Distribution and drug resistance analysis of pathogenic bacteria in a hospital blood culture, 2018-2022 / 中国热带医学

@#Abstract: Objective　To analyze the distribution and drug resistance of pathogenic bacteria in blood culture specimens of patients with bloodstream infections before and after COVID-19 (2018-2019 and 2020-2021), and to provide scientific basis and reference for rational treatment and effective control of bloodstream infections in the post-epidemic period. Methods Blood culture specimens were collected from patients in Zhongnan Hospital of Wuhan University in the two years before and after the COVID-19 outbreak (2018-2021). The Automated Blood Culture Systems were used to perform blood culture on blood specimens sent for clinical inspection, and the Vitek MS automatic bacterial identification mass spectrometer was used for strain identification and the Vitek 2 automatic bacterial drug susceptibility analyzer was used for drug susceptibility testing and drug resistance analysis. Results　Blood culture specimens were performed on 28 736 patients with suspected bloodstream infection submitted for inspection from January 2018 to December 2019, and a total of 2 181 strains of pathogenic bacteria were detected after removing duplicate strains, with a positive rate of 7.69%, including 1 046 strains of Gram-negative bacteria, accounting for 47.96%. From January 2020 to December 2021, blood culture specimens from 26 083 patients with suspected bloodstream infection were submitted for inspection, and a total of 2 111 strains of pathogenic bacteria were detected after excluding duplicate strains, with a positive rate of 8.09%, including 1 000 strains of Gram-negative bacteria accounted for 47.37%. The drug resistance of Klebsiella pneumoniae was relatively serious, and the sensitivity rate to ertapenem, polymyxin B and tigecycline was more than 90%. The main non-fermentative bacteria Acinetobacter baumannii was more than 50% sensitive to piperacillin/tazobactam, amikacin and polymyxin B. The sensitivity rates of Pseudomonas aeruginosa to piperacillin/tazobactam, ceftazidime, cefepime, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, piperacillin and meropenem were more than 50%. Conclusions　In the two years before and after COVID-19, there are many types of pathogenic bacteria in bloodstream infection, but the distribution do not differ significantly. The pathogens of bloodstream infection are mainly distributed in ICU, hepatobiliary research institute, and nephrology department. Among them, Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii are the main ones, and different pathogens showed great differences in drug resistance.

Measurement of superoxide dismutase: clinical usefulness for patients with anti-neutrophil cytoplasmic antibody-associated vasculitis

Abstract Objective To investigate the clinical usefulness of serum superoxide dismutase (SOD) measurement in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). Methods In this single-center retrospective study, demographic data, serum SOD levels, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), the Birmingham Vasculitis Activity Score (BVAS), ANCA, organ involvement, and outcomes were analyzed for 152 AAV patients hospitalized in the Second Affiliated Hospital of Chongqing Medical University. Meanwhile, the serum SOD levels of 150 healthy people were collected as the control group. Results Compared to the healthy control group, serum SOD levels of the AAV group were significantly lower (P < 0.001). SOD levels of AAV patients were negatively correlated to ESR, CRP, and BVAS (ESR rho = − 0.367, P < 0.001; CRP rho = − 0.590, P < 0.001; BVAS rho = − 0.488, P < 0.001). SOD levels for the MPO-ANCA group were significantly lower than the PR3-ANCA group (P = 0.045). SOD levels for the pulmonary involvement group and the renal involvement group were significantly lower than those for the non-pulmonary involvement group and the non-renal involvement group (P = 0.006; P < 0.001, respectively). SOD levels in the death group were significantly lower than the survival group (P = 0.001). Conclusions In AAV patients, low SOD levels might indicate disease associated oxidative stress. SOD levels in AAV patients were decreased with inflammation, suggesting that SOD levels could potentially be a surrogate marker for disease activity. SOD levels in AAV patients were closely related to ANCA serology, pulmonary involvement, and renal involvement, with low SOD levels an important indicator of a poor prognosis for AAV patients.

