Faceta Direta de Resina Composta utilizando Pigmentos Opacificadores para Reabilitação Estética Anterior de Dente Escurecido: Relato de Caso / Direct Composite Resin Veneer using Opacifying Pigments for Anterior Aesthetic Rehabilitation of Discolored Teeth: Case Report

O tratamento estético de dentes com alteração de cor é um grande desafio na Odontologia Restauradora. Nesse sentido, a utilização de técnicas de estratificação com resina composta associada ao uso de pigmentos opacificadores permite que seja possível restaurar por meio de uma técnica direta, que resulta em um menor desgaste da estrutura dental durante o preparo. Dessa forma, o presente trabalho apresenta um caso clínico de faceta direta de resina composta utilizando associação de três pigmentos opacificadores. Paciente do sexo masculino, 54 anos, procurou atendimento apresentando alteração de cor severa do dente 21, relato de trauma dental, tratamento endodôntico e contraindicação de novo protocolo de clareamento interno, sendo sugerido, como plano de tratamento, a restauração direta com resina composta. Para a confecção da faceta direta de resina, foi utilizada uma mistura de três opacificadores na consistência fluida. Para verificar o valor da camada aplicada da mistura, foram feitas fotografias em preto e branco. A estratificação prosseguiu com camadas de resina translúcida para a base palatina, resina opaca de dentina e resina acromática translúcida para o esmalte. Como resultado, constatou-se a função e eficácia do uso da associação de pigmentos opacificadores na resolução do caso, em seguida, foi realizada uma reavaliação após 30 dias e 7 meses do procedimento restaurador, quando verificou-se a estabilidade de cor da restauração. Concluiu-se, portanto, que a utilização da técnica de estratificação de resinas compostas associada a utilização de pigmentos opacificadores traz resultados estéticos satisfatórios e favoráveis por meio de uma técnica direta, realizada em sessão clínica única e com alta previsibilidade.

The esthetic treatment of teeth with discoloration is a major challenge in restorative dentistry. In this sense, the use of composite resin veneering techniques associated with the use of opacifying stains allows restorations to be made using a direct technique, which results in less wear to the tooth structure during preparation. Thus, the present study presents a clinical case of a direct composite resin veneer using an association of three opacifying pigments. A 54-year-old male patient presented with severe color change on the central upper left incisor, a report of dental trauma, endodontic treatment, and contraindication for a new internal bleaching protocol. In order to make the direct resin veneer, a mixture of three opacifiers in a fluid consistency was used. To check the value of the applied layer of the mixture, black and white photographs were taken. Layering proceeded with translucent resin layers for the palatal base, opaque dentin resin and translucent achromatic resin for the enamel. As a result, the function and efficacy of the use of the association of opacifying pigments was verified in the resolution of the case. A reevaluation was performed 30 days and 7 months after the restorative procedure, when the color stability of the restoration was verified. This case allows to conclude that using composite resin layering technique associated with the use of opacifying pigments brings satisfactory and favorable aesthetic results through a direct technique, performed in a single clinical session and with high predictability.

Laboratory derangements and clinical picture of Covid-19 in pediatric age group: A retrospective study

Aim: To assess the clinical presenta?on and laboratory derangements of pediatric covid-19 pa?ents admi?ed to the ter?ary care hospital. Methodology: The present retrospec?ve study was started a?er the approval of the Ins?tu?onal Ethics Commi?ee. Clinical (Sp02, final diagnosis and outcome) and biochemical parameters (Complete Blood Count, Liver Func?on Test, Renal Func?on Test, Lactate De-Hydrogenase, D-dimer, C-Reac?ve Protein, and Serum ferri?n) of pediatric covid-19 pa?ents were collected from Central Laboratory and Medical Record Department of our ins?tu?on. Pa?ent names were anonymized and data were analyzed. The results are expressed in percentages. Results: A total of 16 pediatric covid-19 pa?ent details were iden?fied and collected who were admi?ed during our study period. Out of 16 pa?ents, 09 (56.2%) were female and the remaining 07 (43.7%) were male. Out of 16, 05 pa?ents had mild covid, 07 were moderate and the remaining 04 suffered from severe covid-19 infec?on. The mean values of oxygen satura?on, LDH, D-dimer, CRP, and Ferri?n were 88%, 249.4U/L, 1140.9 ng/ml, 16.17 mg/dl, and 61.7 µg/L respec?vely. Mean values of 17.9 mg/dl and 0.4 mg/dl were recorded for blood urea and S.crea?nine. Regarding liver func?on tests, mean values of 1.7mg/dl, 0.2mg/dl, 1.5mg/dl, 82.4 U/L, 55 U/L, 135.6 U/L respec?vely noted for total bilirubin, direct, indirect, SGOT, SGPT and ALP. Regarding pa?ent outcomes, all the pa?ents were covered and discharged from the hospital. Conclusion: The present study has found an increase in laboratory mean values of liver func?on tests but the mean values of C-Reac?ve protein, LDH, and d-dimer which are the acute inflammatory markers are highly disrupted compared to normal ranges.

