Role of heat shock protein 90 in hepatitis B virus replication / 临床肝胆病杂志

Hepatitis B virus （HBV） has the characteristics of wide transmission， a high chronic infection rate， and a low cure rate， and improving the cure rate of HBV may help to improve the long－term prognosis of patients. Heat shock protein 90 （Hsp90） is a chaperone protein widely present in organisms. In recent years， more and more studies have shown that Hsp90 is associated with HBV infection and plays an important role in HBV replication. It can not only interact with specific proteins of the virus to promote its replication， but also interact with the host’s own proteins to perform its function. This article reviews the role of Hsp90 in HBV replication in recent studies， so as to provide new theoretical guidance and directions for the development of new anti－HBV drugs targeting Hsp90 and the prevention and treatment of HBV infection in the future.

Value of endorectal ultrasonography in the assessment of invasion staging of low rectal cancer with local progression after neoadjuvant radiochemotherapy / Valor de la ultrasonografía endorectal en la evaluación de la estadificación de la invasión del cáncer rectal bajo con progresión local, después de administrar radioquimioterapia neoadyuvante

Abstract Although stages T3 and T4 rectal cancer can be reduced to T1 or T2 after neoadjuvant radiochemotherapy, the accuracy of the endorectal ultrasonography (ERUS) for the post-radiochemotherapy evaluation of low rectal cancer has seldom been reported. We aimed to investigate the value of ERUS in the assessment of invasion staging in low rectal cancer with local progression, and the factors affecting its accuracy, after neoadjuvant radiochemotherapy. A total of 114 patients administered with neoadjuvant radiochemotherapy for stages II and III low rectal cancer (local stage T3/T4) from February 2018 to December 2020 were enrolled in the study. The changes in local lesions were evaluated using ERUS before and after radiochemotherapy, and compared with the pathological T staging. The accuracy of post-neoadjuvant radiochemotherapy re-staging examined with ERUS was evaluated, and univariate analysis was used to identify the factors affecting the accuracy. After neoadjuvant radiochemotherapy, the blood flow distribution within the lesion significantly declined (P<0.05), the max length and max thickness of the longitudinal axis of the lesion were reduced (P<0.05), and the uT staging was decreased (P<0.05), when compared with lesions before the treatment. Compared with postoperative pathological T staging, the accuracies of ERUS in T1, T2, T3 and T4 stages were 11.11%, 28.57%, 27.27% and 100%, respectively. Univariate analysis indicated that review time of ERUS, post-operative T staging and Wheeler rectal regression stage were factors affecting the accuracy of ERUS re-staging. ERUS is more accurate for T4 re-staging, follow-up reviewed six weeks after neoadjuvant radiochemotherapy and low regression tumors, with a high application value for the assessment of the efficacy of neoadjuvant radiochemotherapy for low rectal cancer.

Resumen Aunque el cáncer de recto en estadios T3 y T4 se puede reducir a T1 o T2 después de la radioquimioterapia neoadyuvante, rara vez se ha informado la precisión de la ecografía endorrectal (ERUS) para la evaluación posterior a la radioquimioterapia del cáncer de recto inferior. Nuestro objetivo fue investigar el valor de ERUS en la evaluación de la estadificación de la invasión en el cáncer de recto inferior con progresión local, después de la radioquimioterapia neoadyuvante y los factores que afectan su precisión. Se incluyeron en el estudio un total de 114 pacientes a los que se les administró radioquimioterapia neoadyuvante para el cáncer de recto inferior en estadios II y III (estadio local T3/T4), desde febrero de 2018 hasta diciembre de 2020. Los cambios en las lesiones locales se evaluaron mediante ERUS antes y después de la radioquimioterapia y se compararon con la estadificación patológica T. Se evaluó la precisión de la re-estadificación examinada con ERUS, después de la radioquimioterapia neoadyuvante y se utilizó un análisis univariado para identificar los factores que afectan su precisión. Después de la radioquimioterapia neoadyuvante, la distribución del flujo sanguíneo dentro de la lesión disminuyó significativamente (P<0,05), la longitud máxima y el espesor máximo del eje longitudinal de la lesión se redujeron (P<0,05) y la estadificación uT disminuyó (P<0,05), en comparación con las lesiones antes del tratamiento. En comparación con la estadificación T patológica posoperatoria, las precisiones de ERUS en las etapas T1, T2, T3 y T4 fueron del 11,11%, 28,57%, 27,27% y 100%, respectivamente. El análisis univariable indicó que el tiempo de revisión de ERUS, la estadificación T postoperatoria y la etapa de regresión rectal de Wheeler fueron factores que afectaron la precisión de la re-estadificación con ERUS. ERUS es más preciso para la re-estadificación de T4, el seguimiento seis semanas después de la radioquimioterapia neoadyuvante y en tumores de baja regresión, con un alto valor de aplicación para la evaluación de la eficacia de la radioquimioterapia neoadyuvante para el cáncer rectal bajo.

