Intelligent diagnostic model of keratoconus based on deep learning algorithm / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To establish an intelligent diagnostic model of keratoconus for small-diameter corneas by data mining and analysis of patients' clinical data.METHODS: Diagnostic study. A total of 830 patients(830 eyes)were collected, including 338 male(338 eyes)and 492 female(492 eyes), with an average age of 14-36(23.19±5.71)years. Among them, 731 patients(731 eyes)had undergone corneal refractive surgery at Chongqing Nanping Aier Eye Hospital from January 2020 to March 2022, and 99 patients had a diagnosed keratoconus from January 2015 to March 2022. Corneal diameter ≤11.1 mm was measured by Pentacam in all patients. Two cornea specialists classified patients' data into normal corneas, suspect keratoconus, and keratoconus groups based on the Belin/Ambrósio enhanced ectasia display(BAD)system in Pentacam. The data of 665 patients were randomly selected as the training set and the other 165 patients as the validation set by computer random sampling method. Seven parametric corneal features were extracted by convolutional neural networks(CNN), and the models were built by Residual Network(ResNet), Vision Transformer(ViT), and CNN+Transformer, respectively. The diagnostic accuracy of models was verified by cross-entropy loss and cross-validation method. In addition, sensitivity and specificity were evaluated using receiver operating characteristic curve.RESULTS: The accuracy of ResNet, ViT, and CNN+Transfermer for the diagnosis of normal cornea and suspect keratoconus was 85.57%, 86.11%, and 86.54% respectively, and the area under the receiver operating characteristic curve(AUC)was 0.823, 0.830 and 0.842 respectively. The accuracy of models for the diagnosis of suspect keratoconus and keratoconus was 97.22%, 95.83%, and 98.61%, respectively, and the AUC was 0.951, 0.939, and 0.988 respectively.CONCLUSION: For corneas ≤11.1 mm in diameter, the data model established by CNN+Transformer has a high accuracy rate for classifying keratoconus, which provides real and effective guidance for early screening.

Correlations between alterations of T-helper 17 cells and treatment efficacy after concurrent radiochemotherapy in locally advanced cervical cancer (stage IIB-IIIB): a 3-year prospective study / 中华医学杂志(英文版)

BACKGROUND@#Recently, T-helper 17 (Th17) cells have been proved to play an important role in promoting cervical cancer. But, till now, few study has been carried out to understand the involvement of these cells in efficacy of anti-tumor treatments. This study aimed to investigate the alterations in the percentage of circulating Th17 cells and related cytokines in locally advanced cervical cancer (LACC) patients before and after concurrent chemoradiotherapy (cCRT) and to analyze the correlations between the alterations in Th17 cells and treatment efficacy.@*METHODS@#A prospective study with 49 LACC (International federation of gynecology and obstetrics [FIGO] stage IIB-IIIB) patients and 23 controls was conducted. Patients received the same cCRT schedule and were followed up for 3 years. Circulating Th17 cells (CD3+CD8- interleukin [IL]-17+ T cells) and related cytokines IL-17, transforming growth factor-β (TGF-β), IL-10, IL-23, IL-6, and IL-22 were detected before and after cCRT. Correlations between alterations of circulating Th17 cells and treatment efficacy were analyzed. Kaplan-Meier analysis was used for overall survival (OS) and progression-free survival (PFS).@*RESULTS@#We found that 40 patients finished the entire cCRT schedule and met the endpoint of this study. The percentage of circulating Th17 cells in the LACC patients was higher than that in the controls, and it significantly decreased after cCRT (P < 0.05). After cCRT, patients were divided into two groups based on the average of the Th17 cells declined. The subgroup of patients with a prominent decrease in circulating Th17 cells after cCRT had a higher treatment efficacy and longer PFS and OS times. Compared with the control patients, LACC patients had higher IL-6, IL-10, IL-22, TGF-β levels and a lower IL-23 level (P < 0.05). After cCRT, IL-6, IL-10, IL-17, IL-23 level significantly increased and TGF-β level significantly decreased compared with the levels before cCRT (P < 0.05).@*CONCLUSION@#Circulating Th17 cells in the LACC patients (FIGO stage IIB-IIIB) were higher than those in the controls, but they generally decreased after cCRT. A more pronounced decrease in circulating Th17 cells after cCRT was correlated with better therapeutic effect and longer PFS and OS times.

