Tumor perfusion enhancement effect combined with programmed cell death-Ligand 1 antibody improves the immune microenvironment of solid tumors / 中华超声影像学杂志

Objective:To investigate the tumor perfusion enhancement induced by low intensity ultrasound stimulated microbubble cavitation (USMC) combined with programmed cell death-Ligand 1(PD-L1) antibody on improving the immune microenvironment of solid tumors.Methods:Tumor-bearing mice were divided into 4 groups: Control ( n=26) group, USMC ( n=27) group, anti-PD-L1 ( n=27) group and USMC+ anti-PD-L1 ( n=27) group. USMC treatment was performed with a VINNO 70 ultrasound theranostics system. Tumor perfusion was evaluated by contrast-enhanced ultrasound (CEUS). The anti-tumor efficacy was assessed by the tumor growth curve and the survival time of mice. The number and function of CD8 + T cells, the differentiation of CD4 + T cells, the proportion of MDSC and the phenotype distribution of TAM in tumors were analyzed by flow cytometry. The content of CXCL9, CXCL10 and HIF-1α in tumor were detected by ELISA. The expression of VEGF in tumor tissues was analyzed by immunofluorescence. Results:CEUS showed that the values of PI and AUC of tumors were significantly increased after USMC compared with before USMC (all P<0.05). USMC combined with anti-PD-L1 therapy did suppress the tumor progression. FCM showed the number, the expression of proliferation antigen Ki67, the secretion of IFN-γ and Granzyme B of CD8 + T cells in tumors were higher in combined group than those in other three groups after therapy (all P<0.05). Meantime, the proportion of Th1 was rose while Tregs and MDSC were declined and the polarization of TAM was toward M1 type by combined therapy. ELISA analysis showed that the combined therapy also increased the concentration of CXCL9, CXCL10 and decreased the content of HIF-1α in tumors (all P<0.05). Meanwhile, the immunofluorescence expression of VEGF was significantly lower in combined group than that in the control group after treatment ( P<0.05). Conclusions:Tumor perfusion enhancement by USMC combined with PD-L1 antibody therapy could improve tumor immune microenvironment and USMC might be a novel effective method for potentiating PD-L1 antibody immunotherapy.

Inhalation of Cananga odorata essential oil relieves anxiety behaviors in autism-like rats via regulation of serotonin and dopamine metabolism / 中西医结合学报

OBJECTIVE@#Anxiety is one of the most common symptoms associated with autistic spectrum disorder. The essential oil of Cananga odorata (Lam.) Hook. f. & Thomson, usually known as ylang-ylang oil (YYO), is often used in aromatherapy as a mood-regulating agent, sedative, or hypotensive agent. In the present study, the effects and mechanisms of YYO in alleviating anxiety, social and cognitive behaviors in autism-like rats were investigated.@*METHODS@#The prenatal valproic acid (VPA) model was used to induce autism-like behaviors in offspring rats. The effectiveness of prenatal sodium valproate treatment (600 mg/kg) on offspring was shown by postnatal growth observation, and negative geotaxis, olfactory discrimination and Morris water maze (MWM) tests. Then three treatment groups were formed with varying exposure to atomized YYO to explore the effects of YYO on the anxiety, social and cognitive behaviors of the autistic-like offspring through the elevated plus-maze test, three-chamber social test, and MWM test. Finally, the monoamine neurotransmitters, including serotonin, dopamine and their metabolites, in the hippocampus and prefrontal cortex (PFC) of the rats were measured using a high-performance liquid chromatography.@*RESULTS@#Offspring of VPA exposure rats showed autism-like behaviors. In the VPA offspring, medium-dose YYO exposure significantly elevated the time and entries into the open arms in the elevated plus-maze test, while low-dose YYO exposure significantly enhanced the social interaction time with the stranger rat in session 1 of the three-chamber social test. VPA offspring treated with YYO exposure used less time to reach the platform in the navigation test of the MWM test. YYO exposure significantly elevated the metabolism of serotonin and dopamine in the PFC of VPA offspring.@*CONCLUSION@#YYO exposure showed the effects in alleviating anxiety and improving cognitive and social abilities in the offspring of VPA exposure rats. The role of YYO was related to the regulation of the metabolism of serotonin and dopamine. Please cite this article as: Zhang N, Wang ST, Yao L. Inhalation of Cananga odorata essential oil relieves anxiety behaviors in autism-like rats via regulation of serotonin and dopamine metabolism. J Integr Med. 2023; 21(2): 205-214.

