Narrative Review of Feedback -From Definition to Recent Discussion- / 医学教育

Feedback is an educational activity that occurs in a variety of settings in medical education and has been widely discussed since 2008, when Ridder et al. defined it as "Specific information about the comparison between a trainee's observed performance and a standard, given with the intent to improve the trainee's performance." (Ridder et al., 2008, p.3). Since then, discussions on effective feedback have shifted from a behaviorist, instructor-centered approach to a more multifaceted approach that focuses on relationship and the learner as recipient of feedback, or the learner's potential ability to make use of feedback (self-regulated learning, feedback literacy).

Validation of the prognostic value of the Mayo MASS and R2-ISS staging systems in patients newly diagnosed with multiple myeloma: A single-center study / 中华血液学杂志

Objective: To evaluate the prognostic value of Mayo MASS and R2-ISS staging systems in patients newly diagnosed with multiple myeloma (MM) . Methods: A total of 371 patients newly diagnosed with MM in Jiangsu Province Hospital were included in the study. Cytoplasmic light chain immunofluorescence with fluorescence in situ hybridization (cIg-FISH) was performed to detect cytogenetic abnormality. Clinical characteristics were combined to analyze the disease stage and evaluate the prognosis. Results: There were 37 (10.0%), 264 (71.0%), and 70 (18.8%) patients in R-ISS stage Ⅰ, Ⅱ, and Ⅲ, respectively. The median progression-free survival (PFS) times were 37, 25, and 14 months (P<0.001). The median overall survival (OS) times were not reached (NR), 66, and 30 months (P<0.001). There were 71 (19.1%), 140 (37.7%), and 160 (43.2%) patients in Mayo MASS stages Ⅰ, Ⅱ, and Ⅲ, and the median PFS times periods were 43, 27, and 19 months (P<0.001), and the median OS times were NR, NR, 35 months, respectively (P<0.001). There were, 23 (6.2%), 69 (18.6%), 222 (59.8%), and 57 (15.4%) patients in R2-ISS stages Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively. The median PFS times were 47, 31, 25, and 15 months (P=0.001), and the median OS times were NR, NR, 49, and 55 months, respectively (P<0.001) . Conclusion: Based on the R-ISS staging system, Mayo MASS, and R2-ISS prognostic staging system incorporated 1q21+, which allows a better stratification. However, the proportion of stage Ⅲ patients in Mayo MASS and R2-ISS staging systems is relatively high, which is considered related to the high incidence of 1q21+ and ISS Ⅲ in the Chinese population.

Seven new 3,4-dihydro-furanocoumarin derivatives from Angelica dahurica / 中草药·英文版

OBJECTIVE@#To study the chemical constituents of the roots of Angelica dahurica, a well-known Chinese herbal medicine named Baizhi in Chinese.@*METHODS@#Compounds were separated by various chromatographies, and the structures of new compounds were elucidated based on the analysis of their spectroscopic and spectrometric data (1D, 2D NMR, HRESI MS, IR, and UV). The absolute configurations of new compounds were determined by the calculated electronic circular dichroism and chemical derivatization. The inhibitory activities of all isolates against nitric oxide (NO) production were evaluated using lipopolysaccharide-activated RAW 264.7 macrophage cells.@*RESULTS@#Seven new 3,4-dihydro-furanocoumarin derivatives ( 1a/ 1b, 2a/ 2b, 3a/ 3b, 4) together with a known furanocoumarin ( 5) were isolated from the roots of A. dahurica. The new compounds included three pairs of enantiomers, (4S, 2''R)-angelicadin A ( 1a)/(4R, 2''S)-angelicadin A ( 1b), (4S, 2''S)-angelicadin A ( 2a)/(4R, 2''R)-angelicadin A ( 2b), and (4S, 2''S)-secoangelicadin A ( 3a)/(4R, 2''R)-secoangelicadin A ( 3b), together with (4R, 2''R)-secoangelicadin A methyl ester ( 4). The known xanthotoxol ( 5) inhibited the NO production with the half-maximal inhibitory concentration (IC50) value of (32.8 ± 0.8) µmol/L, but all the new compounds showed no inhibitory activities at the concentration of 100 µmol/L.@*CONCLUSION@#This is the first report of the discovery of 3,4-dihydro-furanocoumarins from A. dahurica. The results are not only meaningful for the understanding of the chemical constituents of A. dahurica, but also enrich the reservoir of natural products.

