Analysis of the experience and procedural complications of trans-radial access versus trans-femoral access for hepatic arterial perfusion chemotherapy in patients with advanced hepatic malignancies:a retrospective study / 中华内科杂志

Objective:To analyze the differences between trans-radial access (TRA) and trans-femoral access (TFA) in hepatic arterial perfusion chemotherapy (HAIC) in terms of patient experience, postoperative complications, and patient preferences; explore whether TRA in HAIC is associated with better patient experience and compliance; and determine whether it is safer than TFA.Methods:The study was a retrospective cohort study of patients with advanced hepatocellular carcinoma and liver metastases from colorectal cancer treated with HAIC. We enrolled a total of 91 patients with advanced liver malignancies treated with HAIC from November 2022 to May 2023 in the Department of Interventional Therapy and Hepatobiliary Medicine at Tianjin Medical University Cancer Hospital. The patients were divided into three groups: group TRA ( n=20, receiving TRA HAIC only), group TFA ( n=33, receiving TFA HAIC only), and crossover group [ n=19, receiving TFA HAIC (Cross-TFA group) first, followed by TRA HAIC (Cross-TRA group)]. Meanwhile, to facilitate the expression of partial results, all patients receiving TRA HAIC were defined as the TRA-HAIC group ( n=39, TRA+Cross-TRA group), and all patients receiving TFA HAIC were defined as the TFA-HAIC group ( n=52, TFA+Cross-TFA group). The primary research index was the Quality of Life (QOL) visualization scale score. The secondary research index included approach-related and catheter-related adverse events, duration of surgery, and mean length of patient stay. We used various statistical methods such as Mann-Whitney U test, t-test, Chi-square test, Fisher′s exact test, univariate logistic regression analysis, and multi-factor analysis. Results:TRA patients had significantly lower QOL scores than TFA patients (all P<0.001). The QOL scores of the Cross-TRA group were significantly lower than those of the Cross-TFA group (pain at the puncture site Z=-3.24, P=0.001, others P<0.001). The QOL scores of the Cross-TRA group were compared with those of the TRA group, which showed that the scores of the Cross-TRA group in overall discomfort ( Z=-3.07, P=0.002), postoperative toilet difficulty ( Z=-2.12, P=0.034), and walking difficulty ( Z=-2.58, P=0.010) were significantly lower than those of the TRA group. Satisfaction scores were significantly higher in the Cross-TRA group than in the Cross-TFA group ( Z=-3.78, P<0.001), and patients were more likely to receive TRA HAIC as the next procedure ( χ2=30.42, P<0.001). In terms of mean length of stay, patients receiving TRA HAIC had a significantly lower mean length of stay than those receiving TFA HAIC (50.1±3.2 h vs. 58.4±6.4 h, t=7.98, P<0.001). The incidence of radial artery occlusion (RAO) as an approach-related adverse event was 15.4% (6/39) in the TRA-HAIC group, which was significantly higher than that in the TFA-HAIC group (15.4% vs. 0, χ2=8.56, P=0.005). Notably, multifactorial analysis of RAO-related factors showed that intraoperative enoxaparin use and patency of radial artery flow during pressure were significantly associated with a reduced risk of postoperative RAO ( P=0.037 for enoxaparin use and P=0.049 for pressure). Conclusions:With respect to procedure approach, TRA was significantly better than TFA in terms of patient satisfaction and mean length of stay. Through further process optimization and prevention of adverse reactions, the incidence of adverse reactions can be maintained at a relatively low level, so that patients can benefit from TRA in future operations in terms of cost-effectiveness and medical efficiency.

Satisfaction survey on the preliminary assessment of unified elderly care needs evaluation in Shanghai： from the perspective of service recipients / 上海预防医学

