Sentinel lymph node melanoma metastases: Assessment of tumor burden for clinical prediction of outcome in the first Multicenter Selective Lymphadenectomy Trial (MSLT-I).

PURPOSE: As clinical management decisions in patients with Stage III melanoma have become more complex, precise pathologic characterization of sentinel lymph node (SLN) metastases has become critical to guide management. The extent of SLN involvement correlates with risk of adverse outcomes, but reported methods of disease quantification vary. We examined SLN metastases from patients participating in an international clinical trial and compared several methods of tumor burden quantification. METHODS: SLNs from 146 node-positive patients in the first Multicenter Selective Lymphadenectomy Trial (MSLT-I) were centrally-reviewed and characterized by number of tumor-positive nodes, percent nodal area tumor replacement, maximum dimension of largest metastasis, tumor penetrative depth, number of tumor foci, metastasis microanatomic location, and extracapsular extension. These data were analyzed for correlation with non-SLN metastasis and melanoma-specific survival (MSS). RESULTS: The median number of tumor-involved SLNs was 1. The median maximum metastasis dimension was 1.11 mm. Median SLN area involvement was 1.5%. Tumor burden measures were highly correlated with each other. Factors associated with non-SLN metastasis by univariable analysis were primary tumor ulceration and extent of metastases. Tumor thickness, ulceration, non-SLN metastasis and multiple measures of SLN tumor burden were significantly related to MSS on univariable analysis. After multivariable adjustment, number of involved SLNs (p = 0.05) and percent nodal area tumor replacement (p = 0.02) were independent predictors of MSS. CONCLUSION: Central review of MSLT-I pathology indicates that primary tumor and SLN tumor characteristics predict non-SLN metastasis and MSS. Percent nodal involvement was more powerfully prognostic than the more commonly used maximum dimension of largest metastasis.

Developing Machine Learning Algorithms to Predict Pulmonary Complications After Emergency Gastrointestinal Surgery.

Objective: Investigate whether machine learning can predict pulmonary complications (PPCs) after emergency gastrointestinal surgery in patients with acute diffuse peritonitis. Methods: This is a secondary data analysis study. We use five machine learning algorithms (Logistic regression, DecisionTree, GradientBoosting, Xgbc, and gbm) to predict postoperative pulmonary complications. Results: Nine hundred and twenty-six cases were included in this study; 187 cases (20.19%) had PPCs. The five most important variables for the postoperative weight were preoperative albumin, cholesterol on the 3rd day after surgery, albumin on the day of surgery, platelet count on the 1st day after surgery and cholesterol count on the 1st day after surgery for pulmonary complications. In the test group: the logistic regression model shows AUC = 0.808, accuracy = 0.824 and precision = 0.621; Decision tree shows AUC = 0.702, accuracy = 0.795 and precision = 0.486; The GradientBoosting model shows AUC = 0.788, accuracy = 0.827 and precision = 1.000; The Xgbc model shows AUC = 0.784, accuracy = 0.806 and precision = 0.583. The Gbm model shows AUC = 0.814, accuracy = 0.806 and precision = 0.750. Conclusion: Machine learning algorithms can predict patients' PPCs with acute diffuse peritonitis. Moreover, the results of the importance matrix for the Gbdt algorithm model show that albumin, cholesterol, age, and platelets are the main variables that account for the highest pulmonary complication weights.

Terpenoids from leaves of Chinese hawthorn / 中国中药杂志

Fifteen compounds were isolated from the 70% EtOH extract of leaves of Chinese hawthorn(Crataegus pinnatifida var. major) by various purification steps, and their structures were determined as 2α,3α,12β,19α,-tetrahydroxyursan-13β,28-olide(1),euscaphic acid(2), tormentic acid(3), ursolic acid(4), pomolic acid(5), corosolic acid(6), maslinic acid(7), linalyl rutinoside(8),(Z)-3-hexenyl β-D-glucoside(9),(3S, 6S)-cis-linalool-3,7-oxide-β-D-glucopyranoside(10), pisumionoside(11), icariside B6(12), byzantionoside B(13),(6R,7E,9R)-9-Hydroxy-4,7-megastigmadien-3-one 9-O-β-D-glucopyranoside(14) and(6S,7E,9R)-6,9-dihydroxy-4,7-megastigmadien-3-one 9-O-β-D-glucopyranoside(15) mainly based on the mass spectrum(MS) and nuclear magnetic resonance(NMR) spectroscopic techniques, of which compound 1 was a new pentacyclic triterpene, and compounds 2, 5, 6, 8, 10, 13 and 15 were isolated form this plant for the first time.

