Surgical management of Dandy-Walker syndrome in infants and the literature review / 中国综合临床

Dandy-Walker syndrome is one of the posterior fossa malformations, which is easily confused with arachnoid cyst or cerebellar dysplasia in clinical practice, leading to misdiagnosis. Dandy-Walker syndrome is easy to be combined with hydrocephalus, resulting in increased intracranial pressure, increased head circumference, growth retardation, spastic hemiplegia and other manifestations, and can also be accompanied by other nervous system malformations. On February 27, 2021, a child with Dandy-Walker syndrome with growth retardation as the primary manifestation was admitted to Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine. After multiple surgical treatment, the child's hydrocephalus was significantly improved. Through the analysis of the clinical data of the child's operation and the treatment of complications, it is helpful to improve the clinicians' understanding of the surgical treatment of the disease.

Discovery and druggability evaluation of pyrrolamide-type GyrB/ParE inhibitor against drug-resistant bacterial infection

The bacterial ATP-competitive GyrB/ParE subunits of type II topoisomerase are important anti-bacterial targets to treat super drug-resistant bacterial infections. Herein we discovered novel pyrrolamide-type GyrB/ParE inhibitors based on the structural modifications of the candidate AZD5099 that was withdrawn from the clinical trials due to safety liabilities such as mitochondrial toxicity. The hydroxyisopropyl pyridazine compound 28 had a significant inhibitory effect on Gyrase (GyrB, IC50 = 49 nmol/L) and a modest inhibitory effect on Topo IV (ParE, IC50 = 1.513 μmol/L) of Staphylococcus aureus. It also had significant antibacterial activities on susceptible and resistant Gram-positive bacteria with a minimum inhibitory concentration (MIC) of less than 0.03 μg/mL, which showed a time-dependent bactericidal effect and low frequencies of spontaneous resistance against S. aureus. Compound 28 had better protective effects than the positive control drugs such as DS-2969 ( 5) and AZD5099 ( 6) in mouse models of sepsis induced by methicillin-resistant Staphylococcus aureus (MRSA) infection. It also showed better bactericidal activities than clinically used vancomycin in the mouse thigh MRSA infection models. Moreover, compound 28 has much lower mitochondrial toxicity than AZD5099 ( 6) as well as excellent therapeutic indexes and pharmacokinetic properties. At present, compound 28 has been evaluated as a pre-clinical drug candidate for the treatment of drug-resistant Gram-positive bacterial infection. On the other hand, compound 28 also has good inhibitory activities against stubborn Gram-negative bacteria such as Escherichia coli (MIC = 1 μg/mL), which is comparable with the most potent pyrrolamide-type GyrB/ParE inhibitors reported recently. In addition, the structure-activity relationships of the compounds were also studied.

Light-responsive nanomedicine for cancer immunotherapy

Immunotherapy emerged as a paradigm shift in cancer treatments, which can effectively inhibit cancer progression by activating the immune system. Remarkable clinical outcomes have been achieved through recent advances in cancer immunotherapy, including checkpoint blockades, adoptive cellular therapy, cancer vaccine, and tumor microenvironment modulation. However, extending the application of immunotherapy in cancer patients has been limited by the low response rate and side effects such as autoimmune toxicities. With great progress being made in nanotechnology, nanomedicine has been exploited to overcome biological barriers for drug delivery. Given the spatiotemporal control, light-responsive nanomedicine is of great interest in designing precise modality for cancer immunotherapy. Herein, we summarized current research utilizing light-responsive nanoplatforms to enhance checkpoint blockade immunotherapy, facilitate targeted delivery of cancer vaccines, activate immune cell functions, and modulate tumor microenvironment. The clinical translation potential of those designs is highlighted and challenges for the next breakthrough in cancer immunotherapy are discussed.