ObjectiveTo analyze the satisfaction of service recipients with the preliminary assessment service of the unified elderly care needs evaluation in Shanghai， so as to provide reference for further optimization of the service system. MethodsA multi-stage random sampling method was employed to recruit participants. A total of 110 individuals who had received unified elderly care needs evaluation service in six districts of Shanghai were investigated using a structured questionnaire. SPSS 25.0 was used to analyze the data. Univariate analyses were conducted using the Chi-square test and Fisher’s precision probability test， while multivariate analysis was performed using ordinal regression. ResultsThere were differences in satisfaction with various aspects of the preliminary assessment process among participants from different areas， with those from outer suburbs generally exhibiting lower satisfaction （P<0.01）. Multivariate analysis results indicated that satisfaction with the timing of the preliminary assessment was related to the service recipients’ residential area and their primary source of income； satisfaction with the service attitude and capability of the assessment personnel was only related to the residential area. Satisfaction with the preliminary evaluation results was related to the participants’ marital status， educational level， income level， and the specific rating results. ConclusionThe satisfaction level with the preliminary assessment of the unified elderly care needs assessment in Shanghai is relatively high. In the process of evaluation， a deeper analysis and exploration of individual needs based on various personal information are essential to ensure the appropriateness of the provided elderly care services， and thereby effectively enhancing recipient satisfaction.

Analysis of the perception and satisfaction levels of unified elderly care needs assessment personnel in Shanghai / 上海预防医学

ObjectiveTo clarify the perception of the work and satisfaction levels among personnel conducting unified elderly care needs assessment in Shanghai， to analyze the factors influencing their job satisfaction， and to provide references for optimizing the job satisfaction of unified elderly care needs assessment personnel in Shanghai. MethodsA survey was conducted among 93 assessment personnel randomly selected from 29 elderly care needs assessment agencies in Shanghai. The personnel’s perception of their work and their levels of job satisfaction were examined. Chi-square test and Fisher’s precision probability test were used to compare regional differences， while the two-factor theory was employed to analyze the factors influencing job satisfaction. ResultsRegarding perception of the work， 92.5% of the surveyed personnel believed their work was important. Moreover， 87.1% were interested in their assessment tasks， and 84.9% believed they made a positive contribution to the assessment work and the assessment position was in line with their personal preferences. Regarding job satisfaction， 83.9% of the participants were satisfied with their assessment work， 78.5% considered the workload appropriate， and 74.2% found the working hours suitable. Additionally， 65.6% expressed satisfaction with the level of cooperation from the assessment subjects， while 94.6% and 91.4% of the personnel were satisfied with the support provided by the assessment agencies and had a sense of belonging， respectively. Furthermore， 65.6% of the personnel expressed satisfaction with their job compensation and benefits. Hygiene factors affecting job satisfaction included salary and compensation， workload， time spent on the job and institutional support related to external assistance， job suitability， teamwork， and client cooperation （P<0.05）， while motivational factors included recognition of the significance of the job， sense of achievement， interest in the job， sense of belonging， and opportunities for personal growth （P<0.05）. ConclusionThe overall work cognition and satisfaction of unified elderly care needs assessment personnel in Shanghai towards their work are relatively positive. Main issues include the heavy workload and actual job subsidies not meeting expectations. It is recommended to improve the standardization of the assessment process， establish a professional team of assessment personnel， and enhance the compensation and incentive mechanisms to continuously increase staff satisfaction.

Factors associated with poor participation in annual eye examination for diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the annual eye examination of diabetic patients in Shenyang and analyze the associated factors by using the Chinese version of the Compliance with Annual Diabetic Eye Exam Survey(CADEES)questionnaire.METHODS: This is a cross-sectional study. The diabetic patients who first visited Shenyang He Eye Specialist Hospital from November 2021 to October 2022 were collected. The Chinese version of the CADEES questionnaire was used to investigate the previous annual eye examinations of these patients, and no fundus examination in the past 1a was defined as poor participation. Factors associated with poor participation in annual eye examinations were identified by multivariate binary logistic regression analyses.RESULTS: A total of 468 patients were collected, including 192 males and 276 females, with an average age of 67.42±10.66 years. There were 330 patients without diabetic retinopathy(DR)and 138 patients with DR, among which 88 patients had vision-threatening diabetic retinopathy(VTDR)and 50 patients had non-vision-threatening diabetic retinopathy(NVTDR). 34.2%(160 cases)of patients had poor annual eye examination. The multivariate logistic regression analysis showed that, after controlling gender, age and other influencing factors, patients in rural area(OR=1.704, 95%CI: 1.019～2.850, P=0.042), VTDR(OR=1.948, 95%CI: 1.145～3.313, P=0.014), the item 7(I have felt blue, downhearted, or depressed over the past 4wk; OR=0.624, 95%CI: 0.401～0.971, P=0.037)and item 42(I receive a reminder from my eye doctor's office when it is time to schedule an exam; OR=0.618, 95%CI: 0.387～0.989, P=0.045)of CADEES questionnaire were risk factors for poor participation in the annual ophthalmic examination.CONCLUSIONS: Approximately one-third of diabetic patients in the Shenyang region may not follow the guidelines for DR annual eye examination. Healthcare providers should improve DR health education, increasing eye exam participation through necessary reminders.