The mechanism by which Peganum harmala L. inhibits high glucose-induced tube formation in endothelial cells / 药学学报

The study investigates the mechanism by which Peganum harmala L. (Luotuopeng, LTP) inhibits tube formation in retinal vascular endothelial cells. Tube formation was induced by treatment of retinal vascular endothelial cells with glucose. The cells were divided into a normal group, model group, and an LTP group. The total length of tube formation was measured. The active components, targets, and pathway by which LTP acts in the treatment of diabetic retinopathy was explored by network pharmacology. The mRNA expression levels of targets [extracellular signal-regulated kinase 2 (ERK2), phosphoinositide 3 kinase catalytic alpha polypeptide (PIK3CA), serine/threonine-protein kinase 1 (AKT1)] related to the mitogen-activated protein kinase (MAPK) signaling pathway and vascular endothelial growth factor (VEGF) signaling pathway was measured by real-time PCR. The results of tube formation indicated that compared with the normal group, the total tube length increased in the model group (P < 0.01); after the treatment with LTP, the total tube length decreased compared with the model group (P < 0.01). Network pharmacology revealed that the targets of LTP included PIK3CA, AKT1, and ERK2, and the pathways involved the MAPK signaling pathway and the VEGF signaling pathway. Real-time PCR indicated that compared with the normal group, the mRNA expression levels of ERK2, PIK3CA and AKT1 were elevated in the model group (P < 0.05); after treatment with LTP, the mRNA expression levels of ERK2, PIK3CA and AKT1 decreased compared with the model group (P < 0.05). LTP may inhibit retinal vascular endothelial cell tube formation by regulating the MAPK signaling pathway and the VEGF signaling pathway. This study confirms the multi-targets and multi-pathways of LTP and provides a basis for its use in the treatment of diabetic retinopathy．

The 479th case: cognitive impairment, respiratory failure, colon mass / 中华内科杂志

A 78-year-old man was admitted to Peking Union Medical College Hospital with fever, weakness of lower extremities, less speech, loss of memory. Fever was relieved after antibiotic treatment, while cognitive impairment and disorder of consciousness progressed rapidly, followed by critical pulmonary infections, respiratory failure, and septic shock. Lab tests showed negative occult blood, normal serum CEA level and positive Anti-nuclear-antibody. PET-CT suggested that strong FDG uptake signals were seen at sigmoid, while bilateral frontal lobe, temporal lobe, parietal lobe, posterior cingulate gyrus showed lower metabolic activity. Colonoscopy biopsy revealed differentiated adenocarcinoma of sigmoid colon. Therefore, paraneoplastic syndrome of nervous system secondary to colon cancer was considered. Rapid and proper diagnosis and treatment were completed by multidisciplinary team including departments of neurology, gastroenterology, general surgery, ICU, rheumatology, clinical nutrition. The laparoscopic sigmoid colectomy was performed under general anesthesia. The patient finally presented with significant improvement of cognition and consciousness. Respiratory function was totally recovered.

Development of tilted implant for free end of maxillary posterior teeth / 华西口腔医学杂志

Vertical bone insufficiency in the maxillary posterior teeth is a common clinical situation. At present, the bone insufficiency in the maxillary posterior teeth is mainly overcome by bone grafting through maxillary sinus floor elevation. Compared with traditional axial implantation, tilted implantation can better avoid bone grafting, reduce complications, shorten the treatment cycle, reduce the treatment cost for patients, and gradually be promoted in clinical settings. This article reviews the concept, biomechanics, clinical evaluation, and digital trend of tilted implants of maxillary posterior teeth.

