Ferroptosis-related Recurrence Risk Model Predicts Clinical Outcomes and Immune Infiltration in Glioblastoma / 肿瘤防治研究

Objective To construct a ferroptosis-related glioblastoma (GBM) recurrence risk model and evaluate the prognosis of patients. Methods Differentially expressed genes (DEGs) related to ferroptosis in recurrent GBM were screened by CGGA and FerrDb databases. Key genes were obtained by Lasso regression. Then, nomogram was constructed according to the key risk genes, and the prediction efficiency was verified using the TCGA database. GO, KEGG, and GSEA databases were used in exploring the mechanism of prognosis. ESTIMATE and TIMER were used in studying tumor immune infiltration and the expression of immune check points. Results WWTR1, PLIN2, and BID were important prognostic factors for GBM recurrence. The nomogram was constructed according to gender and age, and the observed values were in good agreement with the predicted values. The AUC values were 0.65 (1 year), 0.66 (3 years), and 0.63 (5 years) for CGGA and 0.68 (1 year), 0.76 (3 years), and 0.79 (5 years) for TCGA. Epithelial mesenchymal transition, KRAS pathway, and inflammatory response were significantly upregulated in the high-risk subtypes (P < 0.05). Immune cell infiltration was lower (P < 0.05). Risk score was positively correlated with the expression of immunosuppression check points. Conclusion Ferroptosis-related genes WWTR1, PLIN2, and BID can be used in constructing a nomogram with good predictive performance. These risk genes may affect prognosis through tumor-infiltrating immune cells and immune check points.

Locking plate fixation with fibular strut allograft versus locking plate fixation alone for the treatment of proximal humeral fractures in adults:a Meta-analysis / 中国骨伤

OBJECTIVE@#To compare the clinical efficacy of locking plate fixation with a fibular strut allograft (FA group) and locking plate fixation alone (LP group) in the treatment of proximal humeral fractures in adults by Meta-analysis.@*METHODS@#Databases including PubMed, The Cochrane Library, Embase, Chinese BioMedical Literature Database(CBM), China National Knowledge Infrastructure(CNKI), WanFang Data, and China Science and Technology Journal Database (cpvip Database) were searched by computer from establishing to March 2020 to collect studies about locking plate fixation with fibular strut allograft versus locking plate fixation alone for proximal humeral fractures in adults. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. The postoperative humeral head height changes, neck-shaft angle changes, Constant-Murley score, American Shoulder and Elbow Surgeons(ASES)score, visual analogue scale(VAS), varus malunion rate, and screw penetration rate were compared by RevMan 5.3 software for Meta-analysis.@*RESULTS@#Ten cohort studies were enrolled in a total of 749 patients, 300 patients in the FA group and 449 patients in the LP group. The results of Meta-analysis showed that locking plate with fibular strut allograft was superior to locking plate fixation alone in the changes in humeral head height [MD=-2.69, 95%CI(-3.24, -2.13), P<0.000 01], the changes in neck-shaft angle [MD=-5.65, 95%CI(-7.18, -4.12), P<0.000 01], Constant-Murley score [MD=9.00, 95%CI(4.26, 13.73), P=0.000 2], the ASES score [MD=5.56, 95%CI(4.29, 6.84), P=0.000 01], VAS score [MD=-0.23, 95%CI(-0.37, -0.09), P=0.001], the varus malunion rate [RR=0.22, 95%CI(0.09, 0.53), P=0.000 7] and the screw penetration rate [RR=0.26, 95%CI(0.13, 0.55), P=0.000 3], respectively.While there was no significant difference in the rate of osteonecrosis of the humeral head [RR=1.18, 95%CI(0.57, 2.45), P=0.65].@*CONCLUSION@#For proximal humeral fractures in adults, current evidence shows that locking plate fixation with fibular strut allograft is superior to single locking plate fixation in improving postoperative radiological outcomes and shoulder function, relieving postoperative pain, reducing varus malunion rate and screw penetration rate. However, the efficacy in decreasing the osteonecrosis rate is not clear. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.

Research advances in frailty assessment of elderly patients with multiple myeloma / 中华老年医学杂志

Multiple myeloma(MM)is a common hematological malignancy of the elderly.It is characterized by the involvement of multiple organs and its treatment becomes more difficult when aging and frailty exert their influence.In elderly MM patients, frailty is associated with poor tolerance to treatment and poor outcomes.Individualized therapy based on frailty assessment can minimize treatment-related adverse effects and reduce the rate of treatment interruptions, thereby improving the survival in elderly patients.In this review, we aim to provide an overview of the frailty assessment systems for MM patients.We also discuss their clinical applications, issues to be addressed, and future directions for optimizing MM-specific frailty assessment to guide MM treatment in frail elderly patients.

