Pre-operative prognostic nutritional index as a predictive factor for prognosis in non-metastatic renal cell carcinoma treated with surgery / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the implications of the prognostic nutrition index (PNI) in non-metastatic renal cell carcinoma (RCC) patients treated with surgery and to compare it with other hematological biomarkers, including neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and systemic immune inflammation index (SII).@*METHODS@#A cohort of 328 non-metastatic RCC patients who received surgical treatment between 2010 and 2012 at Peking University First Hospital was analyzed retrospectively. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff values of the hematological biomarkers. The Youden index was maximum for PNI was value of 47.3. So we divided the patients into two groups (PNI≤ 47. 3 and >47. 3) for further analysis. Categorical variables [age, gender, body mass index (BMI), surgery type, histological subtype, necrosis, pathological T stage and tumor grade] were compared using the Chi-square test and Student' s t test. The association of the biomarkers with overall survival (OS) and disease-free survival (DFS) was analyzed using Kaplan-Meier methods with log-rank test, followed by multivariate Cox proportional hazards model.@*RESULTS@#According to the maximum Youden index of ROC curve, the best cut-off value of PNI is 47. 3. Low level of PNI was significantly associated with older age, lower BMI and higher tumor pathological T stage (P < 0.05). Kaplan-Meier univariate analysis showed that lower PNI was significantly correlated with poor OS and DFS (P < 0.05). In addition, older age, lower BMI, tumor necrosis, higher tumor pathological T stage and Fuhrman grade were significantly correlated with poor OS (P < 0.05). Cox multivariate analysis showed that among the four hematological indexes, only PNI was an independent factor significantly associated with OS, whether as a continuous variable (HR=0.9, 95%CI=0.828-0.978, P=0.013) or a classified variable (HR=2.397, 95%CI=1.061-5.418, P=0.036).@*CONCLUSION@#Low PNI was a significant predictor for advanced pathological T stage, decreased OS, or DFS in non-metastatic RCC patients treated with surgery. In addition, PNI was superior to the other hematological biomar-kers as a useful tool for predicting prognosis of RCC in our study. It should be externally validated in future research before the PNI can be used widely as a predictor of RCC patients undergoing nephrectomy.

Analysis on off-label use of drugs in pediatric guidelines and consensus published by Chinese authors / 中华儿科杂志

Objective: To understand the current situation regarding pediatric off-label use of drugs recommendations in Chinese clinical practice guidelines and to make recommendations for standardized reporting format regarding off-label use of drugs for children. Methods: This cross-sectional study was carried out by systematically searching the databases for Chinese guideline consensus articles published in journals between 2018 and 2020 and extracting recommendations regarding off-label use of drugs from those articles. The essential characteristics of the included guidelines, the ranking of off-label drug types, the order of drug information, the type of off-label drug use, and the percentage of citation studies on which the recommendations were based were analyzed. Results: Among 108 studies that included Chinese off-label guidelines and consensus, 364 recommendations on pediatric off-label use of drugs were included. The Chinese Medical Association published the most, 48 out of the 108 studies (44.4%), and of those 14 studies (13.0%) were on infectious and parasitic diseases. Of the 364 recommendations on off-label use of drugs, the most commonly addressed drugs were 16 recommendations (4.4%) for cyclosporine A, 11 recommendations (3.0%) for methotrexate , and 11 recommendations (3.0%) for fentanyl. The most commonly addressed drug categories were as follows: 68 recommendations (18.6%) were immune system drugs, 66 recommendations (18.1%) were anti-infectives, and 56 recommendations (15.4%) were oncology drugs. The most commonly addressed drug information accounts were as follows: 364 recommendations (100.0%) were indications, 204 recommendations (56.0%) were dosages, and 198 recommendations (54.4%) were the route of administration. Based on the instructions approved by the Chinese Food and Drug Administration, the main forms of the off-label drug were as follows: 175 recommendations (48.1%) were unapproved indications, 127 recommendations (34.9%) were unapproved populations, and 72 recommendations (19.8%) were unapproved ages. Only 129 recommendations (35.4%) were cited, mainly including clinical guidelines (48 studies, 23.4%), reviews (22 studies, 10.7%), and pediatric randomized controlled trials (22 studies, 10.7%). Conclusions: Off-label use of drugs is commonly recommended in pediatric guidelines and consensus documents written by Chinese authors. However, the reporting of the recommendations varies widely, and the quality of the supporting evidence is poor.