Comparative study of 3D printing implant guide in different implant surgeries in anterior tooth defect area / 华西口腔医学杂志

OBJECTIVE@#To study the accuracy of 3D printing implant-guided anterior tooth implantation under flap or flapless surgery.@*METHODS@#Twenty-one cases (32 teeth) with missing teeth were divided into two groups: tooth implantation on the maxillary models under flap surgery (FP group) and tooth implantation on the maxillary models under flapless surgery (FPS group). A dental implant guide was designed and used in the two groups. The actual position of the dental implants in the two groups was compared with the preplanned deviation values of implant top, bottom, vertical distance, and angle deviation. SPSS 19.0 software was used for statistical analysis.@*RESULTS@#The deviation values of implant top, bottom, vertical distance, and angle were significantly lower in the FP group than in the FPS group (P<0.05).@*CONCLUSIONS@#High accuracy of tooth implantation can be realized by using the 3D printing implant guide. The different surgical methods influence the precision of tooth implantation. Clinicians can choose the surgery reasonably depending on the actual situation.

Network Pharmacology of Polygalae Radix and Gastrodiae Rhizoma in Treating Epilepsy / 中国实验方剂学杂志

Objective:To construct a "drug-target-pathway" network of Polygalae Radix and Gastrodiae Rhizoma in treating epilepsy, in order to explore the "multi-component, multi-target, multi-pathway" mechanism of the two kinds of traditional Chinese medicines. Method:According to the reverse pharmacophore matching method, potential targets of Polygalae Radix and Gastrodiae Rhizoma were predicted. Biological information annotation databases were used to analyze the molecular function and biological process of the action targets. Cytoscape 3.2.1 software was used to construct the "ingredient-core, target-pathway" network of Polygalae Radix and Gastrodiae Rhizoma for the treatment of epilepsy. Result:The 14 major constituents from Polygalae Radix exhibited interactions with 105 potential targets, and the 12 compounds from Gastrodiae Rhizoma showed interactions with 109 potential targets, involving several cancer signaling pathways, neuroactive ligand-receptor interaction and mitogen-activated protein kinase(MAPK) biological process played roles in the treatment of epilepsy. Conclusion:According to the screening for the potential targets relating to epilepsy and the evidences obtaining from docking study, we demonstrated that constituents from Polygalae Radix and Gastrodiae Rhizoma could play an anticonvulsant role by mediating the levels of monoamine substances. The conclusion is close to literatures published online to a certain degree, suggesting the accuracy of the study on the effect of Polygalae Radix and Gastrodiae Rhizoma in treating epilepsy according to the network pharmacology.

The Effect and Its Factors of Autonomy Learning and Its Influencing Factors on the Postgraduates for Professional Degree Education / 昆明医科大学学报

Objective To evaluate the effect and its factors of the postgraduates’ autonomy learning in medical English, and to suggest improving methods. Methods The postgraduates enrolled in Kunming Medical University in 2016 were divided into two groups. Those for professional degree education learnt Medical English by the approach of autonomy learning, while those for academic degree education were taught in traditional method. At the end of the semester,an examination was applied to measure and compare the learning effects in both groups, and questionnaires were conducted to investigate their attitudes and satisfaction. The results were evaluated by quantitative analysis and qualitative analysis.Results The postgraduates for professional degree education got lower examination scores than the postgraduates for academic degree education. Time management appeared to be the main problem. Conclusion Although the postgraduates highly regard the necessity of medical English learning and have great sense of learning responsibility, process supervision from the administration is suggested to assist their time management so that better learning effects can be achieved.

Comparison of Placebo Effect between Asian and Caucasian Type 2 Diabetic Patients: A Meta-Analysis / 中华医学杂志(英文版)

