Isoliquiritigenin suppresses the inflammatory response of vascular endothelial cells via HDAC3 / 西安交通大学学报(医学版)

【Objective】 To investigate the effect of isoliquiritigenin on inflammatory response of vascular endothelial cells and whether the regulatory effect of isoliquiritigenin on inflammation is mediated by histone deacetylase 3 (HDAC3). 【Methods】 Human umbilical vein endothelial cells (HUVECs) were cultured in vitro and treated with LPS, different concentrations of isoliquiritigenin and HDAC3 specific inhibitor, respectively. Real-time PCR and Western blotting were used to detect the mRNA and protein expressions of inflammatory cytokines and HDAC3. Male C57BL/6J mice were randomly divided into vehicle group and isoliquiritigenin treatment group. The vascular inflammation model of C57BL/6J mice was established by ligation of the left carotid arteries. The mRNA expressions of inflammatory cytokines and HDAC3 in the carotid arteries of mice were detected by Real-time PCR. A molecular docking study was performed to investigate the interaction between isoliquiritigenin and HDAC3. 【Results】 Compared with the vehicle group, isoliquiritigenin reduced the mRNA expressions of inflammatory cytokines NLRP3, IL-1β, IL-18, MCP-1 and ICAM-1 and decreased the expression of HDAC3 mRNA and protein in HUVECs stimulated with LPS. In addition, isoliquiritigenin also decreased the mRNA expressions of NLRP3, IL-1β and HDAC3 in carotid arteries of ligated C57BL/6J mice. The docking of isoliquiritigenin in the active site of HDAC3 showed that isoliquiritigenin might act through HDAC3. Furthermore, HDAC3 specific inhibitor RGFP966 further promoted the inhibitory effect of isoliquiritigenin on the expression of inflammatory cytokines in vascular endothelial cells. 【Conclusion】 These results suggest that isoliquiritigenin suppresses the inflammatory response of vascular endothelial cells via HDAC3.

Efficacy observation on prevention of chemotherapy-related anemia by combined therapy of traditional Chinese medicine in malignant tumors / 肿瘤研究与临床

Objective:To explore the effect of combined therapy of traditional Chinese medicine on prevention of chemotherapy-related anemia in malignant tumors.Methods:Seventy-nine patients with malignant tumors diagnosed in Zibo Hospital of Traditional Chinese Medicine from January 2019 to January 2021 were selected, and the patients were divided into experimental group (40 cases) and control group (39 cases) according to the random number table method. The control group received chemotherapy and the experimental group received chemotherapy and combined therapy of traditional Chinese medicine (Wuhong Tang combined with moxibustion). The hemoglobin (Hb) level, Karnofsky score and adverse effects were recorded before and on days 7, 14 and 21 after chemotherapy in the two groups.Results:The Hb level in the experimental group was higher than that in the control group [(117±28) g/L vs. (100±31) g/L] on day 21 after chemotherapy, and the difference was statistically significant ( t = -3.08, P = 0.030). The total effective rate of the experimental group was higher than that of the control group [85% (34/40) vs. 66.7% (26/39)], but the difference was not statistically significant ( χ2 = 4.96, P = 0.084). Karnofsky scores were (77±9) points and (77±12) points before and on day 21 after treatment in the experimental group, with no statistical difference ( t = -0.50, P = 0.623); Karnofsky scores were (78±10) points and (67±9) points in the control group, with statistical difference ( t = 8.32, P < 0.001). There was no statistical difference in Karnofsky score before treatment between the two groups ( t = 1.85, P = 0.068), but the experimental group was higher than the control group on day 21 after treatment ( t = 4.88, P < 0.001). The difference in the incidence of nausea and vomiting between the two groups was not statistically significant ( P > 0.05), and no chemotherapy-related hepatic, renal or cardiac adverse reactions were observed in either group. Conclusions:Combined therapy of traditional Chinese medicine could effectively prevent chemotherapy-related anemia and improve the quality of life of patients.

Advances in lipid metabolism during Chlamydia infection / 中华微生物学和免疫学杂志

Chlamydia, a gram-negative obligate intracellular pathogen, is a major cause of human reproductive tract, eye and respiratory tract infections. It replicates in a special membrane-binding chamber called inclusion and survives in the host′s hostile intracellular environment through secreting effectors, but requires host-derived lipids to grow and develop in the cells. Emerging evidences suggest that Chlamydia has evolved a variety of strategies to meet its lipid needs by interacting with host cell compartments and redirecting the transport pathway to its intracellular niche. This paper briefly described the pathway for obtaining host lipids and the mechanism of lipid metabolic during Chlamydia infection.