Effects of rare ginsenoside on idiopathic pulmonary fibrosis / 中国药科大学学报

@#To investigate whether rare ginsenosides could alleviate idiopathic pulmonary fibrosis (IPF), C57BL/6 mice were randomly divided into control group, bleomycin (BLM)-induced IPF group, rare ginsenoside Rk1 group, rare ginsenoside Rk3 group, rare ginsenoside Rh4 group and rare ginsenoside Rg5 group.All mice except those in the control group were given bleomycin injection.The IPF model was established by BLM for 28 days.The treatment group was given ginsenoside intragastrically at the same time.After the experiment, the lung tissues of mice were collected and the pathological changes of the mice lungs were observed.The content of hydroxyproline (HYP) in mouse lung tissue was measured.The expression of IPF-related genes in mouse lung tissues was detected.In in vitro experiments, Medical Research Council cell strain-5 (MRC-5) was used to induce IPF cell model using transforming growth factor-β1 (10 ng/mL).The effects of four saponins on the expression of IPF-related genes were analyzed by MTT assay, HYP content determination and RT-qPCR.All four rare ginsenosides could effectively alleviate the pathological process such as alveolar structure destruction caused by IPF, reduce the content of HYP, and down-regulate the expression of IPF-related genes, indicating that rare ginsenosides can effectively alleviate IPF.

Forensic Analysis of 9 Cases of Sudden Unexpected Death in Epilepsy / 法医学杂志

OBJECTIVES@#To analyze the case, scene and forensic pathological characteristics of sudden unexpected death in epilepsy (SUDEP), to provide a practical basis for forensic identification.@*METHODS@#A total of 9 autopsy cases of SUDEP were collected. The basic information of the cases, the scene characteristics, the forensic pathological changes, the common drugs and antiepileptic drug test results, and pericardial fluid biochemical test results were analyzed.@*RESULTS@#All of the 9 cases were male epilepsy patients died during sleep at night, the age of death was (37.1±8.6) years, and the course of epilepsy was (21.3±5.6) years. Six corpses were in prone position and three in left lateral position. The hemorrhage of the sternocleidomastoid muscle, sternal thyroid muscle and sternohyoid muscle were found with 8 cases, 5 cases and 4 cases, respectively, all of them were unilateral. Six cases had bilateral hemorrhage of pectoralis minor muscle. Brain edema, phagocytosis of frontotemporal neurons and gliosis, cardiac fibers bend in wavy patterns and eosinophilic staining enhancement, pulmonary edema, pulmonary congestion, alveolar hemorrhage, pulmonary small bronchiole wall shrinking, tubular proteinuria and pancreatic parenchymal hemorrhage were the common histopathological changes. The biochemical test results of pericardial fluid indicated that there were myocardial ischemic damage.@*CONCLUSIONS@#Young male, early onset, long course of disease, sleep in the prone position, poor drug compliance or combination, epileptic seizure may be the risk factors of SUDEP. Cardiac dysfunction and respiratory depression might be the main death mechanism of SUDEP.

Comparison of clinical characteristics of sporotrichosis between children and adults in a third-grade class-A hospital in Jilin province from 2010 to 2019 / 中华皮肤科杂志

Objective:To compare clinical characteristics of sporotrichosis between children and adults in a third-grade class-A hospital in Jilin province during 2010—2019.Methods:Clinical data were collected from 3 124 patients with sporotrichosis in Department of Dermatology, The First Hospital of Jilin University from January 1, 2010 to December 31, 2019, and retrospectively analyzed. There were 911 children aged < 18 years and 2 213 adults aged ≥ 18 years. All the patients were confirmedly diagnosed with sporotrichosis by fungal culture of skin lesions. Chi-square test was used to compare clinical characteristics of sporotrichosis between children and adults.Results:Among the 911 children, the male-to-female ratio was 1.4 ∶1; 720 (79.0%) developed sporotrichosis in cold seasons (January-March and October-December) , 790 (86.7%) were diagnosed with fixed cutaneous sporotrichosis, and 835 (91.7%) presented with skin lesions on the face. Among the 2 213 adult patients, the male-to-female ratio was 1∶2.5; 1 450 (65.5%) developed sporotrichosis in cold seasons, 1 523 (68.8%) were diagnosed with fixed cutaneous sporotrichosis; skin lesions mostly occurred on the extremities (1 090 cases, 49.3%) and face (975 cases, 44.1%) . The proportion of patients developing sporotrichosis in cold seasons was significantly higher in children than in adults ( χ2 = 55.55, P < 0.001) , and the proportion of fixed cutaneous sporotrichosis was also significantly higher in children than in adults ( χ2 = 107.55, P < 0.001) . In addition, the distribution of skin lesions significantly differed between the children and adults ( χ2 = 599.91, P < 0.001) . Conclusion:The epidemiological characteristics and clinical manifestations of sporotrichosis markedly differed between children and adults.

