Clinical characteristics of 11 patients with chronic lymphocytic leukemia with t (14;19) (q32;q13) / 中华血液学杂志

Objective: To analyze the clinicopathological characteristics of 11 cases of chronic lymphocytic leukemia (CLL) with t (14;19) (q32;q13) . Methods: The case data of 11 patients with CLL with t (14;19) (q32;q13) in the chromosome karyotype analysis results of the Blood Diseases Hospital, Chinese Academy of Medical Sciences from January 1, 2018, to July 30, 2022, were retrospectively analyzed. Results: In all 11 patients, t (14;19) (q32;q13) involved IGH::BCL3 gene rearrangement, and most of them were accompanied by +12 or complex karyotype. An immunophenotypic score of 4-5 was found in 7 patients and 3 in 4 cases. We demonstrated that CLLs with t (14;19) (q32;q13) had a mutational pattern with recurrent mutations in NOTCH1 (3/7), FBXW7 (3/7), and KMT2D (2/7). The very-high-risk, high-risk, intermediate-risk, and low-risk groups consisted of 1, 1, 6, and 3 cases, respectively. Two patients died, 8 survived, and 2 were lost in follow-up. Four patients had disease progression or relapse during treatment. The median time to the first therapy was 1 month. Conclusion: t (14;19) (q32;q13), involving IGH::BCL3 gene rearrangement, is a rare recurrent cytogenetic abnormality in CLL, which is associated with a poor prognosis.

Effects of Sevoflurane and Propofol on Neurological Recovery of Traumatic Brain Injury Patients in the Early Postoperative Stage: A Retrospective Cohort Study / 中国医学科学杂志(英文版)

Objective To investigate the effects of propofol and sevoflurane on neurological recovery of traumatic brain injury (TBI) patients in the early postoperative stage.Methods We retrospectively analyzed the clinical data of TBI patients who underwent craniotomy or decompressive craniectomy. Generalized additive mixed model (GAMM) was used to analyze effects of propofol and sevoflurane on Glasgow Coma Scale (GCS) on postoperative days 1, 3, and 7. Multivariate regression analysis was used to analyze effects of the two anesthetics on Glasgow Outcome Scale (GOS) at discharge.Results A total of 340 TBI patients were enrolled in this study. There were 110 TBI patients who underwent craniotomy including 75 in the propofol group and 35 in the sevoflurane group, and 134 patients who underwent decompressive craniectomy including 63 in the propofol group and 71 in the sevoflurane group. It showed no significant difference in GCS at admission between the propofol and the sevoflurane groups among craniotomy patients (β = 0.75, 95%CI: -0.55 to 2.05, P = 0.260). However, elevation in GCS from baseline was 1.73 points (95%CI: -2.81 to -0.66, P = 0.002) less in the sevoflurane group than that in the propofol group on postoperative day 1, 2.03 points (95%CI: -3.14 to -0.91, P < 0.001) less on day 3, and 1.31 points (95%CI: -2.43 to -0.19, P = 0.022) less on day 7. The risk of unfavorable GOS (GOS 1, 2, and 3) at discharge was higher in the sevoflurane group (OR = 4.93, 95%CI: 1.05 to 23.03, P = 0.043). No significant difference was observed among two-group decompressive craniectomy patients in GCS and GOS.Conclusions Compared to propofol, sevoflurane was associated with worse neurological recovery during the hospital stay in TBI patients undergoing craniotomy. This difference was not detected in TBI patients undergoing decompressive craniectomy.

Transoral robotic surgery for treatment of lingual thyroglossal duct cyst / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the feasibility, safety and efficacy of transoral robotic surgery (TORS) in the treatment of lingual thyroglossal duct cyst (LTGDC). Methods: The clinical data of 10 patients with LTGDC treated with TORS in Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2017 to November 2020 were analyzed retrospectively,including 6 males and 4 females, aged 5-44 years. The cysts were fully exposed, and resection usually started from the cephalic side of lesions. The range of resection was 3 to 5 mm away from the lesions, and partial hyoid bone was removed if necessary. Intra-operative robotic set-up time,operation time and estimated blood loss,and post-operative local bleeding, dyspnea and recovery time for oral intake were analyzed. SPSS 12.0 software was used for statistical analysis. Results: The cysts in all 10 patients were successfully resected by TORS with da Vinci Si surgical system. The mean robotic set-up and exposure time, operation time, estimated intraoperative blood loss and recovery time for oral intake were (15.5±7.1) min, (17.6±7.4) min, (8.9±6.4)ml and (2.3±2.2)days, respectively. No patient required tracheostomy intra-or post-operatively, and no symptoms of airway obstruction, postoperative bleeding, pharyngeal fistula, hoarseness and neurological impairment occurred after operation. The patients were followed up for 5 to 47 months, with median follow-up time of 17 months, and no recurrence was observed. Conclusion: TORS is safe and feasible for resection of LTGDC, with rapid recovery and low recurrence rate.

