Combined detection of PAX1 methylation and p16/Ki-67 dual staining improves diagnostic performance for atypical squamous cells in cervical cancer / 陆军军医大学学报

Objective To compare paired boxed gene 1(PAX1)methylation and p16/Ki-67 double staining alone and in combination in thinprep cytologic test(TCT)for distinguishing atypical squamous cells of undetermined significance(ASC-US)and low-grade squamous intraepithelial lesion(LSIL)population.Methods A total of 247 patients with TCT results of ASC-US and LSIL admitted in our hospital from January 2021 to December 2022 were enrolled in this study.Detection efficacy of PAX1 methylation and p16/Ki-67 double staining alone and in combination was evaluated with colposcopic pathologic results as the gold standard and the sensitivity,specificity,accuracy and area under the curve(AUC)as evaluation indexes.Results The positive rates of PAX1 methylation and p16/Ki-67 double staining were increased with the severity of pathological findings.Combined detection of PAX1 methylation and p16/Ki-67 assay had a sensitivity of 91.25％,specificity of 97.72％and accuracy of 95.51％in the women with TCT of ASC-US,and these values were statistically better than those of PAX1 methylation and p16/Ki-67 double staining alone(P＜0.01).Conclusion The combination of PAX1 methylation and p16/Ki-67 double-staining assay can further improve the diagnostic efficacy in patients with ASC-US on TCT results.

Jiangzhi Tongluo Soft Capsules Regulate SIRT1/FoxO3 Pathway to Affect Cell Apoptosis in Rats with Membranous Nephropathy / 中国实验方剂学杂志

ObjectiveTo observe the effect of Jiangzhi Tongluo soft capsule on the protein levels of silent mating-type information regulation 2 homolog 1 （SIRT1） and forkhead transcription factor FoxO3 and podocyte apoptosis in the renal tissue of rats with membranous nephropathy and to reveal the underlying molecular mechanisms for the treatment of MN. MethodSixty male SD rats were randomly assigned into 6 groups with 10 rats each. The six groups included a normal group， a model group， benazepril hydrochloride group， and Jiangzhi Tongluo soft capsule groups of low， medium and high doses （25， 50， 100 mg·kg-1， respectively）. The model rats were established by injection with cationized bovine serum albumin into the tail vein. After modeling， the rats were administrated with corresponding agents by gavage for 4 weeks. At the end of the 4th week， an electron microscope was used to observe the pathological changes in the kidney. Western blot was employed to detect the protein levels of SIRT1 and FoxO3 protein in rat kidney， and immunohistochemistry to detect the expression of B lymphocytoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， Bcl-2-associated death promoter （Bad）， and podocyte split diaphragm proteins nephrin and podocin. ResultCompared with normal group， the expression of pro-apoptotic factors Bax， Bad， and FoxO3 in the kidney was up-regulated （P<0.05）， while that of anti-apoptotic factors Bcl-2， SIRT1， nephrin， and podocin was down-regulated （P<0.05） after modeling. Compared with the model group， the treatments down-regulated the expression of Bax， Bad， and FoxO3 （P<0.05） and up-regulated that of Bcl-2， SIRT1， nephrin， and podocin （P<0.05）. ConclusionJiangzhi Tongluo soft capsule may regulate the SIRT1/FoxO3 pathway to reduce podocyte apoptosis and maintain podocyte structure stability， thereby exerting the renal protection effect.

Mental Health Status and Its Influencing Factors among College Students during the Epidemic of Coronavirus Disease 2019:A Multi-center Cross-sectional Study / 中国医学科学院学报

Objective To measure the prevalence of mental health symptoms and identify the associated factors among college students at the beginning of coronavirus disease 2019(COVID-19)outbreak in China. Methods We carried out a multi-center cross-sectional study via snowball sampling and convenience sampling of the college students in different areas of China.The rates of self-reported depression,anxiety,and stress and post-traumatic stress disorder(PTSD)were assessed via the 21-item Depression-Anxiety-Stress Scale(DASS-21)and the 6-item Impact of Event Scale-Revised(IES-6),respectively.Covariates included sociodemographic characteristics,health-related data,and information of the social environment.Data pertaining to mental health service seeking were also collected.Multivariate Logistic regression analyses were performed to identify the risk factors. Results A total of 3641 valid questionnaires were collected from college students.At the beginning of the COVID-19 outbreak,535(14.69%)students had negative emotions,among which 402(11.04%),381(10.49%),and 171(4.90%)students had the symptoms of depression,anxiety,and stress,respectively.Meanwhile,1245(34.19%)college students had PTSD.Among the risk factors identified,male gender was associated with a lower likelihood of reporting depression symptoms(AOR=0.755,P=0.037],and medical students were at higher risk of depression and stress symptoms than liberal arts students(AOR=1.497,P=0.003;AOR=1.494,P=0.045).Family support was associated with lower risks of negative emotions and PTSD in college students(AOR=0.918,P<0.001;AOR=0.913,P<0.001;AOR=0.899,P<0.001;AOR=0.971,P=0.021). Conclusions College students were more sensitive to public health emergencies,and the incidence of negative emotions and PTSD was significantly higher than that before the outbreak of COVID-19.More attention should be paid to female college students who were more likely to develop negative emotions.We should strengthen positive and proper propaganda via mass media and help college students understand the situation and impact of COVID-19.Furthermore,we should enhance family support for college students.The government and relevant agencies need to provide appropriate mental health services to the students under similar circumstances to avoid the deterioration of their mental well-being.

