The prognosis of patients with extremity osteosarcoma who have undergone misdiagnosis and mistreatment / 中华骨科杂志

Objective:To compare outcomes between standardized and misdiagnosis and mistreatment of osteosarcoma.Methods:A retrospective analysis of patients with high-grade osteosarcoma who received appropriate surgical treatment and chemotherapy (299 cases, control group) and those who were misdiagnosed (benign or infective) and received mistreatment (23 cases, study group) between January 2009 and December 2021. Gender, age, first operation mode, recurrence time, recurrence interval, metastasis time, metastasis interval, total survival time (months), survival status in the two group and tumor site reoperation mode in the study group were statistically analyzed. Further, chi-square test was performed for comparison of the clinical between two groups. The survival analysis was performed using Kaplan-Meier test and Log-rank test.Results:All the 322 patients were followed up. In the control group, the average follow-up time was 42 months (1-137 months), the average age was 24 years (3-80 years), male 184 cases, female 115 cases, and limb salvage rate was 85.3% (255/299). Seven patients underwent amputation, and the amputation rate was 17.7% (44/299). The recurrence rate was 8.4% (25/299), the average recurrence interval was 22.8 months (7-36 months), and the metastasis rate was 28.1% (85/299), the average metastasis time was 32.7 months (0-58 months). In the study group, the average of follow-up time was 30 months (9-117 months), the average age was 36 years (5-67 years), 17 males and 6 females. Among them, eleven patients were treated with limb salvage in the second stage, and the limb salvage rate was 47.8% (11/23). Seven patients underwent amputation, and the amputation rate was 30.4% (7/23). The recurrence rate was 26.1% (6/23), the average recurrence interval was 11 months (1-42 months), and the metastasis rate was 43.4% (10/23), the average metastasis time was 20.3 months (1-44 months). The 5-year survival rate was 50.7% in the study group and 56.1% in the control group. There was no significant difference between the two groups (χ 2=0.09, P=0.760). Conclusion:The overall prognosis of patients with high-grade osteosarcoma who receive active treatment after mistreatment is similar to that of patients with standardized treatment, but the recurrence and metastasis rate is higher, the recurrence time is earlier, and the amputation rate is higher.

Surgical management of sacral neurogenic tumors / 中国骨伤

OBJECTIVE@#To observe the efficacy and complications of one-stage tumor resection to treat primary sacral neurogenic tumors and to discuss some details in the clinically relevant anatomy.@*METHODS@#A retrospective analysis of 26 patients with neurogenic turors of the sacral spine who were surgically treated from January 2001 to January 2018, including 16 males and 10 females, aged from 21 to 69 years old with an average age of (39.3±10.9) years old. The courses of diseases ranged from 3 to 56 months with an average of (17.9±10.1) months. The diameters of presacral components ranged from 3.3 to 19.6 cm with an average of (8.7±4.1) cm. The proximal margin of presacral lesions was above the L5S1 level in 6 cases, and lower than L5S1 in 20 cases. A posterior incision approach for one-stage complete resection of the tumor was used firstly, and an anterior approach was combined when necessary. Spinal-pelvic reconstruction with the modified Galveston technique was also carried out in relevant cases. Whether to preserve the tumor-involved nerve roots depended on the situation during the operation. The operation time, intraoperative blood loss, pain relief, and complications were recorded. The lumbosacral spine stability and sacral plexus neurological function were evaluated during postoperative follow-up, and local recurrence and distant metastasis were examined as well.@*RESULTS@#Total excision was achieved in all 26 patients, with an operation time of (160.4±35.3) mins and an intraoperative blood loss of (1 092.3±568.8) ml. Tumors have been removed via a posterior-only approach in 21 cases and via combined anterior/posterior approaches in 5 cases. The diameter of presacral masses components ranged from 11.3 to 19.6 cm with an average of (15.1±3.2) cm in patients with combined anterior/posterior approaches, and ranged from 3.3 to 10.9 cm with an average of (7.2±2.4) cm in patients with a posterior-only approach. Five of the six patients whose proximal margin of presacral masses was above the L5S1 level adopted combined anterior/posterior approaches, and 20 patients lower than the L5S1 level adopted the posterior-only approach. All the patients were followed up for 6 to 82 months with an average of(45.4±18.2)months. Postoperative lumbosacral pain and lower extremity radicular pain were significantly relieved, and sensation, muscle strength and bowel and bladder function were also improved to varying degrees. The postoperative early complications included superficial wound infection in 1 case and cerebrospinal fluid leakage in 2 cases. Pathology confirmed 17 cases of schwannoma, 7 cases of neurofibroma and 2 cases of malignant schwannoma. Local recurrence was observed in two cases of benign neurogenic tumors. One patient with a malignant nerve sheath tumor had lung metastasis, who died 20 months after the operation. In 17 cases of upper sacral neurogenic tumors, 4 cases did not undergo spinal-pelvic reconstruction with internal fixation, of which 2 cases suffered from postoperative segmental instability. Tumor-involved nerve roots were resected during surgery in 7 cases. One of these patients who had S2 and S3 nerve roots sacrificed simultaneously had an impaired bladder and bowel function postoperatively, and did not recover completely. In the other 6 cases, the neurological function was not damaged obviously or recovered well.@*CONCLUSION@#The posterior approach can directly expose the lesions, and it is also convenient to deal with nerve roots and blood vessels. The operation time, intraoperative blood loss, degree of symptom relief, complication rate, and recurrence and metastasis rate can be controlled at an appropriate level. It is a safe and effective surgical approach. When the upper edge of the presacral mass is higher than the L5S1 level or the diameter of the presacral mass exceeds 10 cm, an additional anterior approach should be considered. The stress between the spine and pelvis is high, and internal fixation should be used to restore the mechanical continuity of the spine and pelvis during resection of neurogenic tumors of the high sacral spine. Most of the parent nerve roots have lost their function. Resection of a single parent nerve root is unlikely to cause severe neurological dysfunction, while the adjacent nerve roots have compensatory functions and should be preserved as much as possible during surgery.