Clinical characteristics of acute renal infarction: an analysis of 15 cases / 中华全科医师杂志

Clinical data of 15 patients diagnosed with acute renal infarction (ARI) in Affiliated Zhongshan Hospital of Dalian University from Jan 2011 to Dec 2021 were retrospectively analyzed. Of the included 15 patients, there were 14 cases of cardiac origin and 1 case of antiphospholipid syndrome. We found that there were 12 cases of atrial fibrillation, 2 cases of atrial premature beats, 12 cases of elevated level of D-dimer, 15 cases of elevated level of LDH, 11 cases of positive urine occult blood and positive urine protein. Among the 15 patients, catheter-directed thrombolysis was performed in 4 cases, of which 3 cases were revascularized successfully, intravenous thrombolysis in 2 cases and alone anticoagulation therapy in 9 cases. It is suggested that CECT or CTA can assist the early diagnosis of ARI especially in patients with acute onset and persistent abdominal pain with high risk factors of thromboembolism, high levels of LDH, microscopic hematuria and/or proteinuria. Despite prolonged embolic ischemia, try to reconstruct blood flow to save the kidney as much as possible. Late standardized anticoagulant therapy is of critical importance to prevent recurrent embolic episodes.

Comparison of domestic and international elderly care needs assessment system and the implication / 上海预防医学

The construction of elderly care needs assessment system is conducive to realize the reasonable matching between care services and needs of the elderly， and to promote the effective allocation of pension resources. It is the basis and premise of the development of long-term care insurance system. Questions such as "Who is responsible for the assessment？ Who can apply for the assessment？ What is the assess tool？ How to pay the assessment fee？" are the core issues that need to be addressed in the construction of the evaluation system. This study compared the current situation of the elderly care needs assessment systems in China， the Netherlands， Germany， Japan and the United States from four aspects： assessment subject， assessment object， assessment cost source， and assessment tools’ dimensions. It has been a trend to entrust a third party for the evaluation work in pilot cities in China. Compared with foreign countries， domestic appraisers’ discipline and professional background are simpler. In foreign countries， the evaluation objects of elderly care needs are more extensive； the legal and financial support system of needs evaluation is more mature； and the evaluation dimensions are more objective and comprehensive. Based on this study， we suggest China to establish a national unified elderly care needs assessment system， cultivate professional assessment teams， expand the coverage of care needs assessment objects， improve the standards of assessment objects and assessment dimensions， and improve the law and financial support regulations related to needs assessment.

Research progress in diagnosis and treatment of post-traumatic stress disorder / 中华全科医师杂志

Post-traumatic stress disorder (PTSD) is a mental disorder characterized by hyperarousal, flashback and avoidance behavior after experiencing traumatic events. This article reviews the diagnostic criteria, pathogenesis and treatment options of this disease.

Effects of Pigment Epithelium-derived Factor and Its Peptides on Proliferation, Apoptosis and Migration of Non-small Cell Lung Cancer / 中国肺癌杂志

