Efficacy and safety of neoadjuvant chemotherapy combined with PD-1 antibody for esophageal squamous cell carcinoma in the real world / 中华肿瘤杂志

Objective: To evaluate the efficacy and safety of neoadjuvant chemotherapy combined with programmed death-1 (PD-1) antibody in operable, borderline or potentially resectable locally advanced esophageal squamous cell carcinoma(ESCC) in the real world. Methods: The study retrospectively analyzed 28 patients with operable or potentially resectable locally advanced ESCC patients treated with preoperative chemotherapy combined with PD-1 inhibitor in Nanjing Drum Tower Hospital, Affiliated Hospital of Nanjing University Medical School from April 2020 to March 2021. According to the clinical TNM staging system of the 8th edition of the American Joint Committee on Cancer, there were 1, 15, 10, 1 and 1 case of stage Ⅱ, Ⅲ, ⅣA, ⅣB and unknown stage respectively. The treatment was two cycle of dual drug chemotherapy regimen including taxane plus platinum or fluorouracil combined with PD-1 antibody followed by tumor response assessment and surgery if the patient was eligible for resection. Results: Of the 28 patients, 1, 2, 3 and 4 cycles of chemotherapy combined with PD-1 antibody treatment completed in 1, 21, 5, and 1 patient, respectively. Objective response rate (ORR) was 71.4% (20/28), and disease control rate (DCR) was 100% (28/28). The incidence of adverse events exceeding grade 3 levels was 21.4% (6/28), including 3 neutropenia, 1 leukopenia, 1 thrombocytopenia and 1 immune hepatitis. There was no treatment-related death. Of the 23 patients underwent surgery, R0 resection rate was 87.0% (20/23), 13 patients had down staged to the T1-2N0M0 I stage, the pCR rate was 17.3% (4/23), and the pCR rate of primary tumor was 21.7% (5/23). Four patients received definitive chemoradiotherapy. One patient rejected surgery and other treatment after achieved PR response. Conclusion: Neoadjuvant chemotherapy combined PD-1 inhibitor is safe and has high efficacy in operable, borderline or potentially resectable locally advanced ESCC, and it is a promising regimen.

Advances in genetic research of FOXL2 in patients with blepharophimosis-ptosis-epicanthus inversus syndrome / 中华实验眼科杂志

Blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) is a rare autosomal dominant disease, which has been divided into two types according to whether it involves premature ovarian failure.BPES is characterized by typical eyelid malformations, including a narrowed horizontal palpehral aperture, ptosis, epicanthus inversus and telecanthus.Mutations in FOXL2 have been identified in the majority of patients with BPES.With the deepening of research, the relationship between FOXL2 genotype and phenotype has received more and more attention, and some researchers have found that the same mutation of the FOXL2 gene may have different phenotypes in different families or even the same family.This review summarizes the relationship between FOXL2 gene mutation and BPES.

Mutation screen of P4HA2 gene in Tujia high myopia patients / 中华实验眼科杂志

Objective@#To investigate the mutation of P4HA2 gene in Tujia high myopia patients.@*Methods@#Clinical data and genomic DNA were collected from 288 Tujia patients with high myopia, whose spherical error ≥-6.00 diopters and axial length≥26 mm.All coding exons regions of P4HA2 were screened in patients to detect causative mutation by Sanger sequencing.The detected mutation was further screened in 192 normal control chromosomes in the same district.The pathogenicity of genetic mutations was predicted through bioinformatics analysis.This study followed the Declaration of Helsinki.All patients or their guardians signed informed consent.@*Results@#Four variations of P4HA2 gene were found in 288 patients, including one missense mutations(c.145C>A), two in-containing mutations (c.1306-62C>T, c.82+ 22C>T) and one insertion mutation (c.179+ 16_179+ 17 ins T). Missense mutation c. 145C>A was predicted as suspicious pathogenic gene by Polyphen2.According to the standard of ACMG in the United States, the variation was uncertain in pathogenicity.@*Conclusions@#Missense mutation c. 145C>A in P4HA2 gene is a suspicious pathogenic gene mutation in Tujia patients with high myopia.

