Tongxie Yaofang regulates tumor-associated macrophage polarization in colorectal cancer under chronic stress / 中国中药杂志

This study aims to investigate the intervention effect and mechanism of Tongxie Yaofang in regulating tumor-associated macrophage polarization on colorectal cancer under chronic stress. BALB/C mice were randomized into blank, control, model, mifepristone, and low-, medium-, and high-dose Tongxie Yaofang groups. The other groups except the blank and model groups were subjected to chronic restraint stress and subcutaneous implantation of colon cancer cells for the modeling of colon cancer under stress. Du-ring this period, the body mass and tumor size of each group of mice were recorded. The degree of depression in mice was assessed by behavioral changes. Enzyme-linked immunosorbent assay was employed to determine the levels of cortisol(CORT), 5-hydroxytryptamine(5-HT), norepinephrine(NE), M1-associated inflammatory cytokines [interleukin(IL)-1β, IL-12, and tumor necrosis factor(TNF)-α], and M2-associated inflammatory cytokines(IL-4 and IL-10) in the serum. The tumor growth of mice in each group was regularly monitored by in vivo imaging. The histopathological changes of tumors in each group of mice were observed by hematoxylin-eosin staining. The proportions of CD86 and CD206 in the tumor tissue were detected by flow cytometry and immunofluorescence staining. Western blot was employed to determine the protein levels of Janus kinase(JAK)1, JAK2, JAK3, signal transducer and activator of transcription(STAT)3, and STAT6 in the tumor tissue. The results showed that chronic stress increased the immobility time of mice, elevated the serum levels of CORT, IL-4, and IL-10, lowered the levels of 5-HT, NE, IL-1β, IL-12, and TNF-α, and promoted the growth of subcutaneous tumors. The tumor cells in the tumor tissue grew actively, with obvious atypia and up-regulated protein levels of CD206, JAK1, JAK2, JAK3, STAT3, and STAT6, and down-regulated protein level of CD86. The treatment with Tongxie Yaofang shortened the immobility time of mice, lowered the serum levels of CORT, IL-4, and IL-10, elevated the serum levels of 5-HT, NE, IL-1β, IL-12, and TNF-α, and inhibited the growth of subcutaneous tumors in mice. Moreover, the treatment caused different degrees of necrosis in the tumor tissues, down-regulated the protein levels of CD206, JAK1, JAK2, JAK3, STAT3, and STAT6, and up-regulated the protein level of CD86. In summary, Tongxie Yaofang can promote the transformation of M2 macrophages to M1 macrophages and change the tumor microenvironment under chronic stress to inhibit the development of colorectal cancer, which may be related to the JAK/STAT signaling pathway.

Decursin affects proliferation, apoptosis, and migration of colorectal cancer cells through PI3K/Akt signaling pathway / 中国中药杂志

We investigated the effects of decursin on the proliferation, apoptosis, and migration of colorectal cancer HT29 and HCT116 cells through the phosphatidylinositol 3-kinase(PI3K)/serine-threonine kinase(Akt) pathway. Decursin(10, 30, 60, and 90 μmol·L~(-1)) was used to treat HT29 and HCT116 cells. The survival, colony formation ability, proliferation, apoptosis, wound hea-ling area, and migration of the HT29 and HCT116 cells exposed to decursin were examined by cell counting kit-8(CCK8), cloning formation experiments, Ki67 immunofluorescence staining, flow cytometry, wound healing assay, and Transwell assay, respectively. Western blot was employed to determine the expression levels of epithelial cadherin(E-cadherin), neural cadherin(N-cadherin), vimentin, B-cell lymphoma/leukemia-2(Bcl-2), Bcl-2-associated X protein(Bax), tumor suppressor protein p53, PI3K, and Akt. Compared with the control group, decursin significantly inhibited the proliferation and colony number and promoted the apoptosis of HT29 and HCT116 cells, and it significantly down-regulated the expression of Bcl-2 and up-regulated the expression of Bax. Decursin inhibited the wound healing and migration of the cells, significantly down-regulated the expression of N-cadherin and vimentin, and up-regulated the expression of E-cadherin. In addition, it significantly down-regulated the expression of PI3K and Akt and up-regulated that of p53. In summary, decursin may regulate epithelial-mesenchymal transition(EMT) via the PI3K/Akt signaling pathway, thereby affecting the proliferation, apoptosis, and migration of colorectal cancer cells.

