Clinical and imaging features of middle ear hairy polyps / 中华耳鼻咽喉头颈外科杂志

Objective: To collect the clinical cases of middle ear hairy polyp, and to summarize the imaging features. Methods: We retrospectively analyzed the clinical data of four cases middle ear hairy polyp confirmed by surgical and pathologic between January 2007 and January 2020 at the Affiliated Eye & ENT Hospital of Fudan University. There were three females, one male, with two left ears and two right ears, aged from 1 to 59 years. The CT and MRI imaging of the patients, and the corresponding clinical manifestations were analyzed. Results: Hairy polyps originated from tympanum in one case, originated from Eustachian tube in two cases, exhibiting recurrent otorrhea without evident inducement. The other case, hairy polyps originated from the Eustachian tube pharyngeal orifice and protruded into the nasopharyngeal cavity, with pharynx discomfort and aural fullness, endoscope showed offwhite polypoid mass with a little hair. All the four cases presented polypoid soft tissue masses on CT and MRI imaging, containing soft tissue wall and a large amount of adipose tissue, with soft tissue in the center of the mass which liked the core, and enhanced. MRI showed stratified arrangement of fat and soft tissue in the wall of the mass. Four cases all had surgical treatment, postoperative pathology examination presented that hair follicles, mature sebaceous glands and other skin appendages were found under squamous epithelium. A large amount of adipose tissue, part of muscle tissue, cartilage tissue, and some fibro-collagenous tissue were proliferated in the mass, accompanied by collagen degeneration. Conclusion: The middle ear hairy polyps has imaging characteristics, the polypoid soft tissue mass usually looks smooth and contains a large amount of adipose tissue, with a soft tissue in the center, and can be suggestively diagnosed by CT and MRI.

Mechanism of paeonol combined with paeoniflorin against myocardial ischemia injury:based on proteomics / 中国中药杂志

The study aims to investigate the effect of the compatibility of paeonol and paeoniflorin(hereinafter referred to as the compatibility) on the expression of myocardial proteins in rats with myocardial ischemia injury and explore the underlying mechanism of the compatibility against myocardial ischemia injury. First, the acute myocardial infarction rat model was established by ligation of the anterior descending branch of the left coronary artery. The model rats were given(ig) paeonol and paeoniflorin. Then protein samples were collected from rat cardiac tissue and quantified by tandem mass tags(TMT) to explore the differential proteins after drug intervention. The experimental results showed that differential proteins mainly involved phagocytosis engulfment, extracellular space, and antigen binding, as well as Kyoto encyclopedia of genes and genomes(KEGG) pathways of complement and coagulation cascades, syste-mic lupus erythematosus, and ribosome. In this study, the target proteins and related signaling pathways identified by differential proteomics may be the biological basis of the compatibility against myocardial ischemia injury in rats.

Comparison of Health Education, Oral Rehydration Solution, Metoprolol and Midodrine Intervention in Children with POTS

Introduction: The postural orthostatic tachycardia syndromeis heterogeneous group of disorder. When a healthy individualstands up, gravity causes about 10%-15% of his or her bloodto settle in the abdomen or limbs. This pooling of bloodmeans that less blood reaches the brain, the result of whichcan be a feeling of lightheadedness, darkening of vision, oreven fainting. Hence, the aim of the present study was toevaluate the clinical features and the effectiveness of nonpharmacological and pharmacological treatment in patientswith POTS.Material and Methods: A retrospective medical recordanalysis of the patients referred to pediatric cardiology unitof our Second Xiangya Hospital of Central South Universitysince June 2003 to February 2010 was done. This studyincluded 33 children patients aged 6 to 16 years old among17 male (mean 10.62±2.88 years) and 16 female (mean11.81±1.64 years) after medication within 14 days to 6 monthswith follow up record.Results: The most common presenting symptoms of POTSwere found to be dizziness or light-headedness (66.66%)followed by chest tightness (30.30%), syncope (27.27%),headache (24.24%) and pallor (24.24%) respectively. About75.5% of children patients met diagnostic criteria for POTSduring 5 to 10 minute of HUTT. There was significant statisticdifference in heart rate between before and after treatment oftotal patients during 5 and 10 minute of HUTT (P<0.05). Theoverall improvement found in 24(72.72%) patients whereas9(27.27%) patients not respond to the given treatment regimen.Conclusion: The most common presenting symptom of POTSwas dizziness or light-headedness. Most of the patients meetdiagnostic criteria for POTS during 5 to 10 minute durationof HUTT. Health education, ORS, propranolol and midodrinewere effective in treatment of POTS and helpful to diminishthe upright tachycardia. Whereas health education and healtheducation with midodrine hydrochloride treatment methodwere more likely effective than health education with ORSand health education with metoprolol method

