Effects of Huangqin Tang on NLRP3/Caspase-1 pathway in mice model of ulcerative colitis / 中国中药杂志

The aim of this study was to explore the effects of Huangqin Tang(HQT) on the NLRP3/Caspase-1 signaling pathway in mice with DSS-induced ulcerative colitis(UC). C57BL/6J mice were randomly divided into a blank group, a model group(DSS group), and low-, medium-and high-dose HQT groups(HQT-L, HQT-M, and HQT-H), and western medicine mesalazine group(western medicine group). The UC model was induced in mice. Subsequently, the mice in the HQT-L, HQT-M, HQT-H groups, and the western medicine group were given low-, medium-, high-dose HQT, and mesalazine suspension by gavage, respectively, while those in the blank and DSS groups were given an equal volume of distilled water by gavage. After 10 days of administration, the body weight, DAI scores, and colonic histopathological score of mice in each group were determined. The levels of IL-6, IL-10, IL-1β, and TNF-α in serum were determined by ELISA. The mRNA expression of NLRP3 and Caspase-1 in colon tissues was determined by RT-qPCR. The protein expression of NLRP3 and Caspase-1 in colon tissues was detected by immunohistochemistry. The results showed that compared with the blank group, the DSS group showed decreased body weight of mice and increased DAI scores and intestinal histopathological score. Compared with the DSS group, the HQT groups and the western medicine group showed improved DAI scores, especially in the HQT-M, HQT-H, and the western medicine groups(P<0.05). The intestinal histopathological scores of the HQT groups and the western medicine group significantly decreased, especially in the HQT-M, HQT-H, and the western medicine groups(P<0.05). In addition, compared with the blank group, the DSS group showed elevated expression of NLRP3 and Caspase-1 in colon tissues, increased serum levels of IL-6, IL-1β, and TNF-α, and decreased IL-10 level. Compared with the DSS group, the HQT groups and the western medicine group displayed decreased expression of NLRP3 and Caspase-1 in colon tissues, reduced serum levels of IL-6, IL-1β, and TNF-α, and increased IL-10 level. The improvement was the most significant in the HQT-H group and the western medicine group(P<0.01). In conclusion, HQT may reduce the expression of NLRP3 and Caspase-1 in colon tissues, reduce the se-rum levels of IL-6, IL-1β, and TNF-α, and increase the expression of IL-10 by regulating the classic pyroptosis pathway of NLRP3/Caspase-1, thereby improving the symptoms of intestinal injury and inflammatory infiltration of intestinal mucosa in DSS mice to achieve its therapeutic effect.

Immunomodulatory Mechanism of Kangxian Yixin Prescriptions on Autoimmune Injury Mice Based on Th17/Treg Cell Balance / 中国实验方剂学杂志

ObjectiveTo investigate the immunomodulatory mechanism of Kangxian Yixin prescription （KYP） on autoimmune injury mice and its relationship with the T helper 17 （Th17）/regulatory T cell （Treg） balance. MethodSixty healthy 8-week-old male BALBc mice were randomly divided into a normal group and an experimental group at a ratio of 1∶5. On the 0th， 7th， and 28th days， 0.2 mL of porcine cardiac myosin emulsion （containing 0.1 mg of porcine cardiac myosin） was subcutaneously injected into the groin， armpit， and back of the mice in the experimental group to induce an animal model of myocardial immune injury. Mice with myocardial immune injury were randomly divided into a model group （Model）， a KYP group （20.4 g·kg-1·d-1， ig）， and a valsartan group （12 mg·kg-1·d-1， ig）. Mice in the control group and the model group received the same amount of normal saline by gavage. After four weeks of intervention， the heart tissues were collected. Hematoxylin-eosin （HE） staining and Masson staining were used to detect pathological damage in heart tissues. Enzyme-linked immunosorbent assay （ELISA） was used to detect the expression of type B-type natriuretic peptide （BNP）， anti-cardiac antibody， interleukin-17 （IL-17）， and interleukin-10 （IL-10） in the serum of mice， and the expression levels of Th17 cells and Tregs in the spleen were detected by flow cytometry. The protein expression of B-cell lymphoma-2 （Bcl-2） and Bcl-2-associated X （Bax） in heart tissues was detected by Western blot， and the mRNA expression of retinoid-related orphan receptor gamma t （RORγt） and forkhead box P3 （FoxP3） in the spleen was detected by quantitative real-time polymerase chain reaction （Real-time PCR）. ResultCompared with the control group， the model group showed worsened pathological damage in heart tissues， elevated serum levels of BNP， anti-myocardial antibody， and IL-17， decreased serum expression of IL-10 （P<0.05）， increased expression of Th17 cells and reduced expression of Tregs in spleen tissues （P<0.05）， increased protein expression of Bax， diminished Bcl-2 protein expression， elevated Bax/Bcl-2 ratio， up-regulated mRNA expression of RORγt， dwindled mRNA expression of FoxP3， and elevated ratio of RORγt/FoxP3 （P<0.05）. Compared with the model group， the KYP group and the valsartan group displayed relieved pathological damage in heart tissues， decreased serum expression of BNP， anti-myocardial antibody， and IL-17， increased serum expression of IL-10 （P<0.05）， reduced expression of Th17 cells and increased Tregs in spleen tissues （P<0.05）， dwindled protein expression of Bax and elevated protein expression of Bcl-2 in heart tissues （P<0.05）， diminished Bax/Bcl-2 ratio， reduced mRNA expression of RORγt， up-regulated FoxP3， and down-regulated ratio of RORγt/FoxP3 （P<0.05）. ConclusionKYP may improve myocardial immune damage by regulating the Th17/Treg cell balance.