Mutation screen of P4HA2 gene in Tujia high myopia patients / 中华实验眼科杂志

Objective To investigate the mutation of P4HA2 gene in Tujia high myopia patients. Methods Clinical data and genomic DNA were collected from 288 Tujia patients with high myopia, whose spherical error ≥-6. 00 diopters and axial length≥26 mm. All coding exons regions of P4HA2 were screened in patients to detect causative mutation by Sanger sequencing. The detected mutation was further screened in 192 normal control chromosomes in the same district. The pathogenicity of genetic mutations was predicted through bioinformatics analysis. This study followed the Declaration of Helsinki. All patients or their guardians signed informed consent. Results Four variations of P4HA2 gene were found in 288 patients,including one missense mutations(c. 145C>A), two in-containing mutations (c. 1306-62C>T,c. 82+22C>T) and one insertion mutation (c. 179+16_179+17 ins T). Missense mutation c. 145C>A was predicted as suspicious pathogenic gene by Polyphen2. According to the standard of ACMG in the United States, the variation was uncertain in pathogenicity. Conclusions Missense mutation c. 145C>A in P4HA2 gene is a suspicious pathogenic gene mutation in Tujia patients with high myopia.

Treatment outcomes of patients with stage II pure endometrioid-type endometrial cancer: a Taiwanese Gynecologic Oncology Group (TGOG-2006) retrospective cohort study / 부인종양

OBJECTIVE: Choice of hysterectomy and adjuvant treatment for International Federation of Gynecology and Obstetrics (FIGO) 2009 stage II endometrioid endometrial cancer (EEC) is still controversial. Aims of this study were to evaluate survival benefits and adverse effects of different hysterectomies with or without adjuvant radiotherapy (RT), and to identify prognostic factors. METHODS: The patients at 14 member hospitals of the Taiwanese Gynecologic Oncology Group from 1992 to 2013 were retrospectively investigated. Patients were divided into simple hysterectomy (SH) alone, SH with RT, radical hysterectomy (RH) alone, and RH with RT groups. Endpoints were recurrence-free survival (RFS), overall survival (OS), disease-specific survival (DSS), adverse effects and prognostic factors for survival. RESULTS: Total of 246 patients were enrolled. The 5-year RFS, OS, DSS and recurrence rates for the entire cohort were 89.5%, 94.3%, 96.2% and 10.2%, respectively. Patients receiving RH had more adverse effects including blood loss (p < 0.001), recurrent urinary tract infections (p = 0.013), and leg lymphedema (p = 0.038). Age over 50-year (HR = 9.2; 95% confidence interval [CI], 1.2–70.9) and grade 3 histology (HR = 7.28; 95% CI, 1.45–36.6) were independent predictors of OS. Grade 3 histology was an independent predictor of RFS (HR = 5.13; 95% CI, 1.38–19.1) and DSS (HR = 5.97; 95% CI, 1.06–58.7). Patients receiving adjuvant RT had lower locoregional recurrence (p = 0.046), but no impact on survival. CONCLUSION: Different treatment modalities yield similar survival outcomes. Patients receiving SH with RT had lower locoregional recurrent with acceptable morbidity. Age and tumor grading remained significant predictors for survival among patients with FIGO 2009 stage II EEC.

Effects of axial length on corneal curvature, corneal astigmatism, anterior chamber depth and intraocular pressure in age-related cataract / 眼科新进展

Objective To investigate the influence of different axial lengths (AL) on corneal curvature (CC),corneal astigmatism (CA),anterior chamber depth (ACD) and intraocular pressure (IOP) in age-related cataract.Methods Ocular data of 368 patients 368 eyes from Zhongnan Hospital of Wuhan University undergoing cataract surgery were retrospectively reviewed.AL,corneal curvature,corneal astigmatism and anterior chamber depth were measured using IOL-Master (Zeiss,German),and the intraocular pressure was measured using an iCare tonometer.Together 80 patients (80 eyes) selected from these patients with different AL using random number table were randomly divided into three groups,including short,moderate and long AL group.Spearman's rank test was used to assess the correlation between AL and ocular biological parameters.Each parameter was compared by one-way analysis of variance among the three groups,respectively.Results Spearman's rank test presented that AL was related with CC (r =-0.424,P ＜ 0.001),CA (r =0.138,P =0.008) and ACD (r =0.561,P ＜0.001),but there was no correlation of AL with IOP (r =0.064,P =0.326).The AL was negatively correlated with CC,positively correlated with CA and ACD,but there was weak correlation between AL and CA,as well as moderate correlation of AL with CC and ACD.The CC of the moderate and long AL group was significantly different from that of the short AL group (all P ＜ 0.001),but there was no significant difference between moderate and long AL group (P =0.438).Moreover,difference in CA was not statistical significant between short and moderate AL group (P =0.333) as well as between moderate and long AL group (P =0.718),but its difference approached statistical significance between short and long AL group (P =0.042).Pairwise comparison of ACD among the three groups had significant difference (all P≤0.001),but difference in IOP was not statistically significant with palrwise comparison (all P ＞ 0.05).Conclusion CC is negatively related to AL,and CA is weakly correlated to AL;meanwhile,it is possible to show that the degree of CA increases as AL gets longer.There is a moderate correlation between ACD and AL,while there is no relationship between AL and IOP.