<p><b>Background</b>Placebo was defined as any therapy that is used for its nonspecific psychological and physiologic effect but has no specific pharmacologic impact on the condition being treated. Besides medication therapies, studies have found that the optimal dietary approach as well as physical activity and education are useful to control hyperglycemia in patients with type 2 diabetes (T2DM). The aim of this study was to evaluate the placebo effects of antidiabetic therapies in Asian and Caucasian T2DM patients and make a comparison between the two ethnicities.</p><p><b>Methods</b>A search using the MEDLINE database, EMBASE, and Cochrane Database was performed, from when recording began until December 2016. The main concepts searched in English were sulfonylurea (SU); alpha glucosidase inhibitors (AGI); metformin (MET); thiazolidinediones (TZD); dipeptidyl peptidase-4 inhibitors (DPP-4i); sodium-glucose cotransporter 2 inhibitors (SGLT2i); glucagon-like peptide-1 receptor agonist (GLP-1RA); type 2 diabetes (T2DM); placebo controlled; and randomized controlled trials. Using the Cochrane instrument, we evaluated the adequacy of randomization, allocation concealment procedures, and blinding.</p><p><b>Results</b>This study included 63 studies with a total of 7096 Asian patients involved and 262 studies with a total of 27,477 Caucasian patients involved. In Caucasian population, the use of placebo led to significant reductions of glycosylated hemoglobin (HbA1c), -0.683% (P = 0.008) in SU monotherapy treatment, -0.193% (P = 0.001) in DPP-4i treatment, and -0.230% (P < 0.001) in SGLT2i treatment, respectively. In Asian population, the use of placebo resulted in significant decreases of HbA1c, -0.162% (P = 0.012) in DPP-4i treatment and -0.269% (P = 0.028) in GLP-1RA add-on therapy, respectively. The placebo also significantly reduced body weight. In Caucasian population, placebo use resulted in 0.833 kg (P = 0.006) weight loss by SU treatment and 0.953 kg (P = 0.006) weight loss by GLP-1RA treatment. In Asian population, the placebo led to a weight change of 0.612 kg (P < 0.001) by GLP-1RA analog treatment. The changes of HbA1c and weight due to the placebo effect in other treatments were not significant in both Asian and Caucasian population. Comparisons of the placebo effect on HbA1c change and weight change in each treatment group indicated that no significant difference was found between Asian and Caucasian population.</p><p><b>Conclusions</b>The overall differences of the placebo effect on HbA1c changes as well as on body weight changes were not significant between Asian and Caucasian T2DM patients. The placebo effect on HbA1c changes and weight changes was not associated with baseline age, gender, baseline body mass index, baseline HbA1c, duration of diabetes, or study duration.</p>

Chemical constituents, biological activities and quality control of plants from genus Pyrola / 中国中药杂志

Plants from the genus Pyrola are widely distributed in North Temperate zone. The quinones, phenol glycosides, terpenoids, flavonoids and volatile oil compounds have been identified from these plants. The in vivo and in vitro studies have shown that the genus Pyrola plants exhibit a wide range of pharmacological properties, including antioxidant, antitumor, antibacterial, anti-ischemia and anti-inflammatory activities. Based on analysis of the literature of the genus Pyrola plant, this review summarized the research on chemical constituents, pharmacology and quality control in recent years which can provide evidences for further investigation on the genus Pyrola plants.

