Clinical observation of Rougan Huaxian granule combined with nucleoside antiviral drugs in treatment of patients with decompensated cirrhosis of hepatitis B / 中国综合临床

Objective:To explore the effects of Rougan Huaxian Granules combined with nucleoside antiviral drugs on liver and kidney function, portal hemodynamics, vascular activity, antiviral indexes and aspartate transaminase-platelet ratio index in patients with hepatitis B decompensated cirrhosis.Methods:A case-control study was conducted on 150 patients with hepatitis B decompensated cirrhosis who were hospitalized in Tangshan Infectious Disease Institute and Affiliated Hospital of North China University of Science and Technology from June 2017 to December 2019 were enrolled. The patients were divided into control group and observation group by computer random random number method, with 75 cases in each group. The control group was given routine liver protection and antiviral treatment; the observation group was given Rougan Huaxian granules on the basis of the control group treatment. Observe the changes of liver and kidney function, portal vein system hemodynamics, vascular activity, antiviral index and aspartate transaminase-platelet ratio index in the two groups. Independent sample T test was used to compare the measurement data between the two groups, paired T test was used for comparison between the same groups before and after treatment, and χ2 test was used for counting data. Results:There were no significant differences in gender, age, course of cirrhosis, Child grade of liver function and baseline data of indexes before treatment between 2 groups (ALL P>0.05). After treatment, alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen, creatinine,diameter of portal vein (Dpv), diameter of splenic vein (Dsv), endothelin-1, nitric oxide, glucagon (GLA), APRI,were all lower than before treatment. Comparison between groups, observation group ALT (51.60±15.97) U/L, AST (62.65±26.28) U/L, urea nitrogen (10.25±1.65) mmol/L, creatinine (78.54±14.09) μmol/L, Dpv (10.20±1.10) mm, Dsv (8.08±0.68) mm, endothelin-1 (31.93±6.35) ng/L, nitric oxide (41.38±8.06) μg/L, GLA (69.54±12.14) mg/L, APRI (3.14±1.35), were significantly lower than those of control group ((97.49±30.87) U/L, (96.03±25.63) U/L, (17.49±2.55) mmol/L, (116.43±22.77) μmol/L, (13.42±1.26) mm, (10.44±0.83) mm, (44.34+11.88) ng/L, (63.47±15.50) μg/L, (107.11+25.29) mg/L, (5.91±1.93)), the differences were statistically significant ( t values were respectively 11.43, 7.87, 20.64, 12.26, 16.62, 18.99, 7.98, 10.96, 11.60, 10.23, all P<0.05). After treatment, albumin, portal vein velocity (Vpv), and velocity of splenic vein blood flow (Vsv) were all higher in the two groups than before treatment. However, there was no significant difference in Vsv of the control group before and after treatment ( t=0.51, P=0.613). Comparison between groups, albumin (39.42±7.35) g/L, Vpv ((25.72±4.06) cm/s), Vsv ((24.22±6.15) cm/s) in the observation group were significantly higher than those in the control group (34.66±7.95) g/L, (19.38±3.46) cm/s, (19.54±5.88) cm/s ( t values were 3.81, 10.28, 4.76, all P<0.05). After treatment, the total effective rate (96.00%(72/75) vs. 86.67%(65/75), χ2=4.13, P=0.042), HBV DNA negative conversion rate (76.00%(57/75) vs. 58.67%(44/75), χ2=5.12, P=0.024), HBeAg negative conversion rate (50.67%(38/75) vs. 30.67%(23/75), χ2=6.22, P=0.013) and serum HBeAg/HBeAb conversion (28.00%(21/75) vs. 13.33%(10/75), χ2=4.92, P=0.027) in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05). HBsAg negative rate (8.00%(6/75) vs. 5.33%(4/75), χ2=0.43, P=0.513) was higher than that of control group, but the difference was not statistically significant ( P>0.05). Conclusion:Rougan Huaxian Granules combined with nucleoside antiviral drugs has significant effect on patients with decompensated liver cirrhosis of hepatitis B, improve liver and kidney function, liver fibrosis and hemodynamics of the portal vein system, increase vascular activity function, and reduce hepatitis B virus (HBV) DNA load, HBV replication, aspartate transaminase-platelet ratio index, APRI, Toll-like receptor (TLR-4) and transforming growth factor β1 (TGF-β1) levels and improves the body′s immune status.