Effects of inhalation of sevoflurane at different time on pulmonary function and oxidative stress in patients with one lung ventilation / 中国基层医药

Objective To investigate effects of inhalation of sevoflurane at different time on pulmonary function and oxidative stress in patients with one lung ventilation.Methods 80 patients who needed external surgery according to the random grouping principle,were divided into sevoflurane preconditioning group(OLV for 30min after inhalation of sevoflurane),sevoflurane treatment group(OLV inhalation of sevoflurane),sevoflurane inhalation group(inhalation of sevoflurane),total intravenous group(propofol and remifentanil anesthesia) four groups,20 patients in each group,each group was treated accordingly.The differences of serum malondialdehyde(MDA),superoxide dismutase(SOD),lactate dehydrogenase(LDH) and intrapulmonary shunt(Qs/Qt) in the four groups were observed and compared at different time points.Results Compared with the other three groups,the intrapulmonary shunt fraction of the sevoflurane preconditioning group were significantly lower[(4.9±0.6)% vs.(6.1±0.5)%,(6.3±0.6)%,(5.9±0.4)%](x2=5.415,5,882,4.977,all P<0.05).The serum levels of MDA,SOD,LDH in the sevoflurane pretreatment group were significantly lower than those in the other three groups[(5.06±2.10)nmol/mL vs.(13.04±3.27)nmol/mL,(12.40±4.28)nmol/mL,(13.13±2.30)nmol/ml],[(58.7±5.9)U/L vs.(84.9±13.8)U/L,(93.9±21.1)U/L,(84.2±11.2)U/L],[(16.3±2.1)U/L vs.(43.1±7.2)U/L,(45.4±6.7)U/L,(35.8±5.1)U/L](t=8.076,7.448,8.277;12.917,15.506,12.586;11.375,12.239,8.220,all P<0.05).Conclusion Thoracic surgery in patients with one lung ventilation during anesthesia,using sevoflurane preconditioning anesthesia surgery can effectively improve the patients with intrapulmonary shunt rate,reduce the level of oxidative stress and improve the prognosis,it is worthy of further clinical application.

Application of Nucleic Acid Aptamers in Polypeptides Researches / 分析化学

Polypeptides play a vital role in physiological processes of life. The pharmacological and medical value of polypeptides has attracted the attention of researchers in recent years. Aptamers are short, single stranded DNA or RNA which developed by an in vitro process called systematic evolution of ligands by exponential enrichment ( SELEX ) . Aptamers can bind targets with high affinity and specificity. Hence, aptamer is also called "chemical antibody" or "chemist's antibody". To date, there are two main application aspects for polypeptides-targeted aptamers. First, aptamer can be used as specific affinitive elements based on their ability of recognition, which would be applied to polypeptides detection or imaging. The other one is that aptamer can also be used as antagonists based on their ability of inhibiting, which can restrict the activity of polypeptides and block the downstream signaling pathways in vivo, thus can be used to treat the disease associated with polypeptides. In this review, we summarize the numbers of polypeptides-targeted aptamers and the related applications in vitro and in vivo. Current issues and development trends throughout the screening, characterizing and applying of polypeptides-targeted aptamers are also discussed.

