Analysis of causes of graft loss in 135 kidney transplant recipients / 南方医科大学学报

OBJECTIVE@#To investigate the causes of graft loss in kidney transplant recipients.@*METHODS@#We retrospectively analyzed the clinical data of 135 recipients with graft loss after renal transplantation in the Eighth Medical Center of Chinese PLA General Hospital from January 1, 2002 to January 1, 2022.@*RESULTS@#A total of 135 kidney transplant recipients experienced graft failure. The causes of graft loss included graft rejection (70 cases, 51.8%), death of the recipients with functional graft (37 cases, 27.4%), surgical complications (12 cases, 8.9%), drug toxicity (4 cases, 3.0%), carbapenem-resistant Klebsiella pneumoniae infection (4 cases, 3.0%), polyoma BK virus-related nephropathy (3 cases, 2.2%), primary nonfunctioning kidney (2 cases, 1.5%), recurrence of primary disease (2 cases, 1.5%), and prerenal acute renal failure (1 case, 0.7%).@*CONCLUSION@#The main cause of graft loss after renal transplantation is graft rejection, and the secondary cause is death of the recipient with functional graft, and other reasons can be rare.

Combination of anlotinib and irinotecan in the second-line treatment of metastatic colorectal cancer: a multicenter phase 1/2 trial / 中华肿瘤杂志

Objective: To evaluate the safety and efficacy of anlotinib plus irinotecan in the second-line treatment of patients with metastatic colorectal cancer (mCRC). Methods: This prospective phase 1/2 study was conducted in 2 centers in China (Cancer Hospital of Chinese Academy of Medical Sciences and Jiangsu Province Hospital). We enrolled patients with mCRC whose disease had progressed after first-line systemic therapy and had not previously treated with irinotecan to receive anlotinib plus irinotecan. In the phase 1 of the trial, patients received anlotinib (8 mg, 10 mg or 12 mg, po, 2 weeks on/1 week off) in combination with fixed-dose irinotecan (180 mg/m(2), iv, q2w) to define the maximum tolerated dose (MTD) and recommended phase 2 dose (RP2D). In the phase 2, patients were treated with the RP2D of anlotinib and irinotecan. The primary endpoints were MTD and objective response rate (ORR). Results: From May 2018 to January 2020, a total of 31 patients with mCRC were enrolled. Anlotinib was well tolerated in combination with irinotecan with no MTD identified in the phase 1, and the RP2D was 12 mg. Thirty patients were evaluable for efficacy analysis. Eight patients achieved partial response, and 21 had stable disease, 1 had progressive disease. The ORR was 25.8% and the disease control rate was 93.5%. With a median follow-up duration of 29.5 months, the median progression-free survival and overall survival were 6.9 months (95% CI: 3.7, 9.3) and 17.6 months (95% CI: 12.4, not evaluated), respectively. The most common grade 3 treatment-related adverse events (≥10%) were neutropenia (25.8%) and diarrhea (16.1%). There was no treatment-related death. Conclusion: The combination of anlotinib and irinotecan has promising anti-tumor activity in the second-line treatment of mCRC with a manageable safety profile.

Clinical application of three-dimensional printed preformed titanium mesh combined with free latissimus dorsi muscle flap in the treatment of squamous cell carcinoma with skull defect in the vertex / 中华烧伤杂志