Spatio-temporal trend of female breast cancer mortality in Shandong Province from 1970 to 2013 / 中华预防医学杂志

The mortality of female breast cancer in Shandong Province has increased since the 1970. The differential decomposition analysis found that the slight decline in the crude mortality of breast cancer among women was entirely due to non-demographic factors during the 1970-1990, and the significant increase in the crude mortality was due to a combination of demographic and non-demographic factors since the 1990. The contribution rate of demographic factor has gradually increased from 53.5% in 2004-2005 to 59.5% in 2011-2013, while that of non-demographic factor has decreased from 46.5% to 40.5%. The women aged 45-64 years old were the major population of female breast cancer deaths, accounting for 40%-60% of total breast cancer deaths in different times, and then the mortality in female aged 55-64 years old increased rapidly, with increases of 52.12%, 115.19% and 29.01% in 2011-2013 over the 1970-1974, 1990-1992 and 2004-2005, respectively (Z=-7.342,P<0.001). Compared with 1970-1974, the age-standardized mortality rate of rural women increased by 41.86% in 2011-2013 (Z=-17.933, P<0.001), and that of urban women increased by 18.62% in 2011-2013 (Z=-25.642, P<0.001). The age-standardized mortality rate of breast cancer in urban women was higher than that in rural women in different times (all P<0.05). The spatial scan analysis found that eastern Shandong Province was found to be a sustained high-risk area for death, and other high-risk areas were transferred from north to southwest of Shandong between 1970 and 2013.

Knowledge attitude and behavior towards COVID 19 prevention among middle school students in the phase of normalized prevention and control in Wuhan / 中国学校卫生

Objective@#To understand knowledge, attitude and behavior toward Coronavirus disease 2019 (COVID 19) among middle school students in Wuhan, in the phase of normalized control and prevention of COVID 19, so as to provide evidence for further health education.@*Methods@#In January 2021, cluster random sampling method was used to select one middle school from Hongshan and Dongxihu District, as well as Donghu high tech zone, respectively. By using the "questionnaire star" platform, questionnaire QR code were sent to students through QQ or wechat by schools. A total of 4 531 middle school students were investigated.@*Results@#Preventive knowledge and behavior rate was 71.5% (3 238) and 56.0% (2 537), respectively. Preventive behaviors towards COVD 19 was reported in 56.0% (2 537) of participants. Students with parents as health care workers reported higher preventive behaviors(P<0.05).Girls had a higher rate of possession of health knowledge for prevention and control than boys. Compared with "essentially no concern about the epidemic","students with less concern about the epidemic" and "those with similar concern as 2020" were more likely to have higher awareness of health knowledge for prevention and control. Compared with the first-year junior middle school students, high school students were less likely to have the rates of knowledge for prevention and control health [OR(95%CI）=1.24（1.09-1.43）,2.56(1.54-4.25),3.30(1.99-5.48),0.49(0.39-0.62),0.45(0.36-0.57),0.63(0.46-0.88)].In terms of health behavior rate, middle school students whose mothers are undergraduates, whose incomes were more than 8 001-15 000 and 15 000 yuan, "whose attention to epidemic situation has declined" , "whose attention is the same as that in 2020" , "who did not plan to study medicine before" , "who are determined to study medicine, and who plan to study medicine more firmly after epidemic situation " were more likely to have health behavior,[OR(95%CI)=1.29(1.04-1.60),1.39（1.07-1.82）,1.74(1.32-2.29),1.77(1.06-2.96),3.47(2.08-5.81)] ,The grade-2 high middle school students had lower probability of preventing and controlling health behaviors [OR(95%CI)=0.74(0.60-0.90)](P<0.05). Preventive knowledge and behaviors towards COVID 19 are mainly from school education, communication with parents and mobile learning.@*Conclusion@#Preventive knowledge and behaviors towards COVID 19 among Wuhan middle school students are needed to be improved and targeted health education should be implemented accordingly.

