Intratumoral and peritumoral radiomics based on diffusion weighted imaging for predicting histological grade of breast cancer / 中国介入影像与治疗学

Objective To observe the value of intratumoral and peritumoral radiomics based on diffusion weighted imaging(DWI)for predicting histological grade of breast cancer.Methods Preoperative DWI data of 700 patients with single breast cancer diagnosed by pathology were retrospectively analyzed.The patients were divided into training set(n= 560,including 381 of grade Ⅰ+Ⅱ and 179 of grade Ⅲ)and test set(n=140,including 95 of grade Ⅰ+Ⅱ and 45 of grade Ⅲ)at the ratio of 8∶2.Intratumoral ROI(ROIintra)was manually delineated on DWI,which was automatically expanded by 3 mm and 5 mm to decline peritumoral ROI(ROIperi,including ROI3 mm and ROI5 mm),then intratumoral-peritumoral ROI(ROIintra+3 mm,ROIintra+5 mm)were obtained.The optimal radiomics features were extracted and screened,and the radiomics model(RM)for predicting the histological grade of breast cancer were constructed.Receiver operating characteristic curves were drawn,and the areas under the curve(AUC)were calculated to evaluate the predictive efficacy of each model.Calibration curve method was used to evaluate the calibration degree,while decision curve analysis(DCA)was performed to explore the clinical practicability of each model.Results AUC of RMintra,RM+3 mm,RM+5mm,RMintra+3 mm and RMintra+5 mm was 0.750,0.724,0.749,0.833 and 0.807 in training set,while was 0.723,0.718,0.736,0.759 and 0.782 in test set,respectively.In training set,significant differences of AUC was found(all P＜0.01),while in test set,no significant difference of AUC was found among models(all P＞0.05).The calibrations of models were all high.DCA showed that taken 0.02-0.88 as the threshold,the clinical net benefit of RMintra+per were greater in training set,while taken 0.40-0.72 as the threshold,the clinical net benefit of RMintra+per was greater in test set.Conclusion Both DWI intratumoral and peritumoral radiomics could effectively predict histological grade of breast cancer.Combination of intratumoral and peritumoral radiomics was more effective.

Actual combat-oriented teaching reform of the course of Military Nautical Psychology / 中华医学教育探索杂志

Centering on the strategic transformation of Chinese Navy and focusing on military medical education in battlefield, troops, and the future, this article explores the actual combat-based innovation and reconstruction of the course of Military Nautical Psychology in Navy Medical University. This article analyzes the existing problems in combat-oriented teaching in the original course and then proposes to deepen the actual combat-oriented teaching reform of the new course. The new course should adjust teaching contents according to actual combat and place more emphasis on the teaching of combat stress and mental health service support, so as to form the teaching mode of "self-study+theoretical lectures+practical teaching+naval exercises". Moreover, the course should create an actual combat-oriented teaching environment relying on cutting-edge technology and establish an actual combat-oriented teaching team to realize the complex transformation of teachers to theory, skills, and experience, in order to improve the post competencies of peacetime mental health maintenance, psychological injury treatment on battlefield, and wartime mental health service support among cadets.

The value of intratumoral and peritumoral radiomics features of multi-parameter MRI in evaluation of the status of human epithelial growth factor receptor 2 in breast cancer / 中华放射学杂志