Risk factors for citrate accumulation in patients with liver failure undergoing continuous renal replacement therapy with regional citrate anticoagulation / 中华危重病急救医学

Objective:To investigate the risk factors of citrate accumulation in patients with liver failure treated with regional citrate anticoagulated continuous renal replacement therapy (RCA-CRRT).Methods:The clinical data of liver failure patients with RCA-CRRT admitted to department of intensive care unit (ICU) of Nantong Third People's Hospital from January 2017 to June 2020 were retrospectively analyzed. The selected patients were divided into citrate accumulation group and control group according to whether there was citrate accumulation (serum total calcium/free calcium ratio ≥ 2.4) during CRRT. The age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), mean arterial pressure (MAP), norepinephrine (NE) dose, blood lactic acid (Lac) concentration, liver function status, citrate dose, filter time and prognosis of the patients were compared between the two groups. Unconditional Logistic regression was used to analyze the risk factors for citrate accumulation.Results:Among 48 patients with RCA-CRRT and liver failure, 20 patients had citrate accumulation (accumulation group), and a total of 96 CRRTs were performed; the remaining 28 patients did not have citrate accumulation (control group), a total of 106 CRRTs were performed. There were no significant differences in age and APACHEⅡ score between the two groups. Compared with the control group, the MAP in the accumulation group was lower [mmHg (1 mmHg = 0.133 kPa): 66.9±13.6 vs. 86.4±8.3, P = 0.032], and the dosage of NE (μg/min: 16.3±8.4 vs. 5.9±2.8, P = 0.015) and lactic acid level (mmol/L: 4.89±1.45 vs. 2.98±0.87, P = 0.004) were higher, the damage of liver function was more serious [total bilirubin (TBil, μmol/L): 220.4±45.2 vs. 163.4±43.8, P = 0.012; Child-Pugh score: 12.0±2.5 vs. 8.8±1.4, P = 0.029; model for end-stage liver disease (MELD) score: 31.30±8.22 vs. 21.78±6.40, P = 0.041], hourly citric acid dosage (mmol/h: 27.4±6.9 vs. 19.3±4.9, P = 0.032) and total citric acid dosage (mmol: 3 393±809 vs. 1 819±502, P = 0.039) were higher. Although there were no significant differences in the length of ICU stay, total length of hospitalization stay and cost of hospitalization between the two groups, the 28-day mortality of the accumulation group was higher than that of the control group (60.0% vs. 28.6%, P = 0.039). Unconditional Logistic regression analysis showed that MAP [odds ratio ( OR) = 2.901, 95% confidence interval (95% CI) was 0.921-19.493, P = 0.019], NE dosage ( OR = 2.098, 95% CI was 1.923-12.342, P = 0.002), Lac level ( OR = 5.201, 95% CI was 3.211-9.433, P = 0.012), Child-Pugh score ( OR = 1.843, 95% CI was 0.437-7.420, P = 0.018), MELD score ( OR = 3.012, 95% CI was 0.384-12.843, P = 0.031), hourly citric acid dosage ( OR = 4.254, 95% CI was 1.734-11.839, P = 0.011) and total citric acid dosage ( OR = 4.109, 95% CI was 1.283-18.343, P = 0.001) were risk factors for citrate accumulation. Conclusion:In patients with tissue hypoperfusion and severe liver function damage, citrate anticoagulation should be avoided or the dosage of citric acid should be reduced, in order to avoid citrate accumulation.