Does Antioxidant Superoxide Dismutase levels Decline with Advanced primary Knee Osteoarthritis in Synovial Fluid ? A Pilot Study

Introduction: Osteoarthritis (OA) is a progressive, degenera?ve disease that leads to joint pain, tenderness, s?ffness, locking, effusion, reduced mo?on, swelling, crepitus, and disability. The pain in OA is the most significant clinical feature and impacts func?on, mobility, quality of life, and the reason for medical advice. Methods: Fi?y individuals with primary knee OA in the age range of 45–90 years were chosen at random for the research (N=50). The American College of Rheumatology’s diagnos?c criteria were employed to diagnose osteoarthri?s, and a visual analogue scale was u?lized to score the severity of pain. Knee OA was graded using the Kellgren-Lawrence (K-L) radiographic assessment method. The an?oxidant levels of superoxide dismutase in the synovial fluid were measured by using a spectrophotometric assay. Results: Grades 1, 2, 3, and 4 have SOD ac?vity values of 1.43±0.55, 1.44±0.72, 0.92±0.52, and 0.87 ±0.52 U/ml, respec?vely, in synovial fluid. Synovial fluid SOD ac?vity was higher in grades 1 & 2 of KOA as compared to grades 3 &4 and the difference was sta?s?cally significant (p<0.05). Conclusions: There was a link between K-L grade and synovial an?oxidant ac?vity level. In the late stages of knee osteoarthri?s, the an?oxidant enzyme (SOD) ac?vity was reduced.According to the results of this study, regular an?oxidant supplementa?on to early osteoarthri?s pa?ents may delay disease progression by improving the an?oxidant status of the knee, which neutralises free radicals and thus prevents car?lage damage.

Speciation of coagulase negative staphylococci (CoNS) isolated from various clinical specimens in a tertiary care hospital of southern Rajasthan

Background: Coagulase negative staphylococci (CoNS) are a group of staph bacteria, which generally exist as normal flora of human skin and the oral flora found on mucous membranes. CoNS in immunocompromised pa?ents can cause variety of infec?ons like bacteraemia, central nervous system shunt infec?on, intravascular catheter-related infec?ons, endocardi?s, surgical site infec?ons, urinary tract infec?ons, foreign body infec?on, endophthalmi?s, peritoni?s and wound, bone and joint infec?ons as well as infec?ons in neonates. These infec?ons are difficult to treat because of the risk factors and the drug resistant nature of the organisms.Objec?ve:To find out species wise distribu?on of Coagulase nega?ve Staphylococci (CoNS) in various relevant clinical samples in our ins?tute. Materials and Method:A total of 500 CoNS strains were isolated from relevant clinical specimens. CoNS strains were isolated from variety of clinical specimens. Strains were iden?fied as CoNS on the basis of colony morphology, gram stain, catalase test and coagulase test. Conven?onal methods were used for species iden?fica?on a?er confirming isolates as CoNS. Results:The most common source of CoNS isola?on was blood (34%), followed by respiratory secre?ons (24.4%), urine (16.8%), pus (13.4%), swabs (5.4%), bodily fluid (1.4%), and others (4.6%). S.epidermidis was most frequently isolated (30.6%), followed by S.hemoly?cus (25.4%), S.hominis (12.6%), S.capi?s (12%), S.lugdunensis (11.4%) and S.cohnii (08%). Conclusion : As CoNS have become major cause of nosocomial infec?ons, there is a need for rapid iden?fica?on and specia?on of CoNS with their an?bio?c suscep?bility for be?er management of these cases and to prevent emergence of drug resistance.

