The beginnings and evolution of a pancreatic surgeon: a technical morphological analysis in first 5 years / 中华外科杂志

Objective: To explore the development of the pancreatic surgeon technique in a high-volume center. Methods: A total of 284 cases receiving pancreatic surgery by a single surgeon from June 2015 to December 2020 were retrospectively included in this study. The clinical characteristics and perioperative medical history were extracted from the medical record system of Zhongshan Hospital,Fudan University. Among these patients,there were 140 males and 144 females with an age (M (IQR)) of 61.0 (16.8) years(range: 15 to 85 years). The "back-to-back" pancreatic- jejunal anastomosis procedure was used to anastomose the end of the pancreas stump and the jejunal wall. Thirty days after discharge,the patients were followed by outpatient follow-up or telephone interviews. The difference between categorical variables was analyzed by the Chi-square test or the CMH chi-square test. The statistical differences for the quantitative data were analyzed using one-way analysis of variance or Kruskal-Wallis H test and further analyzed using the LSD test or the Nemenyi test,respectively. Results: Intraoperative blood loss in pancreaticoduodenectomy between 2015 and 2020 were 300,100(100),100(100),100(0),100(200) and 150 (200) ml,respectively. Intraoperative blood loss in distal pancreatectomy was 250 (375),100 (50),50 (65), 50 (80),50 (50),and 50 (100) ml,respectively. Intraoperative blood loss did not show statistical differences in the same operative procedure between each year. The operative time for pancreaticoduodenectomy was respectively 4.5,5.0(2.0),5.5(0.8),5.0(1.3),5.0(3.3) and 5.0(1.0) hours in each year from 2015 to 2020,no statistical differences were found between each group. The operating time of the distal pancreatectomy was 3.8 (0.9),3.0 (1.5),3.0 (1.8),2.0 (1.1),2.0 (1.5) and 3.0(2.0) hours in each year,the operating time was obviously shorter in 2018 compared to 2015 (P=0.026) and 2020 (P=0.041). The median hospital stay in 2020 for distal pancreatectomy was 3 days shorter than that in 2019. The overall incidence of postoperative pancreatic fistula gradually decreased,with a incident rate of 50.0%,36.8%,31.0%,25.9%,21.1% and 14.8% in each year. During this period,in a total of 3,6,4,2,0 and 20 cases received laparoscopic operations in each year. The incidence of clinically relevant pancreatic fistula (grade B and C) gradually decreased,the incident rates were 0,4.8%,7.1%,3.4%,4.3% and 1.4%,respectively. Two cases had postoperative abdominal bleeding and received unscheduled reoperation. The overall rate of unscheduled reoperation was 0.7%. A patient died within 30 days after the operation and the overall perioperative mortality was 0.4%. Conclusion: The surgical training of a high-volume center can ensure a high starting point in the initial stage and steady progress of pancreatic surgeons,to ensure the safety of pancreatic surgery.

Analysis of prognostic factors of extranodal NK/T-cell lymphoma treated with pegaspargase/L-asparaginase: a multicenter retrospective study / 中华血液学杂志

Objective: To explore the prognostic factors of extracellular NK/T cell lymphoma (ENKTL) treated with pegaspargase/L-asparaginase. Methods: The clinical data of 656 ENKTL patients diagnosed at 11 medical centers in the Huaihai Lymphoma Working Group from March 2014 to April 2021 were retrospectively analyzed. The patients were randomly divided into two groups: a training set (460 cases) and a validation set (196 cases) at 7∶3, and the prognostic factors of the patients were analyzed. A prognostic scoring system was established, and the predictive performance of different models was compared. Results: Patients' median age was 46 (34, 57) years, with 456 males (69.5% ) and 561 nasal involvement (85.5% ). 203 patients (30.9% ) received a chemotherapy regimen based on L-asparaginase combined with anthracyclines, and the 5-year overall survival rate of patients treated with P-GEMOX regimen (pegaspargase+gemcitabine+oxaliplatin) was better than those treated with SMILE regimen (methotrexate+dexamethasone+cyclophosphamide+L-asparaginase+etoposide) (85.9% vs 63.8% ; P=0.004). The results of multivariate analysis showed that gender, CA stage, the Eastern Cooperative Oncology Group performance status (ECOG PS) score, HGB, and EB virus DNA were independent influencing factors for the prognosis of ENKTL patients (P<0.05). In this study, the predictive performance of the prognostic factors is superior to the international prognostic index, Korean prognostic index, and prognostic index of natural killer lymphoma. Conclusion: Gender, CA stage, ECOG PS score, HGB, and EB virus DNA are prognostic factors for ENKTL patients treated with pegaspargase/L-asparaginase.