Effects of astragalin on the cell proliferation and cell cycle of prostate cancer cells through up-regulating miRNA-513 expression / 肿瘤研究与临床

Objective:To investigate the effects of astragalin on the cell proliferation and cell cycle of prostate cancer cell line C4-2B through up-regulating the expression of miRNA-513 (miR-513).Methods:Prostate cancer cell line C4-2B cells were taken and treated with 125 μg/L of astragalin for 48 h (astragalin group), and untreated C4-2B cells were set as the control group. The methyl thiazolyl tetrazolium (MTT) method was used to detect the proliferation ability of C4-2B cells in the two groups, and cell cycle was detected by using flow cytometry. The miRNAMap prediction software was used to predict that the targeted gene of miR-513 was the forkhead box protein R2 (FOXR2), and the dual luciferase gene reporter assay was used to verify it. Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) was used to detect the relative expression levels of miR-513 and FOXR2 mRNA in the two groups of cells. Western blotting was used to detect the expressions of FOXR2, cyclin-dependent kinase 7 (CDK7), β-actin and cyclin H in the two groups of C4-2B cells.Results:Compared with the control group, the proliferation activity of C4-2B cells in the astragalin group was decreased from day 2 to day 5 (all P < 0.05). The proportions of S-phase cells in the control group and the astragalin group were (48.1±3.2)% and (36.0±2.1)%, respectively. The proportion of S-phase cells in the astragalin group was decreased ( t = 3.12, P = 0.021); the proportions of G 2-phase cells were (24.9±3.3)% and (11.8±2.4)%, respectively. The proportion of G 2-phase cells in the astragalin group was decreased ( t = 3.18, P = 0.019). The relative expression levels of miR-513 in C4-2B cells of the control group and the astragalin group were 1.01±0.22 and 6.55±0.61, respectively. The relative expression levels of miR-513 in C4-2B cells in the astragalin group was increased ( t = 7.70, P < 0.01). The dual luciferase reporter gene assay verified that FOXR2 was the targeted gene of miR-513. The relative expression level of FOXR2 mRNA in C4-2B cells of the control group and the astragalin group was 1.04±0.14 and 0.19±0.06, respectively, and the difference was statistically significant ( t = 5.53, P = 0.002), suggesting that after astragalin promoted the expression of miR-513, the FOXR2 mRNA expression was decreased. The relative expression levels of FOXR2, CDK7 and cyclin H protein in C4-2B cells in the astragalin group were all decreased compared with those in the control group. Conclusions:Astragalin inhibits the proliferation of prostate cancer C4-2B cells and induces cell cycle arrest by up-regulating the expression of miR-513.

Identification and expression analysis of R2R3-MYB gene family in Andrographis paniculata / 中国中药杂志

The plant growth, development, and secondary metabolism are regulated by R2 R3-MYB transcription factors. This study identified the R2 R3-MYB genes in the genome of Andrographis paniculata and analyzed the chromosomal localization, gene structure, and conserved domains, phylogenetic relationship, and promoter cis-acting elements of these R2 R3-MYB genes. Moreover, the gene expression profiles of R2 R3-MYB genes under abiotic stress and hormone treatments were generated by RNA-seq and validated by qRT-PCR. The results showed that A. paniculata contained 73 R2 R3-MYB genes on 21 chromosomes. These members belonged to 34 subfamilies, 19 of which could be classified into the known subfamilies in Arabidopsis thaliana. The 73 R2 R3-MYB members included 36 acidic proteins and 37 basic proteins, with the lengths of 148-887 aa. The domains, motifs, and gene structures of R2 R3-MYBs in A. paniculata were conserved. The promoter regions of these genes contains a variety of cis-acting elements related to the responses to environmental factors and plant hormones including light, ABA, MeJA, and drought. Based on the similarity of functions of R2 R3-MYBs in the same subfamily and the transcription profiles, ApMYB13/21/35/67/73(S22) may regulate drought stress through ABA pathway; ApMYB20(S11) and ApMYB55(S2) may play a role in the response of A. paniculata to high temperature and UV-C stress; ApMYB5(S7) and ApMYB33(S20) may affect the accumulation of andrographolide by regulating the expression of key enzymes in the MEP pathway. This study provides theoretical reference for further research on the functions of R2 R3-MYB genes in A. paniculata and breeding of A. paniculata varieties with high andrographolide content.

