The value of plaque-to-aorta CT value ratio in differentiating coronary lipid and fibrous plaques / 实用放射学杂志

Objective To explore the value of plaque-to-aorta CT value ratio(standardized CT value)in differentiating coronary lipid and fibrous plaques,and to preliminarily analyze the stability of the cutoff.Methods Patients who underwent coronary computed tomography angiography(CCTA)and intravascular ultrasound(IVUS)within 1 week were included.The plaque CT value was obtained by measuring the all,four and two short-axis planes,respectively.The CT value of the ascending aorta was measured and standardized(plaque-to-aorta CT value ratio).The receiver operating characteristic(ROC)curves of the standardized and the traditional CT values were drawn.Results A total of 60 patients with 74 plaques were included,35 lipid and 39 fibrous plaques were diagnosed by IVUS.The aorta CT value was significantly correlated with the plaque(r=0.420,P<0.01);the cutoffs for the CT value of all,four and two plaque slices were 55 HU,48 HU and 52 HU,respectively,and all there of the cutoffs of standardized CT value were 0.149;the sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)of four-slice traditional and standardized CT values to differentiate lipid and fibrous plaques were 69%,87%,83%,76%and 91%,82%,82%,91%,respectively.Conclusion Compared with traditional CT value,the standardized CT value can greatly improve the sensitivity and NPV in differentiating coronary lipid and fibrous plaques,while maintaining modest to high specificity and PPV.Furthermore,the cutoff is stable.

Orange-derived extracellular vesicles nanodrugs for efficient treatment of ovarian cancer assisted by transcytosis effect

Extracellular vesicles (EVs) have recently received much attention about the application of drug carriers due to their desirable properties such as nano-size, biocompatibility, and high stability. Herein, we demonstrate orange-derived extracellular vesicles (OEV) nanodrugs (DN@OEV) by modifying cRGD-targeted doxorubicin (DOX) nanoparticles (DN) onto the surface of OEV, enabling significantly enhancing tumor accumulation and penetration, thereby efficiently inhibiting the growth of ovarian cancer. The obtained DN@OEV enabled to inducement of greater transcytosis capability in ovarian cancer cells, which presented the average above 10-fold transcytosis effect compared with individual DN. It was found that DN@OEV could trigger receptor-mediated endocytosis to promote early endosome/recycling endosomes pathway for exocytosis and simultaneously reduce degradation in the early endosomes-late endosomes-lysosome pathway, thereby inducing the enhanced transcytosis. In particular, the zombie mouse model bearing orthotopic ovarian cancer further validated DN@OEV presented high accumulation and penetration in tumor tissue by the transcytosis process. Our study indicated the strategy in enhancing transcytosis has significant implications for improving the therapeutic efficacy of the drug delivery system.

Effects of Bushen Yiqi Huoxue Decoction in Treatment of Patients with Diminished Ovarian Reserve: A Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To explore the therapeutic effect of Bushen Yiqi Huoxue Decoction BYHD) in patients with diminished ovarian reserve (DOR).@*METHODS@#A total of 180 patients with DOR diagnosed from December 2013 to December 2014 were equally assigned into progynova and duphaston (E+D) group, Zuogui Pill group and BYHD group with 60 cases in each by computerized randomization. Patients received E+D, Zuogui Pill or BYHD for 12 months, respectively. Follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), anti-Müllerian hormone (AMH), antral follicle count (AFC), ovarian volume, endometrial thickness, and the resistance indices (RIs) of ovarian arteries and uterine arteries were observed before and after treatment.@*RESULTS@#Nine women (4 from the E+D group, 3 from the Zuogui Pill group, and 2 from the BYHD group) withdrew from the study. After 6 months, Zuogui Pill and BYHD significantly decreased FSH and LH and increased endometrial thickness and AMH (all P<0.01). BYHD also resulted in E2 elevation (P<0.05), ovary enlargement (P<0.05), AFC increase (P<0.01), and RI of ovarian arteries decrease (P<0.05). After 12 months, further improvements were observed in the Zuogui Pill and BYHD groups (all P<0.01), but BYHD showed better outcomes, with lower FSH, larger ovaries and a thicker endometrium compared with the Zuogui Pill group (all P<0.01). However, E+D only significantly increased endometrial thickness (P<0.01) and no significant improvements were observed in the RI of uterine arteries in the three groups.@*CONCLUSIONS@#BYHD had a favorable therapeutic effect in patients with DOR by rebalancing hormone levels, promoting ovulation, and repairing the thin endometrium. The combination of tonifying Shen (Kidney), benefiting qi and activating blood circulation may be a promising therapeutic strategy for DOR.