Review of research progresses in genetics related to myopia / 国际眼科杂志(Guoji Yanke Zazhi)

@# Myopia is an extremely common state of refractive error, and the incidence of myopia is increasing year by year and the age of onset is usually earlier. It has grown up to be a major public health problem that endangers people's visual health. Studies have demonstrated that myopia is a multi-factor complex disease which affected by genetic factors, environmental factors and gene-environment interaction. Genetics includes classical genetics and epigenetics. The emergence of epigenetic research has opened a new perspective of basic research on myopia. In recent years, the researchers have proposed that the occurrence of myopia may be related to epigenetics, and more and more experimental studies have also proved this view. The genetic study of myopia has identified several myopia genes and candidate genes for high myopia and myopia by using linkage and genome-wide association methods, which greatly deepened the understanding of the genetic basis of myopia. This article reviews the research on classical genetics and epigenetics of myopia in recent years.

Short-term complications after transanal total mesorectal excision for mid-low rectal cancer / 中华胃肠外科杂志

Objective: To summarize short-term postoperative complications of transanal total mesorectal excision (taTME) in the treatment of middle-low rectal cancer. Methods: A descriptive case series of cases was constructed. Clinical data of consecutive 83 patients with mid-low rectal cancer who received taTME treatment from November 2016 to April 2021 at Department of General Surgery of Beijing Friendship Hospital, Capital Medical University were collected. Among 83 patients, 58 (69.9%) were males, with a mean age of (61.4±11.8) years; 42 (50.6%) were low rectal cancer, 41 (49.4%) were middle rectal cancer. Short-term postoperative complication was defined as complication occurring within 30 days after operation. The complication was graded according to the Clavien-Dindo classification. At the same time, the morbidity of short-term postoperative complication in the first 40 patients and that in the last 43 patients were compared to understand the differences before and after passing the taTME learning curve. Results: Two patients (2.5%) were converted to laparotomy ; 78 (94.0%) completed anastomosis.While 5 (6.0%) underwent permanent stoma. The total operation time of transabdominal+ transanal procedure was (246.9±85.0) minutes, and the median intraoperative blood loss was 100 (IQR: 100) ml. Seventy-five cases (75 /78, 96.2%) underwent defunctioning stoma, including 74 cases of diverting ileostomy, 1 case of diverting transverse colostomy and 3 cases without stoma. The morbidity of complication within 30 days after operation was 38.6% (32/83), and the morbidity of complication after discharge was 8.4% (7/83). Minor complications accounted for 31.3% (26/83) and major complications accounted for 7.2% (6/83). No patient died within 30 days after operation. The incidence of anastomotic leakage was 15.4% (12/78). Eight patients (9.6%) were hospitalized again due to complications after discharge. The median postoperative hospital stay was 7 (IQR: 3) days. All the patients with minor (I-II) complications received conservative treatment. One patient with grade C anastomotic leakage was transferred to intensive care unit and received a second operation due to sepsis and multiple organ dysfunction. Two patients with paralytic ileus (Clavien-Dindo IIIa) underwent endoscopic ileus catheter placement. There were 3 patients with Clavien-Dindo III or above respiratory complications, including 1 patient with pleural effusion and ultrasound-guided puncture, 2 patients with respiratory failure who were improved and discharged after anti-infection and symptomatic treatment. One patient underwent emergency ureteral stent implantation due to urinary infection (Clavien-Dindo IIIb). The morbidity of postoperative complication in the first 40 cases was 50.0% (20/40), and that in the latter 43 cases decreased significantly (27.9%, 12/43), whose difference was statistically significant (χ(2)=4.270, P=0.039). Conclusions: The procedure of taTME has an acceptable morbidity of short-term postoperative complication in the treatment of mid-low rectal cancer. The accumulation of surgical experience plays an important role in reducing the morbidity of postoperative complication.

Problems exposed in retrospective study of postoperative complications of rectal cancer and causal analysis / 中华胃肠外科杂志

Rectal cancer is a great threat to the health of the Chinese people. With the continuous improvement of surgical treatment level, complication as an important indicator to measure the safety of surgery has received increasing attention from clinicians both at home and abroad. Although there are many studies on postoperative complications of rectal cancer, the morbidity of complication reported by related studies varies greatly. An important reason occurs in the limitations of retrospective research, such as incomplete medical records, unclear diagnostic criteria for some complications, incomplete follow-up records after discharge, and poor communication mechanisms among MDT members. Starting from a retrospective study on postoperative complications of rectal cancer and finding out the defects and problems in the registration of complications in each center, then clarifying the definition of various postoperative complications, so as to establish a sound and standardized registration system, and carry out prospective research, this path could be a reliable method to obtain relatively accurate postoperative complications of rectal cancer.