Clinical efficacy of Nd:YAG laser adjunct to subgingival scaling and root planning for treating severe chronic periodontitis / 西安交通大学学报(医学版)

【Objective】 To evaluate the efficacy of Nd: YAG laser therapy adjunct to subgingival scaling and root planning (SRP) for treating severe chronic periodontitis. 【Methods】 We selected patients with severe chronic periodontitis whose teeth were distributed in 4 quadrants of the mouth, with probing depth (PD) of 5-8 mm, attachment loss (AL)≥5 mm and bleeding on probing (BOP). These teeth were randomly divided into three groups: SRP group, SRP+L group (Nd: YAG laser after SRP treatment), and L+SRP group (SRP after Nd: YAG laser treatment). We recorded parameters including BOP, PD and AL of the three groups at baseline and 8 weeks after treatment and made statistical analysis. 【Results】 At 8 weeks after treatment, BOP, PD and AL of the three groups were improved than those in the baseline (P<0.05). BOP positive percentage of SRP+L group and L+SRP group significantly reduced compared with SRP group (P<0.05). PD of SRP+L group significantly decreased compared with SRP group and L+SRP group (P<0.05), for sites with PD=7 mm, SRP+L group was significantly decreased compared with SRP and L+SRP groups (P<0.05). AL of SRP group significantly decreased compared with SRP+L group and L+SRP group (P<0.05). 【Conclusion】 Severe periodontal treatment with Nd:YAG laser adjunct to SRP is more effective in reducing BOP and PD, and for deeper pockets PD is significantly decreased in SRP+L group, but there is no advantage in the improvement of AL.

The clinical significance of serum 25-hydroxy vitamin D and vitamin D binding protein in premature infants with bronchopulmonary dysplasia / 中国新生儿科杂志

Objective To study the relationship of serum 25-hydroxy vitamin D [25-(OH) D] and vitamin D binding protein (DBP) in premature infants with bronchopulmonary dysplasia (BPD) and their clinical significance.Method From March 2017 to September 2018,the premature infants with gestational age (GA)＜32 weeks admitted to the neonatal department of our hospital were prospectively studied.All the premature infants were given 800 IU/d vitamin D supplement from one week after birth.Venous blood sample were collected at birth and 28 d after birth to measure 25-(OH) D aud DBP levels.The infants were evaluated for BPD at 28 d after birth and then assigned into the BPD group and the non-BPD group.The differences of 25-(OH) D and DBP levels were compared.Result A total of 170 premature infants (GA＜32 weeks) were included,including 56 cases in the BPD group and 114 cases in the non-BPD group.The BPD group had 34 males,the GA was (29.8±1.2) weeks,the birth weight (BW) was (1 198± 157) g.The non-BPD group had 95 males,the GA was (30.2± 1.5) weeks,the BW was (1 243± 146) g.No significant differences existed in GA,BW and male gender proportion between BPD group and non-BPD group (P＞0.05).The BPD group had a lower levels of serum 25-(OH) D at birth [(27.8±5.9) nmol/L vs.(30.4±1.1) nmol/L,P＜0.05].The levels of serum 25-(OH) D in moderate/severe BPD group were significantly lower than mild BPD group [(25.3±4.9) nmol/L vs.(29.7±5.9) nmol/L,P＜0.05];25-(OH) D in BPD group was still lower than the non-BPD group at 28 days after birth (after vitamin D supplement) [(77.5±11.7) nmol/L vs.(83.8±11.6) nmol/L,P＜0.05].Comparison of serum DBP levels between the two groups showed that,DBP at 28 d after birth in BPD group were significantly lower than the non-BPD group,and DBP in moderate/severe BPD group were significantly lower than the mild BPD group [(373.9± 19.1) μg/ml vs.(391.4±23.6) μg/ml],the differences were both statistically significant (P＜0.05).Multivariate analysis showed that the high serum 25-(OH)D level at birth (OR=0.827,95％CI0.693～0.987) was protective factors for BPD,while neonatal pneumonia (OR=4.331,95％CI 1.269～14.784) and neonatal sepsis (OR=4.020,95％CI 1.153～14.015) were risk factors for BPD.Conclusion The high serum 25-(OH) D level at birth in preterm infants was protective factors for BPD,while neonatal pneumonia and sepsis were the risk factors for BPD.Moreover,low serum 25-(OH) D level at birth and low serum DBP level at 28 d after birth maybe useful indicators for the severity of BPD.

