Application of case-based PBL teaching in the postgraduate education of radiography / 中华医学教育探索杂志

Objective:To observe the application of case-based problem-based learning (PBL) teaching in the postgraduate education of radiography.Methods:A total of 48 postgraduates in the Batch 2019/2020 of professional masters majoring in radiography were selected as research objects, and they were divided into observation group ( n=24, Batch 2020) and control group ( n=24, Batch 2019). The students in the control group were taught by traditional teaching, and the students in the observation group were taught by case-based PBL teaching method. The differences in imaging diagnosis level and structured assessment scores of the two groups of students and their evaluation of the teaching process were analyzed. SPSS 20.0 was applied to perform the t test and chi-square test. Results:The imaging diagnosis ability of the students in the observation group (84.98±7.51) was significantly higher than that in the control group (78.21±6.96) , and the difference was statistically significant ( P<0.05). The students in the observation group had higher ability of imaging diagnosis skills and case analysis and diagnosis during the structured assessment ( P<0.05). The students in the observation group had higher overall satisfaction with the teaching process than those in the control group ( P<0.05). Conclusion:The case-based PBL teaching is of great help in improving the clinical thinking and imaging diagnosis ability of postgraduates majoring in radiography. In the application, it is necessary to continuously improve and supplement the teaching implementation plan according to the teaching evaluation and feedback.

Advances in the study of structural modification and biological activities of asiatic acid / 药学学报

Asiatic acid (AA) is a ursane pentacyclic triterpenoids, which possesses a wide range of pharmacological activities, such as anti-tumor, hypoglycemic, anti-inflammatory, anti-bacterial. Due to poor solubility and low bioavailability, clinical application of asiatic acid is limited. To address these defects, the structural modifications of AA have been carried out, and large numbers of AA-based derivatives with novel structure and eximious biological activity have been developed. In this paper, the research progress of structural modifications, biological activity, structure-activity relationship and mechanism studies in recent twenty years are reviewed, which provides reference for development of AA-related drugs.

Effect of electroacupuncture on small airway function in patients with stable chronic obstructive pulmonary disease / 中国针灸

OBJECTIVE@#To observe the regulatory effect of electroacupuncture (EA) on small airway function and exercise tolerance in patients with stable chronic obstructive pulmonary disease (COPD).@*METHODS@#A total of 62 patients with stable COPD were randomized into an observation group (31 cases, 1 case dropped off) and a control group (31 cases, 5 cases dropped off). On the base of routine medication and aerobic exercise, the patients of the two groups all received EA at Danzhong (CV 17), Rugen (ST 18), Guanyuan (CV 4), Zhongwan (CV 12), Tianshu (ST 25) and Yingchuang (ST 16). In the observation group, filiform needles were used and inserted perpendicularly, 3 mm in depth. In the control group, the placebo needling method was performed, in which the needle was not inserted through skin at each point. In both groups, electric stimulation with low-frequency electronic pulse instrument was exerted, with continuous wave, 2 Hz in frequency, lasting 30 min each time in the two groups. The treatment was given once every other day, 3 times a week, for 14 treatments totally. Before and after treatment, the following indexes were compared in patients between the two groups, i.e. the lung function indexes (forced expiratory volume in first second [FEV1], forced vital capacity [FVC], the ratio of FEV1 to FVC [FEV1/FVC], maximal voluntary ventilation [MVV], the percentage of maximal expiratory flow [MEF] at 25% of FVC exhaled [MEF25], MEF50 and MEF75 in predicted value), cardiopulmonary exercise test indexs (metabolic equivalent [METS], oxygen uptake per kg body weight [VO@*RESULTS@#After treatment, FVC%, MVV%, MEF75%, MEF50%, VO@*CONCLUSION@#Electroacupuncture can improve the respiratory function and exercise tolerance in COPD patients through removing small airway obstruction and increasing ventilation.

Resveratrol regulates M1/M2 polarization of mice infected with schistosoma japonicum through mitochondria / 中国药理学通报

Aim To investigate the effect of resveratrol on the polarization of macrophages and its correlation with mitochondrion. Methods Fifty-five mice infected with Schistosoma japonicum for three weeks were randomly divided into three groups; infection group (A), resveratrol group (B) and praziquantel group (C). Fifteen normal mice were taken as normal control group (D). On 9th week of infection, M1 and M2 were measured by flow cytometry (FCM), the mRNA level of Ml and M2 related cytokines, PGC-la and mtDNA level were detected by RT-PCR, and the ATP production was detected by ATP kit. RAW264. 7 cells were stimulated by PBS and SEA respectively. Resveratrol and praziquantel were added after stimulation. The percents of Ml and M2 were detected by FCM. PGC-1 a and mtDNA level were detected by RT-PCR. The level of Ml and M2 related cytokines were measured by ELISA. ATP was detected by ATP assay kit. Results Compared to group A, the proportion of Ml in group B increased (P < 0. 05), and the proportion of M2 decreased (P <0. 01). The levels of M2 related cytokines, PGC-1 a, mtDNA, ATP, basal OCR (oxygen comsumpition rate) in liver macrophages in group B were lower than those in group A (P < 0. 05). The levels of Ml related cytokines in group B were evidently higher than those in group A (P < 0.05). RAW264.7 cells were polarized into Ml (P < 0. 05), but not M2 (P < 0. 05) under resveratrol treatment. Moreover, RAW264. 7 cells with resveratrol treatment produced less M2 related cytokines (P < 0. 05), mtDNA, PGC-1 a, ATP and basal OCR (P <0. 05), and more related cytokines (P < 0. 05). Conclusion Resveratrol shifts macrophage polarization from M2 towards Ml by inhibiting the synthesis and ATP production of mitochondria.