Ginger-partitioned moxibustion plus pediatric massage for treating infantile diarrhea due to spleen deficiency: a randomized controlled clinical trial / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of ginger-partitioned moxibustion plus pediatric massage (tuina) in treating infantile diarrhea due to spleen deficiency. Methods: Ninety infants were randomly divided into a massage plus moxibustion group, a massage group and a drug group by the random number table method, with 30 cases in each group. The intervention was conducted for two consecutive courses. The infants in the massage plus moxibustion group were treated with pediatric massage and ginger-partitioned moxibustion at Shenque (CV 8). The infants in the massage group were treated with pediatric massage alone, while those in the drug group were treated with smecta. The primary and secondary symptom scales were assessed before and after treatment and at the follow-ups, and the total effective rate was evaluated after treatment. Results: The total effective rate in the massage plus moxibustion group was significantly different from that in the massage group and drug group (both P<0.05). After treatment, the scores of primary and secondary symptoms decreased in all three groups, with statistically significant intra-group differences (all P<0.05); the scores of primary symptoms were significantly different between the massage plus moxibustion group and the drug group (P<0.05); the scores of secondary symptoms in the massage plus moxibustion group and the massage group were significantly different from that in the drug group (both P<0.05). The differences in the time to recover normal bowel movement frequency among the three groups were not statistically significant (P>0.05). Conclusion: Ginger-partitioned moxibustion plus pediatric massage compared with pediatric massage or smecta monotherapy shows superior clinical efficacy in treating infantile diarrhea due to spleen deficiency, and has the advantages of appetite improvement, physique strengthening and short course.

Retrospective analysis of sentinel lymph node biopsy using methylene blue dye for early breast cancer / 中华医学杂志(英文版)

BACKGROUND@#Methylene blue is the most commonly used tracer for sentinel lymph node (SLN) biopsy (SLNB) in China. This study aimed to investigate the feasibility of clinical application of SLNB using methylene blue dye (MBD) for early breast cancer and the prognosis of patients with different SLN and non-SLN statuses.@*METHODS@#We retrospectively analyzed the clinicopathological data of patients with early breast cancer treated at the Peking University First Hospital between 2013 and 2018. We calculated the SLN identification rate (IR) in SLNB with MBD and the false-negative rate (FNR), and analyzed the prognosis of patients with different SLN and non-SLN statuses using Kaplan-Meier curves.@*RESULTS@#Between January 2013 and December 2018, 1603 patients with early breast cancer underwent SLNB with MBD. The SLN IR was 95.8% (1536/1603). Two SLNs (median) were detected per patient. There were significant differences in FNR between patients with SLN micrometastasis and macrometastasis (19.0% vs. 4.5%, χ2 = 12.771, P < 0.001). Chi-square test showed that there were significant differences in SLN successful detection rates among patients with different vascular tumor embolism status (96.3% vs. 90.8%, χ2 = 9.013, P = 0.003) and tumor (T) stages (96.6% vs. 94.1%, χ2 = 5.189, P = 0.023). Multivariate analysis showed that vascular tumor embolism was the only independent factor for SLN successful detection (odds ratio: 0.440, 95% confidence interval: 0.224-0.862, P = 0.017). Survival analysis showed a significant difference in disease-free survival (DFS) between patients with non-SLN metastasis and patients without non-SLN metastasis (P = 0.006).@*CONCLUSION@#Our single-center data show that, as a commonly used tracer in SLNB in China, MBD has an acceptable SLN IR and a low FNR in frozen sections. This finding is consistent with reports of dual tracer-guided SLNB. Positive SLNs with non-SLN metastasis are associated with DFS.