Effects of PCIA with esketamine on postpartum depression in puerpera undergoing cesarean section / 中华麻醉学杂志

Objective:To evaluate the effects of patient-controlled intravenous analgesia (PCIA) with esketamine on postpartum depression (PPD) in puerpera undergoing cesarean section.Methods:A total of 300 American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 25-35 yr, with body mass index≤35 kg/m 2, scheduled for elective cesarean section under spinal anesthesia, were divided into 2 groups ( n=150 each) by a random number table method: control group (group C) and esketamine group (group E). PCIA was performed at the end of surgery.In group C, the PCIA solution contained sufentanil citrate 50 μg, butorphanol tartrate 12 mg and metoclopramide injection 20 mg in 200 ml of 0.9% normal saline.In group E, the PCIA solution contained esketamine 1 mg/kg, sufentanil citrate 50 μg, butorphanol tartrate 12 mg and metoclopramide injection 20 mg in 200 ml of 0.9% normal saline.The PCA pump was set to deliver a background infusion of 4 ml/h and a bolus dose of 4 ml at 30 min lockout interval.The analgesia lasted for 48 h after surgery, and the visual analog scale (VAS) score was maintained<4 points.Acetaminophen 0.5 g was administered orally as a rescue analgesic when VAS score≥4 points and pain was still unrelieved after PCA pump was pressed twice in a row.The Edinburgh Postnatal Depression Scale (EPDS) was performed at 1 day before and at 3, 7 and 42 days after surgery.Depression was classified on EPDS as mild (score≥10) and severe (score≥13). The patients with preoperative depression were excluded from the study.The occurrence and degree of depression were recorded.The requirement for rescue analgesia within 0-6 h, 6-12 h, 12-24 h and 24-48 h after surgery and development of adverse effects within 3 days after surgery were recorded. Results:Compared with group C, the incidence of PPD was significantly decreased and degree was reduced at 3 and 7 days after surgery, incidence of rescue analgesia was decreased in different time periods ( P<0.05), and no significant change was found in the incidence of adverse effects in group E ( P>0.05). Conclusion:Esketamine can not only provide good postoperative analgesia but also improve PPD in puerpera when it is used for PCIA after cesarean section.

Improved Differentiation Ability and Therapeutic Effect of miR-23a-3p Expressing Bone Marrow-Derived Mesenchymal Stem Cells in Mice Model with Acute Lung Injury

Background and Objectives@#Implantation of bone marrow-derived mesenchymal stem cells (BMSCs) has been recognized as an effective therapy for attenuating acute lung injury (ALI). This study aims to discover microRNA (miRNA)-mediated improvement of BMSCs-based therapeutic effects. @*Methods@#and Results: Mice were treated with lipopolysaccharide (LPS) for induction of ALI. BMSCs with lentivirus-mediated expression of miR-23b-3p or fibroblast growth factor 2 (FGF2) were intratracheally injected into the mice with ALI. The expressions of miR-23b-3p, FGF2, Occludin, and surfactant protein C (SPC) in lung tissues were analyzed by immunoblot or quantitative reverse transcription polymerase chain reaction. Histopathological changes in lung tissues were observed via hematoxylin-eosin staining. Lung edema was assessed by the ratio of lung wet weight/body weight (LWW/BW). The levels of interleukin (IL)-1β, IL-6, IL-4, and IL-8 in bronchoalveolar lavage fluid (BALF) were assessed by ELISA. LPS injection downregulated the expressions of miR-23b-3p, SPC and Occludin in the lung tissues, increased the LWW/BW ratio and aggravated histopathological abnormalities, while upregulating IL-1β, IL-6, IL-4, and IL-8 in the BALF. Upregulated miR-23b-3p counteracted LPS-induced effects, whereas downregulated miR-23b-3p intensified LPS-induced effects. FGF2, which was downregulated by miR-23b-3p upregulation, was a target gene of miR-23b-3p. Overexpressing FGF2 downregulated the expressions of miR-23b-3p, SPC and Occludin, increased the LWW/BW ratio and aggravated histopathological abnormalities, while upregulating IL-1β, IL-6, IL-4, and IL-8, and it offset miR-23b-3p upregulation-caused effects on the ALI mice. @*Conclusions@#Overexpression of miR-23b-3p in BMSCs strengthened BMSC-mediated protection against LPS-induced mouse acute lung injury via targeting FGF2.