Chinese active lifestyle development: limitations and countermeasures / Desenvolvimento do estilo de vida ativo na china: limitações e contramedidas / Desarrollo del estilo de vida activo en china: limitaciones y contramedidas

ABSTRACT Objective: To analyze the reality of the development of the national active lifestyle, clarify its limitations and countermeasures. Methodology: Official data and consultations in updated bibliographic references were employed for the survey of the main problems with a sedentary lifestyle and their possible solutions. Results: The three urgent problems to be solved in public services are the construction of sports facilities, the organization of regular sports activities, and the establishment of sports organizations. Only a few sports have been promoted in concrete operations. Inadequate physical education and deficient essential public services are also factors affecting national health. Conclusion: Building sports facilities and providing environments with sports equipment are not sufficient against sedentary lifestyles. Relevant policies must be implemented along with massive advertising about the benefits of active lifestyles. Continuous orientation of social workers in community sports groups to promote mass participation is also key to health promotion through sports interventions.

RESUMO Objetivo: Analisar a realidade do desenvolvimento do estilo de vida ativo nacional, esclarecer suas limitações e contramedidas. Metodologia: Foram empregados dados oficiais e consultas em referências bibliográficas atualizadas para o levantamento dos principais problemas com o estilo de vida sedentário e suas possíveis soluções. Resultados: Os três problemas urgentes a serem resolvidos nos serviços públicos são a construção de instalações esportivas, organização de atividades esportivas regulares e o estabelecimento de organizações esportivas. Apenas alguns poucos esportes foram promovidos em operações concretas. A educação física inadequada e os serviços públicos essenciais deficitários também são fatores que afetam a saúde nacional. Conclusão: A construção de instalações esportivas e o fornecimento de ambientes com equipamentos esportivos não são suficientes contra o sedentarismo. Políticas relevantes devem ser executadas juntamente com uma propaganda massiva sobre os benefícios do estilo de vida ativo. A orientação contínua de assistentes sociais em grupos esportivos comunitários para promover a participação das massas também é fundamental para a promoção da saúde através de intervenções esportivas.

RESUMEN Objetivo: Analizar la realidad del desarrollo del estilo de vida activo nacional, aclarar sus limitaciones y contramedidas. Metodología: Para el estudio de los principales problemas del sedentarismo y sus posibles soluciones se emplearon datos oficiales y consultas en referencias bibliográficas actualizadas. Resultados: Los tres problemas urgentes que hay que resolver en los servicios públicos son la construcción de instalaciones deportivas, la organización de actividades deportivas regulares y la creación de organizaciones deportivas. Sólo unos pocos deportes fueron promovidos en operaciones concretas. Una educación física inadecuada y unos servicios públicos esenciales deficientes son también factores que afectan a la salud nacional. Conclusión: La construcción de instalaciones deportivas y la dotación de entornos con equipamiento deportivo no son suficientes contra el sedentarismo. Deben ejecutarse políticas pertinentes junto con una publicidad masiva sobre los beneficios del estilo de vida activo. La orientación continua de los trabajadores sociales en los grupos deportivos comunitarios para promover la participación masiva también es fundamental para la promoción de la salud a través de las intervenciones deportivas.

Enzymatic preparation of manno-oligosaccharides from locust bean gum and palm kernel cake, and investigations into its prebiotic activity

BACKGROUND: Manno-oligosaccharides (MOS) is known as a kind of prebiotics. Mannanase plays a key role for the degradation of mannan to produce MOS. In this study, the mannanases of glycoside hydrolase (GH) families 5 Man5HJ14 and GH26 ManAJB13 were employed to prepare MOS from locust bean gum (LBG) and palm kernel cake (PKC). The prebiotic activity and utilization of MOS were assessed in vitro using the probiotic Lactobacillus plantarum strain. RESULTS: Galactomannan from LBG was converted to MOS ranging in size from mannose up to mannoheptose by Man5HJ14 and ManAJB13. Mannoheptose was got from the hydrolysates produced by Man5HJ14, which mannohexaose was obtained from LBG hydrolyzed by ManAJB13. However, the same components of MOS ranging in size from mannose up to mannotetrose were observed between PKC hydrolyzed by the mannanases mentioned above. MOS stability was not affected by high-temperature and high-pressure condition at their natural pH. Based on in vitro growth study, all MOS from LBG and PKC was effective in promoting the growth of L. plantarum CICC 24202, with the strain preferring to use mannose to mannotriose, rather than above mannotetrose. CONCLUSIONS: The effect of mannanases and mannan difference on MOS composition was studied. All of MOS hydrolysates showed the stability in adversity condition and prebiotic activity of L. plantarum, which would have potential application in the biotechnological applications.