Innovation and exploration in medical immunology experiment lessons that aiming on clinical practice / 中国免疫学杂志

As a frontal subject of life science, the medical immunology lessons are verification and complementary to theory lessons, and students need it to train their scientific ability and spirit. Therefore, some adjustments and explorations is needed in the experiments, for example, the data analysis of ELISA has been imported to the lessons to make them more closer to the practice. It' s shown that our lessons got welcomed by almost all students and is more helpful to them. The results playing an important role in improving our teaching effects in future.

Efficacy Analysis of Unrelated Cord Blood Transplantation for High-Risk Refractory AML1-ETO Positive Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To analyze the clinical outcomes of engraftment, graft-versus-host disease (GVHD) and survival in the patients with AML1-ETO positive acute myeloid leukemia (AML) treated with unrelated umbilical cord blood transplantation (UCBT).@*METHODS@#Forty-Five patients with high-risk refractory AML1-ETO positive AML were treated with a single UCBT in a single center from July 2010 to April 2018. All the patients underwent a myeloablative preconditioning regimen，and cyclosporine A (CSA) combined with mycophenolate mofetil (MMF) was used to prevent GVHD.@*RESULTS@#The median value of total nucleated cells (TNC) in cord blood was 5.21 (1.96-12.68)×10/kg recipient body weight, and that of CD34+ cells was 5.61 (0.56-15.4)×10/kg recipient weight. The implantation rate of neutrophil at 42 d and that of platelet at 120 d were 95.6% and 86.7%, respectively. The median time of absolute neutrophil count (ANC)＞0.5×10/L and platelet 20×10/L were 16 (12-18) d and 37 (17-140) d after transplantation, respectively. The cumulative incidence of Ⅰ -Ⅳ grade acute GVHD (aGVHD) at 100 d after transplantation was 48.9% (95% CI 33.5%-62.6%), Ⅱ-Ⅳ grade aGVHD occurred in 12 cases (33.3%) (95% CI 20%-47.2%) , and Ⅲ-Ⅳ grade a GVHD in 8 cases (20%) (95% CI 9.8% -32.8%). In 5 cases of 40 patients survived over 100 days, the chronic GVHD (cGVHD) occurred after transplantation, among which 4 were localized, and 1 was extensive. 3 patients relapsed, and the 2-year cumulative relapse rate was 9.5% (95% CI 2.4%-22.8%). The median follow-up time was 23.5 (0.9-89.67) months, 10 patients died, 2-year disease-free survival rate (DFS) was 72.7%, and overall survival rate (OS) was 75.5%. Multivariate analysis showed that Ⅲ-Ⅳ. acute GVHD (aGVHD) affected overall survival.@*CONCLUSION@#UCBT is an effective rescue treatment for patients with high-risk refractory AML1-ETO positive AML.

Efficacy analysis of unrelated cord blood transplantation in the treatment of refractory and relapsed adult acute leukemia / 中华血液学杂志

Objective: To explore the clinical efficacy and safety of unrelated umbilical cord blood transplantation (UCBT) in the treatment of refractory and relapsed acute leukemia (AL) patients. Methods: The clinical data of 22 refractory and relapsed AL patients who were treated with UCBT as salvage therapy from November 2009 to May 2017 were retrospectively analyzed. All patients received a myeloablative conditioning regimen for prevention of graft-versus-host disease (GVHD) with cyclosporine A (CSA)/short course of mycophenolate mofetil (MMF). Results: ①Of 22 patients, 9 cases were male and 13 female. The median age was 23 (15-44) years and median weight of 52.5 (43-82) kg. All patients were transplanted with a median umbilical cord blood nucleated cells of 3.07 (1.71-5.30)×107/kg (by weight), the median CD34+ cells was 1.60 (0.63-3.04)×105/kg (by weight). ②The myeloid cumulative implantation rate was 95.5% (95%CI 45.2-99.7%) after transplantation of 42 d, with the median implantation time of 19 (13-27) d. The platelet cumulative implantation rate after transplantation of 120 d was 81.8% (95%CI 54.2-93.6%), the median implantation time of 42 (20-164) d. ③The incidence of Ⅱ-Ⅳ, Ⅲ-Ⅳ aGVHD and the 2 year cumulative incidence of cGVHD were 36.4%, 13.6% and 40.3% respectively. ④ The transplant related mortality (TRM) after transplantation of 180d was 22.7%, 2 year cumulative rate of relapse was 18.7% (95%CI 3.6-42.5%), 2 year disease-free survival rate (DFS) and overall survival rate (OS) were 53.7% and 58.1%, respectively. Conclusion: The preliminary results show that the use of UCBT is safe and effective for refractory and relapsed AL patients who fail to respond to conventional chemotherapy.

