Prognosis Prediction of CRAFITY Score in HCC Undergoing TACE Combined with PD-(L)1 Inhibitors and Molecular Targeted Therapy.

Background: The CRAFITY (C-reactive protein and alpha-fetoprotein in immunotherapy) score has demonstrated prognostic significance in hepatocellular carcinoma (HCC) patients undergoing immunotherapy. The study aimed to validate accuracy of CRAFITY score on predicting prognosis for patients with HCC treated with transarterial chemoembolization (TACE) combined with PD-(L)1 inhibitors and molecular targeted therapy. Methods: Eighty-five HCC patients who underwent TACE in combination with molecular targeted therapy (MTT) and PD-(L)1 Inhibitors were consecutively enrolled from November 2019 to November 2022. Patients were divided into CRAFITY 0 score (n=32), CRAFITY 1 score (n=31), and CRAFITY 2 score (n=22), respectively. The primary outcomes were overall survival (OS) and progression-free survival (PFS), and the secondary outcomes included tumor response rate and treatment-related adverse events (TRAEs). Factors affecting survival were identified via Cox regression analysis. Results: The median overall survival (OS) for HCC patients with CRAFITY scores of 0, 1, and 2 was 33.4 months (95% confidence interval [CI]: 27.1-39.7), 34.5 months (95% CI: 23.1-45.9), and 24.2 months (95% CI: 13.9-39.3), respectively, there were statistical differences among the three groups (p<0.05). The progression-free survival (PFS) was 14.1 months (95% CI: 10.0-18.2), 14.1 months (95% CI: 9.0-19.2), and 9.3 months (95% CI: 7.2-11.4) for patients with CRAFITY scores of 1, 2, and 3, respectively, with a significant difference between the three groups (p<0.05). In patients with CRAFITY scores of 1, 2, and 3, the disease control rates (DCR) were 94%, 84%, and 73%, respectively (p < 0.05), while the overall response rates (ORR) were 78.1%, 67.7%, and 59.1%, respectively (p = 0.318). A higher CRAFITY score showed a correlation with an increased frequency of fatigue and grade 3 fever (p<0.05). Moreover, CRAFITY 2 score was an independent risk factor for both OS (HR = 2.610(1.281-4.564), p = 0.014) and PFS (HR = 2.419(1.281-4.564), p = 0.006). Conclusion: The CRAFITY score may provide an efficient predictive capacity for prognosis in HCC patients undergoing TACE combined with PD-(L)1 inhibitors and molecular targeted therapy.

Online short videos promoting public breast cancer literacy: a pretest-posttest control group trial on efficiency, attitude, and influencing factors.

Background: Short videos on social media are playing an increasingly important role in cancer health education today. It is important to explore how the actual communication effect of health videos and the knowledge absorption of users are influenced by different factors of the video creation process. Objective: The objective of our study is to access the factors influencing breast cancer health education through short videos on efficiency and quality. Methods: Three pairs of videos about breast health were created and participants completed questionnaires before and after watching the videos. A paired t-test was used to analyze within-group change scores. RM-ANOVA was used to assess the relationship between the pretest, posttest, and three variables. Results: Watching short videos can significantly increase viewers' knowledge of related health topics (p < 0.05). The viewers' concentration level while watching was significantly higher for the video with background music (BGM) than for the video without BGM (p = 0.006). The viewers' willingness to share was significantly higher for the video with a progress bar than for the video without a progress bar (p = 0.02). Using an interpreter wearing a doctor's uniform instead of casual wear and setting a progress bar can significantly improve the efficiency of knowledge absorption (p < 0.05). Conclusion: A uniformed interpreter, BGM and a progress bar are factors influencing the efficiency of short health videos. They can be applied in video making to explore better ways of promoting cancer health education in the new mobile Internet environment.

[Anatomical structure and physiological characteristics of Robinia pseudoacacia of different stand ages]. / 不同林龄刺槐解剖结构及生理特性.