Kangxian Yixin Prescription Interferes with Mitochondrial Permeability Transition Pore to Inhibit Cardiomyocyte Apoptosis / 中国实验方剂学杂志

Objective:To explore the mechanism of Kangxian Yixin prescription in regulating mitochondrial permeability transition pore（mPTP）and inhibiting cardiomyocyte apoptosis. Method:H9c2 cardiomyocytes were cultured routinely. After 8 h of starvation，the cells were divided into the normal group，model group，Kangxian Yixin prescription（0.25 g·L^-1） group，and cyclosporin A（CsA，10 μmol·L^-1） group and treated with the corresponding drugs for 24 h for follow-up experiments. The H9c2 cardiomyocyte hypertrophy model was induced by norepinephrine（NE），whose optimal concentration was determined by real-time polymerase chain reaction （Real-time PCR）. The degree of mPTP opening was detected by flow cytometry， followed by the measurement of mRNA and protein expression levels of apoptosis-related factors cyclophilin D（Cyp-D），cytochrome C（Cyt-C），and cysteine aspartate-specific protease-3（Caspase-3） after mPTP opening and the quantification of mitochondrial membrane potential. Result:When the concentration of NE was 200 μmol·L^-1， the mRNA expression levels of atrial natriuretic peptide（ANP） and brain natriuretic peptide（BNP） were the highest， implying that it was the optimal concentration to induce H9c2 cell hypertrophy. Compared with the normal group，the model group exhibited excessive opening of mPTP，weakened relative fluorescence intensity in mitochondria， decreased mitochondrial membrane potential（<italic>P</italic><0.05，<italic>P</italic><0.01），and elevated mRNA and protein expression of Cyp-D，Cyt-C，and Caspase-3（<italic>P</italic><0.05）. Compared with the model group，both Kangxian Yixin prescription and CsA inhibited mPTP opening，enhanced the relative fluorescence intensity of mitochondria， increased mitochondrial membrane potential（<italic>P</italic><0.05，<italic>P</italic><0.01），and lowered the mRNA and protein expression of Cyp-D，Cyt-C，and Caspase-3 （<italic>P</italic><0.05）. Conclusion:Kangxian Yixin prescription inhibits cardiomyocyte apoptosis possibly by regulating mPTP opening and inhibiting the expression of apoptosis-related factors Cyp-D，Cyt-C， and Caspase-3.

Research progress and challenges of neoadjuvant therapy for esophageal squamous cell carcinoma / 中华胃肠外科杂志

Surgery is the main treatment for resectable esophageal squamous cell carcinoma. However, for patients with locally advanced lesions, surgery-based comprehensive treatment is the best treatment strategy. According to the results of some randomized controlled clinical studies and meta-analysis, preoperative neoadjuvant therapy is recommended to improve the survival rate of patients. Neoadjuvant therapy includes neoadjuvant chemotherapy, chemoradiotherapy, targeted therapy and immunotherapy. Great progress has been made in neoadjuvant therapy, but there are still many clinical problems that need to be solved urgently, including the efficacy and safety of neoadjuvant therapy, the choice of neoadjuvant regimen and treatment cycle, the best combination and advantages of multimodal treatment, and the selection of responders to treatment, etc. This article provides a systematic review of the latest developments and existing controversies in neoadjuvant therapy for esophageal squamous cell carcinoma.

Application of laparoscopic exploration and choledocholithotomy in patients with a history of upper abdominal surgery / 国际外科学杂志