Preparation of Rehmanniae Radix Juice for Baihe Dihuangtang Based on UPLC-Q-TOF-MS / 中国实验方剂学杂志

ObjectiveTo compare the four preparation methods of Rehmanniae Radix juice described in ancient literature and find the method that is most suitable for the preparation of Rehmanniae Radix juice used in Baihe Dihuangtang. MethodThe ancient medical books record four methods for preparing Rehmanniae Radix juice： crushing fresh Rehmanniae Radix for juice， steaming fresh Rehmanniae Radix for juice， boiling fresh Rehmanniae Radix for juice， and boiling dry Rehmanniae Radix for juice. Ultra performance liquid chromatography-quadrupole time-of-flight mass spectrometry （UPLC-Q-TOF-MS） was employed to detect the compounds in the four juice samples， followed by principal component analysis （PCA）. Result① Totally 27 compounds were identified in the juice samples， including 10 iridoid glycosides， 14 phenylethanoid glycosides， 2 phenolic acids， and 1 irisone. Among them， 15 common compounds were shared by the four juice samples， including 7 iridoid glycosides， 7 phenylethanoid glycosides， and 1 phenolic acid. ② Five common compounds in the four juice samples can be matched with the reference standards， which were catalpol， aucubin， rehmannioside D， ajugol， and purpureaside C. ③ Verbascoside and isoacteoside were not detected in the juice prepared by crushing fresh Rehmanniae Radix， while it was detected in the other three juice samples， which indicated that the two components were produced after heating rather than being the original components in fresh Rehmanniae Radix. ④ The comparison of the ion fragments demonstrated that verbascoside was produced from purpureaside C after the cleavage of the glycosidic bond and removal of a molecule of mannose. ⑤ Isoacteoside could be isomerized from verbascoside， and its relative content increased with the extension of heating time. However， the relative content of verbascoside and purpureaside C did not decrease significantly. Therefore， it was hypothesized that purpureaside C was produced from its upstream component. ConclusionThe juice prepared by crushing fresh Rehmanniae Radix has the chemical composition significantly different from the juice samples prepared with the other 3 methods， while the latter 3 juice samples had similar chemical composition. Although all the four methods can be used， it is more suitable to prepare Rehmanniae Radix juice by steaming fresh Rehmanniae Radix， boiling fresh Rehmanniae Radix， and boiling dry Rehmanniae Radix.

Research progress on early diagnosis and prevention of anastomotic leak after rectal cancer surgery / 中华胃肠外科杂志

Anastomotic leak is a common and serious complication after anterior rectal resection. Despite the continuous advancement of anastomotic instruments and surgical techniques, the incidence of anastomotic leak has not decreased significantly compared with the past. As more studies on the early diagnosis of anastomotic leak are published, postoperative risk factors of anastomotic leak, such as fever, time to first bowel movement, CT, C-reactive protein (CRP) and procalcitonin (PCT), matrix metalloproteinase-9, and other cytokines and biomarkers (IL-6, TNF-α, lactate, pH, urinary neopterin/creatinine ratio), provide a reference for surgeons to assess the risk and increase the possibility of early diagnosis of anastomotic leak. Nevertheless, preventing the occurrence of anastomotic leak is still the ultimate goal. For the prevention of anastomotic leak, intraoperative ICG fluorescence imaging technology provides a simple and safe objective method for surgeons to evaluate anastomotic perfusion. The diversion stoma may reduce the incidence of anastomotic leak. More and more evidence shows that drainage through the anal canal can reduce the incidence of anastomotic leak after rectal cancer, but whether different types of drainage catheters can clearly reduce the incidence of anastomotic leak still needs more evidence. In addition, there has not yet been a unified opinion on the retention time and location of the drainage catheter. At present, the research of anastomotic leak has not adopted a unified definition and the heterogeneity among related studies is still great. We still look forward to more high-quality multi-center large prospective and randomized controlled studies.

