Effects of sarcopenia on the occurrence of overt hepatic encephalopathy in patients with liver cirrhosis / 中华消化杂志

Objective:To investigate the risk factors of overt hepatic encephalopathy (OHE) in patients with liver cirrhosis, and to clarify the effect of sarcopenia on OHE.Methods:Based on the liver cirrhosis cohort established by our research group, from January 1, 2013 to December 31, 2017, 480 patients diagnosed with liver cirrhosis and underwent upper abdominal computed tomography were selected from 3 centers, including the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital), Shanghai East Hospital Affiliated to Tongji University, and Shandong Provincial Hospital. The L3 skeletal muscle index (L3-SMI) <44.77 cm 2/m 2 for males and L3-SMI <32.50 cm 2/m 2 for females were used as the diagnostic criterion for sarcopenia. The clinical data of all the patients were collected, including baseline medical history, age, serum total bilirubin, serum levels of aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT), albumin, sodium, prothrombin time (PT), international normalized ratio (INR), hemoglobin, platelet count, etc, as well as Child-Pugh classification of liver function, and model for end-stage liver disease (MELD) score. Independent sample t test, rank sum test, and chi-square test were used for statistical analysis. Binary logistic regression analysis was used to analyze the independent risk factors for OHE in patients with liver cirrhosis, and Kaplan-Meier method was used to analyze the effect of sarcopenia on the incidence of OHE in patients with liver cirrhosis. Results:After 2 years of follow-up, the incidence of OHE was 16.2% (78/480). The age, serum total bilirubin level, AST, GGT, PT, INR, Child-Pugh score, and MELD score of OHE patients were all higher than those of non-OHE patients ((59.67±10.30) years old vs. (53.41±12.06) years old, 35.25 μmol/L(20.10 μmol/L, 60.53 μmol/L) vs. 22.70 μmol/L(15.10 μmol/L, 35.20 μmol/L), 40.00 U/L(27.25 U/L, 61.00 U/L) vs. 33.00 U/L(24.75 U/L, 47.00 U/L), 52.50 U/L(26.25 U/L, 86.75 U/L) vs. 34.50 U/L(22.00 U/L, 73.00 U/L), (17.71±3.52) s vs. (15.50±2.98) s, 1.50±0.34 vs. 1.31±0.29, 8.95±2.19 vs.7.20±1.94, 13.56±4.42 vs.11.42±3.92), while serum albumin, serum sodium and platelet count of OHE patients were all lower than those of non-OHE patients ((29.72±5.55) g/L vs. (33.19±5.89) g/L, 139.00 mmol/L(136.00 mmol/L, 142.00 mmol/L)vs.140.00 mmol/L (138.00 mmol/L, 142.00 mmol/L), 60.00×10 9/L(43.75×10 9/L, 90.25×10 9/L) vs. 80.00×10 9/L(56.00×10 9/L, 131.00×10 9/L)), and the differences were statistically significant ( t=-4.77; Z=-4.10, -3.13, -2.24; t=-5.19, -4.71, -6.57, -3.98, 4.99; and Z=2.44 and 3.48; all P<0.05). The proportions of ascites, hepatic encephalopathy, hepatorenal syndrome, spontaneous bacterial peritonitis at baseline, and the incidence of sarcopenia in OHE patients were all higher than those in non-OHE patients (82.1%, 64/78 vs. 63.7%, 256/402; 41.0%, 32/78 vs. 3.5%, 14/402; 5.1%, 4/78 vs. 1.0%, 4/402; 14.1%, 11/78 vs. 2.5%, 10/402; 37.2%, 29/78 vs. 19.7%, 79/402), and the L3-SMI of OHE patients was lower than that of non-OHE patients ((43.14±8.97) cm 2/m 2 vs. (46.29±8.49) cm 2/m 2), and the differences were statistically significant ( χ2=9.11, 101.97, 4.52, 18.38, 10.53; t=2.86; all P<0.05). The results of binary logistic regression analysis indicated that platelet count ( OR=0.995, 95% confidence interval (95% CI) 0.991 to 1.000, P=0.038), L3-SMI ( OR=0.959, 95% CI 0.922 to 0.997, P=0.035) and hepatic encephalopathy ( OR=14.724, 95% CI 6.741 to 32.161, P<0.001) were independent influencing factors for OHE in patients with liver cirrhosis. The incidence of OHE in patients with sarcopenia was higher than that of patients without sarcopenia (26.9%, 29/108 vs. 13.2%, 49/372), and the difference was statistically significant ( χ2=10.53, P=0.001). The results of Kaplan-Meier analysis demonstrated that patients with sarcopenia were more likely to develop OHE ( P<0.001). Conclusion:Sarcopenia is closely correlated to OHE and is an independent predictor of OHE in patients with liver cirrhosis.

