Application of dynamic contrast enhanced status in multiparametric magnetic resonance imaging for prostatic cancer with PI-RADS 4 lesion / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the diagnostic value of dynamic contrast enhanced (DCE) of multiparametric magnetic resonance imaging (mpMRI) for prostate imaging reporting and data system (PI-RADS) 4 lesion in prostate peripheral zone.@*METHODS@#The clinical data of patients with PI-RADS 4 lesion in prostate peripheral zone who underwent prostate biopsy from January 2018 to September 2021 in Peking University First Hospital were retrospectively included. According to DCE status, the patients were divided into the conventional group (4 points for diffusion-weighted imaging) and the comprehensive group (3 points for diffusion-weighted imaging + 1 point for DCE positive). Pearson's chi-square test or Fisher's exact test for comparison was conducted between prostate cancer and non-cancer patients. Univariate and multivariate Logistic regression were performed to analyze the correlation of positive biopsy with age, total prostate specific antigen (PSA), free PSA/total PSA (f/tPSA), prostate volume (PV), PSA density (PSAD) and DCE status.@*RESULTS@#Among the 267 prostate biopsy patients, 217 cases were diagnosed as prostatic cancer (81.27%) and 50 cases were non-cancer (18.73%). Statistical analysis between the prostatic cancer group and the non-cancer group showed that there were significant differences in age, tPSA, PV and PSAD (all P < 0.05), but no significant differences in f/tPSA between the two groups. About different PI-RADS 4 lesion groups, the conventional group and the comprehensive group showed significant difference in biopsy results (P=0.001), and the conventional group had a higher positive rate. The PV of comprehensive group was larger than that of the conventional group. Among the prostate cancer patients diagnosed by biopsy, statistical analysis between the conventional group and comprehensive group showed that there were not significant differences in International Society of Urological Pathology (ISUP) grade and distinguishing clinically significant prostate cancer (all P > 0.05). Logistic univariate analysis showed that the diagnosis of prostate cancer was related to age, tPSA, f/tPSA, PV and DCE group status (all P < 0.05). Multivariate analysis showed that age, tPSA, PV and DCE group status (all P < 0.05) were independent risk factors for the diagnosis of prostatic cancer.@*CONCLUSION@#tPSA, f/tPSA, PV and PSAD are the indicators to improve the diagnosis of prostatic cancer with PI-RADS 4 lesion in peripheral zone lesions. DCE status is worth considering, so that we can select patients for biopsy more accurately, reduce the rate of missed diagnosis of prostate cancer as well as avoid unnecessary prostate puncture.

Neonatal systemic pseudohypoaldosteronism type I / 中国当代儿科杂志

An 18-day-old male infant was admitted to the hospital due to recurrent hyperkalemia for more than 10 days. The neonate had milk refusal and dyspnea. The blood gas analysis revealed recurrent hyperkalemia, hyponatremia and metabolic acidosis. Adrenocortical hormone replacement therapy was ineffective. Additional tests showed a significant increase in aldosterone levels. Family whole exome sequencing revealed that the infant had compound heterozygous in the SCNNIA gene, inherited from both parents. The infant was diagnosed with neonatal systemic pseudohypoaldosteronism type I. The infant's electrolyte levels were stabilized through treatment with sodium polystyrene sulfonate and sodium supplement. The infant was discharged upon clinical recovery. This study provides a focused description of differential diagnosis of salt-losing syndrome in infants and introduces the multidisciplinary management of neonatal systemic pseudohypoaldosteronism type I.

Impacted molar upright with self-made helical spring / 华西口腔医学杂志

With a case of mesial impaction of maxillary first and second molar, the mechanical analysis and clinical applications of a self-made helical spring for the uprighting treatment of mesial impacted molars was introduced.

