No Incidence of Liver Cancer Was Observed in A Retrospective Study of Patients with Aristolochic Acid Nephropathy / 中国结合医学杂志

OBJECTIVE@#To assess the risk of aristolochic acid (AA)-associated cancer in patients with AA nephropathy (AAN).@*METHODS@#A retrospective study was conducted on patients diagnosed with AAN at Peking University First Hospital from January 1997 to December 2014. Long-term surveillance and follow-up data were analyzed to investigate the influence of different factors on the prevalence of cancer. The primary endpoint was the incidence of liver cancer, and the secondary endpoint was the incidence of urinary cancer during 1 year after taking AA-containing medication to 2014.@*RESULTS@#A total of 337 patients diagnosed with AAN were included in this study. From the initiation of taking AA to the termination of follow-up, 39 patients were diagnosed with cancer. No cases of liver cancer were observed throughout the entire follow-up period, with urinary cancer being the predominant type (34/39, 87.17%). Logistic regression analysis showed that age, follow-up period, and diabetes were potential risk factors, however, the dosage of the drug was not significantly associated with urinary cancer.@*CONCLUSIONS@#No cases of liver cancer were observed at the end of follow-up. However, a high prevalence of urinary cancer was observed in AAN patients. Establishing a direct causality between AA and HCC is challenging.

Berberine inhibits erastin-induced ferroptosis of mouse hippocampal neuronal cells possibly by activating the Nrf2-HO-1/GPX4 pathway / 南方医科大学学报

OBJECTIVE@#To explore the mechanism by which berberine inhibits ferroptosis of mouse hippocampal neuronal cells (HT22).@*METHODS@#Cultured HT22 cells were pretreated with 30 or 60 μmol/L berberine for 2 h before exposure to 0.5 μmol/L erastin for 8 h, and the cell proliferation, intracellular ferric iron level, changes in intracellular reactive oxygen species (ROS) and cell apoptosis were detected using CCK-8, Fe2+ fluorescent probe, fluorescent dye (DAPI) and fluorescent probe (H2DCFH-DA). RT-qPCR and Western blotting were used to detect the mRNA and protein expressions of Nrf2, HO-1 and GPX4 in the cells. We further tested the effects of treatments with 2 μmol/L ML385 (a Nrf2 inhibitor), 60 μmol/L berberine and erastin in the cells to explore the protective mechanism of berberine against erastin-induced ferroptosis in the neuronal cells.@*RESULTS@#Treatment with 0.5 μmol/L erastin significantly lowered the viability of HT22 cells (P < 0.05) and increased the production of ROS, cell apoptosis rate and ferric iron level (P < 0.05). Pretreatment with 30 and 60 μmol/L berberine both significantly increased the vitality of erastin-exposed cells (P < 0.05) and lowered the levels of intracellular ROS and ferric iron content (P < 0.05). RT-qPCR and Western blotting showed that berberine obviously promoted the expressions of Nrf2, HO-1 and GPX4 in the cells (P < 0.05), and treatment with ML385 significantly inhibited the Nrf2-HO-1/GPX4 pathway, increased intracellular ROS and ferric iron contents and mitigated the protective effect of berberine against erastin-induced ferroptosis (P < 0.05).@*CONCLUSION@#Berberine can inhibit erastin-induced ferroptosis in HT22 cells possibly by activating the Nrf2-HO-1/ GPX4 pathway.

Association of liver stiffness measurement and serum biochemical parameters with nonalcoholic steatohepatitis / 临床肝胆病杂志