Improved Differentiation Ability and Therapeutic Effect of miR-23a-3p Expressing Bone Marrow-Derived Mesenchymal Stem Cells in Mice Model with Acute Lung Injury

Background and Objectives@#Implantation of bone marrow-derived mesenchymal stem cells (BMSCs) has been recognized as an effective therapy for attenuating acute lung injury (ALI). This study aims to discover microRNA (miRNA)-mediated improvement of BMSCs-based therapeutic effects. @*Methods@#and Results: Mice were treated with lipopolysaccharide (LPS) for induction of ALI. BMSCs with lentivirus-mediated expression of miR-23b-3p or fibroblast growth factor 2 (FGF2) were intratracheally injected into the mice with ALI. The expressions of miR-23b-3p, FGF2, Occludin, and surfactant protein C (SPC) in lung tissues were analyzed by immunoblot or quantitative reverse transcription polymerase chain reaction. Histopathological changes in lung tissues were observed via hematoxylin-eosin staining. Lung edema was assessed by the ratio of lung wet weight/body weight (LWW/BW). The levels of interleukin (IL)-1β, IL-6, IL-4, and IL-8 in bronchoalveolar lavage fluid (BALF) were assessed by ELISA. LPS injection downregulated the expressions of miR-23b-3p, SPC and Occludin in the lung tissues, increased the LWW/BW ratio and aggravated histopathological abnormalities, while upregulating IL-1β, IL-6, IL-4, and IL-8 in the BALF. Upregulated miR-23b-3p counteracted LPS-induced effects, whereas downregulated miR-23b-3p intensified LPS-induced effects. FGF2, which was downregulated by miR-23b-3p upregulation, was a target gene of miR-23b-3p. Overexpressing FGF2 downregulated the expressions of miR-23b-3p, SPC and Occludin, increased the LWW/BW ratio and aggravated histopathological abnormalities, while upregulating IL-1β, IL-6, IL-4, and IL-8, and it offset miR-23b-3p upregulation-caused effects on the ALI mice. @*Conclusions@#Overexpression of miR-23b-3p in BMSCs strengthened BMSC-mediated protection against LPS-induced mouse acute lung injury via targeting FGF2.

Forensic Analysis of 105 Autopsy Cases of Psychiatric Patients / 法医学杂志

Objective To provide reference for medical and health services and forensic expertise, the causes and manners of death of psychiatric patients were analyzed retrospectively. Methods A total of 105 autopsy cases of psychiatric patients accepted and settled by Institute of Forensic Science of Criminal Investigation Police University of China from 2004 to 2019 were collected. The cases were divided into four groups： disease death, suicidal death, accidental death and homicidal death. The common causes of death of each group were statistically analyzed and the differences in age, disease duration, body mass index （BMI） and gender among the groups were assessed. Results Of the 105 cases, 60 were male and 45 were female, the course of psychosis was （12.9±10.4） years, the age of the deceased was （51.3±11.4） years, and 61.0% was schizophrenic. There were 50 cases （47.6%） in the disease death group, in which the psychiatric patients were the oldest and had the longest course of psychosis and lowest BMI. Pulmonary thromboembolism, respiratory infections, and cardiogenic disease were the most common causes of death in the group. There were 26 accidental deaths （24.8%）, among which traffic accidents were the most common cause of death. There were 15 homicidal deaths （14.3%）, all of which were male, with craniocerebral injury being the most common cause of death. There were 14 suicidal deaths （13.3%）. In suicidal death group, the age of the deceased was the youngest, the course of psychosis was the shortest and falling from the height was the most common way to commit suicide. Conclusion Understanding the common causes of death of psychiatric patients may contribute to developing measures to reduce the mortality rate of the population. It is necessary to investigate the age, course of psychosis and gender of the deceased when assessing the manner of death.

Spatial point pattern analysis of hemorrhagic fever with renal syndrome in Jingzhou, Hubei Province, 2017 / 中华疾病控制杂志

Objective To analyze the spatial point pattern distribution characteristics of hemorrhagic fever with renal syndrome (HFRS) in Jingzhou city, Hubei province during the two seasons spring- summer and autumn-winter of 2017, to discuss its high incidence area and reason, and to provide basis for the resource allocation of public health. Methods The analytical data was collected from Infectious Disease Reporting Information System in China, and the spring-summer season was from March to August of 2017, while the autumn-winter was from the September of 2017 to the February of 2018. The Ripley's K-function and kernel density estimation were applied to analyze the spatial point pattern distribution and compare the distribution characteristics of spatial point pattern between the two seasons. Results In 2017, 133 cases of HFRS were reported in Jingzhou city, including the spring- summer and autumn-winter two pick incidences. The strongest aggregation distance was 17.77km in spring-summer season, and 14.40 km in autumn-winter season. The spatial gathering center was located in the north of Jianli County in spring-summer, and it moved to the south of Jiangling County and Shashi District in autumn-winter. Conclusions The key areas for the prevention and control of HFRS in Jingzhou City are Jiangling County, the southern part of Shashi District and the northern part of jianli county. The key groups are the residents of the urban-rural junction in the southern part of Shashi City, residents along the route of large-scale projects, and farmers engaged in agricultural planting or crayfish breeding in the gathering areas.