Computed tomography-based radiomic model predicts radiological response following stereotactic body radiation therapy in early-stage non-small-cell lung cancer and pulmonary oligo-metastases

Purpose@#Radiomic models elaborate geometric and texture features of tumors extracted from imaging to develop predictors for clinical outcomes. Stereotactic body radiation therapy (SBRT) has been increasingly applied in the ablative treatment of thoracic tumors. This study aims to identify predictors of treatment responses in patients affected by early stage non-small cell lung cancer (NSCLC) or pulmonary oligo-metastases treated with SBRT and to develop an accurate machine learning model to predict radiological response to SBRT. @*Materials and Methods@#Computed tomography (CT) images of 85 tumors (stage I–II NSCLC and pulmonary oligo-metastases) from 69 patients treated with SBRT were analyzed. Gross tumor volumes (GTV) were contoured on CT images. Patients that achieved complete response (CR) or partial response (PR) were defined as responders. One hundred ten radiomic features were extracted using PyRadiomics module based on the GTV. The association of features with response to SBRT was evaluated. A model using support vector machine (SVM) was then trained to predict response based solely on the extracted radiomics features. Receiver operating characteristic curves were constructed to evaluate model performance of the identified radiomic predictors. @*Results@#Sixty-nine patients receiving thoracic SBRT from 2008 to 2018 were retrospectively enrolled. Skewness and root mean squared were identified as radiomic predictors of response to SBRT. The SVM machine learning model developed had an accuracy of 74.8%. The area under curves for CR, PR, and non-responder prediction were 0.86 (95% confidence interval [CI], 0.794–0.921), 0.946 (95% CI, 0.873–0.978), and 0.857 (95% CI, 0.789–0.915), respectively. @*Conclusion@#Radiomic analysis of pre-treatment CT scan is a promising tool that can predict tumor response to SBRT.

Role of aloperine on ischemia-reperfusion-induced injury and inflamma-tory response in H9c2 cardiomyocytes / 中国病理生理杂志

AIM:To explore the role of aloperine in ischemia-reperfusion(I/R)-induced H9c2 cardiomyocyte injury and inflammation.METHODS: The H9c2 cardiomyocytes were cultured under hypoxia and re-oxygenation condi-tions to simulate ischemia-reperfusion(SI/R)injury.After treatment with aloperine at various doses,the cell viability was measured by MTT assay.The cell apoptosis was analyzed by flow cytometry.Simultaneously,the levels of lactate dehydro-genase(LDH),malonaldehyde(MDA)and caspase-3 activity were detected by the commercial kits.The levels of inflam-matory cytokines were also detected by ELISA.Moreover,the effects of aloperine on the activation of PI 3K/AKT signaling pathway were determined by Western blot.RESULTS:Pre-treatment with aloperine remarkably abated the inhibitory effect of SI/R on H9c2 cell viability,and decreased the elevations of LDH and MDA triggered by SI /R(P<0.05).Pre-treat-ment with aloperine dramatically suppressed the cell apoptosis induced by SI /R treatment(P<0.05), concomitant with the decrease in caspase-3 activity and increase in Bcl-2/Bax ratio(P<0.05).In contrast to SI/R group,aloperine treat-ment notably restrained the concentrations of pro-inflammatory cytokines, including interleukin-6, tumor necrosis factor-α and interleukin-1β(P<0.05).Furthermore, aloperine remarkably increased the protein levels of p-PI3K and p-AKT. While blocking the PI3K/AKT pathway with its specific inhibitor LY294002, the viability-promoting, anti-apoptotic and anti-inflammatory effects of aloperine on the H 9c2 cells were obviously attenuated(P<0.05).CONCLUSION: Alope-rine protects against cardiomyocytes from I/R injury and inhibits inflammatory responses by activating the PI 3K/AKT signa-ling pathway,implying a potential benefic role of aloperine against myocardial I /R injury.

The prognostic value of sCD163 in patients with acute respiratory distress syndrome / 复旦学报（医学版）

Objective To investigate the diagnostic and prognostic value of plasma soluble CD163 (sCD163) levels in patients with acute respiratory distress syndrome (ARDS).Methods A total of 124 individuals,83 patients with ARDS,20 patients with cardiogenic pulmonary edema (CPE),and 21 healthy controls,were enrolled in this study.ARDS patients were classified into survivors and nonsurvivors according to 28-day mortality.The concentration of plasma sCD163 was measured by enzymelinked immunosorbent assay (ELISA).Receiver operating characteristic (ROC) curves were employed to evaluate the accuracy of sCD163 in diagnosing ARDS and predicting 28-day ICU outcome.Cumulative survival curve was carried out by Kaplan-Meier survival analysis.Logistic regression analysis was assessed by univariate and multivariate analysis to identify independent predictors of outcome controlling for reported risk factor of mortality.Results Patients with ARDS had significantly higher median levels of sCD163 compared to patients with CPE [496.7(421.8-577.5) ng/mL vs.284.5(141.7-459.2) ng/mL,P＜0.001] upon admission to ICU.The sCD163 levels of non-survivors was significantly higher than that of survivors [577.5 (503.7-623.4) ng/mL vs.479.6 (395.4-520.8) ng/mL,P＜0.001].Multivariate logistic regression showed sCD163 (OR =1.02,P =0.001)was the independent predictor for 28-day mortality in patients with ARDS.Conclusions Plasma sCD163 is a potential biomarker for diagnosis of ARDS and differenting the severity of ARDS.Meanwhile,sCD163 was an independent prognostic marker for 28-day mortality in ARDS patients.