Objective: To explore the clinical effects of three-dimensional printed preformed titanium mesh combined with latissimus dorsi muscle flap free transplantation in the treatment of wounds with skull defect after radical surgery of squamous cell carcinoma in the vertex. Methods: A retrospective observational study was conducted. From January 2010 to December 2019, 5 patients with squamous cell carcinoma in the vertex accompanied with skull invasion who met the inclusion criteria were admitted to the Department of Burns and Plastic Surgery of the Second Affiliated Hospital of Air Force Medical University, including four males and one female, aged 50 to 65 years. The original lesion areas ranged from 5 cm×4 cm to 15 cm×8 cm. The titanium mesh was prefabricated via three-dimensional technic based on the result the scope of skull resection predicted with computerized tomography three-dimensional reconstruction before surgery. During the first stage, the soft tissue defect area of scalp (8 cm×7 cm to 18 cm×11 cm) after tumor enlargement resection was repaired with the preformed titanium mesh, and the titanium mesh was covered with latissimus dorsi muscle flap, with area of 10 cm×9 cm to 20 cm×13 cm. The thoracodorsal artery/vein was anastomosed with the superficial temporal artery/vein on one side. The muscle ends in the donor site were sutured together or performed with transfixion, and then the skin on the back were covered back to the donor site. On the 10th day after the first-stage surgery, the second-stage surgery was performed. The thin intermediate thickness skin graft was taken from the anterolateral thigh to cover the latissimus dorsi muscle flap. The duration and intraoperative blood loss of first-stage surgery were recorded. The postoperative muscle flap survival after the first-stage surgery and skin graft survival after the second-stage surgery was observed. The occurrence of complications, head appearance, and recurrence of tumor were followed up. Results: The average first-stage surgery duration of patients was 12.1 h, and the intraoperative blood loss was not more than 1 200 mL. The muscle flaps in the first-stage surgery and the skin grafts in the second-stage surgery all survived well. During the follow-up of 6-18 months, no complications such as exposure of titanium mesh or infection occurred, with good shape in the recipient sites in the vertex, and no recurrence of tumor. Conclusions: Three-dimensional printed preformed titanium mesh combined with latissimus dorsi muscle flap free transplantation and intermediate thickness skin graft cover is an effective and reliable method for repairing the wound with skull defect after extended resection of squamous cell carcinoma in the vertex. This method can cover the wound effectively as well as promote both recipient and donor sites to obtain good function and appearance.

Efficacy of Different Doses of Daunorubicin Induced Chemotherapy in Patients with Newly Diagnosed Primary Acute Myeloid Leukemia Under 65 Years Old / 中国实验血液学杂志

OBJECTIVE@#To compare the efficacy and safety of different doses of daunorubicin combined with a standard dose of cytarabine as induction chemotherapy in newly diagnosed primary acute myeloid leukemia (AML) patients.@*METHODS@#The clinical data and outcome were retrospectively analyzed in 86 newly diagnosed primary AML patients who were under 65 years old and treated with daunorubicin combined with cytarabine (DA regimen) at West China Hospital of Sichuan University from January 2017 to June 2019. Patients were divided into 2 groups based on the dose of daunorubicin they received, 35 cases in the escalated-dose group ［75 mg/(m@*RESULTS@#Median follow-up time of all the patients was 15 months. The CR rate and MRD@*CONCLUSION@#The escalated dose of daunorubicin can induce higher complete remission rate, deeper remission and longer duration of remission without increasing adverse events in newly diagnosed primary AML patients.

Bendamustine treatment of Chinese patients with relapsed indolent non-Hodgkin lymphoma: a multicenter, open-label, single-arm, phase 3 study / 中华医学杂志(英文版)

BACKGROUND@#Bendamustine was approved in China on May 26th, 2019 by the National Medical Product Administration for the treatment of indolent B-cell non-Hodgkin lymphoma (NHL). The current study was the registration trial and the first reported evaluation of the efficacy, safety, and pharmacokinetics of bendamustine in Chinese adult patients with indolent B-cell NHL following relapse after chemotherapy and rituximab treatment.@*METHODS@#This was a prospective, multicenter, open-label, single-arm, phase 3 study (NCT01596621; C18083/3076) with a 2-year follow-up period. Eligible patients received bendamustine hydrochloride 120 mg/m2 infused intravenously on days 1 and 2 of each 21-day treatment cycle for at least six planned cycles (and up to eight cycles). The primary endpoint was the overall response rate (ORR); and secondary endpoints were duration of response (DoR), progression-free survival (PFS), safety, and pharmacokinetics. Patients were classified according to their best overall response after initiation of therapy. Proportions of patients in each response category (complete response [CR], partial response [PR], stable disease, or progressive disease) were summarized along with a two-sided binomial exact 95% confidence intervals (CIs) for the ORR.@*RESULTS@#A total of 102 patients were enrolled from 20 centers between August 6th, 2012, and June 18th, 2015. At the time of the primary analysis, the ORR was 73% (95% CI: 63%-81%) per Independent Review Committee (IRC) including 19% CR and 54% PR. With the follow-up period, the median DoR was 16.2 months by IRC and 13.4 months by investigator assessment; the median PFS was 18.6 months and 15.3 months, respectively. The most common non-hematologic adverse events (AEs) were gastrointestinal toxicity, pyrexia, and rash. Grade 3/4 neutropenia was reported in 76% of patients. Serious AEs were reported in 29 patients and five patients died during the study. Pharmacokinetic analysis indicated that the characteristics of bendamustine and its metabolites M3 and M4 were generally consistent with those reported for other ethnicities.@*CONCLUSION@#Bendamustine is an active and effective therapy in Chinese patients with relapsed, indolent B-cell NHL, with a comparable risk/benefit relationship to that reported in North American patients.@*CLINICAL TRIAL REGISTRATION@#ClinicalTrials.gov, No. NCT01596621; https://clinicaltrials.gov/ct2/show/NCT01596621.