Effect of CXCR4 on the Treatment Response and Prognosis of Carfilzomib in Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To explore the effect of CXCR4 on the treatment response and prognosis of Carfilzomib (CFZ) in multiple myeloma.@*METHODS@#Dataset GSE69078 based on microarray data from two CFZ-resistant MM cell lines and their corresponding parental cell lines (KMS11-KMS11/CFZ and KMS34-KMS34/CFZ) were downloaded from Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) were identified, and Protein-protein interaction (PPI) network was established to identify the key genes involved in CFZ resistance acquisition. Finally, the prognostic roles of the CFZ risistance key genes in MM using MMRF-CoMMpass data study was verified.@*RESULTS@#44 up-regulated and 46 down-regulated DEGs were identified. Top 10 hub genes (CCND1, CXCR4, HGF, PECAM1, ID1, HEY1, TCF4, HIST1H4J, HIST1H2BD and HIST1H2BH) were identified via Protein-protein interaction (PPI) network analysis. The CoMMpass data showed that high CXCR4 expression showed correlation to relative higher relapse and progress rates and the overall survival was significant decreased in high CXCR4 patients (P=0.013).@*CONCLUSION@#CXCR4 perhaps plays a crucial role in CFZ acquired resistance, which might help identifying potential CFZ-sensitive patients before treatment and providing a new therapeutic target in CFZ-resistant MM.

Effect of Hypoxia Inducible Factor-1α on Chemosensitivity of B-ALL Cells to Vincristine and Its Mechanism / 中国实验血液学杂志

OBJECTIVE@#To explore the effect of hypoxia on the chemosensitivity of B-acute lymphoblastic leukemia （B-ALL） cells to Vincristine (VCR) and the mechanisms.@*METHODS@#B-ALL cells SUP-B15, Nalm-6 and RS4;11 were selected as the research objects. The cells were divided into the control group and the hypoxia mimic group (CoCl2 pretreatment). The two groups were treated with VCR at different concentrations for 24 hours, CCK-8 was used to detect cell viability, flow cytometry was used to detect cell apoptosis, and Western bolt method was used to detect hypoxia inducible factor (HIF-1α), BAX, Bcl-2 and β-actin protein expression. Quantitative real-time fluorescent PCR (qRT-PCR) was used to detect BAX and β-actin mRNA levels.@*RESULTS@#CoCl2 could simulate hypoxic environment to induce the expression of HIF-1α. The cells SUP-B15 and RS4;11 of the hypoxia mimic group were lower sensitivity to VCR as compared with the control group; the apoptosis rate of the hypoxia mimic group was lower than that of the control group after 80 nmol/L VCR treatment. The expression levels of BAX protein and mRNA in the hypoxia mimic group were lower than those of the control group, and there was no significant difference in the expression levels of Bcl-2 protein between two groups.@*CONCLUSION@#Under hypoxic conditions, HIF-1α may mediate VCR resistance in B-ALL cells by downregulating the pro-apoptotic protein BAX.

