Cost-effectiveness Analysis of Insulin Analogues and Human Insulin in the Treatment of Type 2 Diabetes Mellitus Based on Net-benefit Regression Framework / 中国药房

OBJECTIVE：To compare the cost-effectiveness of insulin analogues and human insulin in the treatment of type 2 diabetes mellitus ，to reduce economic burden of patients ，and to provide new ideas for non-randomized pharmacoeconomic research. METHODS ：Retrospective data of a Third-grade Class-A hospital were adopted and 533 patients with type 2 diabetes were taken as object to balance the difference between groups through propensity score matching ，and construct net-benefit regression framework so as to analyze the cost-effectiveness of insulin analogues and human insulin in the treatment of type 2 diabetes mellitus. RESULTS ：There was a positive relationship between the efficacy and cost of the two therapeutic schemes ，i.e. insulin analogues were more effective than human insulin ，and the difference of total effective rate between the two schemes was 14.5％. The corresponding treatment cost of insulin analogues was higher than that of human insulin ，and the average total cost difference was 960.3 yuan. The cost of insulin analogues was 66.23 yuan more than that of human insulin for each additional unit of clinical effect （total effective rate ）. Results of net-benefit regression analysis showed that critical value of willingness to pay of therapy plan was 16 947.5 yuan. CONCLUSIONS ：When the willingness to pay is more than 16 947.5 yuan，the insulin analogue scheme is suitable ；on the contrary ，the human insulin analogue scheme is suitable. The propensity scoring technology used for the net-benefit regression analysis can broaden the source of avaliable data for non-randomized pharmacoeconomic evaluation.

Prediction of acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation by the level of galectin-9 in peripheral blood / 中华血液学杂志

Objective@#To evaluate possible effects of Gelctin-9 on acute graft versus host disease (aGVHD) development and clinical outcomes in patients before and afer allogeneic hematopoietic stem cell transplantation (allo-HSCT) .@*Methods@#Peripheral blood samples were obtained from 29 patients and 15 healthy volunteers with heparin anticoagulant tubes. Samples were analyzed using ELISA kits to measure the serum concentrations of Galectin-9.@*Results@#Patients developing aGVHD had significantly lower level of Galectin-9 [ (7.96±1.18) μg/L] before allo-HSCT compared with those not developing aGVHD [ (12.37±0.97) μg/L, P<0.001]. And after allo-HSCT, the consentration of Galectin-9 increased markedly in patients developing aGVHD [ (17.78±1.78) μg/L] compared with those not developing aGVHD [ (9.45±0.80) μg/L, P<0.001]. Patients developing 3-4 grade aGVHD had significantly higher level of Galectin-9 [ (23.25±2.59) μg/L] compared with those developing 1-2 grade aGVHD [ (14.37±1.45) μg/L, P=0.008] and those without aGVHD [ (9.45±0.80) μg/L, P<0.001]. The patients with lower level of Galectin-9 after allo-HSCT (<13.61 μg/L) showed more favorable clinical outcomes compared with those with higher level of Galectin-9 (≥13.61 μg/L) . The 3-year overall survival rates were (100.00±6.05) % and (69.23±12.80) %, respectively (P=0.009) . The cumulative incidence of non-relapse mortality was significantly higher in high Galectin-9 group [ (23.08±11.69) %] in comparison with low Gaelctin-9 group [ (0.00±7.39) %] (P=0.023) . There was no significant difference between the two groups in terms of the cumulative incidence of relapse. The cumulative incidence of relapse at 3 years were (8.33±7.98) % and (12.50±8.27) % in high and low Galectin-9 groups, respectively (P=0.708) .@*Conclusions@#The serum concentration of Galectin-9 at the time of engraftment after allo-HSCT may be used as a predictor for the development and severity of aGVHD. Galectin-9 might be considered as a potential new approach to regulate transplant rejection to achieve desirable survival.

