A retrospective study on multi-targeted small molecule tyrosine kinase inhibitors combined with immune checkpoint inhibitors for 21 patients with advanced solid tumors after standard treatment failure / 实用医学杂志

Objective To investigate the clinical efficacy and safety of the combination therapy of multi-targeted small molecule tyrosine kinase inhibitors(MTKIs)with immune checkpoint inhibitors(ICIs)for late-stage solid tumor in the patients with failed standard treatment regimens.Methods The patients with advanced solid tumors who had been hospitalized in our hospital from January 2021 to January 2023 after failure of≥2 standard treatment regimens were selected and treated with MTKIs combined with ICIs.The efficacy and safety of this regimen were retrospectively studied.Results A total of 21 patients were included.As of March 1,2022,the overall popula-tion had an ORR of 38%,a DCR of 67%,a median progression free survival(mPFS)of 10 months,and a median survival(mOS)of 15 months.Common adverse reactions were pneumonia and oral ulcers.Conclusion For the patients with advanced solid tumors who have failed standard treatment,MTKIs combined with ICIs may be a treat-ment option,but prospective studies with a larger sample size are needed to confirm the efficacy and safety of this combination therapy and to explore the population most likely to benefit from this treatment method.

Bone morphogenetic protein 7 attenuates renal fibrosis in diabetic kid-ney disease rats by down-regulating Ajuba / 中国病理生理杂志

AIM:Bone morphogenetic protein 7(BMP7)reduces the expression of Yes-related protein 1(YAP1)by down-regulating Ajuba level and decreasing extracellular matrix(ECM)deposition.This study aimed to inves-tigate the influence of these factors on modifying the degree of renal fibrosis in rats with diabetic nephropathy.METH-ODS:Eighteen Sprague-Dawley(SD)rats were randomly divided into three groups:the normal control(NC)group,the diabetes mellitus(DM)group,and the DM group treated with BMP7 overexpressing adeno-associated virus(DM+rAAV-BMP7).Each group consisted of six rats.Diabetic kidney disease(DKD)was established in the DM and DM+rAAV-BMP7 groups by injecting 55 mg/kg streptozotocin(STZ)via the tail vein.NRK-52E cells were divided into three groups:the normal glucose(NG)group,the high glucose(HG)group,and the high glucose group treated with recombinant hu-man BMP7(HG+rhBMP7)group.Pathological changes in renal tissues were observed using hematoxylin and eosin(HE)and Sirius red staining.Immunohistochemical staining was performed to examine the expression sites of Ajuba and YAP1 in the renal cortex.Western blot analysis was conducted to determine the expression levels of BMP7,Ajuba,YAP1,colla-gen type Ⅲ(Col-Ⅲ),and fibronectin(FN)in the rat renal cortex and NRK-52E cells.RT-qPCR was used to measure the mRNA levels of Ajuba and YAP1 in the rat renal cortex.RESULTS:Biochemical indices revealed significantly ele-vated levels of blood glucose,serum creatinine,triglycerides,total cholesterol,and 24-hour urinary protein in the DM group compared to the NC group(P<0.05).In the DM+rAAV-BMP7 group,the levels of serum creatinine,24-hour uri-nary protein,triglycerides,and total cholesterol were lower than those in the DM group(P<0.05).Pathological staining demonstrated that the renal interstitium of the DM group exhibited inflammatory cell infiltration,fibrous tissue,collagen fi-ber deposition,disordered renal tubule arrangement,atrophy,and vacuolar degeneration,which were ameliorated in the DM+rAAV-BMP7 group.Immunohistochemistry revealed that Ajuba and YAP1 were mainly expressed in the cytoplasm and nucleus,with high expression in the cytoplasm of the DM group,which was significantly decreased in the DM+rAAV-BMP7 group.Western blot results indicated that the protein levels of FN,Col-Ⅲ,Ajuba,and YAP1 were up-regulated in the DM and the HG groups(P<0.05),but significantly down-regulated in the DM+rAAV-BMP7 group(P<0.05).RT-qP-CR results demonstrated that the mRNA levels of Ajuba and YAP1 were higher in the DM group and significantly lower in the DM+rAAV-BMP7 group(P<0.05).CONCLUSION:The overexpression of BMP7 can ameliorate renal fibrosis in rats with DKD.This effect is likely mediated by the down-regulation of Ajuba,reduction of YAP1 expression,and subse-quent inhibition of ECM deposition.