Meta-analysis of the efficacy of bone anchorage and maxillary facemask protraction devices in treating skeletal class Ⅲ malocclusion in adolescents / 华西口腔医学杂志

OBJECTIVE@#To assess the efficacy of bone anchorage and maxillary facemask protraction devices in treating skeletal class Ⅲ malocclusion in adolescents.@*METHODS@#Articles relating to the use of bone anchorage and maxillary facemask protraction devices for treating skeletal class Ⅲ malocclusion in adolescents were searched from the databases of Cochrane Library, PubMed, EmBase, CNKI, and Wanfang database. Several inclusion and exclusion criteria were developed for the article screening. The clinical data were extracted, and the quality of the selected articles was evaluated. A Meta-analysis of SNA, SNB, ANB, ANS-Me, Wits, and U1-PP change was performed by using RevMan 5.3.@*RESULTS@#Seven studies (264 patients) were included in the Meta-analysis. Among these studies, three were randomized controlled trials, and four were non-randomized controlled trials. Compared with the maxillary facemask protraction device group, the bone ancho-rage device group had higher SNA changes and lower ANS-Me, Wits, and U1-PP changes (P<0.05). No significant differences were observed in the SNB and ANB changes between these two groups.@*CONCLUSIONS@#Compared with the maxillary facemask protraction device, the bone anchorage device can increase the extent of protraction of the maxilla and has better controls for the labial inclination of the maxillary anterior teeth in treating skeletal class Ⅲ malocclusion among adolescents. However, additional high-quality randomized controlled trials must be performed to verify the results.

Molecular identification of Tricula spp. and the parasitized trematode cercariae in schistosomiasis-endemic areas of Yunnan Province / 中国血吸虫病防治杂志

Objective To characterize a species of the genus Tricula and parasitized trematodes in schistosomiasis-endemic areas of Yunnan Province using a molecular analysis, so as to understand their taxonomic positions. Methods Tricula spp. and Oncomelania snails were collected from Xiangyun County, Yunnan Province, and cercaria parasitizing snails were observed using crushing followed by microscopy. Cercaria parasitizing Tricula snails at various morphologies were sampled using a shedding method. Genomic DNA was extracted from snail soft tissues and cercariae, and the 16S rRNA, COI, 28S rDNA genes in snails and the ND1 and 28S rDNA genes in cercariae were amplified using a PCR assay and sequenced. The species of Tricula snails and their parasitized trematodes was characterized using sequence alignment and phylogenetic analysis. Results Among 382 Tricula snails detected, there were three types of trematode cercariae found, including the non-forked (20.94%, 80/382), double-forked (3.40%, 13/382) and swallow shapes (7.07%, 27/382). Sequence and phylogenetic analyses showed that the 16S rRNA, COI and 28S rDNA gene sequences of this species of Tricula had high homology to those in Delavaya dianchiensis, and were clustered in a branch. Sequencing analysis of the ND1 and 28S rDNA genes revealed that the non-forked cercariae belonged to the family Pleu- rogenidae, the swallow-shaped cercariae belonged to the family Opecoelidae, and the double-forked cercariae belonged to another species of the genus Schistosoma that was different from S. sinensium and S. ovuncatum. Conclusion The species and taxonomy of Triculla spp. and their parasitized trematodes are preliminarily determined in schistosomiasis-endemic areas of Yunnan Province; however, further studies are required to investigate the more definite taxonomy and pathogenicity.

Comparison of therapeutic effect on multi‐vessel coronary disease between minimally invasive coronary artery bypass grafting and coronary artery bypass grafting／ / 心血管康复医学杂志

To compare short‐and mid‐term therapeutic effect on aged patients with multi‐vessel coronary disease between minimally invasive coronary artery bypass grafting (MIDCAB) and coronary artery bypass grafting (CABG).Methods : A total of 72 patients with multi‐vessel disease , who were suitable for MIDCAB from 2016 to 2018 , were regarded as MIDCAB group .Another 96 patients with multi‐vessel disease , who were not suitable for MIDCAB , were enrolled as CABG group (received selective on‐pump CABG).Clinical data and incidence of major adverse cardio‐ and cerebrovascular events (MACCE ) within two‐year follow‐up were compared between two groups.Results : Men percentage of MIDCAB group was significantly higher than that of CABG group (83. 3% vs. 67. 7%, P＝0.022) ; compared with CABG group , there were significant reductions in percentages of left anterior descending proximal lesions (61.5% vs.34.7%) and chronic total occlusion disease (57.3% vs.34. 7%) in MID‐CAB group ( P＜0. 01 both) , there were no significant difference in other indexes between two groups , P＞ 0. 05 all.All subjects were followed up for two years , follow‐up rate was 90. 5% .There were no significant difference in incidence rates of all‐cause death and MACCE between two groups , P＞0.05 all.Conclusion : There is no signifi‐cant difference in incidence rate of short‐and mid‐term events between CABG and MIDCAB in patients with multi‐vessel coronary disease .MIDCAB is recommended for proper patients in clinic .

