Orange-derived extracellular vesicles nanodrugs for efficient treatment of ovarian cancer assisted by transcytosis effect

Extracellular vesicles (EVs) have recently received much attention about the application of drug carriers due to their desirable properties such as nano-size, biocompatibility, and high stability. Herein, we demonstrate orange-derived extracellular vesicles (OEV) nanodrugs (DN@OEV) by modifying cRGD-targeted doxorubicin (DOX) nanoparticles (DN) onto the surface of OEV, enabling significantly enhancing tumor accumulation and penetration, thereby efficiently inhibiting the growth of ovarian cancer. The obtained DN@OEV enabled to inducement of greater transcytosis capability in ovarian cancer cells, which presented the average above 10-fold transcytosis effect compared with individual DN. It was found that DN@OEV could trigger receptor-mediated endocytosis to promote early endosome/recycling endosomes pathway for exocytosis and simultaneously reduce degradation in the early endosomes-late endosomes-lysosome pathway, thereby inducing the enhanced transcytosis. In particular, the zombie mouse model bearing orthotopic ovarian cancer further validated DN@OEV presented high accumulation and penetration in tumor tissue by the transcytosis process. Our study indicated the strategy in enhancing transcytosis has significant implications for improving the therapeutic efficacy of the drug delivery system.

Experts consensus on the procedure of dental operative microscope in endodontics and operative dentistry / 国际口腔科学杂志·英文版

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.

Protective effect of serum containing ginseng and Moutan Cortex on HUVEC injured by H_2O_2 / 中国中药杂志

This study aimed to investigate the effect of serum containing ginseng and Moutan Cortex on human umbilical vein endothelial cells(HUVEC) injured with hydrogen peroxide(H_2O_2). HUVEC injured with H_2O_2 were divided into 6 groups, namely blank group, model group, ginsenoside(TGG) group, total glucosides of Moutan Cortex(TGM) group, paeonol(P) group and TGG+TGM+P group. After 24 hours of co-culture with H_2O_2, the activities of succinate dehydrogenase(SDH) and Ca~(2+)-Mg~(2+)-ATP were detected by microenzyme labeling. The apoptosis rate, intracellular Ca~(2+) concentration, reactive oxygen species(ROS) and mitochondrial membrane potential(JC-1) were detected by flow cytometry. The expressions of mitochondrial apoptosis pathway-related proteins Bax, Bcl-2, cytochrome C, caspase-3 and caspase-9 were detected by Western blot. The results showed that H_2O_2 could significantly damage HUVEC, decrease the activity of SDH and Ca~(2+)-Mg~(2+)-ATP(P<0.01), while could increase the apoptosis+necrosis rate, JC-1 decline rate, ROS increase rate and Ca~(2+) concentration increase rate(P<0.01). Serum containing ginseng and Moutan Cortex could increase the activities of SDH and Ca~(2+)-Mg~(2+)-ATP to different degrees, decrease the apoptosis+necrosis rate, JC-1 decline rate, ROS increase rate and Ca~(2+) concentration increase rate(P<0.05 or P<0.01), and down-regulate the protein expressions of Bax, caspase-3, caspase-9, cytochrome C, and up-regulate the protein expression of Bcl-2. The results showed that serum containing ginseng and Moutan Cortex has a protective effect on vascular endothelial cell injury induced by ROS, and its mechanism may be related to the improvement of mitochondrial function and the inhibition of the activation of mitochondrial apoptosis pathway.

2019 Novel Coronavirus (COVID-19) Pneumonia: Serial Computed Tomography Findings

From December 2019, Coronavirus disease 2019 (COVID-19) pneumonia (formerly known as the 2019 novel Coronavirus [2019-nCoV]) broke out in Wuhan, China. In this study, we present serial CT findings in a 40-year-old female patient with COVID-19 pneumonia who presented with the symptoms of fever, chest tightness, and fatigue. She was diagnosed with COVID-19 infection confirmed by real-time reverse-transcriptase-polymerase chain reaction. CT showed rapidly progressing peripheral consolidations and ground-glass opacities in both lungs. After treatment, the lesions were shown to be almost absorbed leaving the fibrous lesions.