ObjectiveTo investigate the association of liver stiffness measurement (LSM) and serum biochemical parameters with hepatic steatosis, liver inflammation, and liver fibrosis in patients with nonalcoholic steatohepatitis (NASH). MethodsA total of 520 patients with NASH who were treated in The Fifth Medical Center of Chinese PLA General Hospital from January 2007 to December 2018 were enrolled, and according to body mass index (BMI) with a cut-off value of 28 kg/m2, the patients were divided into obese group with 151 patients and non-obese group with 369 patients. All patients underwent liver biopsy, and LSM was measured within 3 days before biopsy. Serum biochemical parameters and general clinical data were collected before liver biopsy, and the noninvasive indices aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 (FIB-4) were calculated. The t-test was used for comparison of normally distributed continuous between groups, the nonparametric Mann-Whitney U test was used for comparison of non-normally distributed continuous between groups; the chi-square test was used for comparison of categorical data between groups. A Spearman rank correlation analysis was also performed. ResultsAlanine aminotransferase (ALT), aspartate aminotransferase, LSM, controlled attenuation parameter (CAP), spleen length, and APRI gradually increased with the increase in BMI (all P＜0.05). The Spearman correlation analysis showed that LSM, ALT, BMI, and CAP were positively correlated with the degree of hepatic steatosis (r=0.263, 0.327, 0.184, and 0.452, all P＜0.05); LSM, ALT, and CAP were positively correlated with the degree of liver inflammation (r=0.357, 0.278, and 0.121, all P＜0.05); LSM, ALT, BMI, and CAP were positively correlated with the degree of liver fibrosis (r=0.500, 0.216, 0.248, and 0.101, all P＜0.05); age was negatively correlated with the degree of hepatic steatosis, liver inflammation, and liver fibrosis (r=-0.344, -0.129, and -0.163, all P＜0.05). ConclusionLSM, CAP, ALT, and age are significantly correlated with the degree of liver inflammation, liver fibrosis, and hepatic steatosis in NASH patients, and therefore, they can be used in noninvasive diagnostic and predictive models to access the severity of liver injury.

Current consensus and controversy in neoadjuvant therapy for pancreatic cancer / 中华外科杂志

Pancreatic cancer is malignant and has a poor prognosis.At present, the treatment mode has changed from "Surgery First" to systemic therapy under multi-disciplinary team, but surgical resection is still the only way to cure pancreatic cancer. In systemic treatment of pancreatic cancer, the effect of postoperative adjuvant therapy is significant, and preoperative neoadjuvant therapy has gradually attracted widespread attention. Neoadjuvant therapy can improve the rate of R0 resection in patients with pancreatic cancer.There is a consensus on neoadjuvant therapy for patients who with borderline resectable and locally advanced, but for the patients who with resectable remains controversial.

Clinical significance of the change in plasma D-dimer in patients with hepatitis B cirrhosis / 临床肝胆病杂志

ObjectiveTo investigate the correlation between plasma D-dimer level and severity of hepatitis B cirrhosis and its value in the diagnosis of portal vein thrombosis (PVT). MethodsA retrospective analysis was performed for the clinical data of 500 patients with hepatitis B cirrhosis who were hospitalized in The Fifth Medical Center of Chinese PLA General Hospital from January to December, 2018, and according to the plasma level of D-dimer, they were divided into normal group with 217 patients and elevated group with 283 patients. The correlations of plasma D-dimer level with Child-Pugh class and Model for End-Stage Liver Disease (MELD) score were compared between the two groups. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the Kruskal-Wallis H test was used for multiple groups comparison and further pairwise comparison. The chi-square test was used for comparison of categorical data between two groups. A Spearman correlation analysis was used to investigate correlation. The receiver operating characteristic (ROC) curve was used to evaluate the early warning performance of D-dimer level for PVT in patients with hepatitis B cirrhosis. ResultsThere were significant differences between the two groups in D-dimer level, alanine aminotransferase, aspartate aminotransferase, total bilirubin, albumin, Child-Pugh class, MELD score, and incidence rate of PVT (all P＜0.05). The correlation analysis showed that plasma D-dimer level was positively correlated with Child-Pugh class and MELD score in both groups (r=0.463, 0.455, 0.214, and 0.756, all P＜005). A total of 50 patients with hepatitis B cirrhosis were found to have PVT; the patients with PVT had a significantly higher D-dimer level that those without PVT ［1.96 (0.82-4.91) mg/L vs 0.61 (0.19-1.54) mg/L, Z=-6.02, P＜0.001］. The ROC curve analysis showed that D-dimer level had an area under the ROC curve of 0.758 (95% confidence interval: 0.719-0.796) at the optimal cut-off value of 0.76 mg/L. ConclusionPlasma D-dimer level is correlated with the severity of hepatitis B cirrhosis and can be used to predict the prognosis of patients with hepatitis B cirrhosis. The possibility of PVT should be considered in patients with an elevated D-dimer level.

