiple pulmonary nodules, the diameter of the primary lesion is large, the metastatic rate of secondary lesions tends to decrease. In ipsilateral synchronous multiple pulmonary nodules, especially with node metastasis, the risk of metastatic nodule increases. Bilateral surgical resection does not significantly increase the perioperative morbidity.

Prevalence correlation of video display terminal syndrome and depression among medical students / 中国学校卫生

Objective@#To investigate the prevalence of video display terminal syndrome (VDT) among medical students in university, and to explore the correlation between VDT syndrome and depressive symptoms, so as to provide theoretical guidance for promoting college students mental health.@*Methods@#A total of 3 265 freshmen and juniors in the Department of Medicine of Nanchang University were surveyed with census method in November 2019 to collect information regarding general information, symptoms related to VDT syndrome, depression status.@*Results@#In the valid questionnaire, the detection rate of VDT syndrome among college students was 33.3%, and the detection rates of VDT syndrome varied significantly by sex and clinical major( χ 2=6.45, 18.82 , P <0.05); The detection rate of depressive symptoms was 54.6%. One way ANOVA showed that there was significant differences in VDT syndrome status between those with and without depression symptoms ( χ 2=63.88, P < 0.01 ). Multivariate Logistic regression showed that VDT syndrome could increase the risk of detecting depression ( OR=1.84, 95%CI=1.58-2.14, P <0.01).@*Conclusion@#VDT syndrome has a high detection rate in college medical students and is a risk factor for depression in medical students. Society and schools should pay attention to health education on the rational use of video terminals for medical students, and take corresponding measures to intervene, so as to improve the physical and mental health of medical students.

Establishment, validation and application of fluorescence focus assay for rapid titration of Japanese encephalitis virus / 中华微生物学和免疫学杂志

Objective:To establish and validate a fluorescence focus assay (FFA) for rapid titration of Japanese encephalitis virus (JEV) and to evaluate its application in the production of Japanese encephalitis vaccine.Methods:Recombinant JEV non-structural protein 1 (NS1) was expressed in a prokaryotic expression system. After purification, JEV-NS1 was used to immunize rabbits to induce polyclonal antibody. FFA was established with the polyclonal antibody to titer JEV. The accuracy of FFA was validated by comparing with plaque assay, and the specificity, precision, linearity, range and robustness of FFA were also validated. Twenty-eight batches of live-attenuated Japanese encephalitis vaccine were titrated with FFA and plaque assay to analyze the relationship between the two assays.Results:FFA established with polyclonal antibody against JEV-NS1 could be used to titrate JEV, and there was no cross reaction with other viruses (tick-borne encephalitis virus, yellow fever virus, coxsackievirus A2, coxsackievirus A4). Results of the validation tests showed that FFA met the requirement of quality control for live-attenuated Japanese encephalitis vaccine. FFA was more consistency than plaque assay.Conclusions:The established FFA could be used for virus titration in the production of live-attenuated Japanese encephalitis vaccine.

Coma in spontaneous intracranial hypotension complicated with subdural hematoma: a case report / 中华神经科杂志

Spontaneous intracranial hypotension can frequently result in several complications including subdural hygroma, subdural hematoma and cerebral venous thrombosis, but coma rarely. A case of spontaneous intracranial hypotension presented with orthostatic headaches was described. He experienced somnolence, disorientation, incontinence, and then coma, though received conservative treatment. Brain imaging demonstrated acute-on-chronic subdural hematoma, magnetic resonance myelography using heavily T 2-weighted fast spin-echo pulse sequences showed spinal longitudinal extradural collection, and magnetic resonance myelography with intrathecal gadolinium revealed cerebrospinal fluid leak at the level of T 6, T 7. The patient recovered consciousness after surgical evacuation of the hematoma, and the headache disappeared after a targeted epidural blood patch. The hematoma resolved 2 months later and the patient kept free from headache during follow-up.