Research Progress in Treatment of Chemical Liver Injury with Chinese Medicine Based on Metabolomics / 中国实验方剂学杂志

Liver， as a critical organ of metabolism and detoxification， can be damaged by viral infection， drug abuse， and heavy drinking. Liver diseases pose a serious threat to people's health and life in China.At present， drug therapy has been primarily adopted clinically in the treatment of the liver injury.In-depth investigation of the mechanism of liver-protective drugs is of great significance to the prevention and treatment of clinical liver diseases.In recent years， with the development of the medical industry in China， an increasing number of studies have focused on the treatment of liver injury with Chinese medicine.Compared with western medicine， Chinese medicine is advantageous in few side effects and overall regulation， which plays a pivotal role in liver protection.However， its underlying mechanism in liver protection still needs to be further studied due to its complex compositions and diverse targets.Metabolomics， a new approach to studying the metabolic pathway of biological systems， provides integral and systematic views in the investigation of liver protection with Chinese medicine. By virtue of metabolomics， the mechanism of Chinese medicine in multi-target and multi-pathway liver protection can be analyzed comprehensively， and the corresponding biomarkers can also be screened out. The authors analyzed the studies of the treatment of chemical liver injury models induced by carbon tetrachloride （CCl4）， dimethylnitrosamine （DMN）， α-naphthyl isothiocyanate （ANIT）， and alcohol by Chinese medicinal compounds， single herbal medicines， and monomers of Chinese medicine based on metabolomics， and summarized the biomarkers and related metabolic pathways of Chinese medicine in the intervention of each type of liver injury， aiming at providing a reference for the further research and clinical application in the treatment of different types of liver injuries by Chinese medicine.

Preparation of curcumin TPP-PEG-PE nanomicelles with mitochondrial targeting and lysosomal escape functions and its effect on promoting breast cancer cell apoptosis / 中国中药杂志

Orthogonal experiments were used to optimize the process parameters of curcumin TPP-PEG-PCL nanomicelles; the particle size, electric potential and morphology under the electron microscope were systematically detected for the curcumin TPP-PEG-PCL nanomicelles; and the stability and in vitro release of the curcumin TPP-PEG-PCL nanomicelles were investigated. With DID fluorescent dye as the fluorescent probe, flow cytometry was used to study the uptake of nanomicelles by breast cancer cells, and laser confocal microscopy was used to study the mitochondrial targeting and lysosomal escape functions of nanomicelles. Under the same dosage conditions, the effect of curcumin TPP-PEG-PCL nanomicelles on promoting the apoptosis of breast cancer cells was evaluated. The optimal particle size of curcumin TPP-PEG-PCL nanomicelle was(17.3±0.3) nm, and the Zeta potential was(14.6±2.6) mV in orthogonal test. Under such conditions, the micelle appeared as regular spheres under the transmission electron microscope. Fluorescence test results showed that TPP-PEG-PCL nanomicelles can promote drug uptake by tumor cells, escape from lysosomal phagocytosis, and target the mitochondria. The cell survival rate and Hoechst staining positive test results showed that curcumin TPP-PEG-PCL nanomicelles had a good effect on promoting apoptosis of breast cancer cells. The curcumin TPP-PEG-PCL micelles can significantly reduce the mitochondrial membrane potential of breast cancer cells, increase the release of cytochrome C, significantly increase the expression of pro-apoptotic protein Bcl-2 and reduce the expression of anti-apoptotic Bax protein. These test results were significantly better than those of curcumin PEG-PCL nanomicelles and curcumin, with statistically significant differences. The results revealed that curcumin TPP-PEG-PCL nanomicelles can well target breast cancer cell mitochondria and escape from the lysosomal capture, thereby enhancing the drug's role in promoting tumor cell apoptosis.

Modified Double-Endobutton technique combined with Nice knot in the treatment of Rockwood Ⅲ-Ⅴ acromioclavicular joint dislocation / 中国骨伤