Novel Coronavirus Pneumonia Outbreak in 2019: Computed Tomographic Findings in Two Cases

Since the 2019 novel coronavirus (2019-nCoV or officially named by the World Health Organization as COVID-19) outbreak in Wuhan, Hubei Province, China in 2019, there have been a few reports of its imaging findings. Here, we report two confirmed cases of 2019-nCoV pneumonia with chest computed tomography findings of multiple regions of patchy consolidation and ground-glass opacities in both lungs. These findings were characteristically located along the bronchial bundle or subpleural lungs.

2019 Novel Coronavirus (COVID-19) Pneumonia: Serial Computed Tomography Findings

From December 2019, Coronavirus disease 2019 (COVID-19) pneumonia (formerly known as the 2019 novel Coronavirus [2019-nCoV]) broke out in Wuhan, China. In this study, we present serial CT findings in a 40-year-old female patient with COVID-19 pneumonia who presented with the symptoms of fever, chest tightness, and fatigue. She was diagnosed with COVID-19 infection confirmed by real-time reverse-transcriptase-polymerase chain reaction. CT showed rapidly progressing peripheral consolidations and ground-glass opacities in both lungs. After treatment, the lesions were shown to be almost absorbed leaving the fibrous lesions.

Analysis of coronary intramural hematomas after coronary artery stent implantation / 中国介入心脏病学杂志

Objective To analyze the rates of occurrence,presentations and treatment of coronary intramural hematomas(IMH)after coronary artery stent implantation.Methods Retrospective analysis was carried out in non-chronic total occlusion patients who developed coronary intramural hematomas after coronary artery stent implantation between January 1,2011 to December 31,2016.Statistical analysis was made in the fields clinical data,coronary angiography features,treatment provided,and postoperative follow-up date of the patients.Results Among the 26 IMH patients,the male gender(15/26,57.7％)and existiing hypertension(17/26,65.4％)were more common risk factors for IMH after coronary artery stent implantation.Fourteen patients developed coronary dissection.The coronary intramural hematomas presented as new non-spasm and non-thrombus coronary stenosis.The coronary intramural hematomas were found to have involved the distal segment to the stents in 16 patients.Two patients received balloon dilation,five patients had stents implantation after balloon dilation,13 patients(50.0％)were treated with direct stent implantation and the other 6 patients did not have further intervention.The follow up period after hospital discharge was(2.39±1.68)years.No adverse cardiovascular event occurred.Five patients received follow-up angiography examination.Two patients and another one patient were found to have coronary intramural hematomas fully resolved at three months and one year with coronary angiographic follow up,respectively.Two patients had IMH on angiography at 1 year follow up.Conclusions Coronary intramural hematomas after coronary artery stent implantation often involved the distal segment to the stent in hypertensive patients presenting as new non-spasm and non-thrombus coronary stenosis.Patients at low risk of acute coronary occlusion could receive conservative treatment.Patients with extentsive length of intramural hematomas should consider stent implantation for treatment.

Ultrasound mediated nitric oxide microbubbles enhance the therapeutic efficacy of bone marrow mesenchymal stem cell transplantation on myocardial infarctions / 中国组织工程研究