Network Meta-analysis of efficacy and safety of Chinese patent medicines in treatment of insomnia / 中国中药杂志

To evaluate the efficacy and safety of Chinese patent medicines in the treatment of insomnia by frequency network Meta-analysis. Randomized controlled trials of Chinese patent medicines for insomnia were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase and Cochrane Library databases from the time of database establishment to October 2020. The quality of the included RCTs was evaluated according to the Cochrane bias risk standard, and the data was analyzed by RevMan 5.3 and Stata/MP 15.1. A total of 11 kinds of Chinese patent medicines in 27 RCTs were included. According to Meta-analysis, in term of the effective rate, Tianmeng Liquid, Zaoren Anshen Capsules, Shumian Capsules, Shensong Yangxin Capsules, Shenqi Wuweizi Tablets, Shugan Jieyu Capsules, Anshen Bunao Liquid and Qiye Anshen Tablets combined with nonbenzodiazepine drugs(NBZDs) were superior to NBZDs alone. In term of the improvement of Pittsburg sleeping quality index(PSQI) score, Tianmeng Liquid, Shumian Capsules, Shensong Yangxin Capsules, Bailemian Capsules, Shenqi Wuweizi Tablets, Shugan Jieyu Capsules, Yangxue Qingnao Granules and Yindan Xinnaotong Capsules combined with NBZDs were superior to NBZDs alone. In terms of the safety, Shumian Capsules, Shensong Yangxin Capsules, Shenqi Wuweizi Tablets and Qiye Anshen Tablets combined with NBZDs were superior to NBZDs alone. In terms of the avoidance of dizziness and headache, Qiye Anshen Tablets combined with NBZDs were superior to NBZDs alone. The results of Network Meta-analysis indicated that in term of the effective rate, top three optimal medication regimens were NBZDs combined with Shugan Jieyu Capsules, combined with Zaoren Anshen Capsules and combined with Shensong Yangxin Capsules in the order from high to low. With the respect of improvement of PSQI score, top three optimal medication regimens were NBZDs combined with Yangxue Qingnao Granules, combined with Tianmeng Liquid and combined with Yindan Xinnaotong Capsules in the order from high to low. In terms of the safety, top three optimal medication regimens were NBZDs combined with Qiye Anshen Tablets, combined with Shensong Yangxin Capsules and combined with Shenqi Wuweizi Tablets in the order from high to low. In terms of the avoidance of dizziness and headache, top three optimal medication regimens were NBZDs combined with Qiye Anshen Tablets, combined with Zaoren Anshen Capsules and combined with Shumian Capsules in the order from high to low. In terms of the avoidance of fatigue, top three optimal medication regimens were NBZDs combined with Shensong Yangxin Capsules, combined with Shumian Capsules and combined with Qiye Anshen Tablets in the order from high to low. In conclusion, Chinese patent medicines combined with NBZDs can effectively alleviate the symptoms of insomnia with a high safety. However, the conclusion of this study needs to be verified by more high-quality studies because of the low methodological quality of the included studies.

A multicenter survey of antibiotic use in very and extremely low birth weight infants in Hunan Province / 中国当代儿科杂志

OBJECTIVE@#To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province.@*METHODS@#The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017.@*RESULTS@#The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01).@*CONCLUSIONS@#Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.