Effect of salvianolic acid B on high glucose-induced phenotypic transition and extracellular matrix secretion in human glomerular mesangial cells / 中国病理生理杂志

AIM:To investigate the effect of salvianolic acid B (Sal B) on high glucose-induced phenotypic transition and extracellular matrix (ECM) secretion in human glomerular mesangial cells (HGMCs) and the underlying mechanisms.METHODS:HGMCs were randomly divided into control group, high glucose group and high glucose plus high dose, medium dose and low dose of Sal B groups.The HGMCs except those in control group were exposed to high glucose (33.3 mmol/L) for 72 h, while those in Sal B groups were co-incubated with indicated concentrations of Sal B.The protein levels ofα-smooth muscle actin (α-SMA) , transforming growth () and phosphorylated Smad2 and p38 mitogen-activated protein kinase (MAPK) were determined by Western blot.The secretion levels of collagen type I (Col I) , collagen type III (Col III) , fibronectin (FN) and laminin (LN) were measured by ELISA.RESULTS:Exposure to high glucose markedly increased the protein expression ofI, Col III, FN and LN in the HG-MCs (P<0.01).The phosphorylation levels of Smad2 and p38 MAPK were also significantly increased (P<0.01).Coincubation with Sal B evidently decreased the protein expression ofI, Col III, FN and LN in the HGMCs induced by high glucose (P<0.05 or P<0.01).The phosphorylated levels of Smad2 and p38 MAPK were also reduced noticeably (P<0.05 or P<0.01).CONCLUSION:Sal B significantly suppresses high glucose-induced phenotypic transition and ECM secretion in the HGMCs, which might be attributed, at least partly, to inhibition ofSmad signaling pathway and p38 MAPK activation.

Adiponectin is protective against endoplasmic reticulum stress-induced apoptosis of endothelial cells in sepsis

Endoplasmic reticulum (ER) stress is a critical molecular mechanism involved in the pathogenesis of sepsis. Hence, strategies for alleviating this stress may be essential for preventing cardiovascular injuries under sepsis. Adiponectin is secreted by adipocytes and its levels are decreased in sepsis. The purpose of this study was to investigate the protective effects of adiponectin treatment on endothelial cells and its mechanism. Male Wistar rats underwent cecal ligation and puncture (CLP) before being treated with adiponectin (72 and 120 μg/kg). The levels of malondialdehyde (MDA) in plasma, histological structure, and apoptosis of endothelial cells were evaluated. In vitro, human umbilical vein endothelial cells (HUVECs) were treated with adiponectin at 10 and 20 μg/mL for 24 h after stimulation by lipopolysaccharide (LPS). The levels of reactive oxygen species (ROS), ultrastructure, rate of apoptosis, the expression of inositol-requiring enzyme 1α (IRE1α) protein, and its downstream molecules (78 kDa glucose-regulated protein (GRP78), C/EBP homologous protein (CHOP), and caspase-12) were detected. The results showed that the levels of MDA and ROS induced by CLP or LPS stimulation were increased. Furthermore, endothelial cell apoptosis was increased under sepsis. The IRE1α pathway was initiated, as evidenced by activated IRE1α, increased GRP78, and up-regulated CHOP and caspase-12 in HUVECs. Following treatment with adiponectin, the number of apoptotic endothelial cells was markedly decreased. These findings demonstrated that treatment with adiponectin decreased apoptosis of endothelial cells caused by sepsis by attenuating the ER stress IRE1α pathway activated by oxidative stress.

Study on a New Ultraviolet Sterilizer to the Surface Disinfection of the Ultrasound Probe / 生物医学与环境科学（英文）

We studied the disinfection effect of a new ultraviolet (UV) sterilizer and its utilization on ultrasound probe surfaces. Carrier quantitative germicidal tests, simulated on-the-spot trials, and organic substance influence tests were used to carry out experimental observation. Artificially infected probes were disinfected using the sterilizer or a germicidal lamp for comparison. The total number and types of bacteria were determined and identified. Our results demonstrated the sterilizer had the best disinfection effect among three different disinfection methods in hospital. The sterilizer has been used in a hospital setting for 2 years with no notable damage to the ultrasound probe instrument. It has the advantages of fast disinfection, high disinfection effect, and good compatibility with the ultrasound instrument, worthy of being a promoted application in medical institutions.

Discrimination of Microbe Species by Laser Induced Breakdown Spectroscopy / 分析化学

Laser induced breakdown spectroscopy ( LIBS ) was proposed to rapidly discriminate microbe species. Ten species of microbes were prepared in lab. Filter papers were selected as substrate for enriching bacteria and enhancing the quality of LIBS. The images of plasma were collected by ICCD camera and LIBS spectra were obtained by spectrometers. The results displayed that the images and spectra were different from 10 bacteria. It was demonstrated that this method was feasible to discriminate bacteria species by analyzing image and/or spectroscopy. Furthermore, nine smooth and multiple scattering correction ( MSC) were utilized to preprocess the LIBS full-spectrum data in the wavelength range of 200-420 nm and 560-680 nm. And principal component analysis ( PCA) and PCA-RF ( Random forest) were compared to validate the accuracy of discrimination. The investigation showed that the PCA-RF model coupled with suitable methods in preprocessing data could identify bacteria. The accuracy was 99. 6% for ten species of microbes by evaluating LIBS spectra in training set, and 96. 7% in predicting set. This report indicated that it is feasible to differentiate bacteria species by analyzing LIBS spectra.