The new demands for HCV related clinical examinations for DAA treatment / 中华检验医学杂志

Hepatitis C virus (HCV) is one of leading causes for chronic liver diseases, the treatment area has been changed rapidly since direct acting antiviral agents (DAAs) were approved to treat patients with chronic HCV infection. To cure hepatitis in 2030 is the goal set by World Health Organization. However, globally, especially in China, there are still many difficulties needing to be resolved on the cure road of chronic hepatitis C, such as large patient population, high percentage of untreated patients, nonstandard DAA treatment, low efficacy of special groups, and resistance-associated variants in baseline, etc. This comment will focus on the new demands for HCV related clinical examinations for DAA treatment, so as to improve the treatment effectiveness and to help achieve the goal of eliminating viral hepatitis .

Diagnostic performance of transient elastography for staging of liver fibrosis of patients with drug-induced liver injury / 解放军医学杂志

Objective: To assess the diagnostic performance of transient elastography (TE) on staging of liver fibrosis of patients with biopsy-proven drug-induced liver injury (DILI). Methods: 1157 DILI patients who underwent liver biopsy in the Fifth Medical Center of Chinese PLA General Hospital from January 2012 to December 2017, were enrolled in the study, and liver stiffness measurement (LSM) by TE was performed within 3 days before liver biopsy. Clinical parameters and the pathological features were analyzed retrospectively. Non-invasive models for assessing liver fibrosis (APRI and FIB-4) were calculated based on their own formula. The correlations between these three non-invasive approaches and liver fibrosis stages by biopsy were analyzed with Spearman method, the diagnostic performances were analyzed with receiver operating characteristic (ROC). Results: Altogether, 1157 chronic biopsy-proven DILI patients were enrolled, among them, 83 cases (7.2%) had no liver fibrosis (S0), 440(38.0%) were mild fibrosis (S1), 341(29.5%) moderate fibrosis (S2), 232(20.1%) server fibrosis (S3), and 61(5.3%) cirrhosis (S4), according to pathological liver fibrosis staging. As fibrosis stage increasing, percentage of female patients, age, ALT, AST, TBIL, LSM, APRI, FIB-4, and percentage of autoimmunity increased correspondingly, nevertheless, cholinesterase and blood platelet count decreased, all the differences were statistically significant. Body mass index had no correlation with liver fibrosis stages. LSM, APRI and FIB-4 correlated with fibrosis stages positively (r=0.555, 0.400, and 0.414, P<0.001). Compared with APRI or FIB-4, the correlation of LSM with liver fibrosis was the best, and its areas under the ROC curves of S1-S4 were 0.810, 0.775, 0.798, and 0.896 with the corresponding cuf-off values of 7.2, 8.5, 12.3, and 13.7 kPa, representing the diagnostic performance of LSM was the highest. Conclusion: TE is a promising non-invasive approach for assessing liver fibrosis stage of patients with chronic DILI, which might help to establish or adjust the optimal treatment strategy, thus having a good clinical application value.

Direct acting antiviral agent for Chinese patients with chronic hepatitis C genotype 1b infection——a real world experience / 中华传染病杂志