Effect of proteasome inhibitor Oprozomib on ovarian cancer cells to cis-platinum / 解放军医学杂志

Objective To study the enhancement of sensitivity to cisplatin (DDP) mediated by the addition of proteasome inhibitor Oprozomib (OZ) in ovarian cancer cells. Methods SKOV3/DDP and A2780/DDP cells were cultured in vitro, and the logarithmic growth phase cells were used in this study. To study the effect of OZ on drug-resistant cell viability, a series dilutions of OZ (0, 3, 9, 27, 81, 243, 729, 2181, and 6561 nmol/L) was used. The effect of DDP was also investigated with a series titrations (0, 3, 9, 27, 81, 243, 729, 2181 and 6561 nmol/L) in the presence of 50 μl of 500 nmol/L OZ. CCK-8 method was used to detect cell viability; flow cytometry was used to detect the apoptosis rate after treated with DDP+OZ. The experiments were divided into the control group and OZ group to detect the effects of OZ on the activity of proteasome chymotrypsin (CT-L), the synthesis of intracellular glutathione (GSH); the expression of intracellular glutathione synthetase (GSS) was examined using western blotting. The experiments were divided into the control group, DDP group, OZ group, DDP+OZ group, DDP+OZ+GSH group and DDP+OZ+Tempol group to detect the ROS level and apoptosis rate. Results The IC50 of OZ to SKOV3/DDP and A2780/ DDP cells were 140 and 350 nmol/L, respectively; In the presence of OZ, the IC50 of DDP to SKOV3/DDP and A2780/DDP cells were 154 and 232 nmol/L, respectively. The apoptosis rate of ovarian cancer cells increased significantly (P<0.01) after treated with DDP+OZ together. OZ can inhibit the CT-L activity of the proteasome in a dose-dependent manner and can inhibit GSH synthesis and GSS protein expression (P<0.01). The decrease of GSH level leads to the obstruction of ROS clearance, and the ROS level was significantly reduced by the ROS scavenger Tempol (P<0.05, P<0.01). Tempol significantly inhibits the apoptosis induced by DDP+OZ (P<0.01). Conclusion OZ enhanced sensitivity of SKOV3/DDP and A2780/DDP to cis-platinum by inhibiting the generation of GHS which resulted in the accumulation of ROS.

Effects of two standards on the overweight trend of infants and toddlers in urban Shanghai / 中华儿科杂志

Objective@#To observe and compare the effects of two standards on the overweight trend in urban Shanghai infants and young children.@*Methods@#A cluster randomized controlled trial was conducted in 19 communities in two districts of Shanghai, and the subjects (n=15 019) were divided into S-group and W-group by sealed envelope randomization. The subjects were newborns born between November 2013 and December 2014. The 2005 Shanghai growth standard was applied in the S-group and the 2006 WHO growth standard was used in the W-group. At each follow-up time point age of 1, 2, 4, 6, 9, 12 and 18 months, the outpatient physician assessed the length and weight of the infants according to the standard adopted by each group and provided feeding guidance. The weight-for-age Z scores (WAZ), length-for-age Z scores (LAZ) and weight-for-length Z scores (WLZ) were calculated according to the WHO standard. Weight, length, WAZ, LAZ, WLZ and overweight ratio (WLZ≥2) were compared between the two groups using t test, Wilcoxon test and χ2 test.@*Results@#A total of 6 509 infants (3 391 were boys, 3 118 were girls) were in the W-group, and 8 510 infants (4 374 were boys, 4 136 were girls) were in the S-group. Among the boys, the weight values at the age of 4, 6, 9, 12, 18 months in the W-group were all lower than those in the S-group ((7.5±0.8) vs. (7.7±0.8) kg, (8.6±0.8) vs. (8.7±0.8) kg, (9.6±0.9) vs. (9.7±0.9) kg, (10.4±1.0) vs. (10.5±1.0) kg, (11.5±1.1) vs.(11.7±1.1) kg; t=4.329, 2.422, 3.739, 2.451, 2.736; P<0.01, 0.015,<0.01, 0.014, 0.009). The length had no significant difference between two groups at all months of age(all P>0.05). The overweight ratio in the W-group was lower than that in the S-group at the age of 9, 12, 18 months(3.3% (71/2 170) vs. 4.9% (143/2 927), 2.5% (51/2 037) vs. 4.5% (126/2 818), 0.8% (7/832) vs. 3.1% (39/1 266); χ2=6.520, 14.209, 12.350; P=0.011,<0.01,<0.01).Among the girls, except at the age of 2 months (W-group (5.6±0.6) vs. S-group (5.7±0.6), t=2.935, P=0.003), weight values had no significant difference between the two groups at other age months (all P>0.05).The length in the W-group was higher than that in the S-group at 12 and 18 months of age ((75.6±2.4) vs.(75.5±2.3)cm, (82.4±2.9) vs.(82.2±2.7) cm; t=2.351, 2.197; P=0.019, 0.028). The ratio of overweight in the W-group was lower than that of S-group at the age of 12 and 18 months (1.8% (33/1 871) vs.3.0% (80/2 658), 0.6% (5/790) vs.1.7% (20/1 178); χ2=6.764,4.276; P=0.009, 0.039).@*Conclusions@#The application of WHO growth standard can help to reduce the weight gain rate of boys, promote the linear growth of girls, and thus alleviate the overweight trend of infants within 18 months. It suggested that 2006 WHO growth standard should be applied to infants within 1 year of age in Shanghai.