Risk factors for early castration-resistant prostate cancer after androgen deprivation therapy for bone-metastatic prostate cancer / 中华男科学杂志

<p><b>Objective</b>To investigate the risk factors for early castration-resistant prostate cancer (CRPC) after androgen deprivation therapy (ADT) in patients primarily diagnosed with bone-metastatic prostate cancer (BMPC).</p><p><b>METHODS</b>We retrospectively analyzed the clinical data on 97 cases of primarily diagnosed BMPC treated in our hospital between January 2010 and May 2016. We included the patients without CRPC in group A and those with CRPC found within 12 months after ADT in group B. We obtained clinical data from the two groups of patients, including preoperative levels of hemoglobin, C-reactive protein and serum prostate-specific antigen (PSA), prostate volume, incidence rates of hypertension and diabetes mellitus, long-term use of aspirin or metformin, methods of biopsy and castration, Gleason scores, anti-androgen drugs, and radiotherapy with 89SrCl2, which were subjected to uni- or multivariate logistic regression analysis.</p><p><b>RESULTS</b>CRPC developed in 48 (49.48%) of the 97 patients within 12 months after ADT. Univariate analysis showed the preoperative hemoglobin level, Gleason scores and biopsy by transurethral plasmakinetic resection of the prostate (TUPKRP) to be the risk factors for early CRPC, and multivariate logistic regression analysis identified two independent risk factors for it, which were the Gleason score (P = 0.010) and TUPKRP (P = 0.002).</p><p><b>CONCLUSIONS</b>The incidence rate of early CRPC is high in BMPC patients within 12 months after ADT, for which the independent risk factors include biopsy by TUPKRP and Gleason scores.</p>

Application of Laboratory Indexes in Traditional Chinese Medicine Syndrome Differentiation of Multiple Myeloma / 广州中医药大学学报

Objective To study the relationship between traditional Chinese medicine (TCM)syndrome differentiation of multiple myeloma(MM)and laboratory indexes of MM,thus to supply evidence for the syndrome differentiation of MM. Methods A total of 59 MM patients were enrolled in the study. TCM syndrome differentiation was performed. And we also collected the laboratory indexes of serum protein electrophoresis (SPE),immunofixation electrophoresis (IFE),blood urea nitrogen (BUN),creatinine (CREA),serum beta 2 microglobulin,serum calcium(Ca),hemoglobin(Hb),Bence Jones protein,flow cytometric-immunophenotyping(FCM) and bone marrow cytology. The differences of the laboratory indexes in various syndrome types of MM were analyzed. Results No significant differences were found in myeloma cell morphology, M protein content, IFE typing results, Bence Jones protein positive rate and the concentration of Ca of various syndrome types of MM (P >0.05). However,the concentrations of BUN,CREA,serum beta 2 microsglobulin,Hb,and the positive rates of CD19- and CD56+ were significantly different in various syndrome types of MM (P < 0.05 or P < 0.01). Moreover,Hb,BUN,CREA,and serum beta 2 microspheres were significantly correlated with each other(P<0.05 or P < 0.01). Conclusion Hb, BUN, CREA, blood beta 2 microglobulin and FCM detection can be sued for the auxiliary diagnosis of syndrome types of MM, and for preliminary demonstration of illness severity and prognosis. The results will provide the basis for the treatment of MM with traditional Chinese medicine and western medicine.

