Regulation of Immune Function of Cyclophosphamide-induced Immunosuppressed Mice by Five Plant Polysaccharides： A Network Meta-analysis / 中国实验方剂学杂志

ObjectiveTo compare the regulatory effects of five plant polysaccharides on immune function of cyclophosphamide （CTX）-induced immunosuppressed mice by network Meta-analysis， to provide evidence for the clinical application of polysaccharides and the development of effective polysaccharides and oligosaccharides. MethodSeven databases including PubMed， Embase and Web of Science were searched， and studies that met the inclusion criteria were selected. The methodological quality of the included studies was evaluated using the risk of bias tool of Systematic Review Centre for Laboratory Animal Experimentation （SYRCLE）， and the data were analyzed using RStudio and StataSE 17. ResultA total of 62 randomized controlled trials （RCTs） were included， involving 1 512 mice and five plant polysaccharides： Astragalus polysaccharide （APS）， lentinan （LNT）， Ganoderma lucidum polysaccharide （GLP）， Poria cocos polysaccharide （PCC）， and Codonopsis pilosula polysaccharide （CPP）. The network Meta-analysis showed that APS ranked first in increasing spleen index （mean deviation （MD）=3.54， 95% confidence interval （CI） ［2.10， 5.96］）， thymus index （MD=1.98， 95%CI ［1.55， 2.54］） and T helper cells （CD4+）/T suppressor cells （CD8+） （MD=1.63， 95%CI ［1.13， 2.37］）， while CPP ranked first in up-regulating the number of peripheral blood leukocytes （MD=24.16， 95%CI ［8.21， 71.12］）， macrophage phagocytosis index （MD=2.52， 95%CI ［1.32， 4.82］） and immunoglobulin M （IgM） content （MD=1.79， 95%CI ［1.12， 2.85］）. ConclusionAll the five plant polysaccharides can regulate the immune function of immunosuppressed mice. Among them， APS has advantages in elevating spleen index， thymus index and CD4+/CD8+， while CPP focuses on increasing the number of peripheral blood leukocytes， macrophage phagocytosis index and IgM content. Due to limited number and quality of included studies， the conclusions needs to be further verified with large samples and high-quality studies.

Evidence summary of recurrence prevention in patients with diabetic foot / 中国实用护理杂志

Objective:To retrieve, obtain and summarize the best evidence for the prevention of recurrence in patients with diabetic foot, and to provide reference for clinical practice.Methods:According to the "6S" model of evidence-based resources, JBI, UpToDate, BMJ Best Practice, Cochrane Library, International Working Group on the Diabetic Foot, International Diabetes Federation, National Istitute for Health and Clinical Excellence, PubMed, EmBase, China National Knowledge Internet, Wanfang and China Biology Medicine disc were searched by computer for the prevention of recurrence of diabetic foot patients. The retrieval time limit was from the establishment of the database to April 2022. Two researchers independently evaluated the included literature and extracted the literature that met the quality standards.Results:Totally 12 articles were included at last, including 5 guidelines, 3 expert consensus and 4 Meta-analysis. From the six dimensions of the necessity and risk factors of recurrence prevention in diabetic foot patients, decompression brace prevention, surgery and wound management prevention, nutritional therapy prevention, health education and lifestyle prevention, monitoring and analysis, 18 pieces of best evidence were summarized.Conclusions:The best evidence for the prevention of recurrence of diabetic foot patients was summarized to provide evidence-based basis for management decision makers and decision implementers to prevent recurrence of diabetic foot. In the process of practice, medical workers should also fully evaluate the promoting factors and hindering factors in order to ensure that evidence can be better applied to clinical practice and serve patients.

