Effects of Angelica Four Decoction on Nerve Conduction Velocity and AEGs, Cys-C and Hcy Levels in Patients with Diabetic Peripheral Neuropathy / 世界科学技术-中医药现代化

To investigate the influence of Angelica Four Inverse Decoction on diabetic peripheral neuropathy (DPN) nerve conduction velocity and advanced glycation end products (AEGs), Cystatin C (Cys-C) and homocysteine (Hcy) levels, 78 cases of DPN patients admitted in our hospital from March 2015 to January 2017 were selected and divided into two groups by random number table method. The two groups adopted the same basic treatment, on the basis of which, the control group was added mecobalamin tablets treatment, while the observation group was given Angelica Four Inverse Decoction. The curative effect of Chinese medicine syndrome, the scores of toronto clinical scoring system (TCSS), nerve conduction velocity and the change of serum AEGs, Cys-C and Hcy levels before and after treatment were recorded and compared between the two groups and then the safety of medicine were evaluated between the two groups. 4 weeks after the treatment, the total effective rate of the observation group was 89.7％, significantly higher than 71.8％ of the control group (P ＜ 0.05) . Compared with those before receiving treatment, the SNCV and MNCV values of the common peroneal nerve and median nerve both significantly increased in the two groups 4 weeks after the treatment (P ＜ 0.01); the improvement of nerve conduction velocity of the observation group was significantly better than that of the control group (P ＜ 0.01) . 4 weeks after the treatment, TCSS score and serum AEGs, Cys-C, Hcy levels were all significantly lower than those before receiving the treatment in the two groups (P ＜ 0.01); compared with that of the control group in the same time period, the improvement effect of TCSS score and serum AEGs, Cys-C, Hcy levels were more significant in the observation group 4 weeks after the treatment (P ＜ 0.01) . There were no obvious adverse reactions in the two groups. As a result, Angelica Four Inverse Decoction applied to DPN patients can more effectively relieve clinical symptoms and signs, improve nerve conduction velocity, reduce the level of AEGs, and improve microcirculation with remarkable curative effect and high safety.

Survival of patients with primary central nervous system diffuse large B-cell lymphoma: impact of gene aberrations and protein overexpression of bcl-2 and C-MYC, and selection of chemotherapy regimens / 中华病理学杂志

Objective@#To investigate the impact of clinicopathological features, gene rearrangements and protein expression of bcl-6, bcl-2, C-MYC and chemotherapy regime on the prognosis of patients with primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL).@*Methods@#Thirty-three cases of PCNS-DLBCL diagnosed from January 2006 to December 2016 at Zhejiang Cancer Hospital were collected. The expression of CD10, bcl-6, bcl-2, MUM1 and MYC were detected by immunohistochemical staining (IHC). The presence of EB virus was detected by in situ hybridization(EBER). Copy number variation (ICN) and translocation status of bcl-6, bcl-2 and C-MYC genes were detected by fluorescence in situ hybridization (FISH). The relationship between the above indexes and the prognosis was analyzed by univariate, bivariate survival analysis and multiple Cox hazard regression analysis.@*Results@#The study included 33 patients of PCNS-DLBCL, without evidence of primary or secondary immunodeficient disease. Male to female ratio was 1.36∶1.00, and the average age was 56 years. Twenty cases had single lesion while 13 had multiple lesions. Deep brain involvement was seen in 12 cases. All patients underwent partial or total tumor resection. Five patients received whole brain post-surgery radiotherapy, nine patients received high-dose methotrexate (HD-MTX) based chemotherapy, and 12 patients received whole-brain radiotherapy combined with HD-MTX based chemotherapy. Severn patients received no further treatment and rituximab was used in 8 patients. According to the Hans model, 27 cases were classified as non-GCB subtypes (81.8%). Bcl-2 was positive in 25 cases (75.8%, 25/33) and highly expressed in 8 (24.2%). MYC was positive in 12 cases (36.4%) and double expression of bcl-2 and MYC was seen in 6 cases. EBER positive rate was 10.0%(3/30), all of which had multiple lesions. Two bcl-6 gene translocations and 3 amplifications were found in 28 patients. Two translocations, 3 ICN or with both bcl-2 gene translocation and ICN were found in 30 patients. Four ICNs of C-MYC gene were found in 28 patients. Elevated protein in cerebrospinal fluid (CSF) was found in 13 patients. LDH increased in 10 cases. Follow-up period was 2-90 months with the average survival time of (23.0±3.7) months and two-year survival rate of 39.0%. Univariate survival analysis showed that overexpression of bcl-2 protein (≥70%) and MYC protein (≥40%), bcl-2 gene abnormality (including copy number increase and translocation), C-MYC gene copy number increased were adverse factors for survival. C-MYC/ bcl-2 gene double hit was seen in 2 cases. Bivariate survival analysis found that of bcl-2/MYC protein double expression and bcl-2 and C-MYC genes double aberration were significantly associated with adverse outcomes. Cox multivariate risk regression analysis found that gender, cerebrospinal fluid protein increasing, and ICN of C-MYC gene were independent poor prognostic factors. DH-MTX based comprehensive chemotherapy was associated with better prognosis.@*Conclusions@#Double hit at genomic level (copy number variations and gene rearrangements) and double protein expression of bcl-2 and C-MYC in PCNS-DLBCL are significantly associated with an adverse outcome. DH-MTX based comprehensive treatment may prolong the patient survival.

