A small-molecule pan-HER inhibitor alone or in combination with cisplatin exerts efficacy against nasopharyngeal carcinoma / 医学前沿

The abnormal activation of HER family kinase activity is closely related to the development of human malignancies. In this study, we used HER kinases as targets for the treatment of nasopharyngeal carcinoma (NPC) and explored the anti-tumor effects of the novel pan-HER inhibitor HM781-36B, alone or in combination with cisplatin. We found that HER family proteins were positively expressed in tumor tissues of some NPC patients, and the high levels of those proteins were significantly related to poor prognosis. HM781-36B inhibited NPC in vitro and in vivo. HM781-36B exerted synergistic effects with cisplatin on inhibiting proliferation and promoting apoptosis of NPC cells. In NPC xenograft models in nude mice, HM781-36B and cisplatin synergistically inhibited tumor growth. Downregulating the activity of HER family proteins and their downstream signaling pathways and regulating tumor microenvironment may explain the synergistic anti-tumor effects of HM781-36B and cisplatin. In conclusion, our study provides evidence for HER family proteins as prognostic biomarkers and potential therapeutic targets for NPC. The pan-HER inhibitor HM781-36B alone or in combination with cisplatin represents promising therapeutic effects for the treatment of NPC patients, which provides a new idea for the comprehensive treatment of NPC.

Short-term effects of hyaluronic acid combined with glucocorticoid injection in treating knee osteoarthritis / 中华骨科杂志

Objective:To investigate the short-term effects of articular injection of hyaluronic acid combined with glucocorticoid in patients with knee osteoarthritis.Methods:From October 2017 to June 2018, a total of 188 patients diagnosed with knee osteoarthritis received parallel articular injection. There were 60 cases with mild knee osteoarthritis, 72 with moderate and 56 with severe according to the WOMAC knee functional score. There patients were divided into group rank Ⅰ48 cases, Ⅱ 49 cases, Ⅲ 45 cases, Ⅳ 46 cases according to the knee joint X-ray Kellgren-Lawrence classification. The unified treatment regimen was 2.5 ml Sodium Hyaluronate (SHA) injection for the first time, SHA 2.5 ml and compound betamethasone injection (CBI) 1 ml for the second week, and 2.5 ml of SHA for the third week. WOMAC score and Lequesne index were used to evaluate joint function before the first injection and after SHA and SHA+CBI injection. The improvement rate of Lequesne index ≥30% or improvement rate of WOMAC score ≥25% was regarded as effective treatment.Results:Lequesne index and WOMAC score decreased gradually in the mild, moderate and severe groups after 3 weeks of injection. Among these patients, the improvement rates of Lequesne index after SHA injection and SHA+CBI injection were 36.44%±8.46% and 49.26%±13.75% in the mild group, 23.09%±12.61% and 30.66%±14.95% in the moderate group, and 10.50%±8.78% and 11.07%±6.52% in the severe group. The improvement rate of WOMAC score in the mild group after SHA injection and after SHA+CBI injection was greater than 25%. After SHA injection, the improvement rate of WOMAC score was 13.06%±10.21% in the moderate group, and 27.49%±13.61% after SHA+CBI injection. Those in severe group were all less than 25%. Kendall's staub correlation analysis results showed that there was a strong positive correlation between WOMAC function score and X-ray Kellgren-Lawrence classification ( r=0.744, P<0.001). The Lequesne index and WOMAC scores of the Kellgren-Lawrence X-ray classification decreased gradually after 3 weeks of injection. The improvement rate of Lequesne index period in group rank Ⅰ after SHA and SHA+CBI injection was 36.64%±10.05% and 52.00%±8.19%, respectively. That for group rank Ⅱ was 32.05%±8.09% and 41.95%±10.53%, group rank Ⅲ 16.93%±10.34% and 27.77%±10.25%, group rank Ⅳ 7.52%±5.53% and 7.60%±6.66%. The improvement rate of WOMAC score period in group rank Ⅰ after SHA and SHA+CBI injection was 29.48%±11.77% and 42.59%±13.55%, respectively. That for group rank Ⅱ was 26.72%±10.21% and 30.49%±16.90%, group rank Ⅲ 13.78%±5.96% and 23.05%±9.52%, group rank Ⅳ 4.77%±3.80% and 4.27%±4.23%. Conclusion:For mild or X-ray classification Ⅰ, Ⅱ knee osteoarthritis patients, articular injection SHA or SHA+CBI are effective. Further, SHA+CBI is better than single injection of SHA. SHA+CBI injection was effective for moderate knee osteoarthritis patients. For severe or X-ray classification Ⅲ, Ⅳ patients, SHA or SHA+CBI injection at interval are invalid.