Perceived quality of patient-centered practice in surgical services designed for elderly orthopedic patients / 中华老年医学杂志

Objective:To investigate the effects on perceived quality of a management assessment system for orthopedic surgery in elderly patients.Methods:Based on the concept of lean management and process nodes in systems, an information management system was established to evaluate the perceived quality of surgical service for elderly orthopedic patients.Four hundred and two elderly orthopedic patients receiving orthopedic surgery after the implementation of the management system were included in the observation group, while 402 elderly patients undergoing orthopedic surgery before the implementation of management system formed the control group.Results:The incidence of hypothermia in patients admitted to the resuscitation room after surgery was lower in the observation group than in the control group(1.7% vs.4.5%, χ2=5.136、 P=0.023). The incidence of shivering during resuscitation was lower and the satisfaction rate of surgical services was higher in the observation group than in the control group(0.7% vs.3.2%) χ2=5.279、 P=0.022, 96.55(95.58, 97.28)分, vs.87.9(83.2, 89.95)分, Z=-4.16, P=0.00). Conclusions:A perceived quality assessment system composed of lean management and information technology for surgical services can reduce complications and improve satisfaction for patients receiving surgery.

Risk factors of progression to hepatocellular carcinoma in patients with hepatitis B cirrhosis under nucleoside/nucleotide analogue therapy / 中华临床感染病杂志

Objective:To explore the risk factors of hepatocellular carcinoma (HCC) in patients with hepatitis B cirrhosis receiving nucleoside/nucleotide analogues (NAs) antiviral therapy.Methods:The clinical data of 253 patients receiving NAs antiviral therapy in Zhejiang Provincial People’s Hospital from November 2014 to October 2019 were retrospectively analyzed. During treatment, HCC occurred in 116 patients. Multivariate logistic regression was used to analyze the risk factors of progression to HCC in patients with hepatitis B cirrhosis.Results:Multivariate logistic regression analysis showed that age( OR=1.094, 95% CI 1.034-1.158, P<0.01), smoking history( OR=5.056, 95% CI 1.453-17.594, P<0.05), family history of hepatocellular carcinoma( OR=6.763, 95% CI 1.253-36.499, P<0.05), Lamivudin (LAM) resistance( OR=6.097, 95% CI 1.370-27.134, P<0.05), fasting blood glucose(FBG)level( OR=7.219, 95% CI 3.716-14.024, P<0.01) were independent risk factors for the progression of hepatitis B cirrhosis to HCC; while HBV DNA negative conversion( OR=0.028, 95% CI 0.006-0.137, P<0.01) was a protective factor. Conclusions:For hepatitis B cirrhosis patients receiving antiviral therapy, drug resistance, HBV DNA, FBG levels should be closely monitored, intervention measures such as quitting smoking should be taken and NAs with high drug resistance gene barrier should be selected to prevent the occurrence of HCC.

Relationship between urate deposition on ultrasound and coronary artery calcification score in patients undergoing hemodialysis / 中华风湿病学杂志

Objective:To investigate the relationship between urate deposition on ultrasound and coronary artery calcification score in maintenance hemodialysis (MHD) patients.Methods:A total of 100 stable MHD patients undergoing hemodialysis for at least one year were enrolled in this study. All the patients had clinical and ultrasound examination at both knees, ankles and first metatarsophalangeal joints. Subgroup analysis was done depending on whether double contour sign (DCS) or tophus was found on ultrasound. The volume of coronary artery calcification (CAC) score were determined by a 64-slice CT. Main statistical analysis methods were t test, chi-square test, Spearman correlation and logistic regression model. Results:Among these 100 patients, DCS was found in 35 (35%) patients and tophus was found in 21 (21%) patients. The serum uric acid level, serum phosphate (P), parathyroid hormone (PTH), C-reactive protein (CRP) and incidence of CAC, CAC score of the DCS positive group [(629±61) μmol/L, (2.4±0.8) mmol/L, (658±56) pg/ml, (9.5±2.1) mg/L, 83%(29/35), (276±37), n=35] was significantly higher than the DCS negative group [(569±68) μmol/L, (2.0±0.6) mmol/L, (536±49) pg/ml, (7.9±3.1) mg/L, 59% (38/65), (219±42), n=65] ( t=4.322 6, P<0.01; t=2.712 6, P<0.01; t=11.293 1, P<0.01; t=2.700 3, P<0.01; t=5.070 1, P=0.024 3; t=6.827 6, P<0.01). The serum uric acid level was positively correlated with urate deposition on ultrasound ( r=0.317, P<0.05), which was positively correlated with CAC score ( r=0.302, P<0.05). The serum uric acid level, urate deposition on ultrasound and CAC score were all positively correlated with CRP ( r=0.298, P<0.05; r=0.345 , P<0.05; r=0.336, P<0.05) . Multivariate logistic regression analysis showed that the serum uric acid level and CRP were independent risk factors for positive DCS in MHD patients [ OR=3.040, 95% CI (1.507, 6.133); OR=3.438, 95% CI(1.822,6.489)]. Positive DCS and CRP were independent risk factors for CAC [ OR=3.504, 95% CI (1.414, 9.684); OR=3.885, 95% CI(1.364, 11.063)]. Conclusion:In MHD patients, positive DCS is related with high serum uric acid level and CRP. Positive DCS and CRP are independent risk factors for CAC.