Value of radiographic assessment of lung edema score in evaluating the severity and prognosis of patients with acute respiratory distress syndrome / 中华危重病急救医学

Objective:To explore the value of radiographic assessment of lung edema (RALE) score in evaluating the severity and prognosis of patients with acute respiratory distress syndrome (ARDS).Methods:A retrospective study was conducted. Patients with ARDS admitted to the department of intensive care unit (ICU) of Affiliated Nantong Third Hospital of Nantong University from January 2016 to November 2020 were enrolled. Clinical data of those patients were collected, and two senior radiologists who did not know the outcome of the patients independently scored each chest radiograph, the mean value of which was taken as the RALE score. The patients were divided into death group and survival group according to the 28-day prognosis. The differences of the basic data, PaO 2/FiO 2, sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score and RALE score between groups were analyzed. ARDS patients were classified according to the Berlin standard and RALE scores were compared between groups. Then, the correlations between RALE score and PaO 2/FiO 2, SOFA score, APACHEⅡ score were analyzed. The prognostic capacity of RALE score for 28-day prognosis of ARDS patients were analyzed by Kaplan-Meier survival curve. Results:Of the 98 ARDS patients, 62 were included in the final analysis, 39 patients survived and 23 patients died. The 28-day mortality was 37.1%. Compared with the survival group, patients in the death group were older (years old: 72.83±12.21 vs. 64.44±14.68), had lower PaO 2/FiO 2 [mmHg (1 mmHg = 0.133 kPa): 122.66±48.32 vs. 150.26±50.40], and higher SOFA score and greater difference of RALE score between the third day and the first day after admission (D3-D1 RALE score) (SOFA score: 11.26±3.91 vs. 9.04±3.72, D3-D1 RALE score: 1.35±6.42 vs. -2.74±7.35), with statistically significant differences (all P < 0.05). However, there were no significant differences in gender, cause of ARDS, APACHEⅡ score, and RALE scores on the first and the third day of admission (D1 RALE, D3 RALE) between the two groups. Among the 62 patients, there were 11 mild cases (17.7%), 36 moderate cases (58.1%), and 15 severe cases (24.2%). The D1 RALE score of patients with mild and moderate ARDS were lower than those of patients with severe ARDS (19.09±3.65, 22.58±6.79 vs. 27.07±5.23, both P < 0.05). Correlation analysis showed that D1 RALE score was negatively correlated with PaO 2/FiO 2 ( r = -0.385, P = 0.002), and positively correlated with SOFA score and APACHEⅡ score ( r1 = 0.433, r2 = 0.442, both P < 0.001). Kaplan-Meier survival curve analysis showed that the 28-day survival rate of ARDS patients in D3-D1 RALE score ≥ -1 group was significantly higher than that in D3-D1 RALE score < -1 group (73.08% vs. 55.56%; log-rank test: χ 2 = 3.979, P = 0.046). Conclusions:The RALE score is a simple and reliable non-invasive evaluation index, which can be used to evaluate the severity of ARDS patients. The difference of RALE score in early stage is helpful to identify ARDS patients with poor prognosis.

Prognostic Analysis and Risk Prediction Model Establishment of Extremity Osteosarcoma Based on Vasculogenic Mimicry-related Molecule MIG-7 / 肿瘤防治研究

Objective To investigate the relation between vasculogenic mimicry (VM) and MIG-7 in osteosarcoma, as well as their roles in the prognosis, and to establish a model for predicting the prognosis of osteosarcoma. Methods VM was identified by CD31/PAS double-staining in 156 cases of AJCC stage Ⅱ extremity osteosarcoma. Tumor samples were also immunohistochemically stained for MIG-7 to determine whether it was associated with the occurrence of VM. Univariate and multivariate Cox regression analyses were used to identify prognostic factors and a prognostic nomogram for predicting 3- and 5-year OS and MFS was constructed. C-index and calibration curves were used to verify the predictive accuracy of the model. Results The MIG-7 expression in osteosarcoma tissues was associated with VM formation, but MIG-7 expression was not associated with gender, age, AJCCⅡA/ⅡB stage, tumor location, surgical type or histological response to pre-operative chemotherapy. Survival analysis showed that MIG-7 expression, VM and pre-operative chemotherapy were identified as three independent prognostic factors. The value of C-index in nomogram was greater than 0.7. The predicted calibration curve was similar to the standard curve. Conclusion MIG-7 accelerates the progression of osteosarcoma by promoting VM formation, and may also affect prognosis through other mechanisms. The nomogram could afford accurate prognosis prediction and individualized diagnosis and treatment for osteosarcoma patients.