The correlation between left atrial fat gray value and the prognosis of patients with atrial fibrillation treated by thoracoscopic radiofrequency ablation / 中国胸心血管外科临床杂志

@#Objective    To analyze the correlation between the gray value of epicardial fat and the prognosis of patients with atrial fibrillation (AF) treated by thoracoscopic radiofrequency ablation. Methods    The clinical data of 97 patients, including 75 males and 22 females with an average age of 57.8±9.4 years, who underwent thoracoscopic radiofrequency ablation in Fuwai Hospital from 2017 to 2018 were analyzed retrospectively. The left atrial fat volume and average gray scale were calculated by left atrial enhanced CT. According to the average gray scale of left atrial fat tissue, the patients were divided into three groups: a high gray scale group, a medium gray scale group and a low gray scale group. The patients were followed up at 3, 6 and 12 months after operation. The end point of follow-up was the recovery rate of sinus rhythm. Survival analysis was used to analyze the correlation between CT features of epicardial fat enhancement and prognosis. Results    After adjustment of body mass index, body surface area, gender and left atrial end diastolic diameter, regression analysis showed that the fat gray of left atrial enhanced CT was correlated with the type of AF (OR=0.30, 95%CI 0.12-0.79, P=0.014). Cox regression analysis showed that the fat gray value of left atrial CT predicted the recurrence of AF after thoracoscopic radiofrequency ablation (OR=0.92, 95%CI 0.85-0.99). The Kaplan-Meier curve showed significant difference in the long-term recurrence rate of AF among the three groups (P=0.011). The lower left atrial fat enhanced CT gray scale was, the higher long-term recurrence rate of AF was. Conclusion    The gray value of left atrial fat enhanced CT can effectively predict the recurrence of AF after radiofrequency ablation in thoracoscopic surgery.

Clinical Analysis of 66 Patients with Essential Thrombocytopenia / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical characteristics of essential thrombocytopenia (ET) patients with positive mutations including JAK2, CALR, MPL, or negative mutations.@*METHODS@#A total of 66 newly diagnosed ET cases from January 2016 to December 2018 in Department of Hematology, Huaian No.1 People's Hospital affiliated to Nanjing Medical University were analyzed. Statistical analysis data included the patient's sex, age, symptoms, thrombosis and embolism events, spleen omegaly, platelet count (Plt), leukocyte (WBC) count, hemoglobin (Hb), fibrinogen (FIB), thrombus elastic diagram (TEG), serum potassium, blood glucose (GLU), lactate dehydrogenase (LDH), JAK2, CALR and MPL mutations, treatment options, and efficacy.@*RESULTS@#All the patients were not MPL-positive, and divided in three groups: JAK2 mutation (46 cases, 69.7%), CALR mutation (9 cases, 13.6%) and gene negative mutation (11 cases, 16.7%) group. The average age of patients in the JAK2 mutation group was 63.2 years old, and significantly higher than that in the CALR mutation group (51.8 year) and gene negative group (50.2 year) (P＜0.05). Compared with the JAK2 mutation group and gene negative group, the CALR mutation group had lower WBC count (6.3×10/L vs 13.79×10/L) (P=0.003) (6.3×10/L vs 9.70×10/L) (P=0.009). Also the Hb level of patients in CALR mutation group was lower than the JAK2 mutation group (121.22 g/L vs 136.2 g/L) (P=0.036). However, there was higher tumor burden in the CALR mutation group, compared with the gene negative mutation group (300.11 U/L vs 227.4 U/L) (P=0. 033). There was no significant difference among the three groups, such as the Plt counts, serum potassium level, GLU level and FIB level (P＞0.05). In addition, thrombus and embolism appeared in 30.3% (20/66) cases. 18.2% (12/66) cases were complicated with hyperkalemia, which significantly correlated with Plt counts (r=0.518). TEG was performed in 34 patients, of which 41.2% (14/34) had abnormal TEG and 55.9% (19/34) were accompanied by Plt count ＞ 1 000 ×10/L, but there was no significant correlation between them (r=0.134). After routine clinical treatment, all the 66 cases achieved partial or complete hematological remission, but the disease usually repeated. Until now 4.5% (3/66) cases had been converted to myelofibrosis (MF) all with JAK2 mutation, but without advancing to acute myeloid leukemia.@*CONCLUSION@#ET patients with JAK2 mutation have higher incidence, moreover were in older age. However, the patients with CALR mutations display lower WBC count and Hb level, but higher tumor burden. In short, the multiple gene mutations of ET showed different clinical features closely relates with the prognosis, thus providing guidance for the clinical diagnosis and treatment.