Role of oxidative stress in trichloroethylene-induced toxicity / 环境与职业医学

Trichloroethylene (TCE) is a common industrial organic solvent and environmental contaminant. People are exposed to TCE through occupational contact or environmental pollution, which leads to serious human health hazards. A large number of studies have shown that oxidative stress plays an important role in the TCE-induced multi-target organ toxicity. However, the research of related signaling pathways remains to be deepened. In this review, we summarized the epidemiological, animal, and cellular studies correlated to liver toxicity, kidney toxicity, cardiac developmental toxicity, placental developmental toxicity, neurodevelopmental toxicity, and autoimmune response induced by TCE. In addition, the possible molecular mechanisms of oxidative stress in TCE-induced toxicity were concluded, including DNA damage, mitochondrial dysfunction, cell apoptosis, and abnormal activation of the immune system. Through literature review, we proposed that nuclear factor E2 related factor 2 may play an important role in mediating TCE-induced target organ toxicity, providing a theoretical basis for the prevention and treatment of adverse health effects caused by TCE.

Network Meta-analysis of oral blood-activating and stasis-removing Chinese patent medicines in treatment of hypertensive left ventricular hypertrophy / 中国中药杂志

This study was designed to assess the clinical efficacy of oral blood-activating and stasis-removing Chinese patent medicines in treating hypertensive left ventricular hypertrophy(LVH) based on network Meta-analysis. The clinical randomized controlled trials(RCTs) concerning the treatment of hypertensive LVH with oral blood-activating and stasis-removing Chinese patent medicines were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, and Cochrane Library from their inception to September 2021. Two researchers independently completed the literature screening, data extraction, and quality evaluation. The data were then analyzed by RevMan 5.3, Stata 15.1, and ADDIS 1.16.8. Finally, a total of 31 RCTs were included, involving 3 001 patients and four oral blood-activating and stasis-removing Chinese patent medicines. In terms of the alleviation of heart damage, the Chinese patent medicines combined with conventional western medicine groups were superior to the conventional western medicine groups in lo-wering the left ventricular mass index(LVMI). There was no significant difference in LVMI, left ventricular ejection fraction(LVEF), or the ratio of early diastolic peak flow velocity to late diastolic peak flow velocity(E/A) between different Chinese patent medicines combined with conventional western medicine groups. Xinnao Shutong Capsules/Tablets combined with conventional western medicine had the best efficacy in reducing LVMI and elevating LVEF, while Xinkeshu Capsules/Tablets combined with conventional western medicine had the best effect in improving E/A. In the control of blood pressure, when all Chinese patent medicines except for Xinnao Shutong Capsules/Tablets were combined with conventional western medicine, the resulting systolic blood pressure(SBP) and diastolic blood pressure(DBP) were significantly lower than those in the conventional western medicine group. Xinkeshu Capsules/Tablets combined with conventional western medicine produced the best effect in reducing SBP and DBP, followed by Xinnao Shutong Capsules/Tablets. In terms of safety, no serious adverse reactions occurred in all trials. The four oral blood-activating and stasis-removing Chinese patent medicines included in this study exhibited obvious advantages in the treatment of hypertensive LVH when they were combined with conventional western medicine, with the best effects observed in the Xinnao Shutong Capsules/Tablets combined with conventional western medicine group. However, due to the limitation of the quantity and quality of the included articles, the conclusion of this study still needs to be verified by more high-quality, multi-center, and large-sample RCTs.