The role of platelet to mean platelet volume ratio in the identification of adult-onset still's disease from sepsis

OBJECTIVES: Inflammatory factors exert a significant role in the development of adult-onset Still's disease (AOSD) and sepsis. Although platelet counts and platelet parameters have long served as indicators for inflammatory diseases, their role in the differential diagnosis between adult-onset stilĺs disease and sepsis remains unclear. We designed this retrospective study to explore whether the platelet to mean platelet volume (MPV) ratio (PMR) can help to distinguish AOSD from sepsis. METHODS: A total of 110 AOSD patients and 84 sepsis patients were enrolled in the study. Seventy-three AOSD patients and 56 sepsis patients between January 2010 and June 2017 were enrolled in the test cohort to analyze PMR values, which was then validated in the validation cohort (37 AOSD patients and 28 sepsis patients between June 2017 and December 2019). RESULTS: The values of PMR were significantly higher in AOSD patients than in sepsis patients (test cohort, validation cohort, and entire cohort), In the test cohort, logistic regression analysis showed that PMR was an independent risk factor of AOSD (odds ratios [OR]: 9.22, 95% confidence interval [CI] 2.15-39.46, p=0.003). Further receiver operating characteristic curve (ROC) analysis showed that the area under the ROC curve was 0.735 (95% CI 0.631-0.839, p<0.001) for PMR alone and 0.925 (95% CI 0.869-0.980, p<0.001) for the combination of PMR and serum ferritin. Consistently, the validation cohort exhibited analogous results. CONCLUSIONS: PMR could be used as a single indicator or a complementary indicator to distinguish AOSD from sepsis.

Comprehensive treatment for multicentric giant cell tumors of the pelvis and spine using apatinib: A case report and literature review

Background: There are no standardized treatments for giant cell tumors of the bone (GCTB) in rare locations such as the spine and pelvis or for those that are inoperable and recurrent, let alone for multicentric GCTB. This study reports a novel case of multicentric GCTB treated with a promising antiangiogenic drug, apatinib, a small-molecule tyrosine kinase inhibitor. The efficacy of apatinib in the treatment of GCTB has not been reported previously. Patients and Methods: A 27-year-old female presented with two giant cell tumors of the spine and sacrum–ilium diagnosed on December 15, 2016. Surgery and selective arterial embolization (SAE) were not reasonable options for this patient, and denosumab was unavailable; therefore, the antiangiogenic drug apatinib and the osteoclast inhibitor zoledronic acid were administered. Apatinib was initially administered at a dose of 850 mg daily, which was decreased to 425 mg daily after 7 months, and then increased again to 635 mg after 11 months. The patient was prescribed a maintenance dose of 500 mg daily after 16 months. The patient reported side effects of Grades I–III nausea, vomiting, and Grades II–III hand–foot syndrome. The patient underwent SAE at 26 months, and at that time, she was switched to denosumab instead of zoledronic acid. Results: The patient showed noticeable symptomatic improvement and visibly reduced tumor size after the first month of treatment. Computed tomography in the 4th month identified a partial response based on the RECIST criteria. The patient has achieved an objective reduction in tumor size at 32 months. Conclusions: Comprehensive treatment including apatinib represents a potential new treatment strategy for inoperable GCTB, with tolerable side effects. However, further clinical trials are now necessary to confirm an effective dose and determine the efficacy and safety of apatinib in the treatment of GCTB

Value of intravoxel incoherent motion magnetic resonance imaging for differentiating metastatic from nonmetastatic mesorectal lymph nodes with different short-axis diameters in rectal cancer

Background: Conventional magnetic resonance imaging (MRI) does not accurately evaluate lymph node (LN) status, which is essential for the treatment and prognosis assessment in patients with rectal cancer. Objective: The aim of this study is to evaluate the diagnostic value of intravoxel incoherent motion (IVIM) MRI in differentiating metastatic and nonmetastatic mesorectal LNs with different short-axis diameters in rectal cancer patients. Materials and Methods: Forty patients (154 LNs) were divided into three groups based on short-axis diameter: 3 mm ≤ × ≤5 mm, 5 mm < × ≤7 mm, and × >7 mm. MRI characteristics and IVIM parameters were compared between the metastatic and nonmetastatic LNs to determine the diagnostic value for discriminating them. Results: In the 3 mm ≤ × ≤ 5 mm group, mean D values were significantly lower in metastatic than in the nonmetastatic LNs (P < 0.001). In the 5 mm < × ≤7 mm group, mean f values were significantly lower in metastatic than nonmetastatic LNs (P < 0.05). In the × >7 mm group, only the short-axis diameter of metastatic LNs was significantly greater than that of nonmetastatic LNs (P < 0.05). The area under the curve, sensitivity, specificity, and cutoff values were used for differentiating the metastatic from the nonmetastatic LNs. Conclusion: IVIM parameters can differentiate metastatic from nonmetastatic LNs with smaller short-axis diameters (× ≤7 mm) in rectal cancer, and the short-axis diameter is a significant factor in identifying metastatic and nonmetastatic LNs in larger short-axis diameter groups (× >7 mm).