BACKGROUND: Recent experimental studies have found ultrasound mediated microbubbles potentiate stem cell therapy in myocardial infarction (MI)-induced heart failure, indicating a good application prospect. But whether ultrasound mediated nitric oxide (NO) microbubbles also have the same effect in the intracoronary transplantation of bone marrow mesenchymal stem cells (BMSCs) for treatment of large animals with MI is still unknown. OBJECTIVE: To investigate the effectiveness and possible mechanism of ultrasound mediated NO microbubbles in potentiating intracoronally transplanted BMSCs homing to the infarcted area in a MI pig model.METHODS: Density gradient centrifugation culture method was used in the isolation and cultivation of BMSCs. CM-Dil was used to label BMSCs in vitro. Twenty-four pigs were used to make MI models by blocking the left anterior descending coronary artery, and then were divided into PBS group, BMSCs group, ultrasound+microbubbles+BMSCs(MB) group, ultrasound+NO microbubbles+BMSCs (NO-MB) group(n=6 per group). In the PBS group, 10 mL of PBS was intracoronally injected. In the BMSCs group, about 1×107 BMSCs were diluted in 10 mL of PBS and then intracoronally infused. In the MB group, 0.1 mL/kg sulphur hexafluoride microbubbles (Sono Vue) was intracoronally injected together with ultrasound treatment (1 MHz, 2 W/cm2, 2 minutes), followed by intracoronary infusion of about 1×107 BMSCs that were diluted in 10 mL of PBS. In the NO-MB group, all methods and conditions were identical to those in the MB group except only 0.1 mL/kg of Sono Vue was replaced by 0.1 mL/kg NO microbubbles. Three pigs were sacrificed in each group 48 hours after CM-Dil positive BMSCs transplantation. The labeled BMSCs were observed and counted by fluorescent microscope after frozen sectioning of the infarct area. We assessed and compared left ventricular systolic function with M-mode ultrasound among groups at 4 weeks after intervention. After cardiac function test, the rest pigs were sacrificed and capillary density in the myocardial ischemic area was counted and compared after hematoxylin-eosin staining. RESULTS AND CONCLUSION: (1) The number of CM-Dil positive cells in the area of MI in the NO-MB group was much more than that in the MB group and BMSCs group with statistical significance (P < 0.05). (2) The left ventricle systolic function was significantly improved in the NO-MB group as compared with the MB group (P < 0.05). The same trend was observed between NO-MB group and BMSCs group as well as between NO-MB group and PBS group (P < 0.05). (3) The density of capillaries increased significantly in the NO-MB group compared with the MB group, BMSCs group and PBS group, respectively. To conclude, ultrasound mediated NO microbubble combined with intracoronary BMSCs transplantation can improve the left ventricular systolic function. The possible mechanism could be that ultrasoundmediated NO mocrobubbles promote the homing of transplanted BMSCs to the myocardial ischemia area as well as improve local angiogenesis.

Effect of CYP2C19 polymorphism on platelet P2Y12 receptor signaling pathway in Chinese patients with stable coronary artery disease after the treatment of clopidogrel / 复旦学报（医学版）

Objective To investigate the molecular mechanism of the effect of CYP2C19 polymorphism on the efficacy of clopidogrel in patients with stable coronary artery disease (SCAD).Methods A total of 208 patients with coronary artery disease undergoing percutaneous coronary intervention (PCI) were included.The CYP2C19 variant alleles were detected by gene sequencing.Platelet reactivity was assessed by thrombelastograph at 24 h after 300 mg clopidogrel loading.P2Y12-Gi signaling was measured by flow cytometric analysis of vasodilator-stimulated phosphorylation-platelet reactivity index (VASP-PRI) and Akt phosphorylation (P-Akt) index.Results Among 208 patients,40.9％ were classified as CYP2C19 * 1/* 1 (non-carriers) with no loss-of-function (LOF),44.7％ as CYP2C19 * 1/* 2 or CYP2C19 * 1/* 3 (one LOF carriers) and 14.4％ as CYP2C19 * 2/*2 or CYP2C19 * 2/* 3 (two LOF carriers).Both postclopidogrel platelet aggregation and VASP-PRI increased by the presence of one LOF allele,and were even more pronounced with the presence of two LOF alleles.In contrast,P-Akt index only increased in two LOF carriers.VASP-PRI was positively associated with postclopidogrel platelet aggregation (r =0.661,P＜0.001),but not with P-Akt index.Conclusions The two CYP2C19 LOF carriage was associated with more active state of P2Y12-Gi signaling in postclopidogrel platelet in Chinese patients with SCAD.

Ultrasonic diagnosis of patients with clonorchiasis and preliminary study of pathogenic mechanism