The correlation of serum cartilage glycoprotein 39 and angiopoietin-like protein 3 levels with left ventricular dysfunction in elderly patients of coronary heart disease with heart failure / 中华老年医学杂志

Objective:To analyze the relationship of serum cartilage glycoprotein 39(YKL-40)and angiopoietin-like protein 3(ANGPTL3)with left ventricular dysfunction in elderly coronary heart disease(CHD)patients with heart failure(HF).Methods:The 84 elderly patients divided into group of CHD with HF, and 80 patients divided into group of CHD without HF treated in Shekou People's Hospital of Nanshan District, Shenzhen City from January 2018 to December 2019 were enrolled in this study.Evaluation of the left ventricular function meets the cardiac function classification standard of(NYHA). Serum YKL-40 and ANGPTL3 levels in all patients were detected.The relationships of serum YKL-40 and ANGPTL3 levels with the left ventricular dysfunction were analyzed in the two groups.Results:Serum levels of YKL-40 and ANGPTL3 were higher in the group of CHD with HF than in the group of CHD without HF[(81.24±6.32)μg/L vs.(69.33±5.89)μg/L, and(42.40±5.03)μg/L vs.(30.25±4.23)μg/L, t=12.469 and 16.700, both P<0.001]. Of 84 patients of CHD with HF assessed by NYHA heart function, 35 cases were in the mild group and 49 cases were in the severe group.Logistic regression analysis showed that the elevated serum level of serum YKL-40 and ANGPTL3 was positively correlated with the severity of left ventricular dysfunction in patients of CHD with heart failure( OR=1.548 and 1.854, P=0.002 and 0.001). The receiver operator characteristic(ROC)curve showed that the area under the ROC curve(AUC)of YKL-40, ANGPTL3 alone and the combined index in predicting left ventricular dysfunction in CHD with heart failure were >0.80, and the best predictive value could be obtained when the cut-off values of YKL-40 and ANGPTL3 were 79.535 μg/L and 40.805 μg/L, respectively. Conclusions:The elevated serum level of YKL-40 and ANGPTL3 may indicate the more severe left ventricular dysfunction in patients of CHD with heart failure.Early monitoring of serumYKL-40 and ANGPTL3 levels has an important clinical significance in guiding early prediction and intervention of left ventricular dysfunction in patients of CHD with heart failure.

Research advances of histone deacetylase 3 in cardiovascular diseases / 中国临床药理学与治疗学

Histone deacetylases (HDACs) are a class of epigenetic modification enzymes and closely related to chromatin structure and gene transcriptional regulation. HDAC3 belongs to class I HDACs. It is reported that HDAC3 plays a key role in heart development. Recent studies find that HDAC3 plays an important regulatory role in cardiovascular diseases. This paper reviews the class I HDAC family HDAC3, focuses on its localization, enzyme activity and the research progress of HDAC3 in congenital heart disease, coronary atherosclerotic heart disease, cardiomyopathies, heart failure, and arrhythmias. This review may provide new drug target for the clinical treatment of cardiovascular diseases.

β1 receptor blocker decreases the myocardial inflammation in the sepsis adult rats through inhibition of TLR4/NF-κB signaling pathway / 中华危重病急救医学