Electroacupuncture Intervention Improved Pulmonary Function via Promoting Immunoregulation in Chronic Obstructive Pulmonary Disease Rats / 针刺研究

OBJECTIVE: To observe the immunoregulatory effect of electroacupuncture (EA) intervention for muscular dystrophy chronic obstructive pulmonary disease (COPD) rats, so as to investigate its underlying mechanism in improving respiratory function. METHODS: Forty male SD rats were randomly divided into 5 groups: normal, model, EA, exercise, and EA+ exercise (n=8 in each). The muscular dystrophy COPD model was established by placing the rats in a closed box to be exposed to cigarette smoke (3-10 cigarettes/time) for 60 min, twice daily, 6 days a week for 90 days. The EA, exercise and EA+exercise interventions were given beginning from day 80 after exposure to cigarette smoke. EA (2 Hz/40 Hz, 6 mA) was applied to "Danzhong" (CV 17), "Qihai" (CV 6), "Zhongwan" (CV 12), "Liangmen" (ST 21) and bilateral "Quchi" (LI 11) for 10 min, once every other day, for 20 times. The swimming exercise was conducted by forcing the rat to swim in a water box for 10 min, once every other day, for 20 times. The rat's lung function including the resistance of inspiration (RI), functional residual capacity(FRC), pulmonary dynamic compliance (Cdyn), etc., was detected under anesthesia. Pathological changes of the lung tissue were detected by H.E. staining, and the contents of serum TNF-alpha, IL-6 and IL-1 beta assayed by ELISA. RESULTS: After 80 days' exposure to the cigarette smoke, the rats' body weight values in the model, EA, exercise and EA+exercise groups were significantly lower than that of the normal group(P0.05). The numbers of monocytes and lymphocytes of the lung tissue, and the contents of serum TNF-α, IL-6 and IL-1 β were significantly higher in the model group than in the normal group (P0.05). No significant differences were found among the EA, exercise and EA+exercise groups in the levels of RI and FRC, pulmonary monocytes and serum IL-6 and IL-1 β (P>0.05). The body weight was significantly higher in the exercise and EA+exercise groups than in the EA group, and the pulmonary lymphocytes and serum TNF-α obviously lowered in the EA group than in the exercise group (P<0.05). H.E. staining showed deformation of the bronchial tube cavity, detachment and flattening of the bronchial mucosal epithelial cilia, hyperplasia of Goblet cells, infiltration of abundant inflammatory cells in the submucosal layer and muscular layer, more secretions in the bronchovascular cavity, incomplete alveolar structure, thinning and rupture of the alveolar wall, and expansion of the alveolar cavity to form large pulmonary vesicles after modeling, which was obviously milder in the 3 treatment groups. CONCLUSION: EA intervention can improve the pulmonary function and pathological changes in pulmonary muscular dystrophy COPD rats, which is associated with its effects in reducing pulmonary monocytes and lymphocytes and serum TNF-α, IL-6 and IL-1 β contents, suggesting an enhancement of immunoregulation.

Efficacy analysis of unrelated cord blood transplantation in the treatment of refractory and relapsed adult acute leukemia / 中华血液学杂志

Objective@#To explore the clinical efficacy and safety of unrelated umbilical cord blood transplantation (UCBT) in the treatment of refractory and relapsed acute leukemia (AL) patients.@*Methods@#The clinical data of 22 refractory and relapsed AL patients who were treated with UCBT as salvage therapy from November 2009 to May 2017 were retrospectively analyzed. All patients received a myeloablative conditioning regimen for prevention of graft-versus-host disease (GVHD) with cyclosporine A (CSA)/short course of mycophenolate mofetil (MMF).@*Results@#①Of 22 patients, 9 cases were male and 13 female. The median age was 23 (15-44) years and median weight of 52.5 (43-82) kg. All patients were transplanted with a median umbilical cord blood nucleated cells of 3.07 (1.71-5.30)×107/kg (by weight), the median CD34+ cells was 1.60 (0.63-3.04)×105/kg (by weight). ②The myeloid cumulative implantation rate was 95.5% (95%CI 45.2-99.7%) after transplantation of 42 d, with the median implantation time of 19 (13-27) d. The platelet cumulative implantation rate after transplantation of 120 d was 81.8% (95%CI 54.2-93.6%), the median implantation time of 42 (20-164) d. ③The incidence of Ⅱ-Ⅳ, Ⅲ-Ⅳ aGVHD and the 2 year cumulative incidence of cGVHD were 36.4%, 13.6% and 40.3% respectively. ④ The transplant related mortality (TRM) after transplantation of 180d was 22.7%, 2 year cumulative rate of relapse was 18.7% (95%CI 3.6-42.5%), 2 year disease-free survival rate (DFS) and overall survival rate (OS) were 53.7% and 58.1%, respectively.@*Conclusion@#The preliminary results show that the use of UCBT is safe and effective for refractory and relapsed AL patients who fail to respond to conventional chemotherapy.