Objective:To investigate the value of intratumoral and peritumoral radiomics features of multi-parameter MRI in evaluation of the status of human epithelial growth factor receptor 2 in breast cancer.Methods:The clinical, pathological and imaging data of 340 patients with pathologically confirmed breast cancer in Henan Provincial People′s Hospital from September 2019 to December 2020 were retrospectively collected. All patients were female, 48 (42, 55) years old. All patients underwent multi-parameter breast MRI before surgery, including dynamic contrast-enhanced T 1WI (DCE-T 1WI), fat-suppressed T 2WI (T 2WI) and diffusion-weighted imaging (DWI). The region of interest (ROI) for lesions were manually delineated and the segmented ROIs were zoomed in ring shape by 4 mm to acquire ROI intra and ROI prei, respectively. Then six sets of radiomics features were extracted from ROI intra and ROI prei of DCE-T 1WI, T 2WI and DWI. The cases were divided into a training set (272 cases) and a test set (68 cases) by stratified sampling at a ratio of 4∶1. The Mann-Whitney U test, Select K Best and minimum absolute contraction and selection operator were used for feature selection of the 6 sets of radiomics features. The feature subsets after reduction were used to construct independent and combined radiomics signatures with support vector machine algorithm to predict the HER2 status of breast cancer. Receiver operating characteristic curve was generated and area under curve (AUC) was calculated to compare the prediction performance of different models. Results:Of the 340 patients, 80 were HER2-positive and 260 were HER2-negative. Among the radiomics signatures based on single sequence, the DWI peri showed the best performance in predicting HER2 status of breast cancer, with an AUC of 0.678 for the test set. Among the combination of intratumoral and peritumoral radiomics signatures based on same sequence, the DWI intra+DWI peri had the highest prediction value, achieving an AUC of 0.774 for the testing set. Among the intratumoral or peritumoral radiomics signatures derived from two different sequences, the DCE-T 1WI intra+DWI intra and T 2WI peri+DWI peri showed the best predictive performance, yielding AUC of 0.766 and 0.769 in the testing set, respectively. Among the combination of intratumoral or peritumoral radiomics signatures derived from all 3 sequences or combinations of all features, the DCE-T 1WI intra+T 2WI intra+DWI intra+DCE-T 1WI peri+T 2WI peri+DWI peri obtained the highest prediction efficiency, with an AUC of 0.913 for the testing set. Conclusion:The radiomics features of intratumoral and peritumoral regions based on multi-parameter MRI have a certain value in non-invasive evaluation of HER2 status of breast cancer, which can help clinicians to provide scientific basis for decision-making of targeted therapy in patients with breast cancer.

To establish a method of serum detection by Raman spectroscopy for the diagnosis of gastric cancer / 中华检验医学杂志

Objective:To establish a method of serum detection by Raman spectroscopy for the diagnosis of gastric cancer.Methods:Between April and November 2019, 110 patients with gastric cancer [73 males, 37 females, age (57.4±10.3) years] and 74 patients with colorectal cancer [48 males and 26 females, aged (58.3±12.2) years] were collected at the First Affiliated Hospital of Army Military Medical University, along with 100 healthy subjects [59 males and 41 females, aged (55.6±10.61) years] during the same period. Fasting venous blood serum samples were collected from the subjects. A Raman spectrometer XploRA PLUS was used in this experiment, with an excitation light source of 532 nm, a field of view of 100 times, and a spectrum range of 200-2 000 cm -1, etc. The serum samples were detected by nondestructive and non-contact rapid detection, and the Raman spectra of serum samples were collected. Using the Raman spectrum acquisition and processing supporting software LabSpec6 to smooth, baseline, and normalize the obtained Raman spectrum. Multivariate statistical analysis software SIMCA14.1 were applied to import and analyze the obtained Raman spectrum data by principal component analysis (PCA), orthogonal partial least squares discriminant analysis (OPLS-DA), and other methods for statistical analysis. An operating characteristic curve (ROC) was constructed to evaluate the model analysis effect between serum samples of healthy people and those with gastric cancer. Serum samples from the colorectal cancer group were used to verify the reliability of the model. Results:Six Raman peaks with good repeatability were detected in serum samples in health and gastric cancer group, and peaks were located at 1 001.17, 1 154.63, 1 337.89, 1 446.85, 1 515.33, and 1 658.34 cm -1, respectively. Raman intensities at six Raman peaks were significantly different between healthy and gastric cancer groups. At the displacement of 1 001.17, 1 154.63, and 1 515.33 cm -1, the Raman intensity in the healthy group was higher than that in the gastric cancer group. At 1 337.89, 1 446.85, and 1 658.34 cm -1 displacement, the Raman intensity of the gastric cancer group was higher than that of the healthy group. An OPLS-DA model was constructed to analyze the serum samples of the healthy group and the gastric cancer group. In the model, R 2 is the fitting power, and Q 2 is the predictive ability. The closer the values of R 2 and Q 2 are to 1, the better the performance of the model, and the obtained model's R 2X(cum)=0.809, R 2Y(cum)=0.819, Q 2(cum)=0.758. ROC characteristic curve was drawn based on the OPLS-DA model. The area under the curve (AUC) of the gastric cancer group was 0.998. Six peaks with good repeatability were detected in the serum Raman spectra of gastric cancer stage Ⅰ, Ⅱ, Ⅲ, and Ⅳ, which were located at the displacement of 1 001.85, 1 155.07, 1 338.36, 1 445.75, 1 515.92, and 1 657.68 cm -1, respectively, and at the displacement of 1 155.07 and 1 515.92 cm -1. The Raman intensity of gastric cancer stage Ⅳwas significantly higher than that of gastric cancer stages Ⅰ, Ⅱ, and Ⅲ. Conclusions:According to the model reliability verification, the healthy group, gastric cancer group and colorectal cancer group can also be effectively separated based on OPLS-DA results; it showed a good performance in separating the healthy group from the gastric cancer group. It is possible to detect serum samples from healthy people and gastric cancer patients unlabeled by combining Raman spectroscopy and the OPLS-DA method in multivariate statistics.