Upper Gastrointestinal Tract pH Monitoring in Rats with Chronic Sleep Deprivation and High Fat Diet / 听力学及言语疾病杂志

Objective To investigate the relationship of chronic sleep deprivation and high fat diet with laryn-gopharyngeal reflux (LPRD) .Methods A total of 16 rats were randomly divided into the experimental group and control group .Modified multiplatform water surface method and high fat diet (containing 35％ fat) were used in the experimental group rats .The rats in the control group had free sleep and normal feed .The upper gastrointestinal tract pH monitoring with double detectors was used to record the changes of pH in the both rats for 10 hours .The reflux index ,the times of re-flux with pH<4 and the longest duration of reflux were selected and converted into data of 24 hours .The three indexes of the experiment group were compared to those of the control group .Results There was no animal death during the model construction .The rats in the experimental group were irritable .There was no difference of rats weight in both groups before and after the experiment(P>0 .05) .The median of reflux index ,times of reflux with pH<4 and the longest duration of reflux of pharyngeal pH 2 detector in the rats of the experimental group were 21 .07 ,27 .25 and 61 .11 ,respectively .Those of the control group were 1 .25 ,0 .95 and 8 .44 ,respectively .Above three index of the experimental group increased obviously and the difference was statistically significant when compared to those of the control (P<0 .05) .It was suggested that LPRD might appear in the experimental group rats .The median of reflux index and the times of reflux with pH < 4 of esophageal pH1 detector in the rats of the experimental group were 15 .87 and 96 .67 ,displaying an increase when compared to those of the control group (26 .25 and 5 .6) .The differ-ences were statistically significant(P<0 .05);but the median of the longest duration of reflux in pH1 detector of the experimental group rats was 26 .25 ,failing to show statistical difference compared to that of the control group (5 .6) (P>0 .05) .Conclusion Chronic sleep deprivation and high fat diet may play an important role in the pathogenesis of LPRD .This animal model may be a new vector to study LPRD .

Advances in imaging research of the digestive system tumors from 2017 annual meeting of the American Society of Clinical Oncology / 中华消化外科杂志

The 2017 Annual Meeting of the American Society of Clinical Oncology (ASCO) was held on June 2-6,2017 in Chicago,United States.And the academic event showed the frontier researches in the field of oncology.Survival prediction in patients treated by FOLFIRI regimen and bevacizumab for metastatic colorectal cancer using radiomics approach was made in Abstract 3601.Authors aim to summarize the application and development of radiomics in digestive system tumors.

Research progress on the Pharmacology of senna / 国际中医中药杂志

Senna contains anthraquinones, flavonoids, polysaccharide and volatile oil and other chemical substances, which show the effect of diarrhea, antibacterial, hemostatic, regulating immune function and antioxidation. This article reviewed the Senna chemical composition, pharmacological effects, clinical application and new formulations of drug development, in order to provide reference for the research and clinical application of Senna.

Imaging understanding of the updates of the classification for pancreatic cancer in the American Joint Committee on Cancer cancer staging manual (8th edition) / 中华消化外科杂志

Pancreatic cancer is a highly malignant tumor with a high mortality.Surgery is the only potential hope of cure for patients with pancreatic cancer.Imaging examination plays an essential role in both the early diagnosis and preoperative assessment.Accurate tumor staging has guiding significance for clinical practice.Appropriate therapeutic schedule will be selected according to the tumor staging,and then patients' prognosis can be evaluated.Recently,the TNM staging systems for pancreatic cancer have been updated by American Joint Committee on Cancer (AJCC).Major changes were made in the T and N staging.This article will review the updates of the 8th edition of AJCC cancer staging for pancreatic cancer from radiography aspect.