How to Give Effective Feedback that Encourages Reflection Using Elements of Coaching: Introduction and Japanese Translation of the R2C2 Model / 医学教育

To improve resident performance in clinical practice, the R2C2 model was developed for supervisors who need to guide their residents’ reflection. It consists of four stages: Relationship building, exploring Reactions, exploring Content, and Coaching. It has been shown to effectively engage residents in reflective, goal-oriented discussions and in developing a Learning Change Plan with their supervisors. This paper introduces the Japanese translated version of the model and the evidence of its use.

The ATP Level in the mPFC Mediates the Antidepressant Effect of Calorie Restriction / 神经科学通报·英文版

Food deprivation can rescue obesity and overweight-induced mood disorders, and promote mood performance in normal subjects. Animal studies and clinical research have revealed the antidepressant-like effect of calorie restriction, but little is known about the mechanism of calorie restriction-induced mood modification. Previous studies have found that astrocytes modulate depressive-like behaviors. Inositol 1,4,5-trisphosphate receptor type 2 (IP3R2) is the predominant isoform in mediating astrocyte Ca

The ATP Level in the mPFC Mediates the Antidepressant Effect of Calorie Restriction / 神经科学通报·英文版

Food deprivation can rescue obesity and overweight-induced mood disorders, and promote mood performance in normal subjects. Animal studies and clinical research have revealed the antidepressant-like effect of calorie restriction, but little is known about the mechanism of calorie restriction-induced mood modification. Previous studies have found that astrocytes modulate depressive-like behaviors. Inositol 1,4,5-trisphosphate receptor type 2 (IP3R2) is the predominant isoform in mediating astrocyte Ca

Identification and expression profiling of R2R3-MYB transcription factors in Erigeron breviscapus / 中国中药杂志

R2 R3-MYB transcription factors are ubiquitous in plants, playing a role in the regulation of plant growth, development, and secondary metabolism. In this paper, the R2 R3-MYB transcription factors were identified by bioinformatics analysis of the genomic data of Erigeron breviscapus, and their gene sequences, structures, physical and chemical properties were analyzed. The functions of R2 R3-MYB transcription factors were predicted by cluster analysis. Meanwhile, the expression patterns of R2 R3-MYB transcription factors in response to hormone treatments were analyzed. A total of 108 R2 R3-MYB transcription factors, named EbMYB1-EbMYB108, were identified from the genome of E. breviscapus. Most of the R2 R3-MYB genes carried 2-4 exons. The phylogenetic tree of MYBs in E. breviscapus and Arabidopsis thaliala was constructed, which classified 234 MYBs into 30 subfamilies. The MYBs in the five MYB subfamilies of A.thaliala were clustered into independent clades, and those in E. breviscapus were clustered into four clades. The transcriptome data showed that MYB genes were differentially expressed in different tissues of E. breviscapus and in response to the treatments with exogenous hormones such as ABA, SA, and GA for different time. The transcription of 13 R2 R3-MYB genes did not change significantly, and the expression patterns of some genes were up-regulated or down-regulated with the extension of hormone treatment time. This study provides a theoretical basis for revealing the mechanisms of R2 R3-MYB transcription factors in regulating the growth and development, stress(hormone) response, and active ingredient accumulation in E. breviscapus.

Evidências de validade convergente Raven e R-2 em crianças com TEA / Evidence of convergent validity Raven and R-2 in children with ASD / Evidencia de validez convergente Raven y R-2 en niños con TEA

Visando ampliar os estudos relacionados à avaliação da inteligência de crianças com Transtorno do Espectro Autista (TEA) este estudo investigou a relação entre os testes não verbais de inteligência R-2 e Raven, avaliando 30 crianças com TEA, grau leve e moderado, de idade entre 5 e 11 anos e 9 meses. Os dados foram analisados de forma padronizada e os escores da amostra evidenciaram níveis intelectuais dentro da média no Raven e médio superior no R-2. Com alta correlação e convergência (coeficiente r = 0,897) estes resultados creditam o R-2 como um instrumento psicométrico potencial na avaliação da inteligência no TEA.

Aiming to expand the studies related to the assessment of the intelligence of children with Autistic Spectrum Disorder (ASD) this study investigated the relationship between the non-verbal tests of intelligence R-2 and Raven, evaluating 30 children with ASD, mild and moderate, of age between 5 and 11 years and 9 months. The data were analyzed in a standardized, way and the sample scores showed intellectual levels within the mean in Raven and upper mean in R-2. With high correlation and convergence (coefficient r = 0.897) these results credit R-2 as a potential psychometric instrument in the assessment of intelligence in ASD.

