Role and mechanism of tubastatin A in alleviating brain injury after cardiopulmonary resuscitation by inhibiting endoplasmic reticulum stress-mediated cell apoptosis in swine / 中华急诊医学杂志

Objective:To explore the role and mechanism of tubastatin A (TubA) in alleviating brain injury after cardiac arrest and cardiopulmonary resuscitation (CA-CPR) by inhibiting endoplasmic reticulum stress-mediated cell apoptosis in swine.Methods:Twenty-three conventional male white swine, weighing 33-40 kg, aged 4 to 6 months, were divided into 3 groups by random number table method: sham group ( n=6), CA-CPR group ( n=9), and TubA group ( n=8). The CA-CPR swine model was established by 9 min of electrically induced CA through pacing catheter in the right ventricle and then 6 min of CPR in the CA-CPR group. The CA-CPR swine model was established by the same method, and then a dose of 4.5 mg/kg of TubA at 5 min after resuscitation was intravenously infused in the TubA group. The serum concentrations of neuron specific enolase (NSE) and S100β protein (S100β) were measured using ELISA before modeling and at 1, 2, 4 and 24 h after resuscitation. Neurological deficit score (NDS) was evaluated at 24 h after resuscitation. Thereafter, the animals were euthanized, and brain cortex tissues were harvested, and the expression levels of caspase-12 and caspase-3 were measured using immunohistochemistry. Cell apoptosis index was detected by TUNEL assay. The variables among the three groups were compared with one-way analysis of variance and the Bonferroni hoc test using SPSS software. Results:Twenty-four h after resuscitation, the serum concentrations of NSE and S100β were significantly increased, and NDS was markedly elevated in the CA-CPR and TubA groups compared with the sham group (all P<0.05). Compared with the CA-CPR group, serum concentration of NSE starting 2 h after resuscitation and serum concentration of S100β starting 1 h after resuscitation were significantly decreased in the TubA group [NSE (ng/mL): (23.1±2.0) vs. (20.2±2.0) at 2 h, (28.4±2.3) vs. (23.7±1.9) at 4 h, (32.1±2.7) vs. (26.6±2.0) at 24 h; S100β (pg/mL): (2239±193) vs. (1923±101) at 1 h, (2817±157) vs. (2360±141) at 2 h, (3384±250) vs. (2691±210) at 4 h, (3965±303) vs. (3119±260) at 24 h, all P<0.05], and NDS was markedly reduced (240±30 vs. 63±44, P<0.05). At 24 h after resuscitation, brain cortex tissue detection showed that the expression levels of caspase-12 and caspase-3 were significantly increased, and cell apoptosis index was markedly elevated in the CA-CPR and TubA groups compared with the sham group (all P<0.05). However, the expression levels of caspase-12 and caspase-3 were significantly decreased [caspase-12:(7.1±0.7) vs. (4.2±0.4); caspase-3: (13.3±1.6) vs. (7.7±0.8), all P<0.05], and cell apoptosis index was markedly reduced in the TubA group compared to the CA-CPR group [(31.1±8.6) vs. (17.3±2.2), P<0.05]. Conclusions:TubA alleviates brain injury and neurological dysfunction after CA-CPR in swine, which may be related to the inhibition of cell apoptosis mediated by endoplasmic reticulum stress.

Variation trend of health related behaviors in the residents with chronic diseases in Huangpu District of Shanghai from 2014 to 2019 / 上海预防医学

ObjectiveTo understand the changes of health related behaviors among residents with chronic diseases，and to provide a reference for targeted health intervention. MethodsBased on the surveillance data of chronic diseases and relevant risk factors of the residents in Huangpu District from 2014 to 2019. The study focused on health related behaviors and sociodemographic characteristics which was analyzed by chi-square test. The Cochran-Armitage trend chi-squared test was used to analyze the standardization rate. ResultsSeveral behaviors had been ameliorated such as the health examinations （Z=-3.667， P<0.001）， the measurement of blood glucose （Z=-5.793， P<0.001）， daily vegetables consumption （Z=-5.741， P<0.001）， daily animal food consumption （Z=-23.214， P<0.001）， daily physical activity （Z=-18.361， P<0.001）， sedentary behavior （Z=4.190， P<0.001）， and current smoking （Z=4.615， P<0.001）. ConclusionAn improving trend of health behaviors is found among Huangpu District residents．Targeted health education and health promotion should be carried out according to the characteristics of the population in the future.