Accurate imaging diagnosis and evaluation of pancreatic cancer / 浙江大学学报·医学版

Pancreatic cancer is a highly malignant tumor and surgical resection is the only curative treatment option. In order to improve the prognosis of patients with pancreatic cancer, it is very important to diagnose and evaluate pancreatic cancer accurately and early. Imaging examinations play an important role in tumor detection, staging and surgical resectability evaluation, which can provide reliable evidences for diagnosis and treatment of pancreatic cancer. At present, the imaging techniques commonly used for diagnosis of pancreatic cancer include conventional ultrasound, endoscopic ultrasonography, PET-CT, multi-detector row CT (MDCT), magnetic resonance imaging (MRI), in which MDCT and MRI are the most widely used. In this article, the application and research progress of imaging in accurate diagnosis and evaluation of pancreatic cancer are reviewed.

Three-dimensional finite element analysis on the novel locking plate and AO-PHILOS plate for fixing four-part proximal humeral fractures / 医用生物力学

Objective To compare biomechanical performance of four-part proximal humeral fractures fixed by novel locking plate or by AO-PHILOS plate. Methods The finite element fixation models of both the novel locking plate and AO-PHILOS plate for four-part proximal humeral fractures were established, respectively. The maximum Von Mises stress and displacement under 4 different functional positions of shoulder abduction in the two fixation models were compared by finite element analysis. Results The maximum displacement in shoulder abduction of 0°,30°,60°,90° were 6.644, 7.079, 5.850, 3.005 mm, respectively, in novel locking plate fixation model, and 6.293, 6.826, 5.774, 3.023 mm, respectively, in AO-PHILOS plate fixation model. Since the maximum displacements in both fracture fixation models were similar, it indicated that there was no significant difference in the stability for fixing proximal humeral fracture. The maximum Von Mises stress in shoulder abduction of 0°,30°,60°,90°were 1 033.0, 904.1, 888.1, 1 062.0 MPa in novel locking plate fixation model, while in AO-PHILOS plate fixation model, it showed 743.1, 692.4,486.4,393.5 MPa, respectively. During the process of shoulder abduction, the total stress in both fracture fixation models gradually decreased, but the new locking plate decreased in a larger range, showing an obvious stress dispersion. Conclusions Both the novel locking plate and AO-PHILOS plate can be used as internal fixation treatment for complex four-part proximal humeral fractures with no significant difference in stress distribution, and both showing a stable fixation effect. For fixing proximal humeral fractures with osteoporosis combined with the great and less tuberosity, the novel locking plate has an advantage over AO-PHILOS plate due to its unique anatomical wings and better fixing effect.

Study of negotiation mechanism at designated hospitals at provincial level for catastrophic diseases / 中华医院管理杂志

Stakeholder theory and game theory were applied to analyze the stakeholders,role definition,participation,interest,power,position and the shift of positions under different conditions in the negotiation.Use SPSS 17.0 to analyze the database of NCMS in 2009～2010 in three counties of Hubei province,and then employ Linear programming method to do a case study of price negotiation.It is difficult to meet all stakeholders' expectations under the current condition of catastrophic disease insurance pooled at municipal-level.Medical cost differences in tertiary hospitals at provincial level are small for different regions,which constitute a basis for price negotiation at provincial level.Besides,the negotiation at province level can effectively address the conflicts of interest,and promote the negotiations.Negotiation at provincial level for such diseases,and formulating unified pricing standards for multi-wins.

Study on the status of catastrophic disease medical assistance under NRCMS in A City at Hubei Province and B County at Guizhou Province / 中国卫生政策研究

Objective:This paper designs to analyze the status of catastrophic disease medical assistance in A and B regions, and put forward feasible suggestions to improve the medical assistance level and financial effects. Methods:We selected A city at Hubei province and B county at Guizhou province as sample areas, and obtained 872 copies of questionnaires in the field survey. Then, out-of-pocket health expenditure per year, the incidence, and rel-ative gap of catastrophic health expenditure before and after the financial aid were calculated. Results: Catastrophic disease medical assistance plays a limited role in relieving patients' economic burden. Low financial aid rate, narrow range, high deductibles and low ceiling level are responsible for much lower effective financial aid rate. Conclusion:Raise financial aid rate and widen the scope of medical assistance gradually;Establish effective link-up between cata-strophic disease medical assistance and catastrophic disease insurance / basic medical insurance;Put outpatient OOP into the scope of catastrophic disease medical assistance.