The protective role of raltegravir in experimental acute lung injury in vitro and in vivo

Disruption of pulmonary endothelial permeability and associated barrier integrity increase the severity of acute respiratory distress syndrome (ARDS). This study investigated the potential ability of the human immunodeficiency virus-1 (HIV-1) integrase inhibitor raltegravir to protect against acute lung injury (ALI) and the underlying mechanisms. Accordingly, the impact of raltegravir treatment on an in vitro lipopolysaccharide (LPS)-stimulated human pulmonary microvascular endothelial cell (HPMEC) model of ALI and an in vivo LPS-induced two-hit ALI rat model was examined. In the rat model system, raltegravir treatment alleviated ALI-associated histopathological changes, reduced microvascular permeability, decreased Evans blue dye extravasation, suppressed the expression of inflammatory proteins including HMGB1, TLR4, p-NF-κB, NLRP3, and MPO, and promoted the upregulation of protective proteins including claudin 18.1, VE-cadherin, and aquaporin 5 as measured via western blotting. Immunohistochemical staining further confirmed the ability of raltegravir treatment to reverse LPS-induced pulmonary changes in NLRP3, claudin 18.1, and aquaporin 5 expression. Furthermore, in vitro analyses of HPMECs reaffirmed the ability of raltegravir to attenuate LPS-induced declines in VE-cadherin and claudin 18.1 expression while simultaneously inhibiting NLRP3 activation and reducing the expression of HMGB1, TLR4, and NF-kB, thus decreasing overall vascular permeability. Overall, our findings suggested that raltegravir may represent a viable approach to treating experimental ALI that functions by maintaining pulmonary microvascular integrity.

Insulin Therapy Refusal among Insulin-naïve Type II Diabetes Mellitus Patients in Segamat

@#Introduction: The prevalence of diabetes shows an increasing trend in Malaysia. Insulin is effective towards glycaemic control, but refusal of insulin by type 2 diabetes mellitus (T2DM) patients delay initiation of insulin therapy. This study assessed the prevalence and predictors of insulin refusal among insulin-naïve T2DM patients under all public health clinics in Segamat. Methods: This was a multi-centre, cross-sectional study conducted in 11 public health clinics in Segamat. Data were collected from September until November 2019 by systematic random sampling using a validated self-administered questionnaire. Factors associated with reluctance to use insulin were examined using logistic regression. Results: Out of 295 insulin-naïve T2DM patients recruited in this study, 234 (79.3%) rejected insulin treatment. The two foremost reasons were being unconfident of injecting insulin (83.3%) and feeling of failure to control the disease (82.1%). Educational background and gender were significantly associated with insulin treatment refusal. Patients with no formal or only primary education were found to be 1.97 times more likely to refuse insulin (adjusted OR 1.97, 95% CI 1.09-3.56, p=0.025), and female patients were 1.82 times more likely to refuse insulin therapy than male patients (adjusted OR 1.82, 95% CI 1.02-3.22, p=0.041). Conclusion: The prevalence of insulin refusal is high in public health clinics in Segamat. Besides counselling, intervention steps should be taken to improve insulin acceptance by targeting the most typical reasons for insulin refusal in our setting.

Ruscogenin alleviates LPS-triggered pulmonary endothelial barrier dysfunction through targeting NMMHC IIA to modulate TLR4 signaling

Pulmonary endothelial barrier dysfunction is a hallmark of clinical pulmonary edema and contributes to the development of acute lung injury (ALI). Here we reported that ruscogenin (RUS), an effective steroidal sapogenin of Radix Ophiopogon japonicus, attenuated lipopolysaccharides (LPS)-induced pulmonary endothelial barrier disruption through mediating non-muscle myosin heavy chain IIA (NMMHC IIA)‒Toll-like receptor 4 (TLR4) interactions. By in vivo and in vitro experiments, we observed that RUS administration significantly ameliorated LPS-triggered pulmonary endothelial barrier dysfunction and ALI. Moreover, we identified that RUS directly targeted NMMHC IIA on its N-terminal and head domain by serial affinity chromatography, molecular docking, biolayer interferometry, and microscale thermophoresis analyses. Downregulation of endothelial NMMHC IIA expression in vivo and in vitro abolished the protective effect of RUS. It was also observed that NMMHC IIA was dissociated from TLR4 and then activating TLR4 downstream Src/vascular endothelial cadherin (VE-cadherin) signaling in pulmonary vascular endothelial cells after LPS treatment, which could be restored by RUS. Collectively, these findings provide pharmacological evidence showing that RUS attenuates LPS-induced pulmonary endothelial barrier dysfunction by inhibiting TLR4/Src/VE-cadherin pathway through targeting NMMHC IIA and mediating NMMHC IIA‒TLR4 interactions.

