Correlation between 25-hydroxyvitamin D and nephroblastoma in children and its value in assessing disease prognosis / 中国当代儿科杂志

OBJECTIVES@#To study the correlation between 25-hydroxyvitamin D [25-(OH)D] and nephroblastoma in children and its value in assessing the prognosis of the disease.@*METHODS@#A total of 50 children with nephroblastoma who were admitted from January 2018 to December 2022 were included as the nephroblastoma group, and according to the postoperative pathological type, they were divided into a good prognosis group with 38 children and a poor prognosis group with 12 children. A total of 50 healthy children who underwent physical examination during the same period of time served as the healthy control group. The above groups were compared in terms of serum creatinine and 25-(OH)D level. A Spearman correlation analysis was used to investigate the correlation between serum 25-(OH)D level and therapeutic effect reaction. A multivariate logistic regression analysis was used to identify the risk factors affecting the prognosis of nephroblastoma in children.@*RESULTS@#The nephroblastoma group had significantly lower levels of serum creatinine and 25-(OH)D than the healthy control group (P<0.05). Compared with the good prognosis group, the poor prognosis group had a significantly larger tumor diameter, a significantly higher proportion of children with stage III-IV tumors, a significantly higher rate of tumor metastasis, and significantly lower serum levels of creatinine and 25-(OH)D (P<0.05). The Spearman correlation analysis showed that serum 25-(OH)D level was negatively correlated with therapeutic effect reaction (rs=-0.685, P<0.001). The multivariate logistic regression analysis showed that tumor diameter ≥10 cm, stage III-IV tumors, presence of tumor metastasis, and 25-(OH)D <19 ng/mL were closely associated with the poor prognosis of nephroblastoma in children (P<0.05). Serum 25-(OH)D level had an area under the curve of 0.805 (95%CI: 0.706-0.903, P<0.001) in evaluating the prognosis of nephroblastoma in children, with a Youden index of 0.512, a sensitivity of 0.938, and a specificity of 0.575 at the optimal cut-off value of 1.764 ng/mL.@*CONCLUSIONS@#There is a significant correlation between 25-(OH)D level and the prognosis of nephroblastoma in children, and 25-(OH)D can be used for prognosis prediction.

Shaofu Zhuyu Decoction attenuates fibrosis in endometriosis through regulating PTEN/Akt/mTOR signaling pathway / 中国中药杂志

The present study aimed to investigate the protective role of Shaofu Zhuyu Decoction(SFZY) against endometriosis fibrosis in mice, and decipher the underlying mechanism through the phosphatase and tensin homolog deleted on chromosome ten(PTEN)/protein kinase B(Akt)/mammalian target of rapamycin(mTOR) pathway. Eighty-five BALB/c female mice were randomly assigned into a blank group, a model group, high-, medium, and low-dose SFZY(SFZY-H, SFZY-M, and SFZY-L, respectively) groups, and a gestrinone suspension(YT) group. The model of endometriosis was induced by intraperitoneal injection of uterine fragments. The mice in different groups were administrated with corresponding groups by gavage 14 days after modeling, and the blank group and model group with equal volume of distilled water by gavage. The treatment lasted for 14 days. The body weight, paw withdrawal latency caused by heat stimuli, and total weight of dissected ectopic focus were compared between different groups. The pathological changes of the ectopic tissue were observed via hematoxylin-eosin(HE) and Masson staining. Real-time PCR was employed to measure the mRNA levels of α-smooth muscle actin(α-SMA) and collagen type Ⅰ(collagen-Ⅰ) in the ectopic tissue. The protein levels of PTEN, Akt, mTOR, p-Akt, and p-mTOR in the ectopic tissue were determined by Western blot. Compared with the blank group, the modeling first decreased and then increased the body weight of mice, increased the total weight of ectopic focus, and shortened the paw withdrawal latency. Compared with the model group, SFZY and YT increased the body weight, prolonged the paw withdrawal latency, and decreased the weight of ectopic focus. Furthermore, the drug administration, especially SFZY-H and YT(P<0.01), recovered the pathological and reduced the area of collagen deposition. Compared with the blank group, the modeling up-regulated the mRNA levels of α-SMA and collagen-Ⅰ in the ectopic focus, and such up-regulation was attenuated after drug intervention, especially in the SFZY-H and YT groups(P<0.05,P<0.01). Compared with the blank group, the modeling down-regulated the protein level of PTEN and up-regulated the protein levels of Akt, mTOR, p-Akt, and p-mTOR(P<0.01, P<0.001). Drug administration, especially SFZY-H and YT, restored such changes(P<0.01). SFZY may significantly attenuate the focal fibrosis in the mouse model of endometriosis by regulating the PTEN/Akt/mTOR signaling pathway.

