Relationship between fetal ultrasonic soft markers and adverse pregnancy outcomes during the first trimester / 中华超声影像学杂志

Objective:To explore the relationship between soft markers found in the first trimester (11-13 + 6 gestational weeks) ultrasound screening and fetal adverse pregnancy outcomes. Methods:Single pregnancy fetuses were selected from the Multicenter Clinical Study of First Trimester Screening in China during August 2017 to August 2020. The types and detection rate of soft markers during the first trimester were compared. The correlation between positive soft markers and adverse pregnancy outcomes was analyzed by binary Logistics regression.Results:A total of 16 625 fetuses with complete follow-up outcomes were included in the group. Six hundred and seven ultrasonic soft markers were detected in 556 fetuses with positive soft markers during the first trimester, and the first four most frequently occurred were increased nuchal translucency (NT) (2.08%, 345/16 625), echogenic intracardiac focus (EIF) (0.94%, 156/16 625), hypoplasia of fetal nasal bone (0.20%, 34/16 625), single umbilical artery (SUA) (0.19%, 31/16 625). Among 556 fetuses, the incidence of adverse pregnancy outcome in fetuses with two or more positive soft markers was 32.50% (13/40), which was significantly higher than fetuses with single positive soft marker (11.05%, 57/516), and the difference was statistically significant (χ 2=5.055, P<0.001). The incidence of adverse pregnancy outcome in positive soft markers fetus associated with structural abnormalities was 80.77% (21/26), which was significantly higher than fetuses with isolated positive soft marker (12.08%, 64/530), and the difference was statistically significant (χ 2=90.310, P<0.001). Binary logistic regression analysis showed choroid plexus cyst (CPC), SUA, echogenic bowel (EB), absent/reversed a-wave of ductus venosus, hypoplasia of fetal nasal bone, increased NT, and EIF were closely related to the adverse pregnancy outcomes (all P<0.05). However, there were no significant correlations between tricuspid regurgitation (TR), pyelectasis (PYE) and fetal adverse pregnancy outcomes (all P>0.05). Conclusions:The ultrasonic soft markers during the first trimester are of great significance in predicting fetal adverse pregnancy outcomes. For multiple positive soft markers or positive soft markers combined with structural abnormalities, more attention should be paid to them and comprehensive evaluation is required to be carried out.

Effect of reproductive health education on self efficacy and intention of condom use among college freshmen / 中国学校卫生

Objective@#To analyze the influence of reproductive health education in middle school on self efficacy and intention of condom use among college freshmen, so as to provide evidence for fertility protection related intervention and policy making.@*Methods@#A questionnaire survey was conducted among college freshmen in Beijing by hierarchical cluster sampling method. A total of 3 001 students were surveyed. The difference was compared by using χ 2 test and ANOVA. Multivariate linear and Logistic regression model was used to analyze the influencing factors associated with condom use self efficacy and condom use intention.@* Results@#The overall rate that reproductive health education received before college among freshmen in Beijing was 65.11%. The college freshmen from urban areas reported more adequate reproductive health education (71.11%) than those from non urban areas before college (59.36%)( P <0.05). The total scores of UNGASS (4.22±0.90 vs 4.05±0.98), condom use self efficacy (24.64±5.34 vs 23.09±4.93) and the intention of condom use (82.44% vs 70.88%) of college freshmen received reproductive health education in middle school were higher than those of college students without pre college reproductive health education( P <0.01). Multiple linear regression analysis showed that the score of condom use self efficacy of college students received pre college reproductive health education was higher than those without pre college reproductive health education( β =1.21, 95% CI =0.79-1.63, P <0.01). Multivariate Logistic regression analysis showed that reproductive health, the intention of condom use of college freshmen who received pre college reproductive health education was higher than that of college freshmen without reproductive health education( OR =1.63, 95% CI =1.33-2.01, P <0.01).@*Conclusion@#Reproductive health education in middle school can improve college freshmen s self efficacy and intention of condom use, contribute to the implementation of safe sex, and is of great significance to the protection of college students fertility.