Evidenced summary for comprehensive detumescence treatment for lower limb lymphedema in patients with gynecological malignant tumor / 中国实用护理杂志

Objective:To evaluate and summarize the relevant evidence of comprehensive detumescence treatment of lower limb lymphedema in patients with gynecological malignant tumors, and to provide evidence-based basis for clinical intervention of comprehensive detumescence treatment of lymphedema.Methods:This study was an evidence - based nursing research. Databases such as BMJ Best Practice, UpToDate, PubMed, CNKI, Wanfang and other domestic and foreign databases, as well as websites such as the Australian Lymphology Society, the International Lymphedema, and the European Clinical Oncology Association were searched for relevant evidence and evaluation of comprehensive treatment of gynecological malignant tumor-related lower limb lymphedema. The search time was from the establishment of the database to April 1, 2022.Results:A total of 18 articles were included, including 2 guidelines, 5 systematic reviews, 4 expert consensus, 2 evidence summaries, 4 randomized controlled trials and 1 best practice. Twenty-eight evidence were summarized from 7 aspects : treatment cycle and edema stage, free-hand lymphatic drainage, graduated compression stockings, skin care, elastic socks, functional exercise and health education.Conclusions:The evidence summarized in this study can provide reference for clinical medical staff to formulate comprehensive treatment plans for lower limb lymphedema. Evidence-based practice should consider the individual status of patients and clinical scenarios, and provide personalized comprehensive treatment plans for patients with lower limb lymphedema of gynecological malignant tumors as soon as possible to improve the quality of life of patients.

Research Progress of Proteolysis Targeting Chimeria in NSCLC Therapy / 中国肺癌杂志

Proteolysis targeting chimeria (PROTAC) degrades target proteins by utilizing the ubiquitin-proteasome pathway, subverting the concept of traditional small molecule inhibitors. Among the common mutation targets of non-small cell lung cancer (NSCLC), PROTAC technology has successfully achieved the effective degradation of kirsten rat sarcoma viral oncogene homolog (KRAS), epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK ) and other proteins in preclinical studies. PROTAC drugs with their unique event-driven advantages, are expected to overcome acquired drug resistance caused by small molecule inhibitors and show good therapeutic potential for undruggable targets, thereby providing a new strategy for the treatment of NSCLC.
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Study on three dimensional printing of fetal aortic arch and its branches anomalies / 中华超声影像学杂志

Objective:To explore the feasibility and application value of three dimensional (3D) printing technology in creating models of abnormal fetal aortic arch and its branches.Methods:Eleven cases of abnormal fetuses confirmed fetal aortic arch and its branches anomalies from March 2019 to July 2020 in Renmin Hospital of Wuhan University were prospectively enrolled. All the fetuses underwent two dimensional(2D) echocardiography and spatio-temporal image correlation (STIC) technology examination. The 3D volume images of fetal heart were post-processed by Mimics software to create images of the great vessels and their branches in standard tessellation language format (STL) file. The STL file was output to the 3D printer and the 3D printing models of fetal great vessels and their branches were obtained. Compared with conventional ultrasound, the characteristics and application value of 3D printed models of abnormal fetal aortic arch and its branches were analyzed.Results:Eleven fetuses were successfully modeled and printed out large blood vessels and their branch models. The 3D printing model had its own advantages in displaying large blood vessels and their branch abnormalities. It could provide high quality imaging anatomical details and visualize great vessels origin, branch and position and can better display vascular ring spatial relations.Conclusions:It is feasible to use 3D printing technology to make the fetal aortic arch and its branch abnormal model. The 3D printing model can directly display its characteristic changes and provide a certain reference basis for accurately determining the type of vascular ring in the prenatal stage.

Application of fetal heart quantitative technique in evaluation of fetal heart morphology and function / 中华全科医师杂志

Forty eight singleton normal fetuses underwent two-dimensional echocardiography with fetal heart quantitative technique (fetal HQ) in People′s Hospital of Wuhan University on September 2019. Fetal ventricular intima was successfully tracked by fetal HQ software in 45 cases; the length, transverse width, area, and global spherical index(GSI) of four-chamber view were measured with fetal HQ, meanwhile the dynamic tracking curve of ventricular intima was obtained. The left (right) ventricular global strain (GS), fetal area change (FAC), left ventricular ejection fraction (EF) and 24 segment end diastolic diameter (ED), short-axis shortening (FS), spherical index (SI) were calculated. Fetal heart shape and size and cardiac function parameters, as well as z-score of each parameter after adjustment for gestational age, were obtained successfully. The length, transverse width and area were linearly correlated with gestational age, while other parameters and their Z scores were not significantly correlated with gestational age. Z score of measured values of each parameter fell within the normal range of -2<Z <+2. All measurements of repeatability test were within the consistency limit range. It is suggest that fetal HQ can obtain multiple evaluation indexes easily and reliably, and has good reproducibility, which provides a useful tool for quantitative evaluation of fetal heart shape, size and function.