Early changes of procalcitonin predict bacteremia in patients with intensive care unit-acquired new fever / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Rapid detection of bacteremia is important for critically ill patients. Procalcitonin (PCT) has emerged as a marker of sepsis, but its characterization for predicting bacteremia is still unclear. This study aimed to investigate the role of change of PCT within 6 to 12 hours after new fever in predicting bacteremia.</p><p><b>METHODS</b>An observational study was conducted in the ICU of our hospital from January 2009 to March 2010. Adult patients with new fever were included and grouped as bacteremia and non bacteremia group. Serum PCT concentration was measured at admission and within 6 to 12 hours after new fever (designated PCT0 and PCT1). Other results of laboratory tests and therapeutic interventions were recorded. Multivariate Logistic regression analysis was used to identify the risk factors of bacteremia. The area under the ROC curve (AUC) was constructed to evaluate the discriminative power of variables to predict bacteremia.</p><p><b>RESULTS</b>Totally 106 patients were enrolled, 60 of whom had bacteremia and 46 did not have bacteremia,. The acute physiology and chronic health evaluation II (APACHE II) and sequential organ failure assessment (SOFA) scores were 13.1 ± 7.8 and 5.0 ± 2.2 at admission, respectively. There was no significant difference in PCT0 between the bacteremia group and nonbacteremia group; 1.27 µg/L (range, 0.10 - 33.3) vs. 0.98 µg/L (range, 0.08 - 25.7), (P = 0.157). However, the PCT1 and the rate of change of PCT were significantly higher in bacteremia group; PCT1 was 6.73 µg/L (1.13 - 120.10) vs. 1.17 µg/L (0.10 - 12.10) (P = 0.001), and the rate of change was 5.62 times (1.05 - 120.6) vs. 0.07 times (-0.03 - 0.18) (P < 0.001). The area under the ROC curve (AUC; 95% confidence interval) of the rate of change of PCT was better for predicting bacteremia than that of PCT1; 0.864 (range, 0.801 - 0.927) vs. 0.715 (range, 0.628 - 0.801), (P < 0.05). The AUCs of PCT0 and other parameters (such as WBC count, granulocyte percentage and temperature) were not significantly different (all P > 0.05). The best cut-off value for the rate of change was 3.54 times, with a sensitivity of 88.5% and a specificity of 98.0%. It was also an independent predictor of bacteremia (odds ratio 29.7, P < 0.0001) and wasn't correlated with the presence or absence of co-infection, neutropenia or immunodeficiency (P > 0.05).</p><p><b>CONCLUSION</b>The rate of change of PCT is useful for early detection of bacteremia during new fever and superior to the PCT absolute value and other parameters in non-selected ICU patients.</p>

The role of change of procalcitonin in the therapeutic effect evaluation of severe bacterial pneumonia / 中华检验医学杂志

Objective The aim of this study is to define if early change ofprocalcitonin (PCT) may inform about the efficacy evaluation of severe bacterial pneumonia.Methods A prospective,single-center,observational study was conducted in patients with severe bacterial pneumonia admitted to ICU in 2010 years.PCT samples were collected in baseline,72 hours,7 days and the ending in the duration of therapy.The efficacy evaluation was assessed at the end of treatment 5 days after and divided into the efficacy group and nonefficacy group according to the guiding principle of clinical research on antibacterial drugs by the Ministry of Health.Sixty-five patients with a mean age of (62.1 ± 15.9) years were evaluated.Five patients were severe community acquired pneumonia,32 patients nosocomial pneumonia and 28 patients ventilator associated pneumonia.The clinical pulmonary infection score(CPIS) was 7.9 ± 1.8 ;APACHE Ⅱ score was 14.5 ±5.3.There were 44 patients as the efficacy group and 21 patients as the nonefficacy group.SPSS13.0 was used to analyse the results.Results The PCT levels between efficacy group and nonefficacy group were (3.83 ±2.18)vs(4.23 ±2.64) μg,/L (t =1.249,P =0.387),(2.44 ± 1.05)vs(3.48 ± 1.75) μg/L(t=-1.959,P=0.045),(1.15 ±0.87) vs (3.41 ±1.58) μg/L (t=-2.904,P=0.006),and (0.51 ±0.17) vs (2.63 ±1.08) μg/L (t=-3.772,P =0.000) in baseline,72 hours,7 days and the ending in the duration of therapy.The change of PCT within the first 72 hours were (32.5 ± 12.4)％ vs (14.5 ± 7.1) ％.The area under receiver operating characteristics curve (AUC) of prediction clinical efficacy of the change of PCT within the first 72 hours was 0.823 (P =0.002),the AUC of white blood cell,the neuter granulocyte percentage,body temperature and PCT level within 72 hours were 0.575,0.543,0.521,0.597,respectively (P ＞ 0.05).In multivariate analyses,the change of PCT ＜ 30.8％ (odds ratio,15.2,95％ confidence interval,3.3-21.7,P =0.01) was independent risk factors of effect predictor.The changes of PCT within the first 72 hours (＞30.8％) combined with CPIS(＜6) were the best performance to predict clinical efficacy with a AUC of 0.910,sensitivity of 85.2％ and specificity of 92.5％.Conclusions The change of PCT within the first 72 hours can be used early to evaluate the effect in bacterial pneumonia.Especially,combined with CPIS can further improve the prediction value.