Study Of Cybersickness On Non-Immersive Virtual Reality Using Smartphone

@#Cybersickness is one of the psycho-physiological responses affecting human performances when it is interacting with Virtual Environment. Virtual Environment (VE) is an advanced technological model generated by computer which allows users feel the real-life presence like that in the real environment. However the repetitive exposure to VE causes sickness, especially the eyestrain when the eyes are forced to make an accommodation and focus on the virtual object. This symptom can be identified on the eye’s movement and the eyes muscle contraction. Thus, it is considered significant to evaluate the contraction of eye’s muscle. The objective of this study is to analyse the eyestrain in the constant use of smartphone for playing the war game. Empirical study was conducted to gather the relevant data. Ten subjects, who were familiar with the war game, were involved in this study. Electromyography (EMG) was used to record the signal of muscle contraction on lateral eyes muscle. Statistical analysis was conducted to test the hypothesis. The result of this study showed that there was a significant difference in visual acuity between normal brightness and 0% brightness and 100% brightness of smartphone while sitting in operating. There was also significant difference in visual acuity between the normal brightness 0%, 50%, and 100% of brightness depending on the lying down position. As for the higher contraction on lateral rectus muscle of the eyes occurred in lying down position than in sitting position at any level of brightness.

Comparison of MRI-ultrasound fusion–guided and transrectal ultrasound–guided prostate biopsy for the detection of prostate cancer in biopsy-naive men

OBJECTIVE@#Transrectal ultrasound-guided prostate biopsy (TRUSPBx) is the recommended method for the histopathologic confirmation of prostate cancer. However, the overall cancer detection rate is low; hence, patients are potentially exposed to multiple biopsies and their attendant morbidity. Multiparametric MRI of the prostate followed by MRI-Ultrasound fusion-guided prostate biopsy (FBx) is an emerging diagnostic pathway that has been established and recommended in men with a persistently elevated PSA despite a previous negative biopsy. However, evidence regarding its value in the biopsy-naïve setting is scarce. The objective is to compare the diagnostic accuracy of MRI fusion-guided prostate biopsy against TRUSPBx in biopsy-naïve men. @*METHODS@#This is a retrospective cohort study involving biopsy-naïve men with a PSA of 3 to 20 ng/ml. Primary outcomes of the study include overall cancer detection rate (CDR) and detection of clinically-significant prostate cancer (csPCa). Subgroup analyses were performed based on PSA level and prostate volume. Independent t-test, Mann Whitney U test and Chi square test were used in the statistical analysis.@*RESULTS@#A total of 185 biopsy-naïve men with a PSA level of 3 – 20 ng/mL were included in the study. Median pre-biopsy PSA level was 7.07 ng/mL (5.06 – 11.0) and 9.02 ng/mL (5.8 – 13.8) in the FBx arm and TRUS-guided biopsy arm, respectively. Ninety-nine (n=99; 53%) underwent MP-MRI of the prostate followed by MRI fusion-guided prostate biopsy and eighty-six (n=86; 46%) underwent the standard TRUS-guided prostate biopsy. Compared to TRUSPBx, FBx significantly detected more prostate cancer (CDR: 68% vs 30%, p<0.0001) and csPCa (46% vs 22%, p=0.001). The diagnostic yield of FBx was distinctly superior in the subgroup of men with a PSA of 4 – 10 ng/mL (CDR: 64% vs 7%, p<0.0001; csPCa: 43% vs 2%, p<0.0001) and a prostate volume of <40grams (CDR: 82% vs 36%, p<0.0001; csPCa: 53% vs 21%, p=0.006).@*CONCLUSION@#Compared to the current standard, the diagnostic yield of MRI fusion-guided prostate biopsy is significantly better in biopsy-naïve men. FBx detected more men with prostate cancer, with a higher proportion of men having clinically-significant disease. This advantage is strongly evident in men with a PSA level of 4 – 10 ng/mL and an average prostate volume of 40 grams. Hence, Multiparametric MRI of the prostate followed by MRI fusion-guided prostate biopsy is an effective first-line diagnostic modality for prostate cancer in men presenting with elevated PSA levels.

Effects of a high-intensity pulmonary rehabilitation program on the minute ventilation/carbon dioxide output slope during exercise in a cohort of patients with COPD undergoing lung resection for non-small cell lung cancer / Efeitos de um programa de reabilitação de alta intensidade no comando VE/VCO2 durante exercício em um grupo de pacientes submetidos à ressecção para câncer de pulmão de células não pequenas