Ultrasonographic diagnosis of fetal cleft lip and palate during first-trimester (11-13 + 6 gestational weeks) / 中华超声影像学杂志

Objective:To explore the clinical value of prenatal ultrasound in diagnosis of fetal cleft lip and palate during first-trimester (11-13 + 6 gestational weeks). Methods:Ultrasonographic images were retrospectively selected from those fetuses who underwent first trimester scanning during July 2017 to June 2020 in the Affiliated Suzhou Hospital of Nanjing Medical University. Fetal facial mid-sagittal section and the retronasal triangle (RNT) section were combined together to evaluate whether the fetuses had cleft lip and palate (CLP) or not. All fetuses were followed up to birth or induced abortion.Results:A total of 5 520 fetuses were enrolled, with crown-rump length (CRL) between 45-84 mm. Seven cases of different types of CLP were detected by the 2 combined sections, including 4 cases with unilateral CLP, 1 case with median CLP, and 2 cases with bilateral CLP, which were confirmed by follow-up. In addition, 2 cases of isolated cleft lip (CL) were missed.Conclusions:Combination of fetal facial mid-sagittal section and RNT section is useful for the early diagnosis of fetal cleft lip and palate during first-trimester scanning.

Prenatal diagnosis of a case of Pallister-Killian syndrome / 中华医学遗传学杂志

OBJECTIVE@#To carry out G-banded chromosomal karyotyping and chromosomal microarray analysis (CMA) for a fetus featuring multiple malformations.@*METHODS@#The fetus was found to have increased nuchal thickness, generalized edema, asymmetric lower limbs, tetralogy of Fallot, nasal bone anomaly and cleft palate. Following amniocentesis, G-band karyotyping and CMA were carried out.@*RESULTS@#The fetus had a karyotype of 47,XX,+i(12)(p10) [14]/46,XX[6]. CMA has identified a 33.9 Mb duplication at 12p13.33-p11.1, which was suggestive of tetrasomy 12p.@*CONCLUSION@#Combined chromosomal karyotyping and CMA can delineate the origin of abnormal chromosomal fragments during prenatal diagnosis. The fetus was diagnosed with Pallister-Killian syndrome.

The value of quantitative parameters of dynamic contrast-enhanced MRI in evaluating the biological behavior of soft tissue tumors / 中华放射学杂志

Objective:To explore the value of quantitative parameters of dynamic contrast-enhanced MRI(DCE-MRI) in evaluating the biological behavior of soft tissue tumors.Methods:The clinical data of 69 patients with soft tissue tumors confirmed by pathology in the Affiliated Hospital of Qingdao University from January 2017 to December 2019 were analyzed retrospectively, including 29 benign tumors and 40 malignant tumors. All patients were examined by routine MRI and DCE-MRI before the operation. The DCE-MRI parameters including volume transfer constant (K trans), rate constant (K ep) and extracellular space volume fraction (V e) were acquired by post-processing software analysis. Microvessel density (MVD) and Ki-67 labeling index (Ki-67 LI) were detected using immunohistoche mical method. Spearman correlation test was used to analyze the correlation between DCE-MRI quantitative parameters and MVD and Ki-67 LI.Independent sample t-test or Mann-Whitney U test was used to compare the difference of parameters between benign and malignant group, and the receiver operating characteristic (ROC) curves were performed to evaluate the diagnostic value. Results:There was positive correlation between K trans, K ep and MVD ( r=0.633, 0.727, P<0.0l), and positive correlation between K trans, K ep and Ki-67 LI ( r=0.557, 0.612, P<0.01). There was no correlation between V e and MVD, Ki-67 LI ( P>0.05). The K trans, K ep, MVD and Ki-67 LI in the malignant group were higher than those in the benign group, and the differences were significant ( P<0.05).There was no significant difference in V e value between malignant group and benign group. When K trans value of 0.169/min was used, the sensitivity, specificity and area under the ROC curve (AUC) for differentiating benign and malignant soft tissue tumors were 84.6%, 85.8% and 0.859, respectively. When K ep value of 0.367/min was used, the sensitivity, specificity and AUC were 92.3%, 83.3% and 0.846, respectively. Conclusion:The DCE-MRI quantitative parameters K trans and K ep can be used to evaluate the biological behavior of soft tissue tumors.

