Summary of optimal evidences for early fluid resuscitation management in patients with acute pancreatitis / 重庆医学

Objective To systematically retrieve,evaluate and integrate the best evidences on the early fluid resuscitation management in the patients with acute pancreatitis(AP)at home and abroad to provide ref-erence for clinical decision.Methods The related evidences on the early fluid resuscitation management in the AP patients were retrieved by computer from the databases of BMJ Best Practice,Up To Date,JBI,National Institute for Health and Care Excellence,Registered Nurses Association of Ontario,Guideline International Network,Scottish Intercollegiate Guidelines Network,International Association of Pancreatology,American Pancreatic Association,American College of Gastroenterology,Yimaitong,Cochrane Library,PubMed,Em-bass,CINAHL,The Web of Science,CNKI,Wanfang databases.The retrieval time limit was from the data-base establishment to March 20,2022.The literatures types included thematic evidence summarization,guide-lines,evidence summaries,systematic reviews and expert consensus.The researchers conducted the literature quality evaluation.The literatures meeting the standard conducted the evidence extraction.Results A total of 13 arti-cles were included,including 3 special subject evidence summary,4 guidelines,2 evidence summary,2 systematic evalu-ation and 2 expert consensus.A total of 16 pieces of best evidence were integrated,involving 4 aspects of organization management,evaluation and monitoring,fluid infusion strategy and health education.Conclusion It is recommended to use the target-oriented therapy for early fluid resuscitation management,and perform the fluid resuscitation immediate-ly after diagnosis,according to the patient's underlying disease,disease changes and monitoring indicators,implement precise early fluid resuscitation in order to reverse pancreatic microcirculation disorder,increase tissue perfusion and improve the patient's prognosis.

Effect of regional lymph node diameter on postoperative recurrence in pancreatic cancer patients / 国际肿瘤学杂志

Objective:To investigate the effect of the average diameter of regional lymph node on tumor recurrence after operation of pancreatic head adenocarcinoma without lymph node metastasis.Methods:Clinical data of 49 patients with pancreatic head adenocarcinoma admitted to the 909th Hospital of Joint Logistic Support Force from January 2017 to June 2019 were retrospectively analyzed. The receiver operating characteristic (ROC) curve was used to analyze the average regional lymph node diameter for predicting the optimal threshold of tumor recurrence. The relationship between the average diameter of regional lymph nodes, recurrence and clinicopathological features were analyzed. The influencing factors of tumor recurrence 3 years after surgery were analyzed by logistic regression.Results:All 49 patients with pancreatic head adenocarcinoma were divided into a relapse group ( n=29) and a no-recurrence group ( n=20) based on whether the tumor recurred or not, and the recurrence rate was 59.18%. ROC curve analysis showed that the best threshold of average regional lymph node diameter for predicting tumor recurrence was 0.635 cm, the area under the curve was 0.82, the sensitivity was 0.69, and the specificity was 0.85. The average diameter of regional lymph nodes increased in patients with tumor diameter ≥2 cm ( t=-2.12, P=0.040), tumor with moderate and poorly differentiation ( t=-2.24, P=0.013), vascular invasion ( t=-3.47, P=0.001), nerve invasion ( t=-3.75, P<0.001), capsular invasion ( t=-4.25, P<0.001), and tumor recurrence ( t=-4.42, P<0.001). Univariate analysis showed that tumor diameter ( χ2=5.98, P=0.015), tumor stage ( χ2=3.88, P=0.049), tumor differentiation ( χ2=5.98, P=0.015), vascular invasion ( χ2=3.84, P=0.050), capsular invasion ( χ2=5.79, P=0.016), average lymph node diameter ( χ2=15.61, P<0.001), and postoperative chemotherapy ( χ2=3.89, P=0.049) were all related to whether the tumor recurred or not in patients with pancreatic head adenocarcinoma 3 years after surgery. Multivariate analysis results showed that tumor diameter ≥2 cm ( OR=2.72, 95% CI: 1.46-11.28, P=0.016), tumor with moderate and poorly differentiation ( OR=2.22, 95% CI: 1.23-6.53, P=0.020), capsular invasion ( OR=2.30, 95% CI: 2.19-8.91, P=0.017), and average lymph node diameter ≥0.635 cm ( OR=7.93, 95% CI: 1.25-50.31, P=0.002) were all independent influencing factors for tumor recurrence in pancreatic head adenocarcinoma patients 3 years after surgery. Conclusion:In patients with pancreatic head adenocarcinoma without lymph node metastasis, tumor diameter ≥2 cm, tumor with moderate and poorly differentiation, capsular invasion and average lymph node diameter ≥0.635 cm are independent risk factors for postoperative tumor recurrence. Patients with the average diameter of regional lymph nodes ≥0.635 cm increase the possibility of tumor recurrence after surgery, which can be used as the basis for postoperative evaluation and has certain clinical application value.