Efficacy and Influencing Factors of Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: Retrospective Analysis / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyze the clinical efficacy and possible influencing factors of autologous hematopoietic Stem cell transplantation (auto-HSCT) in the treatment of patients with multiple myeloma (MM).</p><p><b>METHODS</b>Clinical data of 40 MM patients received auto-HSCT in the Department of Hematology of Henan Cancer Hospital from September 2010 to November 2017 were retrospectively analyzed, the clinical curative efficiency was summarized and the related factors were analyzed.</p><p><b>RESULTS</b>The curative efficiency of the patients before transplantation was 9(22.5%) with complete remission(CR), 5(12.5%) with very good partial remission(VGPR), 26(65%) with partial remission(PR), respectively, one of them was PR after 3 recurrences. The curative efficiency after transplantation was 22(55%) with complete remission(CR), 12(30%) with very good partial remission(VGPR), 6(15%) with partial remission(PR), respectively. And 2 cases were CR after double transplantation. Median follow-up time was 28.4 (3.1 to 88) months,15 cases presented disease progression, 7 cases were dead, 3-year estimated progression-free survival(PFS) and overall survival(OS) rate were 45.1% and 82% respectively. Unvariate analysis showed that the OS was affected by ISS stage (P<0.05), CR and VGPR (P<0.05) after transplantation; PFS was affected by ISS stage (P<0.01), before transplantation induction therapy (27 cases with bortezomizomi or thalidomide) (P<0.05), disease risk stratification (6 cases in high risk group) (P<0.05) , CR and VGPR (P<0.05) before transplantation, CR and VGPR (P<0.01) after transplantation. Cox multivariate regression analysis showed that the independent prognostic factors for OS were ISS stage, CR and VGPR after transplantation; the independent prognostic factors for PFS were the CR, VGPR, ISS stage after transplantation and induction therapy before transplant.</p><p><b>CONCLUSION</b>Auto-HSCT can improve the clinical efficacy and survival rate of MM patients; ISS stage, CR and VGPR after transplantation are independent prognostic factors for OS and PFS, and induction therapy before transplantation is also an independent prognostic factor for PFS.</p>

The Institute of Urology, Peking University prostatectomy score: a simple preoperative classification of prostate cancer for predicting surgical difficulty and risk / 亚洲男科学杂志(英文版)

Traditional laparoscopic radical prostatectomy is a treatment choice in many developing countries and regions for most patients with localized prostate cancer; however, no system for predicting surgical difficulty and risk has been established. This study aimed to propose a simple and standard preoperative classification system of prostate cancer using preoperative data to predict surgical difficulty and risk and to evaluate the relationship between the data and postoperative complications. We collected data from 236 patients and divided them into three groups to evaluate and validate the relationships among preoperative, operative, and postoperative data. This new scoring system is based on the body mass index, ultrasonic prostate volume, preoperative prostate-specific antigen level, middle lobe protrusion, and clinical stage. In the scoring group, we classified 89 patients into two groups: the low-risk group (score of <4) and high-risk group (score of ≥4), and then compared the postoperative data between the two groups. The positive surgical margin rate was higher in the high-risk group than low-risk group. The results in validation Groups A and B were similar to those in the scoring group. The focus of our scoring system is to allow for preliminary assessment of surgical difficulty by collecting the patients' basic information. Urologists can easily use the scoring system to evaluate the surgical difficulty and predict the risks of a positive surgical margin and urinary incontinence in patients undergoing laparoscopic radical prostatectomy.