Efficacy and safety of Bevacizumab versus MMC in augmenting trabeculectomy：a Meta-analysis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the efficacy and safety of bevacizumab with mitomycin ( MMC ) in augmenting trabeculectomy for glaucoma. METHODS: Databases including PubMed, CBM, CNKI, VIP and WanFang Data were electronically searched for all randomized controlled trials ( RCTs) about comparing the efficacy and safety between bevacizumab and MMC in augmenting trabeculectomy for glaucoma before the date of Jun. 2016. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, and evaluated the included studies. Then, Meta-analysis was performed. RESULTS: A total 4 RCT involving 286 eyes ( 143 for bevacizumab group, 143 for MMC group) were included. The results of Meta-analysis showed that there was no significant difference between bevacizumab and MMC in the last follow-up after surgery in IOP (WMD=2. 21, 95%CI: -0.17 to 4.58, P=0.07), complete success rate (OR=0. 69, 95%CI:0. 26 to 1. 81, P=0. 45) and the numbers of anti-glaucoma medicine ( OR= 0. 12, 95%CI: -0. 15 to 0.39,P=0. 39). And there was no significant difference between bevacizumab and MMC in postoperative complications:hypotony (OR=0.7, 95%CI:0.12 to 4.05, P=0.69), bleb leak (OR=1, 95%CI: 0. 21 to 4. 74,P=1), encapsulated bleb (OR=1. 15, 95%CI: 0. 38 to 3. 44, P=0.81), choroidal detachment (OR=1. 22, 95%CI: 0. 29 to 5.22, P=0. 78) and cataract (OR=1. 15, 95%CI: 0. 38 to 3.44, P=0. 81). CONCLUSION: Bevacizumab and MMC in augmenting trabeculectomy for glaucoma have similar efficacy and safety. Bevacizumab can't result in better outcome in term of IOP reduction. Clinicians should choose suitable solution according to disease characteristics.

Application of sevoflurane intravenous inhalational anesthesia and remifentanil intravenous anesthesia for sin-gle lung ventilation in the department of thoracic surgery operation / 中国基层医药

Objective To investigate the effect of sevoflurane intravenous inhalational anesthesia and remifentanil intravenous anesthesia for single lung ventilation in the department of thoracic surgery operation .Methods 80 patients using thoracic surgery were randomly divided into the two groups with 40 cases in each group according to the number table methods ,the study group were treated with sevoflurane inhalation anesthesia while the control group were treated with remifentanil intravenous anesthesia .HR,MAP and SBP of the two groups before induction of anes-thesia(T0),1min before intubation(T1),10min after ventilation(T2),30min after ventilation(T3) and 1min before extubation(T4) were compared,and recovery time,extubation time,directional force the recovery time were recorded of the two group.Results The HR in the two groups at T1,T2,T3,T4 time did not change significantly than T0 time, while MAP decreased significantly than T0 time,with significant difference (t =8.12,7.82,8.14,8.05,all P 0.05);The SBP in the study group did not change obviously at each time while the SBP in the control group at T 1 decreased significantly than T0 time,while it increased significantly at T 2 time than T1 time,with a significant difference ( t=10.51,5.34, 5.05,5.06,all P<0.05);The patients in study group were elevated blood pressure during anesthesia or decreased more than 30% occurred in 8 cases while the control group occurred in 24 cases,there was significant differences between the two groups (χ2 =13.33,P<0.05);The postoperative recovery time ,extubation time and orientation recovery time of the study group patients were (11.4 ±5.1)min,(13.4 ±6.8)min,(18.9 ±5.8)min,which were significantly lower than (19.5 ±5.2)min,(26.5 ±7.6)min,(21.9 ±7.8)min of the control group(t=5.34,6.12, 6.15,all P<0.05).Conclusion Sevoflurane intravenous inhalational anesthesia has a better anesthetic effect for single lung ventilation in the department of thoracic surgery operation than remifentanil intravenous anesthesia ,and it can effectively maintain hemodynamics stability .

Chlorogenic acid alters the voltage-gated potassium channel currents of trigeminal ganglion neurons / 国际口腔科学杂志·英文版