Application of modified MELD score based on eGFR for prognosis of patients with liver failure / 中华临床感染病杂志

Objective To evaluate the application of modified MELD score based on the estimated glomerular filtration rate (eGFR) in the prognosis of patients with liver failure.Methods Clinical data of 558 patients with liver failure admitted in the First Affiliated Hospital of Xinjiang Medical University from December 2001 to September 2017 were retrospectively analyzed.Among all patients,238 cases survived (survival group) and 320 died (fatal group) within 3 months.The eGFR was used in the modified model for end stage liver disease (MELD) instead of serum creatinine.Cox regression analyses were fitted with modified MELD or MELD scores by SAS 9.0 PHREG.The receiver operating characteristic (ROC) curve was generated and the values of modified MELD score and MELD score in predicting the prognosis of patients with liver failure in 3 months were compared.Kaplan-Meier method was used to analyze the survival rate of patients with liver failure.Results Cox regression analysis showed that total bilirubin,international normalized ratio (INR) and eGFR were independent prognostic factors for patients with liver failure.The fitted MELD modified score =4.07 × ln total bilirubin (mg/dL) + 12.99 × ln INR-8.32 × ln eGFR.The area under the ROC curve (AUC) of the modified MELD score and the MELD score were 0.814 and 0.757,respectively,and the sensitivity and specificity of the modified MELD score were 70.0％ and 71.4％,respectively.The predictive power of modified MELD scores in patients with liver failure was better than MELD score (Z =4.47,P ＜ 0.01).The 3-month survival rate of patients with modified MELD score ＜-15.38 was significantly higher than those with modified MELD score ≥-15.38 (x2 =99.20,P ＜ 0.01).Conclusions eGFR is an independent risk factor for the prognosis of patients with liver failure.The modified MELD score including eGFR and excluding etiological factors can be more effective and more accurate for prognosis of patients with liver failure.

Accuracy of IL-6 and IL-8 concentrations in exhaled breath condensate in predicting postoperative ARDS in patients undergoing cardiac surgery under cardiopulmonary bypass / 中华麻醉学杂志

Objective To evaluate the accuracy of interleukin-6 (IL-6) and IL-8 concentrations in exhaled breath condensate (EBC) in predicting postoperative acute respiratory distress syndrome (ARDS) in the patients undergoing cardiac surgery under cardiopulmonary bypass (CPB).Methods Forty-two American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes,aged 18-64 yr,scheduled for elective cardiac valve replacement under CPB,were selected.EBC samples were collected for determination of the concentrations of IL-6 and IL-8 by enzyme-linked immunosorbent assay.The patients were divided into either ARDS group or non-ARDS group according to whether the patients developed ARDS after surgery.The receiver operating characteristic curve for IL-6 and IL-8 concentrations in EBC in diagnosing postoperative ARDS was plotted,and the area under the curve and 95％ confidence interval (CI) were calculated.The critical value,sensitivity and specificity were calculated according to the corresponding concentrations of IL-6 and IL-8 in EBC when Youden index reached the maximal value.Results Twenty-two patients developed postoperative ARDS,and the incidence was 52％.The concentrations of IL-6 and IL-8 in EBC were significantly higher at T2-4 than at T1 in two groups (P＜0.05).Compared with group nonARDS,the concentrations of IL-6 and IL-8 in EBC were significantly increased at T2-4 in group ARDS (P＜0.05).The area under the curve (95％ CI) of IL-6 concentrations in EBC measured at T2-4 in predicting postoperative ARDS was 0.822 (0.673-0.922),0.850 (0.706-0.941) and 0.906 (0.775-0.974),respectively,the critical value was 2.92,5.04 and 2.64 pg/ml,respectively,the sensitivity was 95.5％,68.2％ and 77.3％,respectively,and the specificity was 70.0％,90.0％ and 90.0％,respectively.The area under the curve (95％ CI) of IL-8 concentrations in EBC measured at Y24 in predicting postoperative ARDS was 0.700 (0.539-0.831),0.851 (0.707-0.942) and 0.737 (0.579-0.861),respectively,the critical value was 26.75,42.73 and 21.86 pg/ml,respectively,the sensitivity was 68.2％,77.3％ and 72.7％,respectively,and the specificity was 65.0％,80.0％ and 70.0％,respectively.Conclusion The concentrations of IL-6 and IL-8 in EBC can accurately predict the occurrence of postoperative ARDS in the patients undergoing cardiac surgery under CPB.