ThevalueofMRIIDEALIQtechniquetoevaluate myelosuppressionduringradiotherapyandchemotherapyincervicalcancer / 实用放射学杂志

Objective ToexplorethevalueofMRIiterativedecompositionofwaterandfatwithechoasymmetryandleastsquares estimationquantificationsequence(IDEALIQ)techniquetoevaluatemyelosuppressionduringradiotherapyandchemotherapyincervicalcancer. Methods 25femalesubjectswereenrolledinthisstudy,whowereclinicallydiagnosedascervicalcancerandacceptedtheradiotherapyand chemotherapy.AllthesubjectswereperformedwithsagittalMRIIDEALIQscansineachweek’streatmentandattheendofwhole fiveweeks’therapy,soeachpatienthad6timesMRIscans.ROIweremanuallyplacedonL4,L5andS1vertebralbodyandsubcutaneousfatto measurethefatfraction.ThefatfractioncolorimageswerereconstructedonaAW (AdvantageWorkstation)4.6workstation.Results Asthe radiationandchemotherapyprocess,thevaluesoffatfractionincreasedprogressivelyonL4,L5andS1vertebralbody(P<0.001), whilethefatfractionvaluesinsubcutaneousfatappearedstableallthetime(P=0.987).Conclusion MRIIDEALIQtechniquecan evaluatethereal-timefatfraction,andradiotherapyandchemotherapyplansmaybeoptimizedaccordingtothefatfractionresult.

Effectiveness of semi-open suturation of vaginal stump in prevent the development of pelvic lymphocele after pelvic lymphadenectomy / 中国实用妇科与产科杂志

OBJECTIVE: To evaluate the effectiveness of semi-open suturation of vaginal stump in preventing pelvic lym-phocele after pelvic lymphadenectomy during gynecologic cancer surgery.METHODS:This study is a retrospectivestudy.Totally 348 patients with cervic cancer or endometrial cancer who underwent pelvic lymphadenectomy and/or para-aortic lymphadenectomy from January 2012 to September 2018 were divided into two groups according to the suturationof vaginal stump:102 patients were in the semi-open group and 246 patients were in the closed group.The two groupswere compared concerning the surgery time,harvested lymph node,drainage time,albumin level,hemoglobin content,and the incidence of lymphocele and symptomatic lymphocele.RESULTS:There were no differences between two groupswith respect to surgery time,harvested lymph node,drainage time,albumin level or hemoglobin content(P>0.05).Theincidence of lymphocele and symptomatic lyphocele in semi-open group was significantly lower than that in closed group(35.3%versus79.3%,3.9%versus19.5%,P<0.05);the average diameter of lymphocele in semi-open group was also sig-nificantly lower than that in closed group(4.1cm versus 5.9cm,P<0.05).CONCLUSION:The result of this study indicatesthat the application of semi-open saturation of vaginal stump is an effective way to reduce the incidence of pelvic lym-phocele after gynecologic malignancy,which is simple and with reliable effect.It doesn′t increase the incidence of postop-eration complications and deserves clinical application.

Zacopride attenuates pressure overload-induced ventricular remodeling in rats / 中国病理生理杂志