Construction and demonstration of mobile health management model for elderly patients with coronary heart disease / 中华老年医学杂志

Objective:To observe the construction of mobile health management model for elderly patients with coronary heart disease, and to conduct empirical research.Methods:A total of 86 elderly patients with coronary heart disease treated in Henan Provincial People's Hospital from January 2019 to January 2021 were selected.They were randomly divided into 2 groups: the control group receiving routine intervention(n=43), and the observation group receiving mobile health management mode as an add-on to routine interventions(n=43).After 3 months of intervention in control versus observation groups, angina, readmission risk factors were assessed, and status of target criteria for low-density lipoprotein cholesterol(LDL-C), resting heart rate, systolic, and diastolic blood pressure as readmission risk factors were evaluated.Before and 3 months after intervention, the self-care ability of patients was evaluated.Results:Number of angina pectoris attacks was less in observation(0.53±0.18)than in control group(0.64±0.15)( t=3.079, P=0.003).Duration of the angina pectoris was shorter in observation(2.72±0.40)min than in control group(3.06±0.55)min, ( t=3.278, P=0.002).Rate of achieving effectiveness of indicators for the risk factors of readmission was higher in observation group than in control group as following data: LDL-C(90.7% and 72.1%, χ2=4.914, P=0.027), resting heart rate(95.4% and 81.4%, χ2=4.074, P=0.044), systolic blood pressure(86.1% and 60.5%, χ2=7.182, P=0.007)and diastolic blood pressure(88.4% and 67.4%, χ2=5.472, P=0.019).The scores of self responsibility, health knowledge, self-care skills and self-concept were higher in the observation group than in the control group, with a statistical significant difference(all P<0.05). Conclusions:The construction of mobile health management model and its application in elderly patients with coronary heart disease are beneficial to improve the symptoms of angina pectoris, reduce the risk factors of readmission and improve the ability of self-care of patients.

Clinical analysis of 19 patients with gastrointestinal schwannoma / 中国综合临床

Objective:To investigate the clinical features, diagnosis, treatment and prognosis of gastrointestinal neurilemmoma.Methods:A descriptive study was conducted to retrospectively analyze the clinical manifestations, endoscopic findings, pathological features, treatment methods and prognosis of patients with gastrointestinal neurilemmima diagnosed from May 2017 to November 2020 in the Second Affiliated Hospital of Xi'an Jiaotong UniversityResults:A total of 19 patients were collected, ranging in age from 45.0 to 70.0 years old, of whom 68.4% (13/19) were female. The clinical symptoms are non-specific, and some patients are asymptomatic (15.8%(3/19)) and may present with abdominal pain (57.9%(11/19)), nausea (31.6%(6/19)), abdominal distension (21.1%(4/19)) and decreased appetite (21.1%(4/19)), and a few with gastrointestinal bleeding (5.3%(1/19)). Tumors were most frequently found in the gastric body (42.1%(8/19)), followed by the duodenum (15.8%(3/19)). Endoscopic submucosal mass is easy to be misdiagnosed as stromal tumor. The pathological type showed shuttle cell tumor, immunohistochemical staining showed positive S100 and Vim, most Ki-67 staining proliferation rate was <5% (57.9%(11/19)), and a small part was ≥10% (10.5%(2/19)). Treatment was either endoscopic or surgical. No tendency to recur and metastasize was found in any of the neurilemmimas.Conclusion:Gastrointestinal neurilemmoma is a very rare submucosal tumor of the digestive tract, most of which are benign and rare in malignancy, and postoperative pathology is the gold standard for its diagnosis. Gastrointestinal neurilemmoma is common in middle-aged female, with diverse and non-specific clinical symptoms, difficult to differentiate from submucosal tumors such as stromal tumors, and its tendency to malignant transformation increases with tumor enlargement. Endoscopic resection is recommended for tumors with tumor diameter <3 cm without serosal invasion, with little trauma and no recurrence.

Single nucleotide polymorphisms in risk genes of restless legs syndrome: a Meta-analysis / 中华行为医学与脑科学杂志

Objective:To investigate the correlation between single nucleic acid polymorphisms (SNPs) of MEIS1, BTBD9, MAP2K5, PTPRD and restless leg syndrome (RLS).Methods:By searching the literatures published before March 1, 2021 at home and abroad, case-control studies on risk genes associated with RLS were collected, and the Review Manager 5.3 and Stata 15.1 softwares were used for statistical analysis.Results:A total of 8 studies were included, with a total of 7 824 cases and 14 645 controls.Meta analysis results showed that the SNPs locus of the risk gene associated with RLS was MEIS1 rs2300478( OR=1.68, 95% CI: 1.59-1.78), BTBD9 rs9296249( OR=1.62, 95% CI: 1.47-1.77), BTBD9 rs9357271( OR=1.49, 95% CI: 1.44-1.55), MAP2K5 rs12593813( OR=1.44, 95% CI: 1.36-1.53), MAP2K5 rs11635424( OR=1.47, 95% CI: 1.34-1.60)and PTPRD rs1975197( OR=1.34, 95% CI: 1.21-1.49). Conclusion:MEIS1 rs2300478, BTBD9 rs9296249, BTBD9 rs9357271, MAP2K5 rs12593813, MAP2K5 rs11635424 and PTPRD rs1975197 are the risk loci of RLS.