Comparison of therapeutic effect between PCI and CABG on multi-vessel coronary disease / 心血管康复医学杂志

Objective :To compare short-term and midterm therapeutic effect between sirolimus-eluting stent implan-tation (SES-PCI) and coronary artery bypass graft (CABG) in aged patients with coronary heart disease (CHD) and multi-vessel coronary disease (MVD).Methods : Aged MVD patients undergoing selective revascularization were en-rolled and divided into CABG group (n＝301) and SES-PCI group (n＝289).Major adverse cardio-and cerebrovas-cular events (MACCE) were followed up for 30d ,one ,two and five years .Logistic multi-factor regression was used to analyze independent risk factors for different therapeutic methods .Results : Compared with CABG group after 30d follow-up ,there was significant reduction in all-cause mortality (6-3% vs.2-8%) and significant rise in a sec-ond revascularization rate (RVR ,1-3% vs.8-3%) in SES-PCI group , P＜0-05 or ＜0-01 ;compared with CABG group during one ,two and five-year follow up ,there were significant reductions in all-cause mortality [one year :(11-6% vs.4-8%) ,five years :(23-3% vs.12-1%)] and incidence rate of cerebrovascular accidents [one year :(8-6% vs .3-5%) ,five years :(18-3% vs.6-9%)] ,and significant rise in incidence rate of non-fatal myocardial infarction [one year :(6-6% vs.11-8%) ,five years :(12-0% vs.24-9%)] and a second RVR [one year :(3-0%vs.16-3%) ,five years :(9-3% vs.24-6%)] in SES-PCI group , P＜0-05 or ＜0-01- Logistic multi-factor regres-sion analysis indicated that DM and EH were independent risk factors for SES-PCI (OR＝ 45-772 ,13-218 , P＝0-001 both) ,while peripheral vascular disease was independent protective factor for SES-PCI (OR＝ 0-007 , P＝0-001).Conclusion : Compared with CABG ,there are significant reductions in short-term and midterm all-cause mortality ,and significant rise in a second RVR in MVD patients undergoing PCI .

Distal horizontal impaction of right mandibular first molar: a case report / 华西口腔医学杂志

Impacted molars are more common in maxillary and mandibular third molars, whereas impacted first molars are relatively rare. A case of horizontal impaction of mandibular first molar is reported in this study, and the relevant literature are presented.

A New Modified FOLFIRINOX(mFOLFIRINOX)Regimen as First-Line Chemotherapy for Patient with Metastatic Pancreatic Adenocarcinoma(MPC) / 中山大学学报(医学科学版)

[Objective]To investigate efficacy and toxicity of a new modified FOLFIRINOX regimen(mFOLFIRI-NOX)as first-line chemotherapy for the patients with metastatic pancreatic adenocarcinoma(MPC).[Methods]20 patients with metastatic pancreatic adenocarcinoma(MPC)accepted mFOLFIRINOX arm(oxaliplatin 60 mg/m2,irinotecan 150 mg/m2,bolus of 5-FU 400 mg/m2,continuous infusion of 5-FU 2 400 mg/m2)first-line treatment and evaluated the curative effect and side effect after 3 cycles by imaging and laboratory at Sun Yat-sen Memorial Hospital from December 2012 to December 2016.The primary endpoint was overall survival(OS).The second endpoint was response rate(ORR) and toxicity.[Results]Four patients were excluded according to exclusion criteria. A total of 16 patients were enrolled including 7 males and 9 females.The median age is 55 years(ranging from 43 to 67 years).The median cycle of chemo-therapy was 4.5(3-15). The ORR was 31.3% including 5 patients with partial response,9 patients with stable disease and 2 patients with progression disease.The median follow-up duration was 14.1(2.7-24.5)months.The median OS was 16.6 months(95%CI,11.36-21.84). Overall survival rates at 6,12months were 80%and 55.6%,respectively. Three patients were presented grade 3-4 adverse events.[Conclusion]The new mFOLFIRINOX regimen improved survival of patients with MPC with tolerated toxicity as first line treatment.