Con el objetivo de ampliar los estudios relacionados con la evaluación de la inteligencia de los niños con trastorno del espectro autista (TEA), este estudio investigó la relación entre las pruebas no verbales de inteligencia R-2 y Raven, evaluando a 30 niños con TEA, leve y moderada, de edad Entre 5 y 11 años y 9 meses. Los datos se analizaron de manera estandarizada y las puntuaciones de la muestra mostraron niveles intelectuales dentro de la media en Raven y la media superior en R-2. Con alta correlación y convergencia (coeficiente r = 0,897) estos resultados acreditan a R-2 como un instrumento psicométrico potencial en la evaluación de la inteligencia en TEA.

Association Between TAS1R2 Gene Polymorphism (rs12033832) and Sweet Taste Perception Amongst Malay Obese and Nonobese Subjects

@#Introduction: A growing evidence supported that variation of sweet taste perception, mediated by TAS1Rs gene variants could lead to excess sweetened food and beverages intake and also obesity. However, obesity development may also alter individuals' taste sensitivity and perception. Thus, it is best to further investigate whether or not the individuals' sweet taste sensitivity and acceptance are associated with variation in TAS1R2 gene and Body Mass Index (BMI) status. Methods: This comparison cross sectional study comprised of 88 obese and 92 non-obese subjects aged 20-45. All the subjects were genotyped for TAS1R2 gene variant at rs12033832 using polymerase chain reaction – restriction fragment length polymorphism (PCR-RFLP). Suprathreshold sensitivity for sweet taste was assessed using general Labeled Magnitude Scales. Intensity rating and hedonic test were carried out on 2 food samples (tea drink and rose flavoured agar) to examine subject's intensity rating and liking at different sugar contents. Results: Our results showed that rs12033832 of TAS1R2 gene is associated with sweet taste perception among obese and non-obese subjects. No interaction effect between BMI status and TAS1R2 gene variant (rs12022832) was found on sweet taste measures. Overall, non-obese subjects with AA genotype on rs12033832 had the highest sweet taste sensitivity and dislike high sugar content products the most. The effect was reverse among the obese subjects with GG homozygous. Conclusion: These findings suggest that TAS1R2 gene variation plays an important role in sweet taste perception among individuals and may have nutritional implications and obesity.

SAMe-TT2R2 score for prediction of suboptimal time in therapeutic range in a Thai population with atrial fibrillation

INTRODUCTION@#International normalised ratio (INR) control is an important factor in patients with non-valvular atrial fibrillation (NVAF) being treated with warfarin. INR control was previously reported to be poorer among Asians compared to Westerners. We aimed to validate the SAMe-TT2R2 score for prediction of suboptimal INR control (defined as time in therapeutic range [TTR] < 65% in the Thai population) and to investigate TTR among Thai NVAF patients being treated with warfarin.@*METHODS@#INR data from patients enrolled in a multicentre NVAF registry was analysed. Clinical and laboratory data was prospectively collected. TTR was calculated using the Rosendaal method. Baseline data was compared between patients with and without suboptimal INR control. Univariate and multivariate analyses were performed to identify variables independently associated with suboptimal INR control.@*RESULTS@#A total of 1,669 patients from 22 centres located across Thailand were included. The average age was 69.1 ± 10.7 years, and 921 (55.2%) were male. The mean TTR was 50.5% ± 27.5%; 1,125 (67.4%) had TTR < 65%. Univariate analysis showed hypertension, diabetes mellitus, heart failure, renal disease and SAMe-TT2R2 score to be significantly different between patients with and without optimal TTR. The SAMe-TT2R2 score was the only factor that remained statistically significant in multivariate analysis. The C-statistic for the SAMe-TT2R2 score in the prediction of suboptimal TTR was 0.54.@*CONCLUSION@#SAMe-TT2R2 score was the only independent predictor of suboptimal TTR in NVAF patients being treated with warfarin. However, due to the low C-statistic, the score may have limited discriminative power.