Objective To discuss the liver function damage mechanism of patients with clonorchiasis by analyzing the ultrasound characteristics, liver function, change of the serum inflammatory factors and cell apoptosis factors. Methods Color Doppler ultrasound technique was adopted to detect the portal vein and blood flow change of patients with clonorchiasis; ELISA was used to determine the level of different serum inflammatory factors. The levels of serum total bilirubin, serum albumin and glutamic-pyruvic transaminase were detected by automatic biochemical analyzer. Western blot was used to determine the expression of proteins relevant to apoptosis. Results Compared with the health control group, the trunk diameter of portal vein and the thickness of spleen, as well as the hepatic artery pulsation index of clonorchiasis patients increased obviously, the mean blood flow velocity of portal vein (P < 0.05 or P < 0.01) decreased. The content of total bilirubin and transaminase in plasma increased significantly, but albumin decreased (P < 0.05). Levels of TNF-α, IL-6 and IFN-γ increased remarkably, and the level of every factor was significantly different among patients with Child-Pugh, Child-Pugh II and Child-Pugh III classification of liver function (P < 0.05 or P < 0.01). With the exacerbation of liver dysfunction, levels of TNF-α, IL-6 and IFN-γ gradually increased (P < 0.05). Compared with the healthy control group, the expression quantity of apoptosis protein Fas, FasL, Bax and Caspase-3 increased significantly (P < 0.05 or P < 0.01), but Bcl-2 decreased (P < 0.05). Conclusions Changes of ultrasonic characteristics and liver dysfunction, caused by liver fluke infection, may be related to that both inflammatory response and apoptosis response have participated in the pathogenic process and liver damage course of clonorchiasis.

Effects of RhoA gene silencing by RNA interference on invasion of tongue carcinoma / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To study the effects of RhoA down-regulation by RNA interference on the invasion of tongue carcinoma Tca8113 and SCC-4.</p><p><b>METHODS</b>Determination of the human RhoA sequence as well as the design and constructionof a short specific small interfering RNAs (siRNA) were performed. The siRNA of RhoA gene was transfected into humantongue squamous cell carcinoma Tca8113 and SCC-4 cells line by Lipofectamine 2000. Quantitative real-time polymerasechain reaction was used to examine the mRNA expressionlevels of RhoA. Protein expressions of mRNA, galectin-3,and matrix metalloproteinase (MMP)-9 were evaluated byWestern blot. Transwell invasion assay was performed toassess the invasion ability of tongue carcinoma.</p><p><b>RESULTS</b>RhoA expressions in Tca8113 and SCC-4 cells were reducedsignificantly after transfection of RhoA-siRNA. Protein levels f galectin-3 and MVP-9 were also down-regulated significantly. Invasion ability was inhibited as well.</p><p><b>CONCLUSION</b>RhoA-siRNA can effectively inhibit RhoA expression in Tca8113 and SCC-4 cells. The invasion ability of tongue carcinoma cells decreased with down-regulation of the protein expressions of galectin-3 and MMP-9, indicating that RhoA-siRNA can inhibit invasion of tongue carcinoma. Results show that RhoA may play an important role in the processes of invasion and metastasis of tongue carcinoma.</p>

Effects of RhoA silencing on proliferation of tongue squamous cancer cells / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study investigated the effect of RhoA silencing through RNA interference on proliferation and growth of tongue cancer cells, as well as explored the possible mechanisms of this effect.</p><p><b>METHODS</b>SSC-4 tongue cancer cells were cultured in vitro and then transfected with small interfering RNA to knock down RhoA expression. The tested cells were divided into three groups: experimental group (experimental group 1: transfected with RhoA-siRNA-1; experi-mental group 2: transfected with RhoA-siRNA-2), negative control group (transfected by random sequence NC-siRNA), and blank control group (transfected with Lipofectamine). The expression levels of RhoA mRNA were respectively measured by quantitative real-time polymerase chain reaction and western blot assay. Moreover, the expression levels of cyclin D1, p21, and p27 and RhoA protein were evaluated by Western blot assay. Proliferation and growth potentiality were analyzed through evaluation of doubling times and methyl thiazolyl tetrazolium assessment.</p><p><b>RESULTS</b>The expression levels of RhoA gene and protein of experimental groups significantly decreased following siRNA transfection compared with those in the negative and blank control groups. The expression of cyclin D1 decreased significantly and that of p21 and p27 increased significantly. The doubling time was extended and the growth potentiality decreased.</p><p><b>CONCLUSIONS</b>The results indicated that RhoA silencing can inhibit proliferation of tongue cancer cells, whereas RhoA affects cell proliferation by regulating the cell cycle pathway. Thus, RhoA is a potential target in gene therapy for tongue cancer.</p>