The value of quantitative parameters of dynamic contrast-enhanced MRI in evaluating the biological behavior of soft tissue tumors / 中华放射学杂志

Objective:To explore the value of quantitative parameters of dynamic contrast-enhanced MRI(DCE-MRI) in evaluating the biological behavior of soft tissue tumors.Methods:The clinical data of 69 patients with soft tissue tumors confirmed by pathology in the Affiliated Hospital of Qingdao University from January 2017 to December 2019 were analyzed retrospectively, including 29 benign tumors and 40 malignant tumors. All patients were examined by routine MRI and DCE-MRI before the operation. The DCE-MRI parameters including volume transfer constant (K trans), rate constant (K ep) and extracellular space volume fraction (V e) were acquired by post-processing software analysis. Microvessel density (MVD) and Ki-67 labeling index (Ki-67 LI) were detected using immunohistoche mical method. Spearman correlation test was used to analyze the correlation between DCE-MRI quantitative parameters and MVD and Ki-67 LI.Independent sample t-test or Mann-Whitney U test was used to compare the difference of parameters between benign and malignant group, and the receiver operating characteristic (ROC) curves were performed to evaluate the diagnostic value. Results:There was positive correlation between K trans, K ep and MVD ( r=0.633, 0.727, P<0.0l), and positive correlation between K trans, K ep and Ki-67 LI ( r=0.557, 0.612, P<0.01). There was no correlation between V e and MVD, Ki-67 LI ( P>0.05). The K trans, K ep, MVD and Ki-67 LI in the malignant group were higher than those in the benign group, and the differences were significant ( P<0.05).There was no significant difference in V e value between malignant group and benign group. When K trans value of 0.169/min was used, the sensitivity, specificity and area under the ROC curve (AUC) for differentiating benign and malignant soft tissue tumors were 84.6%, 85.8% and 0.859, respectively. When K ep value of 0.367/min was used, the sensitivity, specificity and AUC were 92.3%, 83.3% and 0.846, respectively. Conclusion:The DCE-MRI quantitative parameters K trans and K ep can be used to evaluate the biological behavior of soft tissue tumors.

Effect of Acupuncture at Baihui and Renzhong on Glucose Transporter 1,3 in Acute Cerebral Ischemia Rat Model / 广州中医药大学学报

Objective To investigate the effect of early-stage acupuncture therapy on local glucose metabolism in model rats with cerebral ischemia. Methods Eighty three-month-old SD rats were randomly divided into 4 groups,namely normal group,model group,2-h acupuncture group and 24-h acupuncture group,20 rats in each group. Craniotomy was used to establish the rat model of acute cerebral ischemia. Acupuncture treatment was carried out on acupoint of Baihui(GV20)and Renzhong(DU26)with reducing method,needle twirling and rotating frequency being 120 times per minute,once every other 4 min and for one min,and the total needling time for 30 min. Rats in 2-h acupuncture group were given acupuncture 2 h after the successful modeling,and once again after 24 h,two times in total;rats in 24-h acupuncture group were given acupuncture only for one time 24 h after successful modeling. At the end of treatment,the rat neurological function was scored,and the infarction area was measured by 2,3,5-triphenyltetrazole chloride (TTC)staining. The protein expression levels of glucose transporter(GLUT)1 and 3 in ischemic brain tissue were detected by immunohistochemistry. Results Compared with the normal group, the scores of neurological function in the model group were increased;TTC staining results showed that the left hemisphere was swollen,and the infarct volume was significantly larger than that of the contralateral side;immunohistochemical results showed that the GLUT1 and GLUT3 expression levels in the ischemic brain tissue were increased(P < 0.01). Compared with the model group,2-h acupuncture group and 24-h acupuncture group could effectively improve the cerebral ischemia, reduce the neurological function indexes and infarction area showed by TTC staining,and increase the expression levels of GLUT1 and GLUT3 in ischemic brain tissue significantly (P<0.05). And the therapeutic effect of 2-h acupuncture group was superior to that of 24-h acupuncture group(P<0.05). Conclusion Acupuncture can effectively improve cerebral ischemia in rats with acute cerebral ischemia. Acupuncture can improve the energy metabolism of ischemic brain tissue by up-regulating the protein expression of cerebral GLUT1 and GLUT3 and by increasing the blood-brain barrier transport efficiency for glucose,thus to promote glucose metabolism and provide energy for ischemic brain tissue to relieve relatively inadequate energy, and to protect against cerebral ischemic injury. Early acupuncture intervention exerts a positive effect on regulating energy metabolism of rats with cerebral ischemia.