Drought intensity and frequency have been increased as a result of global warming. Exploring the drought resistance mechanism of Robinia pseudoacacia plantations of different stand ages on the Loess Plateau is crucial for understanding the stability of forest productivity in the region. We investigated anatomical traits, hydraulic function, and non-structural carbohydrate content of the xylem, as well as their association, in R. pseudoacacia plantations of different stand ages in a semi-arid region. The results showed that the vessel diameter, total pit membrane area, pit membrane area, vesture area, and vestured overlap of young and middle-aged stands were larger than those of mature stands, and the pit density was significantly lower in mature stands. Hydraulic conductivity was significantly related to vessel diameter, pit membrane area, and vesture area. Hydraulic conductivities of branches in young, middle-aged, and mature stands were 2.30, 2.12, and 0.76 kg·m-1·s-1·MPa-1, respectively, with embolism values of 54.5%, 53.8%, and 45.1%. Hydraulic conductivity was significantly related to soluble sugar and starch contents. The soluble sugar contents of branches in young, middle-aged and mature stands were 4.9%, 4.2%, and 3.8%, respectively. Xylem growth capacity of R. pseudoacacia in mature stand declined, resulting in the formation of small vessels with many small pits, which reduced hydraulic conductivity while maintaining hydraulic safety, resulting in a decrease of non-structural carbohydrates content. This study revealed the drought response mechanism of R. pseudoacacia plantations with different ages, providing a scientific foundation for the management and nurturing of R. pseudoacacia plantations on the Loess Plateau.

Interaction of Cysteine with Li+ and LiF in the Presence of (H2O) n (n = 0-6) Clusters.

The interaction between cysteine with Li+ and LiF in the microcosmic water environment was investigated to elucidate how ions interact with amino acids and the cation-anion correlation effect involved. The structures of Cys·Li+(H2O) n and Cys·LiF(H2O) n (n = 0-6) were characterized using ab initio calculations. Our studies show that the water preferentially interacts with Li+/LiF. In Cys·Li+(H2O)0-6, Li+ interacts with amino nitrogen, carbonyl oxygen, and hydrophobic sulfur of Cys to form a tridentate mode, whereas in Cys·LiF(H2O) n , Li+ and F- work in cooperation and interact with carbonyl oxygen and hydroxyl hydrogen of Cys to form a bidentate type. The neutral and zwitterionic forms are essentially isoenergetic when the water number reaches three in the presence of Li+, whereas this occurs at four water molecules in the presence of LiF. Further research revealed that the interaction between Li+/LiF and Cys was mainly electrostatic, followed by dispersion, and the weakest interaction occurs at the transition from the neutral form to zwitterionic form. Natural population analysis charge analyses show that for Cys·Li+(H2O) n , the positive charge is mostly concentrated on Li+ except for the system containing three water molecules. For Cys·LiF(H2O) n , the positive charge is centered on the LiF unit in the range n = 0-6, and at n = 5, electron transfer from Cys to water occurs. Our study shows that the contribution of anions in zwitterionic state stabilization should be addressed more generally along with cations.

Ab initio study of hydrated cesium iodide dimer (CsI)2-/0(H2O)0-6 and the cation size effect on (MI)2-/0(H2O)0-6 (M = Li, Na, K, Cs).

The structures of microsolvated (CsI)2-/0(H2O)0-6 clusters were determined using ab initio calculations. Our studies show that one Cs atom at the apex was firstly separated from the pyramid-shaped (CsI)2- unit when the water number reaches 3, whereas CsI distances did not increase significantly from n = 0 to 6 for neutrals. Additionally, the atomic charge and reduced density gradient analyses were carried out; the results reveal that the extra electrons are almost entirely localized on terminal Cs atom and the Cs+-water interactions dominate in (CsI)2-(H2O)0-6. The water-water interactions show up at n = 5. The comparison of (CsI)2-/0(H2O)n with (MI)2-/0(H2O)n (M = Li, Na, K) shows that neutral (CsI)2 is the most difficult to be separated, which matches the law of matching water affinity. As for anions, the most difficult separation occurs in the case of small size (LiI)2- due to the effect of extra electrons, and (MI)2- with larger size cation is more likely to interact with water to form a pyramid structure.

[Effects of different types of exercise on lipid uptake, synthesis and oxidation in skeletal muscles of insulin-resistant rats].