Objective? To?explore?whether?β1?receptor?blocker?could?decrease?the?myocardial?inflammation??through?the?Toll-like?receptor?4/nuclear?factor-κB?(TLR4/NF-κB)?signaling?pathway?in?the?sepsis?adult?rats.? Methods? ?Sixty?male?Wistar?rats?(250-300?g)?aged?3?months?old?were?allocated?to?four?groups?by?random?number?table?(n?=?15):?sham?operation?group?(S?group),?sepsis?model?group?(CLP?group),?β1?receptor?blocker?esmolol?intervention?group??(ES?group),?and?inhibitor?of?the?TLR4?E5564?intervention?group?(E5564?group).?The?rat?sepsis?model?was?established?by?cecal?ligation?and?puncture?(CLP);?S?group?of?rats?underwent?only?an?incision.?Rats?in?S?group,?CLP?group?and?E5564?group?were?subcutaneous?injected?with?0.9%?sodium?chloride?(NaCl)?2.0?mL/kg.?Besides,?the?rats?in?ES?group?were?injected?with?esmolol?(15?mg·kg-1·h-1)?by?micro?pump?through?the?caudal?vein.?The?rats?in?E5564?group?were?injected?with?E5564?(0.3?mg·kg-1·h-1)?by?micro?pump?through?the?caudal?vein?1?hour?before?the?CLP?surgery.?Samples?were?collected?6?hours?after?the?modelling?in?each?group.?The?average?arterial?pressure?(MAP)?and?cardiac?output?index?(CI)?were?monitored?by?PU?electrical?conduction?ECG?monitor.?The?levels?of?serum?cardiac?troponin?I?(cTnI),?interleukin-1β?? (IL-1β)?and?tumor?necrosis?factor-α(TNF-α)?were?detected?by?enzyme?linked?immunosorbent?assay?(ELISA).?The?expressions?of?TLR4,?NF-κB?p65,?IL-1β,?TNF-α?in?myocardial?tissue?was?detected?by?Western?Blot.? Results? There?was?no?significant?difference?in?MAP?in?each?group.?Compared?with?the?S?group,?the?CI?in?the?CLP?group?was?significantly?decreased,?the?levels?of?serum?cTnI,?IL-1β,?TNF-α?were?significantly?increased,?the?protein?expressions?of?myocardial?tissue?TLR4,?NF-κB?p65,?IL-1β?and?TNF-α?were?significantly?increased.?Compared?with?the?CLP?group,?the?CI?in?the?ES?group?and?E5564?group?were?significantly?increased?(mL·s-1·m-2:?58.6±4.3,?58.9±4.4?vs.?41.2±3.9,?both?P?<?0.01),?the?levels?of?serum?cTnI,?IL-1β?and?TNF-α?were?significantly?decreased?[cTnI?(μg/L):?1?113.81±26.64,?1?115.74±25.90?vs.?1?975.96±42.74;?IL-1β(ng/L):?39.6±4.3,?38.9±4.4?vs.?61.2±3.9;?TNF-α?(ng/L):?43.1±2.8,?48.7±2.6?vs.?81.3±4.4,?all?P?<?0.01],?the?protein?expressions?of?myocardial?tissue?NF-κB?p65,?IL-1β,??TNF-αwere?significantly?decreased?(NF-κB?p65/β-actin:?0.31±0.03,?0.43±0.04?vs.?0.85±0.08;?IL-1β/β-actin:?0.28±0.05,?0.32±0.03?vs.?0.71±0.06;?TNF-α/β-actin:?0.18±0.04,?0.28±0.03?vs.?0.78±0.07,?all?P?<?0.01),?but?there?was?no?significant?difference?in?protein?expression?of?TLR4?(TLR4/β-actin:?0.89±0.07,?0.87±0.09?vs.?0.95±0.09,?both?P?>?0.05).?There?was?no?significant?difference?in?CI,?the?levels?of?serum?cTnI,?IL-1β,?TNF-α,?and?the?protein?expressions?of?myocardial?tissue?TLR4,?NF-κB?p65,?IL-1β,?TNF-αbetween?ES?group?and?E5564?group?(all?P?>??0.05).? Conclusion? β1?receptor?blocker?esmolol?may?inhibit?myocardial?inflammatory?response?in?sepsis?adult?rats?through?TLR4/NF-κB?signaling?pathway,?thereby?alleviating?sepsis-induced?myocardial?injury.

Value of dual-energy CT-based volumetric iodine-uptake in the evaluation of chemotherapy efficacy in advanced gastric cancer / 中华胃肠外科杂志

Objective@#To explore the value of dual-energy CT-based volumetric iodine-uptake (VIU) in the evaluation of chemotherapy efficacy in advanced gastric cancer.@*Methods@#Inclusion criteria of subjects: (1) without previous systematic therapy; (2) with complete clinical information before and after chemotherapy; (3) without contraindications of chemotherapy. Exclusion criteria of subjects: (1) unfinished duration and times of chemotherapy; (2) unmeasurable primary lesions; (3) poor imaging quality or poor gastric filling. Clinical and image data of 52 patients with advanced gastric cancer who were diagnosed by pathology from gastroscopic biopsy, and needed chemotherapy evaluated by imaging and clinical information in the First Affiliated Hospital of Wenzhou Medical University from February 2017 to February 2018 were collected and analyzed. Of 52 patients, 38 were male and 14 were female with the median age of 65 (31-88) years old. All the patients underwent a dual-energy, dual phase-enhanced CT scanning before chemotherapy and after the third chemotherapy session. The parameters of the lesions measured before and after chemotherapy in portal vein phase were as follows: the maximum diameter (the largest diameter among those measured in the cross-sectional, coronal, and sagittal planes), average CT value (the regions of interest were manually pinpointed under cross-sectional planes with largest diameter of the tumor, which did not include regions less than 2 mm to the edge of the tumor) and VIU (lesion volume × iodine concentration). The change rates of maximum lesion diameter, average CT value and VIU before and after chemotherapy were calculated [(post-chemotherapy parameters-pre-chemotherapy parameters)/ pre-chemotherapy parameters]. The efficacy of chemotherapy was evaluated by RECIST 1.1 (the change of maximum tumor diameter after chemotherapy), Choi (the change of average CT value after chemotherapy) and VIU (the change of VIU after chemotherapy), respectively, which was categorized by complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Patients with CR, PR, and SD were assigned to the effective group, while those with PD were classified as the ineffective group. Paired t - test or Wilcoxon signed ranks test was used to compare the changes of parameters before and after chemotherapy, whereas Spearman correlation analysis and Kappa test were used for the correlation analysis and the consistency test between the three evaluation criteria (Kappa≥0.75 indicated good consistency).@*Results@#After chemotherapy, the average CT value [(74.01±16.75) HU vs. (81.06±15.87) HU, t=2.202, P=0.030] and median VIU (668.53×102 μg vs. 272.52×102 μg, Z=4.761, P<0.001) decreased significantly, while the difference of the maximum diameter was not statistically significant [(66.71±34.49) mm vs. (78.45±35.62) mm, t=1.708, P=0.091]. The median change rate of VIU (–53.33%) was greater than that of CT values (–5.75%) with significant difference (Z=-5.408, P<0.001). According to the RECIST 1.1 criteria, 47 patients (90.4%, including 19 with PR and 28 with SD) were effective and 5 patients (9.6%) were ineffective. According to the Choi criteria, 45 patients (86.5%, including 37 with PR and 8 with SD) were effective and 7 patients (13.5%) were ineffective. According to the VIU criteria, 46 patients (88.5%, including 41 with PR and 5 with SD) were effective and 6 patients (11.5%) were ineffective. Efficacy comparison among these three criteria showed no significant difference (χ2=0.377, P=0.828). As compared to RECIST 1.1 evaluation, the proportion of PR evaluated by Choi and VIU was significantly higher (χ2=16.861, P<0.001), whereas the proportion of SD was significantly lower (χ2=24.089, P<0.001). There was no significant difference in the proportions of PR and SD between VIU and Choi criteria (χ2=0.887, P=0.346). Consistency and correlation analysis showed that the VIU and Choi evaluation criteria presented the highest consistency and correlation (Kappa=0.912, P<0.001; r=0.916, P<0.001).@*Conclusion@#VIU is a feasible parameter for the evaluation of chemotherapy efficacy in advanced gastric cancer, and may be more sensitive than the evaluation criteria based on maximum diameter or change of CT value in the tumor.