Ultrasonic diagnosis of patients with clonorchiasis and preliminary study of pathogenic mechanism

OBJECTIVE@#To discuss the liver function damage mechanism of patients with clonorchiasis by analyzing the ultrasound characteristics, liver function, change of the serum inflammatory factors and cell apoptosis factors.@*METHODS@#Color Doppler ultrasound technique was adopted to detect the portal vein and blood flow change of patients with clonorchiasis; ELISA was used to determine the level of different serum inflammatory factors. The levels of serum total bilirubin, serum albumin and glutamic-pyruvic transaminase were detected by automatic biochemical analyzer. Western blot was used to determine the expression of proteins relevant to apoptosis.@*RESULTS@#Compared with the health control group, the trunk diameter of portal vein and the thickness of spleen, as well as the hepatic artery pulsation index of clonorchiasis patients increased obviously, the mean blood flow velocity of portal vein (P < 0.05 or P < 0.01) decreased. The content of total bilirubin and transaminase in plasma increased significantly, but albumin decreased (P < 0.05). Levels of TNF-α, IL-6 and IFN-γ increased remarkably, and the level of every factor was significantly different among patients with Child-Pugh , Child-Pugh II and Child-Pugh III classification of liver function (P < 0.05 or P < 0.01). With the exacerbation of liver dysfunction, levels of TNF-α, IL-6 and IFN-γ gradually increased (P < 0.05). Compared with the healthy control group, the expression quantity of apoptosis protein Fas, FasL, Bax and Caspase-3 increased significantly (P < 0.05 or P < 0.01), but Bcl-2 decreased (P < 0.05).@*CONCLUSIONS@#Changes of ultrasonic characteristics and liver dysfunction, caused by liver fluke infection, may be related to that both inflammatory response and apoptosis response have participated in the pathogenic process and liver damage course of clonorchiasis.

Analysis of HPA1-16 and HLA-A, B gene polymorphisms among ethnic Han population from Shandong / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To study the polymorphisms of human platelet antigen (HPA) 1-16 and human leukocyte antigen (HLA)-A and -B loci among ethnic Han population from Shandong.</p><p><b>METHODS</b>A total of 588 samples from platelet donors were genotyped for the above loci with sequence-specific primer PCR and sequence-specific oligonucleotide probe PCR.</p><p><b>RESULTS</b>The frequencies of HPA-la, -1b, HPA-2a, -2b, HPA-3a, -3b, HPA-4a, -4b, HPA-5a, -5b, HPA-6a, -6b, HPA-15a, -15b were 0.9974, 0.0026, 0.9456, 0.0544, 0.5417, 0.4583, 0.9983, 0.0017, 0.9889, 0.0111, 0.9903, 0.0097, 0.5434 and 0.4583, respectively. The HPA-7-14 and HPA-16 showed no heterozygosity as the b allele was not detected in such loci. The most common genotypic combination for HPA was HPA-(1,4,7-14,16,17) aa-2aa-3ab-5aa -6aa-15ab (0.1820). HLA-A2 (0.3070) and HLA-B13 (0.1361) demonstrated the highest frequencies at their respective loci.</p><p><b>CONCLUSION</b>The HPA and HLA loci are highly polymorphic among ethnic Hans from Shandong. The distribution of HPA polymorphisms also shows a great ethnic and territorial difference. It is important to construct regional database for the genotypes of HPA and HLA loci for platelet donors.</p>

Separation and Analysis of Drug Resistance of Staphylococcus Aureus in Patients with Respiratory Infection of Children / 现代检验医学杂志