OBJECTIVE@#To explore the clinical effect of the modified double Endobutton technique combined with Nice node in the treatment of Rockwood Ⅲ-Ⅴ acromioclavicular joint dislocation.@*METHODS@#From March 2016 to January 2019, 23 patients with Rockwood Ⅲ-Ⅴ acromioclavicular joint dislocation were treated with modified double Endobutton technique to reconstruct coracoclavicular ligament and Nice node to repair acromioclavicular ligament, including 18 males and 5 females, aged 31 to 53 (43.2±5.4) years, 9 on the left and 14 on the right, and the time from injury to operation was 1 to 10 days. Before operation, X-ray films and CT three-dimensional reconstruction of bilateral shoulder joint were performed. Postoperative complications were observed. Six months after operation, DASHand Constant-Murley scores were used to evaluate the treatment effect.@*RESULTS@#The incision healed in one stage after operation, and no complications such as vascular and nerve injury and stress fracture occurred. All patients were followed up for 6 to 24 (12.0±4.9) months. At 6 months follow-up, the DASH score was 0.40±0.10 lower than that of 19.80±4.50 before operation, and the Constant-Murley score was 94.20±4.20 higher than that of 38.60±3.90 before operation.@*CONCLUSION@#The treatment of Rockwood Ⅲ-Ⅴ dislocation of acromioclavicular joint with double Endobutton technique and nice knot is satisfactory in the early stage. The long-term effect and complications need further follow-up.

Research progress on hepatotoxicity of traditional Chinese medicine based on metabonomics / 中国中药杂志

With the continuous development of Chinese medicine, traditional Chinese medicine(TCM) has been widely used in the treatment of diseases and health care. At the same time, the toxic and side effects of TCM have been gradually concerned. The liver, as an important place for drug metabolism, is a major target organ for drug toxicity. Clinical reports on liver injury caused by TCM are common, and the problem of liver toxicity of TCM has become an important reason to limit the internationalization of TCM. Metabono-mics is a newly booming subject to study the metabolic pathway of biological system. It shows integrity and systematicness in the study of hepatotoxicity of TCM, which provides a new technical method for finding the early biomarkers of liver injury of TCM and exploring the mechanism of hepatotoxicity of TCM. In this paper, the methods of metabonomics in the study of hepatotoxicity of TCM, as well as the research progress of hepatotoxicity monomer, extract and attenuation of hepatotoxic TCM based on metabonomics were reviewed in order to provide reference for the further study of hepatotoxicity of TCM.

Prognostic significance of the hemoglobin A1c level in non-diabetic patients undergoing percutaneous coronary intervention: a meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#The predictive value of hemoglobin A1c (HbA1c) levels in non-diabetic patients with myocardial infarction undergoing percutaneous coronary intervention (PCI) is still controversial. This study aimed to evaluate whether HbA1c levels were independently associated with adverse clinical outcomes in non-diabetic patients with coronary artery disease (CAD) who had undergone PCI by performing a meta-analysis of cohort studies.@*METHODS@#This meta-analysis included non-diabetic patients with CAD who had undergone PCI. A systematic search for publications listed in the PubMed, Embase, and Cochrane Library databases from commencement to December 2018 was conducted. Studies evaluating the adverse clinical outcomes according to abnormal HbA1c levels in non-diabetic patients diagnosed with CAD who had undergone PCI were eligible. The primary outcomes were long-term all-cause deaths and long-term major adverse cardiac events, and the secondary outcome was short-term all-cause deaths. The meta-analysis was conducted with RevMan 5.3 and Stata software 14.0. Odds ratios (ORs) were pooled using a random or fixed-effects model, depending on the heterogeneity of the included studies. Sub-group analysis or sensitivity analysis was conducted to explore potential sources of heterogeneity, when necessary.@*RESULTS@#Six prospective cohort studies involving 10,721 patients met the inclusion criteria. From the pooled analysis, abnormal HbA1c levels were associated with increased risk for long-term all-cause death (OR 1.39, 95% confidence interval [CI] 1.16-1.68, P = 0.001, I = 45%). Sub-group analysis suggested that abnormal HbA1c levels between 6.0% and 6.5% predicted higher long-term major adverse cardiac event (including all-cause deaths, non-fatal myocardial infarction, target lesion revascularization, target vessel revascularization, recurrent acute myocardial infarction, heart failure requiring hospitalization, and stent thrombosis) risk (OR 2.05, 95% CI 1.46-2.87, P < 0.001, I = 0). Contrarily, elevated HbA1c levels were not associated with increased risk of short-term all-cause death (OR 1.16, 95% CI 0.88-1.54, P = 0.300, I = 0).@*CONCLUSIONS@#An abnormal HbA1c level is an independent risk factor for long-term adverse clinical events in non-diabetic patients with CAD after PCI. Strict control of HbA1c levels may improve patient survival. Further studies in different countries and prospective cohort studies with a large sample size are required to verify the association.