Discussion on the mechanism of Jiangtang Xiaoke Granules for diabetes mellitus based on network pharmacology and molecular docking / 国际中医中药杂志

Objective:To predict the possible targets and signaling pathways of Jiangtang Xiaoke Granules in the treatment of diabetes mellitus (DM) using computer network pharmacology and molecular docking technology.Methods:The active components and targets of Jiangtang Xiaoke Granules were collected by ETCM; the targets of DM were searched from the databases of DisGeNET and GeneCards, and the intersections of the two were taken to draw a Venny diagram; String database was used for gene transformation and network interaction analysis; the network diagram was constructed with Cytoscape3.6.0; the predicted results were supported by molecular docking technology; GO and KEGG analysis was performed through Metascape database.Results:A total of 128 active components of Jiangtang Xiaoke Granules were screened, with 607 corresponding targets, 1 240 DM related targets, and 53 core targets. Molecular docking showed that the active components had good binding energy with the core targets. GO analysis yielded 46 functional items and KEGG analysis yielded 15 pathways.Conclusion:Jiangtang Xiaoke Granules regulate glucose homeostasis by participating in a variety of biological processes through multiple components, and multiple targets, including affecting lipids and atherosclerosis, Alzheimer disease, AMPK signaling pathway, Apelin signaling pathway, and glucagon signaling pathway.

Effectiveness and safety of tenofovir alafenamide for chronic hepatitis B patients with decompensated cirrhosis / 实用医学杂志

Objective To investigate the efficacy and safety of tenofovir alafenamide fumarate(TAF)in the treatment of patients with decompensated hepatitis B cirrhosis.Methods We retrospective analyzed 41 patients with decompensated hepatitis B cirrhosis receiving TAF antiviral therapy for 24 weeks at Wuwei Tumor Hospital in Gansu province from June 2022 to June 2023.Primary endpoint was proportion of patients achieving virologic response(HBV DNA<20 IU/mL).Other endpoints included changes in ALT,AST,TBIL,Child-Pugh score(CTP),and MELD score from baseline to week 24.In terms of safety,changes in Scr,eGFR and adverse events from baseline to week 24 were observed.Results Of 41 patients,73.2%were male(n = 30),with mean age of 53.49 years.24 weeks after treatment with TAF,HBV DNA was undetectable in 90.2%of the patients.The median levels of ALT,AST and total bilirubin(TBIL)were 50.70 U/L,48.70 U/L and 26.40 μmol/L respectively at base-line,and reduced significantly to 31.50 U/L,37.8 U/L and 23.8 μmol/L(P<0.05)respectively after 24-week therapy with TAF.CTP score was improved in 58.6%of the patients(n = 24),and so was MELD score in 63.4%of the patients(n = 26)at week 24.The median serum creatinine and eGFR were 58.5 μmol/L and 106.15 mL/(min·1.73 m2)respectively at baseline,and creatinine and eGFR were stable during treatment.No drug-related adverse events or severe adverse events occurred during treatment,neither did creatinine and eGFR liver transplan-tation,HCC or death.Conclusions Our clinical studies demonstrated better effectiveness and safety of TAF for decompensated CHB patients.

Effect of age factors on pharmacodynamics of intranasal dexmedetomidine for sedation in pediatric patients undergoing transthoracic echocardiography / 中华麻醉学杂志

Objective:To evaluate the effect of age factors on the pharmacodynamics of intranasal dexmedetomidine for sedation in the pediatric patients undergoing transthoracic echocardiography(TTE).Methods:American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ pediatric patients, aged 1-24 months, undergoing TTE from August 2019 to May 2022, were selected. This trial was performed in two parts. Part Ⅰ Pediatric patients were divided into 4 age groups: 1-6 month group, 7-12 month group, 13-18 month group and 19-24 month group. The initial dose of dexmedetomidine was 2.0 μg/kg in 0.1 μg/kg increment/decrement. The dose of dexmedetomidine was determined by using modified Dixon′s up-and-down method. The ED 50 and 95% confidence interval of intranasally administered dexmedetomidine for sedation were calculated by the Dexon-Massey method. Part Ⅱ One hundred patients were divided into 4 age groups ( n= 25 each): 1-6 month group, 7-12 month group, 13-18 month group and 19-24 month group. The 4 groups were further divided into 5 subgroups ( n=5 each) according to the dose of dexmedetomidine: 2.1 μg/kg subgroup, 2.2 μg/kg subgroup, 2.3 μg/kg subgroup, 2.4 μg/kg subgroup, and 2.5 μg/kg subgroup. Part Ⅰ and part Ⅱ trials were combined, and the ED 95 and 95% confidence interval of intranasally administered dexmedetomidine for sedation were calculated using the probit method. Results:A total of 220 pediatric patients were enrolled. There was no significant difference in ED 50 and ED 95 of dexmedetomidine intranasally administered for sedation among groups ( P>0.05). Conclusions:The pharmacodynamics of intranasal dexmedetomidine for sedation shows no significant difference in age in the pediatric patients aged 1-24 months undergoing TTE.