Clinical significance of ultrasonic diagnosis in fetal cardiac tricuspid regurgitation of middle-late pregnancy / 中国医师进修杂志

Objective:To investigate the clinical significance of ultrasonic diagnosis in fetal cardiac tricuspid regurgitation of middle-late pregnancy.Methods:The clinical data of 80 middle-late pregnancy with ultrasound images of fetal cardiac tricuspid regurgitation in Cixi People′s Hospital of Zhejiang Province from June 2017 to June 2019 were retrospectively analyzed. The velocity of tricuspid regurgitation, ratio of color bundle of tricuspid regurgitation to right atrium, ratio of right atrial diameter to left atrial diameter and venous catheter atrial contraction wave A were detected by color Doppler ultrasound, and the prognosis of fetal was recorded. Among them, 49 cases with physiological reflux was as control group, and 31 cases with pathological reflux (congenital structural abnormality of the heart and no-congenital structural abnormality of the heart which affected the heart function) was as abnormal group.Results:The velocity of tricuspid regurgitation, ratio of color bundle of tricuspid regurgitation to right atrium, ratio of right atrial diameter to left atrial diameter in abnormal group were significantly higher than those in control group: (243.39 ± 100.31) cm/s vs. (120.23 ± 40.12) cm/s, (45.9 ± 12.3)% vs. (15.4±2.3)% and 1.30 ± 0.32 vs. 1.08 ± 0.04, the venous catheter atrial contraction wave A was significantly lower than that in control group: (7.96 ± 3.21) cm/s vs. (35.01 ± 4.58) cm/s, and there were statistical differences ( P<0.05). One month after birth, the 49 children in control group were reexamined with cardiac ultrasound, among whom cardiac tricuspid regurgitation disappeared was in 15 cases, and cardiac tricuspid regurgitation decreased in different degrees was in 34 cases. In the 31 cases of abnormal group, congenital structural abnormality of heart was in 23 cases, and no-congenital structural abnormality of heart was in 8 cases; there were neonatal death in 4 cases, fetal death in 2 cases, and induced labor in 8 cases; the other 17 cases had better postnatal condition, and the cardiac ultrasound 1 month after birth showed that cardiac tricuspid regurgitation decreased or disappeared. Conclusions:Prenatal detection of the fetal tricuspid regurgitation has a great significance, and fetal prognosis can be assessed according to the etiology and the degree of the reflux.

Short-Term Effects of Bariatric Surgery on Body Composition Assessed by Dual-Energy X-Ray Absorptiometry / 中国医科大学学报

Objective To assess the short-term effects of bariatric surgery on body composition. Methods Fifty-seven patients who underwent bariatric surgery were assessed by dual-energy x-ray absorptiometry (DEXA) before surgery, and 1 and 3 months after surgery. The body composition indexes of whole body and different regions were compared. Results The body mass index (BMI) decreased by 10.61％ and 18.51％, and the lean mass (LM) by 13.22％ and 14.35％ at 1 and 3 months after surgery, respectively. The A/G far mass (FM) decreased significantly 3 months after surgery (P ＜ 0.05). The bone mineral density (BMD) of the spine increased, but that of the pelvis decreased at 1 and 3 months after the operation, and a reduction was observed in the BMD of the whole body by 1.23％ and 1.45％, respectively (P ＜ 0.05). Compared to the baseline, the bone mineral content (BMC) of the spine, pelvis, and whole body increased at 1 and 3 months post-surgery, with a statistically significant difference (P ＜ 0.05). The FM of the whole body (9.52％ and 22.77％) and four regions (legs, trunk, android, and gynoid) reduced. A significant loss of FM (P ＜ 0.05) was observed in the android region by 15.80％ and 31.86％ at the two follow-ups. Conclusion Bariatric surgery can effectively reduce the patient's BMI and FM in the short term, and promotes the redistribution of fat; however, it may be accompanied by a reduction in LM, while the BMD and BMC change trend of pelvis and whole body are opposite.

Prenatal diagnosis for a pregnant woman affected with Williams-Beuren syndrome / 中华医学遗传学杂志

OBJECTIVE@#To carry out genetic diagnosis for a pregnant woman and her fetus.@*METHODS@#Chromosome G-banding and microarray analysis were used to analyze the woman featuring dysmorphism and recognition defect and her fetus featuring developmental retardation.@*RESULTS@#The karyotype of the woman was normal, but chromosome microarray analysis showed that she has carried a 1423 kb deletion at 7q11.23 region. Her fetus has carried a 1530 kb deletion at the same region. Both individuals were diagnosed as Williams-Beuren syndrome.@*CONCLUSION@#Familiarity with its clinical features and proper selection of genetic testing methods are crucial for the diagnosis of Williams-Beuren syndrome.