Risk factors for neonatal asphyxia and establishment of a nomogram model for predicting neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture: a multicenter study / 中国当代儿科杂志

OBJECTIVES@#To investigate the risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture and establish a nomogram model for predicting the risk of neonatal asphyxia.@*METHODS@#A retrospective study was conducted with 613 cases of neonatal asphyxia treated in 20 cooperative hospitals in Enshi Tujia and Miao Autonomous Prefecture from January to December 2019 as the asphyxia group, and 988 randomly selected non-asphyxia neonates born and admitted to the neonatology department of these hospitals during the same period as the control group. Univariate and multivariate analyses were used to identify risk factors for neonatal asphyxia. R software (4.2.2) was used to establish a nomogram model. Receiver operator characteristic curve, calibration curve, and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the model for predicting the risk of neonatal asphyxia, respectively.@*RESULTS@#Multivariate logistic regression analysis showed that minority (Tujia), male sex, premature birth, congenital malformations, abnormal fetal position, intrauterine distress, maternal occupation as a farmer, education level below high school, fewer than 9 prenatal check-ups, threatened abortion, abnormal umbilical cord, abnormal amniotic fluid, placenta previa, abruptio placentae, emergency caesarean section, and assisted delivery were independent risk factors for neonatal asphyxia (P<0.05). The area under the curve of the model for predicting the risk of neonatal asphyxia based on these risk factors was 0.748 (95%CI: 0.723-0.772). The calibration curve indicated high accuracy of the model for predicting the risk of neonatal asphyxia. The decision curve analysis showed that the model could provide a higher net benefit for neonates at risk of asphyxia.@*CONCLUSIONS@#The risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture are multifactorial, and the nomogram model based on these factors has good value in predicting the risk of neonatal asphyxia, which can help clinicians identify neonates at high risk of asphyxia early, and reduce the incidence of neonatal asphyxia.

Efficacy and safety of Omalizumab for the treatment of pediatric allergic asthma: a retrospective multicenter real-world study in China / 中华实用儿科临床杂志

Objective:To assess the clinical effectiveness and safety of Omalizumab for treating pediatric allergic asthma in real world in China.Methods:The clinical data of children aged 6 to 11 years with allergic asthma who received Omalizumab treatment in 17 hospitals in China between July 6, 2018 and September 30, 2020 were retrospectively analyzed.Such information as the demographic characteristics, allergic history, family history, total immunoglobulin E (IgE) levels, specific IgE levels, skin prick test, exhaled nitric oxide (FeNO) levels, eosinophil (EOS) counts, and comorbidities at baseline were collected.Descriptive analysis of the Omalizumab treatment mode was made, and the difference in the first dose, injection frequency and course of treatment between the Omalizumab treatment mode and the mode recommended in the instruction was investigated.Global Evaluation of Treatment Effectiveness (GETE) analysis was made after Omalizumab treatment.The moderate-to-severe asthma exacerbation rate, inhaled corticosteroid (ICS) dose, lung functions were compared before and after Omalizumab treatment.Changes in the Childhood Asthma Control Test (C-ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) results from baseline to 4, 8, 12, 16, 24, and 52 weeks after Omalizumab treatment were studied.The commodity improvement was assessed.The adverse event (AE) and serious adverse event (SAE) were analyzed for the evaluation of Omalizumab treatment safety.The difference in the annual rate of moderate-to-severe asthma exacerbation and ICS reduction was investigated by using t test.The significance level was set to 0.05.Other parameters were all subject to descriptive analysis.A total of 200 allergic asthma patients were enrolled, including 75.5% ( n=151) males and 24.5% ( n=49) females.The patients aged (8.20±1.81) years. Results:The median total IgE level of the 200 patients was 513.5 (24.4-11 600.0) IU/mL.Their median treatment time with Omalizumab was 112 (1-666) days.Their first dose of Omalizumab was 300 (150-600) mg.Of the 200 cases, 114 cases (57.0%) followed the first Omalizumab dosage recommended in the instruction.After 4-6 months of Omalizumab treatment, 88.5% of the patients enrolled ( n=117) responded to Omalizumab.After 4 weeks of treatment with Omalizumab, asthma was well-controlled, with an increased C-ACT score [from (22.70±3.70) points to (18.90±3.74) points at baseline]. Four-six months after Omalizumab administration, the annual rate of moderate-to-severe asthma exacerbation had a reduction of (2.00±5.68) per patient year( t=4.702 5, P<0.001), the median ICS daily dose was lowered [0 (0-240) μg vs. 160 (50-4 000) μg at baseline] ( P<0.001), the PAQLQ score was improved [(154.90±8.57) points vs. (122.80±27.15) points at baseline], and the forced expiratory volume in one second % predicted (FEV 1%pred) was increased [(92.80±10.50)% vs. (89.70±18.17)% at baseline]. In patients with available evaluations for comorbidities, including allergic rhinitis, atopic dermatitis or eczema, urticaria, allergic conjunctivitis and sinusitis, 92.8%-100.0% showed improved symptoms.A total of 124 AE were reported in 58 (29.0%) of the 200 patients, and the annual incidence was 0(0-15.1) per patient year.In 53 patients who suffered AE, 44 patients (83.0%) and 9 patients (17.0%) reported mild and moderate AE, respectively.No severe AE were observed in patients.The annual incidence of SAE was 0(0-1.9) per patient year.Most common drug-related AE were abdominal pain (2 patients, 1.0%) and fever (2 patients, 1.0%). No patient withdrew Omalizumab due to AE. Conclusions:Omalizumab shows good effectiveness and safety for the treatment of asthma in children.It can reduce the moderate-to-severe asthma exacerbation rate, reduce the ICS dose, improve asthma control levels, and improve lung functions and quality of life of patients.