Screening and analysis for autophagy / 中南大学学报(医学版)

OBJECTIVES@#Long non-coding RNA (lncRNA) has become a key epigenetic regulator that regulates gene expression and affects a variety of biological processes. LncRNA plays an important role in the occurrence and development of rheumatoid arthritis (RA). The study on lncRNA in peripheral blood cells of RA patients has been reported. However, there is no study on autophagy regulation by lncRNA in RA patients. This study aims to provide a new direction for the diagnosis and treatment of RA via screening the changes of lncRNAs in RA fibroblast-like synoviocytes (RA-FLSs) before and after autophagy and finding the key lncRNAs targeting RA-FLSs autophagy.@*METHODS@#Synovial tissues of 6 RA patients after knee and hip joint surgery were obtained, and RA-FLSs were cultured to the 5th generation for further experiments (tissue culture method). After treatment with mTOR inhibitor PP242, the expression of LC3-II was detected by Western blotting. Total RNAs of 3 cases of RA-FLSs before and after treatment with mTOR inhibitor PP242 were extracted by TRIzol and screened by Agilent Human ceRNA Microarray 2019 (4×180 K, design ID: 086188) chip. The lncRNAs with significantly changed expression levels were selected (difference multiple≥2.0, @*RESULTS@#RA-FLSs were successfully isolated and cultured from the synovial tissues of the patient's knee or hip joint. After 6 RA-FLSs were treated with PP242, the expression level of autophagy marker protein LC3-II was increased (@*CONCLUSIONS@#Differentially expressed lncRNAs in RA-FLSs have been identified with microarray analysis. In RA, differential expression of lncRNAs is involved in the autophagy of RA-FLSs. The underlying mechanisms based on bioinformatics analysis include regulating the secretion of cytokines, such as IL-6, TGF-β, TNF-α and IL-17, participating in the immune cell differentiation, such as Th17, Th1, Th2 cells and osteoclasts, as well as regulating the autophagy pathway, MAPK, FoxO, and other signaling pathways. It has been verified that the expression of ENST0000584721.1 is up-regulated and ENST0000615939.1 is down-regulated after autophagy of RA FLSs, which provides a good experimental basis for further study on the mechanism of lncRNA in RA-FLSs autophagy.

Clinical characteristics and related factors of rheumatoid arthritis complicated with tuberculosis infection / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinical characteristics and high risk factors of Rheumatoid arthritis (RA) complicated with tuberculosis infection.@*METHODS@#Patients with rheumatoid arthritis diagnosed in the hospital of Sichuan Provincial People's Hospital from January 2007 to January 2017 was retrospectively collected, who were enrolled in the study group. A control group was randomly selected from the RA patients hospitalized in the same period without co-infection at a ratio of 1 :2. The general data, clinical data, laboratory test data, treatment plan, etc. of the two groups were collected in detail for single factor statistical analysis. Then multivariate Logistic regression was used to analyze the independent risk factors of RA complicated with tuberculosis infection with statistical significance in univariate analysis.@*RESULTS@#The clinical manifestations of fever (83.3%) were most common, followed by cough (69%) and body mass loss (45.2%). In the infected group, pulmonary tuberculosis accounted for 73.3%. In the infected group the chest CT showed two or more cases, accounting for 59%. There were 9 cases (33.3%) occurring in the typical tuberculosis occurrence site. Compared with the control group, the erythrocyte sedimentation rate (ESR), C-reaction protein (CRP) levels, and the daily average dose of glucocorticoid in 1 year in the infected group were higher than those in the control group. And those differences were statistically significant(P < 0.05). There were no significant differences in gender, age, disease duration, disease activity score, white blood cell (WBC), platelet (PLT), hemoglobin (Hb), immunoglobulin G (IgG), complement (C), Anti cyclic citrullinated peptide antibody (anti-CCP), CD4+T cell count, and immunosuppressant use (P > 0.05). Multivariate Logistic regression analysis showed that CRP levels(OR=1.016, 95%CI:1.002-1.031) and the daily average dose of glucocorticoid in 1 year(OR=1.229, 95%CI:1.066-1.418)were the independent risk factors of RA complica-ted with tuberculosis infection.@*CONCLUSION@#RA patients with tuberculosis infection are mainly phthisis. The clinical manifestations of RA combined with tuberculosis infection are lack of specificity, and the chest imaging features of pulmonary tuberculosis are diverse, which are easy to be misdiagnosed. CRP levels and the daily average dose level of glucocorticoid in 1 year were risk factors for RA and tuberculosis infection.

Asymmetric Dimethylarginine Predicts One-year Recurrent Cardiovascular Events: Potential Biomarker of "Toxin Syndrome" in Coronary Heart Disease / 中国结合医学杂志