LPS adsorption and inflammation alleviation by polymyxin B-modified liposomes for atherosclerosis treatment

Chronic inflammation is critical in the onset and progression of atherosclerosis (AS). The lipopolysaccharide (LPS) level in the circulation system is elevated in AS patients and animal models, which is correlated with the severity of AS. Inspired by the underlying mechanism that LPS could drive the polarization of macrophages toward the M1 phenotype, aggravate inflammation, and ultimately contribute to the exacerbation of AS, LPS in the circulation system was supposed to be the therapeutic target for AS treatment. In the present study, polymyxin (PMB) covalently conjugated to PEGylated liposomes (PLPs) were formulated to adsorb LPS through specific interactions between PMB and LPS. In vitro, the experiments demonstrated that PLPs could adsorb LPS, reduce the polarization of macrophages to M1 phenotype and inhibit the formation of foam cells. In vivo, the study revealed that PLPs treatment reduced the serum levels of LPS and pro-inflammatory cytokines, decreased the proportion of M1-type macrophages in AS plaque, stabilized AS plaque, and downsized the plaque burdens in arteries, which eventually attenuated the progression of AS. Our study highlighted LPS in the circulation system as the therapeutic target for AS and provided an alternative strategy for AS treatment.

Thoughts on the Construction of Standard and Method Database for Drug Quality Sampling and Inspection in Provincial Inspection Institutions / 中国药房

OBJECTIVE：To provide reference for improving the operation efficiency of drug quality sampling and inspection in China . METHODS ：Starting from the application and management situation of inspection standards/methods in provincial inspection institutions ，the problems existing in the application and management of inspection standards/methods in provincial inspection institutions were analyzed ；the inspection standards/methods database of provincial inspection institutions is attempted to build，combining with the relevant experience and practices of FDA. RESULTS & CONCLUSIONS ：The inspection methods involved in drug sampling and inspection could be divided into official standards and non-standard methods. Official standards were the main standards for drug sampling and inspection ，and were mainly used for routine inspection. Such kind of standards could be classified according to the characteristics of compiled ，single-page and later-issued supplementary ；an electronic catalogue should be established for unified management. Non-standard methods were only used for sample preliminary screening ，verification of official inspection results ，quality evaluation and inspection of unknown or suspicious samples in emergency inspection. Its tracking，collection and management mechanisms were not yet complete. It is recommended to draw on the experience of drug sampling and inspection in the United States so as to establish method database hierarchically. For the mature method established in drug supervision system ，an electronic catalog and document content database should be established and the method should be confirmed before use ；for national standards and the recommended methods published by authoritative institutions in other industries，and mature methods published in scientific and technological literature ，the retrieval channels should be listed ，the methods should be verified ，reviewed and approved before use ，and an electronic catalogue should be established and recorded in time after use. The electronic catalogue format of non-standard methods generally include controlled number ，applicable variety name，method name ，inspection items ，etc.