Evaluation of retinal blood flow changes in patients with type 1 diabetes mellitus by optical coherence tomography angiography / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To quantitatively evaluate the changes of macular blood flow in patients with type 1 diabetes mellitus using optical coherence tomography angiography(OCTA). <p>METHODS: Totally 20 healthy controls, 20 type 1 diabetes patients with no-diabetic retinopathy(NDR)and 20 type 1 diabetes patients with mild or moderate non-proliferative diabetic retinopathy(NPDR)were enrolled. The area of fovea avascular area(FAZ), vessel density of FD-300 and vessel density of superficial capillary plexus(SCP)and deep capillary plexus(DCP)in macular were automatic measured by built-in software. <p>RESULTS: The vessel density of DCP in NDR group(54.99%±2.27% in paramacular and 53.13%±2.15% in macular)decreased significantly compared with the controls(<i>P</i><0.05). For the mild or moderate NPDR group, the vessel density of FD-300, SCP and DCP(49.11%±4.78% in FD-300, 48.74%±4.78% in parafovea and 45.43%±3.70% in macular of SCP, 53.20%±4.19% in parafovea and 50.84%±3.99% in macular of DCP)all decreased significantly when compared with controls(<i>P</i><0.05). <p>CONCLUSION: In the preclinical stage of type 1 diabetes mellitus, vessels density has already started to decrease in the DCP of macular. For patients with mild or moderate NPDR, vessel density in the SCP and DCP of the macular area both decrease.

Influencing factors and pregnancy outcomes of unsuccessful cell-free DNA testing in maternal perinatal blood / 中华围产医学杂志

Objective:To explore the possible factors leading to failure of cell-free DNA (cfDNA) testing in maternal peripheral blood and analyze the pregnancy outcomes of this group of pregnant women.Methods:This retrospective study involved 5 195 women who underwent cfDNA testing in Peking University Third Hospital from April 2017 to April 2019. Based on the first cfDNA testing results, clinical characteristics of the pregnant women with successful (success group, n=5 107) and failed (failure group, n=88) cfDNA testing were compared using Mann-Whitney U test and Chi-square test. Multivariate logistic regression was used to analyze the risk factors of cfDNA testing failure and the effect of body mass index (BMI) on the success rate, and evaluate the feasibility of re-sampling and the factors affecting the unsuccessful testing of a second sample. Results:The failure rate of first cfDNA testing was 1.7% (88/5 195). Successful cfDNA testing was achieved in 74 (87.1%, 74/85) of 85 re-sampling cases, while results of the other 11 cases (12.9%, 11/85) remained invalid. Thus, the final failure rate was 0.2% (11/5 195). Multivariate logistic regression revealed that increased maternal age ( OR=1.086, 95% CI: 1.023-1.152, P=0.006), BMI ( OR=1.083, 95% CI: 1.021-1.149, P=0.008) and twin pregnancies ( OR=3.093, 95% CI: 1.715-5.577, P<0.001) were the risk factors of cfDNA testing failure, while increased cell-free fetal DNA (cffDNA) concentration ( OR=0.758, 95% CI: 0.720-0.761, P<0.001) was a protective factor. The overweight (BMI: 25-29.9 kg/m 2) and obese (BMI≥30 kg/m 2) women were 3.626 ( OR=3.626, 95% CI: 2.298-5.724, P<0.001) and 4.064 ( OR=4.064, 95% CI: 1.779-9.284, P=0.001) times more likely to have failed cfDNA testing than those with normal weight (BMI: 18.5-24.9 kg/m 2), respectively. The success rate of re-testing decreased as the maternal BMI increased, regardless of the time interval between the two samplings ( OR=0.840, 95% CI: 0.699-1.245, P=0.065). Seven out of the 74 cases with successful results in re-testing were at high risk, including one 45,X and one 47,XXY, confirmed by karyotyping amniocentesis. Among the 11 pregnant women with a failed testing after second sampling, eight underwent prenatal diagnosis with normal fetal chromosome karyotypes, and the other three cases without prenatal diagnosis all gave birth to neonates with normal phenotype. There was no statistical difference in the incidence of pregnancy loss between the failure and success group [9.1% (8/88) vs 2.5% (128/5 107), P=0.090]. Conclusions:Pregnant women with advanced age and higher BMI, lower cffDNA fraction and twin pregnancies are more likely to fail in cfDNA testing. For obese women, blood sampling can be postponed to a larger gestational age to reduce the failure rate. For pregnant women with failed testing in first sampling, a re-sampling is recommended, moreover, prenatal diagnosis is necessary for those had high-risk results or failed in re-testing.