AIM:To investigate the protective effect of zacopride (ZAC) on the pressure-overload left ventricular remodeling in the rats induced by coarctation of abdominal aorta.METHODS:Male Sprague-Dawley (SD) rats with pressure overload were induced by the coarctation of abdominal aorta.The model rats were intraperitoneally administered with ZAC, chloroquine (Chlor) , and zacopride+chlorquine (ZAC+Chlor).The study duration was 8 weeks.The cardiac structure and function were assessed by echocardiography.The heart weight/body weight (HW/BW) ratio and the left ventricular weight/body weight (LVW/BW) ratio were calculated.The changes of structure and shape in myocardial tissue were observed with HE staining.The ultrastructure of the myocytes was observed under transmission electron microscope.The inward rectifier potassium channel (IK1) protein expression was determined by Western blot.The mRNA expression of Kir2.1 was detected by RT-PCR.RESULTS:Compared with vehicle group, ZAC improved cardiac function, as indicated by the decreased left ventricular end-diastolic dimension (LVEDD) and left ventricular end systolic dimension (LVESD) (P<0.05) , and the increased left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) (P<0.01).The HW/BW and LVW/BW ratios were significantly decreased, and the cross-sectional area of the cardiomyocytes was significantly less in ZAC group than that in vehicle group (P<0.01).The ultrastructure of the myocytes was significantly improved.Chlor blocked the protective effect of zacopride on the pressure-overload left ventricular remodeling.The protein level ofmRNA expression of Kir2.1 in the cardiac tissues in ZAC group were significantly increased compared with vehicle group (P<0.01).CONCLUSION:ZAC significantly attenuates pressure overload-induced ventricular remodeling in rats.

Effects of Diallyl Disulfide on the Proliferation and Apoptosis of Epithelial Ovarian Cancer Cells by Inducing G2/M Arrest / 中国医学科学院学报

Objective To explore the effects of diallyl disulfide(DADS)-induced G2/M phase arrest on proliferation and apoptosis of ovarian cancer cells and its possible molecular mechanism.Methods DADS was used to incubate SK-OV-3 and OVCAR-3 cells,respectively,in different concentrations. Cell proliferation was measured by MTT assay and cell apoptosis rate was detected by flow cytometry assay. Xenograft model assay were performed to analyze the antitumor effect in vivo. Cell cycle phase distribution was detected by flow cytometry. Expressions of cell cycle G2/M phase as well as proliferation- and apoptosis-related proteins were measured by Western blotting.Results MTT assay showed that,after treatment of SK-OV-3(F=247.86,P=0.000)and OVCAR-3 cells(F=302.54,P=0.000)with different concentrations of DADS,the cell proliferation inhibition rate was significantly elevated with the increase of DADS concentrations in a concentration-dependent manner. The inhibition rate of SK-OV-3(F=335.12,P=0.000)and OVCAR-3 cells(F=347.43,P=0.000)at 24 h was significantly higher than that at 12 h and 48 h,showing a significant time-dependence manner. Flow cytometry showed that,after SK-OV-3 and OVCAR-3 cells were treated with different concentrations of DADS,the apoptosis rates increased significantly with the increase of DADS concentration in a concentration-dependent manner(P<0.05). The apoptotic rates of SK-OV-3 and OVCAR-3 cells treated with DADS at 24 h was significantly higher than that at 12 h and 48 h in a significant time-dependence manner(P<0.05). Compared with the blank treatment group,intraperitoneal injection of DADS solution significantly inhibited the xenograft volume of ovarian cancer cells in nude mice(F=548.23,P=0.000;F=311.84,P=0.000). After 30 mg/L of DADS was applied to SK-OV-3 and OVCAR-3 cells for 24 h,the percentage of cells in G2 phase of SK-OV-3 and OVCAR-3 cells increased significantly(F=375.11,P=0.000;F=256.48,P=0.000),compared with the blank cells. After 30 mg/L DADS was applied to SK-OV-3 and OVCAR-3 cells for 24 h,the expressions of p-Chk1(ser345)(F=108.89,P=0.013;F=97.58,P=0.018),p-CDC25C(ser216)(F=87.25,P=0.025;F=114.25,P=0.009),p-P53(ser15)(F=112.41,P=0.011;F=255.87,P=0.000),P21WAF1(F=246.38,P=0.001;F=141.36,P=0.005)and p-CDK1(Thr14/Tyr15)protein(F=298.12,P=0.000;F=233.15,P=0.000)were significantly increased,whereas the expressions of CDK1(F=308.24,P=0.000;F=257.55,P=0.000)and CyclinB1 protein(F=223.15,P=0.001;F=241.28,P=0.000)were significantly reduced.The expressions of proliferation and apoptosis-related proteins PCNA(F=77.36,P=0.031;F=157.28,P=0.001),Ki-67(F=205.64,P=0.007;F=315.22,P=0.000)and Survivin(F=122.13,P=0.013;F=188.24,P=0.000)were significantly decreased and Cleaved-caspase3 protein was significantly increased(F=86.46,P=0.023;F=99.11,P=0.009).Conclusion DADS can inhibit the proliferation of ovarian cancer cells and induce their apoptosis,which may be related to the activation of Chk1-CDC25C and P53-P21WAF1 signaling pathways in G2/M checkpoint,decreased kinase activity of CDK1,down-regulated expressions of CDK1 and CyclinB1 proteins,and ultimately cell cycle arrest at G2/M phase.