Clinical features and magnetic resonance imaging evaluation of encephalopathy in high-risk late preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the risk factors, clinical features, and magnetic resonance imaging (MRI) changes of encephalopathy in high-risk late preterm infants.</p><p><b>METHODS</b>Head MRI scan was performed for late preterm infants with high-risk factors for brain injury who were hospitalized between January 2009 and December 2014. The risk factors, clinical features, and head MRI features of encephalopathy in late preterm infants were analyzed.</p><p><b>RESULTS</b>A total of 1 007 late preterm infants underwent MRI scan, among whom 313 (31.1%) had imaging features in accordance with the features of encephalopathy of prematurity. Of all infants, 76.7% had white matter damage. There was no association between the development of encephalopathy and gestational age in late preterm infants, but the detection rate of encephalopathy gradually increased with the increasing birth weight (P<0.05). The logistic regression analysis showed that a history of resuscitation was an independent risk factor for encephalopathy of prematurity (P<0.01).</p><p><b>CONCLUSIONS</b>Encephalopathy of prematurity is commonly seen in high-risk late preterm infants, especially white matter damage. A history of resuscitation is an independent risk factor for encephalopathy in late preterm infants.</p>

Advances in study on compatibility of licorice and its mechanism of detoxification based on pharmacokinetics / 中草药

Licorice is one of Chinese materia medica (CMM) widely used in Chinese medicinal formulae as assistant and guiding medicines, it plays a role in restricting the main drug's toxicity and moderating the property of herbs. Licorice is regarded as a herb that can moderate the property of each herb and remove the hundreds of toxicants. Based on the above characteristics, toxic CMM is always used with licorice. However, the mechanism of the compatibility of licorice is not very clear. It is a good way for us to understand the principle and law of the compatibility of licorice, and to know the relationship between the process and compatibility detoxifying mechanism of licorice through studying on how the licorice has an effect on intracorporal process of the main components in the toxic CMM. The paper mainly summarizes the study on the pharmacokinetics of toxic CMM by compatibility of licorice and its mechanism of pharmacokinetic detoxification.

Association between Polymorphism of Interleukin-23 Receptor and Hashimoto's Thyroiditis in Chinese Han Population of Shandong / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>The interleukin-23 receptor (IL-23R) has been shown to be associated with autoimmune diseases in many different populations. This study aimed to investigate the association between IL-23R gene polymorphism and susceptibility to Hashimoto's thyroiditis (HT) in Chinese Han population of Shandong.</p><p><b>METHODS</b>A case-control cohort study was performed in 145 HT patients from First People's Hospital of Jining between February 2010 to October 2013 and 150 healthy controls. Two single nucleotide polymorphisms located in the promoter region of IL-23R gene (rs17375018 and rs7517847) were examined by polymerase chain reaction-restriction fragment length polymorphism analysis. Hardy-Weinberg equilibrium was performed using the Chi-square test. Genotype frequencies were estimated by direct counting, and allele and genotype frequencies between patients and controls were analyzed by the Chi-square test.</p><p><b>RESULTS</b>The rs17375018 GG genotype and the G allele were significantly increased in HT patients compared with healthy controls (P = 0.034 and P = 0.013, respectively). No association was identified between HT patients and healthy controls in rs7517847.</p><p><b>CONCLUSION</b>The study demonstrated that polymorphism of IL-23R gene rs17375018 is highly associated with HT in Chinese Han population of Shandong, suggesting that IL-23R gene polymorphism (rs17375018 G) may play a critical role in susceptibility to HT.</p>