Efficacy observation of long-retaining scalp acupuncture plus interactive training for upper-extremity dysfunction after cerebral stroke / 针灸推拿医学（英文版）

Objective: To observe the efficacy of long-retaining scalp acupuncture plus interactive training in improving upper- extremity dysfunction in cerebral stroke patients. Methods: Ninety-five patients with upper-extremity dysfunction after cerebral stroke were randomized into two groups, with 48 cases in the treatment group and 47 cases in the control group. Conventional internal medicine treatment was offered to both groups. In both groups, Anterior Oblique Line of Vertex-temporal (MS 6, the middle 2/5) and Posterior Oblique Line of Vertex-temporal (MS 7, the middle 2/5) were selected from the same side of the brain lesion (the side apposing to the hemiplegic limb) for scalp acupuncture treatment. In the treatment group, the scalp acupuncture needles were retained for 7 h, in combination with interactive training, while the needles were also retained for 7 h in the control group but without interactive training. Prior to treatment and at 2-week and 4-week treatment, the two groups were scored using the functional test for the hemiplegic upper extremity-Hong Kong (FTHUE-HK) and simplified Fugl-Meyer assessment-upper extremity (FMA-UE). Results: The total effective rate was 97.9％ in the treatment group, higher than 74.5％ in the control group (P<0.01). The FTHUE-HK score was higher at 2-week and 4-week treatment than before treatment in both groups, presenting statistically significant intra-group differences (all P<0.001); the FTHUE-HK score was higher at 4-week treatment than at 2-week treatment in both groups, presenting statistically significant intra-group differences (both P<0.001). At 2-week and 4-week treatment, the FTHUE-HK score was higher in the treatment group than in the control group, showing significant between-group differences (both P<0.05). During the whole treatment process, the treatment group had higher FTHUE-HK scores compared with the control group, but there was no statistical significance comparing the change of the score between the two groups at 2-week treatment (P>0.05), while the between-group difference in the change of the score was statistically significant at 4-week treatment (P<0.05). The FMA-UE score was higher at 2-week and 4-weeks treatment than before treatment in both groups, presenting statistically significant intra-group differences (all P<0.001); the FMA-UE score was higher at 4-week treatment than at 2-week treatment in both groups, presenting statistically significant intra-group differences (both P<0.001). At 2-week and 4-week treatment, the FMA-UE was higher in the treatment group than in the control group, and the between-group differences were statistically significant (both P<0.01). The FMA-UE score rose gradually with the increase of treatment session, and there was statistical significance comparing the change of the score between the two groups at 2-week and 4-week treatment, respectively (both P<0.05). Conclusion: Long-retaining scalp acupuncture plus interactive training results in more significant efficacy than long-retaining scalp acupuncture alone in improving the upper-limb dysfunction after cerebral stroke and the advantage becomes more notable after 2-week consecutive treatment.