A comparison between endoscopic CO2 laser cauterization and open neck surgery in the treatment of congenital piriform fistula / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the efficacy, advantages and disadvantages of endoscopic CO2 laser cauterization (ECLC) and open neck surgery in the treatment of congenital pyriform sinus fistula (CPSF). Methods: From September 2014 to March 2017, 80 cases with confirmed diagnosis of CPSF received initial treatment at Guangdong Provincial People's Hospital were prospectively analyzed, including 34 males and 46 females, aged 18 to 672 (194.17±141.18) months. They were consecutively divided into endoscopic group and open-surgery group, with 40 cases in each group. Both groups of patients received surgical treatment under general anesthesia. The endoscopic group was treated by endoscopic CO2 laser cauterization, and the open-surgery group underwent the following surgery: first, we performed suspension laryngoscopy examination to confirm the presence of fistula in the bottom of the piriform fossa, then open-neck resection of congenital piriform sinus fistula with recurrent laryngeal nerve and/or lateral branch of superior laryngeal nerve anatomy plus partial thyroidectomy were performed. The data between the two groups were compared, including the operative time, intraoperative blood loss, postoperative pain, average length of stay, neck cosmetic scores, complications and cure rates. All patients were followed up in outpatient clinics. Statistical analysis was performed using SPSS 20.0 software. P<0.05 indicates that the difference is statistically significant. Results: All patients were successfully completed the operation. The operative time, intraoperative blood loss, postoperative pain and average length of hospital stay in the endoscopic group were significantly less than those in the open group [(27.4±5.5) min to (105.8±52.5) min, (0.6±0.5) ml to (33.6±41.5) ml, (1.7±0.9) points to (4.6±0.7) points, (5.9±2.9)d to(8.9±3.3)d, t values were-9.400, -5.031, -16.199, -4.293, P values were all<0.01]; The neck cosmetic score in the endoscopy group was significantly greater than that of the open group [(9.9±0.4) against (5.8±0.9) points, t=25.847, P<0.01]. Compared with the open group (15.0%, 6/40), the complication rate of the endoscopic group (7.5%, 3/40) was not statistically significant (χ²=0.50, P>0.05). Three months after the first treatment, the cure rate in the endoscopic group (82.5%, 33/40) was significantly lower than that in the open-neck group (100.0%, 40/40), χ²=5.64, P<0.05. The follow-up time was 12 months after the last treatment. Eighty cases were followed up and none was lost to follow-up. During the follow-up period, the cure rate of the endoscopy group (97.5%, 39/40) was compared with that of the open group (100.0%, 40/40), and the difference was not statistically significant. Conclusions: In the treatment of CPSF, the two-surgical method each has their advantages. Compared with open-neck surgery, ECLC is simpler, repeatable. ECLC has shorter time in operation and hospital stay, less complications, and less postoperative pain and more precise cosmetic results. It could be preferred for the initial treatment of CPSF and relapsed cases after cauterization. But subject to relatively low cure rate of one-time cauterization and uncertain long-term efficacy, it cannot completely replace the open-neck surgery at present.

MiR-142-3p enhances chemosensitivity of breast cancer cells and inhibits autophagy by targeting HMGB1

MiR-142-3p has been reported to act as a tumor suppressor in breast cancer. However, the regulatory effect of miR-142-3p on drug resistance of breast cancer cells and its underlying mechanism remain unknown. Here, we found that miR-142-3p was significantly downregulated in the doxorubicin (DOX)-resistant MCF-7 cell line (MCF-7/DOX). MiR-142-3p overexpression increased DOX sensitivity and enhanced DOX-induced apoptosis in breast cancer cells. High-mobility group box 1 (HMGB1) is a direct functional target of miR-142-3p in breast cancer cells and miR-142-3p negatively regulated HMGB1 expression. Moreover, overexpression of HMGB1 dramatically reversed the promotion of apoptosis and inhibition of autophagy mediated by miR-142-3p up-regulation. In conclusion, miR-142-3p overexpression may inhibit autophagy and promote the drug sensitivity of breast cancer cells to DOX by targeting HMGB1. The miR-142-3p/HMGB1 axis might be a novel target to regulate the drug resistance of breast cancer patients.