Progress of molecular pathogenesis of extranodal natural killer/T-cell lymphoma / 白血病·淋巴瘤

Extranodal nature killer/T cell lymphoma (ENKTCL) is a highly aggressive non-Hodgkin lymphoma (NHL) with a high mortality. ENKTCL is epidemic in Asia and Latin America, especially in China, Japan and South Korea. EBV has been proved to be associated closely with ENKTCL; however, specific molecular mechanism which can explain how the neoplasm develops is still unclear. Chinese population seems to be more susceptible to this lymphoma and Chinese scientists have made great contributions to the pathogenesis and the treatments of ENKTCL. This review mainly introduces the recent progress of molecular pathogenesis of ENKTCL.

A retrospective study on the treatment of BK virus infection after kidney transplantation with mizoribine conversion in a single center / 中华器官移植杂志

Objective To analyze the incidence of BK virus (BKV) infection after kidney transplantation in our center and to evaluate the efficacy and safety of conversion treatment with Mizoribine (MZR) on BKV infection after kidney transplantation.Methods The information of recipients who received BK virus screening in hospital or outpatient during 2015-02 to 2016-12 in our center was retrospectively analyzed.The recipients positive for BKV were divided into experiment group (given conversion treatment with MZR) and control group (not given MZR conversion) according to the inclusion criteria.The negative rate of BKV,AR,hyperuricemia and the function of renal allograft during the conversion treatment with MZR were observed.Results 182 recipients accepted BKV screening during 2015-02 to 2016-12 and 68 cases were positive.The positive rate of BKV was 38.5 ％.The positive rate of peripheral blood specimens and midstream urine specimens was 7.1％ and 36.8％ respectively.Twelve recipients were positive for BKV in both peripheral blood specimens and midstream urine specimens.There were 27 recipients in experiment group and 36 cases in control group.Fourteen recipients positive for BKV became negative after MZR conversion in experiment group and the negative rate was up to 51.9％.The mean time of negative rate was 3.2 ± 2.7 (1-10) months after MZR conversion.During the conversion treatment with MZR,AR occurred in 1 case and was reversed by the impact therapy with Thymoglobulin in experiment group.The value of serum uric acid was maintained stable before and after MZR conversion under the action of uric-acidlowering drug.The renal function was kept stable in both experiment group and control group after renal transplantation.No deaths and renal allograft failure cases occurred in both groups during the research period.The 2-year survival rate for patients and kidneys was both 100％.Conclusion The incidence of BKV infection after kidney transplantation was high and the treatment scheme of MZR conversion was safe and effective.