Effect of poly adenosine diphosphate-ribose polymerase-1 inhibitor fluzoparib on the proliferation and migration of pancreatic cancer cell PANC1 / 中华胰腺病杂志

Objective:To investigate the effects of poly adenosine diphosphate ribose polymerase-1(PARP-1) inhibitor fluzoparib on proliferation, apoptosis and migration of pancreatic cancer PANC1 cells.Methods:PANC1 cells cultured in conventional culture medium were used as control group, and PANC1 cells cultured in the medium containing fluzoparib were used as fluzoparib group. The effects of fluzoparib with different concentrations on the proliferation of PANC1 cells were detected by CCK8 method, and the half inhibitory concentration (IC 50) of fluzoparib on PANC1 cells was calculated. The effect of fluzoparib on apoptosis and cell cycle of PANC1 cells was detected by flow cytometry, and the migration ability of PANC1 cells was detected by cell scratch test and Transwell chamber. Results:Compared with control group, with the increase of fluzoparib concentration and the prolongation of the action time, the cell proliferation activity of PANC1 in fluzoparib group was significantly decreased, and the differences were statistically significant (all P values <0.05). IC 50 of fluzoparib on PANC1 cells cultured for 24 h was 0.03 mmol/L. After 24 h culture, the IC 50 apoptosis rate of fluzoparib group was (32.19±2.48)%, and the apoptosis rate of control group was (21.99±6.30)%. The former was greatly higher than the latter, and the difference was statistically significant ( P<0.05). The proportion of cells in G 2/M phase was (16.28±0.62)% in the fluzoparib group and (11.64±0.88)% in the control group, and the difference between the two groups was statistically significant ( P<0.05). The migration rates of PANC1 cells in IC 50 fluzoparib group in 12 h and 24 h culture were (2.59±1.46)% and (19.76±7.84)%; and those in control group were (27.08±2.17)% and (45.92±3.61)%, respectively. The number of transmembrane cells was (348±19) cells/10 visual field in the fluzoparib group and (587±14) cells/10 visual field in the control group. The migration ability of PANC1 cells in fluzoparib group was significantly lower than that in control group ( P<0.05). Conclusions:Fluzoparib can inhibit the proliferation and migration of PANC1 cells and promote the apoptosis of PANC1 in vitro, which may be an effective drug for the treatment of pancreatic cancer.

Recommendations on off-label antibiotics use in PICU / 中国小儿急救医学

Off-label antibiotics use in pediatric intensive care unit is not rare.Off-label antibiotics use is due to indication, age, dosage, frequency, route and method of administration, course of treatment, etc.It is necessary and reasonable for off-label antibiotics use in clinical practice, but there are also some risks.Off-label antibiotics use in clinical practice should follow the corresponding principles and standardized management.Drug treatment decisions should always be made on the basis that the individual child would be ultimately benefit.

Follow-up of children with cyclic vomiting syndrome: Combination therapy effects and clinical features / 中国小儿急救医学