Objective To evaluate the effectiveness and safety of direct-acting antiviral agents (DAA) treatment in Chinese chronic hepatitis C (CHC) patients with genotype (GT) 1b HCV infection in a real world setting .Methods The consecutive GT1b CHC Chinese patients treated with sofosbuvir (SOF) plus daclatasvir (DCV) (n＝62) or SOF plus ledipasvir (LDV) (n＝171) were enrolled from July 2014 to December 2016 at 302 Military Hospital of China .The treatment duration for all the patients was 12 weeks .All the clinical parameters were measured at baseline and then 4-weekly till 12 weeks after the end-of-treatment (EOT ).Baseline clinical characteristics ,treatment efficacy ,safety and tolerance were compared .Serum HCV RNA concentration was detected by means of COBAS TaqMan assay with a lower detection limit of 15 IU/mL ,and liver stiffness was measured using FibroScan?.Sustained virologic response (SVR) was defined as HCV RNA under the lower limit of quantification 12 weeks after EOT (SVR12).Students′t-test ,pearson χ2 test ,Spearman rank correlation analysis and Fisher exact test were used for comparison between groups when appropriate .Results Among 233 patients ,173 cases had baseline HCV RNA level ≥ 6 .0 lg IU/mL and 97 cases hade liver stiffness measurement (LSM )≥17.5 kPa.The baseline liver inflamation ,liver fibrosis ,and HCV RNA load of patients in the two groups were not significantly different (all P＞0 .05).The HCV RNA of all the 233 patients was undetectable at the end of 12-week treatment ,while 2 patients relapsed after 12 weeks of EOT with the overall SVR12 of 99.1% .HCV RNA decline was significantly faster in patients with lower LSM than those with higher LSM (ρ＝0 .233 ,P＝0 .001) ,and SVR12 was higher in those with lower LSM .In terms of other clinical characteristics of SOF+DCV and SOF+LVD groups ,alanine transaminase declined from (68 .0 ± 60 .1) and (70 .1 ± 56 .1) U/L to (21 .1 ± 10 .9) U/L and (15 .3 ± 9 .5) U/L ,respectively ,total bilirubin declined from (21 .3 ± 17 .3) and (18 .2 ± 14 .0) μmol/L to (13 .2 ± 6 .7) and (10 .2 ± 4 .6) μmol/L , respectively ,AFP declined from 19 .6 (10 .6 ,62 .3) and 15 .0 (12 .0 ,25 .0) μg/L to 6 .5(4 .5 ,18 .7) and 7 .8(5 .3 ,15 .4) μg/L ,respectively ,LSM declined from 17 .6 (8 .9 ,25 .4) and 15 .7 (7 .8 ,23 .9) kPa to 13.9(6 .5 ,21 .4) and 9 .1(5 .6 ,19 .9) kPa ,respectively ,serum album elevated form (37 .5 ± 5 .8) and (38 .7 ± 5 .5) g/L to (41 .3 ± 4 .7) and (42 .8 ± 5 .1) g/L ,respectively ,platelet elevated from (120.9 ± 78 . 2)×109/L and (136 .6 ± 65 .8 )× 109/L to (139 .5 ± 71.8 )× 109/L and (149 .7 ± 71.4 )× 109/L , respectively .Reports of adverse events were low in both groups .Conclusions Both SOF + DCV and SOF/LDV therapy are highly effective with ＞ 98% of SVR12 and reduce LSM value significantly with good safety for CHC GT1b Chinese patients .

Etiology and clinical features of drug-induced liver injury diagnosed by liver biopsy / 解放军医学杂志

Objective To investigate the etiology and clinical features of drug-induced liver injury (DILI).Methods A total of 194 DILI in patients,who underwent liver biopsy in our hospital from January 2015 to December 2015,were enrolled in the study.The etiology,laboratory markers (such as alanine transaminase,aspartate aminotransferase,total bilirubin,gammaglutamyl transferase and alkaline phosphatase),and the pathological features were analyzed retrospectively.Then,all of the patients were followed up every 3 or 6 months,with a mean of 34.5 months.The risk factors associated with relapse,which was defined as liver enzymes (such as ALT or TBIL) rising at least 2 times of its upper limit of normal value (ULN),were analyzed with a logistic regression model.Results In terms of etiology,Traditional Chinese medicine (TCM) was the most common cause of DILI,which accounted for 46.9％ of patients,in return followed by acetaminophen-containing drugs (14.4％),antibiotics (9.3％),environmental toxins (4.6％),antidepressant (4.6％),dietary supplement (3.1％),lipid-lowering drugs (3.1％),chemotherapeutic agents (2.6％,and others unknown (11.3％).Of 194 DILI patients,hepatocellular type was observed in 78(40.2％) patients,cholestatic type in 63(32.5％),and mixed type in 53(27.3％).Histological findings showed that 70(36.1％) patients had an acute injury,124(63.9％) chronic damages,which composed by G0(9.8％),G,(19.1％),G2(21.6％),G3(9.8％),and G4(3.6％) in terms of inflammation level.Twenty-seven cases (21.8％) relapsed after discharge from hospital,multivariate analysis showed that cholinesterase is an independent risk factor which might predict the relapse of DILI patients.Conclusions The incidence of DILI is increasing,especially induced by TCM,therefore clinicians should master the clinical features of the disease in order to achieve correct diagnosis and establish the optimal treatment strategy.

