Exosomes secreted from human umbilical cord mesenchymal stem cells promote pancreatic ductal adenocarcinoma growth by transferring miRNAs / 中华肿瘤杂志

Objective: To observe the effects of exosomes derived from human umbilical cord mesenchymal stem cells on the proliferation and invasion of pancreatic cancer cells, and to analyze the contents of exosomes and explore the mechanisms affecting pancreatic cancer cells. Methods: Exosomes extracted from human umbilical cord mesenchymal stem cells were added to pancreatic cancer cells BxPC3, Panc-1 and mouse models of pancreatic cancer, respectively. The proliferative activity and invasion abilities of BxPC3 and Panc-1 cells were measured by cell counting kit-8 (CCK-8) and Transwell assays. The expressions of miRNAs in exosomes were detected by high-throughput sequencing. GO and KEGG were used to analyze the related functions and the main metabolic pathways of target genes with high expressions of miRNAs. Results: The results of CCK-8 cell proliferation assay showed that the absorbance of BxPC3 and Panc-1 cells in the hucMSCs-exo group was significantly higher than that in the control group [(4.68±0.09) vs. (3.68±0.01), P<0.05; (5.20±0.20) vs. (3.45±0.17), P<0.05]. Transwell test results showed that the number of invasion cells of BxPC3 and Panc-1 in hucMSCs-exo group was significantly higher than that in the control group (129.40±6.02) vs. (89.40±4.39), P<0.05; (134.40±7.02) vs. (97.00±6.08), P<0.05. In vivo experimental results showed that the tumor volume and weight in the exosomes derived from human umbilical cord mesenchymal stem cells (hucMSCs-exo) group were significantly greater than that in the control group [(884.57±59.70) mm(3) vs. (695.09±57.81) mm(3), P<0.05; (0.94±0.21) g vs. (0.60±0.13) g, P<0.05]. High-throughput sequencing results showed that miR-148a-3p, miR-100-5p, miR-143-3p, miR-21-5p and miR-92a-3p were highly expressed. GO and KEGG analysis showed that the target genes of these miRNAs were mainly involved in the regulation of glucosaldehylation, and the main metabolic pathways were ascorbic acid and aldehyde acid metabolism, which were closely related to the development of pancreatic cancer. Conclusion: Exosomes derived from human umbilical cord mesenchymal stem cells can promote the growth of pancreatic cancer cells and the mechanism is related to miRNAs that are highly expressed in exosomes.

Value of preoperative multimodal image fusion 3D reconstruction technology in brain tumor surgery / 中华神经医学杂志

Objective:To explore the application value of preoperative multimodal image fusion 3D reconstruction technology in brain tumor surgery.Methods:The preoperative cranial CT and MR imaging data of 46 patients with brain tumors admitted to our hospital from October 2019 to September 2020 were collected. The image registration and fusion of above imaging data were performed by AW workstation software (GE company), and 3D reconstruction was performed to construct 3D digital anatomic image of brain tumor and its surrounding anatomic structure. Based on this, the surgical approach and surgical plan were designed, and its application value was evaluated by consistency grading.Results:The reconstructed 3D digital anatomical image could clearly show the size, location, shape of the tumors and the anatomical relationships between the tumors and surrounding structures, which was consistent with the original image before and during the surgery. Among the 46 patients, 43 were completely resected and 3 were partially resected. There were no approach-related complications after surgery. The application value of preoperative 3D image fusion was evaluated as 36 with outstanding value, 8 with value, and 2 without value.Conclusion:Preoperative multimodal image fusion 3D reconstruction technology can provide a large amount of visual information during brain tumor surgery, guide the choice of surgical approach and precise resection of tumors.