Objective:To explore the feasibility, safety and early prognosis of laparoscopic choledocholithotomy in patients with previous history of upper abdominal surgery.Methods:From January 2014 to December 2018, the clinical data of 156 patients with previous history of upper abdominal surgery in hepatobiliary and pancreatic surgery of Central Hospital of Edong Healthcare Group were analyzed retrospectively. Among them, 84 cases with laparoscopic common bile duct exploration and stone extraction were allocated into laparoscopic group, 72 cases with open common bile duct exploration and stone extraction were allocated into open group.In the laparoscopic group, there were 50 males and 34 females, aged 42-83 (66.4±17.8) years; In the open group, there were 40 males and 32 females, aged 45-82 (64.2±16.9) years. The operation time, intraoperative hemorrhage, first defecation time and postoperative hospital stay were compared between the two groups. The postoperative pain score and the incidence of early complications (bile leakage, abdominal distention, ascites, epigastric pain, residual stones) were compared between the two groups. The measurement data subject to normal distribution are represented by ( Mean± SD), the independent sample t test was used for group comparison, and the chi-square test was used for counting data comparison. Results:The laparoscopic group was converted to open surgery in 3 cases, and there was no perioperative death. In the laparoscopic group, the operation time, the intraoperative bleeding volume, the first defecation time, the postoperative hospital stay wee (122.8 ± 28.1) min, (80.3 ± 13.7) mL, (1.8 ± 0.3) d, (7.7 ± 0.8) d, and (146.6 ± 33.5) min, (125.8 ± 19.6) mL, (2.7 ± 0.6) d, (9.1± 1.2) d in the open group; The difference between the two groups was statistically significant ( P<0.05); On the 2nd and 4th day after operation, the abdominal pain scores in laparoscopic group were (3.6 ± 1.3) scores and (2.3 ± 0.7) scores, and (5.5±1.6) scores, (4.2±1.3) scores in the open group, the laparoscopic group were significantly lower than those in the open group ( P<0.05); The incidence of early postoperative complications in the laparoscopic group was 32.1% (27/84), and in the open group was 47.2% (34/72), but the difference was not statistically significant ( P>0.05). Conclusions:For patients with a history of upper abdominal surgery, laparoscopic common bile duct exploration and choledochoscopy are safe and feasible, The operation has the advantages of minimally invasive and less bleeding, which can relieve postoperative pain, shorten postoperative hospital stay, and will not increase the incidence of postoperative complications, It′s good for quick recovery. It is suitable for the promotion of grass-roots hospitals.

Preliminary clinical study on treatment of prostate cancer with Cyber-Knife / 中华放射医学与防护杂志

Objective To evaluate the safety and effectiveness of ultra-hypofractionated stereotactic body radiotherapy in the treatment of prostate cancer.Methods A total of 26 patients with prostate cancer treated with Cyber-Knife from May 2010 to May 2018 were analyzed retrospectively.The median age of the patients was 69 years old (range,57 to 87).Ultra-hypofractionated radiotherapy was delivered in five fractions of 7.0-7.5 Gy for a total dose of 35.0-37.5 Gy.Androgen deprivation therapy (ADT) was administered in combination with the Cyber-Knife.The primary endpoints were radiation toxicity,PSA-response,local control and symptom alleviation,while the secondary endpoints were progression-free survival and overall survival.Results No graded ≥ 3 acute and late radiation toxicities occurred during follow-up.The acute toxicity of Grades 1 and 2 was 38.4％ and 19.2％,while the late toxicity of Grades 1 and 2 was 30.8％ and 3.8％,respectively.At a median follow-up of 22.44 months,for patients with localized stage,PSA level was decreased significantly after radiotherapy (Z =2.900,2.794,2.510,2.090,P＜0.05).However,there was no statistically significant difference for the metastatic group (P＞ 0.05).Conclusions Ultra-hypofractionated stereotactic body radiotherapy is a safe and effective treatment for patients with prostate cancer.

The value of three diaphragm ultrasound indices for ventilator weaning / 中国医师杂志

Objective This study sought to assess the value of the diaphragmatic thickening frac-tion ( DTF) , diaphragmatic-rapid shallow breathing index ( D-RSBI) and diaphragm thickening-rapid shal-low breathing index ( DT-RSBI) in predicting the outcomes of ventilator weaning. Methods A total of 59 patients receiving mechanical ventilation with indications for ventilator withdrawal were included in this stud-y. One hour within the spontaneous breath test ( SBT) began,diaphragmatic displacement ( DD) and DTF were measured with bedside ultrasonography to instead the tidal volume ( VT) in conventional rapid shallow breathing index ( RSBT) to calculate D-RSBI and DT-RSBI. Patients were divided into success group and failure group according to the weaning results. Multivariate logistic regression analysis was used to find inde-pendent risk factors of weaning failure and receiver operating characteristic ( ROC) curve was used to evalu-ate the efficacy of predicting the outcome of weaning. Results The multivariate logistic regression analysis showed that DTF was an independent factor affecting the success or failure after the correction of other fac-tors (P<0. 05), the threshold value is 35％, area under roc curve (AUC) 0. 972. Conclusions The DTF can be effectively used to predict the result of weaning from mechanical ventilation, the value of D-RS-BI and DT-RSBI in SBT needs to be confirmed by more research.