Clinical applications of intelligent pressure control flexible ureteroscope for the treatment of renal calculi ≤2 cm / 中华外科杂志

Objective@#To evaluate the effectiveness and safety of intelligent pressure control flexible ureteroscope for management of renal stones ≤2 cm.@*Methods@#The clinical data of 267 cases of renal calculi treated with flexible ureteroscope lithotripsy at Department of Urology, Ganzhou People′s Hospital from June 2015 to December 2017 were analyzed retrospectively. There were 129 male and 138 female patients, with a mean age of 51.2 years (ranging from 19 to 76 years). Among them, 145 patients underwent intelligent pressure control flexible ureteroscope (intelligent control group) and 122 patients underwent flexible ureteroscope ordinary (ordinary group). The t test, χ2 test or Fisher exact test were used for statistical analysis. The success rate of stone seeking, the stone free rates, the incidence of complications, the average operation time, the average hospital stay after operation were compared between the two groups.@*Results@#The average mean operative time of the patients with intelligent control group was (26.17 ± 8.64) minutes, significantly shorter than (47.23±18.35) minutes of the ordinary group (t=1.968, P=0.000). The stone free rate of the patients with intelligent control group was 97.2%, it was higher than 86.0% of ordinary group (χ2=0.069, P=0.004). The complication rate of the patients with intelligent control group was 2.7%, which was significantly shorter than 18.0% of the ordinary group (χ2=17.586, P=0.000). However, there was no significant difference between the two groups in the success rate of stone seeking and postoperative hospital stay (P>0.05).@*Conclusion@#Intelligent controlled pressure ureteral flexible ureteroscope has the advantages of short operation time, high stone free rate and less complications in the treatment of renal calculi ≤2 cm compared with flexible ureteroscope ordinary.

Analysis of the efficacy of suctioning flexible ureteroscopy with automatic control of renal pelvic pressure / 中华泌尿外科杂志

Objective To evaluate the efficacy and safety of suctioning flexible ureteroscopy with automatic control of renal pelvic pressure in the treament of intrarenal and proximal ureteral stones.Methods From November 2014 to December 2016,a total of 372 patients,including 200 males and 172 females,with upper urinary tract calculi were studied.The average age of patients was 48.1 years old.The average size of stone was 5-35mm,mean 15.7mm.There were 272 cases of renal calculi,80 cases of ureteral calculi and 20 cases of renal calculi combined with ureteral calculi.There were 252 cases of single calculi and 127 cases of multiple calculi.There were 237 cases of urinary tract infection and 14 cases of bacteremia.All patients were treated by suctioning fiexible uretemscopy with automatic control of renal pelvic pressure by a patented intelligent system including an irrigation and suctioning platform and a ureteral access sheath with a pressuresensitive tip.Statistical analysis was performed regarding renal pelvic pressure,operative time,stone-free rates,and complications.Results Three hundred and thirty of 372 patients only accepted one surgery to remove the stone.There were 12 cases of upper ureteral calculi were converted to ureteroscope lithotripsy.Seventeen cases were converted to percutaneous nephrolithotomy due to significant ureteral stenosis.Seven cases who failed the first surgery due to difficulty in placing the ureteral access sheath but flexible ureteroscopy were successfully performed in these patients after indwelling a D-J stent for 2 weeks.No stone was found in 6 cases,and the soft endoscope of ureter was examined.In all patients,the renal pelvic pressure of the pelvis was controlled within 20 mmHg.The average operative time was 15-180 min(mean 58.9 min).The stone-free rates was 95.55％ (322/337),the incidence of postoperative fever was 2.97％ (10/337),the sepsis rate was 1.19％ (4/337),the incidence of urinary sepsis was 0.89％ (3/337),the incidence of lumbago caused by extravasation was 0.59％ (2/337),and no peripheral viscera injury or death case.There was no statistically significant difference between preoperative and postoperative white and red blood cells (P ＞ 0.05).Conclusions This new type of suctioning flexible ureteroscopy with intelligent pressure-control has the advantages of perfusion attraction,pressure feedback,intelligent control and visualization of intracavity pressure.It could be a new type of operation with high safety,low complication and high stone free rate.