Regulatory Mechanism of Electroacupuncture Therapy for Diaphragm Function of Chronic Obstructive Pulmonary Disease Model Rats with Muscular Dystrophy / 广州中医药大学学报

Objective To investigate the effect of electroacupuncture on diaphragm function of chronic obstructive pulmonary disease (COPD) rats with muscular dystrophy, and to explore the regulatory mechanism. Methods Forty male rats were randomly divided into blank group, model group, electroacupuncture group, exercise group, electroacupuncture plus exercise group, 8 rats in each group. After successful establishment of COPD rat model with muscular dystrophy, the modeled rats in various intervention groups were given electroacupuncture and/or exercise treatment. After the last treatment, the changes of rat body mass were observed, the rat lung function was detected, and the mRNA expression levels of myosin heavy chains (MHC) of MHC-1, MHC-2 and diaphragmatic related signal proteins of Atrogin-1, muscle ring-finger protein-1(MuRF-1), MyoD were detected by real-time quantitative polymerase chain reaction (qPCR). Results (1) Compared with the blank group, inspiratory resistance (IR) and functional residual mass (FRC) in the model group were increased (P < 0.05) , and the dynamic lung compliance(Cydn) was decreased(P<0.05). Compared with the model group, IR and FRC in the intervention groups were decreased (P < 0.05), but the differences among the three intervention groups were insignificant(P>0.05). (2) Compared with the blank group, the mRNA expression levels of MHC-1, Atrogin-1, MuRF-1, MyoD in the model group were increased (P<0.05), and the mRNA expression level of MHC-2 was decreased (P < 0.05). Compared with the model group, the mRNA expression levels of MHC-1, Atrogin-1, MuRF-1, MyoD in the intervention groups were decreased (P < 0.05) , and the mRNA expression level of MHC-2 was increased(P<0.05). Compared with the exercise group, the mRNA expression levels of Atrogin-1, MuRF-1, MyoD in the electroacupuncture group were decreased (P<0.05), and the mRNA expression level of MHC-2 was increased (P<0.05) , but the above indexes in electroacupuncture plus exercise group showed no obvious changes(P>0.05). Conclusion Electroacupuncture can improve respiratory function of COPD rats with muscular dystrophy, and the possible mechanism is related with the increase of MHC-2 mRNA expression and with the decrease of Atrogin-1, MuRF-1, MyoD mRNA expression, which result into the regulation of ubiquitin proteasome pathway(UPP), reduction of myosin loss, and the relief of diaphragmatic atrophy.

Comparison of unrelated cord blood transplantation and HLA-identical sibling peripheral blood stem cell transplantation for the treatment of adult hematological malignancies / 中华血液学杂志

Objective@#To compare the efficacy of unrelated cord blood transplantation (UCBT) and HLA-identical sibling peripheral blood stem cell transplantation (PBSCT) for the treatment of adult hematological malignancies.@*Methods@#From April 2011 to December 2015, a total of 81 patients receiving single-unit UCBT and 57 patients receiving HLA-identical sibling PBSCT were enrolled in this study. All of the patients received myelablative conditioning. Cyclosporine combined with mycophenolate mofetil was adopted for GVHD prophylaxis.@*Results@#The cumulative incidence of neutropil engraftment at day-42 was 95.0% and 100% in UCBT and sibling PBSCT groups, respectively (P=0.863) . Platelet engraftment at day 100 was 87.3% (95%CI 76.8%-93.1%) in UCBT group, which was significantly lower than that of sibling PBSCT group[98.2% (95%CI 87.3%-99.7%) ] (P=0.005) . There were no significant differences in terms of Ⅱ-Ⅳ acute GVHD or Ⅲ-Ⅳ acute GVHD in two groups (P=0.142, 0.521) . The 3-year chronic GVHD and extensive chronic GVHD were 14.9% (95%CI 5.2%-23.5%) and 11.2% (95%CI 2.9%-18.7%) , respectively in UCBT group, which was significantly lower than that of sibling PBSCT group[35.2% (95%CI 19.4%-47.8%) , 31.4% (95%CI 16.2%-43.9%) ] (P=0.008, 0.009) . The 3-year transplant-related mortality (TRM) was similar between two groups (30.1% vs 23.2%, P=0.464) . The relapse rate at 3-year in UCBT group[12.9% (95%CI 6.6%-21.5%) ]was significantly lower than that in sibling PBSCT group[24.3% (95%CI 13.5%-36.8%) ] (P=0.039) . There were no significant differences in terms of overall survival (OS) and disease-free survival (DFS) between two groups (58.6% vs 54.8%, P=0.634; 57.0% vs 52.4%, P=0.563) . But GVHD-free and relapse-free survival (GRFS) in UCBT group [55.7% (95%CI 44.1%-65.8%) ]was significantly higher than that of sibling PBSCT group[42.9% (95%CI 29.8%-55.3%) ] (P=0.047) .@*Conclusions@#For adult hematological malignancies, the incidences of acute GVHD and TRM were similar between UCBT and sibling PBSCT recipients, and the incidences of chronic GVHD and relapse were lower in UCBT recipients. UCBT recipients had higher GRFS rate although OS and DFS were similar between two groups, which may reflect the real recovery and better quality of life following UCBT.