A comparative study of MoCA-B and MMSE in screening for cognitive dysfunction in patients with / 中国神经精神疾病杂志

Objective To compare Montreal cognitive assessment-basic ( MoCA-B ) and mini-mental state examination (MMSE) in screening cognitive dysfunction of acute stroke patients. Methods The cognitive function of patients (n=83) with acute stroke onset within 10 days (including new cerebral infarction and cerebral hemorrhage) were assessed using MMSE and MoCA-B. The classification of patients with cognitive impairment was compared between the two scales. The consistency of cognitive impairment and affected domains assessed by MMSE or MoCA with experts were evaluated. Results ①There were 32 cases (38.6%) with abnormal MMSE score and 40 cases (51.8%) with abnormal MoCA-B score. ②The the diagnostic consistency of MoCA-B with experts was 89.16%. The false positive of MMSE was 2.41%and the false negative (rate of missed diagnosis) was 16.87%.False positives of MoCA-B were 4.82%and false negatives (rate of missed diagnosis) were 6.02%.③Among the 51 patients with normal MMSE, 15 had abnormal MoCA-B (29.4%). There were significant differences between these two score system in executive function, verbal fluency, directivity, abstraction, delayed recall, visual perception, naming and other cognitive domains (P＜0.05). Conclusion MoCA-B scale may be more sensitive and better than MMSE scale in screening for cognitive impairment in patients with acute stroke.

Clinical features and rupture risk of anterior communicating artery aneurysms in different age groups / 中国医师进修杂志

Objective To determine clinical features and rupture risk of anterior communicating artery (AComA) aneurysms in different age groups. Methods The clinical data of 519 consecutive patients with AComA aneurysms in the First Affiliated Hospital of Wenzhou Medical University between December 2007 and February 2015 were reviewed and divided into younger group (<65 years) and older group (≥65 years). The clinical characteristics and aneurysm morphologies were compared between the two groups. Results There were 390 aneurysms in younger group, and 129 in older groups. For the younger group, hypertension,the size of the aneurysms, maximum height, perpendicular height, size ratio (SR), aspect ratio (AR), aneurysm angle, A1 segment configuration, morphology showed significantly differences in ruptured aneurysms group compared with those in unruptured aneurysms (P<0.05). The multivariate analysis showed that significant difference between the two groups was aneurysm size ( OR＝1.461,95% CI 1.027-2.079, P＝0.035). For the older group, there were statistically significant differences in hypertension,size of the aneurysms, maximum height, perpendicular height, SR, aneurysm angle, vessel size and the distribution of aneurysm projection between the ruptured aneurysms group and unruptured aneurysms group (P<0.05). The multivariate analysis showed that SR ( OR＝11.516,95% CI 1.782-74.445,P＝0.01) was the only significant predictor of aneurysm rupture. Between the younger and older groups,the distributions of sex, hypertension, smoke, vessel size and SR were statistically significant (P < 0.05). Conclusions For younger people, the males who smoked are more likely to have AcomA aneurysms and the size of the aneurysms is independent risk of aneurysm rupture. For older people, the females with hypertension also more often have AcomA aneurysms and the SR is independently associated with aneurysm rupture.