ARMS-PCR combined with capillary electrophoresis can be a sensitive and quantitative method for detection of MYD88-L265P mutation in lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the feasibility of sensitive and quantitative detection of MYD88 gene L265P mutation in lymphoma patients by using ARMS-PCR combined with capillary electrophoresis.@*METHODS@#ARMS-PCR amplified MYD88 gene was analyzed by capillary electrophoresis in ABI 3730 sequencer; Exon 5 of the same gene was sequenced bi-directionally as reported.@*RESULTS@#The sensitivity of detection L265P mutations by the ARMS-PCR combined with capillary electrophoresis and direct sequencing was 0.2% and 5%, respectively, according to the detection of the gradient-diluted plasmid standards. The detection rate of 184 patients was 13.59% and 8.28%, respectively (p<0.001). Moreover, the former method can successfully detect the mutation ratio(R=0.979), and the repeatabilities (CV=2.86%, 1.94%, 5.49%) are acceptable.@*CONCLUSION@#ARMS-PCR combined with capillary electrophoresis can quantitatively detect the MYD88 gene L265P mutation, and the detection sensitivity is significantly higher than sanger sequencing. As a supplement to the latter, it can effectively lead to the earlier diagnose and monitoring of minimal residual disease.

Clinical Study on Heat-sensitive Moxibustion in Treating Post-stroke Urinary Incontinence / 上海针灸杂志

Objective To observe the clinical efficacy of heat-sensitive moxibustion in treating post-stroke urinary incontinence. Method Ninety patients with post-stroke urinary incontinence were randomized into a treatment group and a control group, 45 cases in each group. The treatment group was intervened by heat-sensitive moxibustion at Qihai (CV 6), Guanyuan (CV 4), and Sanyinjiao (SP 6), while the control group was by moxa-box moxibustion. After 4-week treatment, the two groups were compared with each in the incontinence grading and Activities of Daily Living (ADL).Result After treatment, the incontinence grading and ADL scores were significantly changed in both groups (P<0.05). The incontinence grading and ADL scores of the treatment group were significantly different from that of the control group after treatment (P<0.05).Conclusion Heat-sensitive moxibustion can improve the post-stroke urinary incontinence and ADL.

New technologies for high throughput screening of effective traditional Chinese medicine components / 药学实践杂志

The research progress on new technologies for high throughput screening of effective traditional Chinese med-icine (TCM) components was summarized based on the recent documents at home and abroad ,among which bio-chromatogra-phy ,chip-technology and computer-aided virtual screen technology were widely used .Compared with traditional screening technology ,those new ones had shown advantages in efficiency ,automation and high-throughput ,providing new ways to screen effective components of TCM with high throughput .

Frequently ABL kinase domain G:C→A:T mutation and uracil DNA glycosylase abnormal expression in TKI-resistant acute lymphoblastic leukemia of Chinese population / 中国实验血液学杂志

Most Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+) ALL) patients often show rapid recurrence and development of ABL kinase domain (KD) mutation after tyrosine kinase inhibitor (TKI) treatment. To further investigate the mechanism of Ph(+) ALL fast relapse after TKI treatment, ABL KD mutation in 35 Chinese Ph(+) ALL with TKI resistance was detected by direct sequencing. The results showed that 77.1% (27/35) Ph(+) ALL patients with TKI resistance had ABL KD mutation and 55.6% (15/27) Ph(+) ALL patients with ABL KD mutation had T315I. Interestingly, 77.8% (21/27) Ph(+)ALL showed ABL mutation G: C→A:T, including T315I, E255K and E459K. Furthermore, all the Ph(+) ALL patients with two or more ABL KD mutations collaborated with complex chromosome abnormality and all the TKI-resistant Ph(+) ALL patients, whose karyotype progressed from simple t (9;22) into complex, developed ABL KD mutation. Moreover, the expression level of uracil-DNA glycosylase UNG2, which inhibits G:C→A:T transition in genomic DNA, decreased in Ph(+) ALL with TKI-resistance compared to that in newly diagnosis Ph(+) ALL. It is concluded that there is a high frequent ABL KD G:C→A:T mutation and a high genomic instability in Chinese TKI-resistant Ph(+) ALL. In addition, the decreased UNG2 expression in TKI-resistant Ph(+) ALL probably contributes to their high rate of ABL KD G:C→A:T mutation.

Screening of potential active anti-cancer components of Brucea javanica by SMMC-7721 and Hep-G2 comprehensive two dimensional CMC-monolith chro-matography / 药学实践杂志

Objective To screen potential active anti-cancer components of Brucea javanica.Methods This research has em-ployed comprehensive two dimensional chromatographic technology and cell membrane chromatographic technology simultaneously with mass spectrometry as detector .Results Adenosine and Bruceine B were found to be potentially anti-cancer active .Conclusion This study has combined the advantages of online , high speed and high throughput for the screen of potential active components of traditional Chinese medicine .