The influencing factors of HbA 1C variability and its effect on diabetic retinopathy in patients with type 2 diabetes / 中华内分泌代谢杂志

Objective:To investigate the relationship between HbA 1C variability and diabetic retinopathy(DR) in patients with type 2 diabetes and to explore the influencing factors of HbA 1C variability. Methods:Type 2 diabetic patients who received dilated funduscopic examination annually, were stratified into two groups based on the presence or absence of DR, with a median follow-up period of 4 years(2-5 years). Intrapersonal means and SDs of all recorded HbA 1C measurements were calculated. A 1C-SD represented the measure of HbA 1C variability. In addition, medical history and clinical data of all subjects were collected and analyzed. Subjects were divided into four quartiles based on their A 1C-Mean and A 1C-SD data: Q1(A 1C-Mean<7%, A 1C-SD<0.76%); Q2(A 1C-Mean<7%, A 1C-SD≥0.76%); Q3(A 1C-Mean≥7%, A 1C-SD<0.76%); Q4(A 1C-Mean≥7%, A 1C-SD≥0.76%). Results:Multivariate linear regression showed that exercise, insulin( P<0.01), and smoking( P=0.004) are the influencing factors of HbA 1C variability. Adjusted for age, sex, and diabetes duration, Cox regression analysis revealed that HbA 1C variability was an independent risk factor for DR. Meanwhile, patients in Q4 group had the highest DR prevalence(HR=1.676, P<0.01) while Q1 group had the lowest. In addition, patients in Q2 group(HR=1.437, P=0.005) had a higher risk of DR than those in Q3 group(HR=1.361, P<0.01). Conclusions:HbA 1C variability is an independent predictor of DR in patients with type 2 diabetes. It may play a greater role in DR development than mean HbA 1C does when the mean value of HbA 1C variability index is above 0.75%.

Ultrasonography in prenatal screening of brachydactyly / 中华全科医师杂志

From November.2015 to December 2016,targeted hand ultrasonographic examinations were carried out on 532 fetuses with family history,suspected limb deformities or other abnormalities.The number,size and shape of metacarpal and phalangeal bones were observed from coronal,axial and sagittal view.Three-dimensional ultrasound examination was performed on the suspected short fingers of fetal hands.Follow-up data were obtained in 382 cases.In 6 cases of prenatally detected brachydactyly,5 were bilateral and 1 case was unilateral.In these cases,more than one ossification centers of phalanxes were not present or significantly smaller.In 6 cases of brachydactyly,the termination of pregnancy was performed in 4 (including 2 cases with multiple malformations,and 2 cases with brachydactyly family history but without other abnormalities),while in other 2 cases without other abnormalities the pregnancy was retained until birth.X-rays and autopsies confirmed the prenatal diagnosis of brachydactyly in 4 cases of pregnancy termination,but duplicated distal phalanges of bilateral thumbs of 1 case was missed in prenatal scan.It is suggested that the targeted ultrasonographic scan of the fetal hands in high-risk population during pregnancy helps to detect severe brachydactyly.

Two-dimensional and three-dimensional ultrasonography in diagnosis fetal congenital vertebral deformities / 中华全科医师杂志

Prenatal 2D and 3D ultrasonographic examinations were performed for 67 008 pregnant women in Renmin Hospital of Wuhan University from January 2013 to December 2016.Among 69 013 fetuses,71 cases of congenital vertebral deformities were diagnosed with a detection rate of 0.103%.There were 40 cases of semi-vertebrae,23 cases of butterfly vertebrae,2 cases of coronal vertebral body fissure and 6 cases of vertebral fusion.Half vertebral deformity was the most common vertebral abnormality accounting for 56.3%(40/71),and the coronal vertebral body fissure was the least abnormality.Among 71 abnormal vertebral fetuses,there were 40 cases with other abnormalities,of which 28 fetuses were induced abortion, 12 fetuses were born;there were 31 cases of simple vertebral body anomalies,of which 8 fetuses were born and 23 fetuses were induced abortion.In infants with a single vertebral anomalies had no significant scoliosis,X-ray examination was performed 3-6 months after birth,the results were consistent with prenatal ultrasound diagnosis.Fifty one cases of induced abortion were examined by X-ray,the prenatal diagnosis was consistent with X-ray findings in 48 cases,and the remaining 3 cases were all multiple hemi-vertebrae with missed diagnosis of congenital butterfly vertebral deformity.