Chlorogenic acid (5-caffeoylquinic acid, CGA) is a phenolic compound that is found ubiquitously in plants, fruits and vegetables and is formed via the esterification of caffeic acid and quinic acid. In addition to its notable biological functions against cardiovascular diseases, type-2 diabetes and inflammatory conditions, CGA was recently hypothesized to be an alternative for the treatment of neurological diseases such as Alzheimer's disease and neuropathic pain disorders. However, its mechanism of action is unclear. Voltage-gated potassium channel (Kv) is a crucial factor in the electro-physiological processes of sensory neurons. Kv has also been identified as a potential therapeutic target for inflammation and neuropathic pain disorders. In this study, we analysed the effects of CGA on the two main subtypes of Kv in trigeminal ganglion neurons, namely, the IK,A and IK,V channels. Trigeminal ganglion (TRG) neurons were acutely disassociated from the rat TRG, and two different doses of CGA (0.2 and 1 mmol⋅L(-1)) were applied to the cells. Whole-cell patch-clamp recordings were performed to observe alterations in the activation and inactivation properties of the IK,A and IK,V channels. The results demonstrated that 0.2 mmol⋅L(-1) CGA decreased the peak current density of IK,A. Both 0.2 mmol⋅L(-1) and 1 mmol⋅L(-1) CGA also caused a significant reduction in the activation and inactivation thresholds of IK,A and IK,V. CGA exhibited a strong effect on the activation and inactivation velocities of IK,A and IK,V. These findings provide novel evidence explaining the biological effects of CGA, especially regarding its neurological effects.

Dynamic change of hepatitis B surface antigen expression in chronic hepatitis B patients during the natural recovery course and the short-term antivirus treatment / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the dynamic quantitative changes in expression of hepatitis B virus (HBV) surface antigen (HBsAg) that occurs during the natural recovery course and the short-term antivirus treatment period of patients suffering from flares in chronic hepatitis B (CHB).</p><p><b>METHODS</b>CHB patients presenting for treatment of flare-ups were randomly assigned to receive treatment with Entecavir antiviral (group A, n = 39) or to naturally resolve the acute condition (group B, n = 22). All patients MELD scores were calculated and HBsAg levels and HBV DNA loads were measured upon admission (baseline), at worst-condition stage, and end of treatment/flare-up (discharge). Pairwise comparisons of intergroup differences were made to evaluate the change in the three disease parameters over time in response to the management approach.</p><p><b>RESULTS</b>The levels of HBsAg were not significantly different between the two groups at baseline, worst-condition stage and discharge (group A: (3.68+/-0.45), (3.84+/-0.19) and (3.69+/-0.58) log10 cut-off index (COI) respectively; group B: (3.59+/-0.54), (3.47+/-0.76) and (3.43+/-0.68) log10 COI respectively; all P more than 0.05). However, the HBV DNA loads were significantly lower in group A than in group B at the worst-condition stage and at discharge (all P less than 0.05). In group A, the MELD scores were significantly higher at baseline and at worst-condition stage than at discharge (all P = 0.000), but the difference between baseline and worst-condition stage was not significant. Also in group A, the HBV DNA load showed a gradually decreasing trend over time (baseline more than worst-condition stage more than discharge, all P less than 0.05). No significant differences were observed over time in the HBsAg levels of group A. In group B, the MELD scores were significantly higher at baseline and at worst-condition stage than at discharge (all P = 0.000), but the difference between baseline and worst-condition stage was not significant (P = 0.619). Also in group B, the HBV DNA loads were significantly higher at baseline and worst-condition stage than at discharge (P = 0.000 and P = 0.003 respectively), but the difference between baseline and worst-condition stage was not significant. Finally, no significant differences were observed over time in the HBsAg levels of group B.</p><p><b>CONCLUSION</b>Natural recovery from an acute flare-up of CHB is not accompanied by a change in HBsAg levels. In addition, short-term antiviral treatment to resolve the flare-up has no influence on HBsAg level.</p>

To investigate the opportunity of entecavir treatment for HBeAg-negative acute-on-chronic liver / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore relations between the opportunities and effects of internal general treatment added Entecavir on acute-on-chronic liver failure (ACLF) of HBeAg-negative chronic hepatitis B in different score ranges of acute-on-chronic liver failure severity.</p><p><b>METHODS</b>A total of 108 ACLF of HBeAg-negative chronic hepatitis B patients with different ACLF severity score were treated with internal general treatment added Entecavir. The liver failure severity scores, HBV-DNA loads during the initiation of therapy, recovery phase and in deathbed phase, courses of Entecavir administration and mortalities were studied.</p><p><b>RESULTS</b>For 19 patients with high ACLF score (> or = 12), the difference in ACLF score between pre and post-treatment was not significant. The difference in HBV-DNA load between pre and post-treatment was not significant and the mortality was 18/19. For 30 patients with higher intermediate ACLF score (8-11), the difference in ACLF score between pre and post-treatment was not significant. The difference in HBV-DNA load between pre and post-treatment was significant, and the mortality was 66.67% (20/30). For 36 patients with lower intermediate ACLF score (5-7), the difference in ACLF score between pre and posttreatment was not significant. The difference in HBV-DNA load between pre and post-treatment was significant, and the mortality was 30.56% (11/36). For 23 patients with low ACLF score (< or = 4), the difference in ACLF score between pre and post-treatment was significant. The difference in HBV-DNA load between pre and post-treatment was significant, and the mortality was 8.70% (2/23).</p><p><b>CONCLUSIONS</b>A novel acute-on-chronic liver failure scoring system can syllabify differentiate the relations between the opportunities and efficacies on the Entecavir treatment for HBeAg-negative ACLF.</p>