Association between Lipoprotein (a) Levels and Metabolic Syndrome in a Middle-aged and Elderly Chinese Cohort / 生物医学与环境科学（英文）

OBJECTIVE@#The association between lipoprotein (a) [Lp(a)] levels and metabolic syndrome (MetS) remains uncertain, especially in the Asian population. The purpose of this study was to demonstrate the association between Lp(a) levels and MetS in a middle-aged and elderly Chinese cohort.@*METHODS@#A cross-sectional study of 10,336 Chinese adults aged 40 years or older was conducted in Jiading District, Shanghai, China. Logistic regression analysis was used to evaluate the association between serum Lp(a) levels and MetS.@*RESULTS@#In the overall population, 37.5% of participants had MetS. Compared with individuals in the lowest quartile of serum Lp(a) levels, those in the highest quartile had a lower prevalence of MetS (30.9% vs. 46.9%, P for trend < 0.0001). Multivariate logistic regression analyses showed that compared with participants in the bottom quartile of serum Lp(a) levels, those in the top quartile had decreased odds ratio (OR) for prevalent MetS [multivariate-adjusted OR 0.45 (95% confidence interval 0.39-0.51); P < 0.0001]. Additionally, Lp(a) level was conversely associated with the risk of central obesity, high fasting glucose, high triglycerides, and low HDL cholesterol, but not with hypertension. Stratified analyses suggested that increasing levels of Lp(a) was associated with decreased risk of MetS in all the subgroups.@*CONCLUSION@#Serum Lp(a) level was inversely associated with the risk of prevalent MetS in a middle-aged and elderly Chinese cohort.

Salvianolic acids improve liver lipid metabolism in ovariectomized rats via blocking STAT-3/SREBP1 signaling / 中国天然药物

Postmenopausal women, who have reduced circulating estrogen levels, are more prone to develop obesity and related metabolic diseases than premenopausal women. The absence of safe and effective treatments for postmenopausal obesity has changed the focus to natural products as alternative remedies. Total salvianolic acids (TSA) are the major water-soluble ingredients of Danshen. Salvianolic acid (SA) is the major constituent of the TSA. Salvianolic acids, including TSA and SA, are widely used in traditional Chinese medicine. In the present study, ovariectomized rats and LO2 cells were used to study the effects of salvianolic acids on body weight gain and hepatic steatosis. Salvianolic acids reduced ovariectomy (OVX)-induced body weight gain, attenuated the expressions of hepatic lipogenic genes, such as sterol regulatory element binding protein (SREBP)1, fatty acid synthase (FAS), and stearoyl-CoA desaturase (SCD)1, and decreased the liver triglyceride (TG) and total cholesterol (TC). For the molecular mechanisms, OVX and high glucose-induced phosphorylation of signal transducer and activator of transcription (STAT)-3 was inhibited by salvianolic acids treatment. In LO2 cells, inhibition of STAT-3 by siRNA attenuated the increased expression of SREBP1 and TG induced by high glucose. Salvianolic acids reduced the upregulation of SREBP1 and TG induced by high glucose in LO2 cells. In conclusion, these findings illustrated that salvianolic acids markedly alleviated the lipid metabolism disorders and protected against the postmenopausal obesity. The underlying mechanism was probably associated with the regulation of STAT-3 signaling.