Research progresses of iodine contrast induced acute kidney injury / 中国医学影像技术

The post contrast-acute kidney injury (PC-AKI) after iodine contrast agent injection is a serious clinical problem. The etiology and pathogenesis of PC-AKI are still unclear. Combination of functional MRI and biochemical indicators can be used to monitor PC-AKI, which is of great value in guiding clinical treatment and predicting prognosis. It is of great significance to study the pathogenesis of PC-AKI and to find new targets to prevent PC-AKI. The research progresses of iodine PC-AKI were reviewed in this paper.

Effect of prednisolone and adrenocorticotropic hormone in the treatment of infantile spasms: a Meta analysis / 中国当代儿科杂志

OBJECTIVE@#To compare the effect and safety of prednisolone and adrenocorticotropic hormone (ACTH) in the treatment of infantile spasms (IS).@*METHODS@#Cochrane Library, Embase, PubMed, China Biology Medicine Disc, CNKI, and Wanfang Data were searched for clinical studies on the comparison between prednisolone and ACTH in the treatment of IS. Literature screening, data extraction, and quality assessment were performed. Review Manager 5.3 was used for Meta analysis.@*RESULTS@#Five clinical studies were included according to the inclusion criteria and exclusion criteria. Meta analysis showed that there was no significant difference in the spasm remission rate, spasm remission time, complicating infection rate, and irritability rate between the prednisolone and ACTH treatment groups (P>0.05), but the disappearance rate of hypsarrhythmia in the electroencephalogram was higher in the ACTH treatment group than in the prednisolone treatment group (P<0.05).@*CONCLUSIONS@#The available evidence shows no difference in the clinical efficacy of prednisolone versus ACTH in the treatment of IS. However, ACTH is superior to prednisolone in stabilizing EEG. The two therapies have no difference in the incidence of adverse reactions such as infection and irritability.

Progress of multi-target directed drugs based on tacrine and donepezil in alzheimer′s disease / 中国药学杂志

Alzheimer′s disease (AD) is a progressive multifactorial neurodegenerative disorder in elder people. Currently, the pathogenesis of AD is unclear, and it is presently incurable. In view of the complex network pathological features of AD, a single small molecule compound that can act simultaneously with multiple targets, called multi-target directed ligands (MTDLs), is considered to be an effective therapeutic strategy at present. Here, we review highlights recent MTDLs approach based cholinesterase inhibitors, antioxidant, metal chelator and neuroprotectant in the novel drug candidate prototypes for the treatment of AD.

Effects of Paris polyphylla ethanol extract on human osteosarcoma and its mechanism / 中草药

Objective To evaluate the potential anti-osteosarcoma effects of Paris polyphylla ethanol extract (PPEE) and investigate its underlying mechanisms. Methods The anti-proliferation activity of PPEE was tested on 143B, MG-63, U-2 OS, and hFOB1.19 cells using MTT assay. The pro-apoptotic and cell cycle arrest effects of PPEE were confirmed by Hoechst 33342 staining and flow cytometry. The anti-vasculogenic mimicry effects of PPEE were investigated by Matrigel culture assays. The related proteins expression was evaluated by Western blottig. Results PPEE evidently suppressed cell proliferation of 143B, MG-63, and U-2 OS cells with IC50 values of 10-60 μg/mL, but showed little cytotoxicity against normal osteoblastic cell. PPEE induced G2/M phase arrest associated with elevated phosphorylation of CDK1, Cdc25C, Chk2 and down-regulation of cyclin B1 expression. It also promoted apoptosis in 143B cells by up-regulating the expression of cleaved Caspase-3, Caspase-8, and Caspase-9, and Bax/Bcl-2 ratio. Additionally, PPEE inhibited 143B cells vasculogenic mimicry formation at non-cytotoxic concentrations through decreasing the expression of FAK, Mig-7, MMP-2, and MMP-9. Finally, four weeks’ daily oral administration of PPEE exhibited potent antitumor and anti-vasculogenic mimicry activity in 143B xenograft model with low toxicity. Conclusion These findings demonstrated that PPEE possesses anti-osteosarcoma and anti-vasculogenic mimicry activity in vitro and in vivo, and its underlying mechanisms may be related to inducing apoptosis, blocking cell cycle, and destroying vasculogenic mimicry formation of osteosarcoma cells. Therefore, PPEE is a potential candidate for osteosarcoma treatment.