Exploratory research on detection of influenza viruses by reverse transcriptase-recombinase polymerase amplification / 中华实验和临床病毒学杂志

Objective@#To establish and hevaluate a detection method for influenza virus using reverse transcriptase-recombinase polymerase amplification (RT-RPA).@*Methods@#RT-RPA was developed for detection of influenza viruses (type A and B) and subtyping of H1 and H3 using the primers targeted matrix and hemagglutinin (HA) genes of influenza A virus, and non-structural (NS) protein gene of influenza B virus. The specificity and sensitivity of RT-RPA were determined.@*Results@#The RT-RPA for the detection of influenza viruses showed specific amplification products of corresponding target gene, but no amplification products for other respiratory viruses, indicating that the method had good specificity. The detection limits of RT-RPA were 100 copies/μl. RT-RPA combined with SYBR Green I was used for the detection of influenza B virus with the detection limit of 100 copies/μl.@*Conclusions@#The feasibility of detecting influenza virus by RT-RPA was preliminarily confirmed.

Side effects and complications of yttrium-90 radioembolization therapy for hepatic malignancies. A series review of radioembolizat(i)on with 90Y microspheres(part V) / 介入放射学杂志

Radioembolization with yttrium-90(90Y) microspheres is an alternative treatment choice for hepatic malignancies and has become incorporated into guidelines by many international oncology and other professional organizations. The tumoricidal effects of radioembolization are predominantly derived from its radioactivity rather than ischemia. Therefore, the overall side effects that have been associated with this therapy, such as fatigue, nausea and vomiting, which are mild but common. Occasionally, severe complications may occur due to incidental embolization of non-target tissue by the microspheres. This review describes in detail the manifestation of side effects and various complications that may be associated with radioembolization using 90Y microspheres. Management and treatment options of these potential adverse events will also be discussed briefly.

Series review of radioembolization with yttrium-90 microspheres (Part Ⅳ): dose calculation of yttrium-90 microspheres / 介入放射学杂志

Accurate doses of yttrium-90 (90Y) microspheres are critical for the treatment of liver malignancies,because it is closely related to the clinical efficacy and adverse reactions.The dose calculationis primarily based on the type of ~Y delivery medium,whether it is glass microsphere (TheraSpheres) or resin microsphere (SIR-Spheres).The dose calculation of glass microspheres is based on the assumption that the expected radiation dose of the liver and the microspheres can be evenly distributed throughout the liver,while the dose calculation of resin microspheres is based on the assumption that the microspheres are not uniformly distributed throughout the liver,and the degree of this inhomogeneous distribution depends on the extent to which the normal liver is replaced by the tumor tissue.Many other factors may also potentially affect the therapeutic dose of 90Y microspheres.This review will introduce the calculation methods of 90Y microsphere dose,and describe the factors that need to be considered in order to achieve maximum efficacy and avoid adverse effects.

