Trends and strategies of intestinal microecological intervention for chronic diseases / 中华临床营养杂志

In recent years, with the in-depth research on intestinal microecology, probiotics, probiotics, synbiotics, fecal bacteria transplantation and other microecological therapies have become new clinical treatment and intervention methods. The occurrence and development of some chronic diseases are closely related to the disorder of intestinal flora. Therefore, in clinical practice, the treatment and adjuvant treatment of chronic dis-eases related to intestinal flora disorder with the method of intestinal microecology will bring better treatment op-tions and clinical prognosis. How to better regulate intestinal flora to bring more benefits to such patients, as well as what kind of microecologics and treatment methods are the primary problems and challenges in the inter-vention of chronic diseases with microecologics. Based on the current trend of intestinal microecological inter-vention in chronic diseases, this article proposedthe microecological intervention strategy, in order to improve theunderstanding of this topic.

Analysis of influencing factors of intrafractional positioning errors in the hypofractionated radiotherapy for pulmonary tumors / 中华放射肿瘤学杂志

Objective Image-guided radiation therapy(IGRT)was performed to investigate the intrafractional body motion and identify the relevant influencing factors during hypofractionated radiotherapy for malignant pulmonary tumors. Methods A total of ninety-six patients with malignant pulmonary tumors receiving hypofractionated radiotherapy in Jiangsu Cancer Hospital were enrolled in this clinical trial. The kilo-voltage cone beam CT(kV-CBCT)was acquired prior to each fraction and matched to the planning CT images to correct the set-up errors. CBCT was performed immediately after the end of treatment to evaluate the intrafractional variation in the mediolateral,anteroposterior and craniocaudal dimensions.The relationship between relevant influencing factors and intrafractional variation was analyzed using multivariate linear regression. Results In the anteroposterior and craniocaudal directions,the intrafractional positioning errors were reduced along with the increase of ordinal number of fraction(P= 0.000). In the mediolateral direction, the intrafractional positioning errors were increased along with the longer duration of hypofractionated radiotherapy(P=0.010).The intrafractional positioning errors were decreased over larger body weight(P=0.003).The intrafractional positioning errors were significantly increased when vacuum bag and thermoplastic film were utilized for fixation(P= 0.009). Conclusions Certain intrafractional positioning errors occur during hypofractionated radiotherapy. Relevant influencing factors differ in different directions. Relevant influencing factors should be modified to reduce intrafractional positioning variation and improve the treatment accuracy.

Effect and mechanism of total flavone of epimedium on primary callus formation in ovariectomized rats with fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore the effects and related mechanisms of total flavone of epimedium treatment(TFE)on primary callus for mation in ovariectomized rats.</p><p><b>METHODS</b>Forty male SD rats weighted from 209 to 246 g and aged 6 to 8 weeks were selected. Six weeks after ovariectomy a femur fracture model with middiaphyseal segment fracture was established, estimated and randomly divided into TFE group (150 mg·kg⁻¹·d⁻¹) and control group(received saline). HE staining was used to evaluate the morphologic difference of primary callus during the bone callus healing between these two groups. The relative expression of Runt-related transcription factor 2(Runx2) mRNA in the callus was identified by real-time polymerase chain reaction. Immunohistochemical technique was used to observe the Casein kinase 2-interacting protein 1(CKIP-1) protein level in the callus of the two groups. Maximum fracture load was tested by three point bend test.</p><p><b>RESULTS</b>The BMD, primary callus volume, trabecular member(Tb.N) and trabecular thickness(Tb.Th) were higher in TFE group than that in control group(<0.001). The Tb.N and Tb.Th of primary callus were higher in TFE group than control group (=0.001). The volume and bone volume/tissue volume of primary callus were in TFE group than control group(<0.01). The trabecular separation(Tb.Sp) of primary callus were in control group higher than TFE group(<0.01). The HE staining of the 6 week slices showed that the degree of cartilage ossification in callus of the TFE group was significantly higher than that in control group under high magnification. Real-time PCR revealed that the comparative expression of Runx2 mRNA in control group was higher than that in TFE group(<0.001); the positive number of CKIP-1 was less in TFE group than that in control group (<0.001). TFE could increase the maximum load of the primary callus (<0.001).</p><p><b>CONCLUSIONS</b>TFE can promote the cartiage ossification of callus in ovariectomized rats, enhancing the bone strength and bone quality in the process of fracture healing via the CKIP-1/Runx2 pathway.</p>