Application value of dynamic SPECT 99Tc m-GSA scintigraphy in assessing liver function of perihilar cholangiocarcinoma after portal vein embolization / 中华消化外科杂志

Objective:To investigate the application value of dynamic scintigraphy single-photonemission computed tomography (SPECT) 99m-technetium-galactosyl human serum albumin diethy-lenetriamine pentaacetic ( 99Tc m-GSA) scintigraphy in assessing liver function of perihilar cholangio-carcinoma after portal vein embolization (PVE). Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 16 patients with perihilar cholangiocarcinoma who underwent 99Tc m-GSA scintigraphy after PVE in Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University from October 2019 to January 2021 were collected. There were 8 males and 8 females, aged from 46 to 78 years, with a median age of 64 years. Observation indicators: (1) liver volume after PVE; (2) liver function after PVE; (3) typical case analysis. Measurement data with normal distribution were represented as Mean± SD. Count data were represented as absolute numbers or percentages. Comparison of data of the same patient was analyzed using the paired t test. Results:(1) Liver volume after PVE:the morphological liver volume and functional liver volume for the 16 patients were (1 420±211)mL and (389±112)mL. The morphological liver volume and functional liver volume were (636±143)mL and (234±106)mL of planning reserved lobe, (784±210)mL and (151±106)mL of planning resection lobe, respectively. The functional liver density (FLD) of planning reserved lobe and planning resection lobe were 0.36±0.12 and 0.19±0.11, showing a significant difference between them ( t=3.794, P<0.05). The planning resection rate of morpholo-gical liver volume and functional liver volume were 37.8%±0.6% and 54.8%±0.2%, showing a significant difference between them ( t=?3.720, P<0.05). (2) Liver function after PVE: 13 of 16 patients completed the indocyanine green (ICG) test, and 3 patients didn't complete the ICG test due to intolerance. For the 13 patients undergoing ICG test, the total ICG-K value was (0.15±0.03)/minutes, and the ICG-K value of planning reserved lobe was (0.07±0.02)/minutes. The total GSA-K value of 16 patients was (0.14±0.10)/minutes, and the GSA-K value of planning reserved lobe was (0.08±0.06)/minutes. (3) Typical case analysis: a 46-year-old male patient with type Bismuth Ⅲa perihilar cholangiocarcinoma was planned to perform perihilar hepatectomy combined with right hepatectomy. The imaging evaluation showed that the volume of reserved liver lobe accounted for 27% of the total liver volume. The serum total bilirubin was 256 μmol/L when admitted and decreased to 118 μmol/L on the day 5 after percutaneous transhepatic biliary drainage. The right anterior and right posterior branches of PVE was performed. SPECT 99Tc m-GSA examination was performed on the day 37 after PVE. The morphological liver volume was 559 mL of planned reserved lobe and 1 461 mL of the whole liver. The planned morphological liver volume resection rate was 61.7%. ICG-K was 0.12/minutes of the whole liver, and 0.04/minutes of planned reserved lobe. The functional liver volume was 134 mL of planned reserved lobe and 309 mL of the whole liver. The planned resection rate of functional liver volume was 56.6%. The GSA-K was 0.20/minutes of the whole liver and 0.09/minutes of planned reserved lobe. R 0 resection was achieved in perihilar hepatectomy combined with right hepatectomy and no liver failure occurred. The survival time of patients was 11 months. Conclusion:Dynamic SPECT 99Tc m-GSA scintigraphy can effectively evaluate the regional function of the reserved liver lobe in patients with perihilar cholangiocarcinoma after PVE.

Interference of CD38 monoclonal antibody in blood compatibility testing and its countermeasures: A general consensus among experts / 中国输血杂志

With continuous discovery of tumor immune targets and continuous changes in antibody research and development technology, antibody drugs are becoming more and more widely used in clinical practice. However, some targets are not only expressed on tumor cells, but also on red blood cells. Therefore, the clinical application of antibodies against the corresponding targets may interfere with the detection of blood transfusion compatibility, resulting in difficulty in blood matching or delay of blood transfusion. This consensus summarizes the current solutions for the interference of CD38 monoclonal antibody (CD38 mAb) in transfusion compatibility testing. After analyzing the advantages and disadvantages of different methods, polybrene and sulfhydryl reducing agents [dithiothreitol (DTT) or 2-mercaptoethanol (2-Me)], as a solution for CD38 mAb interference in blood compatibility testing, are recommended for Chinese patients, so as to eliminate blood transfusion interference produce by CD38 mAb and further provide a pre-transfusion workflow for clinicians and technicians in Department of Blood Transfusion.