Evaluation of clinical efficacy of single-unit unrelated umbilical cord blood transplantation based on umbilical cord blood provided by China's public cord blood bank / 中华器官移植杂志

Objective To study the curative efficacy and safety of single-unit umbilical cord blood transplantation (sUCBT) for malignant hematologic diseases,which is provided by China's public cord blood bank.Methods We retrospectively analyzed 409 cases of malignant hematologic diseases who accepted myeloablative single-unit unrelated donor UCBT without ATG at our center between May 2008 and December 2016.A comparative analysis was made on the total nuclear cells (TNC) of the umbilical cord blood before freezing and after thawing,the cells of CD34+,the recovery rate of cells and the clinical effect of UCBT.Result 409 units of umbilical cord blood used in UCBT respectively came from eight China's public cord blood banks.The average TNC of 409 units of umbilical cord blood before freezing and after the tubular recovery were respectively 18.5 × 108 and 16.34 × 108 (p =0.000).The average recovery rate of the tubular recovery was 88.5％,and there was significant difference among cord blood banks (P =0.000).The average TNC of umbilical cord blood before freezing and transfusion were respectively 18.5 × 108 and 15.86 × 108 (p =0.000).The average recovery rate of umbilical cord blood transfusion was 85.9％,with the difference being significant among cord blood banks (P =0.000).The average number of CD34+ cells before freezing and after the tubular recovery was 11.18 × 106and 8.68 × 106 (p =0.000).The average recovery rate of CD34+ cells after the tubular recovery was 80.75 ％,with the difference being significant among the cord blood banks (P =0.000).At 42nd day after UCBT,the cumulative incidence of neutrophil engraftment was 95.4％,and the median time of the engraftment was 17 days (11-38 days).The cumulative incidence of platelet engraftment at 120th day was 84.6％,and the median time of the engraftment was 36 days (14-93 days).The cumulative incidence of erythrocyte engraftment at 60th day was 92％,and the median time of engraftment was 22 days (9d-60 days).After the umbilical cord blood provided by each bank was used in UCBT,it got the difference in cumulative incidence of engraftment.The P values for cumulative incidence of neutrophil,platelet and erythrocyte engraftment were respectively 0.004,0.01 and 0.000 2,with the differences being statistically significant.At 100th day after UCBT,the cumulative incidence of Ⅱ-Ⅳ and Ⅲ-Ⅳ degrees of acute graft-versus-host disease (aGVHD) was respectively 28.63％ and 15.7％.After umbilical cord blood provided by each bank was used in UCBT,it got the difference in cumulative incidence of aGVHD.There was no significant difference between Ⅱ-Ⅳ and Ⅲ-Ⅳ degrees (P =0.809 and 0.68 respectively).At 3rd year after UCBT,the cumulative incidence of relapse was 15.89％.After umbilical cord blood provided by each bank was used in UCBT,there was no significant difference in the cumulative incidence of relapse (P =0.898).At 3rd year after UCBT,the overall survival (OS) rate and disease free survival (DFS) rate were respectively 66.7％ and 59％.After umbilical cord blood provided by each bank was used in UCBT,it got the difference in OS and DFS.There was no significant difference in OS and DFS (P =0.566 and 0.703 respectively).At 3rd year after sUCBT,the rate of graft-versus-host diseases/relapse-free survival (GRFS) was 54.3％.After umbilical cord blood provided by each bank was used in UCBT,there was no significant difference in the rate of GRFS (P =0.449).Conclusion The umbilical cord blood provided by China's public cord blood bank was used in UCBT.It has a high safety and good efficacy in treating malignant hematologic diseases.But it needs to set up the standardized and normalized quality-control system of umbilical cord blood for China's public cord blood bank.