Objective Discuss and analyze Staphylococcusaureus in isolation and drug resistance in patients with pediatric re-spiratory infection,providing guidelines for clinical treatment on the control of infection.Approaches collect 5 413 cases of respiratory tract infection from Jan.2013 to Dec.2014 in patients (including pediatrics neonatology)with sputum specimens, applying MicroScan-As4 automated Microbes Identification analyzer to identify and test drug sensitiveness of the separated strains,using Whonet 5.6 for statistical analysis.Results 1 540 strains of 29 different pathogenic bacteria were isolate from pediatric patients with respiratory tract infection,among which there were 336 strains (21.82%,336/1540)of Staphylococ-cus aureus (SAU,S.aureus),more than 1/5 of the total of pathogenic bacteria.And the isolation rate of pediatric respiratory tract infection accounted for 6.2 1%,significantly higher than that of other pathogenic bacteria isolation rate (with the excep-tion of Haemophilus influenzae>5%,the rest all<5%).In all detected SAU,methicillin-resistant Staphylococcus aureus (MRSA)occpied 59 strains (17.56%,59/336),which indicated that SAU played a leading place in patients with pediatric respiratory infection.The antimicrobial drug resistance rate of SAU against vancomycin,Nai thiazoleamine,daptomycin,and Quinupristin was 0,whereas to other antibiotics it showed different degrees of resistance.The drug resistance rate of MRSA to penicillin and ampicillin,oxacillin,ampicillin/sulbactam,amoxicillin/clavulanic acid and cefazolin,ceftriaxone was 100%,to erythromycin,clindamycin over 50%,to other antimicrobial resistance in low resistance.Conclusion There were more SAU in children with respiratory infection;especially MRSA bears multi drug resistance.Therefore,the monitoring of drug resist-ance of Staphylococcus aureus should be strengthened,and antimicrobial drugs should be rationally chosen according to the results of drug sensitive test for individuals,so that resistant strains can be under effective control and kept being reduced from emergence.

Study of bacterial contamination associated with bandage contact lenses after photorefractive keratectomy / 国际检验医学杂志

Objective To evaluate the occurrence rate and agents of the bacterial contamination of bandage contact lenses after photorefractive keratectomy(PRK) .Methods In a prospective study ,50 patients (100 eyes) underwent PRK .Conjunctival sac se‐creta were placed onto chocolate agar before PRK .All patients accepted bandage contact lenses and anti‐inflammatory drug therapy . Contact lenses and conjunctival sac secreta were placed onto chocolate agar after PRK .Corrected visual acuity ,intraocular pressure and corneal thickness were compared in the 2 groups .Results Among 100 pieces of cornea contact lens ,3 pieces (3% ) were tested positive for bacteria detection and bacteria were staphylococcus epidermis .All conjunctival sac secreta of preoperative and postoper‐ative were not detected bacteria ,postoperative eye infection was not found .Between the positive and negative groups ,tear secretion , may be related to cultivate positive correlation .Conclusion Bacterial contamination is possible when using bandage contact lenses after PRK ,specially for patients with less tear secretion .

3D finite element modeling and analysis of the whole cervical spine based on Simpleware / 医用生物力学

Objective To build a 3D finite element model of the whole cervical spine by using Simpleware software, as well as validate and analyze the model, so as to provide a reliable model for exploring the mechanism of cervical spine injury. Methods The 3D entity model of the whole cervical spine C1-7 was established based on CT tomography images, medical image processing software Simpleware, reverse engineering software Geomagic, which was imported to Hypermesh for meshing, adding ligaments and introducing facet joint contact relation, etc., thus to establish the finite element model of the whole cervical spine C1-7. Biomechanical properties of the cervical spine under flexion, extension, lateral bending and torsion were simulated by ANSYS. Results The established model was proved to be accurate and reliable, and its range of motion (ROM) under flexion, extension, lateral bending and axial rotation was similar to in vitro experiment and finite element analysis results in related literatures. The stress of intervertebral disc was concentrated on the compression side of the vertebral body, and the cervical spine C4/5 was more prone to have a stress concentration. Conclusions The finite element model of the whole cervical spine C1-7 can effectively simulate the biomechanical characteristics of the cervical vertebra, which establishes a good foundation for the follow-up studies on whiplash injury of the cervical spine.