The Institute of Urology, Peking University prostatectomy score: A simple preoperative classification of prostate cancer for predicting surgical difficulty and risk / 亚洲男科学杂志(英文版)

Traditional laparoscopic radical prostatectomy is a treatment choice in many developing countries and regions for most patients with localized prostate cancer; however, no system for predicting surgical difficulty and risk has been established. This study aimed to propose a simple and standard preoperative classification system of prostate cancer using preoperative data to predict surgical difficulty and risk and to evaluate the relationship between the data and postoperative complications. We collected data from 236 patients and divided them into three groups to evaluate and validate the relationships among preoperative, operative, and postoperative data. This new scoring system is based on the body mass index, ultrasonic prostate volume, preoperative prostate-specific antigen level, middle lobe protrusion, and clinical stage. In the scoring group, we classified 89 patients into two groups: the low-risk group (score of <4) and high-risk group (score of ≥4), and then compared the postoperative data between the two groups. The positive surgical margin rate was higher in the high-risk group than low-risk group. The results in validation Groups A and B were similar to those in the scoring group. The focus of our scoring system is to allow for preliminary assessment of surgical difficulty by collecting the patients' basic information. Urologists can easily use the scoring system to evaluate the surgical difficulty and predict the risks of a positive surgical margin and urinary incontinence in patients undergoing laparoscopic radical prostatectomy.

Effect of IL-8 on the Immune Function of Patients with Acute -Lymphoblastic Leukemia and Its Mechanism / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of interleukin -8 (IL-8) on immune function in acute lymphoblastic leukemia patients and its related mechanisms.@*METHODS@#Forty-five ALL patients were selected from January 2014 to September 2017 in our hospital. Out of them, 32 relieved patients were included in group A, 13 patients did not relieved patients after treatment and were included in the group B. The serum IL-8 level was detected by ELISA.Th1 and Th2 cells were measured by flow cytometry. After Th cells were treated with different concentration of IL-8, the Western blot was used to detect the translation levels of p-STAT3 and JAK in cells.@*RESULTS@#The difference of white blood cell count and clinical risk level between the 2 groups was statistically significant (P0.05).@*CONCLUSION@#IL-8 can interfere the balance of Th1/Th2 through STAT3 signaling pathway, and has effect on the immune function of ALL patients.

Effect of exogenous hydrogen sulfide on iNOS/NO in neonatal rats with hyperoxia lung injury / 中国新生儿科杂志

Objective To study the effect of hydrogen sulfide (H2S) on iNOS/NO in neonatal rats with hyperoxia-induced lung injury.Method Eighty full-term neonatal SD rats were randomly assigned into 4 groups (each group 20 rats including control group,hyperoxia group,NaHS + hyperoxia group,PPG + hyperoxia group.Rats in NaHS + hyperoxia group had 90 μmol/kg NaHS injected intraperitoneally,those in PPG + hyperoxia group had PPG 50 mg/kg injected,and those in the other 2 groups had the same amount of 0.9％ normal saline injected.Except for the control group that exposed to air,the other three groups were exposed to 95％ O2 for 7 days.Then pulmonary histopathology was studied by HE staining,the ratios of lung wet/dry weight (W/D) were determined as measurement of the severity of pulmonary edema,maleic dialdehyde (MDA),iNOS activity and NO levels in lung tissue were measured using commercial kits,iNOS mRNA expression was detected by Real-time PCR.Analysis of variance and LSD-t test were used for statistical analysis.Result (1) Compared with control group,the hyperoxia group showed erythrocyte extravasation and leukocyte infiltration in the alveoli with inflammatary cell infiltrations,alveolar septum edema,whereas pathological injury changes induced by hyperoxia were alleviated by NaHS and the damage was exacerbated by PPG.(2) In hyperoxia group,H2S was decreased compared with control group (117.6±20.4 μmol/L vs.184.3 ± 13.7 μmol/L).In NaHS + hyperoxia group,H2S was apparently increased compared with the hyperoxia group (247.3 ±32.4 μmol/L vs.117.6 ±20.4 μmol/L),while in PPG + hyperoxia group H2S was decreased compared with the hyperoxia group (89.2 ± 8.3 μmol/L vs.117.6 ±20.4 μmol/L) (P ＜0.01).(3) In the hyperoxia group,the ratios of lung W/D (5.81 ±0.22),the contents of MDA (1.69 ± 0.14) nmol/ml,iNOS activity (2.24 ± 0.19) U/mg prot,NO levels (22.37 ±3.04) × 10-3 μmol/g prot,iNOS mRNA expression (1.43 ±0.09) showed significant increase respectively (P ＜ 0.01) compared with the control group (5.06 ± 0.15),(0.78 ± 0.08)nmol/ml,(1.18 ± 0.18) U/mg prot,(7.49 ± 1.91) × 10-3 μmol/g prot,(0.90 ± 0.08).NaHS administration showed a significant decrease in lung W/D,lung tissue MDA content,iNOS activity,NO level,iNO SmRNA expression (5.59 ±0.19),(1.44±0.11) nmol/ml,(1.84 ±0.27) U/mg prot,(14.23 ±2.00)× 10-3 μmol/g prot,(1.28 ±0.10) compared with the hyperoxia group (P ＜0.01).The above markers were significantly increased after PPG administration (6.18 ± 0.26),(1.99 ± 0.19) nmol/ml,(2.66 ± 0.23) U/mgprot,(30.94 ±3.31) × 10-3 μmol/g prot,(1.73 ±0.06) (P ＜0.01).Conclusion Exogenous H2S can relieve hyperoxia-induced lung injury by down-regulating the expression of iNOS mRNA,decreasing iNOS activity and decreasing NO production.