Analyze compensation patterns and compensation effects of catastrophic disease insurance in L City / 中国卫生政策研究

Objective:This paper designs to analyze compensation patterns and compensation effects of cata-strophic disease insurance in L City, and put forward feasible suggestions to improve the compensation patterns of cat-astrophic disease insurance. Methods:We combined the relevant policy documents to analyze compensation patterns, and used benefit rate, OOP and The effective reimbursement rate to analyze compensation effects of catastrophic dis-ease insurance. Results:Catastrophic disease insurance benefit rate in L city in 2013 was 3. 2%; Rates of NCMS fund unilization was 92%, which diversed from county to county. Patients' OOP decreased significantly after reim-bursement of catastrophic disease insurance;Catastrophic disease insurance and NCMS total effective reimbursement rate reached 84.8%;The NCMS compensation rate reached 68. 9%, while fund incurred a financial deficit at the same time. Conclusion:Set deductibles, compensation rate and compensation range scientifically, and cancel ceiling level,improve the program of catastrophic disease insurance. Take measures to reduce the unfair between the districts and counties at city level. Establish effective link-up between catastrophic disease insurance and NCMS.

Quantitative Assessment of Skull-Base Invasion in Nasopharyngeal Carcinoma Patients with Signal Intensity Index Based on Magnetic Resonance Imaging / 鼻咽癌杂志

Purpose: To evaluate the use of signal intensity index (SII) of skull-base invasion in nasopharyngeal carcinoma (NPC) using magnetic resonance imaging (MRI), select a best cut-off SII value to predict the outcome of NPC. Materials and Methods: One hundred and twenty-two NPC patients (92 men, 30 women) with skull-base invasion were included. All patients underwent MRI, signal intensities on T1-weighted imaging (T1WI) were measured for each invaded site and its contralateral normal counterpart. The SIIs were calculated, receiver operating characteristic curves were constructed. The optimal cut-off values were extracted. The overall survival (OS) rates of 5-year follow-up were performed. Results: Sensitivities for differentiating skull-base invasion from normal contralateral anatomy were 98.9%, 88.5% and 70.0%, and specificities were 98.9%, 96.0% and 74.4%, respectively. There were three cut-off values for differentiating invasion from normal anatomy of skull-base, 49%, 98%, and 60%. Significant difference in OS rates (84.2% vs. 57.1%, p=0.007) was seen for SII threshold values > 60% and those ≤ 60%. Conclusions: The SII might be a useful means of differentiating invasion from normal tissue at the skull-base in NPC. The cut-off value of quantitative SII at the skull-base may aid in monitoring the response to treatment of NPC patients.

Investigation and analysis of the needs of community pharmaceutical care in Wenzhou city / 中国现代医生

Objective To survey the current status of community pharmacy care, analyze the needs of both community residents and medical staff for community pharmacy care, and provide references for improving the quality of communi-ty pharmacy care and policy making. Methods The form of questionnaire was taken for community residents and com-munity pharmacists from community health service centers, a random survey was conducted to collect information for statistical analysis. Results Sixty-six point eight percent of community residents selected community health service center as the main choice for obtaining drugs. The residents' home-stored drugs were mainly for cold/fever, abdominal pain/diarrhea, common chronic diseases, external wounds treating and antibacterial. Only 16.8%of community residents stored the drugs according to instructions, 70.6% would use antibacterial drug by themselves under various circum-stances, 82.8% thought there were errors in drug usage, over 98.0% of community pharmacists recognized the impor-tance of pharmaceutical care and the needs for further development. 89.1% of them were eager to improve their own capability of serving and have the needs of collaboration with large hospitals. Conclusion Improper drug usage and storage are common among community residents. Their expectations for pharmaceutical service are increasing. And community pharmacists expected to improve their own pharmacy service capability.