ABSTRACT Objective: Preoperative functional evaluation is central to optimizing the identification of patients with non-small cell lung cancer (NSCLC) who are candidates for surgery. The minute ventilation/carbon dioxide output (VE/VCO2) slope has proven to be a predictor of surgical complications and mortality. Pulmonary rehabilitation programs (PRPs) could influence short-term outcomes in patients with COPD undergoing lung resection. Our objective was to evaluate the effects of a PRP on the VE/VCO2 slope in a cohort of patients with COPD undergoing lung resection for NSCLC. Methods: We retrospectively evaluated 25 consecutive patients with COPD participating in a three-week high-intensity PRP prior to undergoing lung surgery for NSCLC, between December of 2015 and January of 2017. Patients underwent complete functional assessment, including spirometry, DLCO measurement, and cardiopulmonary exercise testing. Results: There were no significant differences between the mean pre- and post-PRP values (% of predicted) for FEV1 (61.5 ± 22.0% vs. 62.0 ± 21.1%) and DLCO (67.2 ± 18.1% vs. 67.5 ± 13.2%). Conversely, there were significant improvements in the mean peak oxygen uptake (from 14.7 ± 2.5 to 18.2 ± 2.7 mL/kg per min; p < 0.001) and VE/VCO2 slope (from 32.0 ± 2.8 to 30.1 ± 4.0; p < 0.01). Conclusions: Our results indicate that a high-intensity PRP can improve ventilatory efficiency in patients with COPD undergoing lung resection for NSCLC. Further comprehensive prospective studies are required to corroborate these preliminary results.

RESUMO Objetivos: A avaliação funcional pré-operatória é fundamental para otimizar a seleção dos pacientes para cirurgia torácica para tratamento do CPCNP. Uma alta inclinação VE/VCO2 se mostrou um preditor de complicações cirúrgicas e de aumento da mortalidade. Programas de reabilitação pulmonar (PRP) demonstraram aumentar os parâmetros funcionais e os desfechos de curto prazo em pacientes com DPOC submetidos à ressecção pulmonar. O impacto dos PRP na inclinação VE/VCO2 não foi totalmente investigado. Métodos: Avaliamos retrospectivamente 25 pacientes com DPOC consecutivos submetidos aos efeitos de um programa de reabilitação pulmonar de alta intensidade (PRP) na inclinação VE/VCO2. Resultados: Não foram observadas variações significativas nos principais parâmetros espirométricos após o programa de reabilitação de três semanas (pré-reabilitação VEF1 versus pós-reabilitação VEF1 %prev: 61,5 ± 22,0% para 62,0 ± 21,1%, ns; pré-reabilitação DLCO para pós-reabilitação DLCO %prev: 67,2 ± 18,1% para 67,5 ± 13,2%, ns). Por outro lado, o pico de VO2 e a inclinação VE/VCO2 melhoraram significativamente após PRP (pico de VO2 pré-reabilitação para pico de VO2 pós-reabilitação: 14,7 ± 2,5 para 18,2 ± 2,7 mL/kg/min, p < 0,0000001; inclinação pré-reabilitação VE/VCO2 para pós-reabilitação inclinação VE/VCO2: 32,0 ± 2,8 para 30,1 ± 4,0, p<0,01). Conclusão: Documentamos o benefício no desempenho físico de um treinamento de três semanas em um grupo de pacientes com DPOC com um comprometimento funcional notável em parâmetros de esforço. Dados adicionais e mais abrangentes são necessários para esclarecer os mecanismos fisiológicos.

Antipsychotics and sudden cardiac death risk factors / 中华行为医学与脑科学杂志

Antipsychotics treatment significantly increases the risk of sudden cardiac death in psy-chiatric patients,especially in elder patients. This paper reviews the major clinical risk factors of sudden car-diac death including myocardial infarction,QT interval prolongation and venous thromboembolism,as well as discusses the possible pharmacological mechanisms. We should focus on assessing somatic factors at the on-set of treatment and during maintenance therapy,and choose the antipsychotics reasonably to reduce the pos-sibility of sudden cardiac death.

The dynamics of serum vascular endothelial cadherin levels and its relationship with prognosis in patients with acute respiratory distress syndrome induced by sepsis / 中华传染病杂志