BACKGROUND@#The anti-tumor effect of pigment epithelium-derived factor (PEDF) has been widely confirmed. However, the anti-tumor effect of its peptides is rarely reported. This study aims to investigate the effects of PEDF and its peptides on the apoptosis and migration of non-small cell lung cancer (NSCLC).@*METHODS@#In this study, A549 cells and H1299 cells were selected as the research object, and the cells were divided into normal group, PEDF treatment group, 34 peptide treatment group, 44 peptide treatment group and 34+44 peptide treatment group by administering different drugs at the same concentration to the cells. The proliferation activity of cells in each group was detected by CCK-8 method; the migration ability of cells was detected by scratch test; the expression levels of apoptosis related proteins such as protein kinase 3 (RIP3) and cleaved-caspase-3 were detected by Western blot; the expression levels of epithelial mesenchymal transition (EMT) markers in each group, such as cadherin (E-cadherin) and α-smooth muscle actin (α-SMA) were detected by Western blot; the apoptosis rate of each group was detected by flow cytometry.@*RESULTS@#The results of CCK-8 showed that PEDF and its peptides could inhibit cell proliferation, and the inhibitory effect of 34+44 peptide was the strongest (P<0.05); Observation under the microscope found that PEDF and its peptides can inhibit the proliferation and mesenchymal transformation of A549 cells and H1299 cells, and the inhibitory effect of the 34+44 peptide group is the most obvious; Western blot indicated that compared with other groups, the expressions of cleaved-caspase-3 and RIP3 in 34+44 peptide group were significantly higher (P<0.05), and the expressions of EMT protein E-cadherin were higher, the expression of α-SMA decreased (P<0.05); The results of flow cytometry showed that the apoptosis rate of 34+44 peptide group was significantly higher than those of other groups (P<0.05); The scratch test showed that compared with all the other groups, the healing rate of 34+44 peptide group was the lowest (P<0.05).@*CONCLUSIONS@#34+44 combination peptide can better promote the apoptosis of NSCLC, inhibit the migration of NSCLC, and thereby inhibit the growth of NSCLC.

A CTA-based classification of first plantar metatarsal arteries in thumb reconstruction / 中华显微外科杂志

Objective:To discusses effectiveness of CTA in the classification of first plantar metatarsal artery and its application value in thumb reconstruction.Methods:Thirty-six cases who underwent thumb reconstruction with free second toe or hallucis flap between December, 2015 and December, 2018 were retrospectively analyzed. Among these cases, 22 cases were injured by machine stranding, 7 cases by heavy objects, and 7 cases were injured by rolling. Exact first plantar metatarsal arteries of all these cases were evaluated by using CTA preoperatively. And compared with intraoperative findings at the donor sites. Free first or second toe flap for thumb reconstruction were designed preoperatively based on branching pattern of first plantar metatarsal arteries.Results:The origin, course, 3-dimensional (3D) anatomical relationship with surrounding tissues and branching pattern of all these feet first plantar metatarsal arteries of 35 cases (70 feet)were well displayed in CTA images, and 1 case (2 feet) were showed poor vascular continuity and artifacts in CTA (2.78%). According to the branching pattern of first plantar metatarsal arteries, 29 cases (58 feet, 80.56%) were ramifying type, 5 cases (10 feet, 13.88%) were main trunk type, and 1 case (2 feet, 2.78%) were tiny branch type. Preoperative CTA images and intraoperative findings at the donor site of 35 cases were remarkably consistent. According to CTA images, 27 cases underwent thumb reconstruction with hallucis flap, 8 cases underwent thumb reconstruction with second toe, and 1 case of poor vascular continuity and artifacts in CTA underwent thumb reconstruction with hallucis flap eventually. All these cases were followed-up for 6-24 (average 12) months, and all reconstructed thumbs survived. The clinical outcomes of all these reconstructed thumbs were good with satisfactory appearance, sensory recovery, excellent motion. The donor feet of all cases recovered well.Conclusion:High-quality 3D images of first plantar metatarsal arteries could be obtained by CTA, allowing preoperative assessment of blood supply and planning of donor site. Therefore, success rate of reconstructed operation could be improved with low disability rate of donor site.

Research progress on intestinal flora and renal transplantation / 器官移植

In recent years, with the gradual improvement of people's understanding of intestinal flora, exploring common complications after renal transplantation from the perspective of intestinal flora has become a research hotspot. Studies have demonstrated that the composition of the intestinal flora in renal transplant recipients has significant differences before and after surgery, and this difference is closely related to the occurrence and development of many complications after renal transplantation such as infection, rejection, diarrhea and so on, which could affect the prognosis of the recipients. This article reviewed the research progress on intestinal flora and renal transplantation in order to provide new treatment ideas and strategies for renal transplant recipients.

Exploration of teaching method for tourniquets based on BOPPPS teaching model with a goal of unconscious competence / 中华医学教育探索杂志

Objective:To explore a new teaching method for tourniquets based on BOPPPS teaching model with a goal of unconscious competence, and to maximally increase trainees' application effectiveness of tourniquets.Methods:Theoretic teaching was conducted in accordance with BOPPPS framework; practical curriculum design was made based on a reinforcing stimulus, which was needed in the progress changes within the "unconscious incompetence → conscious incompetence → conscious competence → unconscious competence". This new teaching method was used to train base-force soldiers' rescue skills, and its effect was compared with that of traditional teaching method. The data was analyzed by SPSS 19.0.Results:Trainees who received this new method of training were faster to use tourniquets than those who received traditional method.Conclusion:Applying the BOPPPS model and the conditioned reflex principle which reflected from unconscious incompetence to unconscious competence in the teaching of tourniquets can effectively improve trainees' skills, gaining better results in teaching.