Diffusion-weighted imaging combined with dynamic contrast-enhanced MRI in parotid gland tumors / 中国医学影像技术

Objective To explore the value of DWI combined with dynamic contrast-enhanced MR imaging (DCE MRI) in differential diagnosis of benign and malignant parotid gland tumors.Methods DWI and DCE-MRI was performed in 90 patients with parotid gland tumors (94 lesions),included 75 benign tumors and 19 malignant tumors.The ADCs were measured,and the type of time-intensity curve (TIC) was assessed.ROC curve was used to analyze the diagnostic efficacy of ADC values,TIC types and combination of the two methods in diagnosing benign and malignant tumors.Results The ADC values of malignant tumors ([1.02 ± 0.25] × 10a mm2/s) were significantly smaller than that of benign tumors ([1.38±0.44] × 10-3 mm2/s;t=5.170,P＜0.001).The sensitivity was 0.62 and specificity was 0.92,when type A (persistent),B (washout),and D (flat) tumors regarded as benign and type C (plateau) tumors regarded as malignant.Sensitivity and specificity were significantly improved in diagnosis of malignant tumors when combined type C and ADC＜1.36× 10-3mm2/s,which were 0.92 and 0.95,respectively.Conclusion Due to an overlap within benign and malignant parotid tumors,the diagnosis should not be addressed on the basis of ADC values alone.The TIC manifestations type A,B or D on DCE-MRI indicates benign parotid tumors,and type C indicates malignant diseases.When the TIC shows type C,combining ADC value can elevate the differential diagnostic efficacy of benign and malignant parotid tumors.

Effects of acupuncture on peripheral skeletal muscle exercise ability in patients with chronic obstructive pulmonary disease at stable phase / 中国针灸

<p><b>OBJECTIVE</b>To explore the effects of acupuncture on improving the peripheral skeletal muscle exercise ability in patients with chronic obstructive pulmonary disease (COPD) at stable phase.</p><p><b>METHODS</b>Forty-four patients were randomly divided into an observation group (24 cases) and a control group (20 cases). Based on regular western medication treatment and aerobic training, acupuncture was used in the observation group and placebo acupuncture was used in the control group. The acupoints selected were Danzhong (CV 17), Rugen (ST 18), Guanyuan (CV 4), Zhongwan (CV 12), Tianshu (ST 25), etc., 2-3 times per week, and totally 14 treatments were given. The body mass index (BMI), average distance and average maximum heart rate recorded during bicycle exercise, six-min walking distance (6-MWD), maximum power (Wmax) and maximum heart rate (HRmax) recorded during exercise cardiopulmonary function test, and pulmonary function index including forced expiratory volume in one second/estimate value (FEV1%), forced vital capacity/estimate value (FVC%), FEV1/FVC and maximal voluntary ventilation (MVV) were observed in both groups before and after treatment.</p><p><b>RESULTS</b>The BMI before and after treatment in the observation group was not significantly changed (>0.05), while that in the control group was significantly reduced (<0.05). Compared before treatment, the average distance of bicycle exercise, 6-MWD, Wmax, FEV1%, FVC% and MVV were significantly improved after treatment in the observation group (<0.01,<0.05), which were all superior to those in the control group (<0.01,<0.05). The treatment outcomes in the control group were not significantly changed after treatment (all>0.05).</p><p><b>CONCLUSIONS</b>Acupuncture combined with aerobic training of bicycle and conventional western medication could prevent the reducing of BMI in patients with COPD at stable phase, improve pulmonary ventilation function, and increase the function of peripheral skeletal muscle to improve its performance.</p>

Effect of Acupuncture on Lung Recovery in Chronic Obstructive Pulmonary Disease and Its Safety Analysis / 上海针灸杂志

Objective To observe the effect of acupuncture in promoting the lung recovery in chronic obstructive pulmonary disease (COPD), and to discuss its advantage and safety in lung recovery. Method Forty-four patients were randomized into two groups, 22 cases in the treatment group and 19 in the control group finally (with 3 dropouts). In addition to the required aerobic exercises, the treatment group received active acupuncture treatment and the control group received placebo acupuncture treatment, with acupoints from the Spleen and Stomach Meridians and Conception Vessel as the major points, 2-3 sessions a week, for 14 sessions in total. The body mass index (BMI), athletic ability, COPD Assessment Test (CAT), pulmonary function and inflammation indexes [interleukin (IL)-6 and tumor necrosis factor (TNF)-α] were observed before and after the treatment. Result After the treatment, the improvements in the six-minute walking distance, CAT and pulmonary function scores were statistically more significant in the treatment group than those in the control group (P<0.05,P<0.01); the serum content of TNF-α was increased more significantly in the control group than in the treatment group (P<0.05); there was no significant change in BMI in the treatment group, while a significant decrease of BMI was found in the control group (P<0.05). Conclusion Acupuncture plus exercises can boost the lung recovery in remission-stage COPD and reduce the adverse reactions brought by sports fatigue.