β1 receptor blocker decreases the myocardial inflammation in the sepsis adult rats through inhibition of TLR4/NF-ΚB signaling pathway / 中华危重病急救医学

OBJECTIVE@#To explore whether β1 receptor blocker could decrease the myocardial inflammation through the Toll-like receptor 4/nuclear factor-ΚB (TLR4/NF-ΚB) signaling pathway in the sepsis adult rats.@*METHODS@#Sixty male Wistar rats (250-300 g) aged 3 months old were allocated to four groups by random number table (n = 15): sham operation group (S group), sepsis model group (CLP group), β1 receptor blocker esmolol intervention group (ES group), and inhibitor of the TLR4 E5564 intervention group (E5564 group). The rat sepsis model was established by cecal ligation and puncture (CLP); S group of rats underwent only an incision. Rats in S group, CLP group and E5564 group were subcutaneous injected with 0.9% sodium chloride (NaCl) 2.0 mL/kg. Besides, the rats in ES group were injected with esmolol (15 mg×kg-1×h-1) by micro pump through the caudal vein. The rats in E5564 group were injected with E5564 (0.3 mg×kg-1×h-1) by micro pump through the caudal vein 1 hour before the CLP surgery. Samples were collected 6 hours after the modelling in each group. The average arterial pressure (MAP) and cardiac output index (CI) were monitored by PU electrical conduction ECG monitor. The levels of serum cardiac troponin I (cTnI), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were detected by enzyme linked immunosorbent assay (ELISA). The expressions of TLR4, NF-ΚB p65, IL-1β, TNF-α in myocardial tissue was detected by Western Blot.@*RESULTS@#There was no significant difference in MAP in each group. Compared with the S group, the CI in the CLP group was significantly decreased, the levels of serum cTnI, IL-1β, TNF-α were significantly increased, the protein expressions of myocardial tissue TLR4, NF-ΚB p65, IL-1β and TNF-α were significantly increased. Compared with the CLP group, the CI in the ES group and E5564 group were significantly increased (mL×s-1×m-2: 58.6±4.3, 58.9±4.4 vs. 41.2±3.9, both P < 0.01), the levels of serum cTnI, IL-1β and TNF-α were significantly decreased [cTnI (μg/L): 1 113.81±26.64, 1 115.74±25.90 vs. 1 975.96±42.74; IL-1β (ng/L): 39.6±4.3, 38.9±4.4 vs. 61.2±3.9; TNF-α (ng/L): 43.1±2.8, 48.7±2.6 vs. 81.3±4.4, all P < 0.01], the protein expressions of myocardial tissue NF-ΚB p65, IL-1β, TNF-α were significantly decreased (NF-ΚB p65/β-actin: 0.31±0.03, 0.43±0.04 vs. 0.85±0.08; IL-1β/β-actin: 0.28±0.05, 0.32±0.03 vs. 0.71±0.06; TNF-α/β-actin: 0.18±0.04, 0.28±0.03 vs. 0.78±0.07, all P < 0.01), but there was no significant difference in protein expression of TLR4 (TLR4/β-actin: 0.89±0.07, 0.87±0.09 vs. 0.95±0.09, both P > 0.05). There was no significant difference in CI, the levels of serum cTnI, IL-1β, TNF-α, and the protein expressions of myocardial tissue TLR4, NF-ΚB p65, IL-1β, TNF-α between ES group and E5564 group (all P > 0.05).@*CONCLUSIONS@#β1 receptor blocker esmolol may inhibit myocardial inflammatory response in sepsis adult rats through TLR4/NF-ΚB signaling pathway, thereby alleviating sepsis-induced myocardial injury.

A randomized controlled pilot on chronic non-specific low back pain treated with the superficial needling therapy combined with mild moxibustion / 中国针灸

OBJECTIVE@#To compare the differences in the clinical therapeutic effects on chronic non-specific low back pain (CNLBP) between the combined treatment of the superficial needling technique and mild moxibustion and the traditional warm acupuncture.@*METHODS@#A total of 60 patients were randomized into a combined treatment group and a warm acupuncture group, 30 cases in each one. In the combined treatment group, the superficial needling technique was used in combination with the mild moxibustion with moxa box at the muscle region of the bladder meridian on the back. In the warm acupuncture group, the traditional warm acupuncture was adopted on the lumbar region and the upper back. Each treatment lasted 30 min, 3 times a week. The treatment was provided continuously for 3 weeks. The follow-up visit lasted 3 months. Separately, before, 3 times after treatment and at the end of treatment, as well as after the follow-up visit, the visual analogue scale (VAS), the range of motion of the lumbar region (ROM) and the Oswestry disability index (ODI) were observed in the patients of the two groups.@*RESULTS@#During and at the end of treatment, as well as at the follow-up visit, VAS score, ROM and ODI were all improved as compared with those before treatment in the two groups (all <0.05). The results in the combined treatment group were better than those in the warm acupuncture (all <0.05). At the end of treatment and the follow-up stage, VAS score, ROM and ODI were better than those during treatment in the two groups (all <0.05). At the follow-up stage, VAS score, ROM of the backward extension and rotation of spine, as well as ODI were better than those at the end of treatment in the two groups (all <0.05).@*CONCLUSION@#The combined treatment of the superficial needling technique and mild moxibustion relieves pain, improves the ROM of the lumbar region and reduces the functional disability in CNLBP. This combined therapy achieves the better effects as compared with the traditional warm acupuncture and is high in the patient's compliance.