Objective:To compare the efficacy of combination therapy on cyclic vomiting syndrome(CVS)in children, and improve the efficacy of CVS treatment in the future.Methods:This study retrospectively analyzed patients′ medical records of CVS, which were admitted to Digestive Department of Beijing Children′s Hospital from 2012 to 2019.The treatment regimen was A(Cyproheptadine+ Doxepin+ Valproate), B(Propranolol+ Cyproheptadine), or C(Propranolol+ Amitriptyline). Meanwhile, the patients should take drugs more than three months.The clinical data of 42 cases were analyzed retrospectively, and the treatment effect after discharge was followed up by telephone until October, 2020.Results:Among the 42 cases, 17 were male and 25 were female, whose mean age of onset was (4.65±3.23) years, and the age of diagnosis was (6.79±3.58) years.The main accompanied symptoms were abdominal pain and upper gastrointestinal bleeding.Forty-two patients were moderate/severe CVS.The regimens A, B and C were observed in 7, 11, and 24 patients, respectively.The age at improvement was(8.17±4.12)years.The course of treatment was(1.37±0.96)years.The age at follow-up was(10.32±4.03)years.During the 1-year follow-up, 35 cases were effective, and the efficiency was 83.3%.Among them, 23 cases had no paroxysmal vomiting and 7 cases had no effect.There was no significant difference in therapy effects among group A, B and C. Between the effective group and non-effective group, there were statistical differences in the personal history of hiatus hernia( P=0.024), the weight at follow-up ( P=0.042), and the course of medication( P=0.020). Conclusion:The combination regimen has a higher effective rate in the treatment of CVS.There was no significant difference among the three regimens in the treatment of CVS.For children with refractory CVS, who can not be treated with combination therapy, individualized therapy should be further developed.

Treatment strategies of cyclic vomiting syndrome in children / 中国小儿急救医学

Cyclic vomiting syndrome(CVS)is a functional gastrointestinal disorders, which the pathophysiology remains unclear.CVS usually occurs during childhood.With the increasing recognition of the diagnosis of CVS in children, therapeutic regimens become crucial.Therefore, according to the current research progress, this review summarized the therapeutic strategies of the four phases of CVS: the prodromal phase, the emetic phase, the recovery phase, and the inter-episodic or asymptomatic phase, including drugs dose and the modes of administration, which would help pediatricians to optimize the therapeutic regimes.

Research progress on naltrexone in the treatment of children with inflammatory bowel disease / 中国小儿急救医学

Inflammatory bowel disease refers to a group of non-specific chronic gastrointestinal inflammatory diseases of unknown causes, including ulcerative colitis, Crohn′s disease and indeterminate colitis.Recently, the incidence of inflammatory bowel disease in children has increased, which seriously affects the growth and development of children and the quality of life.Studies have shown that the opioid receptor antagonist naltrexone can reverse the inflammatory activity in inflammatory bowel disease and promote cell repair.This review summarized the research of application of naltrexone in the treatment of inflammatory bowel disease, aiming to further explore the effectiveness and safety of naltrexone in the treatment of inflammatory bowel disease in children.

Aging effect of osteoprotegerin and receptor activator of nuclear factor-κB ligand expression in human periodontal ligament cells under continuous static pressure / 华西口腔医学杂志

OBJECTIVES@#The expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-κB ligand (RANKL) in human periodontal ligament cells (HPDLCs) was investigated by cell culture under continuous static pressure.@*METHODS@#HPDLCs were primarily cultured by tissue explant method and divided into three groups: group A (13-18 years old), group B (19-29 years old), and group C (30-44 years old). CCK-8 was used to detect the proliferation of HPDLCs. The senescence of HPDLCs was detected by senescence-associated β-galactosidase staining. Cells in the three groups were respectively given 0, 1.5, 3, 6, 12, 24, 48, and 72 h of continuous static pressure in vitro. The expression of OPG and RANKL in the supernatant was detected by enzyme-linked immunosorbent assay.@*RESULTS@#After continuous static pressure in vitro for stimulation, the expression of OPG and RANKL changed. The expression of OPG increased with time and age (P<0.01). The expression of RANKL increased with time and decreased with age (P<0.01). The ratio of OPG/RANKL initially decreased, increased with time, and then continued to rise with age (P<0.01).@*CONCLUSIONS@#Aging could increase the expression of OPG and the ratio of OPG/RANKL and decrease the expression of RANKL in HPDLCs under continuous static pressure in vitro.

Analysis of Application Status of Hyperspectral Remote Sensing Technology in Medicinal Plant Research： A Review / 中国实验方剂学杂志