Analysis of 58 neonatal cases with cerebral infarction / 中华儿科杂志

<p><b>OBJECTIVE</b>Cerebral infarction (CI) is one of severe diseases of central nervous system in neonates, and some infants with CI could have poor prognosis in the long term. This study aimed to analyze the clinical data and prognosis of all neonatal cases with cerebral infarction in recent years and to help future clinical work.</p><p><b>METHOD</b>Totally 58 neonatal cases with CI admitted to NICU of the hospital from January 1999 to December 2010 were included in this study. We analyzed all clinical data and prognosis by retrospective analysis.</p><p><b>RESULTS</b>Fifty-two term babies and six preterm babies were included. There were altogether 51 cases with asphyxia and 7 with hemorrhagic cerebral infarction. Perinatal hypoxia-ischemia was the most common high-risk factor and it accounted for 46.6%. Seizure was the most frequent initial symptom and the most common clinical manifestation (accounted for 77.6%), and it was followed by intermittent cyanosis, apnea and lethargy. Cerebral CT scan and magnetic resonance imaging were major methods to help to make the diagnosis and they also had close relation with prognosis. Diffusion weighted imaging was very helpful to diagnose infarction in early stage. Left middle cerebral artery was the most common artery to be involved. Supportive therapy and symptomatic treatment were the main methods in the acute stage of neonatal cerebral infarction. Those babies with poor prognosis mostly had large infarction involving cerebral hemisphere, thalamus and basal ganglia.</p><p><b>CONCLUSIONS</b>Neonatal cerebral infarction was a severe brain injury affecting long tern nervous system prognosis. Perinatal hypoxia was the most common high-risk factor and seizure was the most frequent initial symptom. Diffusion weighted imaging was valuable to diagnose infarction in early stage. Most of infants with poor prognosis had large infarction involving hemisphere, thalamus and basal ganglia. Early diagnosis with brain imaging would be helpful for rehabilitation therapy and improving prognosis.</p>

Hyperglycemic effects of a periocular dexamethasone injection in diabetic patients after vitreoretinal surgery / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To examine the hyperglycemic effects of periocular dexamethasone injection in type 2 diabetic patients after vitreoretinal surgery (VRS).</p><p><b>METHODS</b>This was a retrospective non-randomized controlled trial. Twenty consecutive hospitalized patients with type 2 diabetes and ocular inflammatory reaction after VRS were enrolled in this study. Ten patients received 2.5 mg dexamethasone and 10 patients received 5 mg dexamethasone. Fourteen consecutive type 2 diabetic patients without ocular inflammatory reaction after VRS were used as control group. We measured fasting blood glucose (FBG) and at 2 h after each meal (post prandial glucose, PBG; 09:00, 13:00, and 19:00 h) after periocular dexamethasone injection. Differences among three groups were determined by q tests.</p><p><b>RESULTS</b>The PBG levels in both dexamethasone-treated groups started to increase within 5 h after injection (i.e., PBG at 13:00 h), and were significantly increased at 19:00 h after injection (P<0.05). BG levels were almost 2-fold higher than at baseline and compared with the control group. The BG values declined gradually by 24 h to 48 h after injection. There were no differences in BG levels between the two dexamethasone-treated groups (P>0.05), except for PBG at 19:00 h on day 2 after injection (P<0.05).</p><p><b>CONCLUSION</b>Periocular dexamethasone injection can cause transient hyperglycemia in diabetic patients after VRS. BG monitoring should be performed following such injection.</p>

A survey on the agricultural profession-related injuries among 11 902 rural residents in Shandong province / 中华流行病学杂志