Imaging features of solitary fibrous tumors in the head and neck / 实用放射学杂志

Objective To explore the imaging features of solitary fibrous tumor (SFT)in the head and neck.Methods The CT and MR findings of 10 patients with SFT in the head and neck confirmed by hsitopathology were analyzed retrospectively.All patients underwent CT (including contrast-enhanced dual-phase CT),and MR imaging was obtained in 2 patients.Results All 10 lesions were found as solitary masses ranging in maximum diameter from 20 to 1 1 5 mm (average 35.5 mm),with the location in the orbit (2 cases),nasal cavity and nasal sinuses (4 cases),parotid gland (1 case),supraclavicular region (1 case),subcutaneous tissue of the maxillofacial (1 case)and occipital region (1 case).The lesions showed elliptic shape in 7 cases and lobulated configuration in 3 cases.The majority (8/10 )of lesions demonstrated well-defined margin.The lesions on CT imaging were isodensity or low density, homogeneous density in 4 cases and inhomogeneous density in 6 cases,cystic changes in 2 cases,calcification in 1 case.9 lesions showed strongly homogeneous (n=3)or inhomogeneous (n=6)enhancement,1 lesion showed mildly homogeneous enhancement on contrast-enhanced CT imaging.On dual-phase enhanced CT,8 patients exhibited a rapidly enhancing and slow washout pattern,1 patient exhibited a rapidly enhancing and rapid washout pattern,and 1 patient exhibited delayed enhancement.The lesions showed homogeneous isointense relative to gray matter on T1 WI in 1 patient,mixed isointense and hypointense in 1 patient.On T2 WI,the lesion showed isointense signal in 1 patient,and heterogeneous mixed isointense and hyperintense signal in another.2 lesions demonstrated markedly homogeneous and inhomogeneous enhancement respectively.Conclusion Solitary fibrous tumors shall be considered in cases of inhomogeneous hypervascular tumors in the head and neck.Compared with the gray matter,isointense or mildly hyperintense signal on T2 WI, marked enhancement on contrast-enhanced CT,and a rapidly enhancing and slow washout pattern on dual-phase enhanced CT may be valuable imaging features of SFT.

Regulatory effects of acupuncture on exercise tolerance in patients with chronic obstructive pulmonary disease at stable phase: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To verify the regulatory effects of acupuncture on exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) at stable phase.</p><p><b>METHODS</b>Thirty cases of COPD were randomly divided into a treatment group (16 cases) and a placebo group (14 cases). Based on specified aerobic exercise, acupuncture was applied in the treatment group and placebo acupuncture was used in the placebo group. The acupoints included Danzhong (CV 17), Rugen (ST 18), Guanyuan (CV 4), Zhongwan (CV 12), Tianshu (ST 25) and so on. The needle did not penetrate into the skin for the placebo group. The treatment was required for 2 to 3 times per week for totally 5 weeks. The indices of exercise tolerance, including 6-min walking distance (6-MWD), exercise time, maximum oxygen uptake (VO2max) forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC), maximum ventilatory volume (MVV), St. George respiratory questionnaire (SGRQ) were observed in two groups before and after treatment.</p><p><b>RESULTS</b>(1) Exercise tolerance: the differences of 6-MWD and exercise time were statistically significant between groups, which were more superior in the treatment group (both P<0.01); the VO2max was significantly increased after treatment in the treatment group (P<0.05), but there was no difference between two groups (P>0.05). (2) Pulmonary ventilation function: the differences of FEV1%, FEV1/FVC and MVV% were statistically significant between groups, which were more superior in the treatment group (P<0.05, P<0.01); (3) SGRQ: the SGRQ was significantly improved after treatment in the treatment group (P<0.05), but there was no difference between two groups (P>0.05).</p><p><b>CONCLUSION</b>The acupuncture could improve the exercise tolerance in patients with chronic obstructive pulmonary disease at stable phase, and shorten the onset time of aerobic exercise. Besides, acupuncture combined with aerobic exercise could effectively improve the pulmonary function.</p>

Syndrome of inappropriate ADH secretion following secondary haploidentical stem cell transplantation after graft failure of umbilical cord blood transplantation:a case report and literature review / 白血病·淋巴瘤