The present study aims to investigate the effects of aerobic exercise and resistance exercise on lipid metabolism of skeletal muscle in high-fat diet (HFD)-induced insulin-resistant (IR) rats and the underlying mechanisms. Male Sprague-Dawley (SD) rats at age of 10 weeks were fed with HFD for 10 weeks to establish IR model. The IR rats were then randomly assigned into 3 groups, including IR control (IR) group, aerobic exercise (AE) group and resistance exercise (RE) group. An additional chow diet sedentary control (CON) group was used as well. Fasting blood glucose (FBG), insulin (FIN), glucagon and lipids, as well as triacylglycerol (TG), free fatty acids (FFA), and the protein expression of fatty acid translocase/cluster of differentiation 36 (FAT/CD36), carnitine palmitoyltransferase-1 (CPT-1), stearoyl-CoA desaturase-1 (SCD-1) and peroxisome proliferators-activated receptors γ (PPARγ) in skeletal muscles were measured after 8-week exercise interventions. The results showed that the contents of FBG, FIN, and LDL-C were increased by IR compared with CON group, and significantly decreased by aerobic exercise and resistance exercise; while aerobic exercise induced an increase in HDL-C as well. Furthermore, IR exhibited no significant effects on TG content of skeletal muscles, but significantly increased FFA level. Both aerobic and resistance exercise led to a decrease in TG content, and FFA level was increased by aerobic exercise but deceased by resistance exercise. In addition, the protein expression of FAT/CD36, SCD-1 and PPARγ was increased and that of CPT-1 was decreased by IR, while both types of exercise resulted in a decrease in the protein expression of FAT/CD36, SCD-1 and PPARγ, and an increase in CPT-1. In conclusion, aerobic and resistance exercise may attenuate IR through decreasing HFD-induced ectopic fat deposition and increasing ß-oxidation of fatty acids in skeletal muscle cells, and resistance exercise shows a greater improvement in lipid metabolism of skeletal muscles than aerobic exercise.

[Short-chain fatty acid butyrate acid attenuates atherosclerotic plaque formation in apolipoprotein E-knockout mice and the underlying mechanism].

This study was designed to evaluate the role of short-chain fatty acid butyrate acid on intestinal morphology and function, and atherosclerotic plaque formation in apolipoprotein E-knockout (ApoE-/-) mice. ApoE-/- mice on high-fat, high-cholesterol diet were treated with butyrate acid (200 mmol/L) or NaCl (control) in the drinking water for 12 weeks, followed by histological evaluations of atherosclerotic lesion in aorta. Real-time PCR analysis and ELISA were used to measure the expression levels of proinflammatory cytokines. Butyrate acid significantly attenuated high-fat, high-cholesterol diet-induced atherosclerotic plaque formation in ApoE-/- mice. Butyrate acid prevented high-fat, high-cholesterol diet-induced inflammation in both the aorta and the circulation, as evidenced by reduced expression of proinflammatory cytokines. These changes were accompanied by a marked attenuation in metabolic endotoxemia lipopolysaccharide (LPS). Butyrate acid induced intestinal expression of the tight junction proteins (Occludin and zona occuldens protein-1), thereby preventing the gut permeability. Butyrate acid dose-dependently upregulated the expression of the tight junction proteins in Caco-2 cells in GPR41-dependent manner. In conclusion, butyrate acid attenuates atherosclerotic lesions by ameliorating metabolic endotoxemia-induced inflammation through restoration of the gut barrier.

CircFADS2: A potential prognostic biomarker of colorectal cancer.

IMPACT STATEMENT: Colorectal cancer (CRC) is the third most common malignancy worldwide with the second highest mortality rate. Although multidisciplinary cooperative therapies are helpful for improving the survival of CRC patients, the prognosis remains poor. Therefore, it is imperative to seek new biomarkers for the development of individualized treatment for each CRC patient. Circular RNA, an endogenous transcript with specific covalent closed loop, exhibits higher stability, conservation and expression abundance than the corresponding linear component and thus may be utilized as a promised biomarker. Although the majority of studies have focused on circular RNA expression profiling in various types of cancers, evidence supporting their critical role in the diagnosis and prognosis of CRC is limited. This study aimed to screen and identify novel circular RNA biomarkers of CRC by chip analysis and qPCR verification, and to highlight their potential as targets for CRC prognosis, and therapy.

Endurance Training Counteracts the High-Fat Diet-Induced Profiling Changes of ω-3 Polyunsaturated Fatty Acids in Skeletal Muscle of Middle-Aged Rats.

PURPOSE: To investigate