OBJECTIVE@#To examine the prognostic value of serum levels of asymmetric dimethylarginine (ADMA) in patients with stable coronary heart disease (CHD) thus explore a potential biomarker of "toxin syndrome" in CHD.@*METHODS@#In this prospective nested case-control study, 36 of 1,503 Chinese patients with stable CHD experienced at least 1 recurrent cardiovascular event (RCE) during 1-year follow-up. Serum levels of ADMA at the start of follow-up were compared between these 36 cases and 36 controls which matched to cases in terms of gender, age, history of hypertension, and myocardial infarction.@*RESULTS@#Based on the crude model, subjects in the 2 highest ADMA quartiles showed significantly higher risk of developing RCE than those in the lowest ADMA quartile [odds ratio (OR) 4.09, 95% confidence interval (CI) 1.01 to 16.58; OR 6.76, 95% CI 1.57 to 29.07]. This association was also observed in the case-mix model (OR 5.51, 95% CI 1.23 to 24.61; OR 7.83, 95% CI 1.68 to 36.41) and multivariable model (OR 6.64, 95% CI 1.40 to 31.49: OR 13.14, 95% CI 2.28 to 75.71) after adjusting for confounders. The multivariable model which combined ADMA and high-sensitivity C-reactive protein (hsCRP) showed better predictive power with areas under the receiver operator characteristic curves (0.779) than the model of either ADMA (0.694) or hsCRP (0.636).@*CONCLUSION@#Serum ADMA level may be a potential biomarker of "toxin syndrome" in CHD which shows favorable prognostic value in predicting 1-year RCE in patients with stable CHD. [The registration number is ChiCTR-PRNRC-07000012].

Laparoscopic Pancreaticoduodenectomy:Strength,Weakness,and Future Directions / 中国医学科学院学报

Laparoscopic pancreatoduodenectomy(LPD)is one of the most challenging abdominal procedures.It has been developed for nearly 25 years since the first report in 1994.During the first 10 years,LPD has developed slowly due to widespread controversy and opposition.In the past 10 years,a number of breakthroughs have been made in LPD with the introduction of high-definition laparoscopy,improvements in laparoscopic instruments,advances in minimally invasive surgery,improved selections of patients,and accumulation of experiences in open pancreaticoduodenectomy(OPD).However,many controversies still exist.This review summarizes the strength and weakness of LPD versus OPD in terms of indications,learning curve,complications,short-term benefits,long-term oncology results,and cost and proposes its future directions.

Effects of Maxing-Shigan decoction on airway remodeling and expression of MMP-9 and TIMP-1 in lung tissues of asthmatic mice / 中国病理生理杂志

AIM:To investigate the effects of Maxing-Shigan decoction on airway remodeling and expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the lung tissues of asthmatic mice, and to explore its possible mechanism in treatment of asthma.METHODS:The BALB/c mice were divided into blank control group, model group, low-dose Maxing-Shigan decoction group, middle-dose Maxing-Shigan decoction group, high-dose Maxing-Shigan decoction group and positive control group.The mice were sensitized and challenged with ovalbumin to establish asthma model.The mice in blank control group and model group were given saline by oral administration before 30 min of suscitation.The mice in low-dose, middle-dose and high-dose Maxing-Shigan decoction groups were given Maxing-Shigan decoction at 5.0 g/kg, 10.0 g/kg and 20.0 g/kg, respectively, by oral administration before 30 min of suscitation.The mice in positive control group was given dexamethasone at 0.005 g/kg by oral administration before 30 min of suscitation.After consecutive administration for 7 d, the variations of airway responsiveness, the percentage of the goblet cells, the collagen deposition, and the eosinophil (EOS) counts in bronchoalveolar lavage fluid (BALF) of each group were observed.The protein levels of MMP-9 and TIMP-1 in the lung tissues were determined by ELISA and Western blot.The mRNA expression of MMP-9 and TIMP-1 was detected by RT-qPCR.RESULTS:Compared with blank control group, the airway responsiveness, the goblet cell percentage, the collagen deposition, the EOS counts in BALF, the protein levels of MMP-9 and TIMP-1, and the mRNA expression of MMP-9 and TIMP-1 were significantly increased in model group (P<0.01).Compared with model group, all of the indexes were reversed in low-dose, middle-dose and high-dose Maxing-Shigan decoction groups and positive control group (P<0.05 or P<0.01).CONCLUSION:Maxing-Shigan decoction improves airway remodeling in asthma model mice by down-regulating the expression of MMP-9 and TIMP-1.

Effects of curcumin on expression of caspase-3 , caspase-8 and caspase-9 in PC12 cells induced by Aβ25-35 / 中国病理生理杂志

AIM:To investigate the effects of curcumin on the viability ,the lactate dehydrogenase(LDH)re-lease,the apoptosis,and the activity and the expression levels of caspase-3,caspase-8 and caspase-9 of rat adrenal pheo-chromocytoma PC12 cells induced by β-amyloid protein 25-35(Aβ25-35 ).METHODS:The PC12 cells were treated with Aβ25-35.The viability and LDH release rates were measured by MTT assay and LDH kit ,respectively.The cells were ran-domly divided into blank control group ,model group,curcumin 10μmol/L group and curcumin 20μmol/L group.The ap-optotic rates were evaluated by flow cytometry with Annexin V-FITC/PI staining.The activities and expression levels of caspase-3,caspase-8 and caspase-9 were detected by colorimetric method and Western blot analysis.RESULTS:Com-pared with model group ,curcumin significantly increased the viability ,and decreased the LDH release rates and the apop-totic rates of the PC12 cells treated with Aβ25-35(P<0.01).Compared with model group,curcumin significantly decreased the activity and expression levels of caspase-3,caspase-8 and caspase-9(P<0.05 or P<0.01).CONCLUSION:Cur-cumin inhibits Aβ25-35-induced apoptosis of PC12 cells by inhibiting the expression of caspase-3,caspase-8 and caspase-9.