Effect of compound glycyrrhizin on inflammatory factor and immune function in children with Henoch-Schonlein purpura / 中国基层医药

Objective:To investigate the effect of compound glycyrrhizin on inflammatory factors and immune function in children with Henoch-Schonlein purpura (HSP).Methods:From March 2017 to December 2018, 75 children with clinically confirmed HSP in Shanxi Grand Hospital were divided into two groups by random number table method.The control group (38 cases) was given routine basic treatment, while the observation group (37 cases) was given intravenous drip of compound glycyrrhizin injection once a day.Both two groups were treated for 14 days.The curative effect and the differences of inflammatory factors[interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), procalcitonin (PCT), C-reactive protein (CRP)], immune function[CD 4+ , CD 4+ /CD 8+ , immunoglobulin G (IgG), immunoglobulin A (IgA)] before and after treatment were observed. Results:The effective rate of the observation group was higher than that of the control group (94.59% vs.76.32%, χ 2=5.005, P<0.05). The levels of IL-6, TNF-α, PCT, CRP in the observation group after treatment were lower than those in the control group[(3.52±1.46)ng/L vs.(5.12±1.39)ng/L, (2.31±0.12)μg/L vs.(4.21±0.29)μg/L, (1.25±0.46)μg/L vs.(3.12±0.82)μg/L, (5.98±1.19)mg/L vs.(9.55±3.82)mg/L, t=4.861, 6.891, 12.135, 5.433, all P<0.05]. The levels of IgG, IgA, CD 4+ , CD 4+ /CD 8+ in the observation group were higher than those in the control group[(14.65±2.57)g/L vs.(12.92±2.82)g/L, (5.26±2.57)g/L vs.(4.16±1.64)g/L, (43.94±10.71)% vs.(38.02±10.63)%, (2.90±0.61)% vs.(2.02±0.53)%, t=2.775, 2.216, 2.402, 6.675, all P<0.05]. Conclusion:Compound glycyrrhizin can effectively reduce inflammation in children with HSP, improve immune function and improve clinical efficacy.

The diagnosis value of TNF-α ,IL-6 and NSE in cerebrospinal fluid of children with central nervous system infection / 国际检验医学杂志

Objective To explore the diagnostic value of tumor necrosis factor-alpha (TNF-α) , interleukin-6 (IL-6) and neuron enolase (NSE) in the cerebrospinal fluid of children with central nervous sys-tem infection (CNSI).Methods 54 cases of CNSI hospitalized children ,admitted in the hospital from October 2015 to January 2017 ,were enrolled in the study and divided into viral meningitis group (30 cases) and suppu-rative meningitis group (24 cases).Another 20 cases who underwent cerebrospinal fluid examination and other related examinations were enrolled in the study as the control group.The levels of three biomarkers TNF-α , IL-6 and NSE in cerebrospinal fluid of three groups were detected by enzyme linked immunosorbent assay (ELISA).Results The levels of TNF-α ,IL-6 and NSE in purulent meningitis group were the hightest ,and the levels of these three factors in viral meningitis group were highter than the control group ,and the differ-ence was statistically significant in three groups (P＜0.05).But there were a lot of data overlaps.There was no significant difference in the levels of TNF-α ,IL-6 and NSE between the brain group and the control group (P＞0.05).Conclusion The detection of TNF-α ,IL-6 and NSE in cerebrospinal fluid has a certain clinical val-ue for the diagnosis of CNSI ,but it needs to be further verified by a large sample clinical trial.

Effect of Natural Emulsifier Acacia Senegal on in vivo and in vitro Performance of Chlorogenic Acid Self-microemulsion / 中国药房

OBJECTIVE:To study the effect of natural emulsifier acacia senegal on in vivo and in vitro performance of chloro-genic acid self-microemulsion. METHODS:Chlorogenic acid self-microemulsion containing acacia senegal(new chlorogenic acid self-microemulsion)was prepared by using acacia senegal to gradually replace polysorbate 80 in chlorogenic acid self-microemul-sion containing nonionic emulsifier (traditional chlorogenic acid self-microemulsion). The appearance,morphology,particle size,conductivity,pH value,stability,in vitro release and intestinal absorption kinetics of the 2 kinds self-microemulsions were evaluated. RESULTS:50％of polysorbate 80 was replaced by acacia senegal in new chlorogenic acid self-microemulsion. The tradi-tional and new chlorogenic acid self-microemulsions had clear appearance,and approximately spherical drops. Particle sizes were (24.53 ± 3.03),(35.51 ± 5.91) nm;dectrical conductivities were (195.6 ± 0.3),(189.5 ± 0.4)μs/cm;and pH were 3.87 ± 0.02, 4.08 ± 0.03 (n=3),respectively. Compared with traditional chlorogenic acid self-microemulsion,the absorption rate constant,ef-fective permeability coefficient and absorption amount of the new one in duodenum,jejunum,ileum were increased a little (P>0.05);the above indexes in colon were obviously decreased (P<0.05). CONCLUSIONS:The new chlorogenic acid self-micro-emulsion can maintain the performance of traditional one,and increase absorption of chlorogenic acid in small intestine.