Nursing of sedation and analgesia using low-dose fentanyl with midazolam during thrombectomy for anterior-circulation acute ischemic stroke / 中国实用护理杂志

Objective To investigate the nursing of sedation and analgesia using low-dose fentanyl with midazolam during intra-arterial treatment with mechanical thrombectomy by means of stent for patients with anterior-circulation acute ischemic stroke.Methods All of 61 patients who underwent intra-arterial treatment with anterior-circulation acute ischemic stroke were retrospectively collected.They were divided into two groups according to the different program of individual conscious sedation:the control group(30 cases)used midazolam for intravenous maintain sedation,experimental group(31 cases)added the low-dose fentanyl on the basis of the control group.The thrombectomy was performed by the same group of interventional radiologists,while the effect of sedative,vital signs,respiratory curve and SpO2(blood oxygen saturation),assessment of Ramsay's sedation score,restlessness and other sedation adverse reactions were respectively observed in both groups.Nursing intervention was performed aiming at different states of patients during operation.Results All 61 patients were implemented with good medical care with no intracranial hemorrhage or intraoperative death.In the control group,there were 4 patients with Ramsay 1 point of sedation,resulted motion artifacts in digital subtraction angiography images in 3 of them,1 patient with slight reduction of SpO2,and vomiting in 4 patients.1 patient with decreased mean arterial pressure.In the experimental group,there was no Ramsay 1 point of sedative patient.The SpO2 was decreased in 5 patients.Respiratory inhibition occurred in 3 patients and the mean arterial pressure decreased slightly in the other 3 patients.Conclusions Application of low-dose fentanyl and midazolam is safe and reliable in patients who underwent intra-arterial treatment with anterior-circulation acute ischemic stroke.While closely observation to the changes of breath frequency curve and SpO2 in operation are very essential to actively prevent the occurrence of respiratory depression.

Application of virtual reality technology in teaching course of radiotherapy technology / 中华放射肿瘤学杂志

Objective To discuss the necessity and feasibility of application of virtual reality (VR) technology in the teaching course of radiotherapy technology based on the contradictions between the theory and practice of current teaching mode.Methods After in-depth analysis of the characteristics of the existing disciplinary teaching mode,VR technology was introduced to design software,glasses,operating handles and establish a special interactive platform. The teaching courses could be delivered via mobile phone side AR, helmet and AR, touch screen and PC virtual simulation with VR virtual simulation, etc. Six processes of radiotherapy were tested through online courses and offline groups to analyze the feasibility of this technology applied in the training of radiotherapy professionals. Results After the design of software and hardware and the analysis of test results,the online teaching could be utilized to write interactive programs,build virtual experience scenes, create course resource database and construct practical training courses and teaching system. The offline practice test could be applied to the simulation learning of feedback of the whole process, which possessed feasibility and development value. It could be applied to the theory and practice teaching of radiation therapy technology,making the teaching more convenient,vivid and intuitive. Conclusions VR technique combined with radiotherapy technology training can be delivered through online and offline teaching courses of theory and practice by using the plane and virtual simulation technology, which is convenient, quick and highly efficient and deserves widespread application.

Predictors of cerebral infarction in patients with ruptured anterior communicating artery aneurysms / 中华放射学杂志

Objective To investigate the incidence and predictors of cerebral infarction in patients with ruptured ACoA aneurysms, and to provide diagnostic and therapeutic information.Methods A total of 319 patients with ruptured ACoA aneurysms in our hospital from January 2009 to February 2015 were reviewed in this study. The author collected data regarding clinical characteristics, and measured the aneurysm morphologies on CTA images. Age, flow angle, vessel angle were analyzed by independent-samples t tests in patients with or without cerebral infarction. Mann-Whitney U tests were used for aneurysm size, aneurysm height, perpendicular height, neck size, size ratio, aspect ratio, aneurysm angle , World Federation of Neurosurgical Societies (WFNS) grade at admission and Fisher grade. Chi-square tests and Fisher's exact tests were used for sex, histories of hypertension, smoking and stroke, treatment modalities, anterior cerebral A1 segment configuration and angiographic vasospasm on CTA images. The multivariate logistic regression analyses were used to determine the independent risk factors of cerebral infarction using the stepwise regression method. Results Of the 319 patients, there were 253 without and 66 patients with cerebral infarction. Differences of age(53±11 vs 57±12,respectively;t=-2.415, P=0.016), Fisher grade [Ⅰ 23(9.1%), Ⅱ 27(10.7%), Ⅲ 74(29.2%), Ⅳ 129(51.0%) vs Ⅰ 1(1.5%), Ⅱ 7 (10.6% ), Ⅲ 13(19.7% ), Ⅳ 45(68.2% ), respectively;Z=-2.541, P=0.035] and treatment modalities [endovascular coil embolization 155(61.3% ), neurosurgical clipping 98(38.7% ) vs endovascular coil embolization 23(34.8%), neurosurgical clipping 43(65.2%), respectively;χ2=14.810, P<0.001] reached statistical significance. Multivariate analysis showed that Fisher grade Ⅳ(OR=10.36,95%CI 1.34-80.29, P=0.025) and neurosurgical clipping (OR=3.28, 95% CI 1.84-5.86,P<0.001)still had statistical significance. Conclusions Cerebral infarction in patients with ruptured ACoA aneurysms may be associated with Fisher grade and treatment modalities. Although there is difference between the two groups in age, it is not a predictor of the occurrence of cerebral infarction.