Experience of the support of medicine in Harmonious Mission -2018 / 药学实践杂志

Objective Through the statistics of drug consumption in the task of Harmonious Mission -2018, sort out the process of medication supply of overseas medical services, analyze and evaluate the medication supply services. Methods Count the types and quantities of medicines consumed by marine hospitals in the Harmonious Mission-2018, analyze whether the preparation of medicines is sufficient, effective, and economically reasonable, and find way to improve the process of medicine supply in overseas medical services. Results Statistics on the consumption of drugs in the Harmonious Mission-2018 show that the number of drugs consumed accounted for 68.21% of the total kinds of medicine carried, that the total amount of drugs consumed accounted for 40.61% of the total costs of medicine carried, and that the total number of boxes of drugs consumed (the number of the smallest packages) accounted for 21.72% of the total number of boxes of medicine carried. Conclusion The medicine support services in the Harmonious Mission-2018 was sufficient and effective. But, the workflow and the processes of the services still need to be further improved.

Analysis of drug consumption in medical service for Dominica and Dominican in Harmonious Mission -2018 / 药学实践杂志

Objective To analyze the drug consumption in medical service for Dominica and Dominican in Harmonious Mission -2018, and provide reference for future drug supply services in similar countries. Methods Data of the drugs used during the medical service of the two countries were extracted from the computer system, which were summarized and analyzed. Results Ranking first in drug consumption in medical service for Dominica and Dominican was external drugs. Chinese traditional medicines were very popular in both two countries. There were great similarities and unique characteristics in the drug consumption during medical service between the two countries, orthopedic drugs, digestive system drugs, ophthalmic drugs and dermatological drugs were frequently used drugs. Conclusion The drug consumption in medical service was closely associated with the national conditions. Therefore, in order to prepare medicines reasonably in future overseas medical service, disease distribution of the country which would be visited and drug consumption in the similar country which had been visited before should be concerned.

Preparation and Quality Evaluation of Breviscapine Gastric Adhesive Tablets / 中国药房

OBJECTIVE：To prepar e Breviscapine gastric adhesive tablets ，to optimize the formulation and to evaluate the quality. METHODS ：HPMC K 100M and carbomer 934P were used as bioadhesives and skeleton materials ，and lactose was used as filler，and magnesium stearate was used as glidant and lubricant to prepare Breviscapine gastric adhesive tablets by direct powder pressing method. The comprehensive scores of scores of accumulative release rate of Breviscapine gastric adhesive tablets in pH 6.8 PBS at 2，6，12 h（Q2 h，Q6 h，Q12 h，with scutellarin meter ，by HPLC method ）and in vitro adhesion force of gastric tissue were evaluated by weighting method. Taking this scores as indexes，L9（34）orthogonal test design was used to optimize the amount of HPMC K 100M，carbomer 934P and lactose in Breviscapine gastric adhesive tablets and validation tests were conducted. The properties，identification，weight difference ，fragility，release and the content of scutellarin of the gastric adhesive tablets were determined. RESULTS ：The optimal prescription of Breviscapine gastric adhesive tablets were 42％ breviscapine，10％ HPMC K100M，3％ carbomer 934P and 45％ lactose. The verification test results show that the Q2 h，Q6 h，Q12 h of 3 batches of Breviscapine gastric adhesive tablets were 20.36％，48.55％，and 87.00％ ；the average in vitro adhesion force of gastric tissue was 31.36 g/cm2；the average comprehensive score was 70.23（RSD＝1.84％，n＝3）. The gastric adhesive tablets were light yellow，tasteless or slightly salty ；the peak time was consistent with that of scutellarin control ；its weight difference were ±6％， the fragility was 0.54％，and the Q12 h was 83.51％（RSD＝2.14％，n＝6）. The content of scutellarin was 288.47 mg/g（RSD＝ 0.70％，n＝3）. CONCLUSIONS ：Breviscapine gastric adhesive tablets is prepared successfully ，and its quality evaluation conforms to the requirements of Chinese Pharmacopoeia （2015 edition）.