The clinical feature of glucose transporter 1 deficiency syndrome and literature review / 中国小儿急救医学

Objective To investigate the clinical features of glucose transporter 1 deficiency syndrome(GLUT1-DS) and summarize the characteristics of GLUT1-DS through reviewing related references.Methods The clinical data including manifestation,cerebrospinal fluid (CSF) glucose,electroencephalogram,MRI and gene mutation of a patient with GLUT1-DS was collected and the related literatures were reviewed.Results The patient was a 6 years old boy.The patient,whose seizures occurred at the age of 9 month-old and prolonged to 6 year-old,attacked before breakfast.Physical examination showed microcephaly with head circumference 47.5 cm.Laboratory tests showed that CSF glucose decreased (1.87 mmol/L) and CSF-serum ratio was 0.36.And meantime the MRI was normal and electroencephalogram showed general spike and slow wave complex paroxysm.Mutation of SLC2A1 gene,c.350_385del,was found in the patient.There were 219 cases with GLUT1-DS had been reported and the age of onset was 15.69 months.In 219 patients,159 cases (72％) suffered seizures,105 cases (47％) had motor abnormalities,61 cases (27％) suffered intellectual disability.The CSF glucose values were (1.92±0.31) mmol/L,CSF-serum ratio was 0.36±0.07.SLC2A1 gene mutations were detected in 183 patients(96％)in which missense mutation was the most mutation.Conclusion A wide range of phenotypes of GLUT1-DS include seizures,motor abnormalities,mental retardation.The diagnosis is confirmed when CSF glucose and CSF-serum ratio are continuously decreased which in the absence of meningitis.The SLC2A1 gene should be detected in suspicion of GLUTI-DS patients.Early diagnosis and treatment may improve the prognosis of those GLUTI-DS patients.

Clinical effect and mechanism of hirudin in treating lower limb venous thrombosis after fracture / 中国生化药物杂志

Objective To analyse the clinical effect and mechanism of hirudin in the treatment of patients with lower limb venous thrombosis after fracture.Methods 56 patients who were diagnosed with lower limb venous thrombosis after fracture in our hospital were collected.All patients were randomly divided into experimental group (n:28) and control group (n:28).12h after fracture operation, patients in control group were treated with subcutaneous injection of low molecular weight heparin calcium, patients in experimental group were treated with Maixuekang capsule ( hirudin) orally on the basis of control group.Before and after the treatment, the plasma levels of thrombin antithrombin complex ( TAT) , thrombin activated fiber soluble inhibitor (TAFI), D-Dimer (D-D), fibrinogen (FIB), thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT) and clinical effect were detected in all patients.Results After treatment, the total effective rate of experimental group ( 92.86%) was significantly higher than that of the control group ( 71.43%) ( P<0.05 );compared with control group, the plasma levels of TAT, TAFI were lower in the experimental group (P<0.05); the plasma levels of D-D, FIB were lower in the experimental group (P<0.05); the plasma levels of TT,PT,APTT were higher in the experimental group ( P<0.05 ) .Conclusion The hirudin could inhibit thrombin activation and coagulation function in fracture patients with lower limb venous thrombosis, decrease the plasma D-D and FIB levels for improving blood hypercoagulable state and preventing thrombosis,thus improve the clinical efficacy.

Clinical analysis of 10 patients with anti -N -methyl -D -aspartate receptor encephalitis / 中国基层医药

Objective To analyze the clinical feature of the patients with anti -N -methyl -D -aspartate receptor (NMDAR)encephalitis and feature of brain MRI and electroencephalogram (EEG)in children.Methods We reviewed the clinical manifestations,brain MRI and EEG features of 10 patients who were diagnosed anti -NMDAR encephalitis.Results Of the 10 patients,3 cases were male and 7 cases were female.The age was ranged from 13 months to 14 years (6 years and 11 months on average).No tumor was found in those patients.Main symp-toms included seizure in 9 cases,psychiatric symptoms in 10 cases,consciousness disturbance in 4 cases,involuntary movements in 8 cases,autonomic nerve instability in 5 cases,and sleep disorders in 10 cases.7 patients of MRI exami-nation were normal,2 patients revealed abnormal signal of temporal lobe,frontal,and parietal cortex.One patient revealed brain atrophy.All patients had abnormal EEG with diffusive slow waves,and some with focal spikes or sharp waves,left side abnormal more than right side.Conclusion Anti -NMDAR encephalitis can be found in children, even young boys may be affected.They have a lower incidence of tumors.Its predominant clinical features are psychi-atrics symptoms,seizures,involuntary movements and consciousness alteration.EEG was considered more significant than brain MRI.