Genomic Epidemiology of Imported Cases of COVID-19 in Guangdong Province, China, October 2020 - May 2021 / 生物医学与环境科学（英文）

Objective@#The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been engendering enormous hazards to the world. We obtained the complete genome sequences of SARS-CoV-2 from imported cases admitted to the Guangzhou Eighth People's Hospital, which was appointed by the Guangdong provincial government to treat coronavirus disease 2019 (COVID-19). The SARS-CoV-2 diversity was analyzed, and the mutation characteristics, time, and regional trend of variant emergence were evaluated.@*Methods@#In total, 177 throat swab samples were obtained from COVID-19 patients (from October 2020 to May 2021). High-throughput sequencing technology was used to detect the viral sequences of patients infected with SARS-CoV-2. Phylogenetic and molecular evolutionary analyses were used to evaluate the mutation characteristics and the time and regional trends of variants.@*Results@#We observed that the imported cases mainly occurred after January 2021, peaking in May 2021, with the highest proportion observed from cases originating from the United States. The main lineages were found in Europe, Africa, and North America, and B.1.1.7 and B.1.351 were the two major sublineages. Sublineage B.1.618 was the Asian lineage (Indian) found in this study, and B.1.1.228 was not included in the lineage list of the Pangolin web. A reasonably high homology was observed among all samples. The total frequency of mutations showed that the open reading frame 1a (ORF1a) protein had the highest mutation density at the nucleotide level, and the D614G mutation in the spike protein was the commonest at the amino acid level. Most importantly, we identified some amino acid mutations in positions S, ORF7b, and ORF9b, and they have neither been reported on the Global Initiative of Sharing All Influenza Data nor published in PubMed among all missense mutations.@*Conclusion@#These results suggested the diversity of lineages and sublineages and the high homology at the amino acid level among imported cases infected with SARS-CoV-2 in Guangdong Province, China.

Impact of long-acting somatostatin analogues on glycolipid metabolism in postoperative patients with acromegaly / 中国医师进修杂志

Objective:To analyze the effect of long-acting somatostatin treatment on blood glucose, blood lipid, insulin resistance and islet function in patients with acromegaly after surgical treatment.Methods:Self-control study before and after treatment was used. A total of 30 subjects who were diagnosed as acromegalyand received surgical treatment in Beijing Tiantan Hospital from January 2016 to January 2018 were enrolled in this study. Because patients′ growth hormone (GH) level was notc ompletely controlled after surgery, all the patients were treated with long-acting octreotide for more than 1 year. Before and 1 year after treatment, oral glucose tolerance testing (OGTT) was performed at pretreatment and 1 year after initiation of treatment with long-acting octreotide. Homeostatic model assessment (HOMA) was used to estimate insulin resistance (HOMA-IR) and β-cell function (HOMA-β). The HOMA-IR and HOMA-β were detected by 75 g glucose, insulin, C peptide release test and growth hormone suppression test to evaluate the therapy effects on insulin resistance and islet function.Results:The levels of GH, insulin-like growth factor 1(IGF-1), HOMA-IR, HOMA-β, and triacylglycerol(TG) were all decreased after 1 year of octreotide treatment compared with that before treatment: (2.8 ± 2.5) μg/L vs. (12.1 ± 10.5) μg/L, (356.8 ± 209.2) μg/L vs. (698.1 ± 207.3) μg/L, 1.56 ± 1.08 vs. 2.71 ± 1.52, 1.01 ± 0.97 vs. 4.87 ± 3.57, (1.12 ± 0.49) mmol/L vs. (1.76 ± 0.92) mmol/L, and the differences were statistically significant ( P<0.05). After treatment, the level of fasting blood glucose was increased compared with that before treatment: (5.83 ± 1.19) mmol/L vs.(5.11 ± 1.73) mmol/L, and the difference was statistically significant ( P<0.05). While there were no significant changes in postprandial 2 h blood glucose and glycosylated hemoglobin (GHb), total cholesterol (TC), low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol (HDL-C) levels before and after treatment ( P>0.05). Conclusions:Long-acting somatostatin therapy can effectively improve the insulin sensitivity of acromegaly patients, reduce β cell function, and slightly increase fasting blood glucose. It has no adverse effect on GHb, and can reduce the level of TG of the patients.