125I implantation under computed tomography guidance to treat patients with recurrent pelvic tumors: Retrospective analysis of clinical results

Objective: The objective of the study was to evaluate computed tomography (CT)-guided 125I implantation for the treatment of recurrent and malignant pelvic tumors. Materials and Methods: Fifteen cases of pelvic malignant tumors were studied. Tumor length/diameter was 4–10 cm (average: 6.8 ± 2.3 cm). In patients with pelvic recurrence or metastasis of malignant tumors, comprehensive treatment, including surgery, chemotherapy, or radiotherapy, was performed alongside CT-guided 125I implantation. The follow-up clinical benefit rate, rate of pain relief, quality of life score, and status of any complications were analyzed. Results: The patients were followed up for 6 months after the operation, and evaluation of lesions revealed complete response (CR) in 3/15 cases, partial response (PR) in 8/15 cases, stable disease in 3/15 cases, and progressive disease in 1/15 cases. The total effective rate (CR + PR) was 73.3% (11/15), and the pain relief rate was 86.6% (13/15). No bleeding, pelvic abscesses, intestinal fistulas, intestinal perforations, or other complications were reported. Conclusions: When using CT-guided 125I implantation, patients with malignant abdominal tumors undergo a convenient operation, sustain little trauma, and have an improved quality of life

From ecosystems to human welfare: the role and conservation of biodiversity / Dos ecossistemas ao bem estar humano: o papel e a conservação da biodiversidade

ABSTRACT: Biodiversity plays a key role in human welfare by providing agricultural, economic, and health benefits. However, following the industrial revolution, the rapid expansion of the human population and subsequent economic activities have caused a dramatic loss in global biodiversity, resulting in significant disturbances to ecosystems and our own living conditions. Accordingly, the conservation of biodiversity has become one of the most important challenges for humanity. The vast numbers of plants, animals, and microorganisms, the enormous genetic diversity of these species and the different ecosystems to which these organisms belong are all part of a biologically diverse planet. A substantial proportion of the world's biodiversity has been destroyed, this loss is a catastrophe for all living species, including humans. Fortunately, we are working to remedy the destruction of our ecosystems. Herein, we summarized the discovery and development of biodiversity as a field of study and discuss the importance of the genetic and metabolite diversity. We proposed potential solutions to the loss of biodiversity with the aim of facilitating further exploration and identification of biodiversity, contributing for human welfare through the conservation of human habitats.

RESUMO: A biodiversidade desempenha um papel fundamental no bem-estar humano, proporcionando benefícios agrícolas, econômicos e de saúde. No entanto, após a revolução industrial, a rápida expansão da população humana e as subsequentes atividades econômicas provocaram uma perda drástica na biodiversidade global, resultando em perturbações significativas para os ecossistemas e nossas próprias condições de vida. Consequentemente, a conservação da biodiversidade tornou-se um dos desafios mais para a humanidade. O grande número de plantas, animais e microrganismos; a enorme diversidade genética destas espécies; e os diferentes ecossistemas aos quais pertencem esses organismos fazem parte de um planeta biologicamente diversificado. Uma proporção substancial da biodiversidade mundial foi destruída. Essa perda é uma catástrofe para todas as espécies vivas, incluindo os humanos. Felizmente, estamos trabalhando para remediar a destruição de nossos ecossistemas. Neste artigo resumimos a descoberta e o desenvolvimento da biodiversidade como área de estudo e discutimos a importância da análise funcional e metabólica. Propomos soluções potenciais para a perda de biodiversidade com o objetivo de facilitar a exploração e identificação da biodiversidade, contribuindo para o bem-estar da humanidade através da conservação dos habitats da nossa espécie.