Salvianolic acids improve liver lipid metabolism in ovariectomized rats via blocking STAT-3/SREBP1 signaling / 中国天然药物

Postmenopausal women, who have reduced circulating estrogen levels, are more prone to develop obesity and related metabolic diseases than premenopausal women. The absence of safe and effective treatments for postmenopausal obesity has changed the focus to natural products as alternative remedies. Total salvianolic acids (TSA) are the major water-soluble ingredients of Danshen. Salvianolic acid (SA) is the major constituent of the TSA. Salvianolic acids, including TSA and SA, are widely used in traditional Chinese medicine. In the present study, ovariectomized rats and LO2 cells were used to study the effects of salvianolic acids on body weight gain and hepatic steatosis. Salvianolic acids reduced ovariectomy (OVX)-induced body weight gain, attenuated the expressions of hepatic lipogenic genes, such as sterol regulatory element binding protein (SREBP)1, fatty acid synthase (FAS), and stearoyl-CoA desaturase (SCD)1, and decreased the liver triglyceride (TG) and total cholesterol (TC). For the molecular mechanisms, OVX and high glucose-induced phosphorylation of signal transducer and activator of transcription (STAT)-3 was inhibited by salvianolic acids treatment. In LO2 cells, inhibition of STAT-3 by siRNA attenuated the increased expression of SREBP1 and TG induced by high glucose. Salvianolic acids reduced the upregulation of SREBP1 and TG induced by high glucose in LO2 cells. In conclusion, these findings illustrated that salvianolic acids markedly alleviated the lipid metabolism disorders and protected against the postmenopausal obesity. The underlying mechanism was probably associated with the regulation of STAT-3 signaling.

Analysis of a 452C/T single nucleotide polymorphism in γ-glutamyl hydrolase gene in children with acute leukemia / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the distribution of γ-glutamyl hydrolase gene (GGH) 452C/T genotype and allele frequency in children with acute leukemia (AL) and healthy children.</p><p><b>METHODS</b>Bone marrow samples from 92 children with AL and peripheral blood samples from 124 healthy children were obtained to prepare complementary DNAs (cDNAs). The cDNAs were analyzed for a GGH 452C/T polymorphism by reverse transcriptase-polymerase chain reaction-denaturing gradient gel electrophoresis (RT-PCR-DGGE) and direct sequencing.</p><p><b>RESULTS</b>The frequencies of the AL patients with TT, CT and CC genotypes were 2.2%, 13.0% and 84.8%, and the frequencies of the control children were 1.6%, 16.9% and 81.5%, respectively. There was no significant difference in GGH genotype or T allele frequency between the two groups (P> 0.05). However, the T allele frequency in Han Chinese children was significantly different from those reported in Japanese, Mexican and African-American populations.</p><p><b>CONCLUSION</b>The frequency of 452C/T polymorphism of GGH gene in Han Chinese children has been determined. The results suggested that an ethnic difference may exist.</p>

Solid variant of mammary adenoid cystic carcinoma with basaloid features: a clinicopathologic and immunohistochemical study / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathologic and immunohistochemical features as well as the differential diagnoses of the solid variant of mammary adenoid cystic carcinoma with basaloid features.</p><p><b>METHODS</b>Clinical and pathological data were collected in four cases of the solid variant of mammary adenoid cystic carcinoma with basaloid features, and microscopic pathological examination and immunohistochemistry EnVision method were performed. The relevant literature was also reviewed.</p><p><b>RESULTS</b>The four patients were female, with age ranged from 46 - 65 years old (average 56 years) and the maximum tumor diameter ranged from 1.5 to 2.5 cm. Microscopically, the tumors exhibited a predominantly solid architecture with a myxoid or hyalinized stroma. The tumor cells showed moderate to marked nuclear atypia, and a basaloid appearance with scanty cytoplasm and inconspicuous nucleoli, and ≥ 5 mitotic figures per 10 high power fields. Glandular space embedded within tumor islands could be noticed. These spaces were genuine glandular structures and the cells lining these true glandular lumens had more abundant and eosinophilic cytoplasm. Pseudoglandular spaces of cribriform pattern or variable shape were also occasionally seen, and these cysts contained homogenous eosinophilic material. Focal necrosis was found. All cases were negative for ER, PR and HER2. Immunohistochemical staining for CK5/6, CK7 and CK14 was positive in the genuine glandular structures. All cases were positive for CD10, but also positive with varying intensity from weak to strong for vimentin and CD117. Staining for Ki-67 in three patients showed 10% - 50% positive.</p><p><b>CONCLUSIONS</b>The solid variant of mammary adenoid cystic carcinoma with basaloid features is a histologically distinctive and also a rare subset of the mammary adenoid cystic carcinoma. Awareness of its pathological features can help with the diagnosis as well as differential diagnosis. More cases are still needed for accurately assessing the prognosis of this particular tumor.</p>