Predictive role of clinical features in patients with coronavirus disease 2019 for severe disease / 中南大学学报(医学版)

OBJECTIVES@#Since the outbreak of coronavirus disease 2019 (COVID-19), it has spread rapidly in China and many other countries. The rapid increase in the number of cases has caused widespread panic among people and has become the main public health problem in the world. Severe patients often have difficult breathing and/or hypoxemia after 1 week of onset. A few critically ill patients may not only rapidly develop into acute respiratory distress syndrome, but also may cause coagulopathy, as well as multiple organs failure (such as heart, liver and kidney) or even death. This article is to analyze the predictive role of clinical features in patients with COVID-19 for severe disease, so as to help doctor monitor the severity-related features, restrain the disease progress, and provide a reference for improvement of medical treatment.@*METHODS@#The clinical data of 208 patients with COVID-19 who were isolated and treated in Changsha Public Health Treatment Center from January 17, 2020 to March 14, 2020 were collected. All patients were the mild and ordinary adult patients on admission, including 105 males and 103 females from 19 to 84 (median age 44) years old. According to the "Program for the diagnosis and treatment of novel coronavirus (COVID-19) infected pneumonia (Trial version 7)" issued by the General Office of National Health Committee and Office of State Administration of Traditional Chinese Medicine as the diagnostic and typing criteria. According to progression from mild to severe disease during hospitalization, the patients were divided into a mild group (=183) and a severe transformation group (=25). The clinical features such as age, underlying disease, blood routine, coagulation function, blood biochemistry, oxygenation index, and so on were analyzed. Among them, laboratory tests included white blood cell (WBC), lymphocytes (LYM), neutrophil (NEU), hemoglobin (Hb), platelet (PLT), prothrombin time (PT), plasma fibrinogen (Fib), activated partial prothrombin time (APTT), thrombin time (TT), -dimer, total bilirubin (TBIL), albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), serum creatinine (Cr), creatine kinase (CK), creatine kinase isoenzyme-MB (CK-MB), lactate dehydrogenase (LDH), C-reactive protein (CRP), and oxygen partial pressure in arterial blood. Partial pressure of oxygen in arterial blood/fractional concentration of inspiratory oxygen (PaO/FiO) was calculated. The variables with statistical significance were analyzed by logistic regression analysis.@*RESULTS@#Patients in the severe transformation group had more combined underlying diseases than those in the mild group (<0.05). From the perspective of disease distribution, patients in the severe transformation group had more combined hypertension (<0.05). In the severe transformation group, PT was significantly longer, the levels of Fib, ALT, AST, CK, LDH, and CRP were significantly higher than those in the mild group (<0.05 or <0.001), while LYM, ALB, and PaO/FiO were significantly lower than those in the mild group (<0.05 or <0.001). Logistic regression analysis was performed on clinical features with statistically significant differences. Combined with hypertension, LYM, PT, Fib, ALB, ALT, AST, CK, LDH, and CRP as independent variables, and having severe disease or not was the dependent variable. The results show that combined hypertension, decreased LYM, longer PT, and increased CK level were independent risk factors that affected the severity of COVID-19 (<0.05).@*CONCLUSIONS@#The patients with mild COVID-19 who are apt to develop severe diseases may be related to combined hypertension, decreased LYM, and longer PT, and increased CK level. For the mild patients with these clinical features, early intervention may effectively prevent the progression to severe diseases.

MiR-142-3p target hmgb1 reverses adriamycin resistance of breast cancer cell mcf-7 / 中国药理学通报

Aim To explore the molecular mechanism of miR-142-3p involved in the regulation of chemosen-sitivity of breast cancer by targeting high-mobility group box 1 ( HMGB1 ). Methods Real-time quantitative PCR ( QPCR) was employed to detect the levels of miR-142-3p in human breast cancer MCF-7 cells and doxorubicin-resistant MCF-7/D0X cells. MIT was used to detect the proliferation of doxorubicin ( DOX)-treated groups. Flow cytometry was applied to detect the apoptotic rate of each group after transfection. Western blot was used to detect the expression of HMGB1 and autophagy-related proteins. Double Lucif-erase Report experiment was carried out to evaluate the targeting effect of miR-142-3p on HMGB1. Results The level of miR-142-3p in MCF-7/D0X cells was sig nificantly down-regulated. Overexpression of miR-142-3p enhanced the sensitivity of breast cancer cells to DOX and increased the apoptotic rate induced by DOX. HMGB1 was the direct functional target of miR-142-3p in breast cancer cells,and the overexpression of HMGB1 could significantly relieve the promotion of ap-optosis and inhibition of autophagy by miR-142-3p uP-regulation. Conclusions The overexpression of miR-142-3p may enhance the chemosensitivity of breast cancer cells to DOX by inhibiting autophagy and targeting HMGB1. miR-142-3p/HMGBl provides a new target for reversing the drug resistance of breast cancer.