Clinical characteristics and outcomes of preoperactive short-acting octreotide treatment in patients with thyrotropin-secreting pituitary adenomas / 中华内科杂志

Objective:To explore the clinical characteristics of patients with pituitary thyrotropin-secreting adenoma and evaluate the effect of preoperative short-acting octreotide treatment on hyperthyroidism.Methods:A retrospective analysis was performed in 40 patients with pituitary thyrotropin adenoma diagnosed in Beijing Tiantan Hospital from January 2008 to January 2018. The general data, laboratory examinations and imaging findings were reviewed and analyzed. The clinical effect of preoperative octreotide on hyperthyroidism was evaluated.Results:The age of onset year of the 40 patients (male: female = 24∶16) was (30.5±5.1) years. Among them, 35 patients (87.5%) were with macroadenoma. The most common symptoms were thyroid hypermetabolism syndrome, followed by headache, dizziness, visual field damage and hypogonadism. The thyroid function of 30 patients (75%) recovered to normal within 3-5 days after the octreotide treatment. The total effective rate of the octreotide was 90.0%. The level of free thyroxine (FT 4) before treatment in patients with more than 10 times of effective cumulative dose was significantly higher than that in patients with less than 10 doses. Conclusions:Thyroid hypermetabolism syndrome and pituitary occupying effect are the most common clinical manifestations of thyrotropin-secreting adenoma. Preoperative octreotide treatment can effectively control hyperthyroidism. The level of FT 4 is a crucial factor affecting the efficacy of octreotide.

Kinetic Characteristics of Neutralizing Antibody Responses Vary among Patients with COVID-19 / 生物医学与环境科学（英文）

Objective@#The coronavirus disease 2019 (COVID-19) pandemic continues to present a major challenge to public health. Vaccine development requires an understanding of the kinetics of neutralizing antibody (NAb) responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).@*Methods@#In total, 605 serum samples from 125 COVID-19 patients (from January 1 to March 14, 2020) varying in age, sex, severity of symptoms, and presence of underlying diseases were collected, and antibody titers were measured using a micro-neutralization assay with wild-type SARS-CoV-2.@*Results@#NAbs were detectable approximately 10 days post-onset (dpo) of symptoms and peaked at approximately 20 dpo. The NAb levels were slightly higher in young males and severe cases, while no significant difference was observed for the other classifications. In follow-up cases, the NAb titer had increased or stabilized in 18 cases, whereas it had decreased in 26 cases, and in one case NAbs were undetectable at the end of our observation. Although a decreasing trend in NAb titer was observed in many cases, the NAb level was generally still protective.@*Conclusion@#We demonstrated that NAb levels vary among all categories of COVID-19 patients. Long-term studies are needed to determine the longevity and protective efficiency of NAbs induced by SARS-CoV-2.

Changes of Inflammasome in Children with Immune Thrombocytopenia before and after Treatment / 中国实验血液学杂志

OBJECTIVE@#To clarify the significance of inflammasome NLRP3 in children with immune thrombocytopenia (ITP) by detecting its changes before and after treatment.@*METHODS@#Twenty children with ITP diagnosed and treated in Xuzhou Children's Hospital were enrolled as observation group, and 10 healthy children as control group. The mRNA levels of NLRP3, ASC, and Caspase-1 were measured by real-time quantitative PCR (RT-qPCR), the serum levels of IL-18, IL-1β, and high mobility group protein B1 (HMGB1) were detected by ELISA, and the protein level of NLRP3 was detected by Western blot.@*RESULTS@#In newly diagnosed ITP children, the serum levels of IL-18, IL-1β and HMGB1 significantly decreased after treatment (P<0.05). After treatment, NLRP3, ASC, and Caspase-1 mRNA levels in peripheral blood mononuclear cells were significantly lower than those before treatment (P<0.05). NLRP3 protein expression decreased significantly after treatment.@*CONCLUSION@#Expression of NLRP3 inflammasome and downstream inflammatory factors are decrease after treatment in children with ITP, which may be used as effective prognostic markers.