HRCT manifestations of cochlear aqueduct in normal infants and differences of diameters with sensorineural hearing loss / 中国医学影像技术

Objective To observe HRCT features of cochlear aqueduct (CA) in normal infants,and to explore the differences of CA diameters between sensorineural hearing loss (SNHL) infants and normal infants.Methods Totally temporal bone HRCT data of 129 infants without abnormal hearing (258 ears) were taken as control group,while temporal bone CT data of 58 infants (116 ears) diagnosed as sensorineural hearing loss (SNHL) with normal inner ear structure were collected as SNHL group.Infants in both 2 groups were divided into 1-year,2-year and 3-year subgroups.The width of external aperture and length of CA were measured,and the results were statistically analyzed.Results In normal group,CA diameters and the width of external aperture had no statistical differences between sides and genders (both P＞0.05).There was no statistical difference of CA diameters between the same subgroup in 2 groups (t=0.160,0.979,0.432,all P＞0.05),but the width of CA external aperture in subgroups of SNHL group was smaller than those of normal group (t=3.722,3.101,3.336,all P＜0.01).Conclusion The length of CA and width of external aperture increase with age,and there may be relationship between smaller width of CA external aperture and SNHL.

Effect of miR-126 on proliferation and apoptosis in colon cancer cells via targeting regulation of SOX2 expression / 中国比较医学杂志

Objective To explore the effect of miR-126 on proliferation and apoptosis in colon cancer cells via targeting regulation of SOX2 expression. Methods miR-126 mimics and miR-126 NC were transfected into SW480 cells by liposome LipofectamineTM2000. The expression of miR-126 was detected by RT-PCR. Cell viability was determined by MTT staining. Cell apoptosis and cell cycle were detected by flow cytometry. The expression of SOX2 protein and mRNA was measured by western blot and RT-PCR. Luciferase reporter analysis was performed. Results Compared with miR-126 NC, the expression of miR-126 was upregulated(P< 0.01),cell viability was reduced(P< 0.01),early cell apoptosis rate and late apoptosis rate were increased(P< 0.01), cell cycle was arrested at G1 phase(P< 0.01), meanwhile, miR-126 mimics targeted downregulation of the expression of SOX2 protein and mRNA(P< 0.01). Conclusions miR-126 mimics can inhibit SW480 cell proliferation and induce cell apoptosis by targeting downregulation of expression of SOX2.

Expression of transcription factors Sp1 and Survivin in breast cancer and their correlation / 实用肿瘤学杂志

Objective The objective of this study was to investigate the expression and clinical significance of transcription factors Sp1 and Survivin in breast cancer and to further analyze their correlation.Methods Seventy cases of breast cancer patients were diagnosed as breast cancer from June 2013 to June 2015.The expression of Sp1 and Survivin in 70 cases of breast cancer and 20 cases of adjacent normal tissues were detected by immunohistochemical staining.The relationship was detected between the protein expression and the clinicopathological parameters of breast cancer.Results The positive rates of Sp1 and Survivin in breast cancer were 71.43% and 78.57%,respectively.The positive rates of Sp1 and Survivin were 30% and 10% in adjacent normal breast tissues.They showed a significant difference(P0.05).There were also no differences in the age,tumor size and histological grade of patients with breast cancer(P>0.05).In breast cancer tissues,there was a significant positive correlation between Sp1 and Survivin expression(r=0.517,P<0.01).Conclusion The transcription factors Sp1 and Survivin are closely related to the pathogenesis of breast cancer,which may serve as an adjunctive index for the diagnosis of breast cancer.It has certain guiding value for clinical diagnosis,treatment and prognosis of breast cancer.

Effect of governor moxibustion for restless legs syndrome of maintenance hemodialysis:a rando-mized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To observe the effect of governor moxibustion for restless legs syndrome(RLS) of maintenance hemodialysis.</p><p><b>METHODS</b>Sixty-nine patients with RLS of maintenance hemodialysis were randomly divided into an observation group(34 cases) and a control group(35 cases). Conventional hemodialysis was applied in the two groups. Moxibustion was used at the governor vessel from Dazhui(GV 14) to Yaoshu(GV 2) separated by governor moxibustion powder and ginger mud in the observation group. Treatment was given once two weeks and continuous eight times were taken as a course. One course was adopted. Scores of international restless legs syndrome(IRLS) and Pittsburgh sleep quality index(PSQI) were observed before and after treatment and comprehensive effects were evaluated in the two groups.</p><p><b>RESULTS</b>The total scores of IRLS and PSQI were decreased after treatment in the two groups(all<0.01). And the above two scores after treatment of the observation group were apparently lower than those of the control group(both<0.05). The cured and effective rate of the observation group was 58.8%(20/34),and that of the control group was 22.9%(8/35),with statistical difference(<0.01).</p><p><b>CONCLUSIONS</b>Governor moxibustion can effectively improve the symptoms and sleep quality of RLS of maintenance hemodialysis.</p>