The value of procalcitonin for diagnosing infection in critically ill patients receiving long-term immunosuppressive therapy / 中华内科杂志

Objective To assess the value of procalcitonin(PCT)measurement to differentiate infection from non-infection in critically ill patients requiring long-term immunosuppressive therapy.Methods A prospective study was conducted in patients with underlying diseases requiring corticosteroids or chemotherapy in ICU from January 2008 to December 2009.Patients were divided into the infection group and the non-infection group and their PCT levels were compared.Results A total of 103 patients (65 women)were enrolled in this prospective study[aged(47.9 ± 21.9)years old]with 84 in the infection group and 19 in the non-infection group.The baseline level of PCT was significantly higher in infection than in non-infection patients[2.58(0.08-44.65)pg/L vs 0.62(0.15-6.00)pg/L,P =0.002].Different levels of PCT were manifested in different pathogen groups with 3.41(0.45-44.65)pg/L in bacteria infection,0.99(0.28-6.67)pg/L in fungus infection,0.11(0.08-0.20)pg/L in virus infection group(P =0.018).The AUCROC of PCT was 0.867 for diagnostic bacterial infection.By multivariate analysis,the factors associated with the level of PCT were bacteria infection(OR 5.1,P =0.031)and septic shock(OR 7.5,P =0.027),while the factors not associated with the level of PCT were age,renal function,infection site and prognosis(P ＞ 0.05).Conclusions The level of PCT is increased in the critically ill patients requiring immunosuppressive therapy with infection and it can be used for diagnosis for bacterial infection.

Expression of RAS protein in glioma and its effect on the growth of human glioma cells / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To study the expression of RAS protein in human glioma tissues and its influence on tumor growth.</p><p><b>METHODS</b>RAS protein expression in glioma tissues was determined by immunohistochemical (IHC) staining. Subsequently, MTT cell proliferation assay, flow cytometry and Western blotting were used to assay U251 cells with reduced RAS expression.</p><p><b>RESULTS</b>The expression of RAS in glioma was increased and strongly correlated with pathological grade. Downregulation of RAS resulted in glioma cells growth suppression and increased apoptosis.</p><p><b>CONCLUSION</b>The expression level of RAS protein in human glioma was increased. Downregulation of RAS can inhibit glioblastoma cell growth through the RAS signal pathway.</p>

Honokiol: a promising small molecular weight natural agent for the growth inhibition of oral squamous cell carcinoma cells / 国际口腔科学杂志·英文版

Honokiol (HNK) is a small organic molecule purified from magnolia species and has demonstrated anticancer activities in a variety of cancer cell lines; however, its effect on oral squamous cell carcinoma (OSCC) cells is unknown. We investigated the antitumor activities of HNK on OSCC cells in vitro for the first time. The inhibitory effects of HNK on the growth and proliferation of OSCC cells were demonstrated via in vitro 3-(4,5-dimethyl thiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and propidium iodide (PI) assays, and the apoptotic cells were investigated by the observation of morphological changes and detection of DNA fragmentation via PI, TdT-mediated dUTP-biotin nick end labeling (TUNEL), and DNA ladder assays, as well as flow cytometry assay. The results showed that HNK inhibited the growth and proliferation of OSCC cells in vitro in a time and dose-dependent manner. The inhibitory effect was associated with the cell apoptosis induced by HNK, evidenced by the morphological features of apoptotic cells, TUNEL-positive cells and a degradation of chromosomal DNA into small internucleosomal fragments. The study also demonstrated here that the inhibition or apoptosis mediated by 15 microg x mL(-1) or 20 microg x mL(-1) of HNK were more stronger compared with those of 20 microg x mL(-1) 5-fluorouracil (5-Fu, the control) applied to OSCC cells, when the ratio of OSCC cell numbers were measured between the treatment of different concentrations of HNK to the 5-Fu treatment for 48 h. HNK is a promising compound that can be potentially used as a novel treatment agent for human OSCC.

