Diagnostic value of cardiac magnetic resonance contrast medium perfusion and delayed contrast enhancement for early myocardial ischemia / 中国基层医药

Objective:To investigate the diagnostic value of cardiac magnetic resonance (CMR) contrast medium perfusion and delayed contrast enhancement for early myocardial ischemia.Methods:Ninety-one patients with coronary artery stenosis diagnosed by coronary angiography (CAG) between March 2020 and March 2022 in Yiwu Central Hospital were included in this study. These patients underwent first-pass perfusion cardiac magnetic resonance imaging and delayed enhancement examination. Arrival time ( t0), accumulative signal intensity (ASI), relative peak enhancement rate (SI%), maximum intensity of signal enhancement (SIp), and maximum curve slope (α) were statistically analyzed in the CMR contrast agent normal-dose perfusion and low-dose perfusion segments. The diagnostic value of CMR contrast agent perfusion versus CAG for early myocardial ischemia was determined. The signal intensity was compared between enhanced and non-enhanced areas of CMR contrast agent perfusion. Results:There were significant differences in ASI, SI%, SIp, and Slope (α) between normal perfusion and low perfusion segments ( t = 9.62, 10.65, 8.67, 6.93, all P < 0.05). There was no significant difference in the detection rate of lesioned vessels in early myocardial ischemia between CMR contrast agent perfusion and CAG [50.42% (120/238) vs. 51.68% (123/238), χ2 = 1.32, P = 0.163). There was a significant difference in the detection rate of lesioned vessels in myocardial ischemia between CMR contrast agent perfusion and CAG ( χ2 = 15.31, P < 0.001, r = 0.71). The signal intensity value in the delayed enhancement segment was significantly higher than that in the non-delayed enhancement segment [(598.43 ± 40.19) vs. (298.64 ± 70.58), t =19.85, P = 0.001). Conclusion:CMR contrast agent perfusion can effectively evaluate the severity of early myocardial ischemia and locate the diseased blood vessels. Delayed enhancement can determine the location and area of early myocardial ischemia, and can objectively reflect the severity of myocardial ischemia.

A randomized controlled study of roxatidine in the prevention of stress related mucosal disease / 中华急诊医学杂志

Objective:To evaluate the efficacy of roxatidine and omeprazolein on preventing gastrointestinal bleeding in critically ill patients.Methods:A prospective cohort study was conducted in adult patients admitted to an intensive care unit (ICU), who had risk factors for stress related mucosal disease (SRMD), and had an estimated stay of no less than 5 days and mechanical ventilation for more than 48 h. Patients were randomized into the experiment group (Roxatidine 75 mg IV Q12 h) and control group (Omeprazole 40 mg IV Q12 h). Demographic data, acute physiology and chronic health score (APACHEⅡ) and SOFA score on day 1 were collected, intragastric pH values were tested every 2 hours for the first 5 days, the daily average of pH and proportion of patients with average pH≥4 were calculated. Stool occult blood were detected at day 1 and bacterial culture of gastric juice were performed before medication administration and on day 5 after medication administration. The implementation of enteral nutrition support, situation of gastrointestinal hemorrhage and adverse effects were analyzed. Furthermore, length of hospital stay and mortality in ICU and on the 28th day were acquired. SPSS 22.0 software was used for data analysis. Consecutive data were expressed as mean and standard deviation, categorical data were expressed as frequencies (percentage). Comparison of measurement data between groups was performed by analysis of variance or rank sum test. Comparison of count data between groups was performed by the Chi-square test. P<0.05 was regarded as statistically significant. Results:A total of 91 patients were recruited and randomly separated into experimental group ( n=46) and control group ( n=45) from October 2017 to March 2018. There were no statistical differences in gender, age, body mass index (BMI), enteral nutrition status, APACHEⅡ and SOFA score on day 1 between the two groups (all P>0.05). Roxatidine in the experiment group rapidly increased the intragastric pH to ≥4.0 and continued to stabilize at pH ≥4.0 during the monitoring period. Omeprazole increased and maintained intragastric pH≥5.0. The proportion of patients with average pH≥4.0 was 82.5% in the second 24 hours in the experiment group, and stably increased to 90% on day 5. There were no significant differences between groups in gastrointestinal bleeding, length of hospital stay, and mortality in ICU and on 28th day(all P> 0.05). No drug related adverse effects occurred during the study period. Logistic-regression analysis did not screen for risk factors of SRMD. Conclusions:Roxatidine acetate hydrochloride can rapidly elevate and maintain the gastric pH above 4.0, and has similar efficacy and safety as omeprazole in inhibiting gastric acid secretion and preventing SRMD with gastrointestinal bleeding.