Injury of human gastric epithelial GES-1 cells by MNNG and its effects on Wnt/β-catenin signaling pathway / 生理学报

The aim of this study was to investigate the mechanisms of mono-functional alkylating agent MNNG to damage human gastric epithelial GES-1 cells and roles of Wnt/β-catenin signaling pathway in the process. The GES-1 cells were treated with MNNG (2 × 10 mol/L) for 24 h. The morphological changes of the GES-1 cells were observed under inverted microscope 2 d after treatment. The cell viability was measured by MTT assay. The apoptosis and cell cycle distribution of the GES-1 cells were analyzed by flow cytometry. The mRNA expressions of β-catenin, GSK-3β, c-Met and MMP7 in the GES-1 cells were detected by qPCR. The protein expressions of β-catenin, GSK-3β, p-GSK-3β and c-Met were determined by Western blot. The results showed that MNNG induced the injury of GES-1 cells and changed the normal cell morphology to irregular long spindle shape. MNNG induced the apoptosis of GES-1 cells and blocked the cell cycle progression obviously. MNNG up-regulated the mRNA expressions of β-catenin, GSK-3β, c-Met and MMP7, and increased the protein expressions of β-catenin, GSK-3β and p-GSK-3β. These results suggest that the damage of GES-1 cells induced by MNNG may be related to the activation of Wnt/β-catenin signaling pathway, which will provide the basis for the study of cell model of gastric mucosal cell injury.

A dosimetric analysis of lung tissue in early stage non-small cell lung cancer patients treated by Cyberknife radiotherapy / 中华放射医学与防护杂志

Objective To analyze the radiation dose to the normal lung tissue of patients with early stage of non-small cell lung cancer treated by Cyberknife. Methods A retrospective analysis was conducted by summarizing the treatment plans of 264 patients with early stage non-small cell lung cancer from January 2011 to December 2013 in Tianjin Medical University Cancer Institute and Hospital. Sorted by the tumor volumes and locations, the Cyberknife plans were evaluated by means of dose volume histograms ( DVH) , homogeneity indexes ( HI) , percentage volumes receiving at least x Gy ( Vx ) of dose, i. e. , V5 , V10 , V20 , and V30 of the ipsilateral and contralateral lungs. For the tumors approximate to the hilus, the contralateral lungs were included in the optimization process, and the dose-volume metrics were analyzed for the contralateral and bilateral lungs. Results For the tumors close to the chest wall, V5≥(15. 21 ± 3. 12)％ in ipsilateral lung tissue and V5≥(1. 34 ± 0. 67)％ in contralateral lung tissue were observed. For the tumors near the hilus, V5≥(39. 4 ± 11. 90) ％ in ipsilateral lung tissue and V5≥(1. 48 ± 0. 34) ％ in contralateral lung tissue were observed. The irradiated volume ratios of both ipsilateral and contralateral lung tissue increased with the enlargement of tumor sizes. After including the contralateral lung tissue into the optimization, the irradiated volume ratios of the contralateral and bilateral lung tissue (V5,V10) decreasedsignificantly(t=2.44,4.81,3.53,3.17,P<0.05). Conclusions Higherriskof radiation injury in both ipsilateral and contralateral lung tissue can be expected for tumors near the hilus than near the chest wall. After including contralateral lung tissue into the planning optimization, lower dose to the contralateral and whole lung tissue was achieved, indicating a better protection of normal lung tissue.

Major Metabolite Levels of Preoperative Proton Magnetic Resonance Sectroscopy and Intraoperative Fluorescence Intensity in Glioblastoma / 中国医学科学院学报

Objective To compare the intraoperative major metabolite level of preoperative proton magnetic resonance spectroscopy(H-MRS)and fluorescence intensity marked with fluorescein sodium(FLs)in glioblastoma(GBM)and thus provide an objective basis for fluorescence surgical treatment of GBM. Methods All newly diagnosed patients by plain and enhanced magnetic resonance imaging from the April 1,2014 to December 31,2015 were enrolled in this study.All of them receivedH-MRS and marked with FLs.The expression of Ki67 in tumor boundary were confirmed by postoperative pathology and determined by immunostaining assay.The relationship betweenH-MRS metabolite levels and tumor fluorescence intensity was analyzed. Results Totally 33 patients were included in the study.PreoperativeH-MRS revealed high-grade gliomas in 25 cases.The N-acetylaspartate(NAA)decreased significantly and choline(Cho)increased significantly in high-grade gliomas.The ratios of Cho/NAA,NAA/creatine(Cr),and Cho/Cr significantly differed in different tumor regions(P=0.02,P=0.01,and P=0.00,respectively).Surgical results were marked with FLs intraoperatively.Tissue fluorescence were clearly seen.There were 29 patients undergoing total resection and 4 cases undergoing subtotal resection.No acute encephalocele occured after operation,while 2 patients suffered from epilepsy.Postoperative pathology results included:28 cases were diagnosed as GBM(22 cases consistent withH-MRS diagnosis).The results of GBM fluorescence imaging included:the level of fluorescence intensity in tumor parenchyma was significantly higher than that in tumor boundary and peritumoral edema(P=0.01).The result ofH-MRS metabolite analysis included:The kurtosis of NAA and of Cho and the ratio of Cho/NAA were significantly different according the fluorescence intensity in tumor parenchyma(P=0.01,P=0.02,and P=0.01).While there was no difference in the kurtosis of NAA,the kurtosis of Cho and the ratio of Cho/NAA were significantly different according the fluorescence intensity in tumor boundary(P=0.02, P=0.00).In peritumoral edema,there was no significant different in kurtosis of NAA and of Cho and in the ratio of Cho/NAA(P=0.23,P=0.09,P=0.14).Immunohistochemistry in GBM tumor boundary showed different Ki67 expressions according to different fluorescence imaging(P=0.03). Conclusions The fluorescence intensity in GBM parenchyma is higher than that in other tumor regions,and there are different metabolic levels in different fluorescence intensity.The metabolic information marked by FLs and provided byH-MRS before operationis are important,and the correlation between them should be further investigated.