Chemical constituents from n-butanol parts of Lycii Cortex / 中草药

Objective: To study the chemical constituents from n-butanol-souluble part of Lycii Cortex (the root bark of Lycium chinense). Methods: The air-dried Lycii Cortex were powdered and extracted with 70% ethanol under reflux. After the removal of solvent under reduced pressure, the crude extract was extracted with petroleum ether, ethyl acetate and n-butanol successively. The compounds were isolated and purified by silica gel, Sephadex LH-20, ODS and semi-prepared high performance liquid chromatography from the n-butanol part of Lycii Cortex. The structures were identified by nuclear magnetic spectrometry, mass spectrometry and other spectral analyses. Results: Ten compounds were isolated from n-butanol parts of Lycii Cortex and characterized as (1'S,2R,5S,10R)-2-(1',2'-dihydroxy-1'-methylethyl)-6,10-dimethylspiro [4,5] dec-6-en-8-one 2'-O-β-D- glucopyranoside (1), (1'R,2R,5S,10R)-2-(1',2'-dihydroxy-1'-methylethyl)-6,10-dimethylspiro [4,5] dec-6-en-8-one 2'-O-β-D- glucopyranoside (2), (1R,6R,9S)-6,9,11-trihydroxy-4,7-megastigmadien-3-one 11-O-β-D-glucopyranoside (3), vanillic acid-4-O-β- D-glucopyranoside (4), 3,4-dihydroxyphenylpropionic acid (5), 3,4-dihydroxybenzenepropionic acid methyl ester (6), glucosyringic acid (7), dihydrophaseic acid 3'-O-β-D-glucopyranoside (8), isoscoploletin-β-D-glucoside (9) and fabiatrin (10). Conclusion: Compound 3 is isolated from Solanaceae family for the first time and compounds 1, 2 and 4 are isolated from Lycium genus for the first time. The NMR data of compound 2 is first reported as well.

Evaluación del SAME-TT2R2 score en la calidad de la anticoagulación con warfarina / Evaluation of SAME-TT2R2 score on the quality of anticoagulation with warfarin

Resumen Introducción: la fibrilación auricular (FA) es la arritmia cardiaca más frecuente y está relacionada con eventos embólicos. La eficacia y seguridad de la warfarina en prevención del ictus depende del tiempo en rango terapéutico (TTR). Se han diseñado escalas para predecir el comportamiento del TTR al inicio de la terapia. El objetivo de este trabajo fue evaluar la capacidad predictiva y discriminativa del SAMeTT2R2 score en una población no caucásica. Material y métodos: estudio analítico de cohorte retrospectiva en pacientes con FA no valvu lar tratados con warfarina entre 2013 y 2016 en una clínica de anticoagulación. Se caracterizó la muestra sociodemográfica y clínicamente. Se definió mal control de la anticoagulación como (TTR/ PINNR<65%). Se comparó el TTR/PINNR <65% y SAMeTT2R2 <=2 versus >2 con la prueba U de Mann-Whitney y chi cuadrado. Se construyeron curvas ROC para determinar discriminación de la escala. Se evaluó cada uno de sus elementos a través de regresión logística. Resultados: se incluyeron 646 pacientes (edad media 77 años ± 8,8 años, 51,4% hombres). El TTR promedio fue 67.7% y el PINNR 63.6%. Al comparar la frecuencia de pobre control entre SAMeTT2R2 score ≤2 versus >2 con una prueba chi cuadrado, el PINNR fue significativo (p=0.004). La capacidad discriminativa de la escala para el TTR/PINNR fue baja (AUC: 0.52 y 0.54 respectivamente). No se encontró relación entre cada una de las variables que integran el SAMeTT2R2 score y el TTR/PINNR. Conclusiones: la puntuación SAMeTT2R2 no mostró buena capacidad predictiva y discriminativa en la población estudiada. La calidad de la anticoagulación es el resultado de un proceso dinámico en relación con el cumplimiento, estado de salud o enfermedad intercurrente. (Acta Med Colomb 2019; 44: 75-81).