Application of Operation Management Decision Analysis System in management of incidence of constipation in patients with acute myocardial infarction / 中国实用护理杂志

Objective:To understand the role of operation management decision analysis system in the incidence of constipation in patients with acute myocardial infarction (AMI) and explore its operation mechanism.Methods:From January to December 2019, the operation management decision analysis system was applied to the management of constipation rate of patients with acute myocardial infarction in Gulou Hospital Affiliated to Medical College of Nanjing University. 624 patients were selected before the operation of the system (from January to December, 2018) and 643 cases after operation (from January to December, 2019). The incidence of constipation, patient satisfaction and nurse satisfaction in patients with acute myocardial infarction (AMI) were compared between before and after the operation of the system.Results:The incidence of constipation, patient satisfaction and nurse satisfaction were 5.45% (34/624), 93.59% (584/624) and 81.25% (23/32), respectively, before and after the operation of the system, which were 3.11% (20/643), 99.53% (640/643) and 100.00% (32/32), respectively. There were significant differences before and after operation ( χ2 value was 4.243, 34.122 and 10.473, all P < 0.05). Conclusions:Operational management decision analysis system can help nursing managers to dynamically monitor nursing sensitive indicators, urge nurses to carry out nursing measures, effectively improve the incidence of constipation in patients with acute myocardial infarction, it is worth popularizing in clinical application.

Minimal residual disease detection in multiple myeloma: current status, challenges and strategies / 白血病·淋巴瘤

Long time clinical results have showed that multiple myeloma (MM) patients who achieved complete remission (CR) had heterogeneous prognosis. Some patients who achieved CR relapsed in a short time, even died within 2 years after initial therapy, while other patients acquired long-term survival. With the emergence of minimal residual disease (MRD) assessment, rigorous personal therapy monitoring and accurate prognostic evaluation could be realized. MRD can monitor inside the bone marrow by multi-parameter flow cytometry, allele-specific oligonucleotide-based quantitative polymerase chain reaction and next-generation sequencing, as well as the external conditions of the bone marrow by sensitive imaging techniques. This article focuses on clinical benefit, characteristics of different monitoring methods and future direction of MRD in MM.

Determination of Residual Organic Solvents in Trepibutone by Headspace Gas Chromatography / 医药导报

Objective To establish a headspace GC method for determination of residual organic solvents as methanol, ethanol,dichloromethane and n-hexane in trepibutone. Methods An external standard method was used. A DB-624 capillary column (75 m× 0.450 mm,2.55 μm) was used with a FID detector. The injector temperature was 200 ℃ and the detector temperature was 250 ℃ .The initial column temperature was 50 ℃ ,kept for 6 min,then raised to 200 ℃ at a rate of 20 ℃ ?min-1 and kept for another 12 min. Nitrogen was used as the carrier gas. The flow rate was 3. 0 mL ? min-1 . The headspace vials equilibrium temperature was 80 ℃ and the balance time was 30 min.The injection volume is 1 mL. Results A1l the solvents could be completely separated with good linear relationships.The average recoveries of the four solvents were 100.4% ( RSD =0.5%), 100.6%(RSD = 0.6%), 99.6% ( RSD = 0.8%), 98.7% ( RSD = 0.7%) ( n = 9),respectively. Conclusion The method is simple and accurate,and can be used in the determination of residual solvents in trepibutone.

The current status and influencing factors of empowerment in patients undergoing peritoneal dialysis / 中国实用护理杂志