Clinical diagnosis of atlanto-axial joint involvement in patients with rheumatoid arthritis / 中华风湿病学杂志

Objective To investigate the clinical manifestations,laboratory tests,and image modalities on rheumatoid arthritis (RA) accompanied with atlanto-axial joint involvement.Methods Sixty-four cases of RA accompanied with cervical vertebra involvement were divided into 2groups by lesion location.Twenty-two cases were RA accompanied with atlanto-axial joint involvement,while 42 cases were RA with cervical vertebra other than atlanto-axial joint involvement.The age,course,clinical manifestations and the lab results were compared between the two groups by t test,Chi-square test and Fisher's exact probability.The X-ray,CT and magnetic resonance imaging (MRI) for cervical vertebra were analyzed in RA with atlanto-axial joint involvement.Results Compared with non-atlantoaxial cervical group,the disease course [(15±10) years vs (8±9) years,t=3.030,P=0.004],upper cervical vertebra pain (73％ vs 7％,x2=29.75,P＜0.01),lower cervical vertebra pain (9％ vs 40％,x2=6.813,P=0.009),cervical activity limitation (68％ vs 14％,x2=19.023,P＜0.01),upper cervical vertebra pressing pain (100％ vs 7％,22=52.297,P＜0.01),lower cervical vertebra pressing pain (9％ vs 60％,x 2=15.056,P＜0.01) and erythrocyte sedimentation rate (ESR) [(73±34) mm/1 h vs (53±37) am/1 h,t=2.039,P=0.046)] were significantly different in atlantoaxial joint lesions group.CT combined with MRI exams had high diagnostic..value in RA with atlanto-axial joint involvement.CT scan had the conformed diagnostic value.Sixteen cases were positive (73％) by MRI scan,while 3 cases (14％) by X-ray.Conclusion Timely CT scan and/or MRI scan for RA patients with neck pain in upper cervical vertebra,long disease course,cervical activity limitation and high ESR are helpful for early diagnosis of atlanto-axial joint involvement.

Prognostic analysis of BCL-2/MYC double- hit in diffuse large B-cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of BCL-2/MYC double-hit on prognosis in diffuse large B-cell lymphoma（DLBCL）.</p><p><b>METHODS</b>A retrospective study was conducted to investigate clinical and pathological data of 111 patients with DLBCL. CD10, BCL-6, MUM-1, BCL-2 protein expressions were examined by immune-histochemical methods, and abnormal BCL-2 and MYC genes were analyzed by FISH for patients with sufficient pathological data. SAS 8.2 was adopted to perform Chi- square test, COX's proportional Hazard Model, Life table survival analyses.</p><p><b>RESULTS</b>Of 111 patients, male 77 cases, female 34 cases, the median age was 55（14-85）years, CD10, BCL-6, MUM-1, BCL-2 positive rates were 15.7%（16/102）, 58.8%（60/102）, 33.0%（34/103）, 74.8（77/103）respectively, the abnormal rate of BCL-2 gene was 43.1%（25/58, 24 cases with multiple copies, 1 case with translocation）, and the abnormal rate of MYC gene was 20.4%（10/49, 10 cases with multiple copies）. Coexistence of BCL-2 and MYC genes abnormalities accounted for 13.0%（6/46）. According to the classification of Hans model, GCB subgroup accounted for 41.2%（42/102）, and non-GCB subgroup 58.8%（60/102）, the median survival time was 24 months, 3-year and 5-year overall survival rates were 48.5% and 39.7% respectively. Overall survival rates of normal and abnormal BCL-2 gene were 34.2%，22.8%, respectively with no statistical significance（P=0.770）. Overall survival rates of normal and abnormal MYC gene were 35.9% and 22.2% ，with no statistical significance（P=0.650）. Overall survival rate of double-hit was 0, far worse than that of single abnormal gene（P=0.034）, which implied double-hit of BCL-2 and MYC gene abnormality to be adverse prognostic factors. BCL-6 protein express could be classified as benign prognostic factors, while ECOG score≥2, escalated IPI index as adverse prognostic factors, and further COX risk model regression analysis indicated that ECOG score, IPI grading and treatment methods were independently adverse factors affecting prognosis. Comprehensive therapy based on chemotherapy could improve outcome.</p><p><b>CONCLUSION</b>BCL-2/MYC genes double-hit was the factor for the adverse outcome in DLBCL patients. However, ECOG score, IPI risk grading and treatment methods were the independent factors affecting prognosis.</p>

Comparative study on ultrasonic presentations and pathological features of follicular variant of papillary thyroid carcinoma / 中华医学超声杂志（电子版）