Bacterial outer membrane vesicles as nano carriers to study immunological activities / 浙江大学学报·医学版

To prepare a nano-carrier based on combining bacterial outer membrane vesicles (OMV) with three block polymer pluronic F127 (PEO-PPO-PEO) (OMV-F127) and to investigate its immunological activity.Attenuated salmonella (sal) was cultivated. OMV were separated by centrifugal ultrafiltration or ultrasonication, and OMV-F127 was prepared by mechanical extrudation method. The protein contents and compositions were tested with BCA and SDS-PAGE; the morphology of OMV, F127 and OMV-F127 were observed with FM and TEM; the particle sizes and their zeta potential were determined with DLS. Mouse macrophage RAW246.7 cells were treated with OMV-F127 (50 μg/mL, 100 μg/mL) in vitro, and the concentrations of IL-12, TNF-α and IFN-γ in culture supernatant were measured with ELISA kits.The contents of protein in separated OMV by centrifugal ultrafiltration and ultrasonication were 2.8 mg/mL and 2.7 mg/mL, respectively. SDS-PAGE showed the marker protein OmpF/C in OMV. Under the FM and TEM, ball-like structure of F127 and OMV-F127 was observed. Size analysis revealed that the diameters of OMV, F127 and OMV-F127 were 72±2 nm, 90±3 nm and 92±2 nm, respectively. ELISA tests revealed that OMV-F127 significantly stimulated the secretion of IL-12, TNF-α and IFN-γ in RAW246.7 cells.A nano-carrier based on bacterial outer membrane vesicles has been prepared, which can stimulate the secretion of cytokines and may have immunomodulatory effects.

Preparation, characterization and cytology study of Pluronic-PEI micelles / 浙江大学学报·医学版

To prepare and characterize Pluronic-PEI micelles as a drug/gene delivery system.We used the low-molecular-weight PEI as a cross-linking agent to prepare the Pluronic-PEI micelles. The particle size, zeta potential and critical micelle concentration (CMC) were measured by dynamic light scattering (DLS) and pyrene fluorescence probe. The cytotoxicity, transfection efficiency and the impact on the intracellular ATP and P-gp levels of Pluronic-PEI micelles were investigated at the cellular level.Pluronic-PEI micelles were successfully prepared with a suitable particle size (120-180 nm), zeta potential (+6-+9 mv), and a good ability to carry the drug/gene. Anstudy showed that Pluronic-PEI had low cytotoxicity, and the P123-PEI600 possessed high gene transfection efficiency and could downregulate the intracellular ATP and P-gp levels.Pluronic-PEI is a good drug/gene delivery system, and P123-PEI600 is an ideal vector, which may be used in the combination therapy for reversing multidrug resistance.

Synthesis of BODIPY photosensitizers and their photodynamic effect on cancer cells / 浙江大学学报·医学版

To design and synthesize photosensitizers with different substituents and to identify its physicochemical characteritics and photodynamic effect on cancer cells.Two kinds of BODIPY photosensitizers BPOI and BPCI were synthesized through condensation reaction between aldehyde and reactive hydrogen of pyrrole, followed with electrophilic substitution reaction. Physicochemical properties were characterized byH NMR, FT-IR and UV-visible absorption spectra and fluorescence emission spectra. The ability to produce reactive oxygen species was detected by BPDF and DCFH-DA. Photodynamic therapy effect on rat glioma C6 cellswas determined by MTT method.Two kinds of BODIPY photosensitizers BPOI and BPCI were successfully synthesized with different substituents, which were confirmed byH NMR, FT-IR. Both materials had low toxicity and could be readily taken up by tumor cells. The ability of synthesized photosensitizers to produce reactive oxygen species was strongly influenced by solvent polarity when the substituent was electron-donating group, while no effect was found when the substituent was electron-withdrawing group.Photosensitizer BPOI with electron-donating substituent produces reactive oxygen species with a slow rate in a highly polar environment, while greatly enhanced this effect in a low polarity environment, which is expected to be used for environmental-selective photodynamic therapy in tumor cells.