Meta-analysis of Efficacy and Safety of Endostar Combined with Gemcitabine and Cisplatin in the Treatment of Advanced Non-small Cell Lung Cancer / 中国药房

OBJECTIVE： To systematically evaluate the efficacy and safety of Endostar combined with gemcitabine and cisplatin in the treatment of non-small cell lung cancer （NSCLC）， and to provide evidence-based reference for clinical drug use. METHODS： Retrieved from Cochrane Library， PubMed， Embase， ClinicalTrials， CNKI， Wanfang and VIP database， randomized controlled trials （RCT） about Endostar combined with gemcitabine and cisplatin（trial  group） vs. gemcitabine combined with cisplatin （control group） for NSCLC were collected. After literature screening， data extraction and quality evaluation with Cochrane 5.1.0 bias risk evaluation tool and Jadad scale， Meta-analysis was performed by using Rev Man 5.3 software. RESULTS： A total of 27 RCTs were included， involving 1 646 patients. Results of Meta-analysis showed that response rate [RR＝1.67， 95％CI（1.48，1.89），P＜0.000 01] and clinical benefit rate [RR＝1.26， 95％CI （1.20， 1.33），P＜0.000 01] of trial group were significantly higher than those of control group. There was no statistical significance in the incidence of leucopenia [RR＝0.98，95％CI（0.88， 1.11），P＝0.79]， thrombocytopenia [RR＝1.07， 95％CI（0.91， 1.26），P＝0.39] and gastrointestinal reaction [RR＝1.01， 95％CI（0.90， 1.14），P＝0.85] between 2 groups. CONCLUSIONS： Endostar combined with gemcitabine and cisplatin can improve therapeutic efficacy of NSCLC patients， without increasing the incidence of ADR.

Application of quantitative fluorescencet-PCR in the prenatal diagnosis of chromosomale aneuploidies / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the accuracy of quantitative fluorescence PCR(QF-PCR) for the detection of fetal chromosomal aneuploidies and its values for prenatal diagnosis.</p><p><b>METHODS</b>QF-PCR and chromosomal karyotyping were used to analyze 6066 amniotic fluid samples derived from 6034 pregnant women.</p><p><b>RESULTS</b>Both QF-PCR and karyotyping analysis have detected 135 cases of fetal aneuploidies involving chromosomes 21, 18, 13, X, and Y. The QF-PCR assay was also successful in 67 cases for which amniotic fluid culture has failed. Furthermore, it has identified maternal cell contamination in 7 cases. By determining the consistency of short tandem repeat (STR) sites, the QF-PCR assay has identified 22 dizygotic twins among 32 twins with double chorions and double amniotic sacs. In 12 cases, it has signaled numerical chromosomal aberration by critical or partial abnormal values for the fluorescence peak area ratio, which were verified by karyotyping analysis as mosaicisms of chromosome aneuploidies.</p><p><b>CONCLUSION</b>The QF-PCR can provide an useful supplement for chromosomal karyotyping and has an important role in rapid prenatal diagnosis.</p>

Correlation between CT perfusion imaging and VEGF, and CD105 expressions in solitary pulmonary nodules / 中国医师杂志