Drug resistance genes and homology of Klebsiella pneumoniae in the pediatric intensive care unit of Guiyang area / 中华实用儿科临床杂志

Objective@#To investigate the genetic characteristics of drug resistance and homology of extended-spectrum β-lactamase (ESBLs)-producing Klebsiella pneumoniae (Kpn) in hospitalized children in the pediatric intensive care unit (PICU) in Guiyang area.@*Methods@#The Kpn strains were collected from hospitalized children at 3 PICU from the Affiliated Hospital of Guizhou Medical University, Guizhou Provincial People′s Hospital and Guiyang Children′s Hospital from September 2014 to December 2016.Automatic bacteria identification instrument and Kirby-Bauer method were used to identify Kpn strains and confirm ESBLs phenotype respectively.The drug resistance genes were detected by using polymerase chain reaction (PCR), and their homology was analyzed by means of pulsed field gel electrophoresis (PFGE) and cluster analysis.@*Results@#(1) A total of 207 non-repetitive Kpn strains were isolated, of which 128 strains produced ESBLs (61.8%). There was no significant difference in the ESBLs detection rates among the different hospitals, years and types of samples(χ2=0.40, 5.19, 4.68, all P>0.05). (2) Among those 128 ESBLs-producing Kpn strains, 123 strains (96.1%) were found to have drug-resistant genes, of which the detection rate of SHV type was the highest, accounting for 87.5%.These 3 drug resistance genotypes were distributed in 7 modes, of which 85.2% were carrying more than 2 genotypes.(3) PFGE genotypic assay showed that there were 109 genotypes and 5 dominant clones.The PICU at 3 hospitals were all prevalent with type A strain, accounting for 14.8%.In 2015, there was a short-term outbreak of type A strain in Guiyang Children′s Hospital.While, the resistance phenotypes of Kpn and the genotype of PFGE could both be consistent or different.@*Conclusions@#The ESBLs-producing Kpn at PICU in Guiyang area has the characteristics of multi-drug resistance, its drug-resistant genotypes have diversified, and there is a small-scale short-term outbreak epidemic, which poses a serious threat to clinical anti-infection treatment.It is necessary to strengthen clinical drug resistance monitoring and adopt effective infection control measures to prevent and control the spread of nosocomial infections.

Drug resistance genes and homology of Klebsiella pneumoniae in the pediatric intensive care unit of Guiyang area / 中华实用儿科临床杂志

Objective To investigate the genetic characteristics of drug resistance and homology of extended-spectrum β-lactamase (ESBLs)-producing Klebsiella pneumoniae (Kpn) in hospitalized children in the pediatric intensive care unit (PICU) in Guiyang area.Methods The Kpn strains were collected from hospitalized children at 3 PICU from the Affiliated Hospital of Guizhou Medical University,Guizhou Provincial People's Hospital and Guiyang Children's Hospital from September 2014 to December 2016.Automatic bacteria identification instrument and Kirby-Bauer method were used to identify Kpn strains and confirm ESBLs phenotype respectively.The drug resistance genes were detected by using polymerase chain reaction (PCR),and their homology was analyzed by means of pulsed field gel electrophoresis (PFGE) and cluster analysis.Results (1) A total of 207 non-repetitive Kpn strains were isolated,of which 128 strains produced ESBLs (61.8％).There was no significant difference in the ESBLs detection rates among the different hospitals,years and types of samples (x2 =0.40,5.19,4.68,all P ＞ 0.05).(2) Among those 128 ESBLs-producing Kpn strains,123 strains (96.1％) were found to have drug-resistant genes,of which the detection rate of SHV type was the highest,accounting for 87.5％.These 3 drug resistance genotypes were distributed in 7 modes,of which 85.2％ were carrying more than 2 genotypes.(3) PFGE genotypic assay showed that there were 109 genotypes and 5 dominant clones.The PICU at 3 hospitals were all prevalent with type A strain,accounting for 14.8％.In 2015,there was a short-term outbreak of type A strain in Guiyang Children's Hospital.While,the resistance phenotypes of Kpn and the genotype of PFGE could both be consistent or different.Conclusions The ESBLs-producing Kpn at PICU in Guiyang area has the characteristics of multi-drug resistance,its drug-resistant genotypes have diversified,and there is a small-scale short-term outbreak epidemic,which poses a serious threat to clinical anti-infection treatment.It is necessary to strengthen clinical drug resistance monitoring and adopt effective infection control measures to prevent and control the spread of nosocomial infections.