Nardosinone reduces neuronal injury induced by oxygen-glucose deprivation in primary cortical cultures / 药学学报

The aim of the study is to investigate the effect of nardosinone (Nar) on neuronal injury induced by oxygen-glucose deprivation (OGD) in primary cortical cultures isolated from embryos at gestational day 14. MTT method was used to determine the dosage regimen of Nar in primary neuronal cultures and observe the influence of Nar on the neurons suffering OGD; Western blotting analysis was used to detect expressions of protein kinase A (PKA), Ras related protein 1 (Rap1), mitogen-activated protein kinase kinase 1 (MEK1) and phospho-extracellular signal-regulated kinase 1/2 (p-ERK1/2) of OGD-injured or uninjured primary cultured neurons after Nar treatment. Results showed that Nar (50 and 100 micromol x L(-1)) improved the cell viability during OGD damage (P < 0.01) and increased the expression of PKA, Rap1, MEK1 and p-ERK1/2 in injured neurons. Additionally, elevations of PKA, Rapl, MEK1 and p-ERK1/2 in uninjured neurons were caused by Nar (50, 100 and 200 micromol x L(-1)) with a dose-dependent tenclency as well (P < 0.01). In conclusion, Nar could protect against the neuronal injury exposed to OGD, which may be relevant to the promotion of PKA and ERK signaling pathway.

Risk factor analysis of coexisting endometrial carcinoma in patients with endometrial hyperplasia: a retrospective observational study of Taiwanese Gynecologic Oncology Group / 부인종양

OBJECTIVE: To evaluate the clinical outcome and parameters related to coexisting endometrial carcinoma in women with tissue-diagnosed endometrial hyperplasia. METHODS: Between January 1991 and December 2009, three hundred and eighty-six patients with the presumptive diagnosis of endometrial hyperplasia were retrieved. Among these, one hundred and twenty-five patients were identified as having coexisting endometrial carcinoma in hysterectomy specimens. The three hundred and eighty-six patients were divided into two groups: the hyperplasia-benign group (261 cases) and the hyperplasia-malignant group (125 cases). Several clinical parameters including age, menopausal status, history of abnormal uterine bleeding, obstetrical history, medical history of diabetes and hypertension, BMI, and preoperative pathologic results were investigated. RESULTS: Age > or =53 (odds ratio [OR], 2.40; 95% confidence interval [CI], 1.26 to 4.57), menopausal status (OR, 2.07; 95% CI, 1.14 to 3.76), diabetes history (OR, 7.33; 95% CI, 2.79 to 19.26), abnormal uterine bleeding (OR, 3.99; 95% CI, 1.22 to 13.02), atypical endometrial hyperplasia (OR, 7.38; 95% CI, 4.03 to 13.49), and body mass index > or =27 (OR, 3.24; 95% CI, 1.76 to 5.97) were independent risk factors for prediction of endometrial hyperplasia coexisting with endometrial carcinoma. The diagnostic efficacy of atypical endometrial hyperplasia to predict the endometrial hyperplasia coexisting with endometrial carcinoma was better than or similar to those of other independent factors and combinations of these factors. CONCLUSION: Coexisting malignancy should be considered when examining endometrial hyperplasia patients with the related risk factors, especially atypical endometrial hyperplasia.