Study on the Preparation of Brucine Bilayer Polymer Soluble Microneedle and Its in vitro Transdermal Perme- ability under Different Drug Loading Modes / 中国药房

OBJECTIVE：To prepare Brucine （shorted for “Bru”）bilayer polymer soluble microneedles ，and to investigate their in vitro transdermal permeation characteristics under different drug loading modes. METHODS ：Taking the degree of difficulty of microneedle film uncovering ，array integrity ，bubble amount ，needle shape ，tip hardness and backing toughness as the indexes ， tip and backing materials were screened. The swelling method and drying method of matrix were screened using the morphology of microneedles as index. The double-layer polymer soluble microneedle was prepared by two-step method ，then it was characterized and evaluated in the safety. The in vitro transdermal permeation characteristics of tip-loaded ，backing-loaded and full-loaded Bru bilayer polymer soluble microneedles were investigated by Franz diffusion cell. The in vitro skin penetration curve was drawn ，and the cumulative permeability amount （Q）and cumulative permeability rate were calculated. RESULTS ：The optimal preparation technology of bilayer polymer soluble microneedles included chondroitin sulfate （CS）and polyvinylpyrrolidone K 30（PVP K 30） （1∶1，m/m）as tip materials ，15％ polyvinyl alcohol （PVA）as backing material ，matrix swelling in the refrigerator at 4 ℃ for 1 h，and drying at room temperature for 24 h in dryer. Prepared microneedle array was complete and had good mechanical properties，and could successfully puncture aluminum foil and rat skin. After microneedle treatment ，the skin could return to its original state within 6 h. The results of in vitro transdermal test showed that microneedle drug delivery could greatly increase the cumulative transdermal permeability amount of GNYL Bru，and the tip material could dissolve and release the drug within 10 min； the tip-loaded microneedle was basically released within 8 h，Q8h was 102.185 μg/cm2 and the cumulative permeability rate reached 94.05％ ； the drug cumulativepermeability rate of backing-loaded and full-loaded microneedlesexceeded 50％ within 8 h and exceeded 90％ within 48 h；Q48h were 840.77 and 1 156.73 μg/cm2，showing sustained-release characteristics. CONCLUSIONS ：Bru bilayer polymer soluble microneedles with hard tip and tough backing material are successfully prepared to achieve effective transdermal delivery and sustained release through full-loaded mode.

The technical development and application prospects of CRISPR/Cas9 in laboratory medicine / 中华检验医学杂志

Clustered regularly interspaced short palindromic repeats/CRISPR-associated nuclease 9 (CRISPR/Cas9),a cluster of regularly spaced short palindromic repeats,is a natural immune defense system for bacteria and archaea to identify themselves and exogenous invading DNA fragments,protecting them from viruses.In recent years,CRISPR/Cas9 has become a revolutionary gene editing tool.Its specific targeted spot-cutting ability also plays an important role in nucleic acid detection,bacterial typing,etc.,and has shown great application potential in the field of medical testing.Based on the latest researches,this paper reviews the progress of CRISPR/Cas9 application in the new techniques of nucleic acid detection,pathogen typing and bacterial evolution in laboratory medicine,and also summarizes the application prospect of CRISPR technology in the field of laboratory medicine.