Follow-up Results and Clinical Significance of Magnetic Resonance Spectroscopy Combined with Fluorescence Microscopy in Resection of High Grade Supra-tentoria Gliomas / 中国医学科学院学报

Objective To investigate the clinical effectiveness of magnetic resonance spectroscopy (MRS) combined with sodium fluorescein(FL) in the treatment of high grade gliomas(HGG). Methods From August 2013 to 2015 November,the clinical data of 72 supratentorial HGG(WHO grade Ⅲ-Ⅳ) patients who had received surgical treatment in our hospital were retrospectively studied,among whom 43 cases received MRS combined with intra-perative FL navigation(observation group),and 29 cases only received conventional surgery(control group). Post-operative radiotherapy and chemotherapy were applied for more than 3 months. Routine enhanced MRI were performed 24-48 hours after the operation to investigate the extent of tumor resection. Six months after the operation,the quality of life of patients was evaluated by using the Karnofsky score,and 1-year postoperative survival rate and progression-free survival(PFS) were observed. Results Postoperative MRI showed that the rate of gross total resection(GTR) in observation group was significantly higher than that in control group(72.09%vs.51.72%;χ=23.88,P=0.001),and the GTR rate of WHO grade Ⅳ tumors was significantly higher than that of WHO grade Ⅲ tumors in observation group(92.86% vs.62.07%;χ=6.06,P=0.042). The postoperative Karnofsky score in the observation group was significantly higher than that in control group(μ=2.34,P=0.021). The mean time of follow-up was(16.4±2.4) months(8-21 months) and there was no statistical significant difference between observation group and control group in 1-year survival rate(74.07% vs.77.50%;χ=4.90,P=0.165) and PFS [(13.2±1.2) months vs.(12.7±2.0) months;χ=7.26,P=0.067]. In observation group,the PFS of WHO grade Ⅳ patients was significantly higher than that in control group [(14.2±0.3) months vs.(10.0±1.1) months;χ=11.03,P=0.031]. There was also no statistical significant difference between WHO grade Ⅳ tumors in two groups in terms of 1-year survival rate(71.43% vs.72.54%;χ=5.33,P=0.089),and there was no statistical significant difference between WHO grade Ⅲ tumors in two groups in 1-year survival rate(75.86% vs. 72.22%;χ=3.78,P=0.250) and in PFS [(13.7±1.4) months vs.(12.4±0.8) months;χ=4.85,P=0.083]. Conclusions MRS combined with intraoperative FL navigation technology can improve the resection rate and improve survival quality of patients,and there is no evidence that MRS combined with intraoperative FL navigation prolong the overall survival of patients with high-grade gliomas. Different outcome may be found with longer follow-up and increased simple size.

Aripiprazole for drug-induced sexual dysfunction in schizophrenic males / 中华男科学杂志

Objective@#To investigate the clinical effects of aripiprazole on sexual dysfunction induced by amisulpride or risperidone in male patients with schizophrenia.@*METHODS@#This study included 75 male patients with drug-induced secondary sexual dysfunction after treated with amisulpride or risperidone for first-episode schizophrenia between October 2014 and October 2016. We substituted aripiprazole for amisulpride or risperidone, gradually increased the dose from 10 to 30 mg/d within 2 weeks, and maintained 30 mg/d from the 3rd week. At 4 and 8 weeks after medication, we evaluated the sexual function of the patients, measured the levels of serum prolactin (PRL) and testosterone (T), obtained the scores of the Positive and Negative Symptoms Scale (PANSS), recorded adverse reactions, and compared the parameters with those before aripiprazole administration.@*RESULTS@#Compared with pre-aripiprazole administration, the patients showed significant increases after 4 weeks of medication in the sexual function score (24.3 ± 2.1 vs 32.6 ± 3.6, P 0.05). In comparison with pre-aripiprazole administration, the PANSS score was significantly decreased at 4 weeks after medication (62.1 ± 4.9 vs 57.2 ± 5.5, P <0.05) and even lower at 8 weeks (51.2 ± 5.2) (P <0.05). The incidence rates of medication-related excitation, dizziness, insomnia, and loss of appetite were 6.7%, 5.3%, 4.0% and 1.3% respectively, and no other serious adverse reactions were observed.@*CONCLUSIONS@#Aripiprazole is effective for the treatment of drug-induced sexual dysfunction in schizophrenic men by continuously alleviating their positive and negative symptoms and meanwhile improving their sexual function and restoring their sexual hormone levels.