Progress of Visual Biosensor Based on Gold Nanoparticles / 分析化学

VisualiZation detection methods are used for determination of the concentration of unknown target by comparing the color change in the intensity or type of reaction solution by naked eye.VisualiZation detection method has some advantages such as simple and rapid operation, low detection cost, fast reaction speed, and detecting target concentration by means of naked eye.Gold nanomaterials are widely used in the construction of visual biosensors due to its unique optical properties.For example, when changing the distance or morphology of the particles, the plasmon resonance absorption peak of local surface will change accordingly.Herein, we reviewed the application of gold nanomaterials in visualiZation biosensors for the detection of target molecules, summed up the main problems of AuNP colormertic methods in the determination of actual samples, and provided an outlook of the future of gold nanoparticles-based biosensor in application development.

Effects of Endothelial Progenitor Cells on Vascularization and Osteogenesis of Tissue-engineered Bones in Beagle Dogs / 中国医学科学院学报

Objective The explore the effects of endothelial progenitor cells(EPCs)on vascularization and osteogenesis of tissue-engineered bones in Beagle dogs.Methods Bone marrow mesenchymal stem cells(BMSCs)and EPCs from bone marrow of Beagle dogs were isolated,cultured,and expanded and then seeded in β-tricalcium phosphate(TCP)scaffolds. The cell scaffold complexes(EPCs/ BMSCs/TCP group and BMSCs/TCP group)and the blank TCP scaffold were transplanted into the limb muscles of Beagle dogs,respectively. The relative CT values were calculated in the 3rd and 6th month through CT scan after operation. The vascularization and the osteogenesis were detected 6 months after operation by histological examination.Results Three months after the surgery,the relative CT value in the EPCs/BMSCs/TCP group was(366.67±19.51)HU,significantly higher than that[(163.00±30.81)HU] in the BMSCs/TCP group(t=2.10,P=0.0006);6 months after surgery,the relative CT value in the EPCs/BMSCs/TCP group was(553.34±26.86)HU,which was also significantly higher than that[(241.34±21.57)HU] in the BMSCs/TCP group(t=2.11,P=0.0006). The relative CT values at 6 months after operation were significantly higher than those at 3 months after operation in both BMSCs/TCP group(t=2.10,P=0.0255)and EPCs/BMSCs/TCP group(t=2.10,P=0.0006). Six months after the operation,HE staining showed no bone formation or calcium deposition in the blank TCP group,and osteoblasts,mature bone trabeculae,and calcium deposition were observed in EPCs/BMSCs/TCP group and BMSCs/TCP group. Immunohistochemical staining showed that the number of peripheral,central,and whole vessels in the EPCs/BMSCs/TCP group was 21.67±1.45,23.33±2.60,and 45.00±1.16,which were significantly higher than those in the BMSCs/TCP group[8.67±0.88(t=2.07,P=0.0016),9.33±0.67(t=2.07,P=0.0065),and 18.00±1.00(t=2.07,P=0.001),respectively]. The number of vessels was not significantly different between the BMSCs/TCP group and the blank TCP group(18.00±1.00 vs. 16.67±2.40;t=2.07,P=0.636). The osteogenic area of the EPCs/BMSCs/TCP group was(1 322 000±141 300)pixel,significantly higher than that of the BMSCs/TCP group[(874 900±49 430)pixel;t=2.10,P=0.04]. BMSCs/TCP group showed significantly higher bone area in the peripheral area than in the central region[(170 000±42 320)pixel vs.(613 900±90 290)pixel;t=2.10,P=0.02];in contrast,there was no statistically significant difference in bone area between the peripheral region and the central region in the EPCs/BMSCs/TCP group[(376 400±20 160)pixel vs.(310 400±6917)pixel;t=2.10,P=0.07].Conclusion EPCs as seed cells combined with BMSCs can promote vascularization and osteogenesis of tissue-engineered bone in Beagle dogs.