Relationship between Early Treatment Response and Prognosis in Children with Acute Lymphoblastic Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyze the relationship between the early treatment response and the pregnosis in children with acute lymphoblastic leukemia(ALL).</p><p><b>METHODS</b>Two hundred and Seventy-eight ALL children diagnosed and treated in Hainan general hospital from March 2013 to March 2017 were collected. All ALL children received therapy with CCLg-ALL-2008 regimen. The 3 year event-free survival (EFS) rate of ALL children in different groups was analyzed in terms of 4 indexes including sensitivity response to prednison at day 8 (D8-SRP), bone marrow remission at day 15 (D15-BMR) and at day 33 (D33-BMR), and minimal residual disease at day 33 (D33-BMR), and minimal residual disease at day 33(D33-MRD). These 4 indexes and other indexes possibly affecting the prognosis of ALL children were enrolled in Cox regression model for analysis of independent factors affecting the prognosis of ALL children.</p><p><b>RESULTS</b>The D8-SRP test showed that among 269 ALL children, 240(89.22%) cases displayed prednisone poor response (PPR); the 3-year EFS rate in predrisone good response(PGR) group was significantly higher than that in PPR group(P<0.05). The D15-BMR detection showed that among 262 ALL children, the bone marrow remission(BMR) as M1 was observed in 230 cases (87.79%), M2 in 20 cases (7.63%) and M3 in 9 cases (4.58%); the 3-year EFS rate showed as follows:M1 group >M2 group >M3 group(P<0.05). The D33-BMR detection showed that among 257 ALL children, the BMR as M1 was observed in 227 cases (88.33%), M2 in 21 cses(8.17%) and M3 in 9 caes (3.51%); the 3-year EFS rate in 3 groups showed as follows: M1 group >M2 group >M3 group(P<0.05). The D33-MRD detection showed that among 185 ALL children, MRD<10 was found in 128 cases (69.19%), MRD≥10-10 in 43 cases (23.24%), MRD ≥10 in 14 cases (7.57%); the 3-year EFS rate in 3 groups showed as follows: MRD <10 group > MRD≥ 10-10 group>MRD≥10 group. The Cox regression analysis showed that PPR in D8-SRP test, M2 and M3 in D15 and D33 BMR detection, and MRD≥10 in D33 MRD detection as well as T-ALL typing were independent risk factors affecting the prognosis of ALL children.</p><p><b>CONCLUSION</b>The early treatment response can predict the prognosis of ALL children, which is an independent prognostic factor for ALL children.</p>

The value of diffusion tensor imaging in early diagnosis of chronic allograft nephropathy and monitoring graft fibrosis in rats / 中华放射学杂志

Objective To estimate the value of diffusion tensor imaging (DTI) in early diagnosis of chronic allograft nephropathy (CAN) and monitoring of graft fibrosis in rat models . Methods Thirty CAN rat models were established as experimental group by transplanting Fisher donor kidneys into Lewis recipients. Thirty Lewis rats that received Lewis kidneys served as control group. Serum creatinine (SCr) was monitored regularly every two weeks from 14 days after transplantation. Eight rats were randomly selected by random number table method and underwent DTI examination at 4, 12, 20 weeks after modeling. DTI scans were performed on the renal cortex and medulla to measure apparent diffusion coefficient (ADC) and fractional anisotropy (FA). From the remaining 22 rats in each group, 6 rats were randomly selected and underwent pathological analysis at 4, 12, 20 weeks after modeling. Histological changes in the kidney were evaluated by chronic allograft damage index (CADI) scores. The expression of alpha-smooth muscle actin (α-SMA) and Vimentin were quantitatively measured. The differences in creatinine, DTI parameters, CADI score, α-SMA, Vimentin expression level were analyzed by two independent samples t test in two groups, the differences among CADI score, α-SMA, Vimentin expression level of the experimental group were compared using ANOVA. The correlations among DTI parameters and CADI score, α-SMA and Vimentin expression level were analyzed using Pearson analysis. Results The creatinine in the experimental group increased continuously, and the creatinine in the control group showed no significant increase. The difference in creatinine between the two groups was statistically significant from 8th week after operation (P＜0.01). There was no obvious difference in the size and signal intensity of transplanted kidneys in control group at different time points. Compared with the control group, the graft kidney in the experimental group at the 4 weeks demonstrated increased signal intensity with mild increased volume of kidney, and the boundaries between cortex and medulla were not clear. The cortex and medulla showed gradually increased signal intensity, heterogeneous signal distribution and marginal haziness over time. The ADC and FA value of renal cortex and medulla in experimental group were significantly lower than those in control group at 4, 12, 20 weeks (P＜0.05). The ADC and FA values of the cortex and medulla gradually decreased in the experimental group over time, while the values of the parameters in the control group did not show a significant decrease. The ADC and FA values of the cortex and medulla were negatively correlated with the scores of CADI, and the expression level of α-SMA, Vimentin in the experimental group(r=－0.50 to －0.85, P＜0.01).Conclusion DTI can be an effective technique for early diagnosis of CAN and monitoring of graft fibrosis process.