Robot-assisted partial nephrectomy for totally intrarenal tumors: a single surgeon's experience / 中华泌尿外科杂志

Objective To investigate the safety and efficiency of robot-assisted partial nephrectomy (RAPN) for totally intrarenal tumors (TITs).Methods Thirty-eight patients who underwent RAPN for treating TITs by one experienced surgeon were included between August 2012 and December 2017.There were 25 males and 13 females,aged 26-72 years(mean 51.6 years).Tumors of 24 cases were in right kidney,and 14 cases in left kidney.The diameter of tumor was(3.12 ± 0.92) cm,the R.E.N.A.L.score was(9.76 ± 1.00),and the Scr was (74.82 ± 20.32) μmol/L.Patients' peri-operative and oncological outcomes were analyzed.Results All the tumors were successfully resected without conversion to open surgery or radical nephrectomy.Mean operative time and ischemia time were (188.47 ± 46.75) min and (24.32 ± 7.69) min.Mean blood loss was (115.79 ± 43.66) rrd.One-week postoperative Scr was (85.97 ± 28.33) μmol/L.Postoperative hemorrhage was successfully treated by DSA or drug therapy in 3 patients.The pathological examination showed 28 clear cell renal cell carcinomas,3 chromophobe renal cell carcinomas,3 TFE-3 infusion related renal cell carcinomas,2 metanephric adenomas,1 acidophile adenoma and 2 angioleiomyolipomas.One positive surgical margin occurred in RAPN group for cystic components.No evidence of tumor progression observed during follow-up.Conclusions RAPN is safe and effective in treating TITs when performed by an experienced surgeon at a high-volume institution.Further prospective and large-scale study was warranted to evaluate the long-term outcomes.

Partial nephrectomy for T1b renal masses: comparison of laparoscopic and robot-assisted approach / 中华泌尿外科杂志

Objective To compare the operative-postoperative outcomes of laparoscopic and robotassisted partial nephrectomy (LPN and RAPN) for patients with T1 b renal masses.Methods A total of 169 T1 b renal mass patients receiving LPN (n =69) or RAPN (n =100) in our center between October 2009 and October 2017 were retrospectively collected.There were 46 males and 23 females in LPN group,with a mean age of (55.0 ± 11.9) years.The mean tumor size was (5.09 ± 0.76) cm,and mean R.E.N.A.L score was 6.36 ± 1.53.49 procedures (71％) were performed via a retroperitoneal approach in LPN group.There were 59 males and 41 females in RAPN group with a mean age of (52.9 ± 11.7) years.The mean tumor size was(4.95 ±0.66) cm,and mean R.E.N.A.L score was 8.17 ± 1.50.31 procedures (31％)were performed via a retroperitoneal approach in RAPN group.There was statistical significance between two groups in R.E.N.A.L score and surgery approach (P ＜ 0.001).The group covariates were balanced through propensity score matching (PSM) using 1∶ 1 nearest neighbor matching method.After PSM,operating time,estimated blood loss,warm ischemia time,incidence of complications,hospital stay and postoperative follow-up status were compared between LPN(n =36)and RAPN(n =36)group.Results After PSM,patient distributions were closely balanced.In the LPN vs the RAPN group,there were significant different in warm ischemia time [(23.9 ± 7.3) min vs.(20.4 ± 6.7) min,P ＜ 0.05],estimated blood loss [(136.9 ± 80.2) ml vs.(136.9 ± 80.2) ml,P ＜ 0.05],incidence of complications (8.7％ vs.1.0％,P ＜0.05),and hospital stay [(11.5 ±3.8)d vs.(9.8 ± 1.80)d].There was no significant differences resulted regarding operating time [(164.5 ± 64.4) min vs.(169.0 ± 42.5) min,P ＞ 0.05],variation of estimated glomerular filtration rate from baseline [(9.97 ± 8.98)％ vs.(9.27 ± 9.19)％,P ＞ 0.05],positive surgical margin rate (1.4％ vs.0,P ＞ 0.05) and rate of recurrence or metastasis (1.4％ vs.1.4％,P ＞ 0.05) between groups.Conclusion Considering operative,functional and oncologic outcomes,both RAPN and LPN performed by an experienced surgeon were acceptable for patients with T1b renal masses.If available,robotic approach may reduce operative trauma and complications.