Objective To explore the association of CT perfusion parameters to plasma levels of vascular endothelial growth factor (VEGF) and CD105 in patients with lung cancer to provide a reference for the treatment of patients with vascular targeting anti-selection.Methods Forty eight consecutive patients with diagnosed solitary pulmonary nodules underwent perfusion by 64-slice spiral CT.Among them,31 patients were diagnosed as lung cancers and 17 diagnosed as benign lesions.Statistical methods were used to analyze the differences of CT perfusion parameters [blood flow (BF),blood volume (BV),permeability surface (PS),and mean transit time (MTT)] between benign and malignant lesions,and to observe the correlation between cancer perfusion parameters and VEGF,and CD105.Results Compared to the group of benign lesions,the perfusion parameters BF,BV,and PS in the group of lung cancers were significandy higher than the group of benign lesions (P ＜ 0.05).MTT was not different between two groups (P ＞ 0.05).There were positive correlations between the expressions of VEGF or CD105 and perfusion parameters (BF,BV,and PS) of lung cancers.There were no correlation between perfusion parameter MTT and VEGF or CD105 (P ＞ 0.05).Conclusions CT perfusion parameters BF,BV,and PS can help in differentiating malignant from begin lesions.There is positive correlation between the perfusion parameters (BF,BV,and PS) and VEGF,and CD105 of lung cancers.It indicates that CT perfusion imaging is closely related to tumor angiogenesis,which may provide a non-invasive method to evaluate the blood supply.

Role of hippocampal cannabinoid receptor 2 in postoperative cognitive dysfunction in mice / 中华麻醉学杂志

Objective To investigate the role of hippocampal cannabinoid receptor 2 (CB2R) in postoperative cognitive dysfunction (POCD) in mice.Methods Fifty-four healthy male C57BL/6 mice,aged 12-16 weeks,weighing 20-30 g,were divided into 3 groups (n=18 each) using a random number table:control group (group C),group POCD and POCD plus CB2R agonist JWH133 group (group POCD+J).The mice were subjected to an intramedullary fixation for tibial fracture under 1.5％ isoflurane anesthesia to establish POCD model.In group POCD+J,2 mg/kg JWH133 was injected intraperitoneally at a total volume of 10 ml/kg after emergence from anesthesia and then the injection was repeated once a day until the 7th day after surgery.Open field test was carried out on 1 day before surgery and 1,3 and 7 days after surgery to evaluate the locomotor activity.Fear conditioning test was carried out at 15 min after completion of open field test.Mice were sacrificed at 2 h after the end of behavioral test,and the hippocampus was harvested for determination of the expression of tumor necrosis factor-alpha (TNF-α),interleukin-1beta (IL-1β),monocyte chemotactic protein-1 (MCP-1) and CB2R (by Western blot) and expression of CD11b in hippocampal tissues (by immunofluorescence).Results There was no significant difference in the total exploring distance in open field test,percentage of freezing time in contextual fear conditioning test or percentage of freezing time in tone-fear conditioning text at each time point among the three groups (P＞0.05).Compared with group C,the percentage of freezing time in contextual fear conditioning test was significantly decreased,and the expression of TNF-α,IL-1β,MCP-1,CD11b and CB2R was up-regulated after surgery in group S (P＜0.05).Compared with group S,the percentage of freezing time in contextual fear conditioning test was significantly increased,and the expression of TNF-α,IL-1β,MCP-1,CD11band CB2R was down-regulated after surgery in group S+J (P＜ 0.05).Conclusion Activation of hippocampal CB2R may be involved in the endogenous protective mechanism of POCD in mice,and the mechanism is related to inhibiting activation of hippocampal microglia and attenuating central inflammatory responses.

Efficacy of cervical giant cell tumor surgical treatment via lesion / 中华骨科杂志

Objective To investigate the safety and efficacy of curettage and excision for giant cell tumor of the cervical spine.Methods Retrospectively analyzed 6 cases of giant cell tumors patients who underwent surgical resection of cervical spine between April 2006 and July 2015.There were 2 males and 4 females with an average age of 31.3 years old (ranged from 18 to 42 years).Among them,4 cases were located in C2 vertebral body,1 case located in C3 vertebral body,1 case in C4 spinous pro cess and vertebral lamina.In this study,all the 6 patients underwent intralesional surgery,3 patients were Enneking grade ⅡA,which 1 case underwent curettage,2 cases underwent extended curettage;three cases were Enneking grade ⅢB,which 1 case underwent extended curettage,and 2 cases underwent subtotal spondylectomy.Three patients received local inactivation of the lesion.One patient received local radiotherapy after first posterior occipital-cervical fixation,and underwent posterior and anterior tumor resection,bone grafting and internal fixation 3 months later.One patient was treated with denosumab preoperatively,3 patients were treated with bisphosphonates postoperatively.The neurological status was evaluated by Frankel classification pre-and postoperatively,the pain scale was evaluated by Visual Analogue Scale (VAS) pre-and postoperatively.Imaging examination was used to assess the location and the extent of the tumor preoperatively,as well as the tumor recurrence postoperatively.Results The mean follow-up period was 61.1 months (ranged from 25 to 134 months).One case underwent posterior surgery,while other 5 cases underwent anterior and posterior surgery;3 patients underwent one-stage surgery,3 patients underwent multi-staged surgery.The mean intraoperative bleeding was 2 142 ml (ranged from 300 to 9100 ml).The mean preoperative VAS score was 3 (ranged from 2 to 5),the neck pain of the patients were all relieved postoperatively,and the mean VAS score was 0.The Frankel grade were E in all 6 patients of pre-and postoperation.One intracranial epidural hematoma occurred on the second day after operation,emergency evacuation of hematoma was then performed and the postoperative recovery was good.At the latest follow-up,no internal fixation loosening or failure occurred,and no tumor recurrence was observed in all patients.Conclusion Intralesional curettage and excision of the cervical spinal giant cell tumor is a safe and effective surgical method which can achieve satisfactory local control and prognosis.