Abstract Introduction: atrial fibrillation (AF) is the most common cardiac arrhythmia and is related to embolic events. The efficacy and safety of warfarin in stroke prevention depends on the time in therapeutic range (TTR). Scales have been designed to predict the behavior of TTR at the start of therapy. The objective of this work was to evaluate the predictive and discriminative capacity of the SAMeTT2R2 score in a non-Caucasian population. Material and methods: retrospective cohort analytical study in patients with non-valvular AF treated with warfarin between 2013 and 2016 in an anticoagulation clinic. The sample was demodemographically and clinically characterized. Poor control of anticoagulation was defined as (TTR / PINNR <65%). The TTR / PINNR <65% and SAMeTT2R2 <= 2 versus> 2 were compared with the Mann-Whitney U test and chi square. ROC curves were constructed to determine scale discrimination. Each of its elements was evaluated through logistic regression. Results: 646 patients were included (mean age 77 years ± 8.8 years, 51.4% men). The average TTR was 67.7% and the PINNR 63.6%. When comparing the frequency of poor control between C. L. Sandoval-Riveros y cols. SAMeTT2R2 score ≤2 versus> 2 with a chi square test, the PINNR was significant (p = 0.004). The discriminative capacity of the scale for the TTR / PINNR was low (AUC: 0.52 and 0.54 respec tively). No relationship was found between each of the variables that constitute the SAMeTT2R2 score and the TTR / PINNR. Conclusions: the SAMeTT2R2 score did not show good predictive and discriminative capac ity in the studied population. The quality of anticoagulation is the result of a dynamic process in relation to compliance, health status or intercurrent disease. Acta Med Colomb 2019; 44: 75-81).

Simultaneous Estimation of the Fat Fraction and R₂* Via T₂*-Corrected 6-Echo Dixon Volumetric Interpolated Breath-hold Examination Imaging for Osteopenia and Osteoporosis Detection: Correlations with Sex, Age, and Menopause

OBJECTIVE: To investigate the relationships of T2 *-corrected 6-echo Dixon volumetric interpolated breath-hold examination (VIBE) imaging-based fat fraction (FF) and R2 * values with bone mineral density (BMD); determine their associations with sex, age, and menopause; and evaluate the diagnostic performance of the FF and R2 * for predicting osteopenia and osteoporosis. MATERIALS AND METHODS: This study included 153 subjects who had undergone magnetic resonance (MR) imaging, including MR spectroscopy (MRS) and T2 *-corrected 6-echo Dixon VIBE imaging. The FF and R2 * were measured at the L4 vertebra. The male and female groups were divided into two subgroups according to age or menopause. Lin's concordance and Pearson's correlation coefficients, Bland-Altman 95% limits of agreement, and the area under the curve (AUC) were calculated. RESULTS: The correlation between the spectroscopic and 6-echo Dixon VIBE imaging-based FF values was statistically significant for both readers (pc = 0.940 [reader 1], 0.908 [reader 2]; both p < 0.001). A small measurement bias was observed for the MRS-based FF for both readers (mean difference = −0.3% [reader 1], 0.1% [reader 2]). We found a moderate negative correlation between BMD and the FF (r = −0.411 [reader 1], −0.436 [reader 2]; both p <0.001) with younger men and premenopausal women showing higher correlations. R2 * and BMD were more significantly correlated in women than in men, and the highest correlation was observed in postmenopausal women (r = 0.626 [reader 1], 0.644 [reader 2]; both p < 0.001). For predicting osteopenia and osteoporosis, the FF had a higher AUC in men and R2 * had a higher AUC in women. The AUC for predicting osteoporosis was highest with a combination of the FF and R2 * in postmenopausal women (AUC = 0.872 [reader 1], 0.867 [reader 2]; both p < 0.001). CONCLUSION: The FF and R2 * measured using T2 *-corrected 6-echo Dixon VIBE imaging can serve as predictors of osteopenia and osteoporosis. R2 * might be useful for predicting osteoporosis, especially in postmenopausal women.

Evaluation of renal oxygenation in rats with acute aristolochic acid nephropathy using blood oxygenation level-dependent magnetic resonance imaging / 南方医科大学学报