Complete retroperitoneal robotic nephroureterectomy: a preliminary report / 中华泌尿外科杂志

Objective This study is to investigate the safety,feasibility and efficacy of the complete retroperitoneal robotic nephroureterectomy in treatment of upper urinary tract tumors.Methods Three patients underwent complete retroperitoneal robotic nephroureterectomy due to the upper urinary epithelial tumor from August to October in 2017 in our institution.The 3 patients' demographics and tumor characteristics,including age,gender,body mass index (kg/m2),ASA score,Charlson comorbidity index,tumor laterality and diameter (cm),were 48/75/68 years old,male/female/female,22.9/20.8/21.3,2/2/2,0/2/1,left/right/left,3.2/2.0/1.4,respectively.All patients had complained about the hematuria and accepted the abdominal CT and CTU examination,preoperatively.All patients were diagnosed localized upper urinary tract malignant tumors based on these images.The tumor of case 1 located in the renal pelvis.The tumor of case 2 located in the upper segment of the ureter.The tumor of case 3 located in the lower segment of the ureter.The operations were performed under general anesthesia,and patients were positioned in full flank.A total of five ports were used in the procedure and placed in the following order.The initial port (Port 1) was a robotic camera port,which was placed 3 cm above the intersection of the mid axillary line and the iliac crest.The next three ports (Port 2 to Port 4) were all 8 mm robotic instrument ports and placed at the intersection of posterior axillary line and costal margin,3 cm above the intersection of anterior axillary line and costal margin,and 4 cm medial and inferior to anterior superior iliac spine.The fifth port (Port 5) was a 12 mm assistant port and placed at 3 cm medial and superior to anterior superior iliac spine.Our completely robotic technique did not require patient repositioning and port reassignment,but redocking of the robotic arms was needed.Nephrectomy was performed according to the routine retroperitoneal laparoscopic procedure.Once the remainder of the kidney was mobilized,the dissection was directed down the pelvis to mobilize the distal segment of the ureter.The bladder defect was then closed by Endo-GIA stapler or absorbable sutures.Results All procedures were successful and smooth,with no intraoperative or postoperative complications.Operative duration (min) and estimated blood loss (ml) was 245/270/239,100/100/100,respectively.Postoperative pain measured by the visual analog pain scale(VASP) at day 1,day 2,day 3 was 5/4/4,4/3/3,2/2/1,respectively.Time off oral intake (d),duration of drainage (d),active time post-operation (h) and hospital stay (d) was 2/2/2,3/2/3,24/32/32,3/2/4,respectively.Intravesical chemotherapy was performed within 24 h after the operation.Postoperatively,the urinary catheter was left in place for 2 weeks.Pathological examination confirmed papillary urothelial carcinoma in all cases.Conclusions The initial experience shows that the complete retroperitoneal robotic nephroureterectomy is a safe,feasible and efficacious procedure,but in this early stage the clinical indications should be strictly controlled.

Protective effect of astaxanthin against cognitive impairment in offspring prenatally exposed to maternal epilepsy / 中华围产医学杂志