Analysis and comparison of the clinical features and prognosis between extra - gastrointestinal stromal tumors and duodenal gastrointestinal stromal tumors / 中华胃肠外科杂志

Objective@#To investigate the differences of clinicopathological features, diagnosis, treatment and prognosis between patients with extra-gastrointestinal stromal tumors (EGIST) and duodenal gastrointestinal stromal tumors (DGIST).@*Methods@#A retrospective case - control study was performed. Case inclusion criteria: (1) tumor confirmed by histology and pathology; (2) primary tumor locating in the extra - gastrointestinal tract or duodenum; (3) without other synchronous tumors; (4) complete clinical and pathological data. Clinical data of 20 EGIST patients and 32 DGIST patients from March 2011 to September 2016 at Department of Gastrointestinal Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were retrospectively collected and analyzed. The observational parameters included clinicopathological characteristics, treatment and prognosis conditions. Continuous data of abnormal distribution were expressed as median (range) and compared using the Mann-Whitney U-test. Survival curves were drawn by the Kaplan-Meier method and compared with the Log-rank test.@*Results@#Of the 20 EGIST patients, 8 were males and 12 were females with age of 61.0 (30.0 to 86.0) years and of the 32 DGIST patients, 12 were males and 20 were females with age of 55.5 (27.0 to 70.0) years. Compared with DGIST patients, EGIST patients were older (U=188.000, P=0.012], had larger tumor size [10.0 (3.0 to 29.0) cm vs. 4.0 (1.5 to 10.0) cm, U=98.500, P<0.001] and higher ratio of high risk classification [85.0% (17/20) vs. 12.5% (4/32), χ2=26.870, P<0.001]. Among the 20 EGIST patients, 5 were diagnosed with distal metastasis and received imatinib (400 mg/d), and the other 15 patients underwent radical resection who were included in survival analysis. All the 32 DGIST patients underwent radical resection. The median follow-up of whole group was 43 (14 to 76) months. The 3-year recurrence/metastasis-free survival rate of 15 cases undergoing radical resection in the EGIST group was 85.6%, which was lower than that of the DGIST group (88.6%), and the difference was not statistically significant (P=0.745). There was no significant difference in the 3-year overall survival rate between the EGIST group (92.9%) and the DGIST group (100%) (P=0.271).@*Conclusions@#As compared to DGIST, EGIST mostly occurs in those with older age, larger tumor size and higher risk grade. The prognosis of EGIST patients after radical resection is similar to that of DGIST patients.

Relationship between daily exposure to bisphenol A and male sexual function-a study from the reproductive center / 中华流行病学杂志