Significance of Targeted Sequencing Assay for Patients with Suspected Myeloid Malignancies / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical significance of the targeted next-generation sequencing assay for patients with suspected myeloid malignancies.@*METHODS@#A total of 39 hematopenia patients with suspected myeloid malignamies in Department of Hematology of The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University from January 2018 to April 2019 were treated, 20 hot spot genes of myelodysplastic syndrome (MDS) were detected.@*RESULTS@#Regarding the diagnostic type, there were 7 cases of idiopathic cytopenia of undetermined significance (ICUS), 8 cases of clonal cytopenias of undetermined significance (CCUS) and 24 cases of myeloid myeloid malignancies which included 18 cases of MDS, 4 cases of myelodysplastic/myeloproliferative neoplasms (MDS/MPN) and 2 cases of acute myeloid leukemia. Positive mutation was detected in 70.8% (17/24) of myeloid malignancy patients , and 72.7% (16/22) in MDS and MDS/MPN patients. The main mutation types were ASXL1, TET2 and RUNX1. Compared with gene negative group, there were no significant differences in sex, age (＜60 years old or ≥60 years old), proportion of bone marrow blast cells (＜5% or≥5%) and cytogenetics (good, medium and poor) (P＞0.05). Furthermore, all 8 CCUS patients showed positive mutation, and the incidence of double or multiple mutation in CCUS group was significantly lower than that of the MDS and MDS/MPN group (37.5% vs 54.5%) (P=0.002). The mutation types between the two groups were similar, and there was no significant difference in variant allele frequency (P＞0.05).@*CONCLUSION@#Our results suggest that there are high rates of double or multiple mutations in myeloid malignancies, especially in patients with MDS and MDS/MPN. Targeted sequencing assay can improve the diagnosis of myeloid malignancies, and guide clinical treatment.

Therapeutic Response and Prognosis of Adult Acute Myeloid Leukemia with Chromosome Karyotype Abnormalities / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy and prognosis of acute myeloid leukemia (AML) patients with chromosome karyotype abnormalities.@*METHODS@#The clinical features and treatment responses of 91 patients with AML were collected and analyzed retrospectively. The efficacy and survival rate of the AML patients with normal and abnormal chromosome karyotype were compared.@*RESULTS@#Chromosome translocations and monosomal karyotypes were the main heterogeneity of AML. There was no significant difference in complete remission rate and overall response rate between the normal and abnormal karyotype groups, but the recurrence rate was higher in abnormal karyotype group. There was no significant difference in response of AML patients received the standard "3+7 regimen" and pre-excitation chemotherapy in the treatment of normal and abnormal karyotype groups. The relapse free survival time (RFS) was longer in the normal karyotype group, but there was no significant difference in overall survival time (OS).@*CONCLUSION@#The abnormal karyotype of AML is an independent prognostic factor, monosomal karyotype shows a poor prognosis, and the recurrence rate in AML patients with monosomal karyotype is higher.

The study of surgical treatment of the bicuspid aortic valve with aortic root aneurysm / 医学研究生学报

Bicuspid aortic valve (BAV) is one of the most common congenital valvular diseases, which is often associated with aortic stenosis or insufficiency.Aortic disease is an important component of BAV, aortic root aneurysm is the most finding when it comes to the dilatation of any or all segments of the proximal aorta from the aortic root to the aortic arch.The choice of operation has a great influence on the prognosis of patients.This article discusses the anatomic basis, pathophysiology, surgical treatment and treatment effects of the bicuspid aortic valve with aortic root aneurysm.