Application of microsutures with vascular endothelial growth factor to improve vascular endothelial regeneration after small vessel anastomosis in the rats / 中国组织工程研究

BACKGROUND:The vascular endothelial growth factor (VEGF) plays an important role in the development and formation of blood vessels.Up to now,there are few reports about the treatment of postoperative complications of vascular anastomosis surgery by mcrosutures with VEGF in China.OBJECTIVE:To synthesiize microsutures with VEGF and to evaluate its effect in revascularization following small vessel anastomosis.METHODS:The method of emulsification-diffusion was use to produce biodegradable polymer polylactic acid/glycolic acid (PLGA) copolymer microparticles containing VEGF,and then,the microparticles were added into microsutures to prepare microsutures with VEGF.Ninety Sprague-Dawley rats were enrolled to make animal models of caudal artery anastomosis using microsutures with VEGF in experimental group and microsutures alone in control group.Complications and VEGF level in the peripheral blood were detected and hematoxylin-eosin staining at the anastomotic site was performed at 2,12 hours,1,3,7 days after anastomosis.RESULTS AND CONCLUSION:(1) Postoperative complications:The postoperative incidence of skin necrosis was significantly lower in the experimental group than the control group (P ＜ 0.05).(2) VEGF level:Compared with the control group,the peripheral blood VEGF level was significantly higher in the experimental group at each time point after operation (P ＜ 0.05).(3) Hematoxylin-eosin staining:In the experimental group,proliferated endothelial cells were seen near the anastomotic site at 1 day after anastomosis;there were a large number of proliferated endothelial calls and subcutaneous tissues covering the sutures completely at 3 days after anastomosis;and endothelial cells and internal elastic lamina were completely repaired,smooth muscle cells proliferated further,and the outer membrane returned to normal at 1 week after anastomosis.In the control group,cell degeneration and necrosis were seen near the anastomotic suture,and only adventitial cells infiltrated and exhibited a traumatic proliferative response at 1 day after anastomosis;neonatal endothelial cells appeared in the exfoliated area of the endothelial cells,grew and migrated,and there was a few endothelial cells covering the anastomotic site at 3 days after anastomosis;and newborn endothelial cells got over the anastomotic crack and covered the suture.To conclude,microsutures with sustained-release VEGF microparticles can promote endothelial cell regeneration in rats at the anastomotic site.

Effect of acupuncture on mitophagy of skeletal muscle in rats with exer-cise-induced skeletal muscle damage / 中国病理生理杂志

AIM:The effect of acupuncture on mitophagy-related protein expression in skeletal muscle of rats after heavy-load exercise was investigated to explore the role of acupuncture in the repairment of exercise-induced skeletal muscle damage. METHODS:Male adult Sprague-Dawley rats (n=128) were randomly divided into 4 groups:control (C,n=8) group, exercise (E, n=40) group, acupuncture (A, n=40) group, and exercise and acupuncture (EA, n=40) group. The rats in E group and EA group performed an eccentric exercise,and the rats in A group and EA group immediately after exercise received acupuncture treatment. The rats in the latter 3 groups were further divided into 0 h,12 h,24 h,48 h and 72 h sub-groups(n=8),and soleus muscle was collected at each time point. The transmission electron microscopy was used to observe the ultrastructural changes of the mitochondria in skeletal muscle. The content of citrate synthase (CS) was measured by ELISA. The protein expression of skeletal muscle PTEN-induced putative kinase 1 (PINK1),parkin and microtubule-associated protein 1 light chain 3 (LC3) was determined by Western blot. RESULTS:After the heavy-load exercise,the mitochondria swelled and accumulated under cell membrane. The number of mitophago-somes was increased,and the content of CS was significantly decreased(P<0.05). The expression of PINK1,parkin and LC3 was significantly elevated (P<0.05). However,the acupuncture intervention after exercise promoted the recovery of mitochondrial ultrastructure, attenuated mitophagolysosome formation, maintained CS content and down-regulated the ex-pression of PINK1,parkin and LC3 (P<0.05). CONCLUSION:Heavy-load exercise causes the damages of mitochon-drial structure and function in the skeletal muscle and activates PINK1/parkin pathway to induce excessive occurrence of mitophagy. Acupuncture intervention after exercise is able to alleviate the damage of mitochondria in the skeletal muscle through decreasing the expression of mitochondrial outer membrane protein PINK1,reducing the recruitment of downstream cytoplasmic protein parkin,thereby affecting the combination of LC3 and mitochondria to inhibit the overactivation of mito-phagy.