Identification of human serum protein targets of Qianggu Decoction () in primary type I osteoporosis based on tandem mass tag labeling and liquid chromatography-tandem mass spectrometry technology / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the serum protein targets of Qianggu Decoction (, QGD) on treating osteoporosis by the proteomics analysis using tandem mass tag (TMT) and liquid chromatographytandem mass spectrometry (LC-MS/MS).</p><p><b>METHODS</b>Twenty serum protein samples were recruited (10 patients with primary type I osteoporosis before and after QGD treatment) and the high abundance ratios protein was removed, two serum samples were extracted and labeled with TMT reagent. Then, mass spectrometric detection, identification of differentially expressed proteins and bioinformatics analysis of differentially expressed proteins were carried out.</p><p><b>RESULTS</b>A total of 60 proteins were identified, within a 99% confidence interval, to be differentially regulated of which, 34 proteins were up-regulated and 26 proteins were down-regulated. Differentially expressed proteins analyzed by Gene Ontology (GO) annotation mainly get involved in 12 different biological processes, 7 types of cellular components, and 6 kinds of molecular functions. Angiotensinogen (AGT), stromelysin-1 (MMP3), heparanase (HPSE) and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) were screened as candidate protein targets of QGD treatment, which were related to metabolic mechanism of bone remodeling and/or bone collagen of osteoporosis. By the utilization of the protein-protein interaction network analysis tool named STRING10.0, it showed that AGT, MMP3, HPSE and GAPDH were located in the key node of the protein-protein interactions network. Furthermore, AGT, MMP3, HPSE and GAPDH were found to be directly related to BMP, MAPK, Wnt, SMAD and tumor necrosis factor ligand superfamily member 11 (TNFSF11) families.</p><p><b>CONCLUSIONS</b>The proteomics analysis by using TMT combined with LC-MS/MS was a feasible method for screening the potential therapeutic targets associated with QGD treatment. It suggests that AGT, MMP3, HPSE and GAPDH may be candidate protein targets of QGD treatment which can be used as therapeutic effect monitor and early diagnosis of primary type I osteoporosis.</p>

A dose volume analysis of brain stem injury after intensity-modulated radiotherapy in patients with nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective To investigate the relationship between the incidence of radiation-induced brain stem injury after intensity-modulated radiotherapy (IMRT) and the radiation dose volume in patients with nasopharyngeal carcinoma.Methods A retrospective analysis was performed on the data of 258 patients newly diagnosed with nasopharyngeal carcinoma who received IMRT in our group from 2005 to 2013.The radiation dose per unit volume of brain stem was analyzed.The relationship between the incidence of brain stem injury induced by IMRT and the radiation dose volume was studied.The survival rate was calculated using the Kaplan-Meier method.The factors influencing the radiation-induced brain stem injury were analyzed using the Cox regression model.Results Two patients with stage T3 disease and three patients with T4 disease had radiation-induced brain stem injury.The 3-and 5-year injury incidence rates were 1.6％ and 2.4％,respectively.The latency ranged between 9 and 58 months,with a median latency of 19 months.The median D1％ and Dmax for the brain stem were 54.24 and 59.22 Gy in all patients,54.31 and 59.45 Gy in patients with stage T3 disease,and 61.29 and 66.37 Gy in patients with stage T4 disease,respectively.In the five patients with brain stem injury,the D1％ and Dmax were larger than 60 and 63 Gy,respectively.The univariate analysis showed that the incidence of radiation-induced brain stem injury was correlated with D1％,Dmax,D0.1 cm3,D0.5 cm3,and D1.0 cm3 (all P=0.01).The incidence of radiation-induced brain stem injury was significantly lower in patients with D1％,Dmax,D0.1 cm3,D0.5 cm3,and D1.0 cm3 no larger than 60,63,60,58,and 56 Gy,respectively (all P =0.00).Conclusions The incidence of radiation-induced brain stem injury after IMRT is relatively low in patients with nasopharyngeal carcinoma.Strict control of the dose to the brain stem may help to reduce the incidence of brain stem injury and improve the long-term quality of life.

Cutaneous regressing/regressed malignant melanoma: a clinicopathologic analysis of 8 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and differential diagnosis of cutaneous regressing/regressed melanoma.</p><p><b>METHODS</b>Histopathologic evaluation and immunohistochemical study by EnVision method were performed in 8 cases of cutaneous regressing/regressed melanoma. The clinical presentation, treatment and follow-up data were analyzed.</p><p><b>RESULTS</b>The age of the patients ranged from 40 to 69 years (mean 58 years). The male-to-female ratio was 3: 1. Tumors were located on the back (4 cases), sole of the foot (2 cases), ventral aspect of the toes (1 case), and the forearm (1 case). Clinically, 6 patients presented with progressive black mole of the skin, followed by subsequent focal hypopigmentation, even scarring. Two patients presented with multiple foci of dark-brown pigmentation. Microscopically, 3 cases were completely regressed malignant melanoma. Tumoral melanosis was found in 1 of 3 cases. The other 5 cases were melanoma with severe regression. The extent of regression ranged from 75% to 90%. The Breslow depth of the tumors ranged from 0.5 to 1.0 mm. Immunohistochemically, both metastatic and primary tumor cells were diffusely positive for S-100, HMB45 and Melan A, while melanophages were positive for CD68. Follow-up data were available in 8 patients, ranging from 8 to 27 months. Five patients were alive with no evidence of disease, 1 patient was alive with stable disease and 2 patients died of metastatic melanoma.</p><p><b>CONCLUSIONS</b>Correlation between clinical presentation and pathologic features is important for diagnosis of cutaneous regressing/regressed melanoma. Thin melanoma with extensive regression ( ≥ 75%) should not been regarded as low metastatic risk and wide excision combined with sentinel lymph node biopsy is recommended.</p>