Clinical Study of Androgen Receptor (CAG) Gene Polymorphism and Androgen in Male with Salt Sensitive Hypertension / 现代检验医学杂志

Objective To investigate the relationship between androgen receptor CAG-gene polymorphism and androgen in male with salt sensitive hypertension.Methods Through the oral saline loading test and furosemide volume method male hypertension group were divided into salt-sensitive (SS group) and salt-insensitive (SR group).The samples from 161 males were selected in the study,including salt sensitive hypertension patients (SS group,61/161),salt-insensitive hypertension patients (SR group,40/161) and age-matched healthy samples (control group,60/161).All samples were sequenced with an analysis method (CAG) n repeated polymorphism,and determinated of total testosterone (TT) and free testosterone (FT) level in serum by electrochemiluminescence immunoassay.Results The number of CAG repeats was 14～34,average 22.4± 2.7.The CAG repeats of SS,SR and control group were 23.5±3.75,22.3±3.17 and 21.8±2.95,respectively.There were significant differences among the three groups (t=2.627～ 3.257,all P＜0.05).The level of TT and FT in SS and SR group were decreased compared with that of control group.At the same time,the level of SS group was lower,and there were significant differences among the three groups (t=2.524～ 3.826,all P＜0.05).Conclusion The androgen receptor gene repeat length and androgen levels are associated with male hypertension,especially salt-sensitive hypertension.Long (CAG) n repeat polymorphism maybe a genetic factor in the pathogenesis of hypertension.Plasma androgen levels may be used as a predictor of male salt sensitive hypertension.

Differential Regulation of Bruton's Tyrosine Kinase by the Ubiquitin Pathway / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the regulation of Bruton's tyrosine kinase (Btk) and to explore its possible mechanism.</p><p><b>METHODS</b>After treatment with the proteasome inhibitors and/or phorbol esters (PMA), the mRNA and protein expression level of Btk was detected by RT-PCR and Western blot, respectively. The ubiquitination level of Btk in B lymphoblastoid A20 cells was estimated after stimulation via the crosslinking of BCR with anti-IgM antibody. The cotransfection of COS-7 cell with Btk, ubiquitin and Cbl was performed, then the ubiquitination level of Btk was measured. The Btk ubiquitination level was detected after ectopic expression of ubiquitin transfected with the wild type or triple mutant of Ub (K29R, K48R, K63R) . Mono-ubiquitination of Btk was detected with antibodies preferentially against monovalent ubiquitin; in addition, the protein expression levels of chloroquine-treated stably transfected cells expressing Btk-GFP were detected by Western blot, and quantified with the strength of GFP fluorescence.</p><p><b>RESULTS</b>In the presence of proteasome-specific inhibitors and/or PMA, steady-state levels of Btk protein were reduced due to decrease of transcription. Posttranslational modification of Btk by ubiquitination was observed, which was related with the level of Btk expression and activation. The E3 ubiquitin ligase Cbl, which binds to Btk, was also found to ubiquitinate this kinase. Altogether, the data of this study strongly suggest that Btk is regulated by poly- and/or mono-ubiquitination events.</p><p><b>CONCLUSION</b>The Btk protein is dictated by its expression level through the ubiquitination pathway.</p>

Effect of Homoharringtonine Combined with Imatinib on the K562/G01 Cells and Its Mechanism / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the effect of homoharringtonine(HHT) combined with imatinib(IM) on proliferation and apoptosis of K562/G01 cells and its potential mechanism.</p><p><b>METHODS</b>K562/G01 cells were cultured with HHT and/or IM. CCK-8 assay was used to detect cell proliferation. Cell apoptosis and phosphorylated tyrosine levels were analyzed by flow cytometry. The expression levels of p210, PI3K, p-Akt and Akt protein were determined by Western blot.</p><p><b>RESULTS</b>Compared with HHT or IM alone, drug combination significantly inhibited cell proliferation and induced apoptosis of K562/G01 cells (both P< 0.05). HHT combined with IM could inhibit the levels of phosphorylated tyrosine and phosphorylated Crkl and downregulate the expressions of p210, PI3K and p-Akt in K562/G01 cells.</p><p><b>CONCLUSION</b>HHT combined with IM can synergistically inhibit proliferation and induce apoptosis of K562/G01 cells by suppressing the p210 expression and its kinase activity.</p>