Biological Function of CysR Domain of ADAMTS13 / 中国实验血液学杂志

OBJECTIVE@#To investigate the biological function of Cysteine rich (CysR) domain of a disintegrin and metalloprotease with thrombospondin type 1 repeats-13 (ADAMTS13) on cleavage of von Willebrand factor (vWF) and provide experimental evidence for exploring the pathogenesis of thrombotic thrombocytopenic purpura (TTP).@*METHODS@#The six amino acids (EDGTLS) in ADAMTS13 CysR domain were point mutated one by one, and the mutant ADAMTS13 proteins were expressed and purified. The cleavage products of vWF polymer by wild-type or mutant ADAMTS13 under denaturing condition or shear stress were separated by 1% SeaKem HGT agarose gel and detected by Western blot.@*RESULTS@#The mutant ADAMTS13 plasmids (M1: Glu515Ala; M2: Asp516Ala; M3: Gly517Ala; M4: Thr518Ala; M5: Leu519Ala; M6: Ser520Ala) were successfully constructed and the proteins of wild-type and mutant ADAMTS13 were purified. Wild-type ADAMTS13 almost completely cleaved the vWF polymer under denaturing condition, while the cleavage activity of M1 mutant was significantly reduced in the same condition (P<0.01). The cleavage activity of M1 mutant of ADAMTS13 was also significantly reduced compared with that of the wild-type under shear stress (P<0.01). The activity of M1 mutant to cleave the FRETS-vWF73 was dramatically reduced compared with that of wild-type ADAMTS13. However, the binding ability of M1 mutant to vWF was similar with that of wild-type ADAMTS13.@*CONCLUSION@#The CysR domain of ADAMTS13 plays an important role in the digestion of vWF under denaturing condition and shear stress. The Glu515 amino acid residue might be an important site for substrate recognition.

Effect Analysis of Artemisiae Annuae Herba and Chuanxiong Rhizoma in Treatment of Cerebral Malaria Based on Network Pharmacology / 中国实验方剂学杂志

Objective:To explore the reasonable combination of Artemisiae Annuae Herba and Chuanxiong Rhizoma in treatment of cerebral malaria and investigate its mechanism based on network pharmacology. Method:The traditional Chinese medicine systems pharmacology database and analysis platform （TCMSP） and SymMap were used to obtain all the chemical components of Artemisiae Annuae Herba and Chuanxiong Rhizoma and the action targets were screened to construct a component target protein-protein interaction （PPI） network. Target genes related to cerebral malaria were collected with use of GeneCards and DisGeNET databases. Common targets were screened by overlapping drug targets and disease targets， and protein-protein interaction network analysis was performed to get key targets. Gene ontology （GO） functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis were carried out to get main signaling pathways. Furthermore， the classical experimental cerebral malaria mouse model was used to detect survival curve， protozoanemia level， survival rate， experimental cerebral malaria （ECM） coma and behavior scores. RayBio^® cytokine antibody array was used to detect the expression level of cytokines in tissues and experiment was conducted for verification. Result:After combination of Artemisiae Annuae Herba and Chuanxiong Rhizoma， 23 active ingredients， 179 drug targets， and a total of 100 common targets of the drug and disease were obtained. GO functional analysis identified 59 items （<italic>P</italic><0.05）， involving cytokine activity， growth factor activity， immune response， etc. KEGG pathway analysis revealed 51 related signaling pathways. The experimental results showed that the combined use of Artemisiae Annuae Herba and Chuanxiong Rhizoma could significantly improve the clinical signs of ECM mice， such as survival state， coma and behavioral scores. In the detection of expression levels of related cytokines in mice， the expression levels of <italic>γ-</italic>interferon （IFN-<italic>γ）</italic>， interleukin-10 （IL-10）， IL-4， and IL-1<italic>β</italic> in the compatible drug combination drug were significantly higher than those in the model group （<italic>P</italic><0.05）， which was consistent with the overlapping core targets predicted by network pharmacology. Conclusion:Based on the network pharmacology analysis and<italic> in vivo</italic> experiment verification， this study confirmed the synergistic effect of the combination of Artemisiae Annuae Herba and Chuanxiong Rhizoma in the treatment of cerebral malaria， providing clear direction for further mechanism research， and a new possibility for the clinical intervention of cerebral malaria.

Effect and Mechanism of Shenlian Formula in Treatment of Atherosclerotic Cardiovascular Disease Based on Network Pharmacology / 中国实验方剂学杂志