Analysis of risk factors of hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis complicated with liver failure / 中国综合临床

Objective To explore the risk factom of hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis complicated with liver failure.Methods One hundred and fifty-eight cases hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis were selected.According to whether complicated with liver failure,the patients were divided into observation group with 62 cases (complicated with liver failure group) and control group with 96 cases (without liver failure group).The clinical data and results of 2 groups were analyzed to screen the risk factors of liver failure.Results Compared with control group,observation group in alanine aminotransferase,aspartate aminotransferase,cholinesterase,total bilirubin,and prothrombin time,activated partial thrombin time live enzymes,thrombin time,fibrinogen,serum creatinine,the differences were not statistically significant (P ＞ 0.05);in albumin ((28.02±7.36) g/L vs.(23.26±6.54) g/L,t =4.421,P =0.002),serum urea nitrogen ((8.84±4.71) mmol/L vs.(9.33±5.24) mmol/L,t =3.656,P=0.007),upper gastrointestinal bleeding(x2 =7.534,P=0.006),ascites (x2 =8.615,P =0.003),infection (x2 =10.321,P =0.001),hepatic encephalopathy (x2 =6.561,P =0.010),hepatorenal syndrome(x2 =4.952,P=0.026),the difference were statistically significant.(2)The results of logistic regression analysis showed that upper gastrointestinal bleeding (OR =1.020,95％ CI:1.003-1.036),hepatorenal syndrome(OR=2.872,95％CI:0.385-21.423) were risk factor of hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis complicated with liver failure.Conclusion Upper gastrointestinal bleeding,hepatorenal syndrome are independent risk factors of hepatitis B virus infection and alcoholic liver disease in patients with decompensated cirrhosis complicated with liver failure.

Systematic review on randomized controlled trials of coronary heart disease complicated with depression treated with Chinese herbal medicines / 中国结合医学杂志

<p><b>OBJECTIVES</b>This systemic review evaluated the efficacy and safety of Chinese herbal medicines (CHMs) in patients with coronary heart disease (CHD) complicated with depression.</p><p><b>METHODS</b>All databases were retrieved till September 30, 2014. Randomized controlled trials (RCTs) comparing CHMs with placebo or conventional Western medicine were retrieved. Data extraction, analyses and quality assessment were performed according to the Cochrane standards. RevMan 5.3 was used to synthesize the results.</p><p><b>RESULTS</b>Thirteen RCTs enrolling 1,095 patients were included. Subgroup analysis was used to assess data. In reducing the degree of depression, CHMs showed no statistic difference in the 4th week [mean difference (MD)=-1.06; 95% confidence interval (CI)-2.38 to 0.26; n=501; I(2)=73%], but it was associated with a statistically significant difference in the 8th week (MD=-1.00; 95% CI-1.64 to-0.36; n=436; I(2)=48%). Meanwhile, the combination therapy (CHMs together with antidepressants) showed significant statistic differences both in the 4th week (MD=-1.99; 95% CI-3.80 to-0.18; n=90) and in the 8th week (MD=-5.61; 95% CI-6.26 to-4.97; n=242; I(2)=87%). In CHD-related clinical evaluation, 3 trials reported the intervention group was superior to the control group. Four trials showed adverse events in the intervention group was less than that in the control group.</p><p><b>CONCLUSIONS</b>CHMs showed potentially benefits on patients with CHD complicated with depression. Moreover, the effect of CHMs may be similar to or better than antidepressant in certain fields but with less side effects. However, because of small sample size and potential bias of most trials, this result should be interpreted with caution. More rigorous trials with larger sample size and higher quality are warranted to give high quality of evidence to support the use of CHMs for CHD complicated with depression.</p>