Objective To investigate the current status and influencing factors of empowerment in peritoneal dialysis(PD) patients. Methods A total of 141 PD patients were investigated with the Peritoneal Dialysis Empowerment Scale-Short Form(PDES-SF), the Self-Efficacy for Managing Chronic Disease Scale (SEMCDS), the Self-Management Scale for Peritoneal Dialysis Patients (SMSPD), the Self-Esteem Scale (SES) and the Sense of Coherence-13 (SOC-13). Results The PDES-SF has good reliability and validity: it was positively related with the SMSPD(r=0.416,P<0.001)and the SEMCDS (r=0.465,P<0.01);Cronbach α was 0.851.The mean score of empowerment was (4.21 ± 0.54) points in PD patients. They performed poorly in making specific behavior change plans (3.95 ± 0.94) points and evaluating self management (3.99 ± 1.00) points. Multiple linear regression analysis showed that the education level, the number of PD bags, SMSPD, SEMCDS and SOC-13 were influencing factors of empowerment in PD patients (t=-2.053-6.416,P<0.05), which could explain 43.5% of the variance. Conclusions For PD patients with different education levels and PD dosages, improving the SMSPD, SEMCDS and SOC-13 can increase the empowerment.

The relationship among the sense of coherence, empowerment and self-efficacy in peritoneal dialysis patients / 中国实用护理杂志

Objective To explore the relationship among the sense of coherence,empowerment and self-efficacy in peritoneal dialysis patients.Methods General information,the Sense of Coherence Scale,the Peritoneal Dialysis Empowerent Scale-Short Form and the Self-Efficacy for Managing Chronic Disease Scale were used to investigate a total of 160 peritoneal dialysis patients in a third-class hospital in Tianjin from March to June,2015.Results The mean score of the sense of coherence,empowerment,self-efficacy were (62.01±11.94) points,(4.09±0.68) points and (6.08±2.19) points.Both the sense of coherence and empowerment could positively influence the self-efficacy of peritoneal dialysis patients directly (r=0.429-0.571,P ＜ 0.01),and the sense of coherence could also indirectly influence the self-efficacy through the mediation of empowerment (β decreased from 0.429 to 0.172,P ＜ 0.01),the mediation effect accounted for 60.1％ of the total effect.Conclusions Medical staff should take different actions to improve the sense of coherence and empowerment to improve the self-efficacy of peritoneal dialysis patients.

Clinical Observation of Albumin Tannate and Barm Powder in the Treatment of Infantile Acute Diarrhea / 中国药房

OBJECTIVE:To observe therapeutic efficacy and safety of Albumin tannate and barm powder in the treatment of infantile acute diarrhea. METHODS:81 cases of infantile acute diarrhea were selected and randomly divided into treatment(41 cas-es)and control group(40 cases). Both groups received routine treatment;treatment group was additionally given Albumin tannate and barm powder orally;control group was additionally given Montmorillonite powder. Clinical efficacy,the taste of drugs and ADR were observed in 2 groups after treatment. RESULTS:There was no statistical significance in total effective rate(97.56%)of treatment group and that (100%) of control group (P>0.05). After treatment,defecation times and urine volume score of treat-ment group were higher than those of control group,with statistical significance(P<0.05). The taste score of Albumin tannate and barm powder(2.93±0.35)in treatment group was significantly higher than(1.25±0.44)in control group,with statistical signifi-cance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Albumin tannate and barm powder and Montmorillon-ite powder have good clinical efficacy and safety in the treatment of infantile acute diarrhea. Albumin tannate and barm powder is better than Montmorillonite powder in improving children’s appetite and relieving abdominal pain. Albumin tannate and barm pow-der tastes better when taking,gain a better adherence in the children patients.

The prevalence of depression in adult rheumatoid arthritis patients in China: a Meta-analysis / 中华风湿病学杂志

Objective To evaluate the rate of depression in adult rheumatoid arthritis (RA) patients in China.Methods Literature search was conducted to collect studies on the prevalence of depression in adult RA patients in Cochrane library, Medline, EMbase, China National Knowledge Internet (CNKI),China Biology Medicine (CBM), Chinese science & technology journal database (VIP) and Wanfang database.Data were analyzed by R 3.2.0 software after evaluating all data.Results A total of 25 studies, including a total size of 4 830 and 2 712 patients of depression, were eligible for inclusion in the review.The prevalence of depression by analyzing the effect size was 44.7％ [95％CI (37.5％, 52.0％)], which was close to the median of 43.0％ from all studies included and higher than the global rate 38.8％ [95％CI (34％, 43％)].Eight studies, including the sample size of 1 028 cases, 311 cases of mild depressive disorders and 219 cases of moderate or severe depressive disorders, reported the prevalence levels of 30.2％ [30.2％CI (22.1％, 40.0％)] and 16.5％ [95％CI (9.6％,26.9％)], respectively.Subgroup analysis showed that the depression rate of female RA patients was higher than male, the depression rate in the central and western areas were higher than that of the eastern region, the prevalence level estimated by the Geriatric Depression Scale (GDS) was higher than estimated by other tools.Sensitivity analysis showed that the pooled effect size had good stability and reliability.Conclusion The prevalence rate of depression in adult RA patients is 44.7％, suggesting that medical staff should pay much attention to depression in adult RA patients.