Relationship between EGFR gene mutation and clinicopathological features in peripheral blood of patients with non-small cell lung cancer in Yunnan area / 临床与实验病理学杂志

Purpose To investigate the prevalence of EG-FR mutation in circulating cell-free DNA in non-small cell lung cancer (NSCLC) patients of Yunnan province and its relationship with clinical pathological characteristics,which can provide foundations for individualized targeted therapy of lung cancer in this area.Methods Amplification refractory mutation system (ARMS) was used to detect the EGFR exon 18,19,20 and 21 mutation in circulating cell-free DNA.The relationship between EGFR mutation and clinical characteristics were further analyzed.Results 93 patients (25.5％) harbored circulating EG-FR mutations among 364 patients.The mutation rates of EGFR 18 G719X,19del,20 S768I,T790M,20ins were 3.2％ (3/93),2.2％ (2/93)and3.2％ (3/93)respectively.EGFR21 L858R and L861Q mutation rates were 26.9％ (25/93) and 1.1％ (1/93),respectively.Three patients (3.2％,3/93)harbored G719X + S768I double mutation,four patients (4.3％,4/93) harbored 19Del + T790M mutations.19Del +L858R,L858R + S768I,and S768I + T790M mutation rates were 1.1％ (1/93),1.1％ (1/93) and 2.2％ (2/93) respectively.Conclusion The EGFR mutation rate of female and adenocarcinoma patients is higher in patients with stage Ⅲ B-ⅣNSCLC in Yunnan area.19Del is the major mutation type and double exon mutation is an obvious characteristic in NSCLC patients of Yunnan province.EGFR mutation detection in circulating cell-free DNA by ARMS method is feasible to screen patients receiving EGFR-TKIs treatment.

Detection of Echinoderm Microtubule Associated Protein Like 4-Anaplastic Lymphoma Kinase Fusion Genes in Non-small Cell Lung Cancer Clinical Samples by a Real-time Quantitative Reverse Transcription Polymerase Chain Reaction Method / 中国医学科学院学报

Objective To establish a real-time quantitative reverse transcription polymerase chain reaction assay (qRT-PCR) for the rapid, sensitive, and specific detection of echinoderm microtubule associated protein like 4-anaplastic lymphoma kinase (EML4-ALK) fusion genes in non-small cell lung cancer. Methods The specific primers for the four variants of EML4-ALK fusion genes (V1, V2, V3a, and V3b) and Taqman fluorescence probes for the detection of the target sequences were carefully designed by the Primer Premier 5.0 software. Then, using pseudovirus containing EML4-ALK fusion genes variants (V1, V2, V3a, and V3b) as the study objects, we further analyzed the lower limit, sensitivity, and specificity of this method. Finally, 50 clinical samples, including 3 ALK-fluorescence in situ hybridization (FISH) positive specimens, were collected and used to detect EML4-ALK fusion genes using this method. Results The lower limit of this method for the detection of EML4-ALK fusion genes was 10 copies/μl if no interference of background RNA existed. Regarding the method's sensitivity, the detection resolution was as high as 1% and 0.5% in the background of 500 and 5000 copies/μl wild-type ALK gene, respectively. Regarding the method's specificity, no non-specific amplification was found when it was used to detect EML4-ALK fusion genes in leukocyte and plasma RNA samples from healthy volunteers. Among the 50 clinical samples, 47 ALK-FISH negative samples were also negative. Among 3 ALK-FISH positive samples, 2 cases were detected positive using this method, but another was not detected because of the failure of RNA extraction. Conclusion The proposed qRT-PCR assay for the detection of EML4-ALK fusion genes is rapid, simple, sensitive, and specific, which is deserved to be validated and widely used in clinical settings.

Progress on polyhydroxyalkanoates (PHA) / 生物工程学报

Microbial polyhydroxyalkanoates (PHA) has developed with more diversity and more advanced manufacturing technology. Diversity has now been reflected by diverse monomers, diverse structures and diverse polymerization modes, giving the concept of "PHAome". In addition, the application of synthetic biology and the development of seawater-based biotechnology reduce the production cost of PHA, making PHA more economically competitive. Some examples of commercialized PHA products are described here. Besides, PHA with high value added applications has been exploited.