Ultrasonography of retroperitoneal ifbrosis / 中华医学超声杂志（电子版）

Objective To analyze the ultrasonographic features of retroperitoneal ifbrosis (RPF). Methods Totally 13 patients with retroperitoneal ifbrosis from February 2000 to October 2012 in the Long Gang central Hospital of Shenzhen were retrospectively analyzed. Results In all patients who underwent ultrasound examination, there were ten cases of idiopathic RPF and three cases of secondary RPF with abdominal tumors. In 11 cases, the masses were hypoechoic locating at retroperitoneum and surrounding the abdominal aorta without deifnitive margin. One case showed hypoechoic mass with clear boundary. In ten cases, the internal echogenicity of masses were uniform. In two cases, the internal echogenicity of masses were uneven with a small amount of ifbrous separator with slightly higher echogenicity. No blood was found in all masses. The encasement of inferior vena cava was found in three casesand the masses extended to iliac arteries in three cases. Hydronephrosis could be found in 11 patients (84.6%) and ureter dilatation was found in ten cases. Ureteral localized stenosis were found in two cases. Conclusion Ultrasonography is a preferred imaging method in diagnosing RPF.

Acute epidural hematoma after thoracic spine surgery / 中华骨科杂志

Objective To investigate the risk factors and preventive measures for acute epidural hematoma after posterior thoracic spine surgery.Methods A retrospective study of 14 patients who developed acute epidural hematoma after thoracic spine surgery from May 2002 to May 2012 was conducted.There were 6 males and 8 females,aged from 41 to 69 years (average,61.2 years).There were 10 cases of thoracic spinal canal stenosis,3 cases of thoracic spinal meningioma,and 1 case of thoracic metastasis.About 3-14 h (average,6.6 h) after posterior thoracic spine surgery,the neurological deterioration was found,and according to the American Spinal Injury Association (ASIA) classification,there were 5 cases of grade A and 9 cases of grade B.The neurological function before evacuation of hematoma was compared with that after evacuation of hematoma and that at final follow-up.The correlations between hematoma compression time,neurological improvement rate and neurological function before evacuation of hematoma were statistically analyzed.Results After evacuation of hematoma,the ASIA classification of 14 patients was as follows:grade B in 1 case,grade C in 2 cases,grade D in 4 cases,and grade E in 7 cases.The hematoma compression time of 3 patients with grade B or C was more than 10 hours.Obvious difference of neurological function was found before and after evacuation of hematoma.The neurological improvement rate was 63.7％±23.3％ after evacuation of hematoma,which was negatively correlated with hematoma compression time and positively correlated with preoperative neurological function.The neurological function before evacuation of hematoma was significantly different from that at final follow-up.The neurological improvement rate was 86.97％±17.58％ at final follow-up,which was negatively correlated with hematoma compression time and positively correlated with preoperative neurological function.Conclusion The acute epidural hematoma after thoracic spine surgery could cause severe neurological deterioration.The neurological improvement was negatively correlated with hematoma compression time.Evacuation of hematoma must be done as soon as possible once progressive neurological deterioration is found.

Construction and biological assessment of tissue engineering intervertebral disc / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the value of bone marrow-mesenchymal stem cells (BM-MSCs) transformed by nucleus pulposus (NPs) for construction of tissue engineering disc.</p><p><b>METHODS</b>BM-MSCs and fetal NPs were cultured in vitro, planted on polylactic acid-polyglycolic acid copolymer (PLGA), and observed with inverted microscope and scanning electronic microscope. PLGA scaffolds with adherent BM-MSCs and NPs, as well as BM-MSCs and NPs suspension were implanted into intervertebral discs of New Zealand white rabbits, respectively. Intervertebral signal intensity was evaluated by Thompson grading 12 weeks later. Proteoglycan and type IIcollagen were determined by spectrophotometric method and immunohistochemistry, respectively.</p><p><b>RESULTS</b>Spindle or multi-angular BM-MSCs turned into fibro-like phenotype coculture of BM-MSCs and NPs, which grew well with normal morphology when they attached on PLGA scaffolds. There was statistical difference in intervertebral signal intensity, and the expression of proteoglycan and type IIcollagen between PLGA scaffolds group and control group (P < 0.05), the content of proteoglycan was (3.93 ± 0.31) mg/100 mg in the PLGA scaffolds group whereas (3.52 ± 0.26) mg/100 mg in the control group.</p><p><b>CONCLUSIONS</b>BM-MSCs can be induced into NPs by cocultivation, and PLGA scaffolds can provide good growing conditions, and maintain high mechanical properties and spacial structure which meet the requirement of tissue engineering disc to prevent degeneration.</p>