Clinical and laboratorial analysis for 15 adult cases of mixed phenotypic acute leukemia with Ph chromosome and/or positive BCR-ABL / 中国实验血液学杂志

The purpose of this study was to summary the clinical and laboratorial features in 15 adult cases of mixed phenotypic acute leukemia with Ph chromosome and/or BCR-ABL fusion gene positive (Ph(+)MPAL), 15 adult patients with Ph(+)MPAL were defined by WHO-2008 classification. The clinical characteristics, results of morphology, immunology, cytogenetics and molecular genetic detections and results of follow-up in 15 adult patients with Ph(+)MPAL were analyzed retrospectively. The results showed that 15 patients among 87 cases of MPAL demonstrated Ph(+)MPAL (17.2%; 15/87) (7 males and 8 females), their median age was 51 (range 16-81) year old and median WBC count at diagnosis was 69 (12.7-921)×10(9)/L. Based on FAB criteria, these patients showed different morphologic types, including AML (13.3%; 2/15), ALL (40.0%; 6/15), HAL (46.7%; 7/15). Immunologic analysis indicated that 15 cases of Ph(-)MPAL were all classified as B-lymphoid +myeloid mixed immunophenotype. Except one patient, all expressed CD34 antigen on the surface of leukemia cells with 64.3% strong positive, only Ph (53.3%; 8/15), Ph with additional chromosomal abnormalities (33.3%; 5/15) and normal karyotype (13.3%; 2/15) were cytogenetically identified. BCR-ABL fusion gene transcript positive were detected by multiplex reverse transcription PCR in all cases, with e1a2 subtype (p190) (40.0%; 6/15) and b2a2 or b3a2 (p210) subtype (60.0%; 9/15). Four out of 7 (57.1%) patients were found to have IKZF1 gene deletion, without other common gene mutations. Seven out of 10 cases (70.0%) achieved complete remission (CR) after one cycle of induction chemotherapy. In the induction stage, CR rate seemed higher when tyrosine kinase inhibitors (TKI) were added to chemotherapy (83.3%:50.0%; P = 0.206). Overall survival (OS) in 4 patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT) was longer than that in 4 patients received chemotherapy alone (P = 0.004). It is concluded that Ph(+)MPAL mainly is expressed as B+My phenotype. The majority of patients is older and has CD34 overexpression. In the aspect of molecular genetics, the Ph(+)MPAL is similar to other acute leukemia with Ph chromosome. Ph(+)MPAL is a subtype of acute leukemia with poor prognosis. WBC count at diagnosis is an independent prognostic factor. The combination of TKI and allo-HSCT can improve their long-term survival, which needs to be confirmed through carrying out a prospective and multicenter clinical trial for newly diagnosed Ph(+)MPAL.

The different characteristics of ABL kinase domain mutation in the Chinese Han nationality imatinib resistant Philadelphia chromosome-positive acute lymphoblastic leukemia and chronic myeloid leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To identify the distribution and differentiation of ABL kinase domain mutation in the Chinese Han nationality imatinib resistant chronic myeloid leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph(+)ALL).</p><p><b>METHODS</b>Bone marrow or peripheral blood samples of 112 imatinib resistant CML patients and 21 Ph(+)ALL patients were obtained from the first affiliated hospital of Soochow university according to local law. Total RNA was extracted from the mononuclear cells using a TRIzol reagent. ABL kinase domain (KD) mutation was detected by direct sequencing.</p><p><b>RESULTS</b>Of the 112 imatinib resistant CML patients, 54.46%(61 cases) had ABL KD mutation. Twenty-three mutants were identified in 20 amino acid sites and 23.21% (26 cases) ABL KD mutations were in P-loop region. ABL KD mutations were also detected in 71.43% (15 cases) imatinib resistant Ph(+)ALL patients, with 10 mutations in 8 amino acid sites. The most frequent mutation was T315I (28.57%), followed by E255K/V (19.05%) and Y253F/H (14.29%). The frequency of T315I was much higher in imatinib resistant Ph(+) ALL than that in imatinib resistant CML (P = 0.001). Ph(+)ALL with additional chromosomal aberrations also had a higher rate of ABL KD mutation than that of CML (P = 0.010). Ph(+)ALL gained ABL KD mutation faster than CML (P < 0.010).</p><p><b>CONCLUSION</b>Chinese imatinib resistant CML and Ph(+)ALL patients had different characteristics in ABL KD mutation. The rate of ABL KD mutation in Ph(+)ALL with additional chromosomal aberrations was much higher than that of CML with additional chromosomal aberrations.</p>