The electrophysiological remodeling of atrial myocytes of type 1 diabetic mice and effects of AGE / 中国药理学通报

Aim To explore type 1 diabetes mice and the advance glycation end products (AGE) involved in electrical remodeling of atrial myocytes. Methods The diabetic mouse model was induced by intraperitoneal injection of STZ; action potential duration, and the current density of I

Effects of propofol and sevoflurane on intestinal flora diversity in infants undergoing cochlear implantation / 医学研究生学报

ObjectiveThe correlation of intestinal flora diversity in infants undergoing cochlear implantation (CI) with different general anesthetics remains unclear. The aim of this study was to observe the effects of propofol and sevoflurane on intestinal flora diversity in infants undergoing cochlear implantation.MethodsFrom January 2018 to August 2018, twenty infants with hearing impairment who underwent CI in the Department of Anesthesiology, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine were randomly divided into propofol group (10 cases) and sevoflurane group (10 cases). The propofol group (group P) received intravenous injection while the sevoflurane group (group S) received inhalation. Genomic DNA was extracted for PCR and 16S rDNA sequencing technique was used to analyze the diversity of intestinal flora (intestinal flora taxonomic composition, flora alpha diversity index, and intestinal flora PICRUSt function prediction).ResultsThe analysis of intestinal flora taxonomic composition showed that the intestinal flora of infants in the two groups were mainly Firmicutes and Bacteroidetes after operation. There was no significant difference in species diversity of intestinal flora (Actinobacteria, Bacteriodetes, Firmicutes, etc.) between Group S and Group P（P＞0.05）. The analysis of flora alpha diversity index showed that there was no significant difference in metrics (species information index, chaol index, Shannon index, etc.) between Group S and Group P（P＞0.05）. The analysis of intestinal flora PICRUSt function prediction showed that there were significant differences in Peptidase metabolism (1.82±0.08, 1.91±0.07, P=0.02), Protein Kinase metabolism (0.32±0.03, 0.28±0.03, P=0.02) and Tuberculosis pathway (0.14±0.01,0.15±0.01,P=0.049) between Group S and Group P after operation.ConclusionSevoflurane and propofol can regulate the functional diversity of intestinal flora through affecting different metabolic pathways of KO function in the functional diversity of intestinal flora and provide new guidance for the use of clinical anesthetics in infants undergoing CI.

Predictive value of N-terminal B-type natriuretic peptide on outcome of elderly hospitalized non-heart failure patients / 中华心血管病杂志