Research progress on the effect of low concentration atropine on the prevention and control of myopia in children and adolescents among children and adolescents / 中国学校卫生

Abstract@#Myopia is a common refractive error in the process of development. With the high incidence and low age of myopia in children and adolescents, it has become a worldwide public health problem, seriously endangering physical and mental health. The prevention and control of myopia has a long way to go. Low concentration atropine, as an M type choline receptor inhibitor, has been proved by medical research to effectively delay the progress of myopia. This paper reviews the relevant studies at home and abroad in recent years. The optimal concentration of low concentration atropine, the best clinical regimen and possible potential side effects were discussed. From the point of view of school public health, this paper discusses the significance of low concentration atropine for the prevention and control of myopia among school age students, in order to provide a reliable basis and new ideas for the follow up clinical application of atropine and myopia prevention and control strategies for school students.

Non-alkaloid constituents of Hymenocallis littoralis / 中国中药杂志

Perennial herb Hymenocallis littoralis(Amaryllidaceae) boasts anti-tumor, anti-virus, and anti-inflammatory activities. As the representative constituents, alkaloids have attracted much attention, whereas the non-alkaloid constituents have been rarely reported. Therefore, this study investigated the non-alkaloid constituents of H. littoralis and their contribution to the various pharmacological activities of the herb. Thirteen non-alkaloid compounds were isolated from the 95% ethanol extract of dried whole plant of H. littoralis after a series of chromatographic separation steps and spectral analysis, and they were identified as 5,7-dihydroxy-6,8-dimethoxy-2-hydroxymethyl-4H-chromoen-4-one(1), undulatoside A(2),(2S)-7,4'-dihydroxyflavane(3), naringenin(4), 4',7-hydroxy-8-methylflavanone(5), 8-methylnaringenin(6), 8-demethylfarrerol(7), 6-methyl-aromadendrin(8), 4',5,7-trihydroxy-8-methylflavanone(9), syzalterin(10), 6-methylapigenin(11), isoliquiritigenin(12), and undatuside C(13) based on the spectroscopic data analysis. Among them, compound 1 was a new chromone derivative, and compounds 2 and 4-13 were isolated form this plant for the first time.

Association between carotid intima-media thickness and visceral fat area in children aged 6-7 years / 中国学校卫生

Objective@#To identify the association of carotid intima-media thickness (cIMT) and visceral fat area (VFA) to inform prevention of cardiovascular disease in later life.@*Methods@#All the grade one students of six non-boarding primary schools in Shunyi District, Beijing were enrolled, based on population-based survey design, to establish the child cohort on sensitization, puberty, obesity and cardiovascular risk (PROC). Socio-demographic information survey and anthropometric measure, blood and urine test were carried out. Robust linear regression was used to determine the relationship between cIMT and other factors.@*Results@#Among 1 711 participants, a significant difference were observed between normal, overweight and obesity children on cIMT [(0.35±0.02)(0.36±0.02)(0.37±0.03)mm] (F=41.4, P<0.01) and VFA [16.2(13.6-19.3), 22.7(18.6-27.3), 51.5(33.9-73.0)cm2] (χ2=854.5, P<0.01). After adjusting age and sex, univariate robust linear regression showed that cIMT was associated with height, SBP, DBP, HDL-C, VFA (P<0.05) and TG (P=0.055). Multivariable robust linear regression indicated that in total and boys only included models, cIMT was associated with VFA and SBP(β=0.000 2, 0.000 2, 0.000 2, 0.000 2, P<0.05); while in girls only included model cIMT was associated with VFA and TG (β=0.000 2, 0.006 2, P<0.05).@*Conclusion@#VFA is stable to predict the increase of cIMT in children. We can use VFA to simplify the classification management of children and inform targeted early prevention of cardiovascular disease in adulthood.