Study of the efficacy and toxicity of gemcitabine combined with nedaplatin in anthracycline and/or taxane -pretreated patients with metastatic triple -negative breast cancer / 中国基层医药

Objective To evaluate the short -term efficacy and adverse reactions of gemcitabin combined with nedaplatin to patients with metastatic triple -negative breast cancer after taxane and/or anthracycline treatment. Methods Thirty -three patients with anthracycline and/or taxane -resistant metastatic triple -negative breast cancer received gemcitabin and nedaplatin regimen:gemcitabin 1 000 mg/m2,d1,8 days,intravenous;nedaplatin 80mg/m2,d1,intravenous.Treatments were repeated every 21 days and response rate was evaluated every two cycles. Results Of 33 patients, complete remission ( CR) in 1 case ( 3.03%), partial remission ( PR) in 13 cases (39.39%),stable disease(SD) in 11 cases(33.33%),progressive disease(PD) in 8 cases(24.24%),objective response rate was 42.42%.The main adverse reaction was bone marrow suppression and gastrointestinal reaction. Conclusion Combination therapy of gemcitabin and nedaplatin is an effective and well tolerated rescue regimen in anthracycline and/or taxane -resistant metastatic triple -negative breast cancer patients.

The value of“Leopard pattern” in the diagnosis of breast hyperplasia by ultrasound / 中华医学超声杂志（电子版）

ObjectiveTo study the diagnostic value of sonographic “Leopard pattern” sign in breast hyperplasia.MethodsTwo hundred and twenty-three female patients in Beijing Friendship Hospital from October 2012 to April 2013 were choosen. All the cases were diagnosed as mammary gland hyperplasia clinically, and their breast ultrasound images show the breast imaging-reporting and data system (BI-RADS) grad was 0 or 1. These patients were divided into 3 groups according to their age, Group A: 20 to 35 age (36 cases), Group B: 36 to 50 age (102 cases), and Group C: order than 50 year-old (85 cases). The pathological diagnosis were obtained by ultrasound guided breast biopsy. With pathological diagnosis as the gold standard and “Leopard sign” as ultrasound diagnostic criteria, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated. The consistency between the ultrasonic and the pathological diagnosis were analyzed by Kappa statistical test.ResultThe diagnostic consistency test of the total sample of 223 cases: in terms of the ultrasonic Leopard sign” for the diagnosis of breast hyperplasia, the sensitivity was 69% (59/85),the specificity was 46% (64/138), the accuracy was 55% (123/223), the positive predictive value was 44% (59/133), the negative predictive value was 71% (64/90), the consistency was poor (Kappa=0.14,P<0.05). Group A:the sensitivity was 90% (18/20), the specificity was 50% (8/16),the accuracy was 72% (26/36), the positive predictive value was 69% (18/26), the negative predictive value was 80% (8/10), the consistency was good (Kappa=0.42, P<0.05);Group B:the sensitivity was 70% (33/47), the specificity was 49% (27/55),the accuracy was 59% (60/102), the positive predictive value was 54% (33/61), the negative predictive value was 66% (27/41), the consistency was poor (Kappa=0.19,P<0.05); Group C: the sensitivity was 44% (8/18), the specificity was 43% (29/67), the accuracy was 44% (37/85), the positive predictive value was 17% (8/46), the negative predictive value was 74% (29/39), the consistency was poor (Kappa=0.08,P<0.05).Conclusion“Leopard pattern” sign is not suitable as an independent standard in diagnosing breast hyperplasia disease.

Effect of preoperative neutrophil/lymphocyte ratio on the prognosis of patients with prostate cancer / 中国医师杂志

Objective To explore effect of preoperative neutrophil/lymphocyte ratio (NLR) on the prognosis of patients with prostate cancer.Methods A total of 51 cases died included in our hospital as the died group, also included 124 patients survival patients served as survival group.Preoperative total prostate specific antigen (tPSA), free prostate specific antigen (fPSA), albumin, white blood cell (WBC), neutrophil count, lymphocyte count, Gleason score, and NLR were collected.Receiver operating characteristic (ROC) curve was drawn.The function of the index on prognosis was evaluated.Results The average age was 74.0 (9) years in the died group, and 73.6 (11.0) years in the survival group.Gleason score was 8 ～ 10.The patients were followed up for 10 ～ 36 months with a median follow-up time of 23 months.No significant differences in albumin and Gleason score were found between death and survival groups (P ＞0.05).However, the other major indexes had significant differences between two groups (P ＜ 0.01).NLR area under curve (AUC) was 0.835.The NLR boundary value was 2.84, which was higher than the critical value of patients with poor prognosis.Conclusions NLR can predict the prognosis of patients with malignant prostate cancer as auxiliary index.Patients with NLR ＞ 2.83 had poor prognosis.