Clinicopathologic features of familial nonmedullary thyroid carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Familial nonmedullary thyroid carcinoma (FNMTC) is a variant of nonmedullary thyroid carcinoma(NMTC) with particular clinicopathologic features. In recent years, a number of studies have shown that FNMTC is more invasive than sporadic NMTC(SNMTC). The purpose of this study was to explore the differences in clinicopathologic features of FNMTC between different types of families and to determine in which of these families more invasive FNMTC occurred.</p><p><b>METHODS</b>We retrospectively reviewed all patients with thyroid carcinoma admitted to Peking Union Medical College Hospital from January 2009 to July 2013 in the database. Of all 2000 cases, 55 met the inclusive criteria for FNMTC and were studied. There are two different grouping methods. The first is that all samples were allocated to families with three or more first-degree relatives affected (FNMTC-3 group) and families with only two affected first-degree relatives (FNMTC-2 group). The second is that all patients were divided into families with three or more affected first-degree relatives over two generations (FNMTC-3-2 group) and the other families. We compared the clinicopathologic features such as sex, age, tumor size, multifocality, location, complications by thyroiditis, complications by benign thyroid nodules, surgical procedure, capsule invasion, histological type, lymph node metastases, tumor node metastasis stage, and BRAF mutation between FNMTC-2 group and FNMTC-3 group. We also made the same comparison between FNMTC-3-2 group and other families.</p><p><b>RESULTS</b>No pronounced differences in clinicopathological features were present between FNMTC-2 group and FNMTC-3 group. The proportion of FNMTC-3-2 group aged <45 years was significantly higher than that in the other families (58.8% vs. 26.3%, P = 0.021). A similar difference was found in the proportion of lymph node metastasis (64.7% vs. 34.2%, P = 0.035).</p><p><b>CONCLUSIONS</b>FNMTC-3-2 is more invasive than the other families. Early screening and positive treatment for members of these families are recommended.</p>

Multifactor dimensionality reduction analysis of the correlation of Chinese medicine syndrome evolvement and cardiovascular events in patients with stable coronary heart disease / 中国结合医学杂志

<p><b>OBJECTIVE</b>To analyze the correlation of Chinese medicine syndrome evolvement and cardiovascular: events in patients with stable coronary heart disease (CHD).</p><p><b>METHODS</b>This prospective cohort study investigated and: collected the clinical information of patients with stable CHD and observed the syndrome type at the baseline and 6-month at follow-up, as well as the cardiovascular events during the 6-month and 12-month follow-up. The patients were divided into the event group and the non-event group. The interaction and the impact of syndrome evolvement on cardiovascular events were examined through multifactor dimensionality reduction (MDR) analysis and the results were verified by Chi-square test.</p><p><b>RESULTS</b>Totally 1,333 of 1,503 stable CHD patients enrolled met the inclusion criteria: of MDR analysis. Among them, 959 (71.9%) cases were males and 374 (28.1%) cases were females. Thirty seven cases had cardiovascular events during 6 to 12 months after the study began. The results of the MDR analysis and verification using Chi-square test showed that the development of cardiovascular events was positively correlated with interaction between blood stasis and toxic syndrome at the baseline, blood stasis at the baseline and qi deficiency at the 6-month follow-up, toxic syndrome at the baseline and qi deficiency at the 6-month follow-up, toxic syndrome at the base line and blood stasis at the 6-month follow-up, qi deficiency and blood stasis at the 6-month follow-up (P<0.05 for all).</p><p><b>CONCLUSIONS</b>Blood stasis, toxic syndrome and qi deficiency are important factors of stable CHD. There: are positive correlation between cardiovascular events and syndrome evolution from blood stasis to qi deficiency, from toxic syndrome to qi deficiency and from toxic syndrome to blood stasis, indicating the pathogenesis of toxin consuming qi, toxin leading to blood-stasis in stable CHD patients prone to recurrent cardiovascular events.</p>

Application of 3.0T MR Diffusion Tensor Imaging in Normal Female Pelvic Floor Muscles / 中国医学影像学杂志

Purpose To explore the three-dimensional display and parameter features of 3.0T MR diffusion tensor imaging (DTI) in the imaging of normal female pelvic floor muscle fiber bundles, and to provide a reference standard for the application of DTI in patients with pelvic organ prolapse. Materials and Methods Fifty cases of females who had not given birth or had given birth by cesarean delivery were divided into four groups:20 to 29 years (15 cases), 30 to 39 years (15 cases), 40 to 49 years (12 cases) and 50 to 54 years (8 cases). First, the conventional sagittal, axial, coronal T2WI and axial T1WI images were acquired with a 3.0T MRI scanner;then a dynamic sagittal fiesta sequence was executed to exclude pelvic organ prolapse; at last, the transverse two-dimensional diffusion-weighted spin echo-echo planar imaging (SE-EPI) pulse sequence was executed to acquire pelvic floor DTI data, through the post-processing of the data, normal female pelvic floor muscle fiber bundle images can be obtained and apparent diffusion coefficient (ADC) value and fractional anisotropy (FA) value were calculated. Results Content three-dimensional muscle fiber bundle images and corresponding ADC and FA values of the pubic visceral muscles in pelvic wall and obturator muscles in pelvic wall were acquired in all subjects;there was no statistically significant difference (P>0.05) for the ADC and FA values between the left and right side of the pubic visceral muscles and obturator muscles within the same age group;and the difference of ADC and FA values of pubic visceral muscles and obturator muscles among different age groups were not statistically significant (P>0.05), either. Conclusion 3.0T MR DTI fiber tracking imaging can be applied for the three-dimensional observation of the complicated muscle fiber bundle structures in female pelvic floor, through the measurement of ADC and FA value changes, functional abnormity can be suggested before the anatomy structure changes of the pelvic muscles occurs, thus provides an important new approach for further study of pelvic organ prolapse.