An especial transition phase of hospitals: the adaptation of hospital operations to the development of COVID-19 and policy adjustments

The ongoing pandemic coronavirus disease 19 (COVID-19) remains a significant issue for global health, economics, and society. In order to balance epidemic control and economic recovery, many countries have successively announced the gradual relaxation of some lockdown restrictions. Hospitals and medical staff constitute the backbone in this war against COVID-19. In response to this serious situation, many hospitals went into emergency and impaired healthcare access to patients with conditions other than COVID-19. Therefore, gradually promoting hospital operations and functions back to the new normal is important, especially when this outbreak has been effectively controlled. In this study, we introduce existing and potential problems that could seriously affect people's health. Additionally, we propose that an especial transition phase between the emergency and regular modes of hospitals can be well adapted to the current situation.

Short-term efficacy of directional atherectomy by using Turbohawk in treatment of lower extremity arteriosclerosis occlusion / 西安交通大学学报(医学版)

Objective: To assess the clinical value of excisional atherectomy with the Turbohawk atherectomy device in treatment of lower limb vascular disease. Methods: A retrospective case study method was adopted by using clinical follow-up data between July 2016 and October 2017 from The First Affiliated Hospital of Xi'an Jiaotong University. There were 15 cases of lower limb vascular disease treated with Turbohawk atherectomy device as the atherectomy group. And 15 cases were selected out 284 ones treated with conventional endovascular therapy during the same period as the control group. Clinical features such as age, gender, clinical symptoms, risk factors for arteriosclerosis, the site and length of lower arterial lesion were considered matched with those of the atherectomy group. Analysis was carried out by comparing stenting rate and remission rate in the two groups, and modification of ABI and vascular patency rate 3 and 6 months after treatment. Results: The stenting rate of atherectomy group was 6.7% (1/15), which was lower than that of the control group (86.7%, 13/15)(P0.05). The patency rate of atherectomy group 6 months after treatment was 93.3% (14/15), which was higher than that of control group 73.3% (11/15)(P<0.05). Conclusion: The use of Turbohawk atherectomy device for treatment of lower limb atherosclerosis disease is a safe and efficient method.

The levator muscle combined with Müller′s muscle shortening for treatment of mild and moderate congenital blepharoptosis / 中华整形外科杂志

Objective@#To investigate the therapeutic effect of levator muscle combined with Müller′s muscle shortening for treatment of mild and moderate congenital blepharoptosis.@*Methods@#Thirty-one cases (38 eyes) with mild or moderate congenital blepharoptosis were treated through both skin and conjunctiva approach. The levator muscle was exposed through skin approach. The Müller′s muscle was separated from conjunctiva through conjunctiva approach. The combined flap of levator muscle and Müller′s muscle was freed from the upper edge of tarsus and shortened. Then the combined flap was fixed on the upper 2/3 portion of tarsus to correct the ptosis.@*Results@#All the patients were followed up for 6-24 months with satisfactory result . The result was graded as good 12 eyes, generally 21 eyes, inadequate correction 3 eyes, over-correction 1 eye, and nvalid correction 1 eye. The effective rate was 86.8%.@*Conclusions@#The levator muscle combined with Müller′s muscle shortening is a very simple and practicle method for mild to moderate congenital blepharoptosis with satisfactory result.