The protective effects of curcumin loaded mesoporous silica nanoparticles on rat cardiomyocytes / 药学学报

Inhibition of apoptosis induced by oxidative stress is an effective way to reduce myocardial injury. In this study, we used H2O2-stimulated rat cardiac myoblast cell line (H9c2) as an oxidative damage model. Curcumin (Cur) was chosen as a model drug and mesoporous silica nanoparticles (MSNs) were chosen as the carrier to construct a Cur-loaded delivery system (Cur@MSNs) and to examine its protective effects against oxidative damage. The MSNs guaranteed efficient loading and controlled release of Cur. Besides, the hydrophilicsilanol groups on the surface of MSNs promoted the Cur solubility in water and increased its cellular uptake amount, which improved the bioavailability of Cur. The results suggest that the Cur@MSNs was pharmacologically active in the reduction of the oxidative damage of H9c2 cells. It was verified that a great decrease of reactive oxygen species was inducted by Cur@MSNs, which led to the protective effects against oxidative damage.

Effect of superparamagnetic iron oxide on differentiation of rat bone marrow stem cells into chondrocytes in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of superparamagnetic iron oxide (SPIO) on the differentiation of rat bone marrow stem cells (BMSCs) into chondrocytes in vitro and explore the possible mechanism.</p><p><b>METHODS</b>CCK8 assay was performed to examine the cytotoxicity of SPIO (1 and 5 µg/mL) on cultured SD rat BMSCs. Prussian blue staining and fluorescence excitation assay were used to assess the binding of the SPIO to BMSCs after the cells had been cultured in chondrocytes-induced medium in the presence of SPIO (1 and 5 µg/mL) for 9 days. The mRNA levels of COL2 α2, aggrecan and MMP13 in the cell culture were examined using Q-PCR, and the chondrogenic differentiation of the BMSCs was analyzed using alcian blue staining and immunofluorescence staining for COL2 α2. The protein levels of COL2 α2, aggrecan, MMP13, Ihh and PTHrP in the cells were examined using Western blotting.</p><p><b>RESULTS</b>CCK8 assay showed no significant toxicity of SPIO on BMSCs. Compared with the control cells, the cells cultured in the presence of SPIO showed increased expressions of COL2 α2 and aggrecan and decreased expression of MMP13 at both mRNA and protein levels with also significantly increased expressions of Ihh and PTHrP proteins.</p><p><b>CONCLUSION</b>SPIO can promote the differentiation of rat BMSCs into chondrocytes and up-regulate the Ihh/PTHrP signal pathway, suggesting the potential of SPIO as a new therapeutic agent for chondrocyte-related diseases.</p>

Clinical features and early treatment effects in intermediate risk and poor risk acute myeloid leukemia with EVI1 positive / 北京大学学报(医学版)

Objective:To investigate the clinical biological characteristics of EVI1 positive acute myeloid leukemia (AML) and its effect on early chemotherapy.Methods:The clinical and biological characteristics of 33 AML patients with EVI1 positive were retrospectively analyzed in 361 AML patients who were diagnosed and treated in our institute from March 2015 to July 2016,and the clinical and biological features,and rates of the induced remission were compared between the intermediate risk and poor risk with EVI1 positive AML,moreover,the influential factors on complete remission (CR) were analyzed.The expression of EVI1/ABL was tested in 32 healthy donors to confirm the abnormal threshold of EVI1 expression.Results:The definition of EVI1 positive was that the quantitative expression of EVI1/ABL was more than 8.0％.The 33 AML patients with EVI1 positive were found in 361 newly diagnosed AML patients,in which the female and male patients were 17 and 16 respectively,the median age was 45 (18-67) years,with a median follow-up of 6.6 (0.7-13.2) months.Intermediate karyotype was found in 17 patients (including 9 patients with normal karyotypes,1 patient with + 8);unfavorable karyotype was found in 14 patients [including 7 patients with-7/7q-,4 patients with t (v;11q23),3 patients with inv (3)/t (3;3),and 2 patients without mitotic figures].The rate of CR in the first induction chemotherapy was 42.4％,and the rate of total CR was 60.6％.According to the NCCN,16 intermediate risk patients and poor risk patients were divided,without favorable risk patients.The rate of CR in the first induction chemotherapy were 68.8％ and 17.6％ (P =0.005) in the intermediate risk and poor risk respectively,that of total CR were 81.3％ and 41.2％ (P =0.032),and the rates of relapse were 7.7％ and 14.3％.Univariable analysis revealed that unfavorable karyotype could affect the rate of CR in the first reduction chemotherapy and that of total CR (P =0.004,0.029).The poor risk patients had higher mortality (41.2％ vs.6.3％,P =0.039) and lower overall survival (OS) (P =0.012).Conclusion:EVI1 may be not an independent prognostic factor for the AML patients considering the appearance in the intermediate and poor risk patients.It predicts poor outcome in the EVI1 positive AML patients who have unfavorable karyocytes,such as-7/7q-,t (v;11 q23),and inv (3)/t (3;3),and also a low rate of both CR in the first induction chemotherapy and total CR.It also has a low rate of long-term survival and high mortality in the AML patients with EVI1 positive,who may benefit from allogeneic bone marrow transplantation as soon as possible.