Objective:To analyze active components， its targets and signaling pathways of Shenlian formula based on network pharmacology， and explore the molecular mechanism of Shenlian formula in the treatment of atherosclerotic cardiovascular disease （ASCVD）， in order to provide a basis for the rational interpretation of the prescription compatibility of Shenlian formula. Method:Major chemical compounds of the formula were obtained by SymMap and Systematic pharmacology database and analysis platform of Traditional Chinese Medicine （TCMSP）， its target proteins were obtained by SymMap and ETCM Databases， and the pathogenic genes responsible for of ASCVD were obtained by DisGeNET and GEO Datebases. Protein targets of drugs and pathogenic genes of diseases were overlapped to obtain predicted targets of Shenlian Formula for ASCVD. Proteins-proteins interactions （PPI） network was built through the String Datebase. The Cytoscape 3.6.0 was used to explore the key compounds and targets of Shenlian formula on ASCVD. Then gene ontology （GO） enrichment and Kyoto Encyclopedia of Genes and Genomes （KEGG） signaling pathway were analyzed to screen out the key targets of Shenlian Formula. Rat I/R model was adopted as representative disease model of ASCVD for experimental verification. Result:There were 59 candidate compounds， 67 predicted targets and 29 key targets of Shenlian formula on ASCVD. Key targets mainly included cyclooxygenase 2 （PTGS2）， estrogen receptor 1 （ESR1） and TP53. GO analysis showed that the biological functions of potential genes of Shenlian formula in treatment of ASCVD were mainly related to apoptotic， nitric oxide biosynthetic process， response to estradiol， angiogenesis， inflammatory response and oxidative stress and acute-phase response. KEGG pathway enrichment results showed that the pathways of potential genes of Shenlian formula in treatment of ASCVD mainly involved TNF signaling pathway， phosphatidylinositol-3 kinase （PI3K）/ protein kinase B （Akt） signaling pathway， hypoxia induction factor-1 （HIF-1） signaling pathway and apoptosis. Among them， the regulatory effect of Shenlian formula on apoptosis may act on not only TP53， but also different signaling pathways of apoptosis respectively， thus playing a synergistic effect. <italic>In vivo</italic> experimentation confirmed that Shenlian formula could significantly reduce the myocardial infarction area， improve the myocardial histopathological changes， and especially reduce myocardial mitochondrial injury. Further analysis showed that Shenlian formula can significantly inhibit the expressions of activated proteins in mitochondrial apoptosis pathway. Conclusion:Anti-atherosclerosis traditional Chinese medicine Shenlian formula could effectively intervene ASCVD， and its effect on mitochondrial apoptosis of myocardial cells is one of its mechanisms in protecting myocardial ischemia-reperfusion injury.

Effect of Physical Therapy and Heel Sound Feedback on Motor Function of Lower Limbs for Patients with Stroke Based on ICF Core Set / 中国康复理论与实践

Objective:To study the effect of physical therapy and heel sound feedback on lower limbs motor function, mobility and activities of daily living (ADL) for stroke patients based on International Classification of Functioning, Disability and Health (ICF) core set. Methods:From April, 2018 to May, 2020, 113 stroke patients with motor dysfunction were divided into ischemia group (n = 67) and hemorrhagia group (n = 46) according to the cause of stroke. They received physical therapy for lower limbs and heel sound feedback for eight weeks, and assessed with ICF core set for stroke-gait, Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Timed 'Up and Go' Test (TUGT), and modified Barthel index (MBI) before and after intervention. Results:The main effect of time was significant for qualifiers of ICF core set for stroke-gait, the scores of FMA-LE and MBI, and TUGT time (F > 100.59, P < 0.001), and it improved time by time as Post Hoc test. The main effect of groups was not significant (F < 2.29, P > 0.05), nor as Post Hoc test. The interactive effect between time and groups was significant for TUGT time (F = 6.45, P < 0.01), perhaps improved more in the hemorrhagia group, however, the interactive effect was not significant for the others. Conclusion:Physical therapy and heel sound feedback can improve motor function of lower limb, mobility and ADL for stroke patients.

Regulatory effect of mild moxibustion on P2X3 receptors in spinal cord, anterior cingulate cortex and thalamic ventral posterolateral nucleus of rats with IBS visceral hyperalgesia / 针灸推拿医学（英文版）