A retrospective study of pathological margin evaluation in breast-conserving surgery specimens of patients with early breast cancer / 中国实用外科杂志

OBJECTIVE: To explore the clinical value of pathological evaluation of incision margin of breast-conserving operation specimens for early breast cancer. METHODS: The clinical data of early breast cancer patients undergone breast-conserving surgery in the Breast Disease Center of the Peking University First Hospital from January 1,2013 to December 31,2017 were analyzed retrospectively. The consistency of intraoperative frozen pathology with postoperative paraffin pathology and the relationship between pathological margin and prognosis were discussed. RESULTS: A total of474 breast-conserving cases were included in the study. The overall recurrence and metastasis rate was 3.4%; the local recurrence rate(LRR)was 1.5%; the 5-year disease-free survival rate(DFS)was 95.7%,and the 5-year overall survival rate(OS)was 96.8%. The coincidence rate of paraffin pathology and intraoperative frozen pathology in evaluating the breast-conserving margin was 100%. There was no significant difference in local recurrence rate between positive and negative first margin(χ~2=1.371,P=0.242). There was no significant difference in disease-free survival rate and overall survival rate among patients with negative margin width(χ~2=0.123,P=0.726;χ~2=0.077,P=0.781),and no significant difference in local recurrence rate(χ~2=1.808,P=0.613). CONCLUSION: Rapid frozen pathological examination is safe and reliable in evaluating the incision margin of breast-conserving surgery. On the premise of the negative incision margin,there is no significant difference in disease-free survival rate and local recurrence rate among different incision margin widths.

Digital heart for life

No abstract available.

Warm needling moxibustion versus electroacupuncture for simple obesity due to yang deficiency of the spleen and kidney: a controlled clinical trial / 针灸推拿医学（英文版）

Objective: To compare the therapeutic efficacy between warm needling moxibustion and electroacupuncture (EA) in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Methods: Seventy patients with simple obesity due to yang deficiency of the spleen and kidney were randomly divided into a warm needling moxibustion group and an EA group, with 35 subjects in each group. Same major acupoints were selected for the two groups, including Shuifen (CV 9), Guanyuan (CV 4), Daheng (SP 15), Shuidao (ST 28), Shousanli (LI 10), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The warm needling moxibustion group received warm needling moxibustion, while the EA group received EA treatment. The interventions were performed once every other day, with 15 treatments as one course. The therapeutic efficacy, body weight and body mass index (BMI) were then observed and compared. Results: The total effective rate in the warm needling moxibustion group was 85.7％ versus 77.1％ in the EA group, and the between-group difference was statistically significant (P<0.05). The warm needling moxibustion was remarkably superior to the EA in weight loss and lowering BMI, both with statistical significance (P<0.05, P<0.01). At the three-month follow-up, the body weight and BMI further decreased in the warm needling moxibustion group (both P<0.05), and the levels were lower than those in the EA group (P<0.05, P<0.01). Conclusion: Warm needling moxibustion can produce reliable and consistent efficacy in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Compared with EA, warm needling moxibustion shows advantage in both short-term and long-term efficacies, and thus is worth promotion in clinical practice.

S100A4 Gene is Crucial for Methionine-Choline-Deficient Diet-Induced Non-Alcoholic Fatty Liver Disease in Mice

PURPOSE: To explore the influence of S100 calcium binding protein A4 (S100A4) knockout (KO) on methionine-choline-deficient (MCD) diet-induced non-alcoholic fatty liver disease (NAFLD) in mice. MATERIALS AND METHODS: S100A4 KO mice (n=20) and their wild-type (WT) counterparts (n=20) were randomly divided into KO/MCD, Ko/methionine-choline-sufficient (MCS), WT/MCD, and WT/MCS groups. After 8 weeks of feeding, blood lipid and liver function-related indexes were measured. HE, Oil Red O, and Masson stainings were used to observe the changes of liver histopathology. Additionally, expressions of S100A4 and proinflammatory and profibrogenic cytokines were detected by qRT-PCR and Western blot, while hepatocyte apoptosis was revealed by TUNEL staining. RESULTS: Serum levels of aminotransferase, aspartate aminotransferase, triglyceride, and total cholesterol in mice were increased after 8-week MCD feeding, and hepatocytes performed varying balloon-like changes with increased inflammatory cell infiltration and collagen fibers; however, these effects were improved in mice of KO/MCD group. Meanwhile, total NAFLD activity scores and fibrosis were lower compared to WT+MCD group. Compared to WT/MCS group, S100A4 expression in liver tissue of WT/MCD group was enhanced. The expression of proinflammatory (TNF-α, IL-1β, IL-6) and profibrogenic cytokines (TGF-β1, COL1A1, α-SMA) in MCD-induced NAFLD mice were increased, as well as apoptotic index (AI). For MCD group, the expressions of proinflammatory and profibrogenic cytokines and AI in KO mice were lower than those of WT mice. CONCLUSION: S100A4 was detected to be upregulated in NAFLD, while S100A4 KO alleviated liver fibrosis and inflammation, in addition to inhibiting hepatocyte apoptosis.