Effect of exogenous miR-181b on postoperative cognitive dysfunction in mice / 中华麻醉学杂志

Objective To evaluate the effect of exogenous miR-181b on postoperative cognitive dysfunction ( POCD) in mice. Methods A total of 108 clean-grade healthy male C57BL∕6 mice, weighing 25-30 g, were divided into 4 groups ( n=27 each) using a random number table method: control group ( group C) , POCD group, miR-181b agonist agomir group ( group Ag) , and agomir negative control group ( group AC) . POCD was induced by open tibial fracture in 2. 1％ isoflurane-anesthetized mice. A total vol-ume of miR-181b agomir 4μl ( 0. 25 nmol∕μl) was injected into bilateral hippocampi at 2 days before estab-lishing the model in group Ag. Agomir negative control solution 4μl was given at 2 days before establishing the model in group AC. Eighteen mice were selected at days 1, 3 and 7 after surgery, and contextual fear conditioning test was performed to assess cognitive function. Nine mice in each group were sacrificed at 6, 12 and 24 h after surgery ( 3 mice at each time point) , and the hippocampus was isolated for determination of miR-181b expression ( by quantitative real-time polymerase chain reaction) and interleukin-1β ( IL-1β) and tumor necrosis factor-α ( TNF-α) contents ( by enzyme-linked immunosorbent assay) . Results Com-pared with group C, the percentage of time spent freezing in the contextual fear conditioning test was signifi-cantly decreased at 1, 3 and 7 days after surgery, and the expression of miR-181b was down-regulated and the contents of IL-1β and TNF-α were increased at 6, 12 and 24 h after surgery in POCD and AC groups( P<0. 05) . Compared with POCD and AC groups, the percentage of time spent freezing in the contextual fear conditioning test was significantly increased 1, 3 and 7 days after surgery, and the expression of miR-181b was up-regulated and the contents of IL-1βand TNF-αwere decreased at 6, 12 and 24 h after surgery in group Ag ( P<0. 05). Conclusion Exogenous miR-181b can mitigate POCD, and the mechanism may be related to inhibiting inflammatory responses in the hippocampus of mice.

Changes of miR-146a expression in postoperative cognitive dysfunction mice / 临床麻醉学杂志