Efficacy and significance of various scores for pneumonia severity in the management of patients with community-acquired pneumonia in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Community-acquired pneumonia (CAP) remains one of the leading causes of death from infectious diseases around the world. Most severe CAP patients are admitted to the intensive care unit (ICU), and receive intense treatment. The present study aimed to evaluate the role of the pneumonia severity index (PSI), CURB-65, and sepsis score in the management of hospitalized CAP patients and explore the effect of ICU treatment on prognosis of severe cases.</p><p><b>METHODS</b>A total of 675 CAP patients hospitalized in the Second Affiliated Hospital of Zhejiang University School of Medicine were retrospectively investigated. The ability of different pneumonia severity scores to predict mortality was compared for effectiveness, while the risk factors associated with 30-day mortality rates and hospital length of stay (LOS) were evaluated. The effect of ICU treatment on the outcomes of severe CAP patients was also investigated.</p><p><b>RESULTS</b>All three scoring systems revealed that the mortality associated with the low-risk or intermediate-risk group was significantly lower than with the high-risk group. As the risk level increased, the frequency of ICU admission rose in tandem and LOS in the hospital was prolonged. The areas under the receiver operating characteristic curve in the prediction of mortality were 0.94, 0.91 and 0.89 for the PSI, CURB-65 and sepsis score, respectively. Compared with the corresponding control groups, the mortality was markedly increased in patients with a history of smoking, prior admission to ICU, respiratory failure, or co-morbidity of heart disease. The differences were also identified in LOS between control groups and patients with ICU treatment, heart, or cerebrovascular disease. Logistic regression analysis showed that age over 65 years, a history of smoking, and respiratory failure were closely related to mortality in the overall CAP cohort, whereas age, ICU admission, respiratory failure, and LOS at home between disease attack and hospital admission were identified as independent risk factors for mortality in the high-risk CAP sub-group. The 30-day mortality of patients who underwent ICU treatment on admission was also higher than for non-ICU treatment, but much lower than for those patients who took ICU treatment subsequent to the failure of non-ICU treatment.</p><p><b>CONCLUSIONS</b>Each severity score system, CURB-65, sepsis severity score and especially PSI, was capable of effectively predicting CAP mortality. Delayed ICU admission was related to higher mortality rates in severe CAP patients.</p>

C-kit, NPM1 and FLT3 gene mutation patterns and their prognostic significance in 656 Chinese patients with acute myeloid leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the prevalence and distribution of C-kit, NPM1 and FLT3 gene mutations in patients with acute myeloid leukemia (AML), and to analyze the relationship between the gene mutations and their prognosis.</p><p><b>METHODS</b>Mutations in exon 8 and 17 of C-kit gene, exon 12 of NPM1 gene, exon 20 of FLT3-TKD gene, and exon 14/15 of FLT3-ITD gene were detected by direct sequencing. Clinical data was collected and followed up if the patient had accepted treatment in our hospital.</p><p><b>RESULTS</b>Among the 656 AML patients, mutations in C-kit exon 8 were found in 6 patients (0.9%), C-kit exon 17 in 33 (5.0%), NPM1 in 169 (25.8%), FLT3-TKD in 46 (7.1%), and FLT3-ITD in 178 (27.1%). Six subtypes of mutations were detected in C-kit exon 8, 8 in C-kit exon 17, 11 in FLT3-TKD, 15 in NPM1, of which 5 were not reported before. C-kit exon 17 mutations were more frequently detected in patients with t(8;21) and exon 8 in patients with inv(16) cytogenetic abnormality. No other gene mutations except FLT3 were detected in M(3) patients. NPM1 and ITD mutations were often detected in individuals with normal cytogenetics or M(5) and M(1) of FAB classification, and accompanied with high white blood cell counts in peripheral blood, high blast counts in bone marrow and low CD34 expression. The older the patients were when diagnosed, the more gene mutations and the higher white blood cell count were detected. More mutations were found in individuals with normal karyotype than that with other karyotypes. It appeared that FLT3-ITD was significantly associated with shorter overall survival (OS) (P = 0.004), NPM1 was not significantly associated with OS, but NPM1(+)/ITD(-) patients had the longest OS.</p><p><b>CONCLUSIONS</b>Our results showed that the mutation types and amounts had particular distribution in MICM subtypes, and were associated with white blood cell counts in peripheral blood, blast counts in bone marrow and prognosis. Especially for patients with normal karyotype, the genetic mutations could be new molecule marker.</p>