Objective: To investigate the predictive value of N-terminal type B natriuretic peptide（NT-proBNP) on the prognosis of elderly hospitalized patients without heart failure（non-heart failure). Method: Elderly patients aged 65 years or older, who were admitted to Beijing Hospital from September 2018 to February 2019, were enrolled in this study. Patients with clinical diagnosis of heart failure or left ventricular ejection fraction（LVEF)<50% were excluded. The patients were divided into 2 groups based on the serum NT-proBNP level: low NT-proBNP group （<125 ng/L) and high NT-proBNP group（≥125 ng/L). Patients were followed up at 3, 6, and 12 months after enrollment, and the major adverse events were recorded. The composite endpoint events included all-cause mortality, readmission or Emergency Department visits. Cardiovascular events include death, readmission or emergency room treatment due to cardiogenic shock, myocardial infarction, angina pectoris, arrhythmia, heart failure or stroke/transient ischemic attack. Results: A total of 600 elderly patients with non-heart failure were included in the analysis. The average age was （74.9±6.5) years, including 304（50.7%) males. The median follow-up time was 344（265, 359) days. One hundred and seventy-eight（29.7%) composite endpoint events were recorded during the follow-up, 19（3.2%) patients died, and 12（2.0%) patients were lost to follow-up. There were 286(47.7%) cases in low NT-proBNP group and 314 cases（52.3%) in high NT-proBNP group. Patients were older, prevalence of atrial fibrillation and myocardial infarction was higher; MMSE scores and ADL scores, albumin and creatinine clearance rate were lower in high NT-proBNP group than in low NT-proBNP group（all P<0.05). At 1-year follow-up, the incidence of composite endpoint events was significantly higher in high NT-proBNP group than in low NT-proBNP group（33.4%（105/314) vs. 24.8%（71/286), P = 0.02). Cardiovascular events were more common in high NT-proBNP group than in low NT-proBNP group（17.5%（55/314) vs. 8.4%（24/286), P = 0.001). Kaplan-Meier survival analysis showed both composite endpoint events（Log-rank P=0.016) and cardiovascular events（Log-rank P=0.001) were higher in high NT-proBNP group than in low NT-proBNP group. All-cause mortality was also significantly higher in highNT-proBNP group than in lowNT-proBNP group（4.8%（15/314) vs. 1.4%（4/286), P = 0.020), and Kaplan-Meier survival analysis demonstrated borderline statistical significance（Log-rank P = 0.052). Cox proportional hazard regression analysis showed that after adjusting for age, sex, creatinine clearance rate, myocardial infarction, and atrial fibrillation, NT-proBNP remained as an independent risk factor for composite endpoint events（HR=1.376，95%CI 1.049-1.806, P=0.021), and cardiovascular events（HR=1.777, 95%CI 1.185-2.664, P=0.005), but not for all-cause mortality（P=0.206). Conclusions: NT-proBNP level at admission has important predictive value on rehospitalization and cardiovascular events for hospitalized elderly non-heart failure patients. NT-proBNP examination is helpful for risk stratification in this patient cohort.

Advance in full-functional software of metabolomics / 上海交通大学学报（医学版）

Data processing and analysis has presented major bottlenecks in high-throughput metabolomics research. Bioinformatics tools emerged for performing these high-throughput datasets. These tools can preprocess complex high-dimensional datasets, detect and annotate metabolites, perform various statistical analysis and results interpretation. According to the workflow and methods of metabolomics data processing and analysis, this paper summarized some integral metabolomics softwares and compared the merit and demerit of four typical tools so that it can provide users with a reference guide to select softwares.

Electronic cleaning of intestinal contents tagging by diatrizoate meglumine for single-source dual-energy CT colonography with sequential acquisitions and volume scanning / 重庆医学

Objective To study the feasibility of applying electronic cleaning to intestinal contents tagging by diatrizoate meglumine for single-source dual-energy CT colonography with sequential acquisitions and volume scanning.Methods Twenty-four volunteers had fine effect of intestinal contents tagging by diatrizoate meglumine,good colorectal distension effect,fine image quality of dual-energy fusion colorectal images,and with informed consents were enrolled in this study.The single-source dual-energy CT colonography with sequential acquisitions and volume scanning was performed with an Acquilion ONE 320 row CT scanner,tube voltage 135 kVp/80 kVp.The intestinal contents conducted the dual-energy electronic cleaned based on decomposition of intestinal contents tagging by diatrizoate meglumine,soft tissue and air.The intestinal contents in one segment of intestinal lumen being 100％ electronically cleaned served as the basic standard,the electronic cleaning effects were divided into the 5 grades:excellent,good,moderate,fair and poor;and grade 1-3 were effective fecal electronic cleaning.Results The grade 1,2,3,4,5 of electronic cleaning effect for solid as the main intestinal contents were 22.2％,53.3％,17.8％,6.7％ and 0％ respectively;and which of electronic cleaning effect for liquid as the main intestinal contents were 47.5％,47.5％,5.0％,0％ and 0％ respectively.The together total effective electronic cleaning of intestinal contents was 97.9％ and the electronic cleaning effect was good.Conclusion Electronic cleaning could be used in the intestinal contents tagging by diatrizoate meglumine for single-source dual-energy CT colonography with sequential acquisitions and volume scanning.

Role of Inflammasome in Children's Immune Thrombocytopenia / 中国实验血液学杂志

OBJECTIVE@#To explore the role and the mechanism of NLRP3 inflammasome in children's immune thrombocytopenia (ITP).@*METHODS@#Twenty-one children suffered from ITP were enrolled in ITP group, 10 healthy children were selected in control group. Peripheral blood mononuclear cells (PBMNC) were isolated from ITP children and healthy controls. The mRNA levels of NLRP3, ASC, and Caspase-1 in PBMNCs were measured by quantitative real-time PCR. Moreover, the protein level of NLRP3 in PBMNCs was detected by Western blot. The plasma IL-18 level was detected by ELISA.@*RESULTS@#The expression level of NLRP3, ASC and Caspase-1 mRNA in newly-diagnosed ITP children was dramatically higher than that in control. The plasma IL-18 level was higher than that in healthy control. Furthermore, the level of NLRP3 protein was up-regulated in ITP children.@*CONCLUSION@#The NLRP3 inflammasome and up-regulated level of IL-18 have been found in newlydiagnosed ITP patients, and they may involve in the pathogenesis of ITP.