Uncertainty Evaluation of the Determination of Bilastine in Human Plasma by LC-MS/MS / 中国药师

Objective: To establish a method for the determination of bilastine in human plasma, and evaluate the uncertainty by LC-MS/MS. Methods: The uncertainty sources were obtained from the whole process of the determination including repeatability, e-quipment error, weighting, solution preparation, calibration fitting and plasma sample handling. The uncertainty and synthesized un-certainty of each component were calculated, and then the expanded uncertainty was obtained. Results: The expanded uncertainty for low (15 ng·ml-1), medium (400 ng·ml-1) and high(1 200 ng·ml-1) level of bilastine was 1. 45 ng·ml-1, 28. 72 ng·ml-1 and 74. 61 ng·ml-1, respectively (k=2, P=95% ). Conclusion: The uncertainty in the determination of bilastine in human plasma is mainly caused by equipment error, solution preparation, protein precipitation and calibration fitting (especially at low level).

Clinical anatomic study on the segment and adjacent of tract of congenital pyriform sinus fistula / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the anatomic tract of congenital pyriform sinus fistula (CPSF).@*Methods@#A total of 90 patients with CPSF undergoing open surgery between August, 2007 and March, 2017 at the Department of Guangdong General Hospital were retrospectively analyzed.@*Results@#The tracts of all the fistulas actually walked far different from those of theoretical ones. A whole fistula may be divided into 4 segments according to adjacent anatomy of CPSF. The posterior inner segment to the thyroid cartilage was initial part of the fistula. It originated from the apex of pyriform sinus, then piercing out of the inferior constrictor of pharynx inferiorly near the inferior cornu of the thyroid cartilage (ICTC), and descended between the lateral branch of the superior laryngeal nerve and the recurrent laryngeal nerve. The ICTC segment was the second part of the fistula, firstly piercing out of the inferior constrictor of pharynx and/or cricothyroid muscle, and then entering into the upper pole of thyroid. The relationship between fistula and ICTC could be divided into three types: type A (medial inferior to ICTC) accounting for 42.2% (38/90); type B (penetrate ICTC) for 3.3% (3/90); and type C (lateral inferior to ICTC) for 54.5% (49/90). The internal segment in thyroid gland was the third part of fistula, walking into the thyroid gland and terminating at its upper pole (92.2%, 83/90) or deep cervical fascia near the upper pole of thyroid (7.8%, 7/90). The lateral inferior segment to thyroid gland was the last part of the fisula, most of which are iatrogenic pseudo fistula, and started from the lateral margin of thyroid gland.@*Conclusions@#CPSF has a complicated pathway. Recognition of the tract and adjacent anatomy of CPSF will facilitate the dissection and resection of CPSF in open surgery.

Effects of different intervention time of percutaneous transhepatic gallbladder catheterizing drainage on severe acute biliary pancreatitis / 实用医学杂志

Objective To study the effects of different intervention time of percutaneous transhepatic gallbladder catheterizing drainage (PTGBD)on severe acute biliary pancreatitis Methods Totally 64 patients with severe acute biliary pancreatitis in Affiliated Hospital of Hebei University from July 2013 to July 2017were selected and divided into 3 groups according to the time from attack to PTGBD:group A (less than 72 hours,n =28),group B (from 72 hours to 120 hours,n =22),group C (from 120 hours to 148 hours,n =14).Intergroup comparison of level of WBC,CRP,TBIL,PLT and APACHE-Ⅱ Score,disappearance time of abdominal sign,incidence of pancreatic abscess,length of stay (LOS),mortality and patient satisfaction 48 hours before and after PTGBD were conducted.Results Compared with those in group B and C,all laboratory indexes,APACHE-ⅡScore,disappearance time of abdominal sign,incidence of pancreatic abscess,LOS,mortality and patient satisfaction in group A were all significantly different (P ＜ 0.05).Conclusion Early PTGBD (within 72 hours)can be effective and safe for the treatment of severe acute biliary pancreatitis,and can shorten LOS and reduce the mortality.