Diagnosis Performance of 99mTc-MIBI and Multimodality Imaging for Hyperparathyroidism / 华中科技大学学报（医学）（英德文版）

This study aimed to examine the diagnosis performance of 99mTc-methoxyisobutylisonitrisonitrile (99mTc-MIBI) and multimodality imaging [ultrasound,single-photon emission computed tomography/computed tomography (SPECT/CT)] for hyperparathyroidism (HPT).From Nov.2009 to Dec.2015,clinical data of a total of 43 HPT patients (16 males and 27 females;26-70 years old,average age:51.60±10.66 years old) were retrospectively analyzed.Among them,19 patients with primary hyperparathyroidism (PHPT) underwent 99mTc-MIBI planar imaging,24 [15 with PHPT and 9 with secondary hyperparathyroidism (SHPT)] underwent SPECT/CT hybrid imaging,and 41 (33 with PHPT and 8 with SHPT) had neck ultrasound imaging.Final diagnosis was determined by pathological examination after surgery.The positive rate was compared between different imaging modalities,and the correlation analysis was conducted between imaging results and lesion size or serum parathyroid hormone (PTH) level.The results showed that the total positive rates of 99mTc-MIBI imaging,ultrasound,and the two combined imaging in the 43 HPT cases were 90.70％ (39/43),58.54％ (24/41),and 100％ (41/41),respectively.According to lesion numbers,the positive rates were 79.10％ (53/67),53.23％ (33/62),and 88.71％ (55/62),respectively.SPECT/CT hybrid images were positive in all the 24 patients who underwent this examination.The mean maximum diameters of the lesions in 99mTc-MIBI positive and negative patients were 1.96±0.95 cm and 1.36±0.67 cm respectively,with statistically significant difference noted (P=0.03).The T/NT of 99mTc-MIBI imaging at the early phase was correlated positively with serum PTH level (r=0.40,P=0.01).The T/NT of 99mTc-MIBI imaging at both the early phase and the delay phase was correlated positively with lesion size (r=0.51,and r=0.45,respectively;P＜0.01 for both).It was concluded that 99mTc-MIBI imaging presents significant value for location diagnosis of HPT,especially when combined with SPECT/CT hybrid imaging or ultrasound.The 99mTc-MIBI uptake correlates positively with serum PTH level and lesion size.

Development of hypoxia control device for cell culture in vitro / 口腔疾病防治

Objective@#To simulate the hypoxic environment of cells in vivo more approximately, a hypoxia control device which can control oxygen concentration automatically for cell culture in vitro was developed. @* Methods@#In vitro cell cultur e hypoxia control device consisted of hardware and software which were controlled by computer. The hardware was composed of oxygen detection and control system, nitrogen gas pipeline, cell culture and anti-jamming device, and the software was based on Clanguage. When oxygen controlle rreads the oxygen concent ration more than the set value, the nitrogen gas pipeline opens and nitrogen enter into the incubator; when reaching the set value, the nitrogen gas pipeline closes and nitrogen is not allowed to pass through. Circularly, a constant oxygen concentration was reached and maintained. This device was further verified by comparing the set value of the equipment with figures of the oxygen meter and by monitoring fluctuation condition after the oxygen concentration reaching the set value. @* Results @# There was no significant difference between the oxygen concentration set in the in vitro cell culture hypoxia control device and the actual oxygen concentration in the measured box (P > 0.05), and the accuracy of the device to set the value of the simulation up to ± 0.5% of the requirements to meet the system accuracy requirements, and can remain stable for a long time. @*Conclusion @#The device can effectively control the oxygen concentration to the required requirements, to meet the conditions in the hypoxic conditions for in vitro cell culture.

Reconstruction of abdominal wall defects using small intestinal submucosa coated with gelatin hydrogel incorporating basic fibroblast growth factor

To construct a new biomaterial-small intestinal submucosa coated with gelatin hydrogel incorporating basic fibroblast growth factor, and to evaluate the new biomaterials for the reconstruction of abdominal wall defects. Thirty six Sprague-Dawley rats were used in the animal experiments and randomly divided into three groups. The new biomaterial was constructed by combining small intestinal submucosa with gelatin hydrogel for basic fibroblast growth factor release. Abdominal wall defects were created in rats, and repaired using the new biomaterials (group B), compared with small intestinal submucosa (group S) and ULTRAPROTM mesh (group P). Six rats in each group were sacrificed at three and eight weeks postoperatively to examine the gross effects, inflammatory responses, collagen deposition and neovascularization. After implantation, mild adhesion was caused in groups B and S. Group B promoted more neovascularization than group S at three weeks after implantation, and induced significantly more amount of collagen deposition and better collagen organization than groups S and P at eight weeks after implantation. Small intestinal submucosa coated with gelatin hydrogel incorporating basic fibroblast growth factor could promote better regeneration and remodeling of host tissues for the reconstruction of abdominal wall defects.