Efficacy and safety of percutaneous nephrolithotomy and retrograde intrarenal surgery in the treatment of staghorn calculi / 中国基层医药

Objective:To investigate the efficacy and safety of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) in the treatment of staghorn calculi.Methods:From November 2016 to November 2019, 80 patients with staghorn calculi admitted to the First People's Hospital of Yongkang were selected in this research.They were randomly divided into two groups: RIRS group( n=40) and PCNL group( n=40). They were treated with RIRS and PCNL respectively.The stone removal rate, bleeding and operation time were compared between the two groups. Results:The amount of bleeding during operation, the amount of hemoglobin decrease after operation, the total cost of hospitalization and the time of hospitalization after operation in the RIRS group were less than those in the PCNL group, and the operation time was longer than that in the PCNL group, the differences were statistically significant( t≤25mm=84.306, 5.105, 2.617, 39.219, 7.488, t>25mm=24.630, 5.602, 2.586, 36.172, 6.895; all P<0.05). There was no statistically significant difference in the success rate of stone removal between the two methods for staghorn calculi with diameter ≤25mm(91.30% vs.90.91%)(χ 2=0.002, P>0.05). The success rate of debridement in the PCNL group was significantly higher than that in the RIRS group (94.4% vs.64.71%)(χ 2=4.833, P<0.05). The incidence of complications in the RIRS group was lower than that in the PCNL group (20.00% vs.45.00%), the difference was statistically significant(χ 2=5.698, P<0.05). Conclusion:RIRS and PCNL have their own advantages and disadvantages.For patients with staghorn calculi whose diameter is less than or equal to 25mm, RIRS is the first choice for treatment, with less bleeding during operation, less hospitalization cost and high safety.For patients with staghorn calculi whose diameter is more than 25 mm, PCNL is the best choice, which can significantly improve the removal rate of one-time calculi.

Cardiac electrical and mechanical synchrony of super-responders to cardiac resynchronization therapy / 中华医学杂志(英文版)

BACKGROUND@#Super-responders (SRs) to cardiac resynchronization therapy (CRT) regain near-normal or normal cardiac function. The extent of cardiac synchrony of SRs and whether continuous biventricular (BIV) pacing is needed remain unknown. The aim of this study was to evaluate the cardiac electrical and mechanical synchrony of SRs.@*METHODS@#We retrospectively analyzed CRT recipients between 2008 and 2016 in 2 centers to identify SRs, whose left ventricular (LV) ejection fraction was increased to ≥50% at follow-up. Cardiac synchrony was evaluated in intrinsic and BIV-paced rhythms. Electrical synchrony was estimated by QRS duration and LV mechanical synchrony by single-photon emission computed tomography myocardial perfusion imaging.@*RESULTS@#Seventeen SRs were included with LV ejection fraction increased from 33.0 ± 4.6% to 59.3 ± 6.3%. The intrinsic QRS duration after super-response was 148.8 ± 30.0 ms, significantly shorter than baseline (174.8 ± 11.9 ms, P = 0.004, t = -3.379) but longer than BIV-paced level (135.5 ± 16.7 ms, P = 0.042, t = 2.211). Intrinsic LV mechanical synchrony significantly improved after super-response (phase standard deviation [PSD], 51.1 ± 16.5° vs. 19.8 ± 8.1°, P < 0.001, t = 5.726; phase histogram bandwidth (PHB), 171.7 ± 64.2° vs. 60.5 ± 22.9°, P < 0.001, t = 5.376) but was inferior to BIV-paced synchrony (PSD, 19.8 ± 8.1° vs. 15.2 ± 6.4°, P = 0.005, t = 3.414; PHB, 60.5 ± 22.9° vs. 46.0 ± 16.3°, P = 0.009, t = 3.136).@*CONCLUSIONS@#SRs had significant improvements in cardiac electrical and LV mechanical synchrony. Since intrinsic synchrony of SRs was still inferior to BIV-paced rhythm, continued BIV pacing is needed to maintain longstanding and synchronized contraction.