OBJECTIVE@#To evaluate the changes in renal oxygenation in rats with acute aristolochic acid nephropathy using blood oxygenation level-dependent (BOLD) magnetic resonance imaging (MRI) at 7.0T.@*METHODS@#Wistar rats were randomly divided into AAN group (=18) and control group (=6) for intraperitoneal injections of AAI at 40 mg/kg and PEG400, respectively, on a daily basis for 6 consecutive days. All the control rats and 6 rats from AAN group underwent BOLD MRI scan before and at 2, 4, and 6 days after the initial injection for measuring renal cortical and medullary R2 values. At each of the 4 time points, 3 rats in AAN group were sacrificed for histological evaluation; the control rats were examined at 6 days after the initial injection.@*RESULTS@#The cortical and medullary R2 values of the rats in AAN group on days 4 and 6 were significantly higher than those in the control group ( < 0.05). In AAN group, the cortical R2 values showed no obvious changes on day 2 as compared with the baseline values, but increased significantly on day 4 ( < 0.05) and day 6 ( < 0.01); the medullary R2 values increased progressively and were significantly higher than the baseline values on day 4 ( < 0.01) and day 6 ( < 0.01). In the control group, no significant changes were detected in either cortical or medullary R2 values throughout the experiment.@*CONCLUSIONS@#BOLD MRI allows non-invasive measurement of renal oxygenation levels in rats with AAN. The increase of renal cortical and medullary R2 values, and particularly the latter, indicates a lowered renal oxygenation level, which provides potentially useful information for clinical decisions.

Clinical efficacy of radical resection with individualized surgical approach for borderline resectable pancreatic head carcinoma / 中华消化外科杂志

Objective To explore the clinical efficacy of radical resection with individualized surgical approach for borderline resectable pancreatic head carcinoma.Methods The retrospective descriptive study was conducted.The clinicopathological data of 54 patients with borderline resectable pancreatic head carcinoma who underwent radical resection with individualized surgical approach in the West China Hospital of Sichuan University from January 2015 to January 2018 were collected.There were 37 males and 17 females,aged from 37 to 73 years,with a median age of 59 years.For venous type borderline resectable pancreatic head carcinoma,surgery for pancreatic head carcinoma and (or) pancreatic head and neck carcinoma was performed via inferior mesenteric vein,and surgery for pancreatic uncinate process carcinoma was performed via inferior colon artery.For arterial type borderline resectable pancreatic head carcinoma,surgery for pancreatic head carcinoma and (or) pancreatic head and neck carcinoma was performed via medial uncinate artery,and surgery for pancreatic uncinate process carcinoma was performed via left posterior artery.Observation indicators:(1) surgical situations;(2) postoperative complications;(3) postoperative pathological examination;(4) follow-up.Patients were followed up by outpatient examination or telephone interview once every 3 months to detect survival up to March 2019.Measurement data with normal distribution were represented by Mean ± SD.Measurement data with skewed distribution were represented by M (range),and count data were represented by absolute numbers or percentage.Kaplan-meier method was used to draw the survival curve and calculate the survival rate.Results (1) Surgical situations:all the 54 patients underwent expanded pancreatoduodenectomy combined with superior mesenteric vein/portal vein (SMV/PV) resection,including 15 via inferior mesenteric vein,20 via inferior colon artery,12 via medial uncinate artery,and 7 via left posterior artery.The operation time was (320± 83)minutes,and the volume of intraoperative blood loss was (865±512) mL.(2) Postoperative complications:of 54 cases,28 had postoperative complications,including 13 with grade 1 Clavien-Dindo complications,12 with grade 2 ClavienDindo complications,3 with grade 3 or above Clavien-Dindo complications.One of the 28 patients with postoperative complications died and 27 were improved after symptomatic and supportive treatment.(3) Postoperative pathological examination:of 54 patients,31 had R0 resection and 23 had R1 resection.In the 23 patients with R1 resection,5 underwent surgery via the inferior mesenteric vein (4 with involvement of pancreatic anterior surface,1 with involvement of both pancreatic anterior and posterior surface),9 underwent surgery via the inferior colon artery (2 with involvement of both pancreatic anterior and posterior surface,2 with involvement of superior mesenteric artery margin,2 with involvement of pancreatic posterior surface,2 with involvement of pancreatic anterior surface,1 with involvement of superior mesenteric artery margin and pancreatic posterior surface),5 underwent surgery via the medial uncinate process artery (2 with involvement of superior mesenteric artery margin,2 with involvement of both pancreatic anterior and posterior surface,1 with involvement of pancreatic neck transected margin),and 4 underwent surgery via the left posterior artery (3 with involvement of superior mesenteric artery margin,1 with involvement of both pancreatic anterior and posterior surface).Of 54 patients,16 had no positive lymph nodes,26 had 1-3 positive lymph nodes,and 12 had 4 or more positive lymph nodes.The tumor diameter was (3.20±0.14)cm.There were 48 of 54 patients with nerve infiltration,41 with superior mesenteric vein and/or portal vein infiltration,and 11 with vascular thrombus.There were 17 of 54 patients with high differentiation and medium differentiation,and 37 with low differentiation and undifferentiation.(4) Follow-up:54 patients were followed up for 1-42 months,with a median time of 19 months.The 1-,3-year overall survival rate was 78.0％,11.4％.Condusion As for the borderline resectable pancreatic head cancer,individualized and customized surgical approach according to the location of tumor and the relationship with blood vessels is helpful to standardize the radical resection and avoid R2 resection.