Expression and clinical significance of microRNA-204 in human renal clear cell carcinoma / 重庆医学

Objective To inveatigate the expression and clinical significance of microRNA‐204(miR‐204) in human renal clear cell carcinoma(RCCC) .Methods 65 cases of resected RCCC tissue and corresponding normal tumor‐adjacent tissue were col‐lected and detected the expression level of miR‐204 by using qRT‐PCR .The correlation between the miR‐204 expression level and clilicalpathological features was statistically analyzed .The artificial miR‐204 mimics were adopted to stranfect into Caki‐1 cells ,then the Western blot was used to detect the expression of Bcl‐2 a as the downstream potential targets of miR‐204 and SIRT1 mRNA and protein .Results The expression level of miR‐204 in the RCCC tissue was significantly lowere than that in the normal tumor‐adjacent tissues (P3 cm ,P<0 .05) , lymph node metastasis(P<0 .05) and advanced TNM stage(Ⅲ + Ⅳ ,P<0 .05) .Both the mRNA and protin expression in RCCC Caki‐1 cells were down‐regulated after transfection .Conclusion The expression of miR‐204 is down-regulated in the RCCC tissue and is related to the malignant clinicopathological features ,and miR‐204 may suppress the RCCC genesis and development through down‐regulating the expression of Bcl‐2 and SIRT1 .

The mediation effect of the peer attachment between the self-esteem and the school adjustment of the children affected by AIDS/HIV / 中华行为医学与脑科学杂志

Objective To explore the mediation effect of the peer attachment between the self-esteem and the school adjustment of the children affected by AIDS/HIV.Methods 250 children affected by the AIDS/HIV were investigated in the research in a district affected by AIDS/HIV in the Henan province.Self-esteem scale,peer attachment questionnaire and school adjustment questionnaire was adopted in the study.Results ①Self-esteem had a positive significant effect on the school adjustment (β=0.227,P＜0.01).(②)self-esteem had a positive significant effect on the peer attachment (β=0.236,P＜ 0.01).(③When controlled the indirect effect of peer attachment,the effect of the self-esteem on the school adjustment had still been significant (β =0.145,P＜0.05),it proved that the peer attachment played a partly mediation between the relationship of the self-esteem and the school adjustment.Conclusion Self-esteem has a positive significant effect on the school adjustment; and self-esteem can not only affect the school adjustment directly,but also affect the school adjustment through the peer attachment.

Significance of ultrasound-guided core needle biopsy in diagnosis of thyroid nodules / 国际外科学杂志

Objective To explore the value of ultrasound-guided core needle biopsy (CNB) in diagnosis of thyroid nodules.Methods The clinical data of 395 patients with thyroid nodules who underwent ultrasound-guided CNB were retrospectively analyzed,and the results of CNB pathology of 278 patients who endured surgery were compared with postoperative wax pathology results.Results All patients completed CNB successfully and satisfaction rate for tissue samples was 100％.Local hematoma occurred in one case and relieved by conservative therapy.The CNB pathology results of 278 cases of patients were as follows:92 cases were malignancy,including 91 cases of papillary thyroid carcinoma,lcase of medullary thyroid carcinoma; 182 cases were benign,including lcase of parathyroid adenoma,48 cases of adenoma,and 133 cases of nodular goitre and other nodular affection.In 278 patients who underwent surgery,the CNB pathology results in 273 cases,including 90 malignancy cases and 183 benign cases,were consistent with postoperative wax pathology results and false positive occurred in 1 cases,ambiguous occurred in 4 cases.So the accuracy,sensibility,specificity,missed diagnosis rate,and misdiagnosis rate of ultrasound-guided CNB for differential diagnosis of thyroid malignant nodules from benign nodules were 98.20％ (273/278),95.79％ (91/95),99.45％ (182/183),4.21％ (4/95) and 0.55％ (1/183).Conclusion Ultrasound-guided CNB has important value on differential diagnosis of thyroid nodules.It is safe and effective.