"Three Methods and Three Points" regulates p38 mitogen-activated protein kinase in the dorsal horn of the spinal cord in a rat model of sciatic nerve injury.

Tuina is a traditional Chinese treatment for sensory disturbances caused by peripheral nerve injury and related diseases. Our previous studies showed that tuina regulates relevant regions and indices of the spinal dorsal horn using the Dian, Bo, and Rou method in Yinmen (BL37), Yanglingquan (GB34), and Weizhong (BL40). Treatment prevents muscle atrophy, protects spinal cord neurons, and promotes sciatic nerve repair. The mechanisms of action of tuina for treating peripheral nerve injury remain poorly understood. This study established rat models of sciatic nerve injury using the crushing method. Rats received Chinese tuina in accordance with the principle of "Three Methods and Three Points," once daily for 20 days. Tuina intervention reduced paw withdrawal latency and improved wet weight of the gastrocnemius muscle, as well as promoting morphological recovery of sciatic nerve fibers, Schwann cells, and axons. The protein expression levels of phospho-p38 mitogen-activated protein kinase, tumor necrosis factor-α, and interleukin-1ß also decreased. These findings indicate that "Three Methods and Three Points" promoted morphological recovery and improved behavior of rats with peripheral nerve injury.

Protective effect of Rhodiola rosea polysaccharides on cryopreserved boar sperm.

Cryopreservation brings sublethal damage to sperm, resulting in reduced fertile life of sperm. Rhodiola rosea polysaccharides (RPs) have antiviral, antioxidant and antitumor activities. In the present study, the cryoprotective effect of RPs on boar sperm quality parameters after frozen-thawed process was investigated. Boar sperm was cryopreserved in the extender with RPs added at concentrations of 0 (used as control), 2, 4, 6, 8 and 10mg/L and their effects on the quality of frozen-thawed boar sperm were assessed. Addition of RPs significantly improved sperm motility, mitochondrial activity, acrosomal integrity, plasma membrane integrity, superoxide dismutase and glutathione peroxidase activity and decreased sperm malonaldehyde level (p<0.05). The results indicated that the addition of RPs to the freezing extender decreased the cryodamage to the boar sperm.

Alloantigen-specific T-cell hyporesponsiveness induced by dnIKK2 gene-transfected recipient immature dendritic cells.

Immature dendritic cells (iDCs) have been shown to be able to induce peripheral T-cell tolerance through distinct pathways. Here, we investigated the tolerogenic property of recipient iDCs whose maturation was arrested by a dominant negative mutant of inhibitor of nuclear factor kappa-B kinase 2 (dnIKK2) gene. We found that dnIKK2-iDCs presented a typical semi-mature morphology and expressed lower levels of CD80 and CD86, slightly higher MHC-II than untransfected iDCs. The expression of these molecules had no significant change even dnIKK2-iDCs were pulsed by donor antigen. In primary mixed leukocyte reaction (MLR), dnIKK2-iDCs exhibited impaired ability to stimulate allogeneic T-cells, but induced CD4(+)CD25(-) T-cell formation. In co-culture MLR, these CD4(+)CD25(-) T-cells suppressed T-cell alloreaction in an antigen-specific manner. Besides, CD4(+)CD25(-) T-cells inhibited IL-2 and IFN-γ release, whereas promoted IL-10 and TGF-ß secretion. These data suggested recipient dnIKK2-iDCs could maintain peripheral tolerance through down-regulating costimulatory molecule expressions and inducing CD4(+)CD25(-) T-cell formation.