Establishment of an animal model of blunt scrotal trauma and evaluation of the lesion by conventional and contrast-enhanced ultrasonography / 中华男科学杂志

<p><b>OBJECTIVE</b>To establish an animal model of acute blunt scrotal trauma (BST) and evaluate the types of lesion by conventional ultrasonography (CUS) and contrast-enhanced ultrasonography (CEUS).</p><p><b>METHODS</b>We made acute BST models in 21 healthy male New Zealand rabbits by striking 3 - 12 times the unilateral testes randomly selected with a 0. 5 kg iron ball falling freely from a 30 cm height. Then we evaluated the lesion types in the models by CUS and CEUS and verified our evaluation against pathological results.</p><p><b>RESULTS</b>Acute BST models were successfully established in all the 21 animals, including contusion in 10, hematoma in 6, and rupture in 5, all confirmed by pathology. CUS clearly manifested the morphology, internal echoes, and blood flow of the testes, but had a low rate of accurate diagnosis in testicular contusion for over 6 hours as well as in complex lesions. CEUS revealed an earlier perfusion of the contrast agent and shorter arriving time (AT) and time to peak intensity ( TP) in testicular contusion than in the control testes (P <0.05) , but showed no statistically significant difference between the two groups in the half time of descending peak intensity (P>0.05). For testicular hematoma, contrast agent clearly presented its outline and a delayed low enhancement in the surrounding tissue, with significant differences from the control in AT and TTP. In severe testis rupture, occasional outflow but no perfusion of contrast agent was observed.</p><p><b>CONCLUSION</b>BST models can be established in rabbits by repeated strikes of the unilateral testes lesion of contrast agent was observed. with a freely falling iron ball. Simple contusion injury can be induced by less than 6 strikes, while complex injuries can be inflicted by more than 10. Combined application of CUS and CEUS can improve the accuracy of diagnosis of different types of lesion.</p>

Blood pressure levels and prognosis of intracranial trauma patients with cognitive dysfunction

To evaluate the effects of blood pressure levels on prognosis of intracranial trauma patients with cognitive dysfunction. One hundred and twenty intracranial trauma patients enrolled in our hospital from February 2011 to July 2013 were selected, including 40 hypertension and 80 non-hypertension cases. They were investigated by MiniMental State Examination [MMSE] and Montreal Cognitive Assessment [MoCA] scales, and the clinical data were retrospectively analyzed. Compared with the control group, the MoCA, visuospatial executive function, attention, language, delayed recall, MMSE, orientation and memory scores of the hypertension group were significantly lower. Unconditional Logistic regression analysis showed that age, history of cerebrovascular disease and triglyceride level were the independent risk factors of cognitive function. The blood pressure levels of intracranial trauma patients were associated with cognitive function, with age, history of cerebrovascular disease and triglyceride level as the independent risk factors. Therefore, it is necessary to control blood pressure level to improve prognosis

The evaluation of left ventricular strain using speckle tracking echocardiography in normal young adults：comparison of three-dimensional and two-dimensional approaches / 中华医学超声杂志（电子版）