Effect of shRNA-mediated silencing of BDNF gene on VEGF expression of RPMI8226 cells / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the expression of vascular endothelial growth factor (VEGF) of human multiple myeloma (MM) cell line RPMI8226 regulated by brain-derived neurotrophic factor (BDNF), and preliminarily approach the close relationship between BDNF and angiogenesis of MM.</p><p><b>METHODS</b>The recombinant eukaryotic BDNF siRNA expression vector was designed and constructed. The empty vector pGenesil-1, and the recombinant plasmid, pGenesil-shRNA-BDNF were transfected into RPMI8226 cells using Lipofectamine™ 2000 (groups P0 and P1, respectively). BDNF mRNA and protein level in RPMI8226 cells were detected by RT-PCR and Western blotting, respectively; the cellular proliferation activity was determined by MTT assay, while the cell apoptosis was measured by flow cytometry; the variation of VEGF mRNA level in RPMI8226 cells via transfection was determined by RT-PCR, the secretion of VEGF was detected by ELISA.</p><p><b>RESULTS</b>(1)The recombinant eukaryotic BDNF siRNA expression vectors were successfully constructed. BDNF mRNA expression and protein level in P1 group were significantly inhibited compared to those in non-transfected group (Pn) and P0 groups (P<0.05); (2)MTT tests demonstrated that the cellular proliferation activities were obviously decreased in Pn (0.42 ± 0.06) vs P0 (0.56 ± 0.06) and P1 (0.50 ± 0.04) groups (P<0.05); (3)The early cell apoptosis rates were statistically increased in P1 [(53.84 ± 9.95)%] vs Pn [(5.23 ± 2.46)%] and P0 [(9.10 ± 3.46)%] groups (P<0.01); (4)The silence of endogenous BDNF significantly decreased the expression of VEGF in RPMI8226 cells:the relative expression level of VEGF121, VEGF145 and VEGF165 in P1 group were (0.62 ± 0.07), (0.47 ± 0.09) and (0.57 ± 0.02) folds compared to Pn group (P<0.05); (5)ELISA demonstrated that secretion of VEGF in P1 group were (0.36 ± 0.05) and (0.44 ± 0.06) folds compared to Pn and P0 group, respectively (P<0.05).</p><p><b>CONCLUSION</b>BDNF gene silence can obviously increase apoptosis of RPMI8226 cells, inhibit their proliferation and decrease the expression of VEGF. BDNF might mediate the expression of VEGF in MM cells, which may be involved in MM angiogenesis.</p>

Study Status of Quality Control and Analysis Methods for Vitamin C Injections / 中国药师

Vitamin C injections are a national essential drug with wide clinical applications and instable property. In order to pro-vide the reference for further analysis on the quality status of vitamin C injections and improve the quality,the research on the stability, quality control and analysis methods was summarized in the study.