Objective To investigate the protective effect of prenatal astaxanthin treatment against cognitive impairment in adult offspring induced by exposure to maternal seizures in utero.Methods Female adult Sprague-Dawley rats were randomly divided into four groups:control group,astaxanthin group,kindling group and kindling+astaxanthin group.Each rat was implanted with electrodes.Those in the kindling and kindling+astaxanthin groups were kindled once a day by electrical stimulation of the amygdala.All rats were allowed to mate after one week's amygdala kindling.Rats in the kindling and kindling+astaxanthin groups continued to be treated with electrical stimulation every 48 hours from gestational day 1 to 20,and those in the astaxanthin and kindling+astaxanthin groups were injected intraperitoneally with 30 mg/(kg · d) of astaxanthin simultaneously.Naturally delivered offspring were raised till 12 weeks of age.Morris water maze test was performed to assess the cognitive function of adult offspring.Changes in the morphology of hippocampus were observed with Nissal's staining and transmission electron microscope.Expression of cyclic adenosine monophosphate response element binding protein (CREB) and brain-derived neurotrophic factor (BDNF) in adult offsprings' hippocampus tissues at protein and mRNA levels were determined using Western-blotting and reverse transcription-polymerase chain reaction.Analysis of variance and LSD test were used as statistical methods.Results Morris water maze test showed that from the 3rd day to the 5th day,the kindling group had significantly longer escape latency [(36.33 ±7.85),(28.80± 8.41),(29.50± 11.72) s] than the control [(28.90±7.46),(17.59±9.12),(10.40±3.69) s] and kindling+astaxanthin groups [(28.30±5.75),(18.37±3.39),(15.23±6.63) s] (F=3.601,9.811 and 14.226,all P＜0.05).In probe trials,the kindling group had significantly fewer platform crossings as compared with the control and kindling+astaxanthin groups [(4.40± 1.71) vs (7.20± 1.62) and (6.50±1.84) times,F=6.586,P=0.001].The kindling group spent dramatically less time in the target quadrant than the control and kindling+astaxanthin groups [(27.35±7.63) vs (58.29± 10.48) and (40.41 ± 7.06) s,F=25.825,P＜0.001].Nissl staining showed that hippocampal neurons of offspring in the control group were normal,but there was hippocampal damage in the kindling group and the damage was more severe than that in the kindling+astaxanthin group.Electron microscope observation showed that neurons and synapses in the hippocampal CA1 area of offspring in the control group were normal.However,obvious damage to neurons and synapses was induced in the kindling group and that was worse than the damage induced in the kindling+astaxanthin group.Expression of CREB and BDNF protein in the kindling group (0.19±0.06and 0.32 ±0.04,respectively) were significantly lower than those in the control (0.81 ±0.11 and 0.93 ± 0.04,respectively) and kindling+astaxanthin groups (0.60± 0.07 and 0.80±0.06,respectively) (F were 34.015and 71.074,both P＜0.001).Moreover,the kindling group showed decreased expression of CREB and BDNF mRNA (0.48 ± 0.11 and 0.43± 0.08,respectively) as compared with the control (1.02± 0.65 and 0.99± 0.09,respectively) and kindling+astaxanthin groups (0.89±0.15 and 0.96±0.13,respectively) (F were 13.447 and 21.912,both P＜0.01).Conclusion Treatment with astaxanthin could ameliorate the cognitive impairment and pathological damage in hippocampus of adult offspring induced by exposure to maternal seizures in utero through regulating the CREB-BDNF signal pathway.

Cerebral microbleeds and cognitive impairment in patients with chronic cerebral ischemia / 国际脑血管病杂志