MicroRNA-7 regulates glioblastoma cell invasion via targeting focal adhesion kinase expression / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Invasion growth is the most characteristic biological phenotype of glioblastoma, but the molecular mechanism in glioma cell invasion is poorly understood. Recent data have showed that microRNA plays an essential role in tumor invasion. Our study aimed to explore the mechanism of miR-7 involved in the control of glioblastoma cell invasion.</p><p><b>METHODS</b>Glioma cell invasion was evaluated by transwell and scratch assays after up-regulation of miR-7 using miR-7 mimics in U87 and U251 cells. Luciferase reporter assay was used to determine focal adhesion kinase (FAK) as a target of miR-7. The levels of miR-7, matrix metalloproteinases (MMP)-2 and MMP-9 mRNA were detected by PCR assay, and the levels of FAK, MMP-2, MMP-9, total and phosphorylation serine/threonine kinase (AKT), and extracellular signal-regulated kinase (ERK) 1/2 were measured by Western blotting analysis.</p><p><b>RESULTS</b>Over-expression of miR-7 inhibited the invasion and migration activity of U87 and U251 cells. And up-regulation of miR-7 reduced FAK protein expression, Further, luciferase reporter assay showed that miR-7 modulated FAK expression directly by binding 3'UTR of FAK mRNA. In addition, miR-7 repressed p-ERK1/2 and p-AKT level, MMP-2 and MMP-9 expression. Finally, the inverse relationship between FAK and miR-7 expression was certificated in human glioma tissues.</p><p><b>CONCLUSION</b>To our knowledge, these data indicate for the first time that miR-7 directly regulates cell invasion by targeting FAK in glioblastoma and that miR-7 could be a potential therapeutic target for glioblastoma intervention.</p>

Stroke volume variation in the evaluation of fluid responsiveness in refractory septic shock / 中华内科杂志

Objective To evaluate fluid responsiveness by stroke volume variation (SVV) in mechanically ventilated patients with refractory septic shock.Methods Forty-two refractory septic shock patients were enrolled in the study.According to the responsiveness of fluid loading, the patients were divided into responsive group and non-responsive group.The SVV values of two groups were retrospectively analyzed.The receiver operating characteristic curve was drafted to determine the cut-off value of SVV for predicting fluid responsiveness.Results Among the 42 refractory septic shock patients, 24 were found responsive to fluid loading, 18 were not;before the fluid loading, central venous pressure, heart rate, mean arterial pressure and global end-diastolic volume index in the both groups showed no significant differences whereas the SVV in the responsive group was much higher than that in the nonresponsive group (P =0.006).Using SVV ≥ 12% as the threshold to predict fluid responsiveness, the sensitivity was 77%,specificity was 85%.Conclusion SVV can accurately predict fluid responsiveness in refractory septic shock patients.

Clinical study on the treatment of knee osteoarthritis of Shen-Sui insufficiency syndrome type by electroacupuncture / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the clinical effificacy of electroacupuncture (EA) on treating knee osteoarthritis (KOA) of Shen ()-Sui () insuffificiency (SSI) syndrome type.</p><p><b>METHODS</b>A total of 245 patients (279 knees) of KOA-SSI were randomly assigned to two groups by lottery: 141 knees in the treatment group and 138 knees in the control group. The treatment group was managed with EA at the dominant points of Neixiyan (Ex-LE4) and Waixiyan (Ex-LE5) as well as the conjugate points of Xuanzhong (GB39) and Taixi (KI3) for 30 min, once a day, with 15 days as one course; 2 courses were applied with a 5-day interval in between. The control group was treated with intra-articular injection of 2 mL hyaluronic acid into the affected joint every 7 days for 5 times in total. The clinical effects on the patients in different stages were observed, and their symptom scores of knee and contents of cytokines, including interleukin-1 (IL-1), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), prostaglandin E(2alpha) (PGE(2alpha)) and matrix metalloproteinases-3 (MMP-3), in the knee joint fluid were measured before and after treatment.</p><p><b>RESULTS</b>The study was completed in 235 patients (263 knees); four patients (7 knees) in the treatment group and six patients (9 knees) in the control group dropped out. Comparison of therapeutic effects (excellent and effective rates) between the two groups showed insignificant differences (P>0.05). Symptom scores of knee and contents of cytokines in the knee flfluid after treatment were lowered signifificantly in the patients of stage I-III in both groups (P<0.05 or P<0.01). However, the lowering of the total symptom score of knee in the patients of stage III in the treatment group was more signifificant (P<0.05).</p><p><b>CONCLUSIONS</b>EA could effectively alleviate the clinical symptoms in KOA patients of stage III, showing an effect superior to that of hyaluronic acid. EA also shows action in suppressing the secretion of IL-1, IL-6, TNF-alpha, PGE(2alpha) and MMP-3 in the knee flfluid.</p>