Clinical research on bilateral arcuate artery suture hemostasis of corpus uteri for postpartum hemorrhage due to uterine inertia during caesarean section / 中华妇产科杂志

Objectives To investigate the effect of bilateral arcuate artery suture hemostasis of corpus uteri (haemostasia) for postpartum hemorrhage due to uterine inertia during caesarean section,and to explore the change of blood vessels and blood flow of the uterus after surgery.Methods From May 2009 to Dec.2011,the 212 patients in No.202 People's Liberation Army Hospital received bilateral arcuate artery suture hemostasis of corpus uteri for postpartum hemorrhage due to uterine inertia during caesarean section.Among them,127 patients who failed to respond to conservative management and received haemostasia were defined as the ‘ haemostasia' group.23 patients who received the suture after they failed to respond to conservative management and other conventional surgical hemostasis were defined as the ‘ other +haemostasia' group.62 patients who received the suture simultaneously with conservative management were defined as the ‘ drug + haemostasia' group.The suture was done by the following steps:(1) The uterus should be exteriorised,and the fundus of uterus should be towards the head.(2)Transfix the anterior and posterior wall of corpus uteri with big blunt round needle and absorbable suture.The entry point was 2 cm above the uterine incision and 2 cm to lateral border of corpus uteri.The suture spanned the fundus of uterus,and was stretched tightly in front of the fundus,then tied knots were made.Bleeding volume,prompt hemostatic rate,effect rate,total effect rate and operation time were recorded.The resistance index (RI) of uterine artery,systolic/ diastolic blood pressure (S/D),the visualization ratio of uterine artery and the mean value of artery diameter were obtained through color Doppler ultrasonography and enhancement CT 6-12 months after the surgery.Results (1) In the ‘ drug + haemostasia' group,the bleeding volume was (532 ±28) ml.The operation time was (34 ± 3) min,and the prompt hemostatic rate was 97％.While the ‘ haemostasia' group had more bleeding volume,longer operation time and lower prompt hemostatic rate than the ‘ drug + haemostasia' group,with no statistically significant difference (P ＞ 0.05).In ‘ other + haemostasia' group,the bleeding volume was (1379 ± 95) ml.The operation time was (79 ± 15) min,and the prompt hemostatic rate was 78％.The differences were significant when compared to the other groups (P ＜ 0.01).There was no statistically significant difference on total effect rate among the three groups (P ＞ 0.05).(2) There was no statistically significant difference on the RI and S/D of bilateral uterine artery among all the groups 6-12 months after the surgery.(3)The visualization ratio of left uterine artery of the ‘ other + haemostasia' group was lower (87％) than the ‘ haemostasia' group (97％) and the ‘ drug +haemostasia' group (95％,P ＜ 0.05).There was no statistically significant difference between the ‘ haemostasia' group and the ‘ drug + haemostasia' group on the visualization ratio of bilateral uterine artery and the mean value of bilateral uterine artery diameter (P ＞ 0.05).Conclusions The bilateral arcuate artery suture hemostasis of corpus uteri is a simple,rapid,effective and safe method to control postpartum hemorrhage due to uterine inertia during caesarean section.The ovary and uterine blood flow are not affected after the surgery.

Lack of association of common polymorphism of LRP1 gene with myocardial infarction in a Chinese Han population / 华中科技大学学报（医学）（英德文版）

This study examined the association of a common polymorphic allele (25G) of the low-density lipoprotein receptor-related protein1 (LRP1) gene with myocardial infarction (MI). The genotypes of LRP1 25CG (rs35282763) were determined in 347 MI patients and 347 age- and sex-frequency-matched controls from an unrelated Chinese Han population. Factor VIII (FVIII) levels were measured in the MI patients and controls by chromogenic assay and enzyme-linked immunosorbent assay (ELISA). The results showed that LRP1 25CG (rs35282763) genotype distribution did not differ significantly between patients (n=206 for 25CC, n=122 for 25CG) and controls (n=191 for 25CC, n=126 for 25CG; P>0.05). The 25G allele was not associated with a reduced risk of MI (P>0.05). Further stratifications for age, sex, and other cardiovascular risk factors did not affect the negative findings. It was concluded that the presence of the G allele at the 25CG (rs35282763) polymorphism of the LRP1 is not associated with a reduced risk of MI, and genotyping for LRP1 25CG (rs35282763) polymorphism is not useful in assessing the individual risk of MI.