Objective To investigate the correlation between cerebral microbleeds (CMBs ) and cognitive impairment in patients with chronic cerebral ischemia. Methods From January 2015 to January 2017, patients with chronic cerebral ischemia admitted to the Department of Neurology, the Second Hospital of Hebei Medical University were divided into CMBs positive group and CMBs negative group according to the findings of susceptibility weighted imaging. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to compare the cognitive function of both groups of patients and analyze the effects of different parts of CMBs on cognitive function. They were divided into cognitive impairment group and non-cognitive impairment group according to MoCA scores. Multivariate logistic regression analysis was used to determine the independent risk factors for cognitive impairment. Results A total of 96 patients were enrolled, aged 45-83 years, 32 were females (33. 3％) and 64 were males (66. 7％). There were 51 patients (53. 1％) in the CMBs positive group, and 45 (46. 9％) in the CMBs negative group, there were 33 patients (34. 4％) in the cognitive impairment group and 63 (65. 6％) in the non-cognitive impairment group. In the CMBs positive group, 10 patients had lobar CMBs, 29 had deep brain and infratentorial CMBs, and 12 had mixed CMBs. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1. 115, 95％ confidence interval [CI] 1. 030-1. 207; P = 0. 007), the number of CMBs (OR 1. 254, 95％ CI 1. 064-1. 479; P = 0. 007), Fazekas scale score (OR 2. 697, 95％ CI 1. 012-7. 185; P = 0. 047), and multiple lacunar infarction ( OR 7. 103, 95％ CI 1. 248- 40. 424; P = 0. 027 ) were the independent risk factors for cognitive impairment. Compared with the CMBs negative group, the rates of cognitive impairment and dementia in the CMBs positive group were higher. The total MoCA score, visual space and execution function, attention, and delayed recall scores were significantly lower (all P < 0. 05). Each cognitive domain score in the lobar CMBs group were significantly lower than that in the non-lobar CMBs group (all P < 0. 05). There was no significant difference in each cognitive domain score between deep and infratentorial CMBs group and that of the non-deep and infratentorial CMBs group (all P > 0. 05). The visual space and execution function, attention, and delayed recall in the mixed CMBs group were significantly lower than those in the non-mixed CMBs group (all P < 0. 05). Conclusion CMBs (especially lobar CMBs) may cause a decline in overall cognitive function, even dementia in patients with chronic cerebral ischemia, and they are most closely related to visual space and executive function, attention, and delayed recall.

Potassium 2-(1-hydroxypentyl)-benzoate improves depressive-like behaviors in rat model

Potassium 2-(1-hydroxypentyl)-benzoate (PHPB) is a novel drug candidate for acute ischemic stroke. PHPB has been also shown to be beneficial for some neurodegenerative diseases. In this study, we demonstrated that PHPB improved depressive-like behaviors induced by chronic unpredictable mild stress (CUMS) in rats. Male SD rats were subjected to the stress for five weeks. PHPB (30 and 100 mg/kg) or fluoxetine (FLX 10 mg/kg, as positive control) was administered orally from the third week in CUMS procedure. The behavioral tests were applied and then the biochemical studies were carried out. PHPB or FLX treatment rescued the behavioral deficiency in CUMS-exposed rats. Meanwhile, PHPB normalized the enhanced level of serum corticosterone, improved hippocampal and serum BDNF levels, as well as p-CREB level in hippocampus. In addition, PHPB could reverse the reduced level of extracellular 5-HT and its metabolite 5-HIAA in prefrontal cortex (PFC) of depressed rats. In summary, our results showed that PHPB improved depression-like behaviors in CUMS-exposed rats. The mechanisms might relate to the reverse of neurotrophic disturbance in the brain, reducing excessive HPA axis response and facilitating the release of 5-HT.

Pretherapeutic aassessment of the hepatic arterial vasculature for hepatic malignancy with yttrium-90 radioembolization.A series review of radioembolization with 90Y microspheres (part Ⅲ) / 介入放射学杂志

Potential complications arising from yttrium-90 (90Y) radioembolization are often related to inadvertent embolization of non-target vasculature during particle administration.Therefore,careful pretherapeutic planning with arterial mapping is especially important to help identify potential high-risk arteries and vascular communications.A complete pre-therapeutic evaluation of hepatic arterial vasculature includes selective arteriography,precautionary embolization of potential risk arteries and identification of occurrences of hepatopulmonary shunting secondary to tumor-related pathologic arteriovenous channels.The aim of this review is to discuss the pertinent arterial anatomy during 90Y radioembolization therapy and strategies on how to evaluate the risk and prevent the occurrence of non-target embolization through those vascular structures.

Series review of radioembolization with yttrium-90 microspheres (Part Ⅱ) : pre-treatment evaluation and post-treatment follow-up for patients with hepatic malignancy receiving yttrium-90 microspheres embolization / 介入放射学杂志

Yttrium-90 (90Y) radioembolization therapy can directly deliver a high dose of radiation to the tumor being targeted,which has been demonstrated to be effective in treating patients with hepatic malignancy.Compared with transarterial chemoembolization,90Yradioembolization is less frequently associated with toxicities such as abdominal pain,fever,nausea,and vomiting.However,the efficacy and safety of 90Y radioembolization therapy are largely reliant on careful preprocedural evaluation and diligent follow-up.This review discusses the details of essential preprocedural work-up and postprocedural follow-up for patients treated with 90Y radioembolization.