Efficacy of transcatheter arterial embolization and laparotomy in the treatment of severe liver injury: a comparative study / 中华创伤杂志

Objective:To compare the efficacy of transcatheter arterial embolization (TAE) with laparotomy in the treatment of severe liver injury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 48 patients with severe liver injury admitted to 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from December 2013 to June 2020, including 28 males and 20 females; aged 16-75 years [(45.7±6.2)years]. There were 25 patients with grade III, 15 grade IV and 8 grade V according to the American Association for the Surgery of Trauma (AAST) classification. After general treatments such as infusion and hemostasis, TAE was performed in 26 patients (TAE group) and laparotomy in 22 patients (laparotomy group). The operation time and length of hospital stay were compared between the two groups. Erythrocyte, hemoglobin and serum creatinine were compared before operation and at postoperative 1 day. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were analyzed before operation and at postoperative 1, 3, 7 days. Complications were observed.Results:All patients were followed up for 12-60 months [(17.1±9.1)months]. The operation time and length of hospital stay were (65.7±9.2)minutes and (21.6±6.6)days in TAE group, significantly shorter than (162.5±28.1)minutes and (31.5±7.4)days in laparotomy group ( P<0.05 or 0.01). There was no significant difference between the two groups referring to erythrocyte, hemoglobin and serum creatinine before operation and at postoperative 1 day (all P>0.05). There was no significant difference in ALT and AST between the two groups before operation (all P>0.05). TAE group showed ALT level of 1 154(884, 1 698)U/L, (975.3±400.9)U/L and (403.4±232.9)U/L at postoperative 1, 3, 7 days, significantly lower than 2 053(1 965, 2 132)U/L, (1 604.1±188.2)U/L and (915.3±160.5)U/L in laparotomy group (all P<0.05). TAE group showed AST level of (1 313.2±542.0)U/L, 525(302, 971)U/L and 174(84, 324)U/L at postoperative 1, 3, 7 days, significantly lower than (1 962.9±245.4)U/L, 1 478(1 089, 1 677)U/L and 837(674, 1 006)U/L in laparotomy group ( P<0.05 or 0.01). The complication rate was 26.9% (7/26) in TAE group, significantly lower than 59.1% (13/22) in laparotomy group ( P<0.05). Conclusion:For severe liver injury, TAE can significantly shorten operation time and length of hospital stay, accelerate the recovery of liver function and reduce the complication rate in comparison with laparotomy.

Research on the rules of Traditional Chinese Medicine treatments of insomnia based on Ancient and Modern Medical Records Cloud Platform / 国际中医中药杂志

Objective:To explore the rules of prescription and medication of Traditional Chinese Medicine (TCM) syndrome differentiation treatment for insomnia.Methods:We screened the medical records related to insomnia from the ancient medical cases, modern medical cases, famous medical cases and shared medical record database, and then we put data into the Ancient and Modern Medical Case Cloud Platform (V 1.5.7). The platform software Data mining was applied and performed by frequency analysis, correlation analysis, and drug pair analysis. Results:This study collected 664 cases related to insomnia, like difficulty in falling sleep, early waking up, easy to wake up, dreaminess. The top 5 syndromes included internal phlegm-heat, imbalance between heart-yang and kidney-yin, liver stagnation transforming into fire, heart and spleen deficiency, restless mind. There were 664 prescriptions, 414 TCM medications, where the top 5 medications included Glycyrrhizae Radix et Rhizoma, Poria, Rehmanniae Radix, Ziziphi Spinosae Semen, Angelicae Sinensis Radix. The effect of high-frequency medications were nourishing the heart and calming the mind, clearing heat and dissipating phlegm, soothing the liver and relieving depression, and nourishing yin and yang. The top five drug-combinations included Ostreae Concha- Longgu, Poria- Glycyrrhizae Radix et Rhizoma, Citri Reticulatae Pericarpium- Poria, Angelicae Sinensis Radix- Rehmanniae Radix, Bupleuri Radix- Glycyrrhizae Radix et Rhizoma. Conclusions:TCM syndrome differentiation for insomnia focus on the heart. The medications are mainly to nourish the heart and calm the mind, supplemented by clearing heat, replenishing heart and spleen, soothing the liver and relieving stagnation, nourishing yin and blood for the symptoms relief, with treatment priciple of seeking both temporary and permanent solutions.

Study on morning blood pressure surge and circadian rhythm of blood pressure in children with neurally mediated syncope / 中华实用儿科临床杂志