Microvolt T-wave alternans complemented with electrophysiologic study for prediction of ventricular tachyarrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy: a long-term follow-up study / 中华医学杂志(英文版)

BACKGROUND@#The long-term predicted value of microvolt T-wave alternans (MTWA) for ventricular tachyarrhythmia in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) remains unclear. Our study explored the characteristics of MTWA and its prognostic value when combined with an electrophysiologic study (EPS) in patients with ARVC.@*METHODS@#All patients underwent non-invasive MTWA examination with modified moving average (MMA) analysis and an EPS. A positive event was defined as the first occurrence of sudden cardiac death, documented sustained ventricular tachycardia (VT), ventricular fibrillation, or the administration of appropriate implantable cardioverter defibrillator therapy including shock or anti-tachycardia pacing.@*RESULTS@#Thirty-five patients with ARVC (age 38.6 ± 11.0 years; 28 males) with preserved left ventricular (LV) function were recruited. The maximal TWA value (MaxValt) was 17.0 (11.0-27.0) μV. Sustained VT was induced in 22 patients by the EPS. During a median follow-up of 99.9 ± 7.7 months, 15 patients had positive clinical events. When inducible VT was combined with the MaxValt, the area under the curve improved from 0.739 to 0.797. The receiver operating characteristic curve showed that a MaxValt of 23.5 μV was the optimal cutoff value to identify positive events. The multivariate Cox regression model for survival showed that MTWA (MaxValt, hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.01-1.11; P = 0.01) and inducible VT (HR, 5.98; 95% CI, 1.33-26.8; P = 0.01) independently predicted positive events in patients with ARVC.@*CONCLUSIONS@#MTWA assessment with MMA analysis complemented by an EPS might provide improved prognostic ability in patients with ARVC with preserved LV function during long-term follow-up.

Microvolt T-wave alternans complemented with electrophysiologic study for prediction of ventricular tachyarrhythmias in patients with arrhythmogenic right ventricular cardiomyopathy: a long-term follow-up study / 中华医学杂志(英文版)

Background@#The long-term predicted value of microvolt T-wave alternans (MTWA) for ventricular tachyarrhythmia in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) remains unclear. Our study explored the characteristics of MTWA and its prognostic value when combined with an electrophysiologic study (EPS) in patients with ARVC.@*Methods@#All patients underwent non-invasive MTWA examination with modified moving average (MMA) analysis and an EPS. A positive event was defined as the first occurrence of sudden cardiac death, documented sustained ventricular tachycardia (VT), ventricular fibrillation, or the administration of appropriate implantable cardioverter defibrillator therapy including shock or antitachycardia pacing.@*Results@#Thirty-five patients with ARVC (age 38.6 ± 11.0 years; 28 males) with preserved left ventricular (LV) function were recruited. The maximal TWA value (MaxValt) was 17.0 (11.0–27.0) μV. Sustained VT was induced in 22 patients by the EPS. During a median follow-up of 99.9 ± 7.7 months, 15 patients had positive clinical events. When inducible VT was combined with the MaxValt, the area under the curve improved from 0.739 to 0.797. The receiver operating characteristic curve showed that a MaxValt of 23.5 μV was the optimal cutoff value to identify positive events. The multivariate Cox regression model for survival showed that MTWA (MaxValt, hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.01–1.11; P = 0.01) and inducible VT (HR, 5.98; 95% CI, 1.33–26.8; P = 0.01) independently predicted positive events in patients with ARVC.@*Conclusions@#MTWA assessment with MMA analysis complemented by an EPS might provide improved prognostic ability in patients with ARVC with preserved LV function during long-term follow-up.