Objective To investigate the value of three-dimensional speckle tracking imaging (3D-STI) in assessment of left ventricular (LV) strains. Methods Thirty healthy young adults examined by two-dimensional speckle tracking imaging (2D-STI) and 3D-STI. And the results of LV measurements were compared, which included mean peak systolic longitudinal strains, radial strains and circumferential strains. Also, the time consumption of these two methods was compared. Results The time needed for 3D-STI in acquisition and analysis of the images were (309.3±23.4)s, (305.5±11.2)s, while the time for 2D-STI were (490.6±14.4)s, (1261.4±39.9)s. The differences were signiifcant(t=-21.81, 69.94, both P<0.01). The global mean peak systolic radial strains was (48.59±7.68)%by 3D-STI and (33.25±7.27)%by 2D-STI. The difference was signiifcant(t=9.16, P<0.01). The global mean peak systolic longitudinal and circumferential strains were (-17.66±3.14)%, (-17.13±2.29)% by 3D-STI and (-21.35±2.46)%, (-21.97±3.84)% by 2D-STI. The differences were signiifcant(t=5.33, 5.99, both P < 0.01). The 3D-STI strains were different at different levels of LV. The longitudinal, circumferential and radial 3D-STI strains were largest at middle levels. However, 2D-STI strains didn′ t show such trend. Peak strains measured by 3D-STI and 2D-STI showed high inter-observer and intra-observer agreement in Bland-Altman chart. Conclusion 3D-STI is a novel, convenient and reproducible method to evaluate the strains of LV.

Contrast-enhanced ultrasonography for detecting testicular perfusion in acute testis contusion in rabbits / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate contrast-enhanced ultrasonography (CEUS) in detecting testicular perfusion in acute testis contusion.</p><p><b>METHODS</b>We established the model of testis contusion in 11 healthy male New Zealand rabbits by randomly hitting one side of the scrotum under general anesthesia. We examined the bilateral scrotums of all the animals before, immediately after and at 2, 4 and 6 hours after modeling by color Doppler flow imaging (CDFI) and CEUS, and analyzed the time-intensity curve (TIC), arriving time (AT), time to peak intensity (TTP), peak intensity (PI), half time of descending peak intensity (HT) and area under the curve (AUC) in the healthy and injured testis, respectively.</p><p><b>RESULTS</b>CEUS exhibited a higher sensitivity in detecting tissue perfusion than CDFI. The mode of contrast agent perfusion in testicular contusion was fast in and slow out. There were no evident differences between the contused and the healthy testis in AT, TTP and PI before modeling. The contused testis showed significantly earlier AT and TTP, higher PI and larger AUC (P < 0.05) than the healthy one at different time points after modeling, but no statistically significant difference was found in HT (P > 0.05).</p><p><b>CONCLUSION</b>Accurate parameters of testicular perfusion in acute testis contusion can be quantitatively obtained by CEUS, which are of important value for the diagnosis of testis contusion.</p>

Research of the safety of multi-slice computer tomography angiography as the evaluative criteria before aneurismal microsurgical clipping / 中华急诊医学杂志

Objective To evaluate if MS-CTA can be the primary and sole evaluative criteria for the treatment of intracranial aneurysms by microsurgery clipping. Methods Between January 2008 and October 2010, 105 patients with intracranial aneurysm underwent microsurgery clipping in our institution were respectively analyzed, out of which 39 patients with preoperative MS-CTA (64- or 320-slice CT scanner) examinations (MS-CTA group) , 21 with MS-CTA combined with DSA and 45 with DSA ( DSA group). The aneurismal size, neck, morphous and peripheral branches were compared between the CTA data and operative results, and the concordance between which were analyzed. The rate of operative complication and the GOS scale at discharge were also compared between MS-CTA group and DSA group. t test, Chi-Square test or Rank test were used for analysis of the patients' baseline data, Kappa test for the concordance between MS-CTA and operative results, Kruskal-Wallis test for operative complication and Mann-whitney test for the GOS at discharge between MS-CTA group and DSA group. Results Thirty-seven patients out of the MS -CTA group obtained successful microsurgery clipping, with 1 transferred to coil embolization because of the difficulty in exposing the aneurismal neck and 1 to decompressive craniectomy because of aneurismal rebleeding at removal cranium. There was a good concordance between MS-CTA and operative results on depicting aneurysmal size and neck ( κ =0.726 ,κ =0. 756) and a ordinary concordance on morphous and peripheral branches ( κ =0.524, κ =0.473). There was no significant difference on the rate of operative complication (P =0.509) and GOS scale (P =0.239) at discharge. Conclusions MS-CTA can reveal the important characteristics of intracranial aneurysms, and has a high safety as being the primary and sole criteria before microsurgery clipping.