LINK fixed-bearing versus Oxford mobile-bearing unicompartmental knee arthroplasty for medial unicompartment knee osteoarthritis / 中国组织工程研究

BACKGROUND: In the treatment of unicompartmental knee osteoarthritis, unicompartmental knee arthroplasty has the advantages of less blood loss, less trauma, quick recovery, maximum retention of bone mass, low cost, fewer complications and higher patient satisfaction. However, for the mobile bearing and the fixed bearing, the choice of single condylar prosthesis is till controversial.OBJECTIVE: To investigate the difference of LINK fixed-bearing and Oxford mobile-bearing unicompartment arthroplasty in relieving knee joint pain, reconstruction of the knee joint function, correct the knee joint deformity for medial unicompartment knee osteoarthritis, thus providing the basis for selecting a better prosthesis.METHODS: Ninety patients with medial unicompartment knee osteoarthritis undergoing unicompartmental knee arthroplasty in the Department of Joint Surgery, Guangdong Provincial Hospital of TCM from December 2014 to June 2016 were analyzed retrospectively, followed by allotted into Oxford mobile-bearing and LINK fixed-bearing groups (n=45 per group). The preoperative and postoperative pain level, range of motion of the knee, complications, and limb alignment were assessed. The range of motion and function of the knee were evaluated by Knee Society Score system.RESULTS AND CONCLUSION: (1) The two kinds of prosthesises both could obtain good clinical effectiveness. (2)There was no significant difference in the Knee Society Score, Visual Analogue Scale scores, or the range of motion of the knee between two groups (P > 0.05). (3) No complications such as deep vein thrombosis, prosthesis loosening and joint revision were found in both groups. (4) The correction of limb alignment showed significant difference between two groups (P < 0.05). The corrective femorotibial angle in the Oxford mobile-bearing group was larger than that in the LINK fixed-bearing group. (5) These findings manifest that under the precondition of strictly mastering the indications, both fixed-bearing and Oxford mobile-bearing unicompartment arthroplasties can effectively relieve the pain and improve the function of knee joint in the treatment of unicompartmental knee osteoarthritis. Oxford mobile-bearing prosthesis exhibits advantage in restoring the limb alignment; the movable platform lower limb alignment correction angle is often bigger than fixed platform correction angle, but may accelerate the lateral cartilage wear.

Resource distribution and breeding of medicinal plants in genus Bletilla Reichb. f / 中草药

The plants in genus Bletilla Reichb. f. possess multiple medical uses in traditional Chinese medicine. However, most wild plants of this genus are critically endangered. In this paper, we searched and combed the origins of these medicinal plants, compared and identified the common adulterants. To explore the suitable soil, climate, and geographical conditions for the artificial cultivation of Bletilla Reichb. f. plants, we investigated and described the natural habitats in different spatial scales, collected and sorted out the information of geographical distribution for the wild plants. We also systematically summarized and prospected the technology of artificial breeding for genus Bletilla Reichb. f.. Based on the characteristics of the reproductive system and breeding features for Bletilla Reichb. f., the seed aseptic germination is considered to be the most appropriate breeding method. Therefore, the development of a new-generation technology for direct seeding germination and the breakthrough of the key cultivation technology will greatly improve the reproductive efficiency of Bletilla Reichb. f., resulting to change the mode of plant-resource supply. The formulation of more specific protective measures together with the acceleration of the research on artificial reproduction technology and the enhancement of the basic research on the resources and reproduction, will facilitate to improve the efficiency of the protection and utilization for the Bletilla Reichb. f. plants, which shows the essential significance for sustainable utilization of medicinal resources of Bletilla Reichb. f..

Does Spore Count Matter in Fungal Allergy?: The Role of Allergenic Fungal Species

PURPOSE: Fungi have been known to be important aeroallergens for hundreds of years. Most studies have focused on total fungal concentration; however, the concentration of specific allergenic fungi may be more important on an individual basis. METHODS: Ten fungal allergic patients and 2 non-fungal allergic patients were enrolled. The patients with a decrease in physician or patient global assessment by more than 50% of their personal best were considered to have an exacerbation of allergic symptoms and to be in the active stage. Those who maintained their physician and patient global assessment scores at their personal best for more than 3 months were considered to be in the inactive stage. The concentrations of dominant fungi in the patients' houses and outdoors were measured by direct and viable counts at active and inactive stages. RESULTS: The exacerbation of allergic symptoms was not correlated with total fungal spore concentration or the indoor/outdoor ratio (I/O). Specific fungi, such as Cladosporium oxysporum (C. oxyspurum), C. cladosporioides, and Aspergillus niger (A. niger), were found to be significantly higher concentrations in the active stage than in the inactive stage. Presumed allergenic spore concentration threshold levels were 100 CFU/m3 for C. oxysporum, and 10 CFU/m3 for A. niger, Penicillium brevicompactum and Penicillium oxalicum. CONCLUSIONS: The major factor causing exacerbation of allergic symptoms in established fungal allergic patients may be the spore concentration of specific allergenic fungi rather than the total fungal concentration. These results may be useful in making recommendations as regards environmental control for fungal allergic patients.