Type I interferon and bacterial infection / 浙江大学学报·医学版

Interferons (IFNs) are cytokines playing an important role in immune responses. Interferons are classified into two distinct types according to specific interferon receptors(IFNR). Type I IFNs include IFN-α and IFN-β, whereas IFN-γ is type II IFN. It is well known that type I IFNs have important roles in the host defense against viruses through activation of interferon receptor A (IFNAR). However, many recent studies have also demonstrated that type I IFNs have effects on immune responses to bacterial infection. This review focuses on the immune regulation of type I IFN-mediated signal pathways in bacterial infections such as Listeria monocytogenes, Streptococcus, Mycobacterium tuberculosis, Bacillus anthracis, Legionella, Pseudomonas aeruginosa and others.

Analysis of tyrosine kinases gene mutations in core binding factor related acute myeloid leukemia and its clinical significance / 中华血液学杂志

<p><b>OBJECTIVE</b>To assess the prevalence of several tyrosine kinases (TKs) gene mutations including c-Kit, FLT3 and JAK2 V617F in core binding factor related acute myeloid leukemia (CBF-AML), and analyze their impact on clinical characteristics and prognosis.</p><p><b>METHODS</b>Mutations of c-Kit, FLT3-ITD and FLT3-TKD were detected by genomic DNA PCR and sequencing, and JAK2 V617F mutation screening by allele-specific PCR in 58 newly diagnosed CBF-AML patients [28 AML with inv(16) and 30 with t(8;21)], and analyze the patients clinical characteristics and prognoses.</p><p><b>RESULTS</b>c-Kit aberrations were detected in 32.8% cases, including 6 cases mutated in exon 8 (mutKIT8) and 13 mutated in exon 17 (mutKIT17). MutKIT8 was more prominent in inv(16) than in t(8;21) patients (21.4% vs 0, P = 0.009). Only 2 cases had FLT3-ITD and 7 (12.1%) FLT3-TKD mutations. The result of JAK2 V617F mutation screenings in these CBF-AML patients was negative. The frequency of receptor tyrosine kinases(RTK) mutations was 46.6% and only one case had two kinds of missense mutations (mutKIT8 & TKD(+)). Median age of onset was higher for mutKIT17 than for wide-type c-Kit (wtKIT) patients (55 vs 31, P = 0.003). c-Kit mutations were significantly associated with decreased overall survival (OS) and continuous complete remission (CCR) rates (P = 0.053, and 0.048 respectively), and so did more for exon17 mutated patients reduced (P = 0.005, and 0.013 respectively). FLT3-TKD mutation showed no effects on prognosis of CBF-AML patients.</p><p><b>CONCLUSIONS</b>RTK mutations are common in patients with CBF-AML. c-Kit mutations frequently and JAK2V617F mutation rarely appear in CBF-AML. c-Kit mutations, especially mutKIT17 confers higher relapse risk and poorer prognosis.</p>