On-demand versus on-time dosing of tadalafil for erectile dysfunction: a prospective multi-center study / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of tadalafil on demand and on time in men with erectile dysfunction.</p><p><b>METHODS</b>We conducted a multi-centered randomized controlled study on 120 ED males, who were assigned to take tadalafil at 10 mg/ 20 mg on demand before sexual activity and at the same dose on time twice a week for 8 weeks. Before and at 4 and 8 weeks after treatment, and 1 month after withdrawal, we obtained the scores on IIEF-5, ED Inventory of Treatment Satisfaction (EDITS) and the short form of Psychological and Interpersonal Relationship Scales (SF-PAIRS) , and compared the safety and efficacy of medication between the two groups of patients.</p><p><b>RESULTS</b>Totally, 110 patients accomplished the trial, 56 in the on-time and 54 in the on-demand group. At 4 and 8 weeks of medication and 1 month after withdrawal, the IIEF-5 scores were improved in both the on-time and on-demand groups, even more significantly in the former than in the latter at 8 weeks of treatment (21.6 +/- 2.9 vs 18.5 +/- 1.7) and 1 month after withdrawal (20.9 +/- 2.1 vs 17.9 +/- 2.3) (P < 0.05). The EDITS scores were significantly higher in the on-time than in the on-demand group at 8 weeks of treatment (31.7 +/- 6.9 vs 28.6 +/- 5.8) and 1 month after withdrawal (30.6 +/- 4.7 vs 27.9 +/- 6.5) (P < 0.05). The scores on the sexual self-confidence, spontaneity and time-concern domains of SF-PAIRS were remarkably improved after medication as compared with the baseline (P < 0.05), even more significantly in the on-time than in the on-demand group at 1 month after withdrawal. Both dosing schedules were well tolerated and no significant differences were observed in safety between the two groups.</p><p><b>CONCLUSION</b>On-time dosing of tadalafil is efficacious and well tolerated in the treatment of ED, and has an even better effect than on-demand dosing at 8 weeks of medication and 1 month after withdrawal.</p>

Imatinib atenua a fibrose miocárdica em associação com a inibição da atividade do PDGFRα / Imatinib attenuates myocardial fibrosis in association with inhibition of the PDGFRα activity

FUNDAMENTO: O Imatinib é um inibidor do receptor tirosina-quinase que foi confirmada como exercendo um efeito inibidor sobre a atividade do receptor do PDGF, fator de crescimento plaquetário (PDGFRα e PDGFRβ). OBJETIVO: Investigar o efeito protetor do Imatinib na fibrose miocárdica em acetato de deoxicorticosterona (DOCA)/ratos com hipertensão induzida por sal. MÉTODOS: Sessenta ratos Sprague-Dawley machos, uninefrectomizados foram distribuídos em três grupos: ratos controles (grupo CON): grupo deoxicorticosterona (grupo DOCA); grupo deoxicorticosterona e Imatinib (grupo DOCA IMA). A Pressão Arterial Sistólica (PAS) foi medida quinzenalmente. Foi estudada a porção apical do ventrículo esquerdo. Foram empregados: coloração vermelho sirius, coloração de hematoxilina-eosina, imuno-histoquímica e ensaio de western blot. RESULTADOS: A PAS nos grupos DOCA e IMA+DOCA foi maior que no grupo CON nos dias 14 e 28. Os animais do grupo DOCA apresentaram fibrose intersticial e perivascular grave no dia 28, e as expressões de PI, PIII, tenascina-C e fibronectina foram significativamente maiores que nos grupos DOCA+IMA e CON. Quando comparados com o grupo CON, os grupos DOCA e DOCA+IMA apresentaram resposta inflamatória de tecido miocárdico e infiltração de monócitos/macrófagos de diferentes graus. As expressões proteicas do PDGF-A, PDGF-C e PDGFRα foram significativamente maiores nos grupos DOCA e DOCA+IMA que no grupo CON, mas a expressão proteica do p-PDGFRα no grupo DOCA+IMA foi menor que no DOCA. CONCLUSÃO: O Imatinib pode exercer efeitos inibitórios sobre a fibrose miocárdica em ratos com hipertensão induzida por DOCA/sal, os quais podem ser atribuídos à inibição da atividade do PDGFR-α.