Genetic diversity of Lysimachia christinae by ISSR / 中国药学杂志

OBJECTIVE: To analyze the genetic diversity of Lysimachia christinae Hance germplasm resources from 36 different places of origin with ISSR DNA markers. METHODS: Ten primers screened from 45 ISSR primers wrea mplified with PCR and the amplification products were examined by 1.5% agarose gel electrophoresis. POPGENE32 software was used for statistical analysis of genetic parameters and UPGMA method (NTSYS2.10 software) for cluster analysis and dendrogram constructing. RESULTS: A total of 91 sites were amplified from the 10 ISSR primers, of which 80 sites were polymorphic loci. The percentage of total polymorphic loci (PBB) was 87.91%. The number of observed alleles (Na) was 1.879 1 and the number of effective alleles was number (Ne) 1.381 7. The Nei's genetic diversity index (He) was 0.239 0 and the Shannon information index (I) was 0.374 5. The genetic similarity coefficient of the 36 germplasm resources varied from 0.69 to 0.97 and the 36 materials couldbe divided into six categories at the similarity coefficient of 0.76. Clustering results showed that the samples within small geographic range clustered together in the dendrogram, indicating the nearer genetic relationships of them. Meanwhile, the samples from different provinces or cities could not be differentiated from each other through cluster analysis. CONCLUSION: The germplasm resources of Lysimachia christinae have rich genetic diversities. The genetic diversities of Lysimachia christinae have no significant correlation with their geographic distribution.

Vacuum sealing drainage combined with free skin graft in repairing cutaneous deficiency of traumatic shank amputation stump / 中国骨伤

<p><b>OBJECTIVE</b>To observe clinical efficacy in treating cutaneous deficiency of traumatic shank amputation stump with full-thickness skin graft combined with vacuum sealing drainage.</p><p><b>METHODS</b>From September 2009 to December 2012, 15 patients with cutaneous deficiency of traumatic shank amputation stump were treated with full-thickness skin graft combined with vacuum sealing drainage. Among patients, there were 11 males and 4 females with an average age of 41.5 (ranged from 25 to 62) years old. Ten cases were caused by traffic accident and 5 cases were caused by heavy object, 9 cases on left and 6 cases on right. Six patients with smashed wound were treated with debridement and amputation, combined with vacuum aspiration in-emergency; 9 patients caused by infection and necrosis were treated with debridement and amputation, combined with vacuum aspiration, and full-thickness skin graft were performed at stage II. The skin defect area of residual limbs ranged from 40 cm x 20 cm to 25 cm x 15 cm.</p><p><b>RESULTS</b>All patients were followed up from 3 months to 1 year. Full-thickness skin graft of residual limbs were survived,and obtained satisfactory walking function with prosthetic. Residual skin increased thicken, wearproof without rupture and pain.</p><p><b>CONCLUSION</b>Full-thickness skin graft combined with vacuum sealing drainage in treating cutaneous deficiency of traumatic shank amputation stump could reserve the length of residual limbs, increase survival rate of skin graft with less scar of survival skin, get good wearability and it is conducive to prosthetic wear. It is a simple and easy treatment method.</p>

Optimization for ISSR-PCR system of traditional Chinese medicine Lysimachia christinae by orthogonal design / 中国中药杂志

In order to establish the stable andreliable ISSR-PCR System of Lysimachia christinae, L16 (4(5)) orthogonal design, which based on 7 levels of single factor experiment, were used in this study. The variance analysis was carried out by SPSS 19.0, and 5 main factors affecting the reaction system were optimized in 4 levels. The best annealing temperature was selected by the optimized reaction system. And the stability and reliability of this system was tested by 23 samples from different origins. The results showed that the five factors (DNA template, primer, dNTP, Mg2+ and Taq enzyme) were the most impacts on the amplified results of ISSR-PCR of L. christinae. The order of the influence was: primer > Taq enzyme > DNA template > Mg2+ > dNTP. The optimal system, which was determined by multiple comparison on different levels of each factor, was total volume of 25 microL, including DNA template 60 ng, primer 0.3 micromol x L(-1), dNTP 0.2 mmol x L(-1), Mg2+ 1.8 mmol x L(-1), Taq enzyme 1.25 U. The optimal system was stable and reliable tested by 23 samples from different origins. This study lays the foundation for genetic diversity analysis, fine varieties selection and molecular identification of L. christinae, and provides reference for optimization on ISSR-PCR system of other speciesin future.