A novel missense mutation of folypolyglutamate synthetase gene / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To examine allelic frequencies of coding single nucleotide polymorphisms (cSNPs) of folypolyglutamate synthetase (FPGS) gene in Chinese Han children with acute leukemia (AL), in order to provide a basis for detecting the relationship between FPGS genetic polymorphisms and tumor individualized chemotherapy.</p><p><b>METHODS</b>cSNPs of exon 5 were detected with polymerase chain reaction (PCR)-denaturing gradient gel electrophoresis (DGGE) in 91 children with AL and 124 children with upper respiratory infection as controls. Genotypes and allelic frequencies were examined.</p><p><b>RESULTS</b>A novel missense mutation, 502/490 T>C (L151/101P), was found in exon 5 of FPGS from control children. The novel mutation was found in mitochondrial variants in two cases and cytosolic variants in three cases. The cytosolic and mitochondrial variants displayed allelic frequencies of 0.70 % and 0.47 % respectively. The novel mutation was not associated with susceptibility to AL.</p><p><b>CONCLUSIONS</b>A novel missense mutation 502/490 T>C (L151/101P) in exon 5 of FPGS gene is firstly found in Chinese Han children, and the cytosolic and mitochondrial variants display allelic frequencies of 0.70 % and 0.47 % respectively.</p>

Arrhythmia after a positive head-up tilt table test / 中华心血管病杂志

<p><b>OBJECTIVE</b>to study the characteristics of arrhythmia after a positive head-up tilt table test (HUTT).</p><p><b>METHODS</b>head-up tilt table test (BHUT) or sublingual nitroglycerin-provocation head-up tilt table test (SNHUT) were performed in 1374 patients at the Second Xiangya Hospital of Central South University from March of 2001 to August of 2009. Arrhythmias were recorded in 169 patients after a positive HUTT [57 male, age 6 - 65 years, 86 children < 18 years, mean age (23.1 ± 14.8) years].</p><p><b>RESULTS</b>arrhythmias developed in 75 patients (44.38%) post a positive BHUT and in 94 patients (55.62%) post a positive SNHUT. Major types of arrhythmias were sinus bradycardia (143/169, 84.62%), junctional escape rhythm (55/169, 32.54%) and sinus arrest (26/169, 15.38%). Sinus bradycardia was more common in adult (P < 0.01). Occurrence of junctional escape rhythm and sinus arrest was not affected by age, gender and test mode. Arrhythmia and the manifestation of syncope or pre-syncope occurred simultaneously in 77 (45.56%) patients and mainly in BHUT, while arrhythmia appeared later than the syncope manifestation in 92 (54.44%) patients and mainly in SNHUT (P < 0.05). Arrhythmia and blood pressure reduction occurred simultaneously in 84 (53.50%) cases and mainly in BHUT, while arrhythmia appeared later than reduction of blood pressure in 73 (46.50%) cases and mainly in SNHUT (P < 0.01).</p><p><b>CONCLUSIONS</b>(1) the common types of arrhythmia were sinus bradycardia, junctional escape rhythm and sinus arrest after a positive HUTT. Occurrence of sinus arrest was not affected by age, gender and test mode. (2) In BHUT, arrhythmia occurred mostly simultaneously with the manifestation of syncope or pre-syncope and blood pressure reduction, while arrhythmia appeared later in SNHUT.</p>