Content Determination of Aflatoxin G 2，G1，B2 and B 1 in Qinghuo Tablets （Capsules）by HPLC-post-column Photochemical Derivatization and Its Safety Evaluation / 中国药房

OBJECTIVE： To establish a method for content determination of aflatoxin （AF） G2， G1， B2 and B1 in Qinghuo tablets （capsules）， and to evaluate the safety of the preparation. METHODS： HPLC-post-column photochemical derivatization was adopted， and 266 batches of Qinghuo tablets （capsules） from 37 manufacturers as sample. The determination was performed on Agilent C18 column with mobile phase consisted of water-acetonitrile-methanol （V/V/V， gradient elution） at the flow rate of 1.0   mL/min. The column temperature was set at 40 ℃. Excitation wavelength and emission wavelength of fluorescence detector were 360 and 450 nm. RESULTS： The linear ranges of AF G2， AF G1， AF B2 and AF B1 were 10.197-101.97 （r＝0.999 7）， 10.197-101.97 （r＝0.999 6）， 9.958 6-99.586 （r＝0.999 1）， 9.999 0-99.990 （r＝0.998 3） pg， respectively. RSDs of precision （n＝6）， reproducibility （n＝6） and stability tests （12 h， n＝5） were all lower than 3.0％. The detection limits were 0.80， 4.00， 0.80 and 4.00 pg， respectively. The quantitation limits were 1.60， 8.00， 1.60 and 8.00 pg， respectively. The recoveries were 85％-90％， 85％-90％， 55％-65％， 65％-75％ （RSD＝1.8％-4.7％， n＝6）. AF G2， AF G1， AF B2 and AF B1 were not detected in 266 batches of samples. CONCLUSIONS： This method is suitable for the determination of AF in Qinghuo tablets （capsules）. Although AF was not detected in the sample， it is advisable to add the determination of AF so as to improve its safety.

Regulation of microRNA -22 on glycometabolism of hematopoietic stem cell TF - 1 and its molecular mecha-nism / 中华实用儿科临床杂志

Objective To study the regulation of microRNA - 22(miR - 22)on glycometabolism of hemato-poietic stem cell TF - 1 and its molecular mechanism. Methods TF - 1 cells were cultured for 2 h under hypoxic con-ditions. The expression levels of Glut4 and miR - 22 was detected by quantitative real-time PCR(qRT - PCR). The sgRNA vector of the miR - 22 gene was constructed and miR - 22 gene of TK - 1 cells was knocked out by the CRISPR/ Cas9 technique. Overexpression vectors were constructed,and miR - 22 knocked - out cells were introduced to overexpress miR - 22,the expression of miR - 22 was detected by qRT - PCR and the expression levels of Glut4 and PPAR - γ were detected by qRT - PCR and Western blot. Results Compared with the control group,the expression of miR - 22 in TF - 1 cells decreased (0. 015 ± 0. 000 vs. 0. 056 ± 0. 001)and the expression of Glut4 (0. 351 ± 0. 038 vs. 0. 152 ± 0. 005)and PPAR - γ (0. 421 ± 0. 017 vs. 0. 248 ± 0. 008)increased,when TF - 1 cells were cultured for 2 h under hypoxic conditions,and the differences were statistically significant (all P < 0. 05). Compared with the control group,the expression levels of Glut4 (0. 019 ± 0. 00 vs. 0. 008 ± 0. 000)and PPAR - γ (0. 038 ± 0. 001 vs. 0. 019 ± 0. 000)were significantly increased after miR - 22 gene silencing,and they were significantly decreased (Glut4:0. 005 ± 0. 000 vs. 0. 008 ± 0. 000;PPAR - γ:0. 137 ± 0. 000 vs. 0. 019 ± 0. 000)after overexpression of miR - 22,and the differences were statistically significant (all P < 0. 05). Conclusions It suggests that miR - 22 ex-erts a negative regulation on glycometabolism of hematopoietic stem cell TF - 1 by downregulating the expression of PPAR - γ. A new regulatory factor of TF - 1 glycometabolism and the mechanisms are identified,which has provided new ideas for the targeted medication of diseases induced by hematopoietic stem cell dysfunction.