Is sentinel node susceptibility to metastases related to nodal immune modulation?

Sentinel lymph nodes (SLNs), the initial site of regional metastases, directly receive lymph containing immune-modulatory cytokines and tumor cells from primary melanomas. Immune-suppressed SLNs are ideal for studies of tissue susceptibility to metastases. They show reduced antigen-presenting dendritic cells, activated T cells, high endothelial venules, and transvenular immigration of T cells. Tumor-induced immune suppression contributes to establishment of nodal metastases. SLNs may serve as an effective model to study reversal of tumor-induced immune suppression. We reviewed this topic in Nature Reviews of Immunology in 2006. We here summarize the Nature paper and provide additional results from ongoing studies and the recent literature.

A study on the fists size related to height,weight and body mass index among adults / 预防医学

Objective To explore the relationship of height,weight and body mass index with fists size among adults,and to compare the regression coefficient of different models.Methods Adults aged 20 -80 years were selected by stratified cluster sampling methods.T -test and univariate analysis of variance were used to compare the height,weight and fists size stratified by gender and BMI group.Regression model for fists volume was established.The regression coefficients were compared through covariance interaction analysis.Results The height,weight,BMI and fists size of male were higher than that of female (P <0.01 ).The regression model for fists size(Y)of BMI(X)for male,female and total population were Y=1 67.603 +9.445X,Y =1 1 1 .1 83 +7.779X and Y =77.1 57 +1 1 .028X(R2 =0.324,0.322,0.271 ,P <0.05).Fists size of different BMI groups were related to their height (R2 =0.501 ,0.432,0.624,0.692,P <0.05),respectively, and their regression coefficients have no statistically differences (P =0.07).The fists sizes of different BMI groups were different(P <0.01 ).Fists size of overweight or obesity groups (365.641 ±68.51 4,365.641 ±68.51 4,respectively)were larger than that of the normal and slim groups(P <0.01 ),and fists size of normal body (31 4.261 ±59.590)was larger than that of slim body(261 .081 ±59.478).Conclusion The fists sizes of male were higher than that of female.Fists size was positively related to their BMI.The height had the some impact on fists size among people in different BMI groups.

A study on influence factors of ability of emotional and behavior management among the elderly / 预防医学

Objective To investigate the status of the ability of emotion and behavior management and to explore the influence factors among the elderly in Zhoushan City.Methods Self -designed questionnaires of Activity of Daily Living Scale and Emotion -Behavior Assessment were used to investigate the elderly in Lincheng District,Zhoushan.The incidence of emotion and behavior abnormities were statistically analyzed.The influence factors were analyzed by chi -square test,rank -sum test and the ordinal regression.Results A total of 1 260 valid questionnaires were collected,the incidence of emotion and behavior abnormities among the elderly was 5.56% and the number of mild,moderate,and severe abnormity were 40,19 and 11,which accounted for 3.17%,1.51% and 0.87%.Univariate analysis showed that there were significant differences in emotion and behavior among age,education,marital status,living situation, prevalence,income and the daily living skills.Ordinal regression analysis showed that the major influence factors were living situation,income and the daily living skills.The ordinal regression analysis also showed the risk of emotional and behavior disorders of the elderly in nursing homes were 17.05 times higher than those who live with spouse (95%CI =4.31-67.35),and the elderly with monthly income below 465 yuan were 9.37 times higher than those who with monthly income over 1 160 yuan (95%CI =1.63 -53.79),and the severe,moderate and mild dependent elderly were 236.28, 32.29 and 13.79 times higher than the elderly who were independent.Conclusion Psychological care for the elderly with low income,poor self -care ability and living in nursing homes should be highly focused on.