Feasibility and safety of CT-guided percutaneous needle biopsy and subsequent iodine-125 seed interstitial implantation for pancreatic cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To discuss the feasibility and safety of different approaches for CT-guided percutaneous needle biopsy and subsequent iodine-125 seed interstitial implantation for pancreatic cancer.</p><p><b>METHODS</b>A retrospective study was carried out on the complete data of 35 patients with pancreatic cancer who have received CT-guided percutaneous needle biopsy with or without subsequent iodine-125 seed interstitial implantation. There were 9 lesions located in the head of pancreas, 20 located in the body, and 6 in the tail. The maximum diameter of the lesions varied from 12 mm to 60 mm (mean 37.1 mm). The patients were treated with a needle in diameter of 16-21G. Operations were undertaken via anterior, posterior and lateral approaches.</p><p><b>RESULTS</b>Thirty-five patients underwent 43 times of CT-guided percutaneous needle biopsies. Thirty-one cases were pathologically diagnosed as cancer, 2 cases inflammatory lesions, and 2 were suspected tumors (one of which was finally diagnosed as cancer, while another was pancreatic pseudocyst). The ratio of correct diagnosis was 94.3%. Fourteen patients were treated subsequently with CT-guided iodine-125 seed interstitial implantation therapy, with a total of 65 times of needle puncture. The operations were performed via direct approach to the tumor in 18 cases, transhepatic approach in 2 cases, transgastric approach in 4 cases, transintestinal approach in 10 cases, and through mesenteric vessels in one case. Incidence of complications in the biopsy group was 2.32% (1/43), and in the implantation group was 6.15% (4/65), with a statistically non-significant difference (P = 0.600) between the two groups. Incidence of complications in the group using 16-18G needle was 4.65% (4/86), while in the group using 20-21G needle was 4.55% (1/22), also with a non-significant difference (P = 0.064). The accuracy rate of needle biopsy in this study was 94.28% (33/35).</p><p><b>CONCLUSION</b>CT-guided percutaneous needle biopsy and subsequent iodine-125 seed interstitial implantation are both feasible and safe for pancreatic cancer.</p>

A meta-analysis of carotid endarterectomy versus stenting in the treatment of symptomatic carotid stenosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Carotid stenosis is one of the common reasons for patients with ischemic stroke, and the two invasive options carotid endarterectomy (CEA) and carotid artery stenting (CAS) are the most popular treatments. But the relative efficacy and safety of the methods are not clear.</p><p><b>METHODS</b>About 521 articles related to CAS and CEA for carotid stenosis published in 1995 - 2011 were retrieved from MEDLINE, Cochrane Library (CL), and China National Knowledge Infrastructure (CNKI) China Journal Full-Test database. Of them, eight articles were chosen. Meta-analysis was used to assess the relative risks.</p><p><b>RESULTS</b>The eight studies included 3873 patients with symptomatic carotid artery stenosis, including 1941 cases in the carotid stent angioplasty group, and 1932 cases in the carotid endarterectomy group. Fixed effect model analysis showed that within 30 days of incidence of all types of strokes, surgery was significantly highly preferred in CAS patients (CAS group) than the CEA patients (CEA group), and the difference was statistically significant (relative ratio (RR) = 1.80, 95% confidence interval (CI): 1.380 - 2.401, P < 0.0001). But the incidence of death in the two groups is not showed and is not statistically significant after 30 days (RR = 1.52, 95%CI: 0.82 - 2.82, P = 0.18). The rate of cranial nerve injury in the CAS group is lower than the CEA group (RR = 0.14, 95%CI: 0.05 - 0.43, P = 0.0005). The incidence of CAS patients with myocardial infarction is lower than the CEA group after 30 days, but statistically meaningless (RR = 0.22, 95%CI: 0.05 - 1.02, P = 0.05). The stroke or death in CAS patients were higher than the CEA group after 1 year of treatment (RR = 2.58, 95%CI: 1.03 - 6.48, P = 0.04).</p><p><b>CONCLUSIONS</b>Compared to CAS, carotid endarterectomy is still the preferred treatment methodology of symptomatic carotid artery stenosis. Future meta-analyses should then be performed in long-term follow-up to support this treatment recommendation.</p>