Objective To investigate the changes of miR-146a expression in serum,hippocam-pus and prefrontal cortex in postoperative cognitive dysfunction (POCD) mice.Methods Fifty healthy male C57BL/6 mice,aged 12-14 weeks,weighing 25-30 g,were randomly divided into two groups (n =25 each)using a random number table:control group (group C)and anesthesia plus sur-gery group (group AS).Mice in group AS underwent open tibial fracture of the left hind paw with in-tramedullary fixation in aseptic conditions under general anesthesia with 2.1% isoflurne.Ten mice in each group received the fear conditioning test (FCT)on the 1,3 and 7 days after anesthesia/surgery. The rest of mice were sacrificed 24 h before (baseline),and 6,12,24,48 h after anesthesia/surgery, and then the serum,prefrontal cortex and hippocampus were collected or removed for detection of the expression of miR-146a using quantitative reverse transcription polymerase chain reaction (qRT-PCR).Results Compared with group C,the percentage of freezing time in contextual FCT was sig-nificantly decreased (P <0.05)in group AS,while no significant change in freezing time percentage was found in tone-cued FCT.In serum,compared with group C,miR-146a expression at 6,12,24, 48 h after anesthesia/surgery was significantly up-regulated in group AS (P < 0.05 );and in group AS,the expression of miR-146a was significantly decreased 6,24,48 h as compared to that at 12 h after anesthesia/surgery (P <0.05).In hippocampus,compared with group C,miR-146a expression at 6,12,24,48 h after surgery was significantly up-regulated in group AS (P <0.05);and in group AS,the expression of miR-146a at 6,48 h after surgery was significantly decreased as compared to that at 12 h after anesthesia/surgery (P <0.05).In prefrontal cortex,compared with group C,miR-146a expression at 24,48 h after surgery was significantly up-regulated in group AS (P <0.05);and in group AS,the expression of miR-146a was significantly increased at 48 h as compared to that at 24 h after anesthesia/surgery (P <0.05).Conclusion The expression of miR-146a in serum,hippocam-pus and prefrontal cortex in POCD mice was up-regulated,and changes of miR-146a expression may be related to the development of POCD.

Relationship between levels of miR-125b and miR-181c in cerebrospinal fluid before joint replacement and postoperative delirium in elderly patients / 中华麻醉学杂志

Objective To evaluate the relationship between the levels of microRNA-125b (miR-125b) and miR-181c in cerebrospinal flnid (CSF) before joint replacement and postoperative delirium (POD) in elderly patients.Methods Fifty-two patients of hoth sexes,aged ≥ 65 yr,weighing 45-70 kg,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elcctive hip or knee replacement under spinal anesthesia,were included in the study.CSF was collected after successful puncture to measure the levels of miR-181c and miR-125b by fluorescent quantitative real-time polymerase chain reaction.The patients were divided into POD group and non-POD group using the Chinese reversion of Confusion Assessment Method on postoperative days 1 and 2.Results The incidence of POD was about 28％ in the patients underwent hip or knee replacement.Compared with non-POD group,the preoperative level of miR-181c in CSF was significantly increased (P＜0.05),and no significant change was found in the preoperative level of miR-125b in CSF in POD group (P＞0.05).Conclusion The level of miR-181c in CSF before joint replacement is related to POD in elderly patients,and the preoperative level of miR-181c in CSF is a risk factor for POD.

Hypomethylating treatment induces tumor specific CD8+ T-cell recognition to osteosarcoma / 中华骨科杂志

Objective To investigate feasible immunotherapy strategy using tumor specific cell against osteosarcoma,and to analyze the therapeutic effect of adoptive cellular infusion therapy on osteosarcoma.Methods Decitabine (DAC) was employed as a hypomethylating agent for the treatment in osteosarcoma cell lines HOS and U2OS.After treatment,the expression of cancer-testis antigen (CTA) was evaluated by PCR and Western Blot.In animal studies,human osteosarcoma cell line HOS,which was transfected by luciferase and HLA-A0201 in previous,was inoculated into immune deficient NOD-SCID mice to establish osteosarcoma xenografts.Ex-vivo expanded CTA specific homo CD8+T-ells were labeled with DiR and injected into the mice via the tail vein.In vivo imaging system was utilized to detect the distribution of administrated CD8+ T-cells.In addition,the progression of tumor xenografts was monitored.Moreover,mouse K7M2 osteosarcoma cell line was used to establish animal models in immune competent BALB/c mice.Immune competent models were utilized to evaluate the effectiveness of hypomethylating treatment in regarding to spontaneous immune attack against tumors.Flow cytometry was used to analyze the proportion of intratumoral lymphocytes and the status of these effector antitumor immune cells,and to reveal the effect of hypomethylating treatment in facilitating lymphocyte infiltration and activation.Results The expression of all the evaluated cancer/testis antigens were elevated in HOS and U2OS osteosarcoma cell lines after hypomethylating treatment with DAC.The proliferation of in vitro cultured osteosarcoma cells can be significantly suppressed after at least 5 d treatment with DAC.Besides,DAC alone controlled osteosarcoma cell proliferation.In immune deficient mouse models,hypomethylating pre-treatment resulted in successful T-cell homing to tumor sites.Moreover,the combination treatment with DAC and CTA specific T-cell adoptive transfer significantly suppressed tumor proliferation.In immune competent mouse models,hypomethylating treatment with DAC improved autologous T-cell infiltration into the tumor,and strengthened the activity of intratumoral CD8+ T-cells,elevated the secretion of IFN-gamma,granzyme B and perforin by CD8+ T-cells.Conclusion Hypomethylating treatment is able to suppress osteosarcoma cell proliferation,improve the expression of CTA in osteosarcoma cells,and consequently provide optimal environment for CTA specific T-cell adoptive therapy.