Patient and Care Delays of Breast Cancer in China / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This study differentiates patient and care delays of breast cancer and explores the related factors as well as the associations with the prognosis in Guangzhou, a southern city of China. METHODS: A cohort of female incident breast cancer patients (n=1,551) was recruited from October 2008 to March 2012 and followed up until January 1, 2016 (n=1,374) in the affiliated hospitals of Sun Yat-sen University. The factors associated with patient and care delays were analyzed with multivariable logistic models. Cox proportional hazards regression models were constructed to estimate the impacts of the delays on the prognosis. RESULTS: There were 40.4% patient delay (≥3 months) and 15.5% care delay (≥1 month). The patient delay, but not the care delay, was significantly related to the clinical stage and consequently worsened the prognosis of breast cancer (hazard ratio, 1.45; 95% confidence interval, 1.09 to 1.91 for progression-free survival). The factors related to an increased patient delay included premenopausal status, history of benign breast disease, and less physical examination. CONCLUSION: Patient delay was the main type of delay in Guangzhou and resulted in higher clinical stage and poor prognosis of breast cancer. Screening for breast cancer among premenopausal women may be an effective way to reduce this delay.

Comparison of the effects of different growth standards on infants in Urban Shanghai: a cluster-randomized controlled trial / 中华医学杂志(英文版)

BACKGROUND@#The Shanghai growth standards are higher than World Health Organization (WHO) growth standards, which may influence the feeding practices of the caregivers and increase the risk of overweight in these infants. This study aimed to compare the effects of different growth standards on childhood obesity in Shanghai metropolitan area.@*METHODS@#This was a cluster-randomized controlled trial conducted in 2 downtown areas with 19 community health service centers in Shanghai from November 2013 to December 2015. Randomization was done at the level of the community. Infants (health newborns) were assessed and monitored by the Shanghai growth standards (S-group) and the 2006 WHO growth standards (W-group), respectively. Measurements were taken at 1.0, 2.0, 4.0, 6.0, 9.0 and 12.0 months of age during follow-up period. Based on the values of length and weight measurements, according to the group's growth standards, doctors provided the caregivers with corresponding clinical consultation. Changes in weight-for-age z-score (WAZ), length-for-age z-score (LAZ), and weight-for length z-score (WLZ) between 2 groups were assessed using mixed regression models. Overweight was compared between 2 group at all follow-up measurements.@*RESULTS@#A total of 6509 infants (52.1% were boys) were in the W-group, and 8510 infants (51.4% were boys) were in the S-group. The overweight ratios between two groups were distinct at 9 months of age (3.4% in W-group and 4.3% in S-group) and 12 months of age (2.2% in W-group and 3.8% in S-group), and the differences were statistically significant (P = 0.020 and P < 0.001, respectively). Compared to W-group, the increase in WAZ (coefficient = 0.04, P = 0.004) and WLZ (coefficient = 0.09, P < 0.001) were significantly greater, and the LAZ was lower (coefficient = -0.04, P = 0.047) in S-group (W-group values were used as reference in mixed regression models).@*CONCLUSION@#Compared to the Shanghai growth standards, the adoption of WHO 2006 growth standards would reduce the risk of infant overweight in Shanghai metropolitan area up to 1 year of age.@*TRIAL REGISTRATION NUMBER@#ChiCTR1800015371, http://www.chictr.org.cn/ Chinese Clinical Trial Registry.

Clinical effect of white noise combined with glucose in reducing the pain of retinopathy screening in preterm infants / 中国当代儿科杂志

OBJECTIVE@#To study the clinical effect of white noise combined with glucose in reducing the procedural pain of retinopathy screening in preterm infants.@*METHODS@#A total of 396 preterm infants with a gestational age of 28-34 weeks and a birth weight of ≤2 000 g were randomly divided into 4 groups according to the intervention method for reducing pain in retinopathy screening: control group with 100 infants (no white noise or glucose intervention), white noise group with 96 infants, glucose group with 98 infants and white noise + glucose group with 102 infants. The Premature Infant Pain Profile (PIPP) was used to determine pain score during retinopathy screening, and the four groups were compared in terms of PIPP score before and after retinopathy screening.@*RESULTS@#There were no significant differences in PIPP score, heart rate and blood oxygen saturation between the four groups at 3 minutes before screening (P>0.05). At 1 and 5 minutes after screening, the white noise, glucose and white noise + glucose groups had significantly lower heart rate and PIPP score but significantly higher blood oxygen saturation than the control group (P<0.05).The white noise + glucose group had significantly lower heart rate and PIPP score but significantly higher blood oxygen saturation than the white noise and glucose groups (P<0.05).@*CONCLUSIONS@#White noise combined with glucose can reduce the procedural pain of retionopathy screening and keep vital signs stable in preterm infants.