Effect of laser photocoagulation combined with calcium dobesilate for diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the clinical effect of panretinal laser photocoagulation combined with calcium hydroxide in the treatment of diabetic retinopathy(DR). <p>METHODS: Selected 120 cases(204 eyes)of DR patients who were treated in our hospital from January 2014 to December 2015 were randomly divided into study group(116 eyes in 66 patients)with calcium hydroxide, control group(88 eyes in 54 patients). Two groups were treated with panretinal laser photocoagulation, and the clinical effect of the two groups were compared. <p>RESULTS: At 6mo after surgery, BCVA of study group was higher than that of control group, the difference was statistically significant(<i>P</i><0.05); at 3 and 6mo after operation, fluorescein leakage area of the study group were lower than that of control group, the difference was statistically significant(<i>P</i>< 0.05); at 3 and 6mo after surgery, central macular thickness(CMT)of the study group was lower than that of control group, the difference was statistically significant(<i>P</i><0.05); the study group had complications after surgery in 4 eyes(3.4%)and 5 eyes(5.7%)in control group, the difference was not statistically significant(<i>P</i>>0.05). <p>CONCLUSION: Compared with simple laser photocoagulation, panretinal laser photocoagulation combined with calcium hydroxide for III - IV stage DR reduce fluorescein leakage area and CMT.

Impact of Extended Ambulatory Electrocardiogram Monitoring on Detection Rate of Arrhythmia in Chronic Heart Failure Patients / 中国循环杂志

Objective: To compare the detection rate of arrhythmia in chronic heart failure (CHF) patients by different time of ambulatory electrocardiogram (Holter). Methods: A total of 108 consecutive elderly CHF patients received 72h Holter in our hospital from 2016-01 to 2016-09 were enrolled. According to NYHA classification, LVEF and plasma NT-proBNP level, the patients were divided into 3 sets of groups. Detection rates of supra-ventricular arrhythmia and ventricular arrhythmia were compared among 24h, 48h and 72h Holter recording. Results: Based on NYHA classification, the patients were divided into 3 groups: NYHA Ⅱ group, n=24, NYHAⅢ group, n=42 and NYHAⅣ group, n=26; based on NT-proBNP level, the patients were divided into 2 groups: NT-proBNP≥1000 pg/ml group and NT-proBNP<1000 pg/ml group, n=54 in each group; based on LVEF, the patients were divided into 3 groups: HFpEF group, n=80, HFmrEF group, n=13 and HFrEF group, n=15. Detection rate for non-sustained atrial tachycardia (NSAT) was 81.7% by 48h Holter which was higher than 64.6% at 24h, P<0.01; for non-sustained ventricular tachycardia (NSVT) was 38% at 72h which was higher than 25.9% at 24h, P<0.01. For new-onset paroxysmal atrial fibrillation, only 1 patient was detected by 24h Holter and the additional 3 patients were detected by 72h. Group analysis indicated that the detection rate of NSVT was different by 72h and 24h Holter in NYHA Ⅲ patients, P<0.05; while it was similar in NYHA Ⅳ patients, P>0.05. Conclusion: Long term (72h/48h) Holter had the higher detection rate of arrhythmia in HF patients, 24 h monitoring was easier to find NSVT in severer HF patients. In moderate to severe HF patients, the detection time may be prolonged if NSVT couldn't be found by 24h Holter which was helpful for clinical treatment.