Objective To study the syndrome of inappropriate ADH secretion(SIADH)after all ogeneic hematopoietic stem cell transplantation(allo-HSCT)and the possible etiology.Methods SIADH was occurred in one patient with acute lymphoblastic leukemia who received secondary haploidentical stem cell transplantation after graft failure following umbilical cord blood transplantation.Results An 11-year-old boy was diagnosed as high-risk acute lymphoblastic leukemia,and the transplantation of unrelated double umbilical cord blood was performed for the first time,however,there was no engraftment at 28 days after the first transplantation.Secondary haploidentical stem cell transplantation was administered at day 33 after the first transplantion.The bone marrow and the peripheral blood stem cells from the patient's father transplantation was adopted.Pre-engraftment syndrome was developed in the patient at day 7 after secondary haploidentical HSCT followed by severe hyponatraemia(lowest serum sodium 115.8 mmol/L),natriuresis,hypo-osmolality of plasma,and twitch at day 26 after allo-HSCT.Then SIADH was diagnosed.The clinical condition was improved after restriction of water and administration of hypertonic saline,and eventually SIADH was controlled completely.By now,the patient had lived free of disease more than one year,with a normal diet and serum sodium in normal ranges.Conclusions SIADH after allo-HSCT is a rare fatal acute complication of central nervous system,whic h are probably associated with numerous transplant-related causes.Early accurate diagnosis and treatment promptly are great importance.

Study of implantation dynamics and discipline in unrelated double umbilical cord blood transplantation / 白血病·淋巴瘤

[Objective]To study the discipline of implantation and implantation dynamics in unrelated double umbilical cord blood transplantation(DUCBT).[Methods]Twenty-nine patients with hematologic malignancies who undergoing two-units unrelated donor cord blood transplantation were included in the study.After transplantation,hematopoietic chimerism of peripheral blood was evaluated by the Results of short tandem repeat with polymerase chain reactions(STR-PCR)which quantitatively determinated 16 specific alleles between donor and receptor, to find out their chimerism dynamic change, to judge whether transplantation was implanted and judge which one was implanted,and to study the discipline of implantation in DUCBT.At the same time,total nucleated cells(TNC),dose of CD34 cells,colony forming unit(CFU),colony forming unit-granulocyte and macrophage(CFU-GM),dose of CD; cells,dose of natural killer(NK)cells were compared between dominant units and non-dominant ones,to quest the discipline implantation dynamics of DUCBT.[Results]In 29 clinical cases,23 cases obtained engraftment,including 22 cases appearing one unit cord blood engraftment and 1 case appearing two units cord blood engraftment.Of 22cases with one dominant unit engraftment,at 14 days after DUCBT,the results of STR-PCR showed that 20cases appeared one dominant unit engraftment,other 2 cases appeared one dominant unit engraftment at 21days after DUCBT.Of 6 cases without engraftment,at 14 days after DUCBT,2 cases showed chimerism of two units cord blood,other 4 cases showed chimerism of two units cord blood or one unit cord mixed with receptor.At 30 days after DUCBT,their STR-PCR results of bone marrow showed full donor chimerism.Compared results at day 7,day 14,day 21 by peripheral blood,and day 30 by bone marrow with results of implantation after DUCBT,their coherence were kappa=0.112,P=0.198,kappa =0.811,P =0.001,kappa =0.900,P =0.001 and kappa =0.900,P =0.001,respectively.In addition,compared dominant unit with nondominant unit,TNC,doses of CD+34 cells,CFU,CFU-GM,CD; cells and NK cells were all no significant difference between them (P=0.783,0.455,0.615,0.534,0.114,0.463,respectively).[Conclusion]STR-PCR which quantitatively determinates 16 specific alleles between donor and receptor is sensitively and specifically to judge implant status.The 14 days after DUCBT was the time when implant is embedded.However,the implantation dynamics of DUCBT is still unknown which need further quest in the future.

Unrelated umbilical cord blood transplantation in the treatment of aggressive-phase chronic myeloid leukemia / 白血病·淋巴瘤

[Objective] To retrospectively analyze the outcome of unrelated umbilical cord blood transplantation in the treatment of aggressive-phase chronic myeloid leukemia.[Methods] Fourteen consecutive patients with aggressive-phase chronic myeloid leukemia were treated with unrelated umbilical cord blood transplantation,thirteen patients were treated with myeloablative unrelated CBT and one patients were treated with nonmyeloablative unrelated CBT.All patients received standard cyclosporine A (CsA) and mycophenolate mofetil(MMF) as a graft-versus-host disease (GVHD) prophylaxis.[Results] 14 patients were all successfully engrafted.The median times for their neutrophil returning to ≥0.5×109/L and for platelet returning to ≥20×109/L were 22.8 days and 37.8 days,respectively.Acute GVHD occurred in 10 of 13 evaluable patients.The grading of acute GVHD was gradeⅡ-Ⅳin 6 patients(46.2 ％).Chronic GVHD occurred in 7 of 11 evaluable patients(63.6％).Relapse occurred in 2 of 15 patients,lextramedullary relapse was included.9 of 14 patients were alive and event-free after CBT.The probability of OS rate at 5 years was 64.3 ％,the probability of DFS rate at 5 years was 5,7.1％.[Conclusion]Unrelated umbilical cord blood transplantation is effective in the treatment of aggressive-phase chronic myeloid leukemia.