Evaluation of transisthmus conduction interval in predicting bidirectional block after ablation of typical atrial flutter / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To determine whether the extent of prolongation of the transisthmus interval after ablation predicts complete bidirectional block.</p><p><b>METHODS</b>Since 1996 to 2002, 30 consecutive patients underwent ablation procedures for isthmus-dependent atrial flutter. There were 23 males and 7 females [mean age (47.85 +/- 9.35) years]. With the use of fluoroscopic view of anatomy, radiofrequency ablation was performed during coronary sinus pacing at a cycle length of 600 ms.</p><p><b>RESULTS</b>Bidirectional block was achieved with ablation in 29 (97%) of 30 patients. The transisthmus intervals before ablation and after complete transisthmus block were (73.82 +/- 13.01) ms and (140.47 +/- 20.48) ms, respectively, in the clockwise direction (P < 0.0001), and (77.63 +/- 8.36) ms and (138.17 +/- 15.55) ms, respectively, in the counterclockwise direction (P < 0.0001). A period of incomplete isthmus block was observed during 17 (58%) of the 29 ablation procedures. The clockwise transisthmus intervals during incomplete block [(107.65 +/- 21.33) ms] were (45.5 +/- 8.7)% longer than the baseline transisthmus intervals. An increase in the transisthmus interval by > or = 50% in both directions after ablation predicted complete bidirectional block with 100.0% sensitivity and 83.3% specificity. The positive and negative predictive values were 90.6% and 100.0%, respectively. The diagnostic accuracy of a > or = 50% prolongation in the transisthmus interval was 83.3%.</p><p><b>CONCLUSION</b>The analysis of transisthmus interval is a valuable method for determining complete bidirectional isthmus block.</p>

Long-term results of chemotherapy alone or combined with radiation therapy for limited-stage small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>To evaluate therapeutic outcome of limited stage small cell lung cancer treated with chemotherapy alone or combined with radiation therapy with different doses.</p><p><b>METHODS</b>A retrospective analysis was performed in 128 limited-stage small cell lung cancer patients who were treated with three different ways of treatment, from February 1988 to March 1998 in Heilongjiang Cancer Hospital. All patients were pathologically proved. Forty-two patients received chemotherapy alone (C), 48 patients were treated by interdigitating chemoradiotherapy (IDG) and other 38 patients received concurrent chemoradiotherapy (CON). For thoracic radiation, 20 patients received a dose of ≤45 Gy, 23 ≥60 Gy, and 43 > 45 Gy but < 60 Gy .</p><p><b>RESULTS</b>The 3-year survival rates were 23.7%, 20.8% and 4.8% in the CON, the IDG and the C groups respectively. There was a significant difference between the CON and the C groups ( P < 0.05), as well as between the IDG and the C groups ( P < 0.05). There was no remarkable difference between the CON and the IDG groups ( P > 0.05). Loco-regional recurrence rate was significantly higher in ≤45 Gy group (55.0%) than that in ≥60 Gy group (8.7%)( P < 0.01).</p><p><b>CONCLUSIONS</b>The chemotherapy combined radiotherapy may improve the survival of patients with limited-stage small cell lung cancer. Dose of thoracic radiation might be related to the loco-regional recurrence.</p>

RP-HPLC determination of paeoniflorin,baicalin,palmatine hydrochloride and berberine hydrochloride in Kuntai Capsules / 中成药

AIM: To develop an HPLC method for analyzing the contents of paeoniflorin,baicalin,palmatine hydrochloride and berberine hydrochloride in Kuntai Capsules(Praeparata Radix Rehmannial,Rhizoma Coptidis,Radix Paeoniae,Radix Scutellariae,Colla Asini corii,Poria).METHODS: Four compounds were determirned with an Agilent ZORBAX SB C18 column(4.6 mm ? 250 mm,5 ?m).Acetonitrile-0.4% phosphoric acid was used as the mobile phase at a flow rate of 1.0 mL/min.The mobile phase was in linear gradient elution.The detection wavelength was 230 nm.RESULTS: The linear ranges were within 0.016 58-0.331 6 ?g(r = 0.999 9) for paeoniflorin,0.059 80-1.196 0 ?g(r = 0.999 9)for baicalin,0.012 91-0.258 2 ?g(r = 0.999 9)for palmatine hydrochloride,0.041 98-0.839 6 ?g(r = 0.999 9) for berberine hydrochloride.The average recoveries (n = 6) were 98.91% (RSD = 1.29% ),99.20% (RSD = 0.92% ),97.86% (RSD = 0.89% ),98.63% (RSD = 0.62% ),respectively.CONCLUSION: The method is simple,reliable,sensitive and can be applied to having controls over the preparation.