Morphological and Hemodynamic Parameters for Middle Cerebral Artery Bifurcation Aneurysm Rupture Risk Assessment

OBJECTIVE: To investigate the morphological and hemodynamic parameters associated with middle cerebral artery (MCA)bifurcation aneurysm rupture. METHODS: A retrospective study of 67 consecutive patients was carried out based on 3D digital subtraction angiography data. Morphological and hemodynamic parameters including aneurysm size parameters (dome width, height, and perpendicular height), longest dimension from the aneurysm neck to the dome tip, neck width, aneurysm area, aspect ratio, Longest dimension from the aneurysm neck to the dome tip (Dmax) to dome width, and height-width, Bottleneck factor, as well as wall shear stress (WSS), low WSS area (LSA), percentage of LSA (LSA%) and energy loss (EL) were estimated. Parameters between ruptured and un-ruptured groups were analyzed. Receiver operating characteristics were generated to check prediction performance of all significant variables. RESULTS: Sixty-seven patients with MCA bifurcation aneurysm were included (31 unruptured, 36 ruptured). Dmax (p=0.008) was greater in ruptured group than that in un-ruptured group. D/W (p<0.001) and the percentage of the low WSS area (0.09±0.13 vs. 0.01±0.03, p<0.001) were also greater in the ruptured group. Moreover, the EL in ruptured group was higher than that in un-ruptured group (6.39±5.04 vs. 1.53±0.86, p<0.001). Multivariate regression analysis suggested D/W and EL were significant predictors of rupture of MCA bifurcation aneurysms. Correlation analyses revealed the D/W value was positively associated with the EL (R=0.442, p<0.01). CONCLUSION: D/W and EL might be the most two favorable factors to predict rupture risk of MCA bifurcation aneurysms.

Single nucleotide polymorphism of the TP53 gene is not correlated with male infertility / 中华男科学杂志

Objective@#To investigate the correlation of the single nucleotide polymorphism (SNP) rs1042522 of the tumor protein p53 (TP53) gene with the risk of male infertility.@*METHODS@#This casecontrol study included 380 male patients with idiopathic infertility and 398 normal fertile men as controls from the Nanjing area. We genotyped the SNP rs1042522 of the TP53 gene by Sequence Mass Array and analyzed the correlation of the SNP with male infertility using the logistic regression model.@*RESULTS@#Compared with the normal controls, the patients with idiopathic infertility showed significantly decreased sperm concentration (［77.34±49.24］ vs ［13.13±24.96］ ×106/ml), percentage of progressively motile sperm (［42.55±9.57］ vs ［10.38±5.57］%), serum testosterone level (［14.07±5.36］ vs ［11.89±4.50］ nmol/L), and folliclestimulating hormone level (［16.80±18.20］ vs ［4.55±7.17］ U/L) (P < 0.05) but no statistically significant differences in other parameters. No correlation was observed between the SNP frequencies and male infertility and similar results were found in the subgroups of the cases.@*CONCLUSIONS@#SNP rs1042522 of the TP53 gene is not significantly correlated with the risk of male infertility.

Nucleotide polymorphism rs4880 of the SOD2 gene and the risk of male infertility / 中华男科学杂志

Objective@#To investigate the correlation of the single nucleotide polymorphism (SNP) rs4880 of the superoxide dismutase 2 (SOD2) gene with the risk of male infertility.@*METHODS@#This casecontrol study included 519 male patients with idiopathic infertility (aged 19－40 ［28.93±4.93］ years) in the case group and 338 fertile men (aged 19－40 ［28.40±4.25］ years) in the control group. We collected the clinical data, genotyped the SNP rs4880 of the SOD2 gene by Sequenom Mass Array, and analyzed the association of different genotypes with male infertility using the logistic regression model.@*RESULTS@#Statically significant differences were observed between the case and control groups in the level of folliclestimulating hormone (FSH) (［4.72±2.51］ vs ［15.65±17.24］ U/L, P< 0.01), the percentage of progressively mobile sperm (［9.12±13.5］ vs ［41.95±9.03］%, P< 0.01), and sperm concentration (［12.95±24.38］ vs ［72.88±45.60］ ×106/ml, P< 0.01), but not in other parameters. No correlation was found between male infertility and the heterozygous genotype TC (OR = 0.90, 95% CI: 0.65－1.25, P = 0.516) or the homozygous genotype CC (OR=1.49, 95% CI: 0.38－5.81, P = 0.566) as compared with the wild genotype TT, and similar results were obtained in the analysis of the subgroups.@*CONCLUSIONS@#The SNP rs4880 of the SOD2 gene was not correlated with male infertility, which, however, is to be supported by further studies with larger samples from more areas.