Objective To investigate the ultrasonic features and pathological basis of follicular variant of papillary thyroid carcinoma (FVPTC). Methods Ultrasonic presentation of 30 patients with FVPTC conifrmed by surgery and pathology from the Seventh People′s Hospital of Shaoxing during March 2002 and December 2012 were analyzed retrospectively and compared with pathological results. Results Ultrasonic presentation of 30 FVPTC cases could be classiifed into three types:(1) Six cases (20%, 6/30) of typeⅠ, with typical sonographic features of papillary thyroid carcinoma:nodules with irregular shape, unclear boundary, and very low echo inside, microcalciifcation could be seen. (2) Fourteen cases (47%,14/30) of typeⅡ, presented as clearer iso-echoic or hypo-echoic nodules, with irregular shape, angled and lobular edge, rare microcalciifcation. (3) Ten cases (33%, 10/30) of typeⅢ, presented as adenoma-like features, nodule with clear boundary and regular edge, uniform medium echo inside. The microscopic structure characteristics could be divided into three categories:6 cases of typeⅠ, lesions were featured with no obvious capsule, irregular shape and inifltrative growth;14 cases of type Ⅱ, lesions with irregular shape, which invading the capsule with partial protrusion and peripheral small satellite lesions;10 cases of typeⅢ, lesions with more complete envelope, more regular shape with no signiifcant or lower level and smaller extent invasion of the capsule. Differences in morphology, boundary, aspect ratio, internal echo, presentation of microcalciifcations between the encapsulated type (typeⅡ,Ⅲ) and non-encapsulated type (typeⅠ) FVPTC were statistically signiifcant (Fisher′s exact test, all P0.05). Conclusion Ultrasonic presentation of FVPTC show characteristics of both follicular tumor and papillary carcinoma, and the ultrasonic presentations are closely related to the pathological subtypes.

Anxiety and depression of liver transplant recipients and the related impact factors / 中华器官移植杂志

Objective To evaluate the anxiety and depression status of the liver transplant recipients and to investigate the related impact factors.Method Forty-two liver transplant recipients were under survey by General Information Questionnaire (GIQ),Social Support Rating Scale (SSRS),Self-rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) before and 1,6,12,24 and 36 months after operation.Result The mean anxiety scores before and 1,6,12,24 and 36 months after operation were 37.2 ± 5.3,32.2 ± 6.2,32.1 ± 6.6,31.9± 5.1,30.1 ± 4.6 and 28.5 ± 4.1,respectively.The mean depression scores at those 6 time points were 46.7 ± 7.1,37.9 ± 10.7,36.7 ±7.9,37.1 ± 6.4,34.3 ± 5.8 and 32.1 ± 5.6,respectively.Both the anxiety and depression scores showed statistically significant difference (P＜0).001) before and after operation (all time points).Also there was statistically significant difference (P＜0.001) between post-operative month 36 and other post-operative time points.The impact factors for anxiety of liver transplant recipients were subjective supports and the utilization level of the supports.The impact factors of depression of liver transplant recipients were pre-operative depression score,objective support,subjective supports and the utilization level of the supports.Conclusion Liver transplant recipients suffer less anxiety and depression after operation.The anxiety status can be further improved from 24 to 36 months postoperation.

Investigation of liver transplantation postoperative depression and the impact factors / 现代临床护理

Objective To explore the depression status of the liver transplant recipients after the surgery and the impact factors.Method Forty two liver transplant recipients were assessed at 5 different time points(1 month,6 months,12 months, 24 months,36 months after the transplantation)using general information questionnaire(GIQ),social support rating scale(SSRS) and self-rating depression scale(SDS).Results After the transplantation,the longer recipients lived,the less depression they underwent.Age and post-operative objective support are the two major factors on depression status of the liver transplant recipients Conclusion The clinical and community nurses may pay attention to the mind state of the recipients after liver transplantation,and provide mental nursing in time and social support to prevent and improve the state of their depression.