Objective: To observe the therapeutic effect of mild moxibustion on irritable bowel syndrome (IBS) visceral hyperalgesiamodel rats and its regulatory effect on P2X3 receptors in the spinal cord, anterior cingutate cortex (ACC) and thalamic ventral posterolateral nucleus (VPL). Methods: Thirty 8-day-old newborn rats were randomly divided into a normal group (n=6) and a modeling group (n=24) according to the completely random number table method. Rats in the normal group were bred routinely, and those in the modeling group were subjected to preparing IBS chronic visceral hyperalgesia model using colorectal distention (CRD) in stimulation method. Rats successfully modelled were re-divided into a model group, a mild moxibustion group, a P2X3 receptor antagonist group, and a normal saline group according to the completely random number table method with 6 rats in each group. Rats in each group received corresponding interventions from the 37-day old, once a day for 7 consecutive days. Immunohistochemistry and Western blot assays were used to detect P2X3 protein expressions in the spinal cord, ACC and VPL of rats. Results: Under different intensities of CRD stimulation, the abdominal withdrawal reflex (AWR) scores of the model group were significantly increased versus the normal group (all P<0.05); the AWR scores of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). The P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the model group were significantly increased versus the normal group (all P<0.01); the P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). Conclusion: Mild moxibustion can inhibit the P2X3 receptor expressions in the spinal cord, ACC, and VPL tissues of IBS visceral hyperalgesia model rats, which may be the mechanism of mild moxibustion in relieving the central sensitization of rats with IBS visceral hyperalgesia.

Mechanism of oxymatrine in treatment of collagen-induced arthritis in mice / 中国中药杂志

Sophorae Flavescentis Radix, the root of Sophora flavescens Ait., has been widely applied in the medical field due to its anti-inflammatory, analgesic, bacteriostatic, antiviral, antitumor, and other pharmacological effects. The present study investigated the anti-rheumatoid arthritis effect of oxymatrine(OMT), the active component of Sophorae Flavescentis Radix by observing its effect on the function of B lymphocytes in collagen-induced arthritis(CIA) mice through the Toll-like receptor 9(TLR9)/myeloid differentiation factor 88(MyD88)/signal transducer and activator of transcription 3(STAT3) pathway. The CIA model in DBA/1 J mice was induced by bovine type Ⅱ collagen and complete Freund's adjuvant(CFA). Fifteen days after the primary immunization, mice were treated with OMT for 30 days by intraperitoneal injection. Paw swelling and arthritis index(AI) score were evaluated every 3 days. Joint histopathologic changes were observed by HE staining. Magnetic-activated cell sorting(MACS) was used to isolate B lymphocytes from the spleen of CIA mice spleen. The serum expression level of interleukin(IL)-21 was examined by the enzyme-linked immunosorbent assay(ELISA). The expression of TLR9, STAT3, p-STAT3, and IL-21 in B lymphocytes was detected by Western blot. The mRNA expression of TLR9, STAT3, and IL-21 in B lymphocytes was detected by real-time fluorescence-based quantitative PCR(qRT-PCR). The results showed that OMT could significantly alleviate the paw swelling, decrease the AI score, relieve synovial inflammatory cell infiltration and hyperplasia, reduce the level of inflammatory cytokines, and inhibit the expression of TLR9, STAT3, p-STAT3, and IL-21 of B lymphocytes in CIA mice. Therefore, OMT may alleviate rheumatoid arthritis by regulating TLR9/MyD88/STAT3 pathway in B lymphocytes, providing a valuable reference for the application of OMT in the clinical treatment of rheumatoid arthritis.

Medicinal chemistry strategies in seeking coronavirus inhibitors / 药学学报

The epidemic caused by coronavirus poses a serious threat to human health, but there is no specific drug or vaccine for the treatment of this kind of virus infection. Herein, this article selects typical case studies in recent years and reviews the medicinal chemistry strategies of anti-SARS-CoV, MERS-CoV and other coronavirus drugs from the perspective of medicinal chemistry, and tries to provide some clues to current drug research againstSARS-CoV-2.

Modified Xiaochaihu Decoction () Promotes Collagen Degradation and Inhibits Pancreatic Fibrosis in Chronic Pancreatitis Rats / 中国结合医学杂志

OBJECTIVE@#To investigate the effect of Modified Xiaochaihu Decoction (MXD, ) on collagen degradation in rats with chronic pancreatitis (CP).@*METHODS@#Rats were injected dibutyltin dichloride (DBTC, 7 mg/kg of body weight) into the right caudal vein to induce CP model. Thirty heallhy male Wistar rats were randomly divided into three groups by a random number table: the control, the model and the treatment groups. Rats of treatment group were administered MXD (10 g/kg of body weight) orally once daily starting from the day post-model establishment. Pancreatic tissues were harvested after 28-day feeding and fibrosis was evaluated by picro-sirius red staining. The contents of collagen type I and III were detected using enzymelinked immunosorbent assay (ELISA), the expression of matrix metalloproteinase 13 (MMP13) and tissue inhibitor of metalloproteinase 1 (TIMP1) was analyzed by Western blot and real-time polymerase chain reaction (PCR).@*RESULTS@#The fibrosis scoring of pancreatic tissues, the concentrations of collagen type I and III, the expression levels of MMP13 and TIMP1 proteins and mRNA in the model group were all increased compared with the control group (P0.05).@*CONCLUSIONS@#MXD could promote collagen degradation and reverse pancreatic fibrosis in CP rats via a mechanism involve up-regulation of MMP13 expression.