Chinese materia medica is the material basis of the development of traditional Chinese medicine， but the rapid growth of the demand for Chinese materia medica resources and environmental deterioration make a large number of wild medicine resources endangered. At present， artificial cultivation of Chinese medicinal materials is the main way to alleviate the contradiction between supply and demand in the market， but the production and quality of medicinal materials are seriously affected by the lack of process control， specialization and fine management in medicinal plant cultivation. Early prediction and evaluation of the growth， yield， diseases and insect pests of medicinal plants is an important technical means to guarantee the yield and quality of Chinese medicinal materials， and effective and non-destructive process monitoring technology is the prerequisite for realizing the modernization of Chinese medicine agriculture. With the advantages of rapid， non-destructive and accurate detection， hyperspectral remote sensing has been widely used in recent years for plant growth information extraction and yield assessment， as well as monitoring crop growth and response to adversity stress， becoming an important technical tool for precision agricultural production such as quality monitoring and pest and disease prevention. Therefore， combined with hyperspectral data processing and analysis methods， the application of hyperspectral remote sensing technology in monitoring plant physiological characteristics， environmental stress， resource investigation and quality inspection of medicinal materials is systematically reviewed， and combined with the characteristics of medicinal plants， the application prospect of hyperspectral remote sensing technology in improving the monitoring ability of production process of Chinese medicinal materials， realizing real-time dynamic monitoring of medicinal materials cultivation， developing early diagnosis technology of pests and diseases for nondestructive detection， and establishing quality traceability of high-quality Chinese medicinal materials is discussed， in order to solve the related problems in precision cultivation of Chinese medicine agriculture by hyperspectral remote sensing technology， and provide new ideas and solutions for the sustainable utilization of Chinese medicine resources and the development of intelligent Chinese medicine agriculture.

Analysis of perioperative efficacy and safety of cytoreductive surgery in the treatment of colorectal cancer peritoneal metastases / 中华胃肠外科杂志

Objective: To analyzed perioperative safety of cytoreductive surgery (CRS) for patients with colorectal cancer peritoneal metastasis (CRPM) and to construct a predictive model for serious advese events (SAE). Methods: A descriptive case-series study was conducted to retrospectively collect the clinicopathological data and treatment status (operation time, number of organ resection, number of peritoneal resection, and blood loss, etc.) of 100 patients with peritoneal metastases from colorectal cancer or appendix mucinous adenocarcinoma who underwent CRS at the Sixth Affiliated Hospital of Sun Yat-sen University from January 2019 to August 2021. There were 53 males and 47 females. The median age was 52.0 (39.0-61.8) years old. Fifty-two patients had synchronous peritoneal metastasis and 48 had metachronous peritoneal metastasis. Fifty-two patients received preoperative neoadjuvant therapy. Primary tumor was located in the left colon, the right colon and the rectum in 43, 28 and 14 cases, respectively. Fifteen patients had appendix mucinous adenocarcinoma. Measures of skewed distribution are expressed as M (range). Perioperative safety was analyzed, perioperative grade III or higher was defined as SAE. Risk factors associated with the occurrence of SAEs were analyzed using multivariate logistic regression. A nomogram was plotted by R software to predict SAE, the efficacy of which was evaluated using the area under the ROC curve (AUC) and correction curves. Results: The median peritoneal cancer index (PCI) score was 16 (1-39). Sixty-eight (68.0%) patients achieved complete tumor reduction (tumor reduction score: 0-1). Sixty-two patients were treated with intraperitoneal hyperthermic perfusion chemotherapy (HIPEC). Twenty-one (21.0%) patients developed 37 SAEs of grade III-IV, including 2 cases of ureteral injury, 6 cases of perioperative massive hemorrhage or anemia, 7 cases of digestive system, 15 cases of respiratory system, 4 cases of cardiovascular system, 1 case of skin incision dehiscence, and 2 cases of abdominal infection. No grade V SAE was found. Multivariate logistic regression analysis showed that CEA (OR: 8.980, 95%CI: 1.428-56.457, P=0.019), PCI score (OR: 7.924, 95%CI: 1.486-42.259, P=0.015), intraoperative albumin infusion (OR: 48.959, 95%CI: 2.115-1133.289, P=0.015) and total volume of infusion (OR: 24.729, 95%CI: 3.956-154.562, P=0.001) were independent risk factors for perioperative SAE in CRS (all P<0.05). Based on the result of multivariate regression models, a predictive nomogram was constructed. Internal verification showed that the AUC of the nomogram was 0.926 (95%CI: 0.872-0.980), indicating good prediction accuracy and consistency. Conclusions: CRS is a safe and effective method to treat CRPM. Strict screening of patients and perioperative fluid management are important guarantees for reducing the morbidity of SAE.