Objective To investigate the prognostic significance of serum vascular endothelial cadherine (VE-Cad) in patients with acute respiratory distress syndrome (ARDS) induced by sepsis . Methods A prospective observational study was performed between June 2015 and Dec 2017 ,and 48 ARDS patients induced by sepsis from intensive care unit (ICU) were enrolled .And 30 healthy volunteers were enrolled as control .ARDS group was divided into mild group (n=17) ,moderate group (n=18) and severe group (n= 13) .The dynamic levels of serum VE-Cad ,tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were monitored at day 1 ,3 and 7 of admission .Clinical data including extravascular lung water index (EVLWI) ,pulmonary vascular permeability index (PVPI) ,lung injury score (LIS) , APACHEⅡand SOFA were also collected .The t-test or chi square test were used in the comparison between the two groups .One-way ANOVA was used for comparison among multiple groups .Results The serum VE-Cad level of septic group was higher than control group at day 1 of admission ([5 .67 ± 0 .29] vs [0 .28 ± 0 .03] μg/L ,t= 101 .2 , P< 0 .01) .The serum VE-Cad levels in the mild group , moderate group and severe group were (1 .52 ± 0 .59) ,(3 .45 ± 0 .68) ,and (4 .68 ± 0 .53) μg/L , respectively (F=15 .45 ,P<0 .01) .There were positive correlation between VE-Cad levels and EVLWI , PVPI ,LIS ,TNF-αand IL-6 (r=0 .640 ,0 .601 ,0 .507 ,0 .584 ,and 0 .456 ,respectively ,all P<0 .01) . The PaO2/FiO2 and serum albumin level in death group (n=17) were lower than survival group (n=31) ([146 .74 ± 16 .45] vs [245 .42 ± 12 .13] mmHg [1 mmHg=0 .133 kPa] ,t=23 .72 ,P<0 .01 ;[23 .18 ± 3.24]vs[29.16±3.45]g/L,t=5.865,P< 0.01,respectively),andEVLWI ,PVPI,LIS,serum lactate ,mechanical ventilation time ,7 d fluid balance ,APACHEⅡ and SOFA in death group were all higher than survival group .The serum VE-Cad levels at day 1 ,3 and 7 in death group were all higher than survival group ([4 .72 ± 0 .96] vs [3 .36 ± 0 .47]μg/L ,t=8 .801;[3 .87 ± 0 .28] vs [1 .95 ± 0 .42]μg/L , t=16 .86 ;[3 .92 ± 0 .53] vs [0 .96 ± 0 .28]μg/L ,t=25 .42 ,respectively ,all P<0 .01) .The area under curve (AUC ) of VE-Cad for ARDS outcome prediction was 0 .878 with sensitivity of 100 .00％ and specificity of 58 .06％ with a cutoff of 3 .035 μg/L .Conclusion Serum VE-Cad level increases in patients with ARDS induced by sepsis ,and positively correlates with disease severity ,which could be a potential predictor for prognosis .

Network mechanism of effective constituents from the compound Yizhihao against influenza / 中国药理学与毒理学杂志

Influenza caused by influenza virus,seriously threaten human life and health.Drug treatment is one of the effective measurement. However, there are only two classes of drugs, one class is M2 blockers and another is neuraminidase (NA)inhibitors. The recent antiviral surveillance studies reported a global significant increase in M2 blocker resistance among influenza viruses, and the resistant virus strains against NA inhibitor are also reported in clinical treatment.Therefore thediscovery of new medicines with low resistance has become very urgent.As all known,traditional medicines with multi-target features and network mechanism often possess low resistance. Compound Yizhihao, which consists of radix isatidis,folium isatidis,Artemisia rupestris,is one of the famous traditional medicine for influenza treatment in China, however its mechanism of action against influenza is unclear. In this study, the multiple targets related with influenza disease and the known chemical constituents from Compound Yizhihao were collected, and multi-target QSAR (mt-QSAR) classification models were developed by Na?ve Bayesian algorithm and verified by various datasets. Then the classification models were applied to predict the effective constituents and their drug targets.Finally,the constituent-target-pathway network was constructed,which revealed the effective constituents and their network mechanism in Compound Yizhihao. This study will lay important basis for the clinical uses for influenza treatment and for the further research and development of the effective constituents.

Sensitivity and Usefulness of VE1 Immunohistochemical Staining in Acral Melanomas with BRAF Mutation

BACKGROUND: Acral melanomas are known to have a low frequency of BRAF mutation, in contrary to higher KIT mutation. Recently, VE1 immunostaining was reported to have a good correlation with BRAF mutation status. OBJECTIVE: We aimed to evaluate the clinicopathological features of BRAF-mutated acral melanomas and validate the correlation of the VE1 immunohistochemical stains in those cases. METHODS: The clinical features (age, sex, anatomical site), and histopathological characteristics of 41 patients with acral melanoma were evaluated. We performed a next-generation sequencing to detect BRAF mutation status. We also determined the correlation of VE1 immunohistochemical staining with BRAF mutation status. RESULTS: Among 19 acral melanomas with BRAF mutation, common histopathological subtype was acral lentiginous melanoma (8/19, 42%) and nodular melanoma (8/19, 42%) and superficial spreading melanoma (3/19, 16%) followed. VE1 immunostaining results were positive in all 15 cases with BRAF V600E mutation (sensitivity 100%), and negative in 4 cases of BRAF non-V600E mutation. However, VE1 immunostaining was negative in all 22 patients with BRAF wild-type. CONCLUSION: VE1 immunostaining had a good correlation with BRAF V600E mutation status.