Influence of antiviral treatment on the efficacy and prognosis of compensated Hepatitis B cirrhosis / 中国综合临床

Objective To analyze the efficacy and prognosis of different antiviral agents on compensated hepatitis B cirrhosis.Methods Eight hundred and sixty-five cases of Hepatitis B patients with compensated cirrhosis were randomly divided into five groups:A group(n =143,subcutaneous injection interferon 3 million U every other day for 48 weeks),B group(n =171,orally treatment with lamivudine 100 mg/d for 48weeks),C group(n =137,orally treatment with adefovir 10 mg/d for 48 weeks),D group(n =83,oral treatment with entecavir O.5 mg/d,for 48 weeks) and E group(n =331,treated with general hepatoprotective drugs).Clinical symptoms and signs,changes in liver function were observed and prothrombin time activity degrees (PTA),quantitative HBV-DNA,HBeAg seroconversion and HBeAg/HBeAb conversion situation were detected.Results There were significant differences on HBeAg seroconversion between A group and other four groups after treated for48 weeks(31.5％ vs 13.5％,22.6％,18.1％,5.7％,x2 =58.56,P ＜0.01) and at the end of follow up (33.1％ vs 14.2％,23.3 ％,23.6％,6.4％,x2 =52.87,P ＜ 0.01).Patients' condition in A,B,C,D groups progressed slowly,and their incidence rates of decompensate cirrhosis were significantly lower than that in group E(x2 =122.41,P ＜ 0.01).The incidence rate of liver cancer in group A was significantly lower than that in B,C,D,E groups (x2 =19.61,P ＜ 0.01).Conclusion Antiviral therapy of interferon and nucleoside drugs can slow the progression of compensated Hepatitis B cirrhosis and reduce the incidence rates of decompensate cirrhosis.And interferon can significantly reduce the incidence rate of liver cancer.

A meta-analytic review of ERCC1/MDR1 polymorphism and chemosensitivity to platinum in patients with advanced non-small cell lung cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Platinum-based regimens are used as standard first-line chemotherapy in non-small cell lung cancer (NSCLC) patients. To study if pharmacogenetic approach may allow a tailored selection of platinum chemotherapy for advanced NSCLC, we performed a meta-analysis to compare chemosensitivity to platinum with different ERCC1 C118T/ MDR1 C3435T single-nucleotide polymorphism (SNP).</p><p><b>METHODS</b>Relevant studies were identified by searching the PubMed, Embase, Cochrane, OVID, Springer, EBSCO and CNKI databases. Inclusion criteria were patients with advanced NSCLC who received platinum-based chemotherapy, an evaluated polymorphism of ERCC/MDR1 and overall response rate. We excluded duplicate publications, letters and review articles. The RevMan 4.2 and STATA 11 package were used to do comprehensive quantitative assessment.</p><p><b>RESULTS</b>A total of 11 studies were included in this meta-analysis. For studies evaluating ERCC1 C118T, test for heterogeneity was done (χ(2) = 13.41, P = 0.1), and the odds ratio (OR) for the wild-type C/C genotype versus the heterozygous C/T and T/T genotypes was 1.50 (95% CI 1.09 - 2.06, P = 0.01). In four studies evaluating MDR1 polymorphism, test for heterogeneity was also done (χ(2) = 3.22, P = 0.36), and the OR for the wild-type C/C genotype versus the heterozygous C/T and T/T genotypes was 2.30 (95% CI 1.44 - 3.68, P = 0.0005).</p><p><b>CONCLUSIONS</b>The results indicated that platinum-based chemotherapy sensitivity was significantly associated with polymorphism of ERCC1 C118T and MDR1 C3435T SNP. In further perspective studies, the ERCC1/MDR1 SNPs might serve as simple and less invasive biomarkers for personalized chemotherapy with platinum-based anticancer drugs.</p>