Evaluation the safety and efifcacy of corsair microcatheterin the recanalization for coronary chronic total occlusion with transradialantegrade approach / 中国介入心脏病学杂志

Objective The aim of this study was to evaluate the safety and efficacy of 135 cm Corsair microcatheter inpercutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) with antegrade approach via radial artery. Methods From June 2010 to February 2014, a total of 81 patients with CTO lesions treated with 135cm Corsair microcatheter (Asahi Intec Co, Japan) and transradial antegrade approach was enrolled in this study. The success rate of CTO-PCI, the rate of Corsair microcatheter crossing the CTO lesions and the number of balloon catheters utilization were retrospectively analyzed. Unique complications related to the Corsair microcatheter were also documented. Results Success recanalization of CTO were achieved in 73 (90.1%) patients. Crossing the CTO body with Corsair microcatheter was found in 56(84.8%) patients. The number of balloon utilized after Corsair microcatheter crossing the CTO was much lower than that of patients who Corsair microcatheter failed to cross (1.3±0.6 per patient versus 2.8±1.2per patient, P < 0.05). The success recanalization rate of combined using Fielder XT guidewire with Corsair microcatheter was 51.5%. There was no complications related to Corsair microcatheter during the index procedure, no major adverse cardiac events during in-hospital clinical follow-up. Conclusions Corsair microcatheter was safe and effective in the recanalization for CTO with transradialantegrade approach. It can simplify the CTO-PCI procedure and reduce the number of balloon catheters.

Evaluation of volume transfer coefficient (Ktrans)in differentiating brain metastasis from high-grade gliomas / 实用放射学杂志

Objective To determine whether volume transfer coefficient (Ktrans )can be used to differentiate high-grade glioma (HGG)and metastasis.Methods Thirty-nine patients with brain tumors (12 HGG,27 metastases)underwent dynamic contrast en-hanced MR imaging before surgical resection or stereotactic biopsy.Images were acquired with a three-dimensional (3D)fast gradi-ent echo sequence.Gadolinium-based contrast agent was injected intravenously with dosage of 0.1 mmol/kg bodyweight at a rate of 3.0 mL/s.Ktrans and Ve were calculated from the DCE MRI data.The results of Ktrans and Ve were compared between the 2 types of tumors.Receiver operating characteristic curve analysis was performed for each of the variables in differentiation cerebral metastasis from HGG.Results The Ktrans values in the parenchyma of HGG and metastases were 0.10 (0.11,0.71)min-1 and 0.21 (0.05, 0.77)min-1 ,respectively.The difference was not statistically significant (P>0.05).The Ktrans values in the peritumoral region of the HGG and brain metastasis were 0.04 (0.01,0.10)min-1 and 0.01 (0.00,0.06)min-1 ,respectively.There was a significant difference between the Ktrans values in the peritumoral edema of HGG and cerebral metastases (P<0.05).The optimal cutoff value of Ktrans for differentiating HGG from cerebral metastases was 0.03,with sensitivity of 75% and specificity of 70%.Conclusion Ktrans values in the peritumoral edema may be useful in the differentiating cerebral metastases between HGG.

Risk factors for mortality of total anomalous pulmonary venous connection / 中华实用儿科临床杂志

Objective To analyze the outcomes of the surgery repair for total anomalous pulmonary venous connection(TAPVC),and to investigate the risk factors which influence the mortality of the operation.Methods Comparative analysis was performed in the children with TAPVC who were treated operatively from Sep.2001 to Sep.2011 in the Third Affiliated Hospital of Zhengzhou University,Henan Diagnosis & Treatment Center of Congenital Heart Disease.The children included 37 male and 20 female,aged from 15 days to 6.5 years[(4.27 ± 8.63) months],with body weight 4.0-21.0 (6.33 ± 2.70) kg,and the clinical records in hospital including echocardiogram operation records were collected.The clinical data including the age on operation,body weight,diagnosis,anatomic type of TAPVC,the emergency event before operation,cardiopulmonary bypass time,aortic crossclamping time,were analyzed by chisquared test and Logistic multivariable regression analysis.The risk factors influencing the early mortality of TAPVC were analyzed.Results Fifty-seven children underwent the operation,and 7 (12.2％)cases died during the operation.The univariate analysis on outcomes indicated that the risk factors influencing the mortality of the operation included body weight(P =0.035),anatomic type of TAPVC (P =0.037),the emergency event before operation (P =0.021),and aortic crossclamping time(P =0.046).The Logistic multivariable regression analysis indicated that the emergency events before operation was the independent risk factor for the mortality of TAPVC(P =0.003).Conclusion TAPVC children with preoperative emergency events have higher postoperative mortality.