Relationship between serum vascular endothelial cadherin level and prognosis of patients with septic shock / 中华急诊医学杂志

Objective To investigate the prognostic significance of serum VE-cadherin in patients with septic shock. Methods A prospective observation study was performed between January 2016 and December 2017, forty-eight septic shock patients from intensive care unit (ICU) were enrolled, and 25 healthy volunteers served as the controls. Meanwhile, patients in the septic shock group were divided into two subgroups of the survival and death groups according to the 28-day mortality. The dynamic value changes of serum VE-cadherin (VE-Cad), vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were monitored on the 1st, 3rd and 7th day after admission. Results The serum VE-Cad level of the septic group was significantly higher than that of the control group on the 1st day (3.02±0.18 ng/mL vs. 0.26±0.05 ng/mL, t=3.275, P=0.002). There was a positive correlation between VE-Cad level and VEGF, TNF-α and IL-6 (r=0.826, 0.723, and 0.870, respectively; P<0.01). The PaO2/FiO2 and serum albumin (ALB) level of the death group were lower than that of the survival group, and extravascular lung water index (EVLWI), serum lactate, mechanical ventilation time, 7 day fluid balance, APACHE Ⅱ and SOFA levels of the death group were higher than those of the survival group. The serum VE-Cad levels of the death group were higher than those of the survival group on the 1st, 3rd and 7th day. The serum VE-Cad levels were positively correlated with APACHE Ⅱ and SOFA. The area under the ROC curve of VE-Cad predicting septic shock death on day 1 was 0.723 (95％CI 0.568-0.878). The sensitivity and specificity of VE-Cad with cut-off of 3.1 ng/mL in predicting septic shock death were 60％ and 70.83％, respectively. Conclusions Serum VE-Cad is positively correlated with disease severity and could predict a poor outcome in septic shock patients.

Experimental study on anti-angiogenic activity of T7 peptide derived from active fragment of Tumstatin / 中国现代普通外科进展

Objective:To investigate the influence and related mechanisms of T7 peptide derived from tumstatin on angiogenesis in vitro.Methods:HUVECs were incubated in hypoxia chamber(37℃,1％ O2,5％ CO2,94％ N2) to simulate the hypoxic microenvironment in tumors,and grouped into:hypoxia group,hypoxia+T7 peptide (1.0 μ mol/L) group,and hypoxia+T7 peptide(2.0μ mol/L) group.The tube formation assay was applied to analyze the influence of T7 peptide on angiogenesis under hypoxia.Cell Counting Kit-8 was applied to observe the cell viability.The apoptosis rate was detected with Annexin V-FITC,and the expression levels of pro-apoptotic protein BAX and anti-apoptotic protein Bcl-2 were observed with western blot.Immunofluorescence and western blot were used to detect the expression of VE-cadherin.Results:Under hypoxic condition,T7 peptide significantly inhibited capillary-like tube formation (P＜0.05),inhibited ECs viability(P＜0.05),and increased the ECs apoptosis rate in vitro;T7 peptide resulted in the downregulation of anti-apoptotic protein Bcl-2 (P＜0.01)and upregulation of pro-apoptotic protein BAX(P＜0.05);the expression of VE-cadherin was downregulated by T7 peptide significantly(P＜0.05).Conclusions:T7 peptide could execute its anti-angiogenic activity via inhibition of ECs viability,induction of ECs apoptosis rate,and downregulation of VE-cadherin expression.

Efficacy and prognostic factors of abiraterone combined with prednisone treating metastatic castration-resistant prostate cancer patients / 上海交通大学学报（医学版）