Curative efficacy and safety of Kangfuxin liquid in treating patients of upper gastrointestinal hemorrhage caused by non-steroid drugs treated with somatostatin / 中国免疫学杂志

Objective:To investigate the curative efficacy and safety of Kangfuxin liquid in treating patients of upper gastrointestinal hemorrhage caused by non-steroid drugs treated with somatostatin.Methods:90 patients with upper gastrointestinal hemorrhage caused by non-steroid drugs meeting the inclusion criteria were collected as observational objects to be randomly divided into the control group and the observation group with 45 cases in each group.Besides conventional treatments,the control group was given somatostatin,while the observation group was given Kangfuxin liquid in combination with somatostatin.Then,the curative efficiency,hemostatic time,recurrent bleeding rate,levels of serum inflammatory factors and adverse reactions were observed and compared.Results:Assessment of curative efficacy showed that the total therapeutic efficiency ratio in the observation group was statistically higher than that in the control group(95.6％ vs 82.2％,P＜0.05).In comparison with the control group,the hemostatic time in the observation group was statistically shorter[(1.4±0.5)d vs (2.6±0.7)d,P＜0.05],while the recurrent bleeding rate in the two groups was statistically same(4.4％ vs 11.1％,P＞0.05).As to inflammatory factors,the observation group had statistically lower levels of serum TNF-α and IL-6 than those in the control group [(5.46±0.93)ng/L vs (8.37± 1.08)ng/L,(19.37±3.43)ng/L vs (38.22±8.14)ng/L,both P＜0.05].During the treatment,there was no case of severe adverse reactions.And the incidences of adverse reactions in the observation group and the control group were statistically same (22.2％ vs 15.6％,P＞0.05).Conclusion:Besides treatment of somatostatin,adjuvant therapy of Kangfuxin liquid has well application effect in patients of upper gastrointestinal hemorrhage caused by non-steroid drugs.And it can significantly increase curative efficacy,shorten hemostatic time,alleviate inflammatory reaction with minor adverse reactions.

Effect of astragalus polysaccharides on apoptosis,transdifferentiation and ROS content in renal tubular epithelial cells of diabetic nephropathy / 中国免疫学杂志

Objective:To investigate the effect of Astragalus polysaccharides on apoptosis,transdifferentiation and ROS content in renal tubular epithelial cells of diabetic nephropathy.Methods:HK-2 cells were divided into low glucose group,high glucose group and astragalus polysaccharide+high glucose group,cell proliferation was detected by CCK-8 assay after 48 h;cell apoptosis and ROS content was detected by flow cytometry;the expression of E-cadherin,α-SMA,STAT1,STAT3,p-STAT1,p-STAT3 protein were detected by Western blot.Results:The survival rate of cells in high glucose group was significantly lower than low sugar group (P<0.01),cell apoptosis rate,ROS content and E-cadherin,α-SMA,p-STAT1 and p-STAT3 protein expression was significantly higher than low sugar group (P<0.01),the cell survival rate in high glucose+astragalus polysaccharide group was significantly higher than high glucose group,cell apoptosis rate,ROS content and E-cadherin,α-SMA,p-STAT1 and p-STAT3 protein expression was significantly lower than high glucose group (P<0.01).Conclusion:Astragalus polysaccharides can promote the proliferation of renal tubular epithelial cells induced by high glucose,inhibit apoptosis and transdifferentiation,and the mechanism is related to down regulation of JAK/STAT signaling pathway.

Generation and identification of a mouse macrophage line lacking NLRP3 / 中国免疫学杂志

Objective:To establish a mouse macrophage line lacking NLRP3.Methods:A GFP and neomycin dual selection marker vector which contains an efficient shRNA-coding insert for mouse NLRP3,was constructed and transfected into macrophages (RAW264.7) to select the stable clone cells in G418-contained medium.Then,the expanded clone cells that retain strong GFP expression were further sorted using the popular flow cytometry.The obtained cell mix (herein termed RAWNKD) were passaged and maintained for further identification,including observation of GFP marker,especially quantitative PCR (RT-qPCR) to confirm knockdown of NLRP3 in the generated RAWNKD cells which were challenged with LPS and ATP or not.Results:Over 80% of RAWNKD cells expressed GFP,and little NLRP3 mRNA was detected in RAWNKD cells,notably no obvious increase in NLRP3 mRNA was observed when the RAWNKD cells were challenged by LPS and ATP.Conclusion:The macrophage line lacking NLRP3 was successfully established,and such macrophage deficient in NLRP3 inflammasome is a valuable cell model for investigating the activation of NLRP3 inflammasome,especially signaling in inflammation mediated by NLRP3 inflammasome.