The role of CD14+ HLA-DR-/low MDSC in aGVHD development after allogeneic hematopoietic stem cell transplantation / 中华器官移植杂志

Objective In order to evaluate the possible effects of myeloid-derived suppressor cells (MDSCs) on graft versus host disease (aGVHD) development and clinical outcomes,this study systematically detected the dynamic changes of MDSCs accumulation in patients during the first 100 days after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods Peripheral blood was obtained from 30 patients and 10 healthy volunteers with heparin anticoagulant tubes for 6 mL.For patients,peripheral blood was collected during the first 100 days after allo-HSCT and MDSCs levels were detected by flow cytometry.For measuring the serum concentrations of IL-6,IL-10,IL-1β,TNF-α,Arg-1,HO-1 and iNOS,samples were analyzed using ELISA kits.Results Patients developing aGVHD were infused with significantly less number of MDSCs [(39.94 ± 8.383) 106/kg]than in those not developing aGVHD [(209.0 ± 57.68) 106/kg,P =0.002 6];Patients developing aGVHD Ⅰ-Ⅱ and patients without aGVHD received significantly greater number of MDSCs [(61.96 ± 13.67) 106/kg and (209.0 ± 57.68) 106/kg] than in those developing aGVHD Ⅲ-Ⅳ [(20.37 ±4.304) 106/kg,P =0.013 9].After allo-HSCT,the mean percentage of MDSCs increased markedly in patients developing aGVHD [(7.725 ± 1.460)％] as compared with those not developing aGVHD [(3.423± 1.044)％,P =0.021 3].The high MDSCs group (＞53.712 × 106/kg) showed more favorable clinical outcomes than in the low MDSCs group (≤53.712 × 106/kg).The 2-year overall survival rate as 100％ in high MDSCs group,and 50％ in low MDSCs group (P =0.001 3).The cumulative incidence of 2-year relapse was 6.250％ and 29.252％ in high MDSCs group and low MDSCs group respectively (P =0.112 3).The cumulative incidence of NRM was significantly lower in high MDSCs group (0％) than in low MDSCs group (49.519％,P=0.001 8).MDSCs frequencies significantly increased in patients developing aGVHD after allo-HSCT.After allo-HSCT,the concentrations of IL-6,IL-10,TNF-α,Arg-1,iNOS and HO-1 were significantly elevated in patients developing aGVHD.Conclusion The number of MDSCs when engraftment may be used as a predictor for the development and severity of aGVHD.MDSCs might be considered as a potential new approach to regulate transplant rejection and achieve long-term survival.

Differences of Sagittal Lumbosacral Parameters between Patients with Lumbar Spondylolysis and Normal Adults / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recent studies have suggested an association between elevated pelvic incidence (PI) and the development of lumbar spondylolysis. However, there is still lack of investigation for Han Chinese people concerning the normal range of spinopelvic parameters and relationship between abnormal sagittal parameters and lumbar diseases. The objective of the study was to investigate sagittal lumbosacral parameters of adult lumbar spondylolysis patients in Han Chinese population.</p><p><b>METHODS</b>A total of 52 adult patients with symptomatic lumbar spondylolysis treated in the General Hospital of Armed Police Force (Beijing, China) were identified as the spondylolysis group. All the 52 patients were divided into two subgroups, Subgroup A: 36 patients with simple lumbar spondylolysis, and Subgroup B: 16 patients with lumbar spondylolysis accompanying with mild lumbar spondylolisthesis (slip percentage <30%). Altogether 207 healthy adults were chosen as the control group. All patients and the control group took lumbosacral lateral radiographs. Seven sagittal lumbosacral parameters, including PI, pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), L5 incidence, L5 slope, and sacral table angle (STA), were measured in the lateral radiographs. All the parameters aforementioned were compared between the two subgroups and between the spondylolysis group and the control group with independent-sample t- test.</p><p><b>RESULTS</b>There were no statistically significant differences of all seven sagittal lumbosacral parameters between Subgroup A and Subgroup B. PI, PT, SS, and LL were higher (P < 0.05) in the spondylolysis group than those in the control group, but STA was lower (P < 0.001) in the spondylolysis group.</p><p><b>CONCLUSIONS</b>Current study results suggest that increased PI and decreased STA may play important roles in the pathology of lumbar spondylolysis in Han Chinese population.</p>

Question discussion on Theories of Different Schools of Acupuncture and Moxibustion, "the twelfth five-year plan" teaching material / 中国针灸