Feasibility study of the use of left atrial appendage occluder LACBES with animal experiment / 介入放射学杂志

Objective To introduce a self-developed left atrial appendage occluder,LACBES,and to explore the clinical feasibility of using it for the occlusion of left atrial appendage (LAA).Methods Eight healthy canines were used in this experimental study.The LAA of each canine was occluded with LACBES occluder through trans-femoral vein approach.After the procedure of occlusion,the compression ratio of the occluder was calculated,the residual shunt was assessed by left atrial angiography.The left atrium pressure was monitored before and after the procedure,and the immediate effect of LAA occlusion on the left atrium pressure was statistically analyzed.Results Implantation of LACBES occluder was successfully accomplished in all the eight canines.The compression ratio of the occluders ranged from 10％ to 15％.Small amount of postoperative residual shunt was detected in one canine.After occlusion two canines died of procedure-related complications,including shifting of occluder and formation of hematoma at puncturing site.No device-associated death occurred.After occlusion,the left atrial systolic pressure increased instantly,which went up from preoperative (25.4±2.8) mmHg to postoperative (27.5±3.4) mmHg (P＜0.05),but it returned to the baseline of (25.4±2.8) mmHg within 15 minutes.Conclusion For the occlusion of LAA,the use of LACBES occluder carries higher instant success rate and lower residual shunt rate with less device-associated complications,although the left atrial systolic pressure has a transient rising immediately after the occlusion.Therefore,it is expected that LACBES will be able to be applied in clinical practice.

Drug-resistant and molecular characteristic of Klebsiella pneumoniae isolated from nosocomial and animal origins / 中国人兽共患病学报

We aimed to detect the drug resistant and molecular characteristic of Klebsiella Pneumoniae (KP) isolated from different hosts origin,and to investigate the infection possibility between animals and humans.A total of 98 KP strains were collected in Henan Province from March 2013 to December 2014.Drug-resistance to 15 antibiotics was detected by K-B diffu sion methods.The phenotype of produce mucus was determined by stringing test.Seven drug-resistant gene and 2 virulence gene were amplified by PCR technique.Molecular types were analysis by MLST.The resistant rate of KP isolated from noso comial was higher than those isolated from animals.Among animal strains,the resistant rate of KP isolated from chickens and pigs were higher than that from rabbits and dogs.The multidrug resistant (MDR) of nosocomial isolates were the highest (74.19％).There were 18 STs among 98 KP strains.The main prevalent types were ST37 in chicken,ST258 in pigs,ST60 in rabbits,ST11 in dogs and nosocomial respectively.ST11 was common epidemic types among nosocomial,dogs and pigs.ST235 was common molecular types among chicken and human.ST258 existed in both nosocomial and pigs.The rmpA gene and magA gene were detected in ST11,ST235 and ST 258,producing higher mucus.The blaKPC gene was 54.84％ in nosocomial strains,but not been detected in dog and rabbit strains.The distribution of ESBLs gene in nosocomial was higher than those in animals,but qnrA gene and qnrB gene were higher in chicken than in human.The multidrug resistant gene was the highest distribution in ST11,ST258 and ST235.There were some differences in phenotype of drug-resistance,producing mucus and molecular characteristics,but ST11,ST258 and ST235 were common types of KP isolates from different host origins.