Investigation of enteral iron and energy intake of premature infants in neonatal intensive care unit / 中华实用儿科临床杂志

Objective To assess the enteral iron and energy intake of premature neonates during hospitalization in neonatal intensive care unit(NICU).Methods This retrospective study enrolled 208 premature neonates admitted in the NICU of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine within 48 hours after birth from January 2012 to December 2013.The following data were recorded for all infants:clinical basic information,the amount of formula iron intake in milk,enteral and parenteral nutrition intake as well as oral iron supplementation.Results The amount of enteral iron intake in the 1st,2nd,3rd,4th week after birth and at discharge was (0.2 ± 0.3) mg/(kg · d),(0.9 ±0.7) mg/(kg · d),(1.2 ±1.0) mg/(kg · d),(1.5 ± 1.1) mg/(kg · d),and (2.2 ± 1.1) mg/(kg · d),respectively,which accounted for 10％,45 ％,60％,75 ％ and 110％ of the recommended iron intake.The energy intake in the 1st,2nd,3rd,4th week after birth and at discharge was (13.2 ± 14.8) kcal/(kg · d) (1 kcal =4.184 kJ),(46.0 ± 32.6) kcal/(kg · d),(62.2 ± 38.1) kcal/(kg · d),(71.3 ± 38.2) kca]/(kg · d) and (105.3 ± 32.1) kcal/(kg · d),which accounted for 11.0％,38.3％,51.8％,59.4％ and 87.8％ of the recommended intake,respectively.Lower enteral iron and energy intake after birth occurred in the premature infants with lower birth weight,especially those with anemia who had significantly lower enteral iron intake than the normal neonates in the first 2 weeks after birth.Conclusions Enteral iron and energy intake among premature neonates were insufficient,especially during the first 2 weeks after birth.It is necessary to develop and implement more effective nutritional support to improve the nutritional status of premature infants.

Correlation of serum S100B protein with depressive episode of bipolar disorder and its prognosis / 上海交通大学学报（医学版）

Objective · To explore the correlation of serum S100B protein with depressive episode of bipolar disorder (BD) and its prognosis.Methods· Based on BD criteria of Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-Ⅳ),80 patients with depressive episode of BD (case group) and 42 healthy controls (control group) were enrolled.Patients were randomly assigned into quetiapine group who were treated with lithium and quetiapine and modified electroconvulsive therapy (MECT) group who received lithium and MECT.The serum S100B level and Hamilton Rating Scale for Depression (HAMD) were assayed before and after 4-week treatment.Results· The serum S100B levels before treatment in patients with depressive episode of BD were significantly higher than those in healthy controls (P=0.000).The levels of S100B in both drug and MECT groups decreased after 4-week treatment.The HAMD score after treatment significantly decreased than that before treatment (P=0.000).Pearson correlation analysis showed that the change of S 100B level was positively correlated with the change of HAMD score before and after treatment in case group (r=0.33,P=0.013).Conclusion· S100B may be associated with depressive episode of BD and its prognosis.

Characteristics of yttrium-90 microsphere, techniques and radiation safety of radioembolization procedure.A series review of radioembolization with yttrium-90 microspheres (part Ⅰ) / 介入放射学杂志

Radioembolization with yttrium-90 (90Y) microspheres is a locoregional procedure during which either resin or glass microspheres loaded with β-emitting 90Y are selectively injected into a hepatic artery.The microspheres are trapped in downstream vasculatures,at which point they deliver a cytotoxic dose of radiation to the target tumor.The safety and efficacy of this method have been demonstrated in studies of survival outcomes in patients with nonresectable hepatic malignancies.In this first part of a series of reviews on radioembolization with 90Y microspheres,we cover the basic characteristics of 90Y and 90Y microspheres,techniques for the radioembolization procedure,and methods for ensuring radiation safety and protection.