Clinicopathological features and diagnosis of pericytic tumors of the kidney / 中华病理学杂志

Objective: To investigate the clinicopathologic features,diagnosis and prognosis of pericytic tumor of the kidney. Methods: Three cases of pericytic tumor of the kidney (two cases were diagnosed as glomangiomyomas and one case as pericytic tumor,unclassified) were collected from the affiliated Hospital of Qingdao University between January 2014 to May 2021; the clinical and morphologic features, immunohistochemical and molecular characteristics were analyzed and the relevant literature was reviewed. Results: The three patients included one male and two females, with ages ranging from 21 to 70 years. In two patients the tumors were detected incidentally at physical examination and one patient presented with low back discomfort. Imaging showed a rounded nodular soft tissue density shadow in renal parenchyma, and enhancement scan showed uneven delayed enhancement. Grossly, two tumors were located in the renal hilum and one in the renal parenchyma; all were nodular. The tumors were measured in size from 1.6 cm to 5.1 cm (mean 4.1 cm) and showed gray or gray-red cut surface. Histologic examination showed the tumor cells were arranged in solid sheets or small nodules, closely related to vascular wall. Tumor cells were mostly epithelial-like with abundant cytoplasm, light eosinophilia, obscure boundary and round nuclei with visible nucleoli. Vague bundles and fascicular arrangements of smooth muscle component were noted in some areas, with transition of both components. There was no necrosis. By immunohistochemistry, the tumor cells strongly and diffusely expressed vimentin, SMA and collagen Ⅳ, two cases expressed CD34, all three cases expressed PDGFRB to varying extent, and the Ki-67 index was 2%-3%. PCR tests showed absent K-RAS, BRAF V600E gene mutation in all three cases. PDGFRB mutations in exons 3 and 18, respectively were found in two of the three cases by high-throughput sequencing, and no NOTCH 1/2/3 gene fusions were found in any of them. Follow-up information (range: 6-92 months) showed no evidence of local recurrence or distant metastasis in all three patients. Conclusions: Pericytic tumor of the kidney is a rare mesenchymal tumor originating in the kidney with differentiation to smooth muscle, most commonly glomus tumor. The mild pleomorphism, close relationship with vascular wall and spindled smooth muscle components suggest the diagnosis of the tumor. Expression of both epithelial and muscle-associated markers aids the diagnosis. PDGFRB gene mutations may have an important role in the development of this tumor. Most patients have a good prognosis, and a few cases have malignant biological behavior.

Fructus Zanthoxyli extract improves glycolipid metabolism disorder of type 2 diabetes mellitus via activation of AMPK/PI3K/Akt pathway: Network pharmacology and experimental validation / 中西医结合学报

OBJECTIVE@#This study investigated the potential mechanisms behind the beneficial effects of Fructus Zanthoxyli (FZ) against type 2 diabetes mellitus (T2DM) based on network pharmacology and experimental validation.@*METHODS@#Ultra-high-performance liquid chromatography coupled with hybrid quadrupole-orbitrap high-resolution mass spectrometry, and gas chromatography-mass spectrometry were used to identify the constituents of FZ. Next, the differentially expressed genes linked to the treatment of diabetes with FZ were screened using online databases (including Gene Expression Omnibus database and Swiss Target Prediction online database), and the overlapping genes and their enrichment were analyzed by Kyoto Encyclopedia of Genes and Genomes (KEGG). Finally, the pathway was verified by in vitro experiments, and cell staining with oil red and Nile red showed that the extract of FZ had a therapeutic effect on T2DM.@*RESULTS@#A total of 43 components were identified from FZ, and 39 differentially expressed overlapping genes were screened as the possible targets of FZ in T2DM. The dug component-target network indicated that PPARA, PPARG, PIK3R3, JAK2 and GPR88 might be the core genes targeted by FZ in the treatment of T2DM. Interestingly, the enrichment analysis of KEGG showed that effects of FZ against T2DM were closely correlated with the adenosine monophosphate-activated protein kinase (AMPK) and phosphatidylinositol-3-kinase (PI3K)/protein kinase B (Akt) signaling pathways. In vitro experiments further confirmed that FZ significantly inhibited palmitic acid-induced lipid formation in HepG2 cells. Moreover, FZ treatment was able to promote the AMPK and PI3K/Akt expressions in HepG2 cells.@*CONCLUSION@#Network pharmacology combined with experimental validation revealed that FZ extract can improve the glycolipid metabolism disorder of T2DM via activation of the AMPK/PI3K/Akt pathway.