Causes of diarrheas from kidney transplantation from donation after cardiac death and nursing strategy / 现代临床护理

Objective To study the diarrhea causes and nursing care after kidney transplantation from donation after cardiac death(DCD).Methods The clinical data of 91 patients undergoing kidney transplantations from DCD were retrospectively analyzed from November 2011 to May 2013 in our department,to investigate the incidence of diarrhea and the causes.Results Eighty three cases contracted diarrhea in 91 recipients,with the incidence of diarrhea 91.2%.The use of immunosuppressive agents,intestinal flora,infection and bowel movement dysfunction were all related to the diarrhea.Conclusions The incidence of diarrhea is high and the causes are complex after kidney transplantation from DCD.So nurses should take the appropriate care measures to improve the quality of nursing,avoiding complications and ensuring transplant results based on a different cause of diarrhea.

The Role of Shenmai Injection Combined with Psychotherapy in Chemotherapy of Non-small Cell Lung Cancer / 浙江中医药大学学报

[Objective]To evaluate the efficacy of Shenmai injection combined with psychotherapy in chemotherapy of non-small cell lung cancer.[Method]79 cases of advanced non-small cell lung cancer were randomly divided into two groups,40 cases in observation group with Shenmai injection combined with chemotherapy and psychotherapy,39 cases in control group with chemotherapy alone.The Karnofsky scores,therapeutic efficacy,one year survival rate and incidence of myelosuppression were evaluated.[Result] The two groups were significantly different in Karnofsky scores,therapeutic efficacy and one year survival rate.The improvement and stability rate of Karnofsky scores and that of therapeutic efficacy were 75.0% and 70.0% in observation group,with 46.2% and 46.2% in control group,respectively.One year survival rate was 47.5% in observation group and 25.6% in control group,respectively.The incidence of myelosuppression had significant differences in the two groups,with grade 2～4 leucopenia 32.5% in observation group and 53.8% in control group(P=0.032),with grade 2～3 thrombocytopenia 30.0% in observation group and 46.2% in control group(P=0.032).[Conclusion] Combination treatment in observation group was superior to the treatment in control group,with a higher Karnofsky scores,more effective therapy,a higher one year survival rate and a lower incidence of myelosuppression.The treatment of Shenmai injection combind with chemotherapy could reduce toxicity and enhance therapeutic efficacy.

Dignosis and therapy on hemangiomas and vascular malformation in view of the new classification / 北京大学学报(医学版)

Vascular birthmarks are the most common disease.The morbidity is about 2.5%,most of the lesions occur in oral and maxillofacial regions which accounts for 40%-60% of the total lesions.In 1982,Mulliken and Glowacki proposed a biologic classification of vascular birthmarks on the basis of their clinical manifestations,histopathological features,and natural history.They defined hemangiomas as vascular tumors with a growth phase,marked by endothelial proliferation and hypercellularity,and an involutional phase.They recognized that many entities referred to as hemangiomas are actually structural malformations of the vasculature,derived from capillaries,veins,lymph vessels,or arteries or from a combination of these sources.The classification was confirmed and issued by International Society for the study of vascular anomality(ISSVA) in 1988.Waner and Suen amended the above category in 1995.This paper presents the new classification of vascular birthmarks and the developments in this field in re-cent years,including the pathology,clinical features and the therapy.For example,the classification of venular malformation categorized by Waner in 1989;the classification of lymphous malformation by Waner and Suen in 1995;and the treatments according to above classifications.

Evaluation of high-dose Senmai in treating patients with advanced cancer / 中成药

AIM:To make a evaluation of high-dose Senmai(Radix Ginseng Rubra, Radix Ophiopogonis, Fructus schisandrae.)(HD-SM)in treating patients with advanced cancer.METHODS:32 patients with advanced cancer were assigned to treatment group. And 28 cases were assigned to the control group. The treatment group received chemotherapy and HD-SM, the control group received chemotherapy and the routine supporting treatment (except HD-SM). The toxicity and effect of all patients were observed, and the value of HD-SM was assessed.RESULTS:All cases in treatment group received 4 chemotherapy courses according to plan. The toxicities were tolerable, and the effect was satisfactory. All cases in the control group were only performed 1 course of treatmeur.CONCLUSION:HD-SM can decrease the effect of chemotherapy and reduce chemotherapeutic toxicities, and it is a very effective supporting treatment in chemotherapy.