Effect of Autophagy on Homoharringtonine-treated K562 Cells / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the effect of homoharringtonine (HHT) alone or combined with 3-methyladenine (3-MA) , an autophagy inhibitor, on the apoptosis and autophagy of K562 cells.</p><p><b>METHODS</b>K562 cells were treated with HHT(10 ng/ml) or HHT(10 ng/ml) combined with 3-MA (1.5 mmol/L) for 1 to 8 days. The apoptosis of treated cells was tested by means of flow cytometry(FCM), and the autophagy levels were tested with RT-PCR, Western blot and electron microscopy.</p><p><b>RESULTS</b>In the early stage of HHT-treated group, the apoptosis rate increased and decreased later. Beclin1 mRNA expression level and the LC3II/I ratio were declined firstly and increased later in HHT group. While combining with autophagy inhibitor 3-MA, both the Beclin1 mRNA expression level and the LC3II/I ratio were declined continually during the treated period. The activated caspase-3 protein expression level was also raised sustainability during both HHT and 3-MA cultured period.</p><p><b>CONCLUSIONS</b>HHT can induce apoptosis of K562 cells, but the sustaining effect of HHT can induc autophagy of K562 cells, the combination of HHT with 3-MA may enhance the cytotoxicitic effect of HHT on K562 cells.</p>

A systematic review of stem cells in treatment of spinal cord injury and a network Meta-analysis of the therapeutic effects via different transplantation ways / 中国组织工程研究

BACKGROUND:Stem cell transplantation has been used in the clinical treatment of spinal cord injury.However,the efficacy and safety are still controversial.Although there are many approaches for stem cell transplantation,which one is better is unclear as yet.OBJECTIVE:To systematically evaluate the efficacy and safety of stem cell transplantation for spinal cord injury,and to compare the therapeutic difference in stem cell transplantation via different approaches.METHODS:A computer-based online search was conducted in PubMed,The Cochrane Library (Issue 4,2016),Embase,CNKI,VIP,CBM,and Wan-Fang databases up to May 13,2016 to screen the relevant randomized clinical controlled trials of stem cells in the treatment of spinal cord injury.Two reviewers independently selected the studies,extracted information,and assessed the quality of included trials.Data extracted from eligible studies was pooled and meta-analyzed using Stata13.1 and Gemtc0.14.3 software.RESULTS AND CONCLUSION:A total of 10 randomized controlled trials involving 546 patients (294 in stem cells group and 252 in rehabilitation treatment group) were included.The results of meta-analysis showed that stem cell transplantation had an advantage over rehabilitation treatment in increasing American Spinal Cord Injury Association (ASIA) motor score,ASIA sensory score,Barthel Index,and decreasing the bladder residual urine volume.The incidence of low fever,abdominal distension,headache,lower limb numbness,and meningeal irritation was 14％,7％,7％,8％,and 7％,respectively.Taking the rehabilitation treatment as a common reference,the results of the network meta-analysis showed that there were no significant differences in ASIA motor score,ASIA sensory score,Barthel Index,and incidence of complications among subarachnoid injection,intravenous injection,and intralesional injection.Compared with the rehabilitation treatment,only stem cell transplantation via subarachnoid injection had significant differences in ASIA motor score [MD=9.77,95％CI (0.26,21.46)],and ASIA sensory score [MD=25.79,95％CI (10.07,45.27)].To conclude,the stem cells transplantation via subarachnoid injection is considered the most effective transplantation method.Due to the limitations of the included studies,more high-quality randomized controlled trials are required to verify the above conclusion.In addition,future studies should focus on the long-term efficacy and safety of stem cell transplantation in the treatment of spinal cord injury,and should investigate the clinical effects on spinal cord injury with different ASIA grades,types of stem cells,and transplantation time.