Ureteroscopic holmium laser incision versus ureteroscopic cold knife incision in the treatment of ureteral stricture / 医学研究生学报

Objective　The aim of this study was to compared the clinical effect of ureteroscopic holmium laser incision (USHLI) with that of ureteroscopic cold knife incision (USCKI) in the treatment of ureteral stricture.　Methods　Seventy-eight patients with ureteral stricture underwent USHLI (n = 40) or USCKI (n = 38) in the Armed Police Corps Hospital of Jiangsu Province from January 2010 to December 2016. Comparisons were made between the two surgical strategies in the operation time, postoperative complications, hospital days, short-term effect and long-term effect.Results　Mild postoperative hematuria occurred in all the patients of the USHLI group, which lasted 1-2 days before it disappeared without intervention, but with no other severe complications as adjacent organ injury, ureteral avulsion, or massive hemorrhage. Moderate postoperative hematuria was observed in all the patients of the USCKI group, which was stopped at 2-3 days by administration of hemostatics. Compared with USCKI, USHLI achieved a significantly shorter operation time ([43.4 ± 5.8] vs [35.3 ± 3.8] min, P < 0.05) and postoperative hospital stay ([5.0 ± 1.4] vs [4.0 ± 0.8] d, P < 0.05), lower incidence of postoperative infection (27.3% vs 7.7%, P < 0.05), and higher cure rate (57.6% vs 87.2%, P < 0.05).　Conclusion　USHLI, with its advantages of less damage, lower recurrence rate and fewer complications, is obviously superior to USCKI in the treatment of ureteral stricture.

Effects of artesunate combined with bortezomib on apoptosis and autophagy of acute myeloid leukemia cells in vitro and its mechanism / 中华血液学杂志

Objective: To investigate the effects of artesunate combined with bortezomib on the proliferation, apoptosis and autophagy of human acute myeloid leukemia cell lines MV4-11, and its mechanisms. Methods: MTT method was used to determine the anti-proliferation effect of different concentrations of artesunate, bortezomib and their combination on MV4-11 cells. The cell apoptosis were analyzed by flow cytometry. The expression of cleaved-Caspase-3, Bcl-2 family protein (Bcl-2, Mcl-1, Bim, Bax) and autophagy-related protein LC3B were assayed by Western blot. Results: Artesunate displayed a proliferation inhibition effect on MV4-11 with dose- and time-dependent manner, the IC(50) of artesunate on MV4-11 after 48 hours was 1.44 μg/ml. Bortezomib displayed a proliferation inhibition effect on MV4-11 with dose-dependent manner, the IC(50) of bortezomib on MV4-11 after 48 hours was 8.97 nmol/L. The combination of artesunate (0.75, 1.0 μg/ml) and Bortezomib (6, 8 nmol/L) showed higher inhibition on MV4-11 than artesunate or bortezomib alone in the same concentration gradient after 48 hours (P<0.05) . The cooperation index of the two drugs were all less than 1. The 48 h apoptotic rate of artesunate (1.5 μg/ml) on MV4-11 was (15.27±2.18) %, (19.85±3.23) % of bortezomib (8 nmol/L) , (81.67±5.96) % of combination of the two drugs, significantly higher than the single group (P<0.05) . When combination of the two drugs on MV4-11 after 24 hours, the levels of pro-apoptotic protein Bim and the cleaved activation of Caspase-3 and autophagy-related protein LC3B were up-regulated and the anti-apoptotic protein Bcl-2 expressions was down-regulated. Conclusion: Combination of artesunate with bortezomib shows a significant synergistic effects on proliferation, apoptosis and autophagy of MV4-11 cell lines, which may be associated with Bcl-2 family proteins expression.