Application of ultrasonography in diagnosis and treatment of intrauterine pregnancy complicated with cornual pregnancy after in-vitro fertilization embryo transfer / 中华全科医师杂志

The clinical data of 39 cases of intrauterine pregnancy complicated with cornual pregnancy after in-vitro fertilization embryo transfer ( IVF-ET) were analyzed retrospectively .All the patients were diagnosed by transvaginal ultrasound in early pregnancy , and the position of the gestational sac and its external process were determined by transvaginal ultrasound .According to the location and size of the gestational sac, the patients were divided into two groups: in group A (n=29) the gestational sac was located close to the interstitial tube and the gestational sac was larger , prominent out of the corners of the uterus;in group B (n=10) the gestational sac was located towards the uterine cavity , gestational sac was smaller and the embryo was not active .The laparoscopic angle wedge resection for group A and ultrasound-guided embryo reduction for group B were performed respectively .After treatment , 38 cases were stable to term delivery with intrauterine pregnancy; abortion occurred in 1 case of group A 2 weeks after operation . The early diagnosis and treatment is very important for intrauterine pregnancy complicated with cornual pregnancy . Ultrasonography provides an accurate preoperative assessment and intraoperative real -time monitoring during embryo reduction , which provides an alternative approach for the treatment of intrauterine pregnancy combined with cornual pregnancy .

Quantitative assessments of real-time elastosonography in the diagnosis of uterine fibroids and adenomyoma / 中华全科医师杂志

To explore the diagnostic values of real-time elastosonography quantitative parameters in uterine fibroids and adenomyoma.The clinical data of 175 cases were analyzed retrospectively.Strain ratios (B/A) of lesion and normal adjacent myometrium were measured and mean B/A was calculated.The average B/A of uterine fibroids and adenomyoma was 3.81 ±0.52 and 1.39 ±0.46 respectively.And there was significant statistic difference (t =2.563,P ＜ 0.05).the accuracy rates of real-time elastosonography in the diagnosis of uterine fibroids and adenomyoma were high at 97.4％ (148/152) and 95.3％ (122/128) respectively.Real-time elastosonography has high diagnostic values for uterine fibroids and adenomyoma.

Correlation between ultrasound parameters and hormone level in patients with polycystic ovary and polycystic ovary syndrome / 中华全科医师杂志

A total of 104 patients with polycystic ovarian changes on ultrasound were divided into polycystic ovary syndrome (PCOS) and polycystic ovaries (PCO) groups according to their clinical symptoms and endocrine examinations.And 40 women with normal ovulation served as the controls.Ovarian volume (OV),ovarian stroma area (SA),ovarian total area (TA) and SA/TA ratio were measured by transvaginal uhrasonography.Their endocrine hormone levels were determined.Patients with PCOS showed significantly higher OV,SA,TA and SA/TA than those of PCO and control groups.SA/TA was positively correlated with testosterone.The median serum levels of anti-Mullerian hormone (AMH) and inhibit B in the PCO group were intermediate between those in control and PCOS groups.AMH and inhibin B of PCOS were higher than the PCO and control groups.It indicated that the levels of AMH and inhibit B were associated with the degree of polycystic ovaries and they could be used to differentiate PCOS and PCO.SA/TA is associated with the elevated serum testosterone of PCO.And SA/TA is an important ultrasonic parameter for diagnosing PCOS.

Pulmonary expression of Nr1d1 in rats with ventilation-induced lung injury / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the changes in the expression of nuclear receptor subfamily1 (Nr1d1) in the lungs of rats with ventilation-induced lung injury and explore the molecular mechanism.</p><p><b>METHODS</b>Seventy-two rats were randomly divided into 4 groups for observation at 4 time points (1:00 AM, 7:00 AM, 1:00 PM and 7:00 PM), and each group was further divided into 3 subgroups (Group FB, Group LV and Group HV). After ventilation for 3 h, the rats were sacrificed and lung tissue samples were obtained for testing the expression of Nr1d1 using gene chip technology and RT-PCR.</p><p><b>RESULTS</b>Nr1d1 gene expression was down-regulated in HV group as shown by gene chip RT-PCR data. Cosine analysis showed that Nr1d1 expression exhibited a rhythmicity in FB group (P<0.05).</p><p><b>CONCLUSION</b>The rhythmicity of Nr1d1 expression disappears as the tidal volume the increase. Diminished Nr1d1 expression is closely correlated with ventilation-induced lung injury in rats.</p>