Objective To understand the prevalence and risk factors of agricultural activities related injuries among rural residents in Shandong province. Methods A retrospective investigation was conducted among agricultural profession-related workers in 20 villages with multistage cluster sampling method in Shandong province. Four times face-to-face interview were conducted by trained interviewers, including 32 students and local medical personnel under constructed questionnaires.Accidental injuries occurred in the activities or in the agricultural profession-related jobs were recorded, from May 1st 2009 to April 30st 2010. Data was input and analyzed by SPSS 13.0 statistical software. Results A total of 837 cases reported at least 1 job-related injury out of the 11 902 people who had been surveyed in one year. The crude incidence rate was 7.03% and the standardized incidence rate was 7.36%, higher in males (9.01%) than in females (4.10%), X2= 105.53, P=0.000.Children and adolescents (≤ 14 aged) had the higher incidence rate (9.50%), X2=9.70, P=0.008.People working in the area of commercial service related to agricultural products had the highest incidence rate (12.94%). In particular, those occupations that related to agricultural construction or materials appeared to have had higher incidence rates as 16.80% and 15.59% respectively, than other kinds of jobs (X2= 167.30, P=0.000). There were higher proportion of injuries occurred in the roads (28.79%), in the fields(28.08%) during labor work(38.00%) transportation(27.97%), respectively.The seasonality of agricultural injures mostly occurred between June and August, accounted for 47.43%. Major external causes related to injuries were instruments or tools (31.42%) being used,transportation (24.13%) and falls (20.19%). Wounds on limbs took the majority (56.39%). The accidental self-inflicted injury occupied 76.82%, while accidents to passive injuries occupied 11.47%,other kinds accounted for 11.71%. Most of the accidents caused mild or moderate damage, accounted for 60.22% and 30.34% respectively. 7 cases died of injuries, with the fatality rate as 0.84% and the mortality rate was 58.81 per one hundred thousand. 72 cases ended up in disability caused by injuries,with the morbidity rate as 6.05 per thousand. Answers to the major internal causes of injuries appeared to be: "did not know how to protect oneself" (29.87%) with females (45.41%) in particular,followed by "over fatigue" and "inappropriate treatment" which took the 2nd place in males. Major natural environmental factors of injuries would relate to "high air temperature and humidity but lower wind velocity"(14.93%), "unclear signs on the country road"(12.19%), "the sky was cloudy or dark"(10.87%), "slippery road caused by rain or snow" (10.51%), "kids were unintended" (10.27%) etc.Most of the wounded received treatment clinically (50.18%), with the percentile (P50) of medical cost as 182.76 RMB (Yuan). The proportion of inpatient was 27.72% and with percentile of time as P50=7.57 day and cost as P50=2840.00 RMB Yuan. The wounded had a rest of P50=5.9 days, with an indirect cost as P50=233.16 RMB Yuan. Conclusion The results of this study indicated that the incidence of agricultural profession-related injuries was high, with serious harm. Behavioral intervention and awareness of injuries should be enhanced, together with the improvement of environmental condition.

Synthesis of colon-specific prodrug of indomethacin and its inhibitory effect on liver metastasis from colon cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To develop a colon-specific prodrug of Indomethacin microbially triggered, carry out in vitro/in vivo evaluation of drug release, and appraise its inhibitory effect on liver metastasis from colon cancer.</p><p><b>METHODS</b>Indomethacin prodrugs were synthesized and characterized by FTIR and NMR, and dissolution test simulating gastrointestinal tract was employed to screen the colon-specific prodrug. Then, the pharmacokinetic profile of portal vein and peripheral blood in Sprague-Dawley rats was studied. Lastly, the inhibitory effect on liver metastasis from colon cancer in nude mice was observed.</p><p><b>RESULTS</b>The chemical structure characterized by FTIR and NMR demonstrated that six kinds of indomethacin-block-amylose with different drug loading (IDM-AM-1-6) were synthesized, among which IDM-AM-3 was degraded 1.3%, 9.3% and 95.3%, respectively, in simulated gastric fluid for 4 h, small intestine for 6 h, and colon for 36 h. The pharmacokinetic test of IDM-AM-3 showed that absorption was delayed significantly (P < 0.01), peak time [(11.35 + or - 2.45) h], elimination half-life [(16.74 + or - 4.04) h] and mean residence time [(22.27 + or - 0.52) h] were significantly prolonged (P < 0.01), as well as peak serum concentrations [(9.69 + or - 2.40) mg/L] and AUC(0-t) [(236.7 + or - 13.1) mg x L(-1) x h] were decreased markedly (P < 0.01) as compared with those of IDM regarding to portal vein. Additionally, its AUC(0-t) in peripheral blood was remarkably lower than that in Portal vein (P < 0.01). The tumor suppression observation showed that it could remarkably reduce the number of liver metastases in contrast to IDM (P < 0.05).</p><p><b>CONCLUSION</b>Colon-specific IDM-AM-3 possesses advantage of sustained release in portal vein providing some experimental basis for colon-specific delivery system applied to sustained release in the portal vein.</p>