Clinicopathologic features and expression of OCT4 protein in testicular diffuse large B cell lymphoma / 中华病理学杂志

Objective@#To evaluate the expression of OCT4 and SALL4 in testicular diffuse large B-cell lymphoma (DLBCL), and the utility of an immunohistochemical (IHC) panel of OCT4, SALL4 and CD20 in the differential diagnosis of DLBCL and GCT of the testis.@*Methods@#Eighteen cases of testicular DLBCL were selected.IHC method was used to detect the protein expression of CD20, CD3, CD5, CD10, bcl-6, MUM1, Ki-67, bcl-2, c-MYC, OCT4 and SALL4.@*Results@#Among the 18 cases, CD20 and PAX5 were strongly and diffusely expressed in all cases, while CD21, CD3, cyclinD1, SALL4, CD117 and PLAP were all negative. CD5, bcl-2 and c-myc were expressed in 3, 16 and 8 cases, respectively. Ki-67 proliferation index ranged from 40%-95%. Bcl-2 and c-MYC were co-expressed in seven cases. Four cases were GCB-DLBCL and the remaining 14 cases were non-GCB-DLBCL, according to Hans algorithm. Nuclear OCT4 expression was present in two cases, which demonstrated moderate expression in >50% of neoplastic cells. Univariate analysis showed that clinical stage, CD5 and OCT4 expression were relevant to prognosis. Multivariate Cox regression analysis further confirmed that clinical stage, CD5 and OCT4 were independent prognostic factors in patients with testicular DLBCL.@*Conclusions@#Care should be exercised in using OCT4 as the sole marker of germ cell differentiation in the testis. The association of OCT4 and CD5, bcl-2 co-expression raises the question of whether OCT4 expression in DLBCL may reflect more aggressive biology.

Association between high expression of intrahepatic programmed death-1 and liver inflammation in patients with autoimmune hepatitis / 中华肝脏病杂志

Objective@#To investigate the expression of programmed death-1 (PD-1) in liver tissue and its association with liver pathology in patients with autoimmune hepatitis (AIH).@*Methods@#A total of 54 AIH patients (38 in the active stage and 16 in the remission stage) were enrolled, and 9 healthy volunteers were enrolled as control group. Immunohistochemistry combined with quantitative image analysis was used to measure the expression of PD-1 in liver tissue. The t-test, rank sum test, one-way analysis of variance, least significant difference t-test, Mann-Whitney U test, and Pearson relation analysis were used for statistical analysis of different types of data.@*Results@#The AIH group had a significantly higher positive rate of PD-1 in liver tissue than the control group (13.57%±6.84% vs 2.22%±0.66%, P < 0.01), and the patients in the active stage of AIH had a significantly higher positive rate of PD-1 in liver tissue than those in the remission stage (16.53%±7.72% vs 6.56%±3.16%, P < 0.01). The positive rate of PD-1 in liver tissue was 6.56%±3.16% in G0 group, 14.33%±5.08% in G1-2 group, and 19.23%±5.41% in G3-4 group (P < 0.01), but there was no significant difference in the positive rate of PD-1 between S0, S1-2, and S3-4 groups (P > 0.05). In AIH patients, the positive rate of PD-1 in liver tissue was positively correlated with the levels of total bilirubin, alanine aminotransferase, aspartate aminotransferase, and IgG (r = 0.665, 0.721, 0.711, and 0.813, all P < 0.01).@*Conclusion@#AIH patients have regulated PD-1 expression in liver tissue, which is closely associated with liver inflammation and is not associated with fibrosis degree, suggesting that PD-1 is involved in the development and progression of inflammation in AIH patients.