Effect of high glucose on cultured retinal Müller cell in vitro / 中华实验眼科杂志

Background Retinal Müller cells can offer nutrient and maintain the normal structure of retina.Researches showed that the abnormality of Müiller cells leads to retinal vascular disease.To explore the effect of high glaucoma on retinal Müller cells is of a very important significance for the study on diabetic retinopathy (DR).Objective This study was to investigate the effects of different concentrations of glucose on retinal Müller cells in vitro.Methods Retinal tissue was isolated from 1 10-day-oM clean SD rat.Mtiller cells were cultured by explant culture method and passaged in DMEM containing 20％ fetal bovine serum.The third generation of cells were obtained and identified using glial fibrillary acidic protein (GFAP) staning.Then,5.5,30.0 and 40.0 mmol/L glucose were added into the culture medium for 4 days respectively.The proliferation (A570) of Müller cells was detected by MTT,and apoptosis rate of Müller cells was calculated by flow cytometer to evaluate the effects of 5.5,30.0 and 40.0 mmol/L glucose to cell vitality.Results Cultured and passaged cells grew well with the spindle shape.The positive reactive cells were ＞95％ for GFAP.The A570 value of Müller cells was 0.24±0.01,0.21±0.03 and 0.20±0.02 in 5.5,30.0 and 40.0 mmol/L glucose group respectively,showing a significant difference among the three groups(F=6.755,P＜0.05).Compared with 5.5 mmol/L glucose group,As70 values were significantly lower in 30.0and 40.0 mmol/L glucose group (q =0.645,0.486,P ＜ 0.05).Apoptosis rates of Miiller cells were (26.40 ±0.25)％,(30.19±0.16)％ and (36.23±0.19)％ in 5.5,30.0 and 40.0mmol/L glucose groups,with a significant difference among them (F =294.530,P＜0.05),and those in 30.0 and 40.0 mmol/L glucose groups were significantly reduced in comparison with 40.0 mmol/L glucose group (q =0.754,0.484,P ＜ 0.05).Conclusions High concentration of glucose inhibits the viability and promote the apoptosis of retinal Müller cells at a concentrationdependent manner.

Effect of high glucose on the expression of activating transcription factor 4 in cultured retinal Müller glia cells / 中华眼底病杂志

Objective To observe the effect of high glucose on the expression of activating transcription factor 4 (ATF4) in cultured retinal Müller glia cells.Methods The retinal tissue of Sprague Dawley (SD) rats was collected,and Müller cells were isolated and cultured.The glial fibrillary acidic protein (GFAP) and glutamine synthetase (GS) of Müller cells were identified by streptavidin-biotinperoxidase complex.Cultured rat Müller cells were divided into control group (5.5 mmol/L glucose),group A (20 mmol/L glucose),group B (30 mmol/L glucose) and group C (40 mmol/L glucose).ATF4 protein expressions in Müller cells of four groups were measured by Western blot four days after cultured.Results GFAP and GS expressed in more than 95％ of Müller cells.Over 95％ of Müller cells of group A,B and C were positive for GFAP and GS.Western blots indicated that ATF4 protein in group A,B and C increased obviously compared with the control group (q=0.293,0.754,0.484; P＜0.05).Conclusion High glucose can increase the expression of ATF4 protein and cause endoplasmic reticulum stress in retinal Müller glia cells in vitro.

Dynamic expression profile of HBsAg according to hepatic parenchyma cells' volume at different liver fibrosis stages in the immune clearance phase / 中华肝脏病杂志

The aim of this study was to determine the dynamic expression profile of hepatitis B surface antigen (HBsAg) according to hepatic parenchyma cells' volume at different stages of liver fibrosis during the immune clearance phase. Eighty-nine patients with HBeAg-positive chronic hepatitis B (CHB) in the immune clearance stage were recruited for study. Each patient's serum HBsAg levels were detected by electrochemiluminescence. The serum HBsAg levels were apportioned according to hepatic parenchyma cells' volume at liver fibrosis stages 1, 2, 3, and 4 and compared by ANOVA. The unapportioned serum HBsAg levels (IU/mL) at liver fibrosis stages 1 (227.2+/-237.7), 2 (211.0+/-131.4), 3(300.1+/-144.6), and 4 (278.7+/-148.8) were not significantly different (all comparisons, P range: 0.061 to 0.759). However, when the serum HBsAg levels were apportioned by the same hepatic parenchyma cells' volume at liver fibrosis stages 1 (343.9+/-359.8), 2 (336.4+/-209.5), 3 (508.7+/-245.1), and 4 (525.2+/-274.8), the levels were significantly different (all comparisons, F = 3.045 and P = 0.033; stage 1 vs. 3, P = 0.041; stage 1 vs. 4, P = 0.046; stage 2 vs. 3, P = 0.028; stage 2 vs. 4, P = 0.034). During the immune clearance phase of chronic hepatitis B, increased HBsAg expression is associated with increased hepatic parenchyma cells' volume and progressive liver fibrosis stage.