Preparation and antitumor effects of nanovaccines with MAGE-3 peptides in transplanted gastric cancer in mice / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>As a prospective vaccine carrier, nanoparticles can protect antigens from degradation and enhance immune response. This study prepared nanovaccines with MAGE-3-derived CD4+-CD8+T cell epitope peptides, and investigated its character and antitumor effects on transplanted gastric cancer in mice.</p><p><b>METHODS</b>We adopted the self-assembly method to prepare peptide/chitosan conjugated with deoxycholic acid (chitosan-deoxycholic acid) nanoparticles. We observed the appearance of the chitosan-deoxycholic acidnanoparticles through a transmission electron microscope (TEM) and analyzed the peptide content and its release pattern by fluorescence spectrophotometry. We observed tumor-suppression efficacy in vivo through animal experiments.</p><p><b>RESULTS</b>We successfully prepared nanoparticles with MAGE-3 peptide antigen, and its encapsulation efficiency and loading level were about 37% and 17.0%, respectively. These nanoparticles presented a delayed release pattern in phosphate buffered saline (PBS) at pH 7.4, and the full release time was about 48 h. In 2 mg/mL lysozyme, the nanoparticles showed a sudden release, and the full release time was about 24 h. ELISPOT and cytotoxic experiments showed that the MAGE-3 peptide loaded nanoparticles could stimulate immune response in vivo and could generate MAGE-3-targeted cytotoxic T lymphocytes (CTLs), and kill MAGE-3-specific tumor cells. Tumor suppression experiments showed that the regression ratio of the peptide-loaded nanoparticles group was 37.81%.</p><p><b>CONCLUSIONS</b>MAGE-3 peptide/chitosan-deoxycholic acidvaccine-loaded nanoparticles can stimulate antitumor immune response in vivo and can regress the growth of mouse forestomach carcinoma cell line MFC.</p>

Meta analysis of the effect of immunoglobulin infusion on neonatal isoimmune hemolytic disease caused by blood group incompatibility / 中华儿科杂志

<p><b>OBJECTIVE</b>Neonatal isoimmune hemolytic disease is still one of the major causes of neonatal hyperbilirubinemia. The infants with severe hemolysis even need phototherapy and exchange transfusion. Early intravenous immunoglobulin infusion may block hemolysis to some extent. This study aimed to investigate the efficacy and safety of immunoglobulin infusion on neonatal isoimmune hemolytic disease by meta analysis.</p><p><b>METHOD</b>All randomized controlled trials on the effect of immunoglobulin infusion on neonatal Rh and ABO incompatible hemolytic disease obtained by searching MEDLINE, Cochrane Library, EMBASE, CNKI and CBM were included. Meta analysis was done by Review Manager 4.2 software.</p><p><b>RESULTS</b>Six trials with totally 456 neonates were included. There were 109 infants with Rh blood group incompatible hemolysis in 4 studies and 347 infants with ABO blood group incompatible hemolysis in 4 studies. There was no significant difference in gestational age, weight and sex between the immunoglobulin infusion and control groups. Compared with those neonates treated with only phototherapy, the infants treated with immunoglobulin and phototherapy had shorter duration of phototherapy (weighted mean difference, WMD -15.42, 95%CI -29.00 to -1.85), less chance to be given exchange transfusion (RR 0.25, 95%CI 0.17 to 0.39) and shorter duration of hospitalization (WMD -25.44, 95%CI -36.93 to -13.94). While intravenous immunoglobulin could not decrease the maximum serum bilirubin level (WMD -29.91, 95%CI -78.24 to 18.42). There was no significant difference in the incidence of late anemia between the two groups. No adverse reaction was found in neonates who received immunoglobulin.</p><p><b>CONCLUSIONS</b>The results of this meta analysis support that the intravenous immunoglobulin had some therapeutic effect on neonatal isoimmune hemolytic disease. The infants who received immunoglobulin had shorter duration of phototherapy and less chance to be given exchange transfusion. Well designed, double blind and randomized controlled trials with large sample size and long-term follow-up are needed for further evaluation of the efficacy and safety of the immunoglobulin therapy.</p>