A randomized controlled clinical study on amniotic stent and silicone tube implantation through nasolacrimal duct for the treatment of lacrimal duct obstruction disease / 中华实验眼科杂志

Objective:To investigate the efficacy and side effects of amnion stent implanted in lacrimal duct for the lacrimal duct obstruction diseases (LDOD).Methods:A randomized controlled clinical trial was adopted.Seventy-two eyes of 72 patients with LDOD treated in Jiangxi Provincial People's Hospital from June 2014 to January 2015 was randomized into the experiment group and the control group with amnion stent or silicone tube retrogradely implanted according to grouping in accordance with block randomization with 36 eyes in each group.All patients were performed irrigation of lacrimal passage at 3 and 6 months postoperatively to compare the patency rate of lacrimal duct and side effects between the two groups.This study followed the Declaration of Helsinki.Written informed consent was obtained from each subject prior to entering the study cohort.The study protocol was approved by the Ethics Committee of Jiangxi Provincial People's Hospital (No.2014-002).Results:The patency rate of lacrimal duct was 91.7%(33/36) and 80.6%(29/36) at 3 months postoperatively in the experimental and control group, respectively.Although the difference was obvious, there was no statistical significance ( P=0.307). The patency rate of lacrimal duct was 88.9%(32/36) and 75.0%(27/36) at 6 months postoperatively in the experimental and control groups, respectively.Similarly, the difference was obvious, however there was no statistical significance ( P=0.220). At 3 months and 6 months postoperatively, the incidence of epiphora in the experimental group was lower than that in the control group, it was significantly different ( Z=2.729, P=0.006), and there was no significant difference at 6 months postoperatively ( Z=1.921, P=0.055). At 6 months follow-up period, the attack rate of side effects, such as dacryon congestion and exudation, was 2.8%(1/36) and 13.9%(5/36) in the experiment and control groups, respectively, however, the difference was no statistical significance ( P=0.199). Conclusions:The implantation of amnion stent in lacrimal duct for LDOD is effective, and the patency rate of lacrimal duct is not lower than that of the implantation of silicone tube in the lacrimal duct.

Application of Ultrasound Elastography in Quantitative Evaluation for Spasticity of Forearm Flexor Muscles after Stroke / 中国康复理论与实践

Objective:To apply the ultrasound elastography in quantitative evaluation for spasticity of forearm flexor muscles after stroke, and observe its characteristics. Methods:From January to October, 2019, 30 inpatients with stroke were recruited, followning spasticity of wrist and finger flexor muscles. They were measured the shear wave velocity (SWV) of flexor carpi ulnaris (FCU), flexor digitorum superficialis (FDS), flexor digitorum profundus (FDP) and flexor carpi radialis (FCR) with ultrasound elastography, and assessed the tension of wrist and finger flexors with modified Ashworth Scale (MAS). Results:The SWV of all the muscles were more in stretching position than in relaxation position in both sides (|Z| > 3.844， P < 0.001). The SWV of all the muscles were more in the affected side than in the unaffected side in stretching position (|Z| > 3.593， P < 0.001). The differences of SWV between stretching and relaxation were more in all the muscles in the affected side than in the unaffected side (t > 3.199, P < 0.01). The mean SWV of all the muscles significantly correlated with the MAS score of wrist (r = 0.605, P < 0.001), while the mean SWV of FDS and FDP correlated with the MAS score of finger (r = 0.540, P < 0.01). Conclusion:Ultrasound elastography is useful to quantitatively evaluate the spasticity of each muscle of forearm flexors after stroke.