The incidence of TET2 gene mutation and its clinical significance in acute myeloid leukemia patients / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the prevalence of TET2 gene mutation in acute myeloid leukemia (AML) patients, and analyze their clinical characteristics and prognosis.</p><p><b>METHODS</b>Polymerase chain reaction (PCR) and direct sequencing were used to sequence exon 3 to 11 of TET2 gene.</p><p><b>RESULTS</b>Among 96 AML patients, TET2 gene mutation was detected in 13 (13.54%) patients (95%CI 6.70% - 20.38%). The median age was 54 years in mutated group and 41 years in unmutated group (P = 0.010). Mutated and unmutated patients did not significantly differ in gender, white blood cells (WBC) count at diagnosis, platelet count, PB and BM blast percentage and chromosome karyotype, excepting for hemoglobin level 84 (70 - 108) g/L in mutated group versus 70 (55 - 87) g/L in unmutated group (P = 0.032). TET2 gene mutation had no significant correlation with C-KIT, FLT3, JAK2V617F mutations, but did with NPM1 mutation. TET2 mutated patients had lower CR1 rate and 2-year overall survival than unmutated in non-M(3) patients (P < 0.05).</p><p><b>CONCLUSIONS</b>TET2 gene mutation is more prevalent in older AML patients and has a certain correlation with clinical characteristics and outcome. It may be a molecular marker for poor prognosis in AML.</p>

Transmasseter approach to mid-and-low condylar fractures by mini-retromandibular access / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To explore a new access for internal rigid fixation of mandibular mid-and-low condylar fracture.</p><p><b>METHODS</b>16 patients of unilateral mid-and-low condylar fractures were treated with a 2cm mini-retromandibular approach. The subcutaneous tissues superficial to the superficial muscular aponeurotic system (SMAS) were dissected forward that parallel to the masseter muscle fiber bundles, aiming to the fracture. After exposing the fracture, the fracture segments were reduced and fixed under sufficient exposure.</p><p><b>RESULTS</b>Correct anatomic reduction and occlusion were achieved in all cases. Additionally, all patients showed normal articular function and the surgical scars were barely visible.</p><p><b>CONCLUSION</b>The transmasseter approach by retromandibular access is one of the feasible methods for curing mid-and-low condylar fracture, which minimizeing the risk of facial nerve injury and reducing the visible scars.</p>

Retrospective analysis of 2461 patients with maxillofacial fractures / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To review the 2461 cases of maxillofacial fractures.</p><p><b>METHODS</b>From 2003 to 2009, 2461 maxillofacial fracture cases were treated in Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Traditional Chinese Medicine. Data regarding sex, age, cause of injury, occupation, geographic distribution, blood type, fracture site, multiple associated injuries, injury severity, the patient's first admitted department, treatment results were reviewed.</p><p><b>RESULTS</b>The male and female ratio was 4.28:1, 1424(57.86 %) patients were between 20 and 40 years of age. The most common cause of injury was road traffic accident (938 cases, 40.98%). People in tertiary industry (900 cases, 78.53%) were most vulnerable to injuries. The zygomatic complex (22.08%), nasal bone (20.67%) and mandible (16.35%) were the most frequent fracture sites, which were often associated with skull (21.74%), brain (38.36%) and soft tissue contusion injury (48.84%). 85.98% (2116/2461 cases), of patients' AIS score was less than 2. Orthopaedics (939/2461 cases, 38.16%) was the first admitted department.</p><p><b>CONCLUSIONS</b>The traffic accidents are the main cause of the maxillofacial fractures. Most injuries are found in the young and middle-aged people.</p>

Hyperoxygenated solution for improved oxygen supply in patients undergoing lung lavage for pulmonary alveolar proteinosis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>At present, the most effective treatment for pulmonary alveolar proteinosis (PAP) remains whole-lung lavage in spite of the usually accompanying severe hypoxemia, which is expected to be prevented by hyperoxygenated solution improving oxygen supply during lavage. In this study, the efficacy and safety of the effect of hyperoxygenated solution were evaluated.</p><p><b>METHODS</b>Five patients underwent whole-lung lavage over a 28-month period. Each lung was lavaged with hyperoxygenated (HO) and normal saline solution (plain lactated Ringer's solution, NO) randomly and alternatively until the reclaimed fluid was clear. Random number was generated by computer before every cycle of lavage. If the number was odd, the patient was assigned to receive a lavage cycle with hyperoxygenated solution (HO group, n = 109); if the number was even, normal saline solution was used (NO group, n = 115). Data of saturation of peripheral oxygen (SPO(2)), mean arterial pressure (MAP), central venous pressure (CVP), heart rate (HR) and end-tidal carbon dioxide tension (P(ET)CO(2)) were taken down at 0, 30, 60, 90, 120, 150, 180, 210 and 240 seconds from the beginning of the instillation of solution, and frequency and volume of unilateral lung lavage were also recorded. Time interval between the left and the right lung lavage was 1 week.</p><p><b>RESULTS</b>No patient was withdrawn from the study due to low SPO(2) or leakage. Oxygen pressure was (730.21 +/- 7.43) mmHg in the hyperoxygenated solution against (175.73 +/- 5.92) mmHg in the normal saline solution (P < 0.01). Compared with baseline, SPO(2) increased significantly as the instillation of solution began (P < 0.01), leveled for about 30 seconds (P > 0.05), and then decreased significantly to the lowest at the time of drainage (compared with 120 seconds or peak, P < 0.01). SPO2 was higher in HO group than in NO group (P < 0.01). There were no significant differences in MAP, HR, CVP and P(ET)CO(2) between HO group and NO group (P > 0.05) and also among different time points (P > 0.05).</p><p><b>CONCLUSION</b>During the lung lavage for pulmonary alveolar proteinosis, hyperoxygenated solution could significantly improve oxygen supply in comparison with normal saline solution without obvious side effects.</p>