Application of titanium cages and poly(ether-ether-ketone) cages in anterior cervical discectomy and fusion surgery / 中国组织工程研究

BACKGROUND:The two main cages used in anterior cervical surgery are titanium cages and poly(ether-ether-ketone) cages, but it is stil controversial in imaging performances and clinical outcomes. OBJECTIVE:To systematical y evaluate imaging performances and clinical outcomes between titanium cages and poly(ether-ether-ketone) cages in anterior cervical discectomy and fusion surgery. METHODS:The Cochrane library (issue 5, 2013), Medline database, EMBASE, CNKI and Wanfang database were retrieved by computer. The deadline of al the retrieves concerning control study of uses of titanium cages and poly(ether-ether-ketone) cages was June 1st, 2013. Two reviewers assessed literatures independently, and the meta-analysis was conducted by RevMan 5.2 software. RESULTS AND CONCLUSION:A total of four literatures including 235 patients, 128 of titanium cages and 107 of poly(ether-ether-ketone) cages, were included. Meta-analysis results showed that there was no statistical y significant difference between the groups in fusion rates, subsidence and dislocation rates of short-term fol ow-up and clinical outcomes (al P>0.05). There were statistical y significant differences between the groups in subsidence and dislocation rates of long-term fol ow-up (P<0.05). Poly(ether-ether-ketone) cage group was superior to titanium cages group in maintenance of cervical curvature and intervertebral height. This meta-analysis showed that poly(ether-ether-ketone) cages had good fusion rates and clinical outcomes, less subsidence and dislocation rates, and can better maintain cervical curvature and intervertebral height compared with titanium cages.

[The value of histopathologic examination of testis tissue from testicular sperm aspiration].

OBJECTIVE: To evaluate histopathologic examination of the testis tissue from testicular sperm aspiration (TESA). METHODS: We analyzed the results of inverted microscopy and histopathologic examination of 96 samples of testis tissue from TESA, and compared the accuracy of the two methods in detecting sperm in the testis tissue. RESULTS: Among the 11 cases in which sperm was found by inverted microscopy, 9 were confirmed by histopathologic examination, and among the 57 cases in which sperm was not detected by inverted microscopy, 11 (19.3%) were found with sperm by histopathologic examination. Histopathologically, the cases in which sperm was not found by inverted microscopy included Sertoli-cell-only syndrome (n = 34), maturation arrest (n = 12) and hypospermatogenesis (n = 11). CONCLUSION: Histopathologic examination may reveal sperm in the TESA testis tissue proved to be sperm-absent by microscopy, and thus offer valuable information for a second testicular sperm retrieval.

Prolongation of rat renal allograft survival by CD4⁺CD25⁻ T cells induced by recipient dendritic cells transfected with IKK2dn.

Previous studies have demonstrated that recipient-derived immature dendritic cells transfected by recombinant adenovirus-mediated IKK2dn (Adv­IKK2dn) and loaded with donor splenocyte lysate generate CD4+CD25- T cells (Adv-IKK2dn-CD4+CD25- T cells). These cells may inhibit T cell responses in vitro. In the present study, Lewis (LW) rats were administered with an intravenous injection of naive CD4+ T cells, empty adenovirus (Adv-0)-dendritic cell-generated CD4+CD25- T cells (Adv-0-CD4+CD25- T cells), Adv-IKK2dn-CD4+CD25- T cells or an equal volume of normal saline, seven days prior to transplantation. The potency and the mechanism of action of Adv-IKK2dn-CD4+CD25- T cells was analyzed, as well as an investigation of their tolerogenic properties in vivo. Administration of Adv-IKK2dn-CD4+CD25- T cells in vivo to LW rats was observed to markedly prolong the survival of a kidney allograft from Brown Norway rats. Furthermore, the Adv-IKK2dn-CD4+CD25- T cell-treated group exhibited significantly reduced levels of interleukin (Il)-2 and interferon-γ production and increased Il-10 and transforming growth factor-ß (TGF-ß) secretion. The serum creatinine levels remained at low levels in the Adv-IKK2dn-CD4+CD25- T cell-treated group. Their ability to induce allogeneic T cell proliferation was markedly reduced compared with the other groups. These observations indicated that Adv-IKK2dn-CD4+CD25- T cells induce prolongation of kidney allograft survival in vivo, which is hypothesized to be due to the high expression levels of Il-10 and TGF-ß.