Role of spinal Toil-like receptor 4 signaling pathway in development of inflammatory pain in rats / 中华麻醉学杂志

Objective To evaluate the role of spinal Toll-like receptor 4 (TLR4) signaling pathway in the development of inflammatory pain in rats.Methods Thirty-six adult male Sprague-Dawley rats were divided into 3 groups (n=12 each) using a random number table:control group,inflammatory pain group and TLR4 signaling pathway inhibitor epigallocatechin gallate (EGCG) group (EGCG group).Inflammatory pain was induced by injecting 50 μl of complete Freund's adjuvant (CFA) into the ankle joint cavity of the left hindpaw of rats anesthetized with isoflurane.At 1-3 days after injection of CFA,EGCG 30 μg was intrathecally injected once a day in group EGCG.At 1,3 (30 min after intrathecal injection),5and 7 days after injection of CFA,the mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured.The ipsilateral L4.5 segments of the spinal cord were removed at 3 days after CFA injcction for determination of TLR4 expression (by Western blot) and contents of tumor necrosis factor-alpha (TNF-oα),interleukin-6 (IL-6) and IL-1β in the spinal dorsal horn (by enzymelinked immunosorbent assay).Results Compared with control group,the MWT was significantly decreased and the TWL was shortened at each time point after injection of CFA,the expression of TLR4 in the spinal dorsal horn was up-regulated,and contents of TNF-α,IL-6 and IL-1β in the spinal dorsal horn were increased in inflammatory pain group (P＜ 0.05),and no significant change was found in the parameters mentioned above in EGCG group (P＞0.05).Compared with inflammatory pain group,the MWT was significantly increased and the TWL was prolonged at each time point after injection of CFA,the expression of TLR4 in the spinal dorsal horn was down-regulated,and contents of TNF-α,IL-6 and IL-1β in the spinal dorsal horn were decreased in EGCG group (P＜0.05).Conclusion Spinal TLR4 signaling pathway is involved in the development of inflammatory pain in rats.

Correlation analysis of pediatric allergic rhinitis symptoms with house dust-mite-specific IgE and the household environment dust mites allergens / 中国耳鼻咽喉头颈外科

OBJECTIVE To explore the correlation of allergic rhinitis symptoms in preschool children with the household environment dust mites and house dust-mite-specific IgE, as to provide theoretical basis for pediatric allergic disease prevention and control work. METHODS The children with rhinitis who was born in the Second People's Hospital of Wuhu were selected in this study. When the children were 3 or 4 years old, they were followed up. The allergic rhinitis symptoms integral of the children were evaluated, the household environment dust samples of the children were collected. The content of dermatophagoides pteronyssinus allergen components 1(Der p1) and dermatophagoides farinae allergen components 1(Der f1) in dust samples were determined by the method of enzyme-linked immunosorbent(ELIEA). The children house dust-mite-specific serum IgE(sIgE) level was also examined. RESULTS Pediatric allergic rhinitis symptoms had a positive correlation with dermatophagoides pteronyssinus sIgE and dermatophagoides farinae sIgE(P0.05). CONCLUSION The allergic rhinitis symptoms of the children are positively correlated with household environment dust mites and dust mites specific IgE. That indicated the severity of allergic rhinitis symptom in children may be determined by detecting specific IgE levels. The prevention of allergic disease and improvement the quality of life of the allergic children can be done by strengthening the health education of dust mites and decreasing the content of bedroom environment dust mites.

Distribution characteristics and influencing factors of children with allergic rhinitis in a domestic dust mites allergens content distribution characteristics and influencing factors / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the household environment dust mites allergens content distribution characteristics and influence factors of children with allergic rhinitis to dust mites in Wuhu.@*METHOD@#Collect the surface dust in bedroom and living room floor, mattresses, pillows, sofa of 102 children with allergic rhinitis families. Dust mite allergen components 1 (Der f1) and house dust mites allergens 1 components (Der p1) of the dust samples were determined by enzyme-linked immunosorbent assay (ELISA).@*RESULT@#One hundred and twenty samples were collected . In a domestic dust mites samples, with a median of M (Min and Max) said dust mite allergen levels, Der f1 and Der p1 content was 2.66 (0.03, 26.63), 3.48 (0, 03, 33.68), respectively. Der f1 was significantly less than Der p1, and the difference was statistically significant (P 0.05).@*CONCLUSION@#The household dust mites of children allergic rhinitisin Wuhu area is given priority to with Der p1, and urban dust mites are significantly more than village's and town's. Enhancing health education, controlling dust mites allergens contamination inside the bedroom, especially urban areas, are positive differences for the prevention and treatment of allergic diseases such as allergic rhinitis in children.