Needle-stick injuries among health care workers and protective strategies in a hospital / 中国感染控制杂志

Objective To investigate the condition and causes of needle-stick injuries among health care workers(HCWs), and explore effective strategies for preventing needle-stick injuries.Methods Needle-stick injuries recorded by healthcare-associated infection management department in a hospital between January 2013 and December 2015 were surveyed retrospectively.Results 164 HCWs suffered needle-stick injuries, including 71 (43.29%) doctors, 81 (49.39%) nurses, and 12 (7.32%) other HCWs.The number of injuries in 2013, 2014, and 2015 were 47(28.66%), 54(32.93%),and 63(38.41%)respectively.152(92.68%), 9(5.49%),and 3(1.83%)injuries were caused by contaminated medical instruments, uncertain-contaminated medical instruments, and non-contaminated medical instruments.Among 164 cases of needle-stick injuries, 67(40.85%) occurred in operating rooms, 141 (85.98%) were finger injuries;the main causes of needle stick injuries were carelessness, busy work and nonstandard manipulation(n=115, 70.12%), most doctors suffered needle stick injuries due to the lack of experience (52.11%), most nurses suffered needle stick injuries due to carelessness, busy work and nonstandard manipulation(93.83%).Conclusion Needle stick injuries among HCWs increased year by year, strategies should be implemented to reduce the occurrence of needle injuries, including strengthening occupational protection consciousness among HCWs, strengthening construction of healthcare-associated infection management system, and improving medical environment.

Clinical application of the computer-aided movable and measurable ankle-foot orthosis / 中国组织工程研究

BACKGROUND: The traditional ankle-foot orthosis focuses on the protection, correction, stability, and compensation;therefore, it is important to explore a new rehabilitation method for ankle joint dysfunction.OBJECTIVE: To explore the effect of computer-aided movable and measurable ankle-foot orthosis that designed by the Department of Rehabilitation in Longgang Central Hospital of Shenzhen on postoperative dysfunction after ankle fracture.METHODS: Fifty-two patients with ankle fractures at 3 weeks after internal fixation were selected and equivalently randomized into two groups. Both groups received conventional oral medication and rehabilitation therapy. In addition,the patients in control group were given joint mobilization treatment, while those in experimental group were given computer-aided movable and measurable of ankle-foot orthosis, 20 minutes daily, 6 days weekly for consecutive 4 weeks. The efficacy was evaluated by muscle strength, active range of motion, Kofoed ankle score and visual analogue scale on computer at baseline, 7, 14, and 28 days after training.RESULTS AND CONCLUSION: (1) There were no significant differences in baseline data and ankle function scores between two groups before training (P > 0.05), and all above indicators were significantly improved in both two groups at 4 weeks after training (P 0.05). To conclude, the unique ankle-foot orthosis can reduce postoperative pain, enhance muscle strength and improve ankle mobility after ankle fracture.

Teaching practice of patent application for scientific research of the medical postgraduates / 中华医学教育探索杂志

To enhance the scientific research participation of the medical postgraduates, and pro-mote core competitiveness of the medical colleges, based on analysis of the necessity of patent application in medical colleges postgraduate, we constructed the teaching teams including the medical professors, patent engineers, graduate teaching manager, and science and technology managers. The problem-based learning (PBL) and case-based learning (CBL) as teaching methods were used in practice. The patent courses included the reference search and analysis, basic knowledge of patent law, and patent application training module were constructed; and the teaching effect were evaluated and optimized through the scores of the patent basic theory test, research output, and the training of the patent application. The patent course of the medi-cal postgraduates provides a reference for cultivating the compound talents have scientific research innova-tion and patent application capability.

Effects of high plasma triglyceride caused by ApoC Ⅲ transgene on ab-dominal aortic aneurysm induced by elastase in LDLR-/-mice / 中国病理生理杂志