Clinical characteristics in adults and children with vasovagal syncope / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics in adults and children with vasovagal syncope (VVS).</p><p><b>METHODS</b>Clinical data including head-up tilt table (HUTT) results were analyzed and compared in 136 children (mean age 12.3 +/- 2.7 years, 50 boys, 86 girls) and 119 adults (mean age 36.4 +/- 14.0 years, 29 men, 90 women) with VVS.</p><p><b>RESULTS</b>(1) There were more female VVS patients in adults group than that in children group (male and female ratio: children group 1:1.7 and adults group 1:3.1, P = 0.033) in this cohort. (2) The incidence of chest distress in adults group was significantly higher than that in children group [45.4 (54/119) vs. 27.2% (37/136), P = 0.003] while the incidence of headache [10.9% (13/119) vs. 20.6% (28/136), P = 0.036] and abdominal pain in children group was significantly higher than that in adults group [7.6% (9/119) vs. 19.1% (26/136), P = 0.008]. (3) Incidences of muggy environment [22.8% (26/114) vs. 12.5% (17/136), P = 0.032] and urination VVS [9.7% (11/114) vs. 1.5% (2/136), P = 0.004] were significantly higher in adults group than those in children group. (4) The mean time of mixed response vasogal episode in adults group was significantly longer than that in children group in sublingual nitroglycerin head-up tilt table test (SNHUT) stage (5.04 +/- 2.27 min vs. 3.50 +/- 1.24 min, P = 0.036).</p><p><b>CONCLUSIONS</b>The incidences of chest distress, muggy environment and urination VVS were more often and the mean time of vasogal episode of mixed response in SNHUT stage was longer in adults VVS while the incidence of abdominal pain and headache was higher in children VVS patients compared to adults VVS patients.</p>

Influence of number of removed lymph nodes on the TNM staging and survival in advanced esophageal carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the impact of total number of removed regional lymph nodes (LN) during esophagectomy on TNM staging and long-term survival.</p><p><b>METHODS</b>Between 1984 and 1989, a total of 1098 patients with advanced squamous cell carcinoma of the thoracic esophagus were surgically treated, and the data were retrospectively analyzed. The survival was analyzed by Kaplan-Meier method. Multivariate and univariate analysis were performed using Cox proportional hazard model and Log-rank test respectively in order to compare the survival difference and the impact of <6 or > or =6 removed LN on TNM staging and survival.</p><p><b>RESULTS</b>The shortest follow-up time was 10 years with a follow-up rate of 91.4%. Of these 1098 patients, 378 patients were found to have regional LN metastases with a LN metastasis rate of 34.4%. Totally, 4157 LN were removed and tumor spreading into the lymph node was documented in 800 with a lymph node metastasis degree of 19.2%. The mean number of removed LN in each esophgectomy was 3.8. According to the number of total removed LN, patients were divided into group A (removed LN <6, N=825) and group B (removed LN > or =6, N=273). The survival of group A was worse than that of group B. The depth of tumor invasion, degree of lymph node metastasis, tumor location, and tumor residual status were the most important prognostic factors. Even though the lymphatic metastasis rate in group A was significantly lower than that in group B (30.3% vs. 46.9% P < 0.001), the LN metastasis degree was higher in group A than that in group B (21.2% vs. 17.5% P = 0.002) due to less number of removed LN in group A than in group B. With the stratification analysis according to the number of involved lymph nodes, for patients without LN spreading, the survival in group A was significantly worse than that in group B (P = 0.003), but in the patients with only one or > or =2 positive nodes, the survival was similar (P = 0.919 and 0.182, respectively). When stratified patients according to TNM stage, for stage IIa patients (T2N0M0, T3N0M0), the survival in group A was significantly worse than that in group B (P = 0.006), while such difference did not exist in patients with stage IIb or stage lIII(P = 0.302 and 0.108, respectively).</p><p><b>CONCLUSION</b>A large series of retrospective study on advanced squamous cell carcinoma of the thoracic esophagus demonstrates that the number of metastatic LN is an important prognostic factor, therefore, it should be considered when refining UICC-TNM classification for esophageal cancer. If the total number of LN removed during each esophagectomy is less than 6, the occult positive regional LN might be missed, resulting in an inaccurate N classification and incorrect staging. Removal of > or = LN for each esophageal cancer patient during esophagectomy recommended by UICC is rational and should be complied with.</p>