Anti-thrombotic activity of fermented rice bran extract with several oriental plants in vitro and in vivo / 대한수의학회지

Although the effects of the rice bran have recently been investigated, there is no information regarding platelet physiology available. However, it is well known that fermented natural plants have a beneficial effect on cardiovascular diseases. Therefore, this study was conducted to investigate whether fermented rice bran extract (FRBE) with several plants (Artemisia princeps, Angelica Gigantis Radix, Cnidium officinale, and Camellia sinensis) affected agonist-induced platelet aggregation, and if so, what the underlying mechanism of its activity was. We performed several experiments, including in vitro platelet aggregation, intracellular calcium concentration and adenosine triphosphate release. In addition, the activation of integrin alphaIIbbeta3 was determined using fibrinogen binding. Thrombus formation was also evaluated in vivo using an arterio-venous shunt model. The FRBE inhibited collagen-induced platelet aggregation in a concentration-dependent manner. FRBE significantly and dose dependently attenuated thrombus formation using rat arterio-venous shunt. FRBE suppressed the intracellular calcium mobilization in collagen-stimulated platelets. We also found that FRBE inhibited extracellular stimuli-responsive kinase 1/2, p38-mitogen-activated protein kinases and c-Jun N-terminal kinase phosphorylation. These results suggested that FRBE inhibited collagen-induced platelet aggregation, which was mediated by modulation of downstream signaling molecules. In conclusion, FRBE could be developed as a functional food against aberrant platelet activation-related cardiovascular diseases.

Clinical Analysis of Intraperitoneal Lymphangioma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intraperitoneal lymphangioma (IL) used to be thought of as a benign lymphatic malformation with a low rate of preoperative diagnosis. This retrospective study aimed to explore the connection between the cysts and clinical manifestation and imaging characteristics, and to study diagnostic confusion, therapeutic principles and potential recurrent reasons, to further enhance the comprehension of this rare disease.</p><p><b>METHODS</b>Here, we retrospectively reviewed 21 patients diagnosed with IL. Age, sex, complaints, physical findings, and imaging features of each patient were documented. The therapies, postoperative complications and treatments were discussed.</p><p><b>RESULTS</b>Symptomatology included eight patients (38%) with intermittent dull pain in the abdomen, and three patients (14%) complained of abdominal persistent pain. The physical examination revealed an abdominal mass in 16 patients (76%), and eight (38%) were reported no discomfort. IL was correctly established preoperatively in 19 patients (90%). Patients were treated using laparotomy, except one who was treated with laparoscopy. Two recurrences were noted during follow-up.</p><p><b>CONCLUSIONS</b>IL should be suspected in any patient with a mobile abdominal mass and surgery is required immediately after discovery of the tumor.</p>

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.

Clinical study of FibroScan efficiency for diagnosing size of oesophageal varices in liver cirrhosis patients / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate reliability of FibroScan (FS) in diagnosing size of oesophageal varices (OV) in patients with liver cirrhosis.</p><p><b>METHODS</b>A total of 260 patients with liver cirrhosis were enrolled in the study. All patients underwent endoscopy to assess OV stage and FS to measure liver stiffness. Receiver operating characteristic (ROC) curves were generated to evaluate the diagnostic reliability of FS.</p><p><b>RESULTS</b>The FS values according to OV stage were 20.9 ± 10.3 kPa for patients without OV, 32.2 ± 13.5 kPa for patients with mild OV, 45.6 ± 18.3 kPa for patients with moderate OV, and 55.1 ± 15.6 kPa for patients with severe OV. Significant differences were found among the groups (P < 0.001) as well as between any two groups (t=6.574, 10.533, 13.247, 4.719, 7.072 and 2.171, P less than 0.05 respectively). ROC curves of FS for the diagnoses of patients with various OV stages showed the following:with vs. without OV, 0.824 (95% CI:77.5% to 87.4%); less than moderate vs. more than moderate OV, 0.849 (95% CI:79.6% to 90.2%); and less than severe vs. severe OV, 0.871 (95% CI:81.1% to 93.0%); the corresponding FS cut-off values were 22.8 kPa, 30.6 kPa, and 34.6 kPa.</p><p><b>CONCLUSION</b>Liver stiffness measurement by FibroScan allows prediction of the oesophageal varices stage in patients with liver cirrhosis.</p>