Treatment of septic shock in children with low dose pituitrin: report of 24 cases / 中华儿科杂志

<p><b>OBJECTIVE</b>To explore the clinical effect of low dose pituitrin in children with septic shock.</p><p><b>METHODS</b>A total of 48 pediatric cases with septic shock, in whom 6 hours, conventional treatment could not reverse shock from January 2008 to December 2010, were selected for this study. The patients were divided into two groups randomly (completely random design) (control group 24, remedial group 24). The conventional treatment included antibiotics/fluid resuscitation/correcting acid-base imbalance, glucocorticoid, organ (heart/lung) support, dopamine 1 - 15 µg/(kg·min) and norepinephrine 0.5 - 2 µg/(kg·min) pumped in continuously in the control group. In initial 6 hours the same treatment was given to the remedial group, while low dose pituitrin (0.01 - 0.03 U/min) was pumped additionally during the rest of time. The therapeutic effect on correcting shock was evaluated in both groups.</p><p><b>RESULTS</b>The total effective rate was 76.2% in the remedial group and 40.0% in the control group; the mortality was 33.3% and 60% respectively. The difference between both groups was significant (P = 0.025).</p><p><b>CONCLUSION</b>Low dose pituitrin could improve the clinical effect significantly in children with septic shock in whom 6 hours conventional treatment failed to correct shock, shorten the total periods of treatment, and decrease mortality.</p>

Contrast-enhanced ultrasonography in the diagnosis of acute experimental incomplete testicular torsion / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the application value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of acute experimental incomplete testicular torsion.</p><p><b>METHODS</b>Seven incomplete and 1 complete testicular torsion models were established in 8 healthy hybrid dogs by twisting unilateral spermatic cord. The twisted testes were included in the model group and the healthy ones in the control. All the dogs underwent CEUS before, immediately after, and/or 6 hours after the torsion, followed by time-intensity curve analysis.</p><p><b>RESULTS</b>The arriving time (AT) and the time to peak (TTP) of the contrast agents in the bilateral testes were almost coincident, and the peak intensity (PI) and the area under the curve (AUC) in the bilateral testes basically the same before the torsion. The incompletely torsion testes showed delayed perfusion of contrast agents, prolonged AT and 'TP, and decreased PI and AUC as compared with the contralateral testes (P < 0.05), while the completely torsion one exhibited no perfusion all the time.</p><p><b>CONCLUSION</b>CEUS has a very high application value in the diagnosis of acute incomplete testicular torsion.</p>

Toxicity evaluation of chicken calamus keratin conduit as a tissue-engineering scaffold biomaterial / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the toxicity of chicken calamus keratin (CCK) conduit as a tissue-engineered scaffold material.</p><p><b>METHODS</b>The chemical composition of the leaching solution of CCK was determined by means of ultraviolet spectrometry, and the toxic effects of the solution was evaluated by skin sensitization test in rats, intracutaneous stimulation test in rabbits, acute systemic toxicity test in mice, and cytotoxicity test in L929 cells.</p><p><b>RESULTS</b>The leaching solution of CCK consisted mainly of middle-molecular-weight peptides with a small quantity of macromolecular proteins. Skin sensitization test in rats showed that application of the CCK leaching solution caused no obvious skin reddening, regional edema, or skin necrosis. Intracutaneous injection of the leaching solution in rabbits did not induce obvious skin stimulation manifested by intradermal erythema or edema. In acute systemic toxic test, administration of the leaching solution in mice caused no death, organ dysfunction, cyanosis, tremor, severe peritoneal irritation, ptosis, or dyspnoea. In vitro cytotoxicity test indicated that the cell toxicity of the CCK leaching solution was approximately at 0 level.</p><p><b>CONCLUSION</b>CCK contained in the treated chicken calamus easily undergoes hydrolysis to release mainly some peptides which do not induce obvious toxic effects, suggesting the safe potential applications of CCK conduit as a tissue-engineering biomaterial.</p>