Objective: To explore the relationship between male sexual function and daily exposure to bisphenol A (BPA) at a reproductive center in Taiyuan. Methods: Male patients who were seeking treatment of infertility due to problems caused by either of the spouse were selected from the Shanxi reproductive center between September 2014 and April 2015. Information on general characteristics, sexual function and fasting venous blood samples were collected. Total scores of sexual function were evaluated by Delphi expert scoring method. Levels of serum BPA were measured by high-performance liquid chromatography. Data was analyzed by Spearman rank correlation, rank sum test, multivariate logistic regression analysis and χ(2) trend test. Relationship between BPA and sexual function was presented as OR and corresponding 95%CI. Results: Among the 353 participants, 45.0% was defined as sexual dysfunction with low sexual desire (47.3%) as the major reason. BPA was detected in all the 353 patients, with a range of concentration as 0.38-21.93 ng/ml and an average as 5.79 ng/ml. Results from the Spearman rank correlation analysis revealed significant negative correlations between serum BPA and sexual function, sexual desire, erectile ability and ejaculation intensity, while serum BPA was positively correlated with premature ejaculation. According to the four percentile of BPA concentration (ng/ml), the subjects were divided into four groups. Compared with the low concentration group (0.38-3.79 ng/ml), the risk of sexual dysfunction significantly increased in the groups with higher BPA levels. Particularly, in the highest BPA group (8.68-21.93 ng/ml), more obvious effects were seen on sexual dysfunction (OR=1.55, 95%CI:1.00-3.23), reduced sexual desire (OR=4.75, 95%CI: 2.44-9.22), reduced erection ability (OR=2.40, 95%CI: 1.18-4.88), reduced ejaculation intensity (OR=2.53, 95%CI: 1.25-5.16) and premature ejaculation (OR=1.95, 95%CI: 1.02-3.72). Conclusion: Low sexual desire appeared as the main type of male sexual dysfunction, the exposure to higher levels of BPA in daily life might lead to male sexual dysfunction.

Analysis of imaging features of dynamic contrast-enhanced MRI in the detection of invasive ductal carcinoma of breast cancer / 中国基层医药

Objective To investigate the imaging features of MRI in patients with invasive ductal carcinoma of breast cancer .Methods 75 patients with breast ductal carcinoma treated by surgical treatment were selected . According to the age,75 patients were divided into young group (≤40 years) with 22 cases and elderly group ( >40 years) with 53 cases.The morphology,location,size,border and edge of the two groups were analyzed .The time signal intensity curve ( TIC) was analyzed.Results The proportion of patients with non -luminal invasive ductal carcinoma of the young group was 54.55％,which was higher than 30.19％ of the elderly group,the difference was statistically significant(χ2 =3.94,P=0.047).The proportion of breast cancer infiltrating ductal carcinoma in the young group was 63.64％,which was higher than 37.74％in the elderly group,the difference was statistically signifi-cant(χ2 =4.21,P=0.040).The proportion of the infarcted ductal carcinoma in the young group was 59.09％,and that in the elderly group was 62.26％,the difference was not statistically significant(χ2=2.19,P=0.14).The proportion of breast invasive ductal carcinoma in the young group was 63.64％, which in the elderly group was 54.72％, the difference was not statistically significant (χ2 =0.13,P=0.72).Ⅰ,ⅡandⅢtype of breast ductal carcinoma TIC in the young group were 0cases,14cases,8cases,respectively,which in the elderly group were 0cases,36cases,17cases, respectively,there was no statistically significant difference in TIC grade between the two groups (χ2 =2.26,P=0.13 ) .Conclusion Breast infiltrating ductal carcinoma is mostly pulmonary lump type ,tumor border is unclear;MRI dynamic enhancement technique for the detection of breast invasive ductal carcinoma can reduce misdiagnosis .

Relationship between daily exposure to bisphenol A and male sexual function-a study from the reproductive center / 中华流行病学杂志

Objective To explore the relationship between male sexual function and daily exposure to bisphenol A (BPA) at a reproductive center in Taiyuan.Methods Male patients who were seeking treatment of infertility due to problems caused by either of the spouse were selected from the Shanxi reproductive center between September 2014 and April 2015.Information on general characteristics,sexual function and fasting venous blood samples were collected.Total scores of sexual function were evaluated by Delphi expert scoring method.Levels of serum BPA were measured by high-performance liquid chromatography.Data was analyzed by Spearman rank correlation,rank sum test,multivariate logistic regression analysis andx2 trend test.Relationship between BPA and sexual function was presented as OR and corresponding 95％CI.Results Among the 353 participants,45.0％ was defined as sexual dysfunction with low sexual desire (47.3％) as the major reason.BPA was detected in all the 353 patients,with a range of concentration as 0.38-21.93 ng/ml and an average as 5.79 ng/ml.Results from the Spearman rank correlation analysis revealed significant negative correlations between serum BPA and sexual function,sexual desire,erectile ability and ejaculation intensity,while serum BPA was positively correlated with premature ejaculation.According to the four percentile of BPA concentration (ng/ml),the subjects were divided into four groups.Compared with the low concentration group (0.38-3.79 ng/ml),the risk of sexual dysfunction significantly increased in the groups with higher BPA levels.Particularly,in the highest BPA group (8.68-21.93 ng/ml),more obvious effects were seen on sexual dysfunction (OR=1.55,95％CI:1.00-3.23),reduced sexual desire (OR=4.75,95％CI:2.44-9.22),reduced erection ability (OR=2.40,95％CI:1.18-4.88),reduced ejaculation intensity (OR=2.53,95％ CI:1.25-5.16) and premature ejaculation (OR=1.95,95％ CI:1.02-3.72).Conclusion Low sexual desire appeared as the main type of male sexual dysfunction,the exposure to higher levels of BPA in daily life might lead to male sexual dysfunction.