BACKGROUND: Imatinib is a tyrosine kinase receptor inhibitor that has been confirmed to exert inhibitory effect on the platelet derived growth factor PDGF receptor (PDGFRα and PDGFRβ) activity. OBJECTIVE: To investigate the protective effect of imatinib on the myocardial fibrosis in deoxycorticosterone-acetate (DOCA)/salt induced hypertensive rats. METHODS: Sixty male uninephrectomized Sprague-Dawley rats were assigned to three groups: control rats (CON group); deoxycorticosterone group (DOCA group); deoxycorticosterone and imatinib group (DOCA+IMA group). Systolic blood pressure (SBP) was measured biweekly. The apical portion of the left ventricle was studied. Sirius-Red staining, Hematoxylin-Eosin staining, immunohistochemistry and Western blot assay were employed. RESULTS: SBP in the DOCA group and DOCA+IMA group was higher than that in the CON group on day 14 and 28. Animals in the DOCA group showed severe interstitial and perivascular fibrosis on day 28, and the expressions of PI, PIII, tenascin-C and fibronectin were significantly higher than those in the DOCA+IMA group and CON group. When compared with the CON group, myocardial tissue inflammatory response and monocyte/macrophage infiltration of different degrees were observed in the DOCA group and DOCA+IMA group. Protein expressions of PDGF-A, PDGF-C and PDGFRα were signiflcantly higher in the DOCA and DOCA+IMA groups than those in the CON group, but the p-PDGFRα protein expression in the DOCA+IMA group was lower than that in the DOCA group. CONCLUSION: Imatinib can exert inhibitory effects on myocardial fibrosis in DOCA/salt induced hypertensive rats, which may be attributed to the inhibition of PDGFR-α activity.

Experience in reducing intraoperative blood loss in radical retropubic prostatectomy / 中华男科学杂志

<p><b>OBJECTIVE</b>To search for an effective method of reducing intraoperative blood loss in radical retropubic prostatectomy (RRP).</p><p><b>METHODS</b>We performed RRP for 100 patients with prostate cancer, 50 (group A) with the Walsh or Poor method for handling the dorsal venous complex (DVC), and the other 50 (group B) through the following three additional procedures for hemostasis: first placing a #7 prophylactic suture in the distal position of DVC, then ligating the vascular bundle of the prostatic apex with continuous 4-0 Vicryl sutures, and lastly placing a 4-0 absorbable suture followed by freeing the neurovascular bundle (NVB) or freeing NVB before suturing the remained levator ani myofascia and the deep layer of Denovilliers' fascia above the rectal serosa with 4-0 Vicryl. We assessed the effects of the three hemostatic methods in RRP by comparing the volumes of intraoperative blood loss and transfusion, operation time and perioperative levels of hemoglobin.</p><p><b>RESULTS</b>There were no significant differences between groups A and B in age, PSA, Gleason score, clinical stage, prostate volume, operation time and perioperative hemoglobin levels (P>0.05). The volumes of intraoperative blood loss and transfusion were markedly higher in group A ([1103.00 +/- 528.03] ml and [482.00 +/- 364.60] ml) than in B ([528.00 +/- 258.96] ml and [140.00 +/- 266.28] ml) (P<0.05).</p><p><b>CONCLUSION</b>Intraoperative blood loss in RRP could be significantly decreased by placing a prophylactic hemostatic suture in the distal position of DVC, continuous suture of the vascular bundle of the prostatic apex after cutting off the urethra, and placing a fine absorbable suture above NVB or continuous suture of the remained levator ani mony fascia and the deep layer of Denovilliers'fascia above the rectal serosa with absorbable sutures after freeing NVB.</p>

Multi-targeted tyrosine kinase inhibitor sunitinib: a novel strategy for sporadic malignant pheochromocytoma / 中华医学杂志(英文版)

Sporadic malignant pheochromocytoma, a rare disease with poor prognosis, is always difficult to treat due in part to lack of effective agents. We presented three patients with advanced malignant pheochromocytoma treated by sunitinib, which indicates that sunitinib is an effective agent for this malignancy.

Myxoid adrenal cortical tumor: report of four cases / 中华医学杂志(英文版)

Myxoid adrenocortical neoplasms are rare. Surgical resection of the mass is the first-line therapy. Here we reported a total of four patients, aged 44–66 years, diagnosed with myxoid adrenocortical tumor. The clinical characteristics and immunohistochemical features of the tumor are discussed in the current literature.