Mutation analysis of FLT3-ITD gene in acute myeloid leukemia / 中国病理生理杂志

AIM:To investigate the mutation of FLT3-ITD gene in the patients with newly diagnosed acute myeloid leukemia (AML). METHODS:From March 1, 2015 to June 1, 2017, 207 patients with AML admitted to de-partment of hematology, sichuan provincial people′s hospital were enrolled in this study. The bone marrow samples were collected from the patients. PCR was used to detect the mutation of FLT3-ITD gene. After the corresponding chromosome was obtained by R-banding, the cells were made into strips and banding. Twenty karyotypes with relatively cleavage were automatically selected from each specimen to complete karyotyping. By analysis of the clinical data and following-up the prognosis, the FLT3-ITD gene mutation in diagnostic and evaluative values for AML were performed. RESULTS:FLT3-ITD gene mutation was found in 42 cases of 207 AML patients, the positive rate was 20. 29 % . FLT3-ITD positive patients showed 3 bands. FLT3-ITD gene mutation in 42 patients with positive results showed that FLT3-ITD gene mutations in turn met the end to end, and insert a number of nucleotides, but all the mutations were in-frame mutations. According to the FAB and WHO standard, in 42 cases of FLT3-ITD positive positive patients, M0 accounted for 0.00% , M1 accounted for 2.38% (1/42), M2 accounted for 23.81% (10/42), M3 accounted for 0.00% , M4 accounted for 2.38% (1/42), M5 accounted for 69.05% (29/42), M6 accounted for 0.00% , M7 accounted for 2.38% (1/42). The white blood cell ( WBC) level and complete response (CR) rate in FLT3-ITD positive patients were lower than those in FLT3-ITD negative patients (P<0.05). CONCLUSION:The WBC level and CR rate, which are lower in FLT3-ITD positive patients than those in negative patients, are the clinical risk factors. It will be helpful to determine the prognosis evaluation for AML pa-tients.

Effects of the relationship between bone cement and endplate on the vertebral height loss after percutaneous vertebroplasty / 复旦学报（医学版）

Objective To investigate the effects of the relationship between bone cement polymethyl methacrylate (PMMA) and endplate on the vertebral height loss after percutaneous vertebroplasty (PVP).Methods A retrospective analysis of 84 female patients with single segment osteoportic vertebral compression fracture who had undergone PVP between Jun.,2013 and May,2016 was conducted.According to the X-ray radiographs and CT scans,all subjects were divided into the doPMMA-endplate-contact group (40 cases,average age 76.88 years) and the non-PMMA-endplatecontact group (44 cases,average age 77.96 years).The volume of bone cement,operation time,fractured vertebral height restoration rate,3-month postoperative vertebral height loss rate,changes in local sagitta view Cobb angle and bone cement leakage rate were respectively recorded and compared.Results There were no significant difference in age,body mass index,the levels of serum calcium and phosphorus,bone mineral density and preoperative vertebral body compression rate between the two groups (P＞0.05).Postoperative vertebral height loss rate and changes in local sagitta view Cobb angle in the do-PMMA-endplate-contact group were significantly less than the non-PMMA-endplate-contact group (P＜0.05).However,there was no significant difference in bone cement leakage rate between the two groups (P＞0.05).Conclusions Making bone cement contact with endplate would reduce the height loss of cemented vertebrae without increasing the rate of cement leakage.

Efficacy analysis of percutaneous microwave ablation in treatment of hepatic metastases from gastric adenocarcinoma after gastrectomy / 中国医师进修杂志

Objective To evaluate the efficacy of of percutaneous microwave ablation(MWA) in treatment of hepatic metastases from gastric adenocarcinoma after gastrectomy. Methods Twenty-four patients who underwent percutaneous MWA after gastrectomy for a hepatic metastasis from a gastric cancer from October 2009 to October 2014. Median age was (63 ± 11) years. Three-two times MWA was done in 27 metastatic tumors. Patients′ outcomes were assessed by enhancement CT or MRI. Results The rate of total ablation was 92.6%(25/27). The deadline of follow up was 2016-04-01. One patient was living and 23 patients died with tumor progression. The median overall survival was 24.1(95%CI:9.8-34.3) months. The survival rate of 1, 2, 3, 4 and 5 years was 78.7%, 40.7%, 38.5%, 19.4%and 8.2%. The median progression-free survival was 13.4 (95%CI:2.0-30.4) months, and the survival rate of local progression-free of 6 months, 1, 2 and 3 years was 64.3%, 50.1%, 40.2%and 26.9%. The main complication was moderate and severe pain in 10 cases, and 17 cases had post ablation syndrome. Conclusions For patients with metastatic tumors≤3 cm, MWA is a safe and feasible treatment option for hepatic metastases from gastric adenocarcinoma.