Surgical treatment for hilar cholangiocarcinoma of Bismuth-Corlette type IV / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the surgical treatment for hilar cholangiocarcinoma(HCCA) of Bismuth-Corlette type IV.</p><p><b>METHODS</b>The clinical data of 73 HCCA patients admitted in Southwest Hospital, the Third Military Medical University from January 2002 to December 2008 were analyzed retrospectively. There were 41 males and 32 females, aged from 30 to 84 years old (averaged, 56.8 years old). All patients were diagnosed as hilar mass with hilar biliary obstruction by B-ultrasound, CT, magnetic resonance imaging, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography or percutaneous transhepatic cholangiography, and confirmed by pathological examination in intra-operation and post-operation. Diagnosis of all patients were according to Bismuth-Corlette type IV.</p><p><b>RESULTS</b>Fifteen cases underwent percutaneous transhepatic cholangial drainage, stents were implanted in 8 patients. Simple internal drainage was performed on 25 of the 73 patients and 4 with palliative resection. Radical resection was performed on 19 patients. The radical resection rate of HCCA were 26.0%. The 1, 3 years of survival rates were 36.8%, 10.5% respectively. The 1 year survival rate was 6.3% in drainage group.</p><p><b>CONCLUSION</b>Radical resection is the potentially curative treatment for HCCA, a sufficient, reasonable use of internal and external drainage would improve the patient's quality of life.</p>

Different effects of isoflurane and sevoflurane on cytotoxicity / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Isoflurane, a commonly used inhaled anesthetic, induces apoptosis in primary rat cortical neurons of rat in a concentration- and time-dependent manner by an unknown mechanism. We hypothesized that isoflurane induced apoptosis by causing abnormal calcium release from the endoplasmic reticulum (ER) via activation of inositol 1, 4, 5-trisphosphate (IP(3)) receptors. Sevoflurane has a reduced ability to disrupt intracellular calcium homeostasis and is a less potent cytotoxic agent. This study examined and compared the cytotoxic effects of isoflurane and sevoflurane on rat primary cortical neurons and their relationship with disruption of intracellular calcium homeostasis and production of reactive oxygen species (ROS).</p><p><b>METHODS</b>Primary rat cortical neurons were treated with the equivalent of 1 minimal alveolar concentration (MAC) of isoflurane and sevoflurane for 12 hours. MTT reduction and LDH release assays were performed to evaluate cell viability. Changes of calcium concentration in the cytosolic space, [Ca(2+)](c), and production of ROS were determined after exposing primary rat cortical neurons to isoflurane and sevoflurane. We also determined the effects of IP(3) receptor antagonist xestospongin C on isoflurane-induced cytotoxicity and calcium release from the ER in primary rat cortical neurons.</p><p><b>RESULTS</b>Isoflurane at 1 MAC for 12 hours induced cytotoxicity in primary rat cortical neurons, which was also associated with a high and fast elevation of peak [Ca(2+)](c). Xestospongin C significantly ameliorated isoflurane cytotoxicity in primary cortical neurons, as well as inhibited the calcium release from the ER in primary cortical neurons. Isoflurane did not induce significant changes of ROS production in primary rat cortical neurons. Sevoflurane, at equivalent exposure to isoflurane, did not induce similar cytotoxicity or elevation of peak [Ca(2+)](c) in primary rat cortical neurons.</p><p><b>CONCLUSION</b>These results suggested that isoflurane induced elevation in [Ca(2+)](c), partially via elevated activity of IP(3) receptors, which rendered cells vulnerable to isoflurane neurotoxicity. ROS production was not involved in isoflurane-induced neurotoxicity. Sevoflurane, at an equivalent exposure to isoflurane, did not induce similar elevations of [Ca(2+)](c) or neurotoxicity in primary cortical neurons of rat.</p>