Effect of Local External Application of Wuwei Shuangbai Powder on Cancer Pain and Hemorheology Indexes of Primary Liver Cancer Patients / 广州中医药大学学报

Objective To study the effect of external application of Wuwei Shuangbai Powder on relieving primary liver cancer pain and to observe its effect on hemorheology indexes.Methods A double-blind,randomized and controlled trial was carried out in 60 primary hepatocellular carcinoma patients with cancer pain.The patients were divided into control group and treatment group,30 cases in each group.The treatment group was given external application of Wuwei Shuangbai Powder and oral use of placebo capsules,and the control group was given external application of placebo powder and oral use of celecoxib capsules.The treatment for the two groups lasted for 7 days.Before and after treatment,pain was scored by Numeric Rating Scale (NRS),and the peripheral blood hemorheology indexes of both groups were observed.Results (1) After treatment,the NRS pain scores of both groups were decreased compared with those before treatment (P ＜ 0.05 or P ＜ 0.01),and the scores of the treatment group were significantly lower than those of the control group (P ＜ 0.05),indicating that the treatment group had better effect on relieving cancer pain.(2) After treatment,the indexes of hemorheology of treatment group were significantly higher than those of the control group,and the differences of the indexes except the hematocrit were significant between the two groups(P ＜ 0.05 or P ＜ 0.01).Conclusion Wuwei Shuangbai Powder is effective for the treatment of primary liver cancer pain.The mechanism may be related to the improvement of hemorheology of liver cancer patients.

Progress in relationship of the long non-coding RNA and sepsis / 中华危重病急救医学

The mechanism of long chain non-coding RNA (lncRNA) is diverse. LncRNA can regulate the expression of genes at multiple levels and is closely related to some pathological process, such as tumor formation, viral replication, inflammatory damage, etc. The abnormal expression of lncRNA is involved in the patho-physiological changes of the disease, and plays a key role in many links, such as the stability of mRNA, the regulation of translation level, protein transport, RNA processing and modification, and so on. The development of sepsis inflammatory injury is a complex process involving multiple genes and pathways, in which the abnormal structure and expression of many encoding genes or non-coding genes exist.This paper review the research progress on lncRNA in the regulation of chondriokinesis, pro-inflammatory cytokines, calcium ion transport, nuclear factor-κB (NF-κB) in signal pathway and other inflammatory lesions, which may provide a new method for the diagnosis and treatment of sepsis.

Optimizing scanning time of CT perfusion imaging in acute cerebral infarction / 中国医学影像技术

Objective To explore the effect of scanning time on CT perfusion (CTP) imaging quality and the accuracy of parameters in acute stroke patients.Methods CTP data of 30 patients with unilateral acute cerebral infarction were investigated retrospectively.CTP data with scanning times of 56 s,52 s,48 s,44 s,40 s and 36 s were analyzed for image postprocessing,the time density curves (TDCs) of the superior sagittal sinus (SSS),perfusion maps and the parameter values of ROI were obtained,and the first passage time of SSS was recorded.Results Compared with 56 s group,there was no significant difference of the image quality in the scanning time of 52 s group and 48 s group (both P＞0.05).The image quality was significantly negatively correlated with the first passage time of SSS in 52 s group,48 s group,44 s group,40 s group and 36 s group.Compared with 56 s group,there were significant differences in partial parameters of ROI when the scanning time was 44 s (all P＜0.05).Conclusion Decreasing whole-brain CTP scanning time reasonably can ensure the image quality and the accuracy of parameters and reduce the radiation dose.The whole-brain CTP with delay of 8 s,and scanning time of 48 s are recommended.