Objective· To assess the efficacy of abiraterone acetate (AA) plus prednisone treating metastatic castration-resistant prostate cancer (mCRPC) patients and analyze the prognostic factors for this treatment. Methods · The medical history of 112 patients with mCRPC treated in Renji Hospital affiliated to Shanghai Jiao Tong University School of Medicine, including 70 patients in the chemotherapy-na?ve setting and 42 in the post-chemotherapy setting, were retrospectively reviewed. Coprimary end points were prostate specific antigen progression-free survival (PSA PFS), radiographic PFS (rPFS) and overall survival (OS). Univariable and multivariable Cox analyses were performed to determine prognostic factors that were associated with PSA PFS, rPFS and OS. Results · At a median follow-up of 20.2 months, 59 (52.7%) patients had died. The median PSA PFS, rPFS and OS were 8.9 (7.8~10.0) months, 9.7 (9.0~10.4) months, and 22.2 (20.3~24.1) months, respectively. In multivariate analysis, previous chemotherapy, neutrophil lymphocyte ratio(≥3 vs<3),serum lactate dehydrogenase level(≥196 U/L vs<196 U/L)and ECOG PS(≤?1 vs 2)were independent predictors for PSA PFS and rPFS,and previous chemotherapy,ECOG PS(≤?1 vs 2)remained significant predictors for OS. Conclusion·These results further support the favourable profile of AA plus prednisone in patients with mCRPC in China.Previous chemotherapy,ECOG PS(≤?1 vs 2)remained significant predictors for OS.

Effects of intraoperative expansion on expression of stenosis-related genes in saphenous vein graft / 局解手术学杂志

Objective To investigate the effect of high pressure distention on the expression of stenosis-related genes of saphenous vein graft(SVG) during the coronary artery bypass grafting(CABG).Methods The biopsy specimens of saphenous vein collected from 10 patients who have undergone CABG,were divided into expansion group and no-expansion group.Real-time PCR and immunohistochemical staining were performed for examination of mRNA and protein expression of VE-cad,Egr-1,VCAN respectively.Student's t and Chi-square test were used to do statistic analysis.Results The results of RT-PCR showed that the mRNA transcription of Egr-1,VCAN in the expansion group were statistically significantly higher than those in no-expansion group(P<0.05).The mRNA transcription VE-cad in expansion group was statistically significantly lower than that in the no-expansion group(P<0.05).The immunohistochemical staining results showed that the expression of Egr-1 and VCAN in expansion group were significantly stronger than those in no-expansion group,while the expression of VE-cad was significantly lower than no-expansion group.Conclusion The intraoperative expansion of SVG can increase the expression of stenosis-related genes Egr-1 and Versican,and decrease the expression of stenosis-related gene VE-cad,which may be related with the SVG stenosis after CABG.

BRAF V600E mutation and expression of its protein in papillary thyroid carcinoma / 中国癌症杂志

Background and purpose:The BRAF V600E mutation is a highly attractive drug target. Therefore, determining the BRAF gene mutation status of patients is essential in order to assess patients' eligibility for targeted BRAF geneinhibitor therapy. The aim of this study was to validate the utility of immunohistochemistry to rapidly obtain the BRAF gene mutation status. This study aimed to analyze the correlation of the BRAF V600E gene mutation and VE1 protein ex-pression with the clinical pathological characteristics in papillary thyroid carcinoma (PTC).Methods:The mutation status of BRAF V600E was detected by DNA sequencing. Immunohistochemistry was used to detect the expression of BRAF V600E protein in 108 cases of PTC, 54 cases of thyroid adenoma and 54 cases of normal thyroid tissue.Results:The gene mutation rate of BRAF V600E is 67.6%, and VE1 protein expression rate is 64.8% in 108 cases of PTC. The differences were statistically significant compared with thyroid adenoma and goiter (P<0.05), but have no correlation with the clinical pathological characteristics.Conclusion:BRAF V600E gene mutation and VE1 protein expression are useful biomarkers for the pathological diagnosis of PTC. High consistency was observed between the immunohistochemical staining results and the DNA sequencingresults of BRAF V600E gene mutations. Immunohistochemical technique detecting the BRAF V600E protein expression can effectively reflect indirectly BRAF V600E gene mutation status in PTC.BRAF V600E gene mutation has no contribution to the development of papillary thyroid carcinoma.

Network pharmacology study of the effective constituents in the Compound Yizhihao against influenza disease / 药学学报

Compound Yizhihao, consists of Radix isatidis, Folium isatidis, Artemisia rupestris, has a significant therapeutic effect on the treatment of influenza and fever. However, the mechanism of its action is still unclear. In this investigation, we collected the key target molecule of influenza disease and the chemical constituents of Compound Yizhihao, and developed Naïve Bayesian classification models based on the input molecular fingerprints and molecule descriptors. The built models were further applied to construct classifiers for predicting the effective constituents. We used the professional network-building software to build the constituent-target network and target-pathway network, which revealed the network pharmacology of the effective constituents in Compound Yizhihao. It will contribute to the further research of mechanism of Compound Yizhihao.