Safety and effectiveness of transoral robotic surgery for oropharyngeal cancer: a pilot study / 中华耳鼻咽喉头颈外科杂志

To evaluate the indication, safety and effectiveness of transoral robotic surgery (TORS) for oropharyngeal cancer based on our preliminary experience. Twelve patients, including six with tonsil cancer, five with tongue base cancer and one with posterior pharyngeal wall cancer, who underwent TORS with Da Vinci Si surgical system from March 2017 to October 2018 at Tongji Hospital of Huazhong University of Science Technology were respectively analyzed. And the surgical time, intraoperative blood loss, postoperative local bleeding, dyspnea, nerve function injury, oral intake time, whether or not to receive chemoradiotherapy were analyzed. All tumors in the 12 patients were en bloc removed by TORS. Surgical time ranged from 25 to 80 min with an average of 34.2 min. The blood loss ranged from 10 ml to 50 ml with an average of 20.8 ml. The recovery time for oral intake ranged from 1 day to 30 days with an average of 8.4 days. No patient underwent tracheostomy after TORS. Also, no patient manifested with airway obstruction, bleeding or nerve injury symptoms after operation. All 12 patients reached pathologically negative surgical margins. The patients were followed up for 4 to 22 months, with a median of 12 months. All patients who combined with more advanced than T3 stage, or more advanced than N2 stage were recommended to oncologist, then, followed with radiotherapy or chemoradiotherapy if no relevant contradictions occurred. No local recurrence or distant metastasis case was found. With proper indications, the application of TORS in oropharyngeal cancer is a relatively safe, effective and minimal invasive therapy, which merits more clinical applications.

Difference analysis of myeloid leukemia fusion oncogene expression network based on time series / 中华疾病控制杂志

@#Objective Focusing on four types acute myeloid leukemia ( AML) fusion oncogenes，so as to explore the network difference with time series expression data and further identify important genes in networks． Methods Gene network difference analysis was conducted while focusing on the global attributes of the union network． The CompNet neighborhood similarity index ( CNSI) was adopted to assess network similarity．“fast-greedy”algorithm was used to detect communities based on the union network，and further identify hub genes． Ｒesults The CNSI value between NUP98-HOXA9-3 d and NUP98-HOXA9-8 d was 0． 73，while AML1-ETO-6 h and PML-ＲAＲA-6 h was 0．25． We identified ten AML associated genes and sev- en of them ( TNF，VEGFA，EP300，EGF，CD44，PTGS2，SMAD3) were reported in the literature． Conclu- sions The network difference analysis revealed the pattern and heterogeneity of AML gene expression change across different time points，and further provided target genes for efficient treatment of AML with different types of fusion oncogenes．

Detection of regulatory T cells ratio and tumor markers CA 125, CA19-9 in patients with ovarian cancer and its clinical significance / 解剖学报

Objective: To investigate the difference of ovarian benign diseases and healthy regulatory T cells (Tregs) and tumor markers CA 125 and CA 19-9 in patients with ovarian cancer, and to analyze their correlation with clinicopathological factors and prognosis. Methods: We selected 43 cases pathologically diagnosed ovarian cancer patients in gynecological department from October 2016 to October 2017 in our hospital as a malignant group, another 55 cases of benign ovarian patients treated in the same period as benign group, 50 cases of healthy physical examination women as control group. The Tregs number and expression levels of tumor markers CA 125 and CA 19-9 in ovarian cancer were compared among the three groups, and their relationship with clinicopathological factors and prognosis was analyzed. Results: The proportions of Tregs in the malignant and benign groups were higher than those in the control group, and the proportions of Tregs, CA 125 and CA 19-9 in the malignant group were higher than that in the benign group (P0.05). Conclusion: Tregs, CA 125, and CA 19-9 can all be promising markers for clinical diagnosis, treatment and prognosis of ovarian cancer.