"Evaluation on therapentic effect of ""ladder dosage"" propranolol on mixed and deeper infantile hemangioma" / 吉林大学学报(医学版)

Objective:To treat the mixed and deeper infantile hemangioma with ladder dosage propranolol, and to explore its efficacy and safety.Methods:A total of 98 infants with hemangioma were treated by ladder treatment of propranolol.Before treatment,comprehensive assessments of electrocardiogram(ECG),heart color ultrasound, blood glucose,liver function,kidney function,myocardial enzymes and blood routine were conducted.After excluding contraindications,the dose of propranolol incrementally doubled from 0.5 mg·kg-1·d-1 to 4.0 mg·kg-1·d-1.Propranolol was taken 3 times a day.Before and after medication for 1 and 2 h,ECG was monitored.The changes of tumor size,texture,color and other changes or an onset of adverse reactions were dynamicly observed.The infants were visited every month.The efficacy was evaluated using Achauer system.Results: After medication,98 cases had different degrees of color changes or tumor consistency softening.After the dosage of propranolol was increased to 4.0 mg·kg-1·d-1,the change of tumor was the fastest.According to the 4-grade method, there were 84 cases(85.71%) as gradeⅣ (excellent),2 cases (2.04%) as grade Ⅲ (good),4 cases (4.08%) as gradeⅡ (medium)and 8 cases (8.16%) as gradeⅠ (poor).The curative effect of mixed hemangioma was better than that of deeper hemangioma(P<0.05).The recovery time of 74 cases of hemangiomas was 6 months.The major adverse reactions were heart rate decline(5/98,5.10%),drowsiness(3/98,3.06%),diarrhea(7/98,7.14%),loss of appetite (1/98,1.02%), and convulsions (2/98,2.04%).After treatment,all adverse reactions disappeared.Two months after drug withdrawal there were 4 cases of recurrence,and they were continously treated with propranolol.Conclusion: The efficacy of oral ladder dosage propranolol in treatment of mixed and deeper infantile hemangioma is increased significantly and there are no significant adverse reactions.

Effect and safety of methylprednisolone pulse therapy on spinal nerve function in patients with acute spinal cord injury / 中国生化药物杂志

Objective To investigate the effect of methylprednisolone pulse therapy on spinal nerve functions in patients with acute spinal cord injury (ASCI) and evaluate its safety. Methods 200 patients with ASCI treated in our hospital from January 2010 to December 2016 were selected and were randomly divided into two groups,with 100 cases each group. The patients in control group were treated with routine basic treatment while patients in the study group were treated with methylprednisolone pulse therapy. On the basis of the American spinal cord injury Society scoring criteria (ASIA), the neurological functional recovery scores were performed were scored before and 6 weeks after treatment between the two groups and the adverse reactions were recorded. Results The scores of sensory and motor function of the patients in the two groups were higher than those before the treatment and there was statistical difference (P<0.05), and the scores in the study group was significantly higher than those in the control group, and the difference between the two grouPs was statistically significant (P<0.05). The incidence of adverse reactions in the study group (25.00％) was significantly higher than that in the control group (10.00％), and the difference was statistically significant (P<0.05). The incidence of lung infection and gastrointestinal reaction in the study group were significantly higher than those in the control group and there were statistical difference (P<0.05). Conclusion Methylprednisolone pulse therapy has significant effect on the recovery of neurological function in patients with ASCI, but the incidence of adverse reactions is high, so it is necessary to strengthen the monitoring and intervention in clinic.

Expression of hMOF in Esophageal Cancer and Its Correlation with Radiotherapy Prognosis / 中国医科大学学报

Objective To examine human males absent on the first (hMOF) protein expression in patients with esophageal cancer and explore its correlation with radiotherapy prognosis.Methods Prior to radiotherapy,hMOF protein expression levels were examined using immunohistochemistry,in 13 pairs of esophageal cancer tissues and adjacent,non-tumorous,esophageal tissues,as well as in 90 esophageal cancer biopsy tissues.The hMOF protein expression level was classified into a high-expression group and a low-expression group,based on immunohistochemical staining scores.The correlation between these groups and radiotherapy prognosis was analyzed.Results Both esophageal cancer tissues and adjacent,non-tumorous,esophageal tissues displayed hMOF protein expression,although a significantly higher level of hMOF expression was found in esophageal cancer tissues (P ＜ 0.05).Survival analysis showed that hMOF protein expression and chemotherapy were independent prognostic factors.The 1-,3-,and 5-year survival rates of patients receiving concurrent chemoradiotherapy were higher than the survival rates in patients receiving sequential chemotherapy or radiotherapy alone.The survival rate after radiotherapy was lower in the high hMOF expression group than in the low-expression group.Conclusion hMOF protein expression may be involved in the development and tumorigenesis of esophageal cancer.In patients with esophageal cancer,hMOF could be used as a new radiotherapy prognostic marker.