Study on the change of retinal thickness and choroidal thickness and correlative factors for macular edema after Ranibizumab injection / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the change of retinal thickness and choroidal thickness in patients with diabetic macular edema or retinal vein occlusion- macular edema after intravitreal Ranibizumab injection using spectral domain-optical coherence tomography(SD-OCT),and to identify determinants for the change of different types of macular edema. METHODS: Patients were recruited from March 2016 to July 2017 diagnosed with diabetic macular edema or retinal vein occlusion - macular edema. Subfoveal choroidal thickness (SFCT) and central retinal thickness (CRT) of all eyes were measured by SD - OCT preoperatively and at 1, 3, 6mo after operation. The change of retinal thickness and choroidal thickness after intravitreal ranibizumab injection for macular edema caused by different diseases were evaluated. Moreover, the potential determinants were studied about the change of retinal thickness and choroidal thickness. RESULTS: Thirty-six eyes of 36 patents with macular edema were treated with intravitreal ranibizumab injection. After the intravitreal ranibizumab injection, the CRT and SFCT decreased, when compared with the CRT and SFCT preoperative. There was a significant difference in the change of CRT and SFCT in different time points of following-up (FCRT=40.876, PCRT<0.001; FSFCT=46.319, PSFCT< 0. 001). In diabetic macular edema group, the change of SFCT was associated with the preoperative SFCT, and the change of CRT was correlated with preoperative CRT and the fast blood glucose level. In retinal vein occlusion-macular edema group, the change of SFCT was associated with the preoperative SFCT, the change of CRT was associated with preoperative CRT,the obstructive positions and the onset time of disease. CONCLUSION: Reduction of choroidal thickness and retinal thickness in macular edema caused by different diseases can be detected with SD-OCT after intravitreal injections of ranibizumab. The reduction of choroidal thickness was correlated with the preoperative choroidal thickness. In diabetic macular edema eyes, the reduction of retinal thickness was correlated with preoperative CRT and the fast blood glucose level. Whereas,in retinal vein occlusion-macular edema eyes, the reduction of retinal thickness was correlated with the preoperative CRT, the obstructive positions and the onset time.

Application of lower abdominal incision surgery two analysis of ampicillin sodium in preoperative and postoperative infection rate and discuss the corresponding intervention measures / 中国生化药物杂志

Objective The infection rate and the corresponding intervention measures of postoperative application of ampicillin sodium to reduce abdominal incision after operation. Methods The control group in the conventional antibiotic administration based on preoperative, postoperative combined with ampicillin sodium; research group in the control group based on the use of the corresponding operation room intervention measures. Results The incidence of incision infection in study group (18.18%) was significantly lower than the control group (4.55%)(P<0.05); the control group SDS, SAS scores did not change significantly than before , SDS of the study group, SAS scale score was significantly lower than before (P<0.05). Conclusion Application of ampicillin sodium combined with the corresponding intervention measures can significantly reduce abdominal incision surgery in two postoperative infection rate and is conducive to protect the quality of life of patients, life safety.

Relationship between Work Ⅱ type of congenital first branchial cleft anomaly and facial nerve and surgical strategies / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the relationship between Work Ⅱ type of congenital first branchial cleft anomaly (CFBCA) and facial nerve and discuss surgical strategies.@*Methods@#Retrospective analysis of 37 patients with CFBCA who were treated from May 2005 to September 2016. Among 37 cases with CFBCA, 12 males and 25 females; 24 in the left and 13 in the right; the age at diagnosis was from 1 to 76 ( years, with a median age of 20, 24 cases with age of 18 years or less and 13 with age more than 18 years; duration of disease ranged from 1 to 10 years (median of 6 years); 4 cases were recurren after fistula resection. According to the classification of Olsen, all 37 cases were non-cyst (sinus or fistula). External fistula located over the mandibular angle in 28 (75.7%) cases and below the angle in 9 (24.3%) cases.@*Results@#Surgeries were performed successfully in all the 37 cases. It was found that lesions located at anterior of the facial nerve in 13 (35.1%) cases, coursed between the branches in 3 cases (8.1%), and lied in the deep of the facial nerve in 21 (56.8%) cases. CFBCA in female with external fistula below mandibular angle and membranous band was more likely to lie deep of the facial nerve than in male with external fistula over the mandibular angle but without myringeal web.@*Conclusions@#CFBCA in female patients with a external fistula located below the mandibular angle, non-cyst of Olsen or a myringeal web is more likely to lie deep of the facial nerve. Surgeons should particularly take care of the protection of facial nerve in these patients, if necessary, facial nerve monitoring technology can be used during surgery to complete resection of lesions.