AIM:To investigate the effects of high plasma triglyceride (TG) caused by apolipoprotein C Ⅲ( ApoC Ⅲ) transgene on the occurrence and development of abdominal aortic aneurysm ( AAA) .METHODS:The animal models of hypercholesterolemia and hypercholesterolemia combined with hypertriglyceridemia were established by feeding high-fat diet to LDLR-/-and ApoC Ⅲ+LDLR-/-mice, respectively.AAA was induced in these mice by pancreatic elastase. By evaluating the incidence of AAA, relative maximal abdominal aortic diameter, disruption of the elastic lamellar structure and expression of matrix metalloproteinases ( MMPs) in the aorta walls of the AAA, the occurrence and development of AAA were compared in LDLR-/-and ApoC Ⅲ+LDLR-/-mice fed with either chow diet or high-fat diet.In addition, an in vitro TNF-α-induced aneurysmal microenvironment model on vascular smooth muscle cells ( VSMC) was used to study the impact of triglyceride-rich lipoproteins ( TRLs) from mice with normal or high contents of ApoCⅢon elastin protein expres-sion.RESULTS:Feeding the high-fat diet aggravated the severity of AAA in the LDLR-/-mice.ApoC Ⅲ+LDLR-/-mice fed with high-fat diet had less severe AAA than LDLR-/-mice fed with high-fat diet.TRLs inhibited degradation of VSMC elas-tin protein induced by TNF-α, and in vitro TRLs from the mice with high content of ApoC Ⅲ, compared to those with nor-mal content of ApoC Ⅲ, had better inhibitory effect on the degradation of elastin.CONCLUSION:High plasma TG caused by ApoC Ⅲtransgene alleviates AAA of the LDLR-/-mice induced by elastase and high-fat diet.The effect is probably attrib-uted to the hypertriglyceridemia caused by ApoC Ⅲtransgene.

Effects of Pulsed Radiofrequency on Hyperalgesia and Expression of NR2B Subunit in Spinal Dorsal Horn in Chronic Constriction Injury Rats / 中国康复理论与实践

Objective To observe the behavioral and the histopathology changes and expression of NR2B subunit in spinal dorsal horn in chronic constriction injury (CCI) rats after pulsed radiofrequency (PRF). Methods Forty-eight adult Sprague-Dawley rats were randomly divided into Sham-Sham (SS), Sham-PRF (SP), CCI-Sham (CS) and CCI-PRF (CP) groups. The right sciatic nerves (SNs) of the CS and CP groups were ligated to create the CCI model. For the SS and SP groups, the right SNs were separated without ligation. The CP and SP groups accepted PRF at the ligation site 15 days after modeling, while the electrode was placed in rats in the SS and CS groups without elec-tricity. The hindpaw withdrawal threshold (HWT) was measured before and 3, 7, 11, 15 days after modeling, and 1, 3, 7, 11, 15 days after treatment. The right SNs at ligation sites were assessed with optical microscopic score 15 days after treatment, and the NR2B expression in the L4-6 spinal dorsal horn were determined with Western blotting. Results HWT was significantly shorter in the CS and CP groups than in the SS and SP groups after modeling, and was more in the CP group than in the CS group. Under the optical microscope, the axonal diame-ter and myelin sheath thickness increased in the CP group compared to those in the CS group (P<0.01), the NR2B expression was less in the CP group than in the CS group after treatment (F=10.769, P<0.05). Conclusion PRF may reduce hyperalgesia and repair damaged SNs in CCI-induced neuropathic pain, which may associate with inhibition of the NR2B subunit expression in spinal dorsal horn.

Analysis of pathogen in bronchoalveolar lavage lfuid and its clinical features in 80 children with lobar pneumonia / 临床儿科杂志

Objective To investigate the pathogenic types and clinical features of children with lobar pneumonia. Methods Eighty children with lobar pneumonia diagnosed from April 2013 to May 2015 were enrolled. Bronchoalveolar lavage lfuid (BALF) of patients were collected. FQ-PCR was used to detect and analyze pathogens in BALF. Results In 80 cases, 59 cases were Mycoplasma pneumoniae, and 2 cases were Chlamydia pneumoniae, 12 cases were Streptococcus pneumoniae, 1 case was Klebsiella pneumoniae, 8 cases were adenovirus, 1 case was respiratory syncytial virus, 14 cases were of mixed infection. The prevalence of MP lobar pneumonia in children of 7-14 years old age group were higher than that of other age groups. Conclusions The pathogen of children with lobar pneumonia varied from Mycoplasma pneumoniae, Chlamydia pneumoniae, bacteria, virus and so on, and Mycoplasma pneumoniae was the common pathogen in lobar pneumonia.