Application of APRI score and FIB-4 index in prognostic evaluation of patients with chronic liver failure / 中华临床感染病杂志

Objective To assess the prognostic value of APRI score and FIB-4 index for patients with chronic liver failure.Methods Clinical data of 426 patients with chronic liver failure admitted in the First Affiliated Hospital of Xinjiang Medical University from March 2005 to September 2014 were retrospectively analyzed.The MELD score,APRI score and FIB-4 index were calculated.Patients were divided into survival group and fatal group according to survival situation within 3 month after admission.Logistic regression was used to analyze the differences in all the indexes between the survival group and fatal group.Receiver operating characteristic (ROC) curve was used to assess the value of the above indexes in predicting the 3-month survival.Results Among 426 patients 244 died within three months after admission.Univariate analysis and multivariate Logistic regression showed that MELD score and FIB-4 index were statistically significant between the survival and fatal groups (Z =-4.783 and-4.104,x2 =26.31 and 11.34,both P ＜ 0.01).The area under the ROC curve of MELD score,APRI score and FIB-4 index was 0.635,0.511 and 0.616 for predicting 3-month survival,respectively.Compared with the APRI score,MELD score and FIB4 index were statistically different (x2 =13.669 and 6.341,P ＜ 0.05 or P ＜ 0.01).When MELD score ＞ 28,FIB-4 index ＞ 11.27,the patient has a high fatality rate and poor prognosis within three months.Conclusion FIB-4 index can be used to evaluate the short-term prognosis of patients with chronic liver failure,and the higher score of FIB-4 index predicts the worse prognosis.

A dosimetric study of 3D intracavitary brachytherapy in combination with applicator-guided IMRT boost for cervical cancer / 中华放射肿瘤学杂志

Objective To evaluate the dosimetric feasibility of three-dimensional(3D)intracavitary brachytherapy in combination with applicator-guided intensity-modulated radiation therapy(IMRT)boost for patients with locally advanced cervical cancer who have unfavorable topography following external beam irradiation. Methods A total of 7 patients with locally advanced cervical cancer who had unfavorable topography following external beam irradiation were included. Two plans were generated for brachytherapy using Oncentra 4.3 treatment planning system:3D intracavitary brachytherapy and 3D intracavitary brachytherapy in combination with applicator-guided IMRT boost.To further evaluate cumulative doses to organs at risk(OAR)in the four fractions of combined plans,two methods were used:simple dose-volume histograms(DVH)parameter addition and deformable image registration(DIR)-based DVH accumulation. The D90, V100, and conformity index(CI)were evaluated. The paired t-test or Wi1coxon signed rank test was used for statistical analysis. Results Compared with the 3D plan,the combined plan yielded higher D90, V100, and CI(P=0.000), but showed no significant difference in D2ccof the rectum,sigmoid colon,and bladder(P>0.05). There were also no significant differences in D2ccof the rectum, sigmoid colon, and bladder calculated by the two methods for calculating OAR cumulative doses, simple DVH parameter addition and DIR-based DVH accumulation(P>0.05). Conclusions For patients with cervical cancer who have unfavorable topography following external beam irradiation,3D intracavitary brachytherapy in combination with applicator-guided IMRT boost can improve target coverage and CI, without increasing OAR doses. DIR-based DVH accumulation and simple DVH parameter addition may be both acceptable for assessing OAR cumulative doses.

Effect of angle correction factors of MatriXX on VMAT dose verification / 中华放射肿瘤学杂志

Objective To investigate the effect of the angle correction factors of ionization chamber array Matrixx on the dosimetric verification of volumetric modulated arc therapy plan.Methods The Matrixx (IBA)was put in the middle of the MultiCube Phantom. Computed tomography scan was performed and the results were sent to the Raystation treatment planning system(TPS). All data calculated from TPS and actually measured using MatriXX were gained under the following conditions:6 MV,100 MU,28 cm×28 cm radiation field. And the directions of beam were from 0°to 180°with an interval of 5°(except an interval of 1° from 85° to 95°). The angle correction factors(CF)(θ)cor of MatriXX were calculated by the calculated dose values from TPS and the measured values using MatriXX and then mirrored to the opposite side. CF (θ)cor values were compared with CF(θ)def values that were given by manufacturer. The comparison was made by paired t-test. Results CF(θ)cor and CF(θ)def were different, and the difference was significant between 85° and 95°,with a maximum of 7.5%(P<0.05). The CF(θ)cor correction method had a higher gamma pass rate than the CF(θ)def correction method,with a maximum of 17%(P<0.05). Conclusions The ionization chamber array MatriXX has an angular dependence and the angle correction should be performed.The angle correction factors have the individual characteristics and are different in every unit ionization chamber of the MatriXX. Therefore, it is necessary to do angle correction for every unit ionization chamber of the MatriXX and the possible errors caused by various factors should be considered in order to improve the accuracy rate and gamma pass rate of the plan verification.