Clinical observation of optical coherence tomography angiography in the macular vascular density after repair of retinal detachment / 眼科新进展

Objective To investigate the macular vascular density after successful repair of rhegmatogenous retinal detachment (RRD) for one year using optical coherence tomography angiography (OCTA),and discuss the correlation between the macular vascular density and visual acuity.Methods Totally 42 patients of the RRD (42 eyes),their contralateral eyes (A group) and 42 patients of the normal eyes (B group) were recruited into this study.All participants underwent examination with best corrected visual acuity (BCVA) and OCTA.The difference in macular vascular density was compared and the correlation between BCVA and the vascular density was analyzed.Results The macular vascular density of superficial layer,deep layer and choroidal capillary layer was 0.422 4 ±0.089 3,0.4836 ±0.0748,0.527 1 ±0.039 0 in RRD group,respectively,0.469 3 ±0.112 5,0.550 0 ±0.074 0,0.546 2 ±0.034 3 in A group,respectively,0.5619 ±0.053 7,0.611 2 ±0.035 2,0.562 6 ±0.030 4 in B group,respectively.The macular vascular density was significantly decreased in RRD group when compared with A and B groups (all P ＜ 0.05).There was a positive correlation between BCVA and the macular vascular density in the deep layer and choroidal capillaries layer (r =0.629,0.654,both P =0.000).However,there's no correlation between the macular vascular density of superficial layer and BCVA (P =0.103).Conclusion All the macular vascular densities are decreased in patients of RRD after successful repair of retinal detachment one year later,which indicated that the blood flow does not completely recover.And there is a positive correlation between BCVA and macular vascular densities in deep layer and choroidal capillaries layer.And meanwhile,OCTA can objectively and effectively quantify the status of macular region blood flow.

Clinicopathologic characteristics and molecular genetic analysis of 17 cases with multilocular cystic clear cell neoplasm of low malignant potential / 临床与实验病理学杂志

Purpose To investigate the clinicopathological features, immunophenotype, molecular genetic alteration in multilocular cystic clear cell neoplasm of low malignant potential. Methods 17 cases of multilocular cystic clear cell neoplasm of low malignant potential with complete clinical data, systematic measurement and follow-up were retrospectively studied. Histopathological evaluation and immunophenotyping were examed by HE staining and EnVision two steps methods, chromosome 3p deletion was analyzed by interphase fluorescence in situ hybridization. Results In 17 cases, there were 12 males and 5 females, and the ratio of male and female was 2.4: 1. The prevalence age was at a range of 28-73 years, and the average age is54 years. Mostly of them were found by incidental or physical exmanination. Microscopically, most cysts were lined by a single layer of tumor cells with clear cytoplasm, small nuclear, and no obvious nucleoli. According to WHO/ISUP nuclear grade, they were level I. Clear cell groups similar to cells lined cysts were seen within the fibrous septa. Immunohistochemically, tumor cells were positive for CK(AE1/AE3), CK7, EMA, vimentin, CD10, CAIX, PAX-2, and PAX-8, but negative for CD68. Ki-67 index were less than 10％. The loss of heterozygosity of 3p chromosome was detected in 11 cases and the rate of the loss of heterozygosity was 64.7％. Conclusion Multilocular cystic clear cell neoplasm of low malignant potential is a relatively rare type of renal cell carcinoma with low malignant potential and a good prognosis. It is suggested that tumor cells may be derived from tumor stem cells with pluripotent potential in renal tubules based on the immunophenotypes. Multilocular cystic clear cell renal cell carcinoma and renal clear cell carcinoma is similar in immunophenotype and molecular genetics, which suggesting that it may be a special histologic subtype of renal clear cell carcinoma.