Growth differentiation factor 11 promotes proliferation of mouse neural stem cells and activates both transforming growth factor-β/Smads and Wnt/β-Catenin signal pathways / 中华神经医学杂志

Objective To investigate the effects of growth differentiation factor 11 (GDF11) on proliferation of mouse neural stem cells (NSCs) and expression levels of transforming growth factor (TGF)-β/Smads and Wnt/β-Catenin signal key proteins.Methods NSCs,derived from the subventricular zone of E14 d CD1 mice,were cultured and induced differentiation;specific proteins nestin and SOX2 were confirmed by immunofluorescence assay.Neuron marker nucleus antigen (NeuN)and astrocyte marker glial fibrillary acidic protein (GFAP) were identified by immunofluorescent staining.The cells of third generation in their exponential phase were chosen and randomly divided into experimental group (adding GDF11 to make the final concentration as 40 ng/mL) and control group (adding equal amount of culture fluid).The proliferation of the cells in the two groups was detected by 5-ethynyl-2'-deoxyuridine (EdU) kits and protein expressions of Smad2/3,phosphorylated (p)-Smad2/3,Smad4 and β-Catenin were measured by Western blotting one and 6 h after treatment.Results Round and bright cells suspended in culture medium were observed through optical microscope.Immunofluorescence assay showed that over 90％ cells expressed both nestin and SOX2,and some of them expressed NeuN or GFAP.EdU proliferation test showed that the percentage of EdU positive cells in the experimental group (0.34±0.08) was significantly higher than that in the control group (0.24±0.03,P＜0.05).Western blotting showed that the expression levels ofp-Smad2/3,Smad4 and β-Catenin were significantly increased one and 6 h after treatment as compared with those in the control group (P＜0.05).Conclusion GDF11 can promote the proliferation of NSCs in vitro and probably is on account of activating TGF-β/Smads and Wnt/β-Catenin signal pathways.

Construction of serum-resistant cationic polymer α-CD-PAMAM and evaluation of its performances as gene delivery vector / 药学学报

Polyamidoamine (PAMAM) dendrimers as synthetic gene vectors are efficient gene delivery systems. In this study, a kind of α-cyclodextrin-PAMAM conjugates polymer (CyD-G1) was synthesized as a gene delivery vector. Based on 1H NMR detectation, about 6.4 PAMAM-G1 molecules was grafted onto an α-CD core. Agarose gel electrophoresis revealed that CyD-G1 could efficiently bind with DNA to condense them into nano-scale particles, which showed a similar binding capacity of PEI-25K. Besides, it could protect DNA from DNase I degradation in a low N/P ratio. When N/P ratio in the CyD-G1/DNA polyplex was 40, the average particle size of CyD-G1/DNA polyplex was about 120 nm, and zeta potential was +21 mV. This polyplex could maintain its particle size in serum-containing solution within 360 min. In comparison with PEI-25K carrier, CyD-G1 showed low cytotoxicity in various cell lines. Cell transfection results showed that CyD-G1 efficiently delivered DNA into cells at N/P=80 compared with Lipofectamine 2000 and PEI-25K.Unlike Lipofectamine 2000 and PEI-25K, in serum-containing test condition, CyD-G1/DNA polyplex could maintain the transgene activities. The results of confocal laser scanning microscopy indicated that most DNA entered into cell nuclei within 4 h, and this phenomenon was consistent with the results calculated by flow cytometry. Taken together, CyD-G1 showed good transgene activities and the gene delivery vector could be used not only in vitro but also in vivo.

Efficacy of different types of self-expandable stents in carotid artery stenting for carotid bifurcation stenosis / 华中科技大学学报（医学）（英德文版）

Both open and closed loop self-expandable stents were used in carotid artery stenting (CAS) for carotid bifurcation stenosis. We sought to compare the efficacy of two types of stents in CAS. The data of 212 patients treated with CAS (42 and 170 cases implanted with closed and open loop stents, respectively) for carotid bifurcation stenosis and distal filtration protection devices were retrospectively analyzed. Between closed and open loop stents, there were no significant differences in hospitalization duration, NIHSS score before and after the treatment, stenosis at 12th month, and cumulative incidence of primary endpoint events within 30 days or from the 31st day to the 12th month; while there were significant differences in hemodynamic changes and rate of difficulty in recycling distal filtration protection devices. Use of open vs. closed loop stents for carotid bifurcation stenosis seems to be associated with similar incidence of complications, except for greater rate of hemodynamic changes and lower rate of difficulty in recycling the distal filtration protection devices.