Dynamics of serum HBV DNA levels during the terminal phases of acute-on-chronic hepatitis B liver failure with different HBeAg status / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the dynamics and clinical significance of serum hepatitis B virus (HBV) DNA levels during the terminal phase of acute-on-chronic liver failure (ACLF) with different hepatitis B e antigen (HBeAg) status.</p><p><b>METHODS</b>One-hundred-and-seven patients with terminal ACLF were tested for HBeAg status by electrochemiluminescence immunoassay and serum HBV DNA levels by real-time PCR at three chronological time ranges, representing increasing severity of disease phases prior to death (day 0): 29-56 d, 15-28 d, and 0-14 d.</p><p><b>RESULTS</b>In the 37 HBeAg(+) patients, HBV DNA levels at above-mentioned phases were 6.10+/-1.63, 5.61+/-1.50, and 5.29+/-1.96 log10 copies/mL. In the 70 anti-HBe(+) patients, HBV DNA levels were 4.63+/-1.82, 5.81+/-1.78, and 4.93+/-1.73 log10 copies/mL. Phase to phase comparisons revealed that the HBV DNA level in the HBeAg(+) group was significantly higher than that in the anti-HBe(+) group at 29-56 d (P less than 0.05), and that 15-28 d and 0-14 d were not significantly different (P more than 0.05). Intragroup comparisons of phases revealed no significant differences in the HBeAg(+) group (P more than 0.05), but a significant difference between 15-28 d and 0-14 d (P less than 0.05) for the anti-HBe(+) group.</p><p><b>CONCLUSION</b>Serum levels of HBV DNA in patients with HBeAg positivity are higher than those in patients with anti-HBe positivity as the disease phase of ACLF nears fatality. Following the deterioration to liver failure, the HBV DNA load in HBeAg(+) patients remains stable while that in anti-HBe(+) patients decreases.</p>

The relationship of HBeAg status with HBV DNA loads, MELD scores in patients with acute-on-chronic hepatitis B liver failure during terminal phases / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the relationship and clinical significances of HBeAg status with serum HBV DNA loads, model for end-stage liver disease (MELD) scores in patients with acute-on-chronic hepatitis B liver failure during terminal phase.</p><p><b>METHODS</b>120 fatal patients were enrolled. At three phases of 0 -14 d, 15-28 d and 29-90 d before death, they were detected serum HBeAg, HBV DNA loads order meanwhile MELD scores were calculated.</p><p><b>RESULTS</b>In 51 patients with HBeAg positive, HBV DNA levels were (5.25 +/- 1.99), (5.45 +/- 1.47) and (6.06 +/- 1.77) log10 copies/ml while MELD scores were (30.33 +/- 5.25), (26.36 +/- 6.43) and (20.13 +/- 6.47) respectively. In 69 patients with HBeAg negative,HBV DNA loads were (5.14 +/- 1.84), (5.49 +/- 1.75 ) and (4.62 +/- 1.65) log10 copies/ml while MELD scores were 32.38 +/- 9.95, 28.17 +/- 6.82 and 26.19 +/- 5.56 in sequence. Compared with the same phase between HBeAg-positive group and HBeAg-negative group, significant differences in both HBV DNA loads and MELD scores were found only at the phase of 29-90 d (P < 0.05). In multiple comparisons among three phases, regardless of the HBeAg status,there wasn't significant difference for HBV DNA loads (P > 0.05). But increasing MELD scores are associated with the disease exacerbation and significant differences were found (P < 0.05).</p><p><b>CONCLUSIONS</b>To initiate acute-on-chronic hepatitis B liver failure, serum HBV DNA loads of HBeAg-positive patients are higher than that of HBeAg-negative ones. Once ACLF has been initiated,sustained high HBV DNA loads may promote the disease worsened and be fatal regardless of the HBeAg status.</p>