Establishment of New Zealand rabbit models of aplastic anemia / 南方医科大学学报

<p><b>OBJECTIVE</b>To screen for the optimal dose of benzene and cyclophosphamide using an orthogonal design for establishment of New Zealand rabbit models of aplastic anemia.</p><p><b>METHODS</b>Following an orthogonal experimental design, the effects of 3 levels of 4 factors, namely the dose of benzene (A), the dose of cyclophosphamide (B), the number of benzene injections (C), and the number of cyclophosphamide injections (D) were tested in the establishment of New Zealand rabbit models of aplastic anemia using a L(3) orthogonal table, and the optimal protocol for the model establishment was selected from the 9 experimental groups. Each rabbit received subcutaneous injection of benzene on the back every other day, followed by daily cyclophosphamide injection via the ear vein for prescribed times. The blood routine was examined every 6 days, and before modeling and at 36 days after modeling, a small sample of the femoral bone was collected for bone marrow histopathological examination.</p><p><b>RESULTS</b>Comparison of the white blood cell, erythrocyte and platelet counts among the 9 groups showed successful modeling in Groups 4-9, and daily mean reduction rates of the cell counts in Groups 7, 8, and 9 differed significantly from those in the other groups (P<0.05). In Group 7, bone marrow sections showed low myelodysplasia, reduced hematopoietic tissue, reduced or even absence of megakaryocytes, and increased fat cells. Further observation found that the rabbits in Group 7 had sustained bone marrow suppression, consistent with the clinical characteristics of the disease.</p><p><b>CONCLUSION</b>Stable models of aplastic anemia can be established efficiently in New Zealand rabbits by a combination of 8 subcutaneous injections of benzene at 1.5 mL/kg and 4 intravenous injections of cyclophosphamide at 10 mg/kg.</p>

Study on colorectal distension with partially automated and individualized insufflation of air for dual-energy CT colonography / 重庆医学

Objective To study the compliance of examinees,and effectiveness of colorectal distension with partially automated and individualized insufflation of air for dual-energy CT colonography.Methods Forty-six healthy adult volunteers without history of conditions affecting gastrointestinal motor function were enrolled in this study.One day before CT examination,volunteers were asked to orally administered 60 mL 4% diatrizoate meglumine five times for fecal tagging.Air was insufflated by using an inflator in a partially automated and individualized manner.The volunteers were initially asked to assume the right lateral decubitus position,then slowly turn to the supine position.Insufflation rate began at 1.5 L/min,and decreased to 0.5 L/min at later stage.The necessity and volume of air insufflation were decided according to effectiveness of colorectal distension on CT scout images,self-reported sensation of volunteers,and intestinal pressure.Dual-energy CT scanning was performed,and dual-energy blended images were acquired.Compliance of volunteers was statistically analyzed.The effectiveness of colorectal segments distension was statistically analyzed by using Kruskal-Wallis H test.Results No abdominal pain,bloating,nausea or vomiting were noted in the 46 volunteers.All volunteers easily accepted colorectal insufflation of air,with grade 1 compliance.The effectiveness of colorectal distension of grades 1,2,3 and 4 were 0%,2.1%,5.1% and 92.8%,respectively.The difference of effectiveness of colorectal segments distension had no statistical significance(χ2=6.19,P=0.288).The effectiveness of insufflation was poor in 6 colorectal segments,including 2 in sigmoid colon and 2 in rectum.Effectiveness of insufflation was suboptimal in 14 colorectal segments,including 4 in descending colon,4 in sigmoid colon,and 3 in rectum.Conclusion Compliance of examinees with partially automated and individualized insufflation of air for dual-energy CT colonography is excellent,with good effectiveness of colorectal distension.