Objective:To investigate the circadian rhythm of blood pressure and morning blood pressure surge (MBPS) in children with neurally mediated syncope (NMS).Methods:From July 2018 to June 2019, 135 cases [aged 3-16 years old (10.12±2.53) years old, with 74 males and 61 females] with unexplained syncope, presyncope, and symptoms such as headache, dizziness, chest pain, and chest tightness were collected in the Second Xiangya Hospital, Central South University for the first time.The 24 hour ambulatory blood pressure monitoring (24 h ABPM) was completed on the same day of the head-up tilt test (HUTT). Patients were divided into HUTT negative and positive groups, and dippers and non-dippers groups. MBPS (sleep-trough surge) was calculated and compared respectively.Results:(1) There were 51 patients in the HUTT positive group, including 27 patients with vasovagal syncope, 23 patients with postural orthostatic tachycardia syndrome, and 1 patient with orthostatic hypotension. In HUTT positive group, there were 22 cases (43.14%) of dippers and 29 cases of non-dippers.There were 84 patients in the HUTT negative group, there were 32 cases (38.10%) of dippers and 52 cases of non-dippers. There were no statistical significances in the dipper proportion between HUTT positive and negative group ( χ2=1.305, P>0.05). (2) Sleep-trough systolic blood pressure (SBP) surge was 1-45 mmHg [(15.97±8.03) mmHg](1 mmHg=0.133 kPa), and sleep-trough diastolic blood pressure (DBP) surge was -6-43 mmHg[(14.05±7.97) mmHg]. There were no statistical significances in sleep-trough surge between the HUTT negative and positive group (all P>0.05). (3) The age in the dipper group was higher than that in the non-dipper group [(10.72±2.20) years old vs. (9.72±2.66) years old, t=2.288, P<0.05]. The daytime average SBP [(110.20±8.33) mmHg vs.(105.54±7.51) mmHg, t=3.381, P<0.01], and morning peak SBP [(109.99±10.19) mmHg vs.(106.63±8.71) mmHg, t=2.045, P<0.05] of the dipper group were higher than those of the non-dipper group.The nighttime average SBP[(95.41±7.50) mmHg vs.(98.59±6.88) mmHg, t=2.540, P<0.01], nighttime average DBP[(48.61±4.52) mmHg vs.(52.28±4.65) mmHg, t=4.547, P<0.01], nocturnal minimum SBP[(89.62±8.18) mmHg vs.(93.60±7.38) mmHg, t=2.940, P<0.01], and nocturnal minimum DBP[(44.99±5.32) mmHg vs.(49.01±5.54) mmHg, t=4.205, P<0.01] of the dipper group were lower than that of the non-dipper group.Nocturnal SBP reduction rate [(13.42±2.68)% vs.(6.48±2.49)%, t=15.384, P<0.01], nocturnal DBP reduction rate[(19.98±4.92)% vs.(12.46±5.05)%, t=8.561, P<0.01], sleep-trough SBP surge[(20.37±8.30) mmHg vs.(13.03±6.36) mmHg, t=5.800, P<0.01], and sleep-trough DBP surge[(16.91±8.06) mmHg vs.(12.13±7.36) mmHg, t=3.554, P<0.01] of the dipper group were higher than those of the non-dipper group. Conclusions:Nocturnal blood pressure reduction and sleep-trough surge decreased in NMS children, and there is a circadian rhythm disorder of blood pressure.

Preliminary study of the clinical value of colposcopy in diagnosing vagina invasion in cervical cancer / 中华妇产科杂志

Objective:To explore the preliminary clinical values of colposcopy in the diagnosis of vaginal invasion in cervical cancer.Methods:A retrospective review of the clinical records of patients (31 cases) with cervical cancer treated in Xuzhou Cancer Hospital from April 2015 to August 2019. For those with early-stage cervical cancer and the vagina invasion being difficult to be determined, those with advanced cervical cancer and the scope of vaginal invasion being difficult to be judged, and those with obvious vaginal tumor and underexposed cervix or inconspicuous cervical lesion and the primary location needing to be identified, colposcopy-guided vaginal and cervix biopsy were performed before treatment.Results:(1) Image characteristics of colposcopy and pathological diagnosis: among 31 cases, 30 of them had the similar images of vagina and cervix. The images were dense acetowhite and (or) thick mosaic, coarse punctate and atypical vessels. Lugol′s staining was uniformly bright yellow or brown. Pathological biopsy of vaginal wall: 27 cases were metastatic carcinoma, 3 cases were vaginal intraepithelial neoplasia (VaIN) Ⅱ-Ⅲ. One case showed dense acetowhite epithelium and atypical vessels image in cervix and thin acetowhite epithelium in upper 1/3 vagina which disappeared in two minutes; the results of vaginal biopsy was chronic inflammation. (2) Vaginal invasion diagnosed by colposcopy: among 31 cases, 14 of them without invasion of uterine side, vaginal invasion was judged as followed by colposcopy, being consistent with biopsy: 1 case of chronic vaginitis, 2 cases VaINⅡ, 1 case VaINⅢ, 6 cases upper 1/3 vagina invasion, 4 cases lower 1/3 vagina invasion. Among 10 cases with invasion of uterine side, vaginal invasion were identified by colposcopy, being consistent with biopsy: 4 cases upper 1/3 vagina invasion and 6 cases upper 1/2 vagina invasion. Five cases who had clinical diagnosis of vaginal cancer were diagnosed as cervical cancer with vaginal invasion by colposcopy, being consistent with biopsy. Two cases with no obvious lesions of cervix and vagina were diagnosed as cervical cancer with vaginal invasion by colposcopy, being consistent with cervical and vaginal biopsy: 1 case with stage Ⅳ (transfer to the left supraclavicular lymph node) and 1 case with stage Ⅱ a1.Conclusions:Colposcopy and multi-point biopsy have complementary diagnostic value for the cervical cancer cases that the invasion and scope of vagina are difficult to be determined by physical examination and (or) imaging examination. Thus the range of vaginal resection for patients underwent operation and the lower boundary of pelvic radiation field for those underwent radiotherapy could be fixed, so as to make the treatment much more individualized and humanized; the indications need further discussion.