A multi-center randomized double-blind placebo-controlled trial of Xiongshao Capsule in preventing restenosis after percutaneous coronary intervention: a subgroup analysis of senile patients / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of Xiongshao Capsule (XS), consisting of Chuangxiongol and paeoniflorin, in preventing restenosis after percutaneous coronary intervention (PCI) in senile coronary heart disease (CHD) patients.</p><p><b>METHODS</b>A multi-center, randomized, double-blind, placebo-controlled trial was conducted. A total of 335 CHD patients were randomly assigned to treatment with oral administration of XS, or a placebo for 6 months after successful PCI. A clinical follow-up was performed at 1, 3 and 6 months after PCI and an angiographic follow-up was scheduled at 6 months. The primary endpoint was angiographic restenosis defined as a luminal stenosis ≥ 50% in follow-up. The secondary endpoints were combined incidence of death, target lesion nonfatal myocardial infarction, repeat target-vessel angioplasty, and coronary artery bypass graft surgery (CABG). The follow-up for the above clinical endpoint events was continued to 1 year after PCI.</p><p><b>RESULTS</b>The subgroup analysis of 152 senile patients (68 cases angiographic follow-up) showed that the restenosis rates tended to reduce in the XS group as compared with that in the placebo group (24.32% vs. 38.71%, P > 0.05), and the minimum lumen diameter (MLD) significantly increased in the follow-up (2.15 ± 0.84 for XS vs. 1.73 ± 0.91 for placebo, P < 0.05). The incidence of recurrent angina at 3 and 6 months after PCI was also significantly reduced in the XS group (4.11% and 12.33%) as compared with those in the placebo group (17.72% and 43.04%), but there was no significant difference in the combined incidence of clinical outcomes (6.85% in the XS group vs. 11.39% in the placebo group, P > 0.05). No significant adverse reactions occurred within the 6-month follow-up period in the XS group.</p><p><b>CONCLUSION</b>Administration of XS in addition to standardized Western medication for 6 months is demonstrated to be safe and effective in reducing post-PCI recurrent angina and inhibiting luminal restenosis after PCI in senile CHD patients.</p>

Application of timolol in preventing variceal hemorrhage in patients with portal hypertension / 中国医学科学院学报

<p><b>OBJECTIVE</b>To determine the effectiveness of timolol in preventing first variceal hemorrhage in portal hypertensive patients with esophageal varices.</p><p><b>METHODS</b>A total of 42 cirrhotic patients with esophageal varices were enrolled in this study and received timolol or band ligation therapy randomly,with 21 patients in each group. The diameters of portal vein (PV), superior mesenteric vein (SMV), and splenic vein (SPV) as well as the portal venous flow and the splenic venous flow were measured. The first esophageal variceal bleeding of the two groups was recorded.</p><p><b>RESULTS</b>The diameters of PV, SMV, and SPV as well as the flow of PV and SPV showed no significant difference before and after treatment in band ligation group (P>0.05). In timolol group,however,the diameter of portal vein significantly decreased after treatment [(14.11±2.96) mm vs. (12.15±1.61)mm, P<0.05], and the average blood flow of portal vein also significantly decreased after treatment [(1277.33±495.19) ml/min vs. (719.17±245.16)ml/min, P<0.05]. Both timolol and band ligation effectively prevented esophageal variceal bleeding, and the risk of first esophageal variceal bleeding in these two groups were not significantly different (15% vs. 10%, P<0.05).</p><p><b>CONCLUSIONS</b>Timolol is safe and effective in preventing the first variceal bleeding in portal hypertensive patients with esophageal varices.</p>

Effect of submarine training on antioxidant ability in submarine men / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the effect of the submarine training on the antioxidant ability of the submarine men.</p><p><b>METHODS</b>50 sea-training submarine men, 50 land-training submarine men and 50 resting submarine men were randomly selected from some submarine troops. The blood routine, the total antioxidative capacity (T-AOC), the content of malondialdehyde (MDA) and the levels of IFN-gamma in blood plasma, the hemolytic degree of RBC, the proliferation of peripheral-blood lymphocyte (PPL) of them were detected in each group.</p><p><b>RESULTS</b>The T-AOC of the sea-training submarine men, the land-training submarine men and the resting submarine men significantly increased by turns [(15.38 +/- 3.11), (18.81 +/- 2.45), (20.93 +/- 2.95) U/ml], but MDA and the hemolytic degree of RBC significantly decreased by turns [(2.56 +/- 0.70), (2.12 +/- 0.53),(1.77 +/- 0.56) nmol/ml and 25.72% +/- 1.67%, 21.45% +/- 1.02%, 18.28% +/- 1.37%] (P < 0.05). Compared with the land-training submarine men and the resting submarine men, IFN-gamma [(31.89 +/- 3.52) pg/ml] and the proliferation of PPL of the sea-training submarine men were significantly lower, whereas the red blood count (RBC) and hemoglobin (Hb) were significantly higher (P < 0.05).</p><p><b>CONCLUSION</b>Submarine training, especially sea training, may decrease the antioxidant ability.</p>

Analysis of pathogen distribution and risk factors from 52 cases of hospital-acquired septicemia / 国际外科学杂志

Objective To study the pathogen distribution,risk factors and preventive measures in the patients with hospital-acquired septicemia. Methods Retrospective survey was carried out in 52 patients with hospital-acquired septicemia from 2007 to 2009. Results The hospital-acquired septicemia was related to the underlying disease and aggressive procedure. The most bacteria were Gram-negative bacilli and fungemia must be paid attention. Conclusion It is important to reduce the aggressive procedures and reasonably use antibiotics in the prevention of the hospital-acquired septicemia.