Evaluation on image quality and radiation dose of 640-slice CT coronary arteriography with AIDR3D reconstruction algorithm / 重庆医学

Objective To investigate the image quality and radiation dose of 640-slice CT coronary arteriography(CTCA) with adaptive iterative dose reduction three-dimensional (AIDR3D)reconstrucction algoritym.Methods 640-slice CTCA with auto-matic exposure was performed on 84 consecutive patients.The original image data were reconstructed with AIDR3D and the filtered back-projection (FBP)algorithms at the image postprocessing workstation.Two experienced radiologists without knowing clinical information and reconstruction algorithms independently measured and calculated the image noise,signal-to-noise ratio and contrast-to-noise ratio with AIDR3D and FBP reconstruction algorithms.The qualitative image quality was assessed by using the 4-point scale.The radiation dose was calculated based on dose-length product exported on CT scanner.The quantitative and qualitative im-age quality with two kinds of reconstruction algorithm was analyzed statistically.Results The CTCA image noise was (27.20± 4.40)HU with AIDR3D and (60.00±12.40)HU with FBP,which with AIDR3D was decreased by 46.10% than that with FBP;the signal-to-noise ratio was 21.10 ± 5.10 with AIDR3D and 11.40 ± 2.80 with FBP,which with AIDR3D was increased by 84.70% than that with FBP;the contrast-to-noise ratio was 24.70±5.10 with AIDR3D and 13.50±3.20 with FBP,which with AIDR3D was raised by 82.20% than that with FBP,the differences in 3 indexes between the two kinds of reconstruction algorithm were statistically significant(P < 0.05 ).The CTCA qualitative image quality scores of proximal,middle and distal parts with AIDR3D were (3.90±0.30),(3.70±0.50)and (3.60±0.60)respectively,which all were higher than (2.60±0.60),(2.30± 0.60)and (2.10±0.70)with FBP respectively,the differences in 3 items between 2 kinds of algorithm had statistical significance (P <0.05).The total segments which could be used to diagnose the CTCA images with AIDR3D and FBP algorithms were 1 216 segments (96.50%)and 504 segments (40.00%),respectively,the difference had statistical significance(P <0.05).The mean ef-fective radiation dose was (2.10±1.00)mSv.Conclusion 640-slice CTCA with AIDR3D reconstruction algorithm not only signifi-cantly reduces the image noise than the conventional FBP algorithm,improves the quantitative and qualitative image quality,but also decreases the effective radiation dose.

Observation on effects of transcranial ultrasound to arterial recanalization in acute ischemic stroke patients / 中国医学装备

Objective:To investigate the clinical effects of transcranial ultrasound to arterial recanalization in acute ischemic stroke patients.Methods: Eighty cases of patients with acute ischemic stroke from February 2010 to May 2013 in our hospital were chosen as the experimental objects, and were divided into experimental group and control group randomly. The control group were treated with urokinase and transcranial ultrasound, the experimental group were treated with urokinase and placebo. The clinical effects of each group were compared.Results: The experimental group in the 2h and 24h when the recanalization rate was obviously higher than the control group, and the difference is statistically significant(x2=8.916,x2=8.155,P<0.05). Symptoms improved rate of patients in the 2h and 24h in the experimental group was obviously higher than that of the control group, and the difference was statistically significant. The experimental group prognostic good rate was 56.09%, while the control group was 23.08%, the difference was statistically significant(x2=9.081,P<0.05). The two groups had no statistically significant difference in mortality(x2=0.005,P<0.05). Conclusion: Patients with acute ischemic stroke with transcranial ultrasound treatment can significantly improve the prognosis of the patients condition, improve the rate of recanalization.

Reliability and validity of the Chinese Version of the Personal Diabetes Questionnaire(PDQ) / 中国实用护理杂志

Objective To translate the Personal Diabetes Questionnaire(PDQ),and test the relia bility and validity of the Chinese version of PDQ.Methods Through forward translation,back translation,cultural adjustment,etc.,the Personal Diabetes Questionnaire (PDQ) was introduced to localize it.60 eligible patients with diabetes were selected in a tertiary hospital to make a preliminary investigation.The results were statistically analyzed in order to assess the reliability and validity of the Chinese version of PDQ.Results The Chinese version of PDQ had good reliability,whose total internal consistency coefficient was 0.831 and test-retest reliability was 0.801.The questionnaire has good validity.Total Content Validity Index was 0.938.I-CVI was between 0.800 and 1.000.The questionnaire's dimensions had good parallel validity with glycosylated hemoglobin (HbAlc) and body mass index (BMI).Conclusions The Chinese Version of the personal diabetes questionnaire has good reliability and validity,which can be widely used as the evaluation tool of diabetes self-management education.