The role of galactomannan detection in the diagnosis of invasive pulmonary aspergillosis in critically ill patients / 中华内科杂志

Objective To evaluate the usefulness of serum galactemannan(GM) for the diagnosis of invasive pulmonary aspergillosis (IPA) in critically ill patients. Methods Study was conducted between February 2007 and July 2008. Included patients on admission ICU who suffer from suspected IPA. GM test and culture were collected 2 weekly. Chnical feature, mycological evidence and optical density index (ODI) were noted. Clinically invasive fungal infection(IFI) were defined proven, probable and possible. The patients were classified into neutropenia, non-neutropenia and treated with immunosuppressive agents, non-neutropenia and non-immunosuppressive agents. To compared of the sensitivity and specificity of GM in different patients. Results 94 patients were included, 4 patients were proven, 29 patients were probable, 34 patients were possible IFI, 27 patients were non-IPA. The positive rate of the GM was 31.9% (30/94). The sensitivity and specificity of GM in proven cases and probable cases are 66.7% and 92.6%. GM assay tended to become positive earlier than the culture 2-10(5.33±2.17)d. We found that differences in patient diagnosis and selection might account for the disparities seen for positive rate for the GM test. There was positive in three of the four patients with proven, the positive rate of GM was 65.5% for probable cases, for possible cases was 17.6%, for non-IPA cases was 7.4% (P=0.001). For patient with neutropenia , treated with immunosuppressive agents and without immunosuppressive agents, the positive rate of GM was 52.9%vs 41.7% vs 34. 6% (P=0.015) ;the sensitivity was 80.0% vs 70. 0% vs 53.8% (P=0.011), the ODI was 1.365 (0.582-6.736) vs 1. 123 (0. 623-6.868) vs 0.554 (0.522-0.823), P=0. 005, respectively. Conclusion These results show that GM test is useful for early diagnosis IPA in critically ill patients. Differences in patient selection and diagnosis might account for the disparities seen for positive rate and sensitivity for the GM test. It has been higher sensitivity and ODI in the patient treated by immunosuppressive agents.

DAPT enhances the apoptosis of human tongue carcinoma cells / 国际口腔科学杂志·英文版

<p><b>AIM</b>To investigate the effect of DAPT (gamma-secretase inhibitor) on the growth of human tongue carcinoma cells and to determine the molecular mechanism to enable the potential application of DAPT to the treatment of tongue carcinoma.</p><p><b>METHODOLOGY</b>Human tongue carcinoma Tca8113 cells were cultured with DAPT. Cell growth was determined using Indigotic Reduction method. The cell cycle and apoptosis were analyzed by flow cytometry. Real-time PCR and Immuno-Fluorescence (IF) were employed to determine the intracellular expression levels.</p><p><b>RESULTS</b>DAPT inhibited the growth of human tongue carcinoma Tca8113 cells by inducing G0-G1 cell cycle arrest and apoptosis. The mRNA levels of Hairy/Enhancer of Split-1 (Hes-1), a target of Notch activation, were reduced by DAPT in a dose-dependent manner. Coincident with this observation, DAPT induced a dose-dependent promotion of constitutive Caspase-3 in Tca8113 cells.</p><p><b>CONCLUSION</b>DAPT may have a therapeutic value for human tongue carcinoma. Moreover, the effects of DAPT in tumor inhibition may arise partly via the modulation of Notch-1 and Caspase-3.</p>