Principals of selecting designated hospitals for inpatients of NRCMS with critical illness / 中华医院管理杂志

Objective To explore how to determine the designated hospitals for critical illness scientifically and reasonably.Methods Analyzing the choice of medical providers by inpatients with critical illness,by means of the database of NRCMS in 2009～2010 in one county,Guangxi province.And analyzing the current policies on the basis of general principals used in health policy analysis.Results The choices of medical providers made by inpatients with critical illness are influenced by various factors.Choice of such hospitals should only be dependent on scientific and reasonable determination of patients' reasonable medical needs,instead of on the medical competency of the hospitals only.Conclusion Maximal cost-effectiveness should prevail,be it the class-1 demand of complete healing which is highly dependent on medical technology,or class-2 demand requiring repeated hospitalizations and not highly dependent on medical technology.Reasonable designation of hospitals for critical illness should be based on reasonable medical needs of patients,instead of medical competency of hospitals only.

Solid neuroendocrine breast carcinoma: mammographic and sonographic features in thirteen cases / 癌症

This study aimed to determine and quantitate the mammographic and sonographic characteristics in 13 cases of solid neuroendocrine breast carcinoma (NEBC) and to analyze the association of radiological findings with the clinical and histopathologic findings. The clinical data and imaging findings of 13 female patients with histologically confirmed solid NEBC were reviewed. Imaging data were evaluated by two radiologists for a consensual diagnosis. All patients presented with one palpable mass; only 1 experienced occasional breast pain, and 5 complained of fluid discharge. In 7 patients, the masses were firm and mobile. Regional lymph node metastasis was noted in only 1 patient. For the 10 patients who underwent mammography, 6 had a mass, 1 had clustered small nodules with clustered punctuate microcalcifications, 2 had asymmetric focal density, and 1 had solitary punctuate calcification. Most of the masses had irregular shape with indistinct or microlobulated margins. For the 9 patients who underwent ultrasonography (US), 9 masses were depicted, all of which were hypoechoic, mostly with irregular shape and without acoustic phenomena. Different types of acoustic phenomena were also identified. One patient had developed distant metastases during follow-up. NEBC has a variety of presentations, but it is mostly observed on mammograms as a dense, irregular mass with indistinct or microlobulated margins. Sonographically, it typically presents as an irregular, heterogeneously hypoechoic mass with normal sound transmission. Histories of nipple discharge and calcification observed using imaging are not rare.

Effects of oleanolic acid on apoptosis and PTEN expression of Jurkat cells / 中国实验血液学杂志

This study was aimed to explore the effects of oleanolic acid on PTEN expression and apoptosis of Jurkat cells. The inhibitory rate was measured by Cell Counting Kit-8. The apoptotic nucleus morphous was observed by Hoechst 33258 staining. The apoptosis rate of Jurkat cells were determined by flow cytometry with Annexin V/PI double staining. PTEN mRNA and protein were detected by quantitative real-time PCR and Western blot respectively. The results showed that oleanolic acid inhibited the proliferation of Jurkat cells in time- and dose-dependent manners. The 50% growth inhibition (IC(50)) at 12, 24 and 48 hours were about 85.35 µmol/L, 53.66 µmol/L and 33.18 µmol/L respectively. Flow cytometric assay showed that the apoptotic rates of Jurkat cells treated with oleanolic acid (0, 40, 80 and 160 µmol/L) for 24 hours were 6.72%, 19.8%, 28.72% and 30.12% (p < 0.05). PTEN mRNA and protein expressions were up-regulated in Jurkat cells treated with oleanolic acid of concentration 80 µmol/L and 160 µmol/L for 24 hours. It is concluded that up-regulation of PTEN mRNA and PTEN protein may be involved in oleanolic acid-induced Jurkat cell apoptosis.

Neoadjuvant endocrine therapy of breast cancer / 国际肿瘤学杂志

With the development of endocrine drugs,neoadjuvant endocrine therapy becomes the hotspot of the research on breast cancer.A lot of studies have proved that neoadjuvant endocrine therapy can degrade the tumor staging,increase the local control rate and breast-conserving rotes.And the therapeutic effect of the third generation aromatase inhibitor is superior to that of tamoxifen.