Acupoint embedding for female functional constipation:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the effects between acupoint embedding and oral medication for female functional constipation.</p><p><b>METHODS</b>Fifty-six female patients were randomized into an embedding group and a medication group (1:1).There were 22 cases in the embedding group and 26 cases in the medication group with total 8 patients dropped out. The main embedding acupoints were Zhongwan (CV 12), bilateral Tianshu (ST 25) and Guanyuan (CV 4), combined with Xiawan (CV 10), Huaroumen (ST 24), Wailing (ST 26), Zhigou (TE 6) and Shangjuxu (ST 37). It was given once a week. Oral lactulose was applied in the medication group, 3 times a day. The treatment cycle was 8 weeks. The primary outcome was the percentage of patients whose weekly average number of complete spontaneous bowel movement (CSBM) was increased ≥ 2 compared with baseline during the last 6 weeks in the treatment period. The secondary efficacy indices were compared before and after treatment as well as at follow-up at the 12th week, including the weekly average number and increased number of CSBM, the quality of life of patients with constipation (PAC-QOL), the Bristol stool character score, and the assessment of difficulty in defecation.</p><p><b>RESULTS</b>The percentage of patients whose weekly average number of CSBMs were increased ≥ 2 in the embedding group significantly increased compared with that in the medication group (<0.05). The weekly average number of CSBM in the two groups increased after treatment compared with those before treatment (both<0.01); the score of Bristol stool character improved (both<0.01); the scores of PAC-QOL and difficulty in defecation decreased (all<0.01). The increasing time of weekly average CSBM in the embedding group was higher than that in the medication group (<0.01); the score of PAC-QOL in the embedding group after treatment was better than that in the medication group (<0.01); the Bristol stool character and difficulty degree in the embedding group after treatment were superior to those in the medication group (both<0.05).</p><p><b>CONCLUSIONS</b>The acupoint embedding significantly improve the CSMB, Bristol stool character, the difficulty of defecation, and the quality of life for female patients with functional constipation.</p>

"Some Suggestions on Teaching the Course of""Meridians and Acupoints""" / 浙江中医药大学学报

[Objective]To improve the teaching quality ofMeridians and Acupoints. [Methods]Based on the ten-year experience of teaching the course ofMeridians and Acupoints, the authors suggest three issues on how to study well with this subject. [Results] The first, using the comparing method to remember meridians and acupoints, always do analysis and summary are all important ways to learn the basic knowledge.The second, understanding the property of acupoints, make prescription of acupoints like the way of making Chinese herbal formula according to syndrome differentiation, can cultivate students' dialectical thinking and improve the ability of diagnosis and treatment in acupuncture clinic.The third, introducing the origin,history and development of each meridian and some special acupoints. [Conclusion]The above three suggestions can help students to learn better about the science of acupuncture,and improve their professional thinking, and mine the potential ability of innovation.

Balloon dilatation of the cervix and pubeisheng on labor induction of full-term pregnancy use of oxytocin, mode of delivery and the analysis of the occurrence of adverse reactions / 中国生化药物杂志

Objective To investigate the effect of labor induction of full-term pregnancy use of oxytocin,and the incidence of adverse reactions of mode of delivery of cervical dilatation balloon with pubeisheng.Methods The clinical data of full-term pregnant women who were delivered in our hospital from October 2014 to November 2015 were retrospectively analyzed,According to the induction of labor is divided into the way of pubeisheng group and cervical dilation balloon group.The differences of delivery mode,oxytocin utilization,maternal and neonatal outcomes and adverse reactions were observed between the two groups.Results Cervical dilatation balloon group vaginal delivery rate was 90.38％,higher than that of pubeisheng group(P<0.05); oxytocin use rate of 11.54％,lower than that of pubeisheng group(P<0.05); Cervical dilatation balloon group first,second and third labor time is shorter pubeisheng group(P<0.001); The cervical dilation balloon group bleeding more than pubeisheng group(P<0.001),two groups of infection,urinary retention complication rate had no significant difference.Two groups of neonatal aspiration pneumonia incidence rate had no significant difference after the birth of 1min Apgar score difference,and cervical dilatation balloon group after the birth of 5min Apgar was higher than that of pubeisheng group(P<0.05).Conclusion The application of cervical dilation balloon in the induction of labor in term pregnancy is better,which can significantly improve the rate of vaginal delivery,reduce the use rate of oxytocin and shorten the labor process,and has the value of clinical application.

Effectiveness Analysis of Collaboration Application of SPD and HIS in Drug Logistics Management / 中国药房

OBJECTIVE:To study the effects of the collaboration application of hospital information system (HIS) andsmart chaininventory automation management system(SPD)in drug distribution enterprises on drug logistics management,and achieve the centralized distribution of drugs. METHODS:Related countermeasures in achieving the informatization and scientiza-tion of drug inventory management after the collaboration application of HIS and SPD were introduced,and effectiveness analysis was conducted for the inventory management by comparing related indicators before and after collaboration application. RESULTS:Through the establishment ofunified receiving platformsystem and barcode technology that combined with HIS and SPD,drug barcode acceptance was achieved;setting drug fixed package and scanning fixed cards in outer packing in theunified receiving platformsystem can achieve automatic out-and into-storehouse and generating purchase plan;the collaboration application of HIS and SPD achieved drug concentration distribution. Compared with before,monthly inventory amount was decreased 27.07%(P<0.05)in the condition that both drug purchases and sales amount were increased,into-warehouse time of pharmacy acceptance was decreased from 6-12 s in each drug to 10-15 s in each order,pharmacy staff dropped from 2.5 to 2 persons. CONCLUSIONS:The collaboration application of HIS and SPD in drug logistics management has improved efficiency of warehouse,reduced drug inven-tory and achieved the informatization and scientization of drug inventory management.