Value of modified Killian′s method in diagnosis of congenital pyriform sinus fistula / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the feasibility and significance of modified Killian(MK) method in the clinical diagnosis of congenital pyriform sinus fistula(CPSF) by electronic laryngoscopy.@*Methods@#The following examinations were performed for 30 suspected cases of CPSF, including the traditional electronic laryngoscopy, MK examination(modified Killian position+ head rotation+ the Valsalva maneuver), barium swallow X-ray(BSX) and CT , and a prospective comparison among them were done. Patients were divided into two groups according to their age: young age group(≤14 years old) and older age group (>14 years old). The results of MK examination from the patients were analyzed and the positive diagnostic rates (PDR) between groups were compared by using χ2 tests.@*Results@#Sinuses in 20 of 30 patients were depicted from pyriform sinus in BSX, and the PDR was 66.7%(20/30). The PRD of CT was 83.3%(25/30). The presence of air bubbles around the upper lobe of the thyroid gland or at the inferomedial edge of cricothyroid joints, morphological changes of thyroid grand as well as pseudo-fistula formation on lower neck were detected clearly on CT. Comparing to the traditional electronic laryngoscopy, the effect of exposing piriform fossa fistula by MK examination is significant(χ2=17.05, P<0.05), with the PDR of 13.3%(4/30) and 76.7%(23/30) respectively. Nevertheless, comparing to BSX and CT, there were no statistically significant differences in the effect to diagnose CPSF (χ2=0.31, χ2=0.10 respectively, P>0.05). The PDR of MK in older group is significantly higher than younger group(χ2=6.68, P<0.05).@*Conclusions@#MK examination can clearly reveal the hypopharyngeal anatomical structure and detect the sinus of CPSF .It could be a safe, feasible, convenient and economical method as an application in preoperative diagnosis and follow-up examination of clinical suspected CPSF.

Integration of multiple disciplines on primary breast bidirectional synovial sarcoma / 中国肿瘤临床

Objective:To explore the diagnosis and treatment process of integrated multiple disciplines on primary bidirectional synovi-al sarcoma in breasts. Methods:A patient with breast sarcoma was diagnosed and treated with body satisfaction scale (BSS) on May 2017 in the Department of Breast Surgery of Guizhou Provincial People's Hospital. Procedures were fully discussed. The patient was prepared for the surgery and was successfully treated by palliative resection (in the right breast tumor) and partial pectoralis major muscle resection and reconstruction (in the chest wall flap). Results:Patient's condition and quality of life significantly improved. Ex-tended treatment was provided for continuous survival. Conclusion:Prognosis of primary bidirectional synovial sarcoma of the breasts can be improved by early diagnosis and treatment. Patient's willingness of medical consultation could affect the ontcome.

Correlation between nicotine dependence and brain changes:a voxel-based morphometry study / 实用放射学杂志

Objective To study the pattern of cerebral gray matter and white matter volume changes among smokers with differ-ent level of nicotine dependence (addition)using voxel-based morphometry (VBM).Methods The current case-control study recrui-ted 53 healthy male smokers and 53 healthy non-smokers from outpatients of our hospital during January 2013 to May 2014.Personal information (including for example age,sex and addition dependence of subjects)was collected using a questionnaire.3D-T1 images of whole brain structure were collected and were analyzed using DARTEL toolbox of SPM8.Smokers were divided into mild to mod-erate nicotine dependence group (n=23)and severe nicotine dependence group (n=30)based on Fagerstr?m Test for Nicotine De-pendence (FTND)score.Independent sample t-test analyses were performed to compare the volumes of gray matter and white mat-ter between smokers with different levels of nicotine dependence and non-smokers.Results Compared with non-smokers,gray and white matter volumes of smokers were smaller in multiple brain areas,mainly in the middle occipital gyrus,posterior cingulate,cer-ebellum anterior lobe,precuneus,caudate body and insula,which however,had larger number and scope of focal areas with gray and white matter atrophy in the mild to moderate nicotine dependence group than that in the severe nicotine dependence group.Conclusion Smokers with mild to moderate nicotine dependence have more pronounced gray and white matter atrophy than that smokers with severe nicotine dependence have.