Choroidal thickness in patients with central serous chorioretinopathy over 50 years old / 眼科新进展

Objective To investigate the choroidal thickness (CT) in patient (＞ 50 years old) with central serous chorioretinopathy (CSC) compared to age-matched healthy controls.Methods Together 25 (＞ 50 years old) patients with CSC from January 2016 to January 2017 were enrolled in these study.Of 25 patients,20 patients were affected unilaterally and 5 patients were affected bilaterally.These patients were divided into affected eye group (30 eyes) and unaffected fellow eye group (19 eyes).Addition 26 age-matched healthy subjects were recruited as control group (26 eyes).Enhanced depth imaging technique of optical coherence tomography (EDI-OCT) was used to measure the choriodial thickness at 5 sites,including subfovea and 500 μm,1500 μm temporal and nasal to the fovea.Results The mean age of patients with CSC was (60.08 ± 7.68) years.The subfoveal choroid thickness of both affected eye group and unaffected fellow eye group was significantly thicker than that of the control group [(414.17 ±85.88)pan vs.(352.89 ±97.22) μn vs.(280.69 ±90.99) pau] (both P ＜0.05).In the patients with monocular affected eyes,the subfoveal choroid thickness of the affected eyes was thicker than that of the fellow eyes [(414.07 ± 85.88) μm vs.(352.89 ± 97.22) μm] (P ＜ 0.05).There were significant differences in choriodal thickness at other sites in the three groups (all P ＜ O.05).Conclusion The choriodal thickness in patients with CSC at over 50 years of age is significantly thicker than that in the agematched healthy subjects,with subfoveal choroid thickness ＞ 400 μm,which is helpful for the differential diagnosis of elderly patients with macular serous retinal detachment.

Mechanisms of Chinese materia medica multi-target to reverse MDR of leukemia / 中草药

Leukemia is a common malignant tumor in blood system, and it is one of the 10 high incidence malignant tumors in China. The main reason related to the failure of chemotherapy in leukemia is multidrug resistance (MDR). Chemical reversal agents often have the side effects and the mechanisms of chemical reversal agents are single, which restricts its clinical application. With efficiency, low-level toxicity, and multi-target points, Chinese materia medica shows its unique advantages in reversing MDR of leukemia. This paper summarizes the MDR mechanisms of leukemia and reversal agents in Chinese medicine in order to find more Chinese medicine to reverse leukemia.

Structure activity relationship of annonaceous acetogenins against multidrug resistant human lung cancer cell line A549/Taxol in vitro / 中国中药杂志

10 kinds of annonaceous acetogenins were selected for antitumor activity testing against human lung cancer cell line A549/Taxol and the structure activity relationship was analyzed.MTT assay was used to detect the inhibitory activities of 10 kinds of annonaceous acetogenins and positive drugs against A549/Taxol cells, respectively uvariamicin-Ⅲ(1), uvariamicin-Ⅱ(2), annosquacin D(3), desacetyluvaricin(4), annosquatin A(5), squamostatin D(6), bullatacin(7), squamocin(8), motrilin(9), annosquatin B(10), verapamil and cisplatin. Annonaceous acetogenins showed significant inhibitory activities against A549/Taxol cells, and were more potent than the positive drug verapamil and cisplatin.The more carbon atoms between the tetrahydrofuran ring and the lactone ring of annonaceous acetogenins exhibited more potency.Besides,ACGs with two substituted hydroxyl showed more potency than the compounds with three substituted hydroxyl in the bis-adjacent-THF ACGs. Furthermore, ACGs with three substituted hydroxyl showed more potency than the compounds with four substituted hydroxyl among the no bis-adjacent-THF ACGs.

Acadesine Inhibits the Proliferation of K562 Cells and Enhances their Sensitivity to Imatinib / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effects of AMPK agonist Acadesine (AICAR) on growth inhibition of K562 cells and their sensitivity to imatinib (IM).</p><p><b>METHODS</b>K562 cells were cultured with different concentrations of AICAR alone or its combination with IM for 48 hours, the CCK-8 assay was used to detect cell proliferation, the cell cycle distribution and apoptosis were analyzed by flow cytometry. The expression levels of Cyclin D1, Cyclin E1 and Caspase 3 protein were determined by Western blot.</p><p><b>RESULTS</b>AICAR inhibited the proliferation of K562 cells in dose-dependent manner, and their IC50 value was 0.45 mmol/L at 48 hours. AICAR could induce arrest of K562 cells in G1 phase and down-regulated the protein expression levels of Cyclin D1 and Cyclin E1; whereas it didn't influence the cell apoptosis. Additionally, the growth inhibition of cells induced by IM was enhanced by AICAR.</p><p><b>CONCLUSION</b>AICAR can inhibit the proliferation of K562 cells by arresting the cell cycle and enhancing the sensitivity of K562 cells to IM.</p>