Value of three-dimensional power Doppler imaging for discrimination between benign and malignant endometrium in women with postmenopausal bleeding / 中华超声影像学杂志

Objective To evaluate the value of three-dimensional power Doppler imaging(3D-PDI) in the discrimination between benign and malignant endometrium in women with postmenopausal bleeding. Methods Eighty-four women with post menopausal bleeding who examined by 3D-PDI were enrolled. All patients scheduled for pathological examination were divided into benign group (30 cases with endometrial polyps and 34 cases with hyperplasia) and malignant group (20 cases with endometrial carcinoma). Endometrial volume, vascularity index ( VI) , flow index ( FI) and vascularity flow index ( VFI) were measured. The diagnostic value of parameters derived from 3D-PDI was evaluated by using the receiver operating characteristic ( ROC) curve. Results Differences of these parameters (VI, FI and VFI) were considered statistically significant between two groups, the parameters of endometrial volume had no significant differences between two groups; the area under ROC curve(AUC) of the meaningful data were 0.976,0.888 and 0.894 respectively. Among these parameters, VI had the highest diagnostic value for discriminating between benign and malignant endometrium, the cut-off value of which was 2. 97 with a sensitivity of 95% and a specificity of 86%. Conclusions 3D-PDI is a good diagnostic tools in the discriminations between benign and malignant endometrium in women with postmenopausal bleeding.

Application of intracavitary three-dimensional ultrasonography in the diagnosis of polycystic ovary syndrome / 中华全科医师杂志

To evaluate the application of intracavitary three-dimensional ultrasonography in the diagnosis of polycystic ovary syndrome ( PCOS). The three-dimensional volumes of ovary were measured by intracavitary ultrasonography in 40 PCOS patients and 40 normal controls. The diagnostic value of parameters derived from three-dimensional ultrasonography was evaluated by using the receiver operating characteristic (ROC) curve. The ovarian volume, stromal volume, and the stromal/total volume ratio in PCOS group were significantly higher than those in control group (both P ＜ 0. 05 ) ; the area under ROC curve ( AUC ) of them were 0. 876, 0. 926, 0. 886 respectively. Among these parameters, stromal volume had the highest diagnostic value for PCOS, the cut-off value of which was 7.52 cm3 with a sensitivity of 88% and a specificity of 90%. Volume parameters of ovary measured by intracavitary three-dimensional ultrasonography can offer quantitative information for the diagnosis of PCOS.

Clinic study of strain rate and dobutamine stress echocardiography in the diagnosis of coronary heart disease / 中华超声影像学杂志

Objective To explore the value of strain rate and dobutamine stress echocardiography(DSE) in the diagnosis of coronary heart disease. Methods High-dose DSE was performed in 18 patients with coronary heart disease and 10 healthy persons, proved by selected coronary angiography. Ten patients had single coronary lesion, and the other 8 patients had more. By strain rate technology, systolic peak strain rate(SR_ SYS ) was measured in 12 segments of healthy persons and ischemic segments of patients. Results SR_ SYS of healthy subjects enhanced by the increasement of dose of DSE. In patients with single coronary lesion, SR_ SYS enhanced on the first states of baseline, 10 and 20 ?g?kg -1 ?min -1 ,while SR_ SYS changed non-significantly on 30 ?g?kg -1 ?min -1 , and began to decrease on 40 ?g?kg -1 ?min -1 . However in patients with more than one coronary lesions, SR_ SYS of 10 ?g?kg -1 ?min -1 became larger than that of baseline, while SR_ SYS didn't increase any longer on 20 ?g?kg -1 ?min -1 , and fell significantly on 40 ?g?kg -1 ?min -1 . Conclusions Combining stain rate and DSE to quantify local myocardial motion is valuable to offer many important clinic messages, and improves the diagnosis of coronary heart disease.