Research on Network Pharmacology of Flavonoids from Glycyrrhiza uralensis / 中国药房

OBJECTIVE： To analyze and predict potential pharmacological effects and mechanism of flavonoids from Glycyrrhiza uralensis. METHODS： By the means of network pharmacology， according to TCM integrative pharmacology platform （TCMSP）， using oral bioavailability （OB）＞30％ and drug-likeness （DL）＞0.18 of compound as reference， flavonoids compound of G. uralensis were screened. The potential targets of flavonoids were predicted with pharmacophore matching and PharmMapper date base. DAVID V 6.8 analysis tool was used for KEGG signaling pathway analysis and GO biological process enrichment analysis （using P＜0.05 as judgement standard） of target protein. A flavonoids-targets-signaling pathways network was built through Cytoscape 3.5.1 software. RESULTS： A total of 19 flavonoids compounds （such as liquiritin， isoliquiritin and liquiritigenin， etc.） were screened， involving 78 target proteins as cellular retinoic acid-binding protein 2 and neprilysin （188 times in total）， 40 signaling pathways （among them， 8 pathways related to cancer， 8 pathways related to endocrine system， 6 pathways related to signal transduction， 5 pathways related to infectious diseases and 3 pathways related to metabolism） as insulin signaling pathway， PI3K-Akt and so on. The flavonoids-targets-signaling pathways network model showed that flavonoids compounds of G. uralensis could act on different metabolic pathways through multiple targets. CONCLUSIONS： The flavonoids of G. uralensis have therapeutic effect on diseases of cancer， endocrine system， infectious diseases， metabolism and so on. It may have potential anti-parkinson’s effect.

Effect of radiotherapy for primary orbital lymphoma: analyses of 28 cases / 白血病·淋巴瘤

Objective@#To analyze the effect and adverse reactions of radiotherapy in patients with primary orbital lymphoma.@*Methods@#A total of 28 patients with primary orbital lymphoma from Tianjin Union Medical Center, the First Central Hospital of Tianjin and Tianjin Dagang Oil Company Hospital between March 2006 and August 2012 were retrospectively analyzed. All the patients received orbital tumor dissection or biopsy, then received radiation therapy. Three patients received chemotherapy with CHOP protocol before radiotherapy. Radiotherapy was delivered routinely with 3D-conformal radiation therapy (CRT) technique with daily 2-2.5 Gy for 5 times per week and 3-5 fields. Total dosage was 20-50 Gy. There were 18 cases of 30 Gy, 1 case of 22 Gy, 1 case of 25 Gy, 1 case of 20 Gy, 1 case of 28.8 Gy, 3 cases of 40 Gy, 1 case of 42 Gy, 1 case of 46 Gy and 1 case of 50 Gy.@*Results@#All the patients had complete remission (CR) after radiotherapy during follow-up. One patient recurred after radiotherapy of 4 months and received CR with radiotherapy again. One patient died of lung infiltration. Acute complications during radiotherapy were conjunctivitis (28 cases, 100.0%) and keratitis (1 case, 3.6%), long-term complications with ophthalmoxerosis (10 cases, 35.7%) and decreased visual acuity (1 case, 3.6%).@*Conclusion@#Radiotherapy is an effective method for primary orbital lymphoma, and the adverse reactions can be tolerated for most patients.

Clinical analysis of 128 cases of cervical lesion diagnosed by multi-point biopsy of colposcopy and endocervical curettage / 中华肿瘤杂志

Objective@#To investigate the clinical values of colposcopy and cervical biopsy and/or endocervical curettage (ECC) in the diagnosis of cervical lesion.@*Methods@#Clinical data of 128 cases of cervical lesion diagnosed by Xuzhou Cancer Hospital from January 23, 2014 to October 11, 2016 were collected and retrospectively analyzed, all patients underwent colposcopy and cervical biopsy and/or ECC.@*Results@#Among them, the age between 30 to 50 years old were 70 cases, whose transformation zone types of Ⅰ, Ⅱ and Ⅲ were 28 cases (40.0%), 23 cases (32.9%) and 19 cases (27.1%), respectively. The age older than 50 years were 45 cases, whose transformation zone types of Ⅱ and Ⅲ were 1 case (2.2%) and 44 cases (97.8%), respectively. Among the 128 cases of cervical lesions, diagnostic results of colposcopy showed that the chronic inflammation were 57 cases, cervical intraepithelial neoplasia (CIN)Ⅰwere 35 cases, CINⅡor CINⅡ~Ⅲ were 8 cases, CIN Ⅲ were 5 cases and cervical cancer were 23 cases. Alternatively, the pathological results showed that the chronic inflammation were 81 cases, CINⅠwere 17 cases, CINⅡor CINⅡ~Ⅲ were 7 cases, CIN Ⅲ were 5 cases and cervical cancer were 18 cases, respectively. Among the 81 cases of chronic inflammation diagnosed by pathology, 52 cases (64.2%) were consistent with the diagnostic results of colposcopy. Among the 17 cases of low grade squamous epithelial cell lesion (LSIL) diagnosed by pathology, 10 cases were in agree with the diagnostic results of colposcopy. Among the 12 cases of high-grade squamous epithelial cell lesion (HSIL) diagnosed by pathology, 9 cases were concordant with the diagnostic results of colposcopy. Among the 18 cases of cervical cancer diagnosed by pathology, 17 cases were consistent with the diagnostic results of colposcopy.@*Conclusions@#The type of transformation zone is positively correlated with the age, and it can help to choose biopsy and therapeutic manner. The diagnostic accuracies of HSIL and early stage of cervical cancer by multi-point biopsy of colposcopy and/or ECC are high. The cervical lesions which are difficultly found by direct visualization can be identified by colposcopy, and thus provides objective evidence to determine the therapeutic manner for patients with stage ⅡA of cervical cancer.

Comparison of curative effect and serum electrolytes between different oral rehydration salts in treatment of neurally mediated syncope children / 中南大学学报(医学版)

Objective:To compare the curative effect and the changes of serum electrolytes between oral rehydration salts (ORS) Ⅰ and ORS Ⅲ treatment in neurally mediated syncope children.Methods:The children with the symptom of unexplained syncope and pre-syncope were collected in Second Xiangya Hospital from May 2014 to May 2017.After head-up tilt test (HUTT),their serum electrolytes levels were examined.Children who were positive in the HUTT received ORS (ORS Ⅰ or ORS Ⅲ) and health education.Subjects were randomly divided into an ORS Ⅰ group (n=27) and an ORS Ⅲ group (n=49).Results:There was no statistical significance in sex,age,height,body mass,initial diagnosis and re-diagnosis interval between the 2 groups (P＞0.05);the total efficiency after ORS Ⅲ and ORS Ⅰ treatment were 79.59％ and 62.96％,respectively,with no statistical significance (x2=2.483,P＞0.05);the HUTT negative conversion rate after ORS Ⅲ and ORS Ⅰ treatment were 51.02％ and 48.16％,respectively,with no statistical significance (x2=0.058,P＞0.05);before treatment,the serum sodium [(140.20±2.26) mmol/L vs (138.39±2.72) mmol/L;t=2.856,P＜0.05] in the ORS Ⅲ group was higher than that in the ORS Ⅰ group,the serum phosphorus [(1.46±0.19) mmol/L vs (1.65±0.29) mmol/L;t=3.146,P＜0.05] in the ORS Ⅲ group was lower than that in the ORS Ⅰ group;after treatment,the serum sodium [(140.31±2.01) mmol/L vs (138.88±2.08) mmol/L;t=2.692,P＜0.05] and serum calcium [(2.31±0.09) mmol/L vs (2.24±0.11) mmol/L;t=2.696,P＜0.05] in the ORS Ⅲ group were higher than those in the ORS Ⅰ group,the serum phosphorus [(1.45±0.16) mmol/L vs (1.61±0.25) mmol/L;t=3.128,P＜0.05] in the ORS Ⅲ group was lower than that in the ORS Ⅰ group;after ORS Ⅲ treatment,there was no statistical significance in serum electrolytes between HUTT positive group and HUTT negative group (P＞0.05);after ORS Ⅰ treatment,the serum calcium [(2.29±0.10) mmol/L vs (2.19±0.10) mmol/L;t=2.501,P＜0.05]and serum phosphorus [(1.71±0.24) mmol/L vs (1.50±0.21) mmol/L;t=2.392,P＜0.05] in HUTT positive group were higher than those in HUTT negative group.There was no statistical significance in serum sodium,potassium,magnesium,and chloride (P＞0.05);there was no statistical significance in serum electrolytes between pre-treatment and post-treatment in the ORS Ⅰ group and the ORS Ⅲ group (P＞0.05);there was no statistical significance in serum electrolytes between vasovagal syncope and postural orthostatic tachycardia syndrome in the ORS Ⅰ group and the ORS Ⅲ group before ORS treatment (P＞0.05).Conclusion:The ORS Ⅲ and ORS Ⅰ have the similar efficacy in the treatment of children with neurally mediated syncope.ORS Ⅲ is easier to be accepted by children than ORS Ⅰ,with better compliance.

Mechanism of low-dose ketamine-induced reduction of cognitive dysfunction following sevoflurane anesthesia in aged rats: plasticity of dendritic spines in entorhinal cortical neurons / 中华麻醉学杂志

Objective To investigate the relationship between the plasticity of dendritic spines in entorhinal cortical neurons and mechanism of low-dose ketamine-induced reduction of cognitive dysfunction following sevoflurane anesthesia in aged rats.Methods Thirty-six pathogen-free healthy male SpragueDawley rats,aged 18 months,weighing 500-600 g,were divided into 3 groups (n=12 each) using a random number table:control group (group C),sevoflurane anesthesia group (group Sev) and ketamine group (group K).Group C received no treatment.Group Sev inhaled the mixture of air (flow rate 1 L/min) and 3.6％ sevoflurane for 3 h.In group K,ketamine 10 mg/kg was injected intraperitoneally,and 5 min later the mixture of air (flow rate 1 L/min) and 3.6％ sevoflurane was inhaled for 3 h.Open field test and Morris water maze test were performed 3 days after anesthesia.After the behavioral tests,the animals were sacrificed,and their brains were removed and cut into sections for determination of the density of neurons,density of dendritic spines,and expression of postsynaptic density protein-95 (PSD-95) and synaptophysin (SY38) in superficial laminaes (Ⅱ-Ⅲ) of entorhinal cortex using Nissl's staining,Golgi staining and immunohistochemistry,respectively.Results Compared with group C,the time of staying at the central region was significantly shortened,the escape latency was prolonged,the density of dendritic spines was decreased,and the expression of PSD-95 and SY38 was down-regulated in group Sev (P＜0.05).Compared with group Sev,the time of staying at the central region was significantly prolonged,the escape latency was shortened,the density of dendritic spines was increased,and the expression of PSD-95 and SY38 was upregulated in group K (P＜0.05).There were no significant differences in the density of neurons in entorhinal cortex between the three groups (P＞0.05).Conclusion The mechanism by which low-dose ketamine attenuates cognitive dysfunction induced by sevoflurane anesthesia may be related to the enhanced plasticity of dendritic spines in entorhinal cortical neurons of aged rats.

Effects of icarⅡn on viability, migration and invasion of prostate cancer cells / 中国病理生理杂志

AIM:To investigate the effects of icarⅡn on the viability, migration and invasion of the prostate cancer lines Du145 and PC3.METHODS:Du145 cells and PC3 cells were treated with icarⅡn at different concentrations (0, 5, 10, 20, 40 or 80 μmol/L), and the cell viability was measured by CCK-8 assay.The cell migration and invasion abilities were detected by Transwell assay.The protein expression of Notch-1, matrix metalloproteinase (MMP)-2, MMP-9 and hairy/enhancer of split-1 (Hes-1) was determined by Western blot.RESULTS:The results of MTT assay revealed that icarⅡn inhibited the viabilitiy of Du145 cells and PC3 cells in a dose-dependent manner.The maximal effect was at dose of 40 μmol/L.IcarⅡn treatment significantly decreased the abilities of migration and invasion of Du145 cells and PC-3 cells.Moreover, the protein expression of Notch-1, MMP-2, MMP-9 and Hes-1 was dramatically reduced after icarⅡn treatment.CONCLUSION:IcarⅡn inhibits prostate cancer cell viability, migration and invasion by decreasing the protein expression of Notch-1, MMP-2, MMP-9 and Hes-1.

Changes in serum and urine electrolytes of children with neurally mediated syncope after oral rehydration salts [Ⅰ]treatment / 中华实用儿科临床杂志

Objective To explore the changes in serum and urine electrolytes of children with neurally media-ted syncope (NMS)after oral rehydration salts (ORS)[Ⅰ]treatment.Methods The study group included 135 patients [60 male and 75 female,aged 4 -16 years,average of (10.20 ±2.68)years old]with unexplained syncope and prodro-mal symptoms of syncope in our hospital between May 2014 and April 2015.The patients underwent head -up tilt test (HUTT),and completed serum electrolytes and 24 -hour urine electrolytes,and the serum electrolytes and 24 -hour u-rine electrolytes in different hemodynamic type of HUTT were compared.Positive HUTT patients were treated with health education and ORS[Ⅰ],while negative HUTT patients were received health education.Then 21 -154(42.63 ±27.71) days later,the patients returned to hospital,for the inquiry of symptom improvement,and review of HUTT,24 -hour urine and serum electrolytes.Results (1)The total effective rate of ORS[Ⅰ]treatment was 62.96% (17 /27 cases),while negative conversion rate of HUTT was 48.15% (13 /27 cases).(2)There was no significant difference in serum electro-lytes,24 -hour urine electrolytes or 24 -hour urine volume between HUTT positive group and negative group during the first visit (all P >0.05).(3)In return visit,serum calcium [(2.30 ±0.10)mmol/L vs (2.20 ±0.09)mmol/L,t =2.72,P 0.05).(4)24 -hour urine sodium [(159.06 ±72.76)mmol/24 h vs (118.97 ±52.75)mmol/24 h,t =2.712,P 0.05).(5)There was no significant difference in serum elec-trolytes,24 -hour urine electrolytes or 24 -hour urine volume between vasovagal syncope group and postural orthostatic tachycardia syndrome group during the first visit(all P >0.05).Conclusions ORS[Ⅰ]treatment can obviously increase the 24 -hour urine sodium,24 -hour urine chloride in children with NMS.ORS[Ⅰ]is an effective therapy for NMS.

Changes in P-wave, T-wave, and ST segment amplitude in 12 lead electrocardiogram in children with breath holding spell / 中南大学学报(医学版)

OBJECTIVE@#To explore the change of the amplitude of P wave, T wave and ST segment of 12 lead electrocardiogram (ECG) in children with breath holding spell.
@*METHODS@#A total of 29 children (24 males and 5 females) with breath holding spell in Second Xiangya Hospital, Central South University were enrolled for this study from October, 2009 to September, 2015. Their ages ranged from 3 months to 6 years, with an average of 1.82±1.27 years old. The control group consisted of 30 age-matched and gender-matched healthy children. All subjects were underwent electrocardiography by the SR-1000A comprehensive automatic electrocardiograph analyzer, and the changes of the ECG parameters were compared between the two groups.
@*RESULTS@#Compared with the control group, the amplitude of P-wave of V5 lead was decreased [(44.10±23.98) vs (58.30±21.19) μV, P<0.05], the amplitude of T-wave of V6 lead was increased [(423.80±122.6) vs (350.00±105.73) μV, P<0.05], the amplitude of ST segment of II lead was increased [(84.80±39.97) vs (57.30±38.77) μV, P<0.05], the amplitude of ST segment of aVR lead was increased [(-77.60±37.41) vs (-51.00±33.46) μV, P<0.05], the amplitude of ST segment of aVL lead was increased [(35.20±28.24) vs (17.70±33.90) μV, P<0.05], the amplitude of ST segment of V5 lead was increased [(111.00±59.36) vs (69.00±36.33) μV, P<0.05], the amplitude of ST segment of V6 lead was increased [(79.30±45.51) vs (51.30±33.19) μV, P<0.05]. 
@*CONCLUSION@#The children with breath holding spell have autonomic nerve dysfunction. The amplitude of ST segment changes is sensitive.

Comparison of surgical site infection between laparoscopic distal gastrectomy and open distal gastrectomy for gastric cancer:A Meta-analysis / 中国内镜杂志

Objective To compare the differences of surgical site infection (SSI) between laparoscopic distal gas-trectomy (LDG) and open distal gastrectomy (ODG) for gastric cancer. Methods We set up strict inclusion and ex-clusion criteria. All the randomized controlled trials (RCT) on LDG and ODG for gastric cancer were collected. Meta-analysis was performed according to the recommendation by the Cochrane handbook. Results Six RCTs in-cluding 767 patients were analyzed, who were divided into LDG group (n =394) and ODG group ( n=373). Postop-erative wound infection and SSI were significantly lower in LDG than in ODG [RR=0.32, 95 %Cl (0.11, 0.91).P =0.03; RR= 0.28, 95 %Cl (0.12, 0.70),P =0.006]. There was no significant difference in intra-abdominal abscess between the two groups [RR=0.35, 95 % Cl (0.09, 1.31), P=0.12]. Conclusions LDG was associated with a lower incidence of SSI, especially wound infection, as compared with ODG in the meta-analysis.

Regulation of developmental and environmental signaling by interaction between microtubules and membranes in plant cells

Cell division and expansion require the ordered arrangement of microtubules, which are subject to spatial and temporal modifications by developmental and environmental factors. Understanding how signals translate to changes in cortical microtubule organization is of fundamental importance. A defining feature of the cortical microtubule array is its association with the plasma membrane; modules of the plasma membrane are thought to play important roles in the mediation of microtubule organization. In this review, we highlight advances in research on the regulation of cortical microtubule organization by membrane-associated and membrane-tethered proteins and lipids in response to phytohormones and stress. The transmembrane kinase receptor Rho-like guanosine triphosphatase, phospholipase D, phosphatidic acid, and phosphoinositides are discussed with a focus on their roles in microtubule organization.

Multi-center cross-sectional study on type-specific human papillomavirus infection among Chinese women / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the type-specific prevalence of human papillomavirus (HPV) infection among women in China and to provide evidence for primary prevention and screening of cervical cancer programs.</p><p><b>METHODS</b>From May, 2004 to April, 2007, a population-based multicenter cross-sectional study was conducted by the Cancer Hospital, Chinese Academy of Medical Sciences. Women aged 17-59 years from 4 urban areas and 4 rural areas, were screened, under both liquid based cytological and HPV tests for cervical cancer. Specimens of cervical cell were used for genotyping with Linear Array or enzyme-linked immunesorbent assay. Women showed positive in primary screening were referred to exams for further colposcopy and/or histo-pathological detections.</p><p><b>RESULTS</b>A total of 6723 women were included in the data analysis. The overall prevalence of HPV infection was 15.5%. Two age-specific peaks of prevalence of HPV infection were detected among the different age groups. The first peak occurred in 17-24 year-old women in both rural areas and urban areas, while the second one occurred in 40-44 year-old women in urban areas and in 45-49 year-old women in rural areas. The prevalence of HPV infection increased with the severity of diagnosed cervical intraepithelial lesions by cytological or histo-pathological test (χ(2)=62.857, 22.113, P<0.001). HPV16 (3.2%) was seen the most common high risk HPV type, followed by HPV58 (1.8%) , HPV52 (1.5%) , HPV18 (1.0%) and HPV33 (1.0%) respectively. Other common types would include HPV66 (0.64%) , HPV42 (0.58%) and HPV53 (0.46%). The prevalence of HPV16 infection in rural women was significantly higher than that in urban women (χ(2)=4.696, P< 0.05).</p><p><b>CONCLUSION</b>Prevalence of HPV infection in Chinese women seemed to be high and with two age-specific peaks. HPV16 appeared the most commonly seen type in women with cervical lesions. HPV58 and 18 were the predominant types. Type-specific distribution of HPV infection should be taken into consideration in the development of comprehensive cervical cancer prevention strategies in China.</p>