A preliminary investigation of body composition in prediction of malnutrition in patients with nasopharyngeal carcinoma / 中华放射肿瘤学杂志

Objective To investigate the relationship between nutritional status and quality of life ( QOL) in patients with nasopharyngeal carcinoma undergoing concurrent chemoradiotherapy, and to identify the optimal indices of body composition for evaluation of malnutrition. Methods Based on the European Society Parenteral and Enteral Nutrition ( ESPEN) consensus on the diagnosis of malnutrition and patient?generated subjective global assessment (PG?SGA), a prospective study was performed in 48 patients with nasopharyngeal carcinoma who received concurrent chemoradiotherapy in our hospital from 2014 to 2015. Changes in body composition and nutritional status were evaluated in those patients. The relationship between nutritional status and QOL was studied. The predictive factors for nutritional status in patients with nasopharyngeal carcinoma were explored. The correlation between datasets was evaluated by the Pearson correlation coefficient. The influencing factors for nutritional status were analyzed by Logistic regression. Results During concurrent chemoradiotherapy, some indices of body composition, including weight, body mass index ( BMI) , fat mass index ( FMI) , fat?free mass index ( FFMI) , body cell mass ( BCM) , skeletal muscle mass ( SM) , and phase angle ( PA) had different degrees of reduction ( P=0?00) , while the PG?SGA score gradually increased. The incidence of malnutrition in patients with nasopharyngeal carcinoma during radiotherapy was 2?1%?39?6% based on 2015 ESPEN consensus on the diagnosis of malnutrition and 12?5%?41?7% based on PG?SGA. These two methods showed good agreement at the fourth and sixth weeks of radiotherapy ( Kappa=0?911;Kappa=0?957) . The changes in QOL score were correlated with changes in FFMI and weight during radiotherapy ( r= 0?805, P= 0?00;r= 0?777, P= 0?00 ) . Logistic regression indicated that age, FMI, and FFMI were influencing factors for nutritional status ( P= 0?035, 0?013, 0?043) . Conclusions Patients with nasopharyngeal carcinoma have substantial nutritional deterioration during chemoradiotherapy. The nutritional status is closely associated with QOL. A prediction model of nutritional status can provide a comprehensive and accurate judgment of nutritional status in patients.

Pharmaceutical Care for One Case of Allergic Reactions Caused by Oxaliplatin / 中国药房

OBJECTIVE:To explore the role of clinical pharmacists on pharmaceutical care for allergic reaction caused by ox-aliplatin. METHODS:Clinical pharmacists conducted pharmaceutical care for a patient with oxaliplatin-induced allergic reaction, and suggested stopping taking oxaliplatin,giving Dexamethasone injection 5 mg and then slowing down injection speed. RE-SULTS:Physicians adopted the suggestions of clinical pharmacists. Allergic reaction relieved 5 min after giving Dexamethasone in-jection. The patient didn't suffered from this allergic reaction again under tight supervision. CONCLUSIONS:Oxaliplatin is often used for tumor therapy. Medical staff should be familiar with the prevention,diagnosis and treatment of ADR,evaluate oxaliplatin chemotherapy plan in advance and screen high risk allergy factor. The participation of clinical pharmacists in pharmaceutical care contribute to ADR monitoring and promote safe and rational drug use in the clinic.

Diagnostic value of digital subtraction CT angiography in small intracranial aneurysms / 实用放射学杂志

Objective To evaluate the value of digital subtraction computed tomography angiography(DSCTA)in the diagnosis of intracranial small aneurysms.Methods 92 patients with intracranial aneurysms confirmed by digital subtraction angiography(DSA) or surgery were selected as the subjects of this study.Their clinical and CT imaging data were analyzed retrospectively.The diagnos-tic accuracy of DSCTA and conventional CTA for intracranial aneurysms was compared.Results A total of 102 aneurysms were con-firmed in the 92 patients,100 of them were detected by DSCTA and 89 by conventional CTA (χ2 =8.707,P =0.003).Two small aneurysms of less than 5.0 mm located respectively at the cavernous sinus and beneath the clinoid segments were missed by DSCTA, while 13 by conventional CTA.When aneurysms of less than 3.0 mm and 3.0-5.0 mm were combined with calculation,the sensi-tivity of DSCTA in detecting aneurysms of less than 5.0 mm was significantly higher than that of conventional CTA (χ2 =8.393,P =0.004).Conclusion DSCTA has more advantages than conventional CTA in the diagnosis of intracranial aneurysms,especially for the small aneurysms adjacent to the skull base.DSCTA can be used as a preferred technique in the screening and diagnosis of in-tracranial aneurysms.