The several questions in Theories of Acupuncture and Moxibustion of Different Schools, "the twelfth five-year plan" teaching material, are analyzed and discussed. The expression of DOU Han-qing on "playing a role of meridians, collaterals, qi and blood" is not so accurate, which is suggested to modify as "attaching the importance to needles". "Theory of heaven, human being and earth" "theory of acupuncture on qi regulation" and "the eight therapeutic methods in treatment of disease" in Jinzhenfu (Ode to Golden Needles) are valuable academically and suggested to be supplemented. The expression of XI Hong on "reinforcing and reducing technique by following or against the running course of meridian" and the expression of XU Feng on "the magic turtle eight techniques" are not concrete. It is required to elaborate them in detail. These questions are put forward and needed to discuss with the editors so as to perfect the teaching material.

The analysis of risk factors in gastrointestinal graft versus host disease following allogeneic hematopoietic stem cell transplantation / 中华器官移植杂志

Objective To investigate the risk factors of gastrointestinal graft versus host disease(GVHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT).Method 214 patients receiving allo-HSCT from 2003 to 2012 were enrolled in this study,and assessed on the degree of gastrointestinal GVHD.The effects of the primary diseases status,gender,age,conditioning regimen intensity,donor type,the number of cells positive for the CD34 expression,and the use of anti-lymphocyte immunoglobulin (ALG) in the pretreatment scheme on the occurrence of gastrointestinal GVHD was studied.The responses of different degrees of GVHD to immunotherapy were evaluated.Result Univariate and multivariate analyses revealed that the graft type and the conditioning regimen intensity were the risk factors of gastrointestinal GVHD (P＜0.05).Conclusion Donor type and conditioningregimen intensity may be the main risk factors of gastrointestinal GVHD.

Observation on therapeutic effect of the new Bianshi (stone needle) therapy on migraine / 中国针灸

<p><b>OBJECTIVE</b>To observe the effect of the new Bianshi (stone needle) therapy on migraine.</p><p><b>METHODS</b>Eighty cases of migraine were treated by the new Bianshi therapy with the multi-functional fish-shaped stone board. Manipulations such as pushing, scraping and kneading at acupoints were applied on head, neck and back as well as Baihui (GV 20), Shuaigu (GB 8) and Fengchi (GB 20). The intensity of headache and clinical effect before and after the treatment were observed.</p><p><b>RESULTS</b>The pain score before the treatment was (8.31 +/- 0.61), and (3.90 +/- 0.82) after the treatment. The intensity of pain after the treatment was sighificantly lower than that before the treatment (P < 0.01). The total effective rate of the excessive syndrome [hyperactivity of liver yang and blood stagnation in meridians and collaterals, 100% (40/40)] was better than that of the deficiency syndrome [kidney yin deficiency and qi and blood deficiency, 87.5% (35/40)] (P < 0.05).</p><p><b>CONCLUSION</b>The new Bianshi therapy is applicable for treatment of migraine, which has a comparatively ideal clinical effect.</p>

Practice on the case-based teaching innovation of Science of Meridians, Collaterals and Acupoints / 中国针灸

The case-based teaching method which is applied to the teaching of Science of Meridians, Collaterals and Acupoints is discussed in this paper, in which the typical cases such as the growth of the acupuncture-moxibustion eminent physicians, the application of acupoints by the eminent physicians and the experiences in the acupoint combination are integrated. The students are instructed to launch the clinical practical activity through establishing the clinical base of Science of Meridians, Collaterals and Acupoints, in association with the true cases. It is proved that the case-based teaching method can promote the training of the manipulation techniques of the students and the inheritance of the experiences of eminent physicians in higher education.