Influence of active and passive treadmill combined occupational therapy on patients with chronic ob—structive pulmonary disease during stable period／ / 心血管康复医学杂志

Objective :To explore therapeutic effect of upper and lower extremity active and passive rehabilitation treadmill combined occupational therapy on patients with chronic obstructive pulmonary disease (COPD) during sta—ble period .Methods : A total of 92 COPD patients were randomly and equally divided into occupational therapy group and treadmill + occupational therapy group .Both groups received routine nursing care ,treatment and com—prehensive rehabilitation therapy ,occupational therapy group also received occupational therapy ,while treadmill +occupational therapy group received upper and lower extremity active and passive treadmill training based on occupa—tional therapy group .After eight—week treatment ,pulmonary function ,exercise function ,daily living capacity and quality of life were analyzed and compared between two groups .Results : Compared with before treatment ,after treatment ,there were significant improvements in pulmonary function ,exercise function ,score of activity of daily living scale (ADL) and quality of life (SGRQ) in two groups , P＜ 0. 05 or ＜ 0. 01. Compared with occupational therapy group after treatment ,there was significant reduction in modified Medical Research Council dyspnea scale (mMRC) [ (2. 7 ± 0. 4) grade vs.(2. 4 ± 0.6) grade] ,and significant rise in 6min walking distance [ (291. 4 ± 28. 9) m vs.(307. 8 ± 30. 4) m] and ADL score [(56.0 ± 11.4) scores vs .(62. 0 ± 10.9) scores] in treadmill + occupation—al therapy group ( P＜0.05 or ＜0. 01) ,but there were no significant differences in pulmonary function indexes and quality of life (SGRQ) between two groups , P＞0.05 all.Conclusion : Upper and lower extremity active and passive treadmill training combined occupational therapy can significantly improve pulmonary function and exercise function and daily living capacity in patients with chronic obstructive pulmonary disease .

Evaluation of Renal Pathophysiological Processes Induced by an Iodinated Contrast Agent in a Diabetic Rabbit Model Using Intravoxel Incoherent Motion and Blood Oxygenation Level-Dependent Magnetic Resonance Imaging

OBJECTIVE: To examine the potential of intravoxel incoherent motion (IVIM) and blood oxygen level-dependent (BOLD) magnetic resonance imaging for detecting renal changes after iodinated contrast-induced acute kidney injury (CI-AKI) development in a diabetic rabbit model. MATERIALS AND METHODS: Sixty-two rabbits were randomized into 2 groups: diabetic rabbits with the contrast agent (DCA) and healthy rabbits with the contrast agent (NCA). In each group, 6 rabbits underwent IVIM and BOLD imaging at 1 hour, 1 day, 2 days, 3 days, and 4 days after an iohexol injection while 5 rabbits were selected to undergo blood and histological examinations at these specific time points. Iohexol was administrated at a dose of 2.5 g I/kg of body weight. Further, the apparent transverse relaxation rate (R2*), average pure molecular diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were calculated. RESULTS: The D and f values of the renal cortex (CO) and outer medulla (OM) were significantly decreased compared to baseline values in the 2 groups 1 day after the iohexol injection (p < 0.05). A marked reduction in the D* values for both the CO and OM was also observed after 1 hour in each group (p < 0.05). In the OM, a persistent elevation of the R2* was detected for 4 days in the DCA group (p < 0.05). Histopathological changes were prominent, and the pathological features of CI-AKI aggravated in the DCA group until day 4. The D, f, and R2* values significantly correlated with the histological damage scores, hypoxia-inducible transcription factor-1α expression scores, and serum creatinine levels. CONCLUSION: A combination of IVIM and BOLD imaging may serve as a noninvasive method for detecting and monitoring CI-AKI in the early stages in the diabetic kidney.

Prevention of abdominal adhesions in rats by rhynchophylline through inhibition of Smad singnaling pathway / 药学学报

Postoperative intra-abdominal adhesion is one of the most common complications in the postoperative period. Current remedies are very ineffective to prevent the pathological outcomes except steroid hormones. Rhynchophylline is deemed as a pharmacologically active component from traditional Oriental medicine Uncaria rhynchophylla (Miq.) Jacks. (Rubiaceae). This study was designed to investigate the preventative effect of rhynchophylline on the abdominal adhesions in rats. Rhynchophylline relieved the experimental abdominal adhesion and decreased the levels of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the blood serum in a dose-dependent manner. The levels of transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) were reduced significantly in the peritoneal fluid. The potential mechanism of the activity is related to inhibition of the TGF-β1/Smad signaling pathway.