Characterization of vinflunine tartrate liposomes in vitro and in vivo / 药学学报

Vinflunine tartrate-loaded liposomes (VT-L) with two drug-to-lipid ratios were prepared by pH gradient method. Vesicle size and zeta potential were determined by the Zetasizer Nano ZS. Entrapment efficiency was evaluated by cation exchange resin centrifugalization method. The toxicity and tumor inhibition to nude mouse administrated by VT-L with different drug-to-lipid ratios were investigated and compared with the vinflunine tartrate injection (VT-I). The results showed that the mean particle size, zeta potential and entrapment efficiency of the VT-L with drug-to-lipid ratios of 1 : 5 and 1 : 10 were 124.6 nm and 128.3 nm, -25.3 mV and -22.8 mV, 94.46% and 97.31%, respectively. The VT-L with two different drug-to-lipid ratios has significantly higher anti-tumor effect to nude mouse transplanted human non-small cell lung carcinoma A549 and lower toxicity than VT-I. While there were no significant differences in anti-tumor effect and toxicity between VT-L with two different drug-to-lipid ratios.

Effects of cucurbitacin B on cell proliferation and apoptosis in Hep-2 cells / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the mechanism underlying the anticancer activity of cucurbitacin B on human laryngeal cancer.@*METHOD@#Hep-2 cells were treated with different concentrations of cucurbitacin B for different time. MTT assay was used to evaluate cell proliferation. Flow cytometry with PI staining and fluorescent microscopy with Hoechst 33258 staining were used to estimate cell cycle distribution and cell apoptosis. Expression of p-STAT3, cyclin B1 and Bcl-2 proteins was evaluated by Western blot assay. In vivo inhibitory effects of cucurbitacin B on tumor growth was evaluated in a nude mouse xenograft model.@*RESULT@#Cucurbitacin B inhibited cellular proliferation in a dose and time dependent manner (P <0.05 or 0.01). Flow cytometry analysis showed that treatment with cucurbitacin B resulted in accumulation of cells at the G2/M phase of the cell cycle and cell apoptosis in a dose and time dependent manner (P <0.05 or P <0.01). Marked morphological changes of cell apoptosis including condensation of chromatin, nuclear fragmentation and apoptotic bodies were observed clearly by Hoechst 33258 staining. Western blot analysis demonstrated that the expression of p-STAT3, cyclin B1 and Bcl-2 proteins was suppressed significantly. In vivo studies showed that the inhibitory rates on laryngeal squamous carcinoma xenograft model were 32.43%, 43.24% and 70.27% for lower, moderate and higher dosage group, respectively.@*CONCLUSION@#Cucurbitacin B inhibited cell proliferation and induced apoptosis of Hep-2 cells by suppressing STAT3 signal pathway, down regulating the expression of cyclin B1 and Bcl-2 proteins.

Inhibitory effects of fenofibrate on plasminogen activator inhibitor-1 expression in human endothelial cells / 华中科技大学学报（医学）（英德文版）

The effects of fenofibrate on plasminogen activator inhibitor-1 (PAI-1) expression in human umbilical endothelial cell-derived transformed cell line--ECV 304 cells were investigated. ECV 304 cells were incubated with different concentrations of fenofibrate (0, 10, 50, 100 micromol/L) for 24 h. PAI-1 mRNA and protein was detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot respectively. PAI-1 antigenic content of endothelial cells was measured by using ELISA. Fenofibrate could inhibit the PAI-1 mRNA and protein expression and reduce PAI-1 antigenic content dependently. After treatment with fenofibrate (10 micromol/L), the expression levels of PAI-1 mRNA and protein were 0.65 +/- 0.05 and 0.96 +/- 0.11 respectively, significantly lower than in the control group (0.78 +/- 0.03 and 1.21 +/- 0.15, respectively, P<0.05). PAI-1 antigenic contents (24.52 +/- 8.39) in ECV304 cells treated with 10 micromol/L fenofibrate were significantly lower than those in the control group (6.98 +/- 5.12, P<0.05). It was concluded that fenofibrate inhibited the expression of PAI-1 mRNA in ECV304 cells, and reduce the protein expression and the antigenic content of PAI-1, suggesting that fenofibrate may have an antiatherosclerotic effect on endothelial cells by PAI-1 pathway.