Current Progress in Isocitrate Dehydrogenase Mutations and Its Inhibitors in Gliomas / 中国药学杂志

Glioma is a primary brain tumor produced by canceration of the glial cells in the brain and spinal cord, accounting for 74.6% of the malignant tumors in the central nervous system. Isocitrate dehydrogenase (IDH) is the rate-limiting enzyme of the tricarboxylic acid cycle and catalyzes the oxidative decarboxylation of isocitrate to produce α-ketoglutarate (α-KG). Its mutant (mIDH) is a new point mutation, not only lose its original function but also gain new activity: catalyzing the production of carcinogenic R-2-hydroxyglutarate (2HG) by α-KG. Isocitrate dehydrogenase inhibitors can reduce the production of 2HG and induce the demethylation of histones, thereby inhibiting tumor progression. Although discovered in 2008, the mIDH has become a tumor diagnostic marker and therapeutic target, mIDH2 and mIDH1 inhibitors for acute myeloid leukemia have been approved for marketing in 2017and 2018,respectively.For the treatment of acute myeloid leukemia, the reliability of isocitrate dehydrogenase mutants as tumor therapeutic targets was confirmed.At present, many pharmaceutical institutions around the world are conducting research and development of isocitrate dehydrogenase inhibitors.This article reviews the current research status of current IDH inhibitors.

Study on chemical constituents of Artemisia integrifolia (II) / 中草药

Objective: To study the chemical constituents of Artemisia integrifolia. Methods: Solvent extraction, silica gel column chromatography, and HPLC were used for isolation and purification. The structure was identified by NMR spectrum analysis. Anti-oxidant activity tests were performed using DPPH. Results: A total of 21 monomeric compounds were isolated from A. integrifolia and identified as 2R-(2Z-pentenoic acid methyl ester)-3S-(methyl acetate) cyclopentanone (1), methyl-4S-6α-hydroxy-3- oxoeudesma-1,11 (13)-dien-12-oate (2), methyl caffeate (3), dextrin inositol (4), monobutyl fumarate (5), caffeic acid (6), monobutyl malonate (7), 6,8-dimethoxycoumarin-7-O-β-D-glucoside (8), 3,5-O-di-caffeoyl quinic acid butyl ester (9), 3,4-O-dicaffeoyl quinic acid butyl ester (10), 4,5-O-dicaffeoyl quinic acid butyl ester (11), 3,5-O-dicaffeoyl quinic acid methyl ester (12), 4,5-O- dicaffeoylquinic acid (13), 1,5-O-dicaffeoylquinic acid (14) 3,5-O-dicaffeoylquinic acid (15), o-hydroxycinnamic acid glucoside (16), 1,3-O-dicaffeoyl quinic acid (17), chlorogenic acid (18), 3,4-O-dicaffeoylquinic acid (19), methyl 3,4-O-dicaffeoylquinate (20), and o-hydroxycinnamate methyl glucoside (21). Conclusion: Compound 1 is a new natural product. Compounds 2, 5, 7-11, 14, 16, and 21 are isolated from Artemisia for the first time, and the rest are isolated from A. integrifolia for the first time. Both caffeoyl quinic acid compounds had strong anti-oxidant capacity, and the activity is basically equivalent to Vc.

A new alkaloid from endophytic fungus Aspergillus fumigatus of Euphorbia royleana / 中草药

Objective: To study the secondary metabolites of endophytic fungus Aspergillus fumigatus from Euphorbia royleana. Methods: The fermentation liquor of the fungal strain A. fumigatus was isolated and purified using various chromatographic methods. The structures of the compounds were identified by spectroscopic analysis. Results: Three compounds were isolated and their structures were identified as (R)-2-propylhexyl-2H-1,2,3-triazole-4-carboxylate (1), decumbenone A (2), and (+)-cyclopenol (3). Conclusion: Compound 1 is a new compound isolated from this fungus, which is identified as aspergillus triazolate A.