Occurrence and mechanism of cervical vertigo in head injury patients / 中华神经医学杂志

Objective To investigate the occurrence of cervical vertigo in patients with mild or moderate head injury and the related mechanism. Methods 312 cases suffering from mild or moderate head injury were examined by cervical spine X-ray and transcranial Doppler (TCD), or spinal computed tomography (SCT) in some. The examination results were analyzed by single factor analysis first, then the independent variables which had statistical meaning were analyzed by unconditional multivariate Logistic regression analysis to find out the relationship between abnormity of their results and cervical vertigo. Results By single factor analysis, the abnormity of cervical spine X-ray, SCT and over moderate abnormity of TCD had statistical significance with cervical vertigo. Logistic regression analysis indicated that the abnormity of SCT and over moderate abnormity of TCD had statistical significance with cervical vertigo. Cervical vertigo may be occurred when one of the two examination results were abnormaL, and it must be attached importance to when both examination results were abnormal. Conclusion The patients suffering from mild and moderate head injury accompanied with cervical spine SCT abnorrnity, or over moderate abnormity of TCD indicating insufficient blood in the vertebrae-base arteries may greatly have cervical vertigo. SCT and TCD may forecast whether cervical vertigo occurs in the patients with mild or moderate head injury.

Early therapy of cervical vertigo in head injury / 中华神经医学杂志

Objective To discuss early therapy scheme for cervical vertigo in mild and moderate head injury. Methods Eighty-four patients suffering from cervical vertigo in mild or moderate head injury were randomly divided into 2 groups: combined therapy group (n=38) and control group (n=46). In the combined therapy group, patients underwent cervical vertebra traction and stellate ganglion block and early physical therapy for cervix as well as medication; in the control group, simple medication was used. The results were analyzed by nonparametric rank sum test Ridit analysis. Results In the combined therapy group, 29 cases were cured, 8 got better, and 1 remained unchanged, average therapy duration 20 d, while in the control group, 26 were healed, 15 changed better, and 5 did not show a sign of recovery, average therapy duration 30 d. The curative effect was significantly different between the 2 groups, and the combined therapy group was better than the control group (P<0.05). Conclusion The early application of the combined therapy for cervical vertigo in mild and moderate head injury can improve the cure rate and reduce the therapy duration.

Operation and endovascular interventional therapy for intracranial aneurysms / 介入放射学杂志

Objective To summary indications and treatment results of operation and endovascular interventional therapy for intracranial aneurysms. Methods From 1992 to 2003 , 345 cases of intracranial aneurysms were reviewed .We putted attention to condition of patients and the size, shape and site of aneurysms particulary. Angiography was requested in all patients at different times. Results 236 patients undergo clipping operation . 31 patients appeared operation complications. 6 patients with postoperative hemorrhage recepted surgical operation again.9 cases died.3 patients were reoperated because of aneurysm clips translatory. 103 cases were embolized by microcoil.4 cases suffered transient aphasia after embolization, recovered after medical treatment. 1 patients died because of cerebral vessel spasm. 6 patients recepted medical treatment. Conclusions Operation is suitable for very small,gaint aneurysms which locate anterior circulation and indovascular interventional therapy for small, middle, big aneurysms. The result needs further long term follow-up study.