Biological dressing with human hair keratin-collagen sponge-poly 2-hydroxyethyl methacrylate composite promotes burn wound healing in SD rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To develop a composite material containing human hair keratin (HHK), collagen sponge (inner layer) and poly 2-hydroxyethyl methacrylate (PHEMA) film that allows sustained release of polydatin and test its effect as a biological dressing in promoting burn wound healing in SD rats.</p><p><b>METHODS</b>Three HHK materials with fast, moderate, and low degradation rates were mixed at the ratio of 4:3:3 to prepare a reticular structure, which was processed into a composite material with bovine tendon-derived collagen sponge, and further complexed with HEMA film containing PD prepared by polymerization. Degree II burn wound was induced in SD rats by scalding and within postburn day 2-5, the wounds were cleansed and covered with the composite material or with glutaraldehyde-treated porcine skin (positive control). At week 1, 2, 4, 6 and 8 following wound dressing, 6 full-thickness skin samples were harvested from the wounds for histological observation and immunohistochemical detection of collagen and elastic fibers, and the wound healing time and healing rate were recorded.</p><p><b>RESULTS</b>The prepared collagen sponge film was transparent and porous (50-300 microm in diameter) and allowed sustained PD release into normal saline within 48 h. Compared with the porcine skin, the composite material reduced exudation and maintained ideal moisture of the wound, and significantly shortened the wound healing time (P=0.000). On day 7, 14, and 21 following dressing, the composite material and porcine skin significantly increased the wound healing rate as compared with the negative control group (P=0.000), and on day 14, the composite achieved significantly greater healing rate than the porcine skin (P<0.05).</p><p><b>CONCLUSION</b>HHK-collagen sponge-PHEMA/PD composite as a dressing material promotes burn wound healing in rats by allowing in vivo construction of tissue engineered epidermis. PHEMA is feasible for sustained drug delivery in this composite.</p>

From meridians and acupoints to self-supervision and control system: a hypothesis of the 10th functional system based on anatomical studies of digitized virtual human / 南方医科大学学报

Chinese acupuncture and moxibustion has been widely accepted as a useful therapeutics all over the world, but its mechanism has not been fully defined. For this purpose, a reticular framework of whole-body fascia and connective tissues has been established by means of digitized virtual human technique. The virtual acupoints represented three-dimensionally were compared with the sites for stimulation in practice of traditional Chinese medicine (TCM) acupuncture therapy. The results showed that the fascial network constituted by the connective tissues may be the anatomical basis for acupuncture therapy. We found that the acupoints were mainly located where thick connective tissues were present. In this fascial network, sensitive nerve endings, active cells and lymphatic vessels abounded in the sites with thick connective tissue, and needling at these sites induced definite biological effects. In light of biological phylogeny and embryo development, we believe that the connective tissue network may constitute a new functional system in the human body, the Self-supervision and control system (Fasciology), which provides a theoretical base for acupuncture therapy.

Collagen gel coating or cyclosporine A for improving histocompatibility of chicken calamus keratin / 南方医科大学学报

<p><b>OBJECTIVE</b>To improve the histocompatibility of chicken calamus keratin (CCK) graft by collagen-gel coating or using of cyclosporine A (CsA).</p><p><b>METHODS</b>Thirty SD rats were equally randomized into 5 groups, and in 4 of them, CCK implantation into the bilateral erector spinae was performed on different treatment protocols. In group A, the rats received daily intraperitoneal injection of CsA (5 mg/kg) for two consecutive weeks after CCK implantation; in group B, CCK was soaked in CsA (2.5 mg/ml) solution at 4 degrees Celsius; for 48 h before grafting; in group C, CCK coated with collagen gel was grafted; and in group D, only CCK was implanted. Rats in the fifth group received only cutaneous incision as well as muscular dissection to serve as the blank control. CCK degradation and its effect on the surrounding tissues were observed at 2, 4 and 8 weeks after grafting. Immunohistochemistry was performed to identify T lymphocyte infiltration in the host tissues.</p><p><b>RESULTS</b>All the rats survived the operation. Numerous macrophages, especially multinucleated giant cells occurred on the peripheral of the CCK grafts, and small degraded CCK pieces were observed in their cytoplasm. Only a few inflammatory cells were seen in the host tissues. At 2, 4 and 8 weeks after CCK implantation, only a few CD3-positive cells were found in all the groups, and in group A and B, the density of T lymphocytes was significantly lower than that in group D, and there was no significant difference between group A and the blank control group.</p><p><b>CONCLUSIONS</b>CsA significantly improves the histocompatibility of CCK material, and short-term systemic CsA administration achieves the best results. Macrophages, especially multinucleated giant cells participate in CCK degradation in vivo.</p>