Postoperative Complications and Related Risk Factors in Neurosurgery Patients during Anesthesia Recovery / 中国康复理论与实践

Objective To investigate the characteristics of postoperative complications and related risk factors in neurosurgery patients. Methods A retrospective study was carried out in neurosurgery patients during anesthesia recovery period from March, 2009 to November, 2013. The recorded complications included respiratory and circulatory system complications, pain, shivering, nausea and vomiting, agitation and delaying recovery. Multivariate logistic regression analysis was performed to screen the risk factors for these complications. Results Da-ta of 13,495 patients were available for analysis. The general incidence was 48.8%. Post-operative complications included post-operative nausea and vomiting (PONV) (14.5%), agitation (13.5%), hypertension (13.4%), arrhythmia (9.3%), shivering (8.9%), pain (5.9%), hypox-emia (2.5%), delayed recovery (1.9%), airway obstruction (1.7%) and hypotension (0.3%). Regression analysis showed that the risk factors for hypoxemia included male,<59 years old and infratentorial tumor (P<0.05);the risk factors for PONV included male, supratentorial tu-mor, infratentorial tumor, cerebrovascular disease, inhalation anesthesia, the use of muscle relaxants antagonism and tramadol (P<0.05);and the risk factors for postoperative restlessness included male, infratentorial tumor and cerebrovascular disease, inhalation anesthesia, the use of muscle relaxants antagonism and no use of patient-controlled analgesia (PCA) pump (P<0.05). Conclusion Patients with different neuro-logical diseases showed different post-operative complications and exhibited different risk factors for these complications. Anesthesiologists should closely monitor patients receiving various neurosurgery and provide timely treatment.

Cell suspension and level of IL-17 in bronchoalveolar lavage fluid (BALF) of children with labor pneumonia combined with mycoplasma pneumonia and its clinical significance / 中国内镜杂志

Objective To explore cell suspension and level of IL-17 in bronchoalveolar lavage fluid (BALF) of children with labor pneumonia combined with mycoplasma pneumonia and its clinical significance. Methods 87 children with labor pneumonia who had been done BAL were divided into CPIS ≥ 6 group and CPIS 0.05). The percentage of columnar epithelial cells in CPIS < 6 group were higher than CPIS ≥ 6, how-ever, macrophagocyte was lower ( < 0.05). The percentage of neutrophils are related with both MP-DNA ( = 0.48,= 0.000) and IL-17 ( =0.49, =0.000). Conclusions The composition of BALF is more appropriate to react the circumstance of lobar pneumonia. When lobar pneumonia occurs, columnar epithelial cells are damaged, macrophagocyte gathered to participate in the inflammatory response. In Mycoplasma pneumonia infection group, IL-17 raises neutrophils to resist infection, NE%in BALF can indirectly reflect the mycoplasma infection degree.

Clinical effect of laparoscopy combined with choledochoscopy on choledocholithiasis / 中华老年医学杂志

Objective To explore the clinical effect of laparoscopy combined with choledochoscopy on choledocholithiasis.Methods Totally 134 elderly patients with choledocholithiasis were treated in our hospital from Jan 2013 to Dec 2014, who were randomly divided into observation group and control group (n=67 for each), treated with laparoscopy combined with choledochoscopy, and traditional surgery, respectively.The operation time, bleeding volume, exhaust time, in-hospital stay, complications and residual stones rate were compared between the two groups.Results The operation time was higher in observation group than in control group [(124.6±21.2) min vs.(94.7± 17.9) min, t=8.821, P＜0.001].The bleeding volume were less in observation group than in control group[(43.8±10.4) ml vs.(113.5±37.6) ml, t=14.624, P＜0.001].The exhaust time and in hospital time were decreased in observation group than in control group[(27.6 ±5.5) h vs.(43.4±8.1) h, (7.4±2.4) d vs.(10.3±2.8) d, t=13.209 and 6.437, P＜0.001 for both].The incidences of postoperative pain and other complications were lower in observation group than in control group [6.0％ vs.28.4％, 16.4％ vs.43.3％, x2=11.810and 11.547, P=0.001 for all].Conclusions The laparoscopy combined with choledochoscopy has advantages to minimize the surgical injury, reduce the bleeding volume and promote the postoperative recovery in treating choledocholithiasis in elderly patients.