The research of acute kidney injury after coronary artery bypass surgery with or without pump / 中华胸心血管外科杂志

Objective To study the impact of the off-pump coronary artery bypass compared to the on-pump coronary artery bypass technique on the rate of acute kidney injury.Methods A retrospective analysis of 824 patients accepted coronary artery bypass surgery in FuWai Hospital Surgical ICU from March 2011 to January 2013.Patients were divided into two groups according to the surgical approach,597 patients in on-pump group and 227 patients in off-pump group.Then compared the difference of acute kidney injury incidence in the two groups.Results 92 patients in the on-pump group occurred AKI,the incidence of AKI was 15.4％.32 patients in the off-pump group occurred AKI,the incidence of AKI was 14.1％.Two groups of patients had no statistical difference in the incidence of AKI,x2 =0.222,P =0.638.Based on the preoperative baseline creatinine clearance levels.We defined normal creatinine clearance (SCR ≥ 60 ml/min),mild renal insufficiency (45 ml/min ＜ SCR ＜60 ml/min),moderate renal dysfunction group(31 ml/min ＜ SCR ＜45 ml/min).Decline with the preoperative creatinine clearance rate,the AKI incidence was elevated significantly,P ＜0.05.Patients with moderate renal insufficiency,offpump patients had lower incidence of AKI than those in on-pump group,P ＜ 0.05.The incidence of renal replacement in the two group patients had no statistical differences.Conclusion The incidence of AKI after coronary artery bypass surgery had no statistical differences with or without pump.In the patients with preoperative moderate renal insufficiency,off-pump can reduce the incidence of AKI,but could not change the kidney the incidence of renal replacement treatment.

Effect of breastfeeding on infant cytomegalovirus viral load / 中华实用儿科临床杂志

Objective Follow-up monitoring was carried out in infants infected with cytomegalovirus (CMV) so as to find out whether breastfeeding could bring about changes of CMV viral load.Methods Saliva of the neonates born in Changzhou Maternal and Child Health Hospital from Nov.2010 to Feb.2012,was collected for CMV screening.Premature infants,or the infants with seriously infectious diseases and deformities were excluded,such as severe intrauterine infection,congenital immune deficiency disease and so on.The full-term infants with aymptomatic infection were divided into the artificial feeding group and the breastfeeding group,and followed up for 6 months.During the 1st,the 3rd and the 6th month after their birth,their saliva and their mother's breast milk were collected.The method of realtime fluorescent quantitative PCR was adopted to test the changes in the viral load of CMV-DNA in the saliva and breast milk.Meanwhile,head B-ultrasound test,otoacoustic emission hearing screening,liver function test,blood routine analysis and so on were performed.Results Among infants from both artificial feeding group and breastfeeding group,during the 1 st,the 3 rd and the 6th month after birth,no significant changes in the DNA viral load of saliva and breast milk cytomegalovirus were found (t =2.832,3.161,3.475,all P ＞ 0.05).And in breastfeeding group,the cytomegalovirus DNA viral load in breast milk were 3.125 × 103 ±2.017 × 102 (the 1st month),2.688 × 103 ±2.251 × 102 (the 3rd month),3.016 × 103 ±2.613 × 102 (the 6th rmonth),also no significance during the time (F =1.725,P =0.667).Meanwhile,the head B-ultrasound,otoacoustic emission hearing screening,liver function test,blood routine analysis,etc showed no clinical significance (F =1.725,P =0.667).Conclusions In the CMV-infected neonates,even if CMV in breast milk is tested to be positive,breastfeeding can continue without causing secondary symptoms of infection.