Development of a propidium monoazide-polymerase chain reaction assay for detection of viable Lactobacillus brevis in beer

ABSTRACT The spoilage of beer by bacteria is of great concern to the brewer as this can lead to turbidity and abnormal flavors. The polymerase chain reaction (PCR) method for detection of beer-spoilage bacteria is highly specific and provides results much faster than traditional microbiology techniques. However, one of the drawbacks is the inability to differentiate between live and dead cells. In this paper, the combination of propidium monoazide (PMA) pretreatment and conventional PCR had been described. The established PMA-PCR identified beer spoilage Lactobacillus brevis based not on their identity, but on the presence of horA gene which we show to be highly correlated with the ability of beer spoilage LAB to grow in beer. The results suggested that the use of 30 µg/mL or less of PMA did not inhibit the PCR amplification of DNA derived from viable L. brevis cells. The minimum amount of PMA to completely inhibit the PCR amplification of DNA derived from dead L. brevis cells was 2.0 µg/mL. The detection limit of PMA-PCR assay described here was found to be 10 colony forming units (CFU)/reaction for the horA gene. Moreover, the horA-specific PMA-PCR assays were subjected to 18 reference isolates, representing 100% specificity with no false positive amplification observed. Overall the use of horA-specific PMA-PCR allows for a substantial reduction in the time required for detection of potential beer spoilage L. brevis and efficiently differentiates between viable and nonviable cells.

A study on the influence of blood glucose fluctuation on the ultra - structure of thyroid gland tissues in diabetes rats / 预防医学

Objective To learn the injury severity and the possible mechanism of the thyroid tissue of DM rats with different levels of glucose levels. Methods Firstly,20 Wistar rats were treated with STZ to create the experimental diabetic rats models. Then,the DM rats were divided into two groups including the persistence hyperglycemia group(n = 10),and blood glucose fluctuation group(n = 10). Another 10 Wistar rats were treated as the control group. Rats were sacrificed after 12 week treatment. The bilateral thyroid were weighted and the blood biochemistry tests were conducted for detecting glucose level,lipid levels,and thyroid functions. The ultra - structure of thyroid tissue was observed using electron microscope. Results The MBG,LAGE,and SDBG of blood glucose fluctuation group and the persistence hyperglycemia group were all higher than the control group(P ﹤ 0. 05). The MBG of blood glucose fluctuation group were lower than the persistence hyperglycemia group(P ﹤ 0. 05),the SDBG and LAGE were higher than the persistence hyperglycemia group(P ﹤ 0. 05). The TC,FPG,and HbA1c levels of DM rats were significantly higher in blood glucose fluctuation group than in control group(P ﹤ 0. 05). TC ,FPG and TG levels of the DM rats in blood glucose fluctuation group were significantly lower than the rats in persistence hyperglycemia group(P ﹤ 0. 05). No significance of the free T3 and free T4 levels was observed between the diabetes rats in persistence hyperglycemia group and blood glucose fluctuation group. However,the free T3 and T4 levels were significantly lower in both model groups than in control group(P ﹤ 0. 05). The injury of follicular epithelial cells and loss of microvilli were observed in diabetes rats in both the hyperglycemia group and blood glucose fluctuation group. Conclusion The ultra - structure changes of thyroid gland tissues indicated that abnormal glucose and lipid metabolism could result in thyroid gland tissue injury,which is the potential mechanism. However,no difference of the thyroid function and ultra - structure were observed between the hyperglycemia group and blood glucose fluctuation group.

A study on the inducing factors of type 2 diabetic ketosis among type 2 diabetes mellitus patients / 预防医学