Clinical significance of expression and phosphorylation of FAK in human osteosarcoma / 中国肿瘤临床

Objective: To examine expression patterns of focal adhesion kinase (FAK) and its activated form, phosphorylated FAK (pFAK),in human osteosarcoma and to investigate the correlation of FAK expression with clinicopathological parameters and prognosis. Functional consequence of manipulating FAK protein levels was also investigated in human osteosarcoma cell lines. Methods: Immunohistochemical staining was used to detect FAK and pFAK levels in pathologically archived materials from 113 patients with primary osteosarcoma. Kaplan-Meier survival and Cox regression analyses were used to evaluate prognoses. The role of FAK in cytological behavior of MG63 and 143B human osteosarcoma cell lines was studied via the FAK protein knockdown with siRNA. Cell proliferation, migration, invasiveness, and apoptosis were assessed using cell counting kit-8, Transwell, and Annexin V/PI staining methods. Results: Both FAK and pFAK were overexpressed in osteosarcoma patients. Tumor cells exhibited cytoplasmicity and occasional membranous immunoreactivity for FAK. A total of 42 cases (37.17%) mainly showed expressed pFAK in cytoplasm of osteosarcoma cells. No overexpression staining of anti-FAK and anti-pFAK antibodies was observed in normal cancellous bone tissues or negative controls. Significant differences were observed in overall survival between FAK-/pFAK- and FAK+/pFAK- groups (P=0.016), FAK+/pFAK- and FAK+/pFAK+ groups (P=0.012), and FAK-/pFAK- and FAK+/pFAK+ groups (P<0.001). All groups showed similar metastasis-free survival. Cox proportional hazard analysis showed that FAK expression profile is an independent indicator of both overall andmetastasis-free survival. siRNA-based knockdown of FAK significantly reducedmigration and invasion of MG63 and 143B cells and affected proliferation and apoptosis in osteosarcoma cells. Conclusion: Osteosarcoma malignancies in vitro and in vivo were correlated with overexpression and phosphorylation of FAK. These findings suggest that FAK plays an important biological role in osteosarcoma carcinogenesis. This study provides a better understanding of diagnostic and prognostic relevance of FAK overexpression and phosphorylation in osteosarcoma patients. Therefore, FAK and pFAK can be used as independent predictors of overall and metastasis-free survival in osteosarcoma patients.

Gene expression profiling and functional analysis of cerebral artery after experimental subarachnoid hemorrhage / 天津医药

Objective To explore the difference of gene expression profiling between normal basilar arteries and basilar arteries of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) in rabbits. Methods cDNA chip of normal basilar arteries and basilar arteries of CVS after SAH in rabbits were downloaded from GEO database. The chip was analyzed and screened by Bioconductor software, and function enrichment and pathway analysis of the differentially expressed genes were analyzed by Cytoscape software. Then 6 adult male Japanese rabbits were used, and randomly divided into normal control group (n=3) and SAH model group (n=3). Rabbit SAH models were established by cisterna secondary-blood-injection method. RNA data of normal basilar artery specimens on the 0 day and basilar artery specimens after SAH on the 5-day were used to validate the parts of differentially expressed genes by qRT-PCR. Results A total of 4356 differentially expressed genes were found in normal basilar arteries and basilar arteries of CVS after SAH in rabbits. Among them, 920 genes were considered to be significant with P-value<0.05, such as GRIK1, MYH13, ZNF45, SAA3, RLN1, MSR1 and others. Function enrichment analysis indicated that the differentially expressed genes were involved in regulation of Ca2+transmembrane transporter activity, negative regulation of ion transmembrane transport, regulation of potassium ion transport, positive regulation of JAK-STAT signaling cascades and other biological processes. Pathway analysis showed that calcium signaling pathway, cGMP-PKG signaling pathway, HIF-1 signaling pathway, PI3K-Akt signaling pathway and other signaling pathways maybe related with the differentially expressed genes. qRT-PCR verification showed that the expression of MSR1 in SAH model group was consistent with that of the chip result. Conclusion The gene expressions of basilar arteries of CVS after SAH in rabbits are significantly different, and MSR1 gene can be used as a potential target for studying the pathological mechanism of CVS.