Effects of total flavonoids of Hippophae rhamnoides L. on intracellular free calcium in cultured vascular smooth muscle cells of spontaneously hypertensive rats and Wistar-Kyoto rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the effects of total flavonoids of Hippophae rhamnoides L. (TFH), quercetin (Que) and isorhamnetin (Isor) on the intracellular free calcium ([Ca(2+)](i)) in vascular smooth muscle cells (VSMC) of spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY).</p><p><b>METHODS</b>Fluo 3-acetoxymethylester (Fluo-3/AM) was used to observe the effects of TFH (100 mg/L) and its essential monomers, namely Que (10(-4) mol/L) and Isor (10(-4) mol/L) on changes of [Ca(2+)](i) in cultured SHR and WKY VSMC (abbr. to Ca-SHR & Ca-WKY) following exposure to high K(+), norepinephrine (NE) and angiotensin II (Ang II), and to compare with the effects of verapamil (Ver).</p><p><b>RESULTS</b>(1) TFH, Que and Isor had inhibitory effects on resting Ca-SHR (P < 0.05), but had no significant effects on Ca-WKY (P > 0.05). (2) High K(+) could increase Ca-SHR more significantly than Ca-WKY (P < 0.05); TFH, Que and Isor could inhibit the elevation of [Ca(2+)](i) induced by high K(+)-depolarization, with the effects similar to that of Ver, and the effect on Ca-SHR was more significant than that on Ca-WKY (P < 0.05). (3) NE and Ang II could increase Ca-SHR more significantly than Ca-WKY (P < 0.05), TFH, Que and Isor had remarkably inhibitory effect on the elevation of Ca-SHR and Ca-WKY induced by NE or Ang II. (4) In the absence of extracellular Ca(2+), TFH, Que and Isor also had certain inhibitory effect on Ca-SHR and Ca-WKY induced by NE, and the effect on the former was more significant than that on the latter (P < 0.05).</p><p><b>CONCLUSION</b>TFH, Que and Isor might decrease the levels of [Ca(2+)](i) in VSMCs by blocking both voltage-dependent calcium channels (VDC) and receptor-operated calcium channels (ROC) in physiological or pathological state, which may be one of the important mechanisms of their hypotensive and protective effects on target organs in patients with hypertension.</p>

Gastrointestinal pacemaking for gastric dynamic disorders / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of gastrointestinal pacemaker in treatment of gastric dynamic disorders.</p><p><b>METHODS</b>Sixty patients with more than two symptoms as postprandial fullness, epigastric pain,epigastric fullness, belch, nausea, hypercoria,anorexia,vomiting and at least for twelve weeks were divided into three groups randomly. Thirty patients were treated with gastrointestinal pacemaker for ten days(pace maker group); fifteen patients were treated with gastrointestinal placebo machine for ten days (control group); fifteen patients received treatment with cisapride 5 mg three times daily, thirty minutes before meal (cisapride group) for ten days. Electrogastrogram(EGG) was performed on before and after treatments, the mean frequency and mean amplitude of EGG, the clinical symptoms and adverse reactions were observed.</p><p><b>RESULTS</b>Total efficacy of pace maker group, control group and cisapride group was 90.0%, 46.6% and 86.7%, respectively. The score of symptoms was significantly decreased after treatment with gastrointestinal pacemaker and cisapride (P<0.05). Before and after meal EGG exam showed that average frequency was reversed to normal level after treatment with gastrointestinal pacemaker.</p><p><b>CONCLUSION</b>Gastrointestinal pacemaking can relieve symptoms and improve the average frequency of EGG in patients with gastric dynamic disorders.</p>

Relationship between Unexplained Chest Distress and(or) Chest Pain in Children and Head-Up Tilt Test / 实用儿科临床杂志

0.05).Conclusions Unexplained chest distress and(or)chest pain of children may has close relationship with the autonomic disturbance.As for children with unexplained chest distress and(or)chest pain without organic cardiovascular disease,HUTT in a timely manner will contribute to diagnosis of the cause.J Appl Clin Pediatr,2009,24(1):24-25