Objective To investigate the inducing factors of diabetic ketosis(DK)in type 2 diabetes mellitus( T2DM) patients for more effective prevention. Methods A total of 545 T2DM patients with DK who received treatment in Zhejiang Provincial Diabetes Prevention and Treatment Center from June 2011 to June 2015 were enrolled,which contains 297 newly- diagnosed ketosis - prone diabetic(KPD)patients(KPD group)and 248 T2DM patients with DK(T2DM group),the etiological factors and clinical characteristics were analyzed retrospectively. Results The leading causes of DK were long term nonintervetion(71. 71% )and infection(15. 15% )in KPD group,while unadjusted therapeutic regimen(39. 91% )and break - off(22. 98% )and infection(20. 97% )were the leading cause in T2DM group. Compared with T2DM group, patients in KPD group were younger(P ﹤ 0. 01),and had lower BMI index(P ﹤ 0. 01),higher HbA1c level(P ﹤ 0. 01), more serious ketosis patients(urine ketone≥ ﹢ ﹢ ,P ﹤ 0. 05)and more DKA patients(P ﹤ 0. 05). Conclusion T2DM patients with ketosis could not be ignored,especially the KPD patients. More attention should be paid to diabetes health education,and screening of high - risk group and long term follow - up in patients with T2DM are effective means to reduce the incidence of DK in T2DM.

Evaluation of Toosendan Fructus-induced hepatotoxicity based on metabolic profile of fatty acids / 中草药

Objective: To evaluate the hepatotoxicity caused by water extract with alcohol precipitating of Toosendan Fructus (TF) and Toosendan Fructus + Corydalis Rhizoma (TF + CR) based on metabolic profiling of fatty acids in mice serum. Methods: A gas chromatography-mass spectrometry method was applied for simultaneous quantification of 15 fatty acids, including both non-esterified and esterified fatty acids, in the serum of control, TF-treated, and TF + CR-treated mice. Meanwhile, the change of fatty acid metabolic profile in liver injured mice was analyzed by principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA). Results: The result of PCA showed that the metabolic profile of serum fatty acids in TF-treated mice significantly deviated from the normal level, and CR with hepatoprotective effect could obviously reverse the deviation. More importantly, the result of PLS-DA illustrated that palmitoleic acid, vaccenic acid, and arachidonic acid had important contribution on the hepatotoxicity induced by TF. Therefore, the three fatty acids were identified as potential biomarkers. Conclusion: Hepatotoxicity caused by TF has a good correlation with the metabolic profiling of fatty acid. The project can provide foundation for further investigation on the evaluation and mechanism of TF-induced hepatotoxicity.

The metabolic profile of serum fatty acids in rats with Rhizoma Dioscoreae Bulbiferae-induced liver injury / 药学学报

Rhizoma Dioscoreae Bulbiferae is a traditional Chinese medicine with hepatotoxicity, but the metabolic profile of fatty acids has not been identified in the rats with liver injury. In this project, a gas chromatography-mass spectrometry method was applied to simultaneous quantification of 16 non-esterified fatty acids (NEFA) and esterified fatty acids (EFA) in the serum of control, ethanol extraction of Rhizoma Dioscoreae Bulbiferae (ethanol extraction, ET) and diosbulbin B (DB)-treated rats. Meanwhile, the change of fatty acid metabolic profile of liver injured rats was analyzed by principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA). The results of NEFA concentration indicated that the serum concen-trations of palmitic acid (C16:0), stearic acid (C18:0), palmitoleic acid (C16:1n7), oleic acid (C18:1n9), vaccenic acid (C18:1n7), linoleic acid (C18:2n6), linolenic acid (C18:3n3), eicosatrienoic acid (C20:3n6), arachidonic acid (C20:4n6) and docosahexaenoic acid (C22:6n3) in DB-treated rats decreased significantly, while that of C18:2n6 and C20:3n6 obviously increased and that of C20:4n6 and C22:6n3 noticeably dropped in ET-treated rats when compared with control. Furthermore, the results of EFA concentration illus-trated that the serum concentrations of C16:0, C18:0, C20:4n6, C22:6n3 and eicosapentaenoic acid (C20:5n3) in two toxic groups were remarkably decreased when compared with control. The fatty acid meta-bolic profiles of the two toxic groups exhibited significant difference from the normal levels, and the degree of deviation of ET group was higher than that of DB group. More importantly, the results of PLS-DA showed that C20:4n6 and C22:6n3 were important indicators of the hepatotoxicity induced by ET and DB, and the serum concentrations of the two fatty acids had good correlation with the levels of alanine aminotransferase, aspartate aminotransferase and total bilirubin using Pearson's correlation analysis and canonical correlation analysis (CCA). Therefore, C20:4n6 and C22:6n3 were identified as potential biomarkers of ET and DB-induced liver injury. The project can provide a foundation for furture investigation of molecular mechanism of hepato-toxicity caused by Rhizoma Dioscoreae Bulbiferae.