A case report of extensively ossification renal cell carcinoma and review of literature / 中华泌尿外科杂志

Objective To review the pathogenesis, pathology, diagnosis and prognosis of calci-fication or ossification renal cell carcinoma with 1 case report. Methods A 48-year-old man was re-ferred for evaluation of an incidental mass found on the upper-middle right kidney, and computed tomography showed a 7 cm tumor with extensively calcification. PET-CT found an extensively calci-fied and ossification mass without high-function in the upper-middle right kidney. Under the diagnosis of renal cell carcinoma, a transabdominal radical right nephrectomy was performed. Results During the operation, a 7.5 crux 5.0 cm well-circumscribed, encapsulated heterogeneous mass was found on the upper-middle right kidney. The patient underwent an partial nephrectomy. Frozen section diagno-sis was renal cell carcinoma with heterotopic bone formation. Then a transabdominal radical right ne-phrectomy plus regional lymph node dissection were performed. Paraffin sections showed renal cell carcinoma with heterotopic bone formation(clear cell carcinoma, pT2b No M0 ). There was neither me-tastasis nor recurrence during the 8 months follow-up. Conclusions Renal cell carcinoma with ossifi-cation is extremely rare. Renal mass with obvious substantive calcification ossification should be trea-ted as malignant mass before operation. The prognosis of renal cell carcinoma associated with ossifica-tion is relatively good.

Clinical characteristics of adult Wilms' tumor / 中华泌尿外科杂志

Objective To investigate the clinical characteristics of adult Wilms'tumor in Chinese adults and to improve the recognition of adult Wilms'tumor.Methods The clinical data of 6 Wilms'tumor patients treated in our hospital were reviewed. Of them, there were 4 male patients and 2 female patients with mean age of 31 years old. Four patients with abdominal and flank pain and 2 patients with abdominal masses were the main clinical manifestations. One case accompanied with hematuria and another one had fever.Tumor masses were palpable by physical examination in 4 patients. Five patients had percussion tenderness over kidney region and 1 case had abdominal tenderness. Six cases underwent urinalysis and red blood cell was positive in 2 cases. There were no abnormal results in other laboratory tests. Chest X-ray was routinely performed before operation. Six patients underwent ultrasonography and all showed hypoechoic masses (5.0cm×5.0 cm-22.0 cm×25.0 cm) with clear margin. Four cases examined by CT and all had solid masses with inhomogeneous density and clear margin. On enhanced CT scan, 1 of 4 cases demonstrated irregular enhancement of the mass with local hemorrhagic necrosis area. The CT value ranged from 11-40 HU, with an average value of 22.5 HU, and increased to 35-78 HU, with an average value of 63.5 HU after administration of contrast. Two cases of MRI revealed solid mass defects.Three cases underwent IVU examination and showed the enlargement of renal umbra as well as thinning of renal calices caused by the compression of tumor and 1 case showed hydronephrosis.Thus, 5 cases were diagnosed with renal tumor and 1 case was diagnosed with cavitas pelvis tumor before operation. Five patients successfully underwent nephrectomies and 1 patient accepted oophorotomy with no subsequent complication.Retroperitoneal lymph node dissection(RPLND) was performed at the time of radical nephrectomy or oophorotomy in all patients. The tumor was found to be about 5-25 cm in size during operation. One of the tumors had invaded pancreas tail, one had invaded to the lateral abdominal wall and one had invaded into the inferior caval vein. Renal hilar lymph node was found to be exceeded 1.5 cm×1.5 cm in 2 patients. The post-operative incisal surface of the tumor presented with gray-yellow color. Capsule was intact in 4 patients. Three cases had hemorrhagic necrosis in tumor center. All the specimens sent for the pathological examination. None received adjuvant therapy before operation. Four patients received chemotherapy plus radiotherapy after surgery and other 2 patients received chemotherapy only. All patients were followed up with routine lab tests, ultrasonography and chest X-ray.Results Six patients were staged according to the National Wilms'Tumor Study staging system as follows: 1 case in stage Ⅰ, 2 cases in stageⅡ, 2 cases in stage Ⅲ and 1 case in stage Ⅳ. Nephrectomies or oophorotomy were performed in all patients successfully. Tumor diameters were from 4.5-25.0 cm, in average 11.8 cm.All cases had pathological diagnosis of Wilm's tumor. Five cases were classified into favorable histologic type and 1 case was in unfavorable histologic type. Two patients with lymph node metastasis and 3 patients with local invasion were observed. One patient with pulmonary metastasis was recorded. Six patients were followed up for 1-7 years. Five patients survived with no evidence of cancer recurrence. One patient died of pulmonary metastasis 2 years after surgery.Conclusions The majority of adult Wilms'tumors are found with local invasion and metastasis. The incidence of hematogenous metastasis in adult Wilms'tumor is higher than other types of renal tumor as well. The early diagnosis and radical surgical treatment and adjuvant chemoradiotherapy could improve the survival rate.