Risk factors for postoperative seromas in Chinese breast cancer patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Seroma formation is one of the most common complications after breast cancer surgery. Various risk factors have been evaluated for their associations with the development of seromas in Western populations. However, similar data are not available in Chinese series. Therefore, we sought to investigate the potential risk factors for Chinese breast cancer patients.</p><p><b>METHODS</b>A prospective study of female breast cancer patients undergoing surgery was carried out in Cancer Hospital of Fudan University, Shanghai, China. Univariate analyses were performed by chi-square test or Student's t test or Mann-Whitney test and multivariate analyses by stepwise Logistic regression. The logistic model included age (years), total serum protein concentration (g/L), drainage volume on postoperative day 3 (POD 3; ml) and time to daily drainage volume not more than 30 ml (TTV30; days).</p><p><b>RESULTS</b>A total of 158 patients with breast cancer were studied. The mean age at diagnosis was (52.14 ± 10.77) years (range 25 - 92). During the follow-up period, 24 (15.2%) patients developed seromas. Calculated as continuous variables in the stepwise Logistic regression, age (OR = 1.090, 95%CI 1.028 - 1.155, P = 0.004), total serum protein concentration (OR = 0.886, 95%CI 0.791 - 0.992, P = 0.036), drainage volume on POD3 (OR = 1.013, 95%CI 1.002 - 1.023, P = 0.017) and TTV30 (OR = 1.273, 95%CI 1.039 - 1.561, P = 0.020) were independent risk factors for seroma formation. Additionally, significant difference in daily drainage volume was substantiated in the analysis by seroma formation (P = 0.034) rather than by type of surgery (P = 0.713).</p><p><b>CONCLUSIONS</b>Although the pathogenesis of seroma remains controversial, such risk factors as age, nutritional status, drainage volume on POD3 and TTV30 should be considered for prediction and prevention of seroma formation in Chinese breast cancer patients.</p>

Therapeutic features of endostar, a modified endostatin, on ascites tumor in mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of endostar in controlling ascites tumor formation in mice.</p><p><b>METHODS</b>Mouse models bearing ascites tumors were established via intraperitoneal injection of H22 and S180 cell lines. Eighty-eight ICR mice were randomly assigned into 4 groups, namely the control group (0.9% normal saline) and 3 endostar groups with 8 mg/kg endostar administration daily, every other day or every two days. The peritoneal membrane permeability of the mice was assessed using Evan blue staining. The body weight curve of mice was drawn, and the cumulative ascites volume and number of red cells and tumor cells in the malignant ascites were determined. The survival of the mice was evaluated to assess the therapeutic effect of endostar.</p><p><b>RESULTS</b>Compared with the control group, the mice receiving daily endostar injection showed obviously lower ascites accumulation and peritoneal capillary permeability (P<0.05) with reduced count of ascites tumor cells and red cells and tumor burden of the abdominal cavity. The mice with daily endostar injection also showed longer survival than the control group.</p><p><b>CONCLUSIONS</b>Continuous intraperitoneal injection can be the optimal means for endostar administration for treatment of malignant ascites.</p>

Expression of ER alpha in chemically induced MDA-MB-435 cells and its responsiveness to endocrine / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of ER alpha in chemically induced, ER alpha-negative human breast cancer MDA-MB-435 cells and its restoration of the responsiveness to endocrine therapy.</p><p><b>METHODS</b>MDA-MB-435 cells were treated with HDAC inhibitor trichostatin A(TSA)and DNMT1 inhibitor 5-AZA-CdR (AZA). The mRNA level of ER alpha, PR and PS2 in treated MDA-MB-435 cells was detected by RT-PCR. The WST-8 (water-soluble tetrazolium salt-8) method was used to analyze the proliferation rate of the cells. Xenograft in female nude mice was used to further explore the change of proliferation rate of treated MDA-MB-435 cells in vivo.</p><p><b>RESULTS</b>After treatment with AZA and TSA, mRNA expression of ER alpha, PR and pS2 was up-regulated in MDA-MB-435 cells. The mRNA level of ER alpha was the hightest when MDA-MB-435 cells were treated with 2.5 micromol/L AZA and 100 ng/ml TSA. The treated MDA-MB-435 cells showed different proliferation rate in various media containing different concentration of estrodial. The MDA-MB-435 cells showed down-regulated proliferation rate after treatment with the combination of 2.5 micromol/L AZA and 100 ng/ml TSA, and 4-OH tamoxifen could suppress the growth rate of the induced MD-MBA-435 cells but not the untreated cells. The treated MDA-MB-435 cells showed slower proliferation rate than that of untreated cells in vivo (P <0. 01), and the proliferation rate of the treated MDA-MB-435 cells became lower when the nude mice were deprived of estrogen by castration (P <0. 01).</p><p><b>CONCLUSION</b>After treatment with TSA and AZA, ER alpha-negative MDA-MB-435 cells can express functional ER alpha and regain responsiveness to estrogen both in vitro and in vivo. HDAC inhibitor and DNMT1 inhibitor may play an important role in restoration of sensitivity of ER alpha-negative breast cancers to endocrine therapy.</p>