Cutaneous anaplastic large cell lymphoma: clinicopathologic, immunohistochemical and prognostic study of 44 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features, immunophenotype and prognosis of primary cutaneous anaplastic large cell lymphoma (CALCL).</p><p><b>METHODS</b>Histopathologic evaluation and immunohistochemical study by Envision method were carried out in 44 archival cases of CALCL. The clinical information and follow-up data were analyzed.</p><p><b>RESULTS</b>The patients presented with skin nodules, masses or plaques, sometimes associated with ulceration. The commonest sites of involvement were the extremities. Follow-up data were available in 39 patients. The overall survival rate was 87.2% (34/39). Disease relapses were detected in 46.2% (18/39) of the patients. Statistical analysis indicated that patients older than 50 years of age or with no less than two involved anatomic sites were more likely to have disease relapses (P < 0.05). Histologically, 31 cases were classified as common variant, 6 cases as small cell variant and 7 cases as neutrophil/eosinophil-rich variant. Immunohistochemical study showed that the rates of expression of CD30, CD45, CD45RO, CD43, CD3, cytotoxic protein and epithelial membrane antigen were 100% (44/44), 91.2% (31/34), 82.6% (19/23), 94.7% (18/19), 70.0% (28/40), 73.3% (22/30) and 31.8% (7/22), respectively. The CD4(+)/CD8(-), CD4(-)/CD8(+) and CD4(-)/CD8(-) immunophenotypes were found in 58.3% (21/36), 22.2% (8/36) and 19.4% (7/36) of the CALCL cases, respectively. Only one case (3.7%) expressed CD56.</p><p><b>CONCLUSIONS</b>CALCL is a form of low-grade primary cutaneous T-cell lymphoma with a wide spectrum of clinicopathologic pattern. Special variants of CALCL should not be confused with other types of cutaneous lymphomas and inflammatory lesions. CALCL patients older than 50 years of age or with no less than two involved anatomic sites are more likely to have disease relapses.</p>

Expression of gastrin receptor in HCC cell lines and tissues / 中华肝胆外科杂志

Objective To study the expression of gastrin receptor in 4 HCC cell lines and tis-sues and their relation to clinieopathological features. Methods Immunohistochemical staining of GR was performed for the 4 HCC cell lines and the paraffin sections of 25 HCC cases. The relationship be-tween the GR expression in HCC sections and the clinicopatho[ogical parameters were analyzed. Results Positive staining for GR in the 3 HCC SMMC-7721>HepG2>QGY-7701 cell lines and HCC tissues was observed. The expression rate of gastrin receptor was 56 % (14/25). However, there was no association between expression of GR and elinieopathologieal features such as age, gender and clini-cal stage etc except for tumor thrombosis. Concision GR exists in the HCC. Futher study is needed to identify whether GR is a applicable target for endocrine therapy in HCC.

Cutaneous Rosai-Dorfman disease / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic feature, immunophenotype and differential diagnosis of cutaneous Rosai-Dorfman disease (CRDD).</p><p><b>METHODS</b>Clinical manifestation, morphologic features and immunohistochemical staining were studied in 8 cases of CRDD.</p><p><b>RESULTS</b>All 8 patients presented with multiple papules, nodules and/or coalescent patches or plaques distributing over the extremities or trunk, without lymphadenopathy or other systemic abnormalities. Microscopically, the lesions were located intradermally and/or subcutaneously. CRDD was characterized by the presence of S-100 positive histiocytic cells exhibiting emperipolesis, accompanying with infiltration of mixed inflammatory cells. Fibrosis, somewhere in vague storiform pattern due to stromal responses, with distribution of individual neutrophil microabscess was seen in cases with a long course of illness. Dilated vascular spaces in dermis containing numerous large typical histiocytes were seen in 2 cases.</p><p><b>CONCLUSIONS</b>CRDD is a benign, persistent proliferative disease of histiocytes. Systemic involvement is rare, outcome favorable. It should be differentiated from other types of histiocytosis, dermatofibrosarcoma protuberans, xanthoma and lymphoproliferative disorders. Immunohistochemical staining for S-100 protein and CD68 is helpful in making a correct diagnosis.</p>

Study of gene expression in osteoblasts induced shear stress / 中华创伤骨科杂志

Objective To elucidate the mechanotransduction pathways and gene expression in osteoblasts in response to fluid-induced shear stress in hope to be applied in tissue engineering.Methods Osteoblastic MG63 cells were exposed to shear stress of 12 dynes/cm2 for the designated times and their activations of MAPK(i.e., ERK,JNK,and P38)were examined by western blotting.The expressions of bone formation-related genes,in- cluding COX-2,Egr-1,c-fos,and OPN,were detected by RT-PCR.Results We found that shear stress induced phosphorylation of ERK,JNK,and P38 MAPK,and expressions of bone formation-related genes,including COX-2, Egr-1,c-los,and OPN.Conclusions Shear stress can turn on the signal transduetion and enhance bone forma- tion-related gene expression in osteoblasts.This phenomenon may imply that shear stress can be applied in tissue engineering.