Case-control study on locking titanium plate in treating comminuted proximal humeral fracture in elderly / 中国骨伤

<p><b>OBJECTIVE</b>To observe therapeutic effects of locking titanium plate for the treatment of comminuted proximal humeral fracture in elderly.</p><p><b>METHODS</b>From June 2011 to May 2013, 72 elderly patients with comminuted proximal humeral- fractures were divided into locking titanium plate group and anatomical plate group, 36 cases in each group. In locking titanium plate group, there were 16 males and 20 females aged from 60 to 79 years old with an average of (69.55±5.62) years old; 10 cases were type Neer II, 18 were type Neer III and 8 cases were type Neer IV in accordance with Neer classification; treated with locking titanium plate. In anatomical plate group, there were 15 males and 21 females aged from 60 to 81 years old with an average of (69.76±5.70) years old; 9 cases were type Neer II, 20 were type Neer III and 7 cases were type Neer IV; and treated with anatomical plate. Clinical effects, preoperative and postoperative Neer scoring, operative time, bone healing time and incidence of complications between two groups were compared.</p><p><b>RESULTS</b>All patients were followed up from 1 to 3 years with an average of 15 months. The excellent and good rate of locking titanium plate group (91.7%) was significantly higher than anatomical plate group (75.0%). Postoperative Neer score of two groups were improved obviously, but locking titanium plate group (92.51±7.85) was higher than anatomical plate group (83.64±8.56); there was no significant differences between two groups in operative time (P>0.05); bone healing time in locking titanium plate was (18.6±3.4) weeks, and shorter than anatomical plate group (24.3±3.9) weeks; incidence of complications in locking titanium plate was (5.6%) shorter than anatomical plate group (22.2%), and had obviously differences between two groups.</p><p><b>CONCLUSION</b>Locking titanium plate for the treatment of comminuted proximal humeral fracture in elderly plays an important role in good rate, bone healing time and Neer score. It has advantages of early rehabilitation exercise, less shoulder pain, rapid recovery of shoulder joint, less complications, safe and effective, and be worthy of clinical application, especially for senile osteoporosis patients.</p>

Evaluation of a new method and instrument for detection platelet aggregation function and its clinical application / 中国实验血液学杂志

This study was purpose to evaluate a new method and instrument for detecting platelet aggregation function, establish the reference intervals for PL-11 platelet analyzer, and evaluate its clinical application. The evaluation was based on the guidelines of Clinical and Laboratory Standards Institute (CLSI or NCCLS) and Clinical Laboratory Improvement Amendment 88. Intravenous blood samples anticoagulated with sodium citrate were detected by PL-11 platelet analyzer. The reference intervals were defined after statistic analysis. The clinical diagnostic significance of the PL-11 platelet analyzer was evaluated by testing the change rate of platelet maximum aggregation rate (MAR) of acute cerebral infarction (ACI) patients in the department of Neurology who took clopidogrel 7 d before and after. The result showed that all the parameters meet the standard of CLIA'88. The platelet MAR of 247 healthy volunteers which was induced by PLR-06, PLR-07, PLR-09 and PLR-10, was detected by the PL-11 platelet analyzer, respectively. The MAR is 58.8 ± 10.1 (%), 61.2 ± 11.8 (%), 51 ± 10.2 (%), 53.1 ± 9.2 (%), respectively. The MAR of ACI patients is significantly lower than that after taking clopidogrel. It is concluded that the PL-11 platelet analyzer is an ideal platelet function detector for early warning and diagnosis of thromboembolic disease, which is worthy to be extended and applied.