Reiview of metabolic syndrome in TCM clinical and experimental studies / 国际中医中药杂志

The paper summarized the literature in recent 5 years about the researches on the metabolic syndrome (MS) in traditional Chinese medicine. The paper discussed the etiology and pathogenesis, summarized the clinical research and experiment of traditional Chinese medicine for MS.

Application and development of patient-derived tumor xenograft model in translational medicine of tumor / 中华胃肠外科杂志

Development of novel drugs is an integral part of the translational medicine in the field of cancer research, and the construction and application of preclinical animal models play vital roles in drugs development. Patient-derived tumor xenograft models (PDX) have been shown to be more accurate in prediction of clinical outcomes of novel drugs and are being used for preclinical drug evaluation based on the fact that PDX models mostly retain the principal histologic and genetic characteristics of their donor tumor. To set up PDX model, primary or metastatic tumor are achieved to translate into immune-deficiency mice. The tumor in immune-deficiency mouse is acquired to translate to other immune-deficiency mouse to generate stable PDX model, which usually is affected by the strain of mouse, translation method and translation location in mouse. PDX models recapitulate the same histology and gene expression as the original patients' carcinoma. PDX models can accurately predict the effectiveness of novel drugs, screen more predictive biomarker for drug resistance and optimize the use of classic drugs in clinic. However, sole source of surgical resection of tumor, long time of construction, high failure rate and hardly used in evaluating immune drugs would be the barriers to be overcome to improve PDX models. The methodological issues, salient features, practical applications, and future directions of PDX models will be illustrated.

Clinical Observation on Diabetic Nephropathy Treated with Enalapril and Yinxingdamo Injection / 国际中医中药杂志

Objective To explore the clinical effects of diabetic nephropathy treated with enalapril and Yinxingdamo injection. Methods 80 patients were randomly recruited into a control group and a treatment group. The control group was treated with enalapril, and the treatment group was treated with Yinxingdamo injection on the basis of the control group. Results Comparing with the control group, the treatment group could be seen a obvious decrease of 24h UAE, BUN and Cr(P<0.01). Conclusion The therapeutic effects of combined using enalapril and Yinxingdamo injection is better than only using enalapril in treating diabetic nephropathy.

Observation on Therapeutic Effects of Sanjiexiaopi Decoction Treating Hyperplasia of Mammary Gland during Premenstrual Phase / 国际中医中药杂志

Objective To observe the therapeutic effect of periodical treatment of Sanjiexiaopi decoction on hyperplasia of mammary gland during premenstrual phase. Methods 110 cases were randomly recruited into a treatment group and a control group with 55 case in each group. The treatment group was given Sanjiexiaopi decoction 7 days before menstruation, and the control group was given Rupixiao tablet. Both groups received no treatment during menstruation and were treated for three months. Patients in both groups underwent molybdenum target X-ray photographs and infrascan before and after the treatment. Therapeutic effects of the two groups.were compared. Results The total effective rate was 96.4% and 81.8% in the treatment group and the control group respectively. The patients in treatment group showed obvious improvent than the control group in terms of X-ray photographs and infrascan, having statistical significance (P<0.05) . Conclusion Sanjiexiaopi decoction has obvious effects on hyperplasia of mammary gland during premenstrual phase.