Anesthetic effect and safety of different doses of midazolam on lung cancer / 中国生化药物杂志

Objective To observe the anesthesia effect and safety of different doses of midazolam on operation in patients with lung cancer , to explore the appropriate dose.Methods 60 cases with lung cancer were divided into observation group and control group according to the dosage of midazolam,30 cases in each group.Hemodynamic changes, recovery time, extubation time, pain score and the dosage of anesthetic drug in the two groups were observed.Results There was no significant differences in hemodynamic indexes of each time point of the two groups .Compared with control group, recovery time, extubation time, pain score, the dosage of propofol and remifentanil dosage in the observation group were significantly lower than that of the control group, the difference was statistically significant (P <0.05).Conclusion Select the 0.075 mg/kg midazolam for lung cancer operation before anesthesia induction can reduce the operation to patients stimulation, make the operation smoothly.

Parameter optimization for non-contrast-enhanced renal MR angiography and its relationship with age / 中国医学影像技术

Objective To investigate the feasibility of non-contrast-enhanced renal MR angiography (NCE-MRA) using time spatial labeling inversion pulse (Time-SLIP) technique,and to discuss the optimized inversion time (TI) and its relationship with age.Methods A total of 61 healthy volunteers were divided into two groups by age,22-50 years (n=32)and 51 80 years (n=29).All volunteers underwent 3.0T MRI examination with 6 different TIs sequences (1 200,1 300,1 400,1 600,1 600,1 700 ms).The vessel to-kidney signal ratio (VKR),grade of renal artery branches,grade of renal artery imaging quality were measured and analyzed.Results The VKR values were the highest at TI=1 500 ms in both sides ot kidneys.The scores of renal artery branches were gradually rising up but tending to be steady higher than 1 400 ms.Among all the subjects,the highest score of renal artery imaging quality was at TI=1 500 ms.In 22-50 years group,the highest score of renal artery imaging quality was at TI=1 500 ms.Meanwhile,the highest score was found at TI=1 600 ms in 51 80 years group.Moreover,the grade of renal artery imaging in the 22-50 years group acquired better scores compared to the 51 80 years group (all P＜0.05).Conclusion Time-SLIP technique is helpful to obtain renal MRA without contrast medium.The optimized TI value is 1 500 ms.Moreover,age can affect the optimized TI value.

Determination of Organophosphorus Pesticide Residues in Fruits and Vegetables Using Porous Carbon Nanoparticles Based on Citrus Compose / 分析化学

Porous carbon nanoparticles ( NPC) were prepared by ZnCl2 activation and carbonization using citrus waste as carbon source. A sample pretreatment method with NPC as dispersive solid phase extraction (d-SPE ) absorbent was established for the determination of organophosphorus pesticides in fruits and vegetables by gas chromatography. The NPC was characterized by scanning electron microscopy (SEM), X-ray diffraction ( XRD), FT-IR spectra, Raman spectroscopy, Brunauer, Emmett and Teller surface area(BET). Those results showed that the NPC was an amorphous porous carbon material with pore size in the range of 0-15 nm. Its specific surface area and pore volume were 1243 m2 / g and 1. 28 cm3 / g, respectively. The analysis conditions, including the amount and clean up time of adsorbent, were optimized by analysis of 14 kinds of oranophosphorus pesticides in fruits and vegetables with gas chromatography-flame photometric determination(GC-FPD). Moreover, the comparison for NPC with commercial materials of PSA, C18 and GCB was investigated in this study. The results indicated that the purification time was only 2 min using 0. 01 g NPC. The cost of NPC was about 25% of C18 , 21% of PSA and 16% of GCB. Because of the porous structure of NPC, the purification efficiency was significantly higher than the three commercial materials mentioned above. Under the optimum conditions, the calibration curves of the 14 organophosphorus pesticides were linear in the range of 0. 02-1. 00 mg / L with good correlation coefficients (R2>0. 99) and detection limits (S / N=3) of 0. 63-5. 30 μg / kg. The recoveries of the pesticides at three spiked levels ranged from 71. 3% to 114. 7%with the relative standard deviations (RSDs) of 0. 9% -12. 9% . The method is simple, rapid, sensitive, and low cost, and can satisfy the requirements of detection of organophosphorus pesticide residues in fruits and vegetables, displaying a good application prospect.

Progress of research on corneal collagen cross-linking for corneal melting / 国际眼科杂志(Guoji Yanke Zazhi)

?Corneal collagen cross-linking ( CXL ) could increase the mechanical strength, biological stability and halt ectasia progression due to covalent bond formed by photochemical reaction between ultraviolet - A and emulsion of riboflavin between collagen fibers in corneal stroma. Corneal melting is an autoimmune related noninfectious corneal ulcer. The mechanism of corneal melting, major treatment, the basic fundamental of ultraviolet- A riboflavin induced CXL and the clinical researches status and experiment in CXL were summarized in the study.