Bacterial pathogenic characteristics of respiratory tract infection in children in Suzhou, China: an analysis of 14,994 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the bacterial pathogenic characteristics of respiratory tract infection in children.</p><p><b>METHODS</b>The medical data from 14,994 children with respiratory tract infection who were hospitalized in Children's Hospital Affiliated to Soochow University between November 2005 and October 2014 were retrospectively reviewed.</p><p><b>RESULTS</b>Among the 14,994 sputum samples from the children with respiratory tract infection, 3,947 (26.32%) had a positive bacterial culture. The most common bacterial pathogen was Streptococcus pneumonia (12.79%), followed by Haemophilus influenzae (5.02%) and Moraxella catarrhalis (2.91%). The bacterial detection rates differed significantly in different years and seasons and children of different ages (P<0.01). The children who had not taken antibacterial agents before admission had a significantly higher positive bacterial culture rate than those who had taken antibacterial agents (P<0.01). There were significant differences in the bacterial detection rate among the children with different course of disease (<1 month, 1-3 months and >3 months) (P<0.05). The detection rates of Streptococcus pneumonia, Moraxella catarrhalis and Acinetobacter baumannii showed an increased trend with a prolonged disease course (P<0.05).</p><p><b>CONCLUSIONS</b>Streptococcus pneumonia is the most common bacterial pathogen causing respiratory tract infection in children, followed by Haemophilus influenzae and Moraxella catarrhalis. The detection rate of bacterial pathogens varies in different years and seasons and children of different ages. The course of the disease and application of antibacterial agents outside hospital can affect the detection rate of bacterial pathogens in children with respiratory tract infection.</p>

Investigation of the resistant mechanism of carbapenem-resistant Klebsiella pneumoniae / 国际检验医学杂志

Objective To investigate the molecular mechanism of Klebsiella pneumoniae resistant to imipenem.Methods Anti-microbial susceptibility was evaluated by disk diffusion test,Seven imipenem-resistant strains of Klebsiella pneumoniae were select-ed.And PCR was used to amplify so as to detect eighteen resistant genes.Results Seven imipenem-resistant strains of Klebsiella pneumoniae were more sensitive to aminoglycosides and sulfamethoxazole/trimethoprim.The positive rates of KPC,ant(3′′)-Ⅰ, SHV,CTX-Mand ant(2′′)-Ⅰin these imipenem-resistant strains were high.Conclusion Carbapenem-resistant Klebsiella pneumon-iae isolated from our hospital carries several kinds of resistant genes.Carrying KPC may be the main resistant mechanism of Kleb-siella pneumoniae resistant to carbapenem,but other mechanisms also exist at the same time.

The quantitative assessment of left ventricular regional diastolic function after intracoronary stent implantation by strain rate imaging / 中国医师进修杂志

Objective To investigate the application of strain rate imaging in quantitative assessment of left ventricular regional diastolic function after intracoronary stent implantation.Methods Fifty-six healthy person and 60 patients with coronary artery disease were performed quantitative assessment of left ventricular regional diastolic function by apical four chamber view,apical two chamber view and left ventricular long axis view before and after intracoronary stent implantation using strain rate imaging.Results Compared with those of normal myocardium,the peaks of strain rate curve at diastole of ischemic myocardium were reduced,and were increased after operation (P ＜ 0.05).Conclusions Intracoronary stent implantation can significantly improve the blood supply to the ischemia myocardium.Strain rate imaging can quantitatively analyze the changes of left ventricular regional diastolic function.

Analysis of the clinicopathologic characters and prognostic impact of extranodal metastasis in gastric cardia patients / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the correlation between extranodal metastasis (EM) and clinicopathologic features as well as the effect of EM on the prognosis in gastric cardia patients.</p><p><b>METHODS</b>Retrospective analysis was performed for the 323 cases with histologically proven adenocarcinoma of gastric cardia who underwent curative resection from January 2000 to January 2007. There were 272 male patients and 51 female patients with their median age of 63 (22 to 85) years. The relationship between clinicopathological features and extranodal metastasis was studied. The effects of the EM on the recurrence and survival of these patients were also analyzed.</p><p><b>RESULTS</b>EM positive was detected in 67 (20.7%) of the 323 patients. The incidence of EM was correlated with tumor Lauren typing, differentiation degree, invasive depth and lymph node metastasis (χ(2) = 4.647-27.216, P < 0.05). The 5-year survival rate and media survival time between patients with EM and those without EM were 12.3%, 34.1% and 20, 39 months, there was a statistically significantly difference (χ(2) = 23.936, P = 0.000) in 5-year survival rate. Multivariate analysis identified that invasive depth, lymph node metustasis and EM as an independent prognostic factor of all the patients. To the last follow up, the cumulative probability of recurrence of EM-positive patients was significant higher than EM-negative patients (59.7% vs. 35.9%; χ(2) = 12.409, P = 0.000). To study furthermore, stratified analysis showed that, in the node-positive patients, the cumulative recurrence rate of EM-positive patients was higher than EM-negative patients (60.9% vs. 40.0%; χ(2) = 8.410, P = 0.004) and the 5-year survival rate of EM-positive patients was less than the EM-negative patients (12.9% vs. 30.1%; χ(2) = 12.939, P = 0.000), the differences were statistically significant.</p><p><b>CONCLUSIONS</b>EM positive is determined to be an independent prognosis factor of gastric cardia after curative resection. EM-positive patients have a high risk for recurrence and a short time to live.</p>