Gut microbiota analysis and its significance in vasovagal syncope in children / 中华医学杂志(英文版)

BACKGROUND@#Vasovagal syncope (VVS) is common in children and greatly affect both physical and mental health. But the mechanisms have not been completely explained. This study was designed to analyze the gut microbiota in children with VVS and explore its clinical significance.@*METHODS@#Fecal samples from 20 VVS children and 20 matched controls were collected, and the microbiota were analyzed by 16S rRNA gene sequencing. The diversity and microbiota compositions of the VVS cases and controls were compared with the independent sample t test or Mann-Whitney U test. The correlation between the predominant bacteria and clinical symptoms was analyzed using Pearson or Spearman correlation test.@*RESULTS@#No significant differences in diversity were evident between VVS and controls (P > 0.05). At the family level, the relative abundance of Ruminococcaceae was significantly higher in VVS children than in controls (median [Q1, Q3]: 22.10% [16.89%, 27.36%] vs. 13.92% [10.31%, 20.18%], Z = -2.40, P  4, P < 0.05). The relative abundance of Ruminococcaceae in VVS patients was positively correlated with the frequency of syncope (r = 0.616, P < 0.01). In terms of its correlation with hemodynamics, we showed that relative abundance of Ruminococcaceae was negatively correlated with the systolic and diastolic pressure reduction at the positive response in head-up tilt test (HUTT; r = -0.489 and -0.448, all P < 0.05), but was positively correlated with the mean pressure drop and decline rate (r = 0.489 and 0.467, all P < 0.05) as well as diastolic pressure drop and decline rate at the HUTT positive response (r = 0.579 and 0.589, all P < 0.01) in VVS patients.@*CONCLUSION@#Ruminococcaceae was the predominant gut bacteria and was associated with the clinical symptoms and hemodynamics of VVS, suggesting that gut microbiota might be involved in the development of VVS.

Comparation of Effects of Botulinum Toxin Type A Injection under Different Guidance Approaches on Wrist and Finger Spasticity in Stroke Patients / 中国康复理论与实践

Objective:To compare the effects of Botulinum toxin type A (BTX-A) injection guided with electromyographic/electric stimulation or ultrasonography in patients with post-stroke spasticity of wrist and finger flexor muscles. Methods:Inpatients with post-stroke spasticity of wrist and finger flexor muscles accepted BTX-A injection from January, 2015 to May, 2019 were reviewed. They were divided into electromyographic/electric stimulation-guided group (n = 36) and ultrasound-guided group (n = 37). They were assessed with modified Ashworth Scale (MAS) and Fugl-Meyer Assessment (FMA) before injection and four weeks after treatment. Results:The scores of both MAS and FMA improved in both groups after treatment (|Z| > 4.654, P < 0.001), and the scores of MAS improved more in the ultrasound-guided group (|Z| > 1.980, P < 0.05), with less dosage of BTX-A (t = 4.023, P < 0.001). Conclusion:Ultrasound-guided injection of BTX-A is more effective on wrist and finger flexion muscles spasticity than electromyographic/electric stimulation-guided method in stroke patients.

Effect of Exogenous Nitric Oxide on Plant Hormones and Enzyme Content of Acanthopanax senticosus Seeds / 中国实验方剂学杂志

Objective: To investigate the effect of exogenous nitric oxide (NO) on breaking the dormancy of Acanthopanax senticosus seeds and the changes in endogenous hormones and enzymes,and provide a basis for breaking the dormancy as well as artificial cultivation of A. senticosus seeds.Method: Different concentrations (1,5,10,20 mmol·L-1) of sodium nitroprusside (NO donor) were used to treat the A. senticosus seeds, and then thermophilic stratification was conducted. The content changes of endogenous hormones such as gibberellin (GA3), abscisic acid (ABA),indolo acetic acid (IAA),indolo butyric acid (IBA) and salicylic acid (SA) at different stratification time (0, 30, 50, 80, 100,130 d) were tested by high performance liquid chromatography (HPLC). The activity change of its in vivo enzymes[catalase (CAT), superoxide dismutase (SOD), peroxidase (POD), and malondialdehyde (MDA)] were tested by enzyme-labeled instrument.Result: In the seed germination process of A. senticosus,the contents of GA3,IAA,IBA,and SA were increased gradually,while the content of ABA was reduced gradually. The enzyme activities of POD and MDA were significantly reduced,and the enzyme activities of CAT and SOD were increased obviously. Exogenous NO could increase the seed germination rate and shorten the seed germination time. The effect of 20 mmol·L-1 sodium nitroprusside showed the most obvious effect and 10 mmol·L-1 SNP showed the weakest effect in promoting seed germination,showing an obvious "V" shape for changes.Conclusion: Sodium nitroprusside could promote the seed germination effect of A. senticosus, probably by increasing the content of hormones and enzyme in the stage of seed germination and improving the contents of endogenous NO during germination.