Clinical observation of Shenqi Fuzheng injection combined with chemotherapy for reduction of the side effects of tumor chemotherapy / 肿瘤研究与临床

Objective To observe the effect of Shenqi Fuzheng injection combined with chemotherapy on reducing the side effects of malignant tumor chemotherapy. Methods Eighty cancer patients in Traditional Chinese Medicine Hospital of PLA General Hospital from January 2015 to March 2017 were randomly divided into treatment group and control group by using random number table method, each group contained 40 cases. The patients in the treatment group were given Shenqi Fuzheng injection combined with chemotherapy, while the control group used chemotherapy only. Results The incidence of WBC and Plt reduction in the treatment group [35.0 % (14/40), 32.5 % (13/40)] was lower than those in the control group [70.0 % (28/40), 57.5 % (23/40)], and the differences were statistically significant (χ 2= 9.825, P = 0.002;χ2=5.051, P=0.025). The incidence rates of digestive tract reaction and oral ulcers[52.5 %(21/40), 32.5 % (13/40)]were lower than those in the control group[75.0 %(30/40), 60.0 %(24/40)], and the differences were statistically significant (χ2= 4.381, P = 0.036; χ2= 6.084, P = 0.014). The quality of life in the treatment group was significantly improved compared with the control group [(51.4 ±5.1) points vs. (48.3±5.5) points], and the difference was statistically significant(t =2.595,P =0.011). Conclusions Shenqi Fuzheng injection combined with chemotherapy can reduce chemotherapy-induced side effects and improve the life quality of the patients.The injection can be used as the adjuvant therapy for chemotherapy in clinic application.

Brief Introduction on High-value Drug Insurance Access Mechanism in Australia and Its Enlightenment on Orphan Drug Medical Insurance in China / 中国药房

OBJECTIVE:To introduce high-value drug insurance access mechanism in Australia,and to provide suggestion for improving orphan drug medical insurance access in China. METHODS:By literature study and policy analysis,access principle, risk-sharing mechanism and restricted use principle of high-value drug insurance access in Australia were summarized and analyzed, so as to evaluate the effects of high-value drug insurance access mechanism. RESULTS & CONCLUSIONS:The inclusion of high-value drug in Australian National Formulary considers not only the cost-effectiveness ratio,but also the drug’s clinical effica-cy,irreplaceability and the social principles;risk-sharing mechanism and restricted use principle achieve a good balance between the accessibility of patient’s medication and the sustainability of health insurance fund;remarkable results are achieved in guarantee-ing patient’s medication and strengthening basic medical insurance. It is recommended to perfect orphan drugs medical insurance ac-cess standard,introduce risk-sharing mechanism and standardize the use of orphan drugs and reimbursement in China.

Relation between psoriasis features and Framingham cardiovascular risk assessment / 医学研究生学报

Objective Many studies have suggested that cardiovascular risk factors seem to be more common in psoriasis patients than in general population.In this study we aimed to investigate the prevention and treatment of cardiovascular risk in psoriasis patients by Framingham cardiovascular risk assessment in patients with psoriasis vulgaris and normal people using Framingham score.Methods We conducted a prospective study including 90 outpatients with psoriasis vulgaris and 137 controls without psoriasis from October 2015 to October 2016 in our hospital.All psoriasis patients were diagnosed clinically and histopathologically.The severity of psoriasis was assessed according to the psoriasis area and severity index (PASI) score.Along with a thorough medical history and physical examination, serum lipid profile, blood pressure and fasting plasma glucose tests were carried out.The 10-year Framingham risk score (FRS) for general cardiovascular disease included indexes concerning age, gender, total cholesterol, HDL-cholesterol, systolic blood pressure and smoking history.Results We found the 10-year FRS was significantly higher in patients with psoriasis vulgaris than in controls (P0.05).No significance was found in the 10-year FRS of patients with mild and severe psoriasis (P>0.05).FRS was significantly higher in male patients and in patients above 50 years old (P<0.05).Conclusion Psoriasis patients, especially the older male patients, tend to have high risks of cardiovascular disease.Therefore, risk assessment for cardiovascular diseases should be conducted in psoriasis patients, and complications should be actively prevented and treated.