Determination of anaprazole in human plasma by LC-MS/MS in pharmacokinetic study / 药学学报

Anaprazole is a proton pump inhibitor clinically used for curing peptic ulcer. A rapid, sensitive and convenient LC-MS/MS method was first established for the determination of anaprazole in human plasma. d3, 13C-anaprazole was used as internal standard (IS). After extraction from human plasma by protein precipitation with acetonitrile, all components were separated on an Extend C18 column (100 mm×4.6 mm, 3.5 μm). The assay was linear over the concentration range of 5.00-3 000 ng·mL-1 (r2 > 0.995). The method was successfully applied to a pharmacokinetic study of 40 mg anaprazole enteric-coated tablets in 14 Chinese healthy volunteers under fasting or high fat diet conditions. Cmax was (1 020±435) ng·mL-1 and AUC0-t was (2 370±754) h·ng·mL-1 under fasting condition. And Cmax was (538±395) ng·mL-1 and AUC0-t was (1 610±650) h·ng·mL-1 under high fat diet condition. The plasma results suggest that the exposure of anaprazole is reduced by the high fat diet.

The role of CXCR2 in the invasion and metastasis of head and neck squamous cell carcinoma / 实用口腔医学杂志

Objective:To explore the role of CXCR2 in the invasion and metastasis of head and neck squamous cell carcinoma (HNSCC).Methods:The expression of CXCR2 in HNSCC tissues of 105 cases was detected by immunohistochemical staining,the correlation between CXCR2 expression and cervical lymph node metastases of HNSCC was analysed.Then,3 stable HNSCC cell lines with CXCR2 interference were established,the effects of CXCR2 silencing on cell migration and invasion were observed by in vitro tests.Results:CXCR2 was positively expressed in 51.43% of HNSCC specimens and was statistically associated with the cervical lymph node metastases of HNSCC.CXCR2 silencing markedly inhibited the migration and invasion of HNSCC cells in vitro.Conclu-sion:CXCR2 may play a key role in the invasion and metastases of HNSCC.

Study of clinical practical model of urinary system injury / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In order to improve the clinical treatment level of urinary system injury, it is necessary to build up an animal model of urinary system wound, which is not only analogous to real clinical practice, but also simple and practical.</p><p><b>METHODS</b>We have developed the third generation of firearm fragment wound generator based on the first and the second producer. The best explosive charge of the blank cartridge was selected by gradient powder loading experiments. The firearm fragment injuries were made to the bulbous urethra of 10 New Zealand male rabbits. One week preoperatively and 2, 4 and 8 weeks postoperatively, all the animals underwent urethroscopy and urethrography. At 2, 4 and 8 weeks postoperatively, two animals were randomly selected and killed, and the urethra was cut off for pathological examination.</p><p><b>RESULTS</b>The shooting distance of the third generation of firearm fragment wound generator is 2 cm. The best explosive charge of the blank cartridge is 1 g of nitrocotton. All rabbits survived the procedures and stayed alive until they were killed. Injuries were limited to bulbous urethra and distal urethra. Round damaged areas, 1-1.5 cm in length, on the ventral wall were observed. Ureteroscopy results showed that canal diameter gradually shrank by over 50% in 9 rabbits. The rate of success was 90%. Urethrography result noted that a 1-1.3 cm stricture was formed at the bulbous urethra. Histology results of injured stricture urethra showed that fibrous connective tissue hyperplasia and hyaline degeneration caused further stricture in the canal.</p><p><b>CONCLUSIONS</b>The third generation of firearm fragment wound generator imitates the bullet firing process and is more accurate and repeatable. The corresponding rabbit model of traumatic complex urethral stricture simulates the real complex clinical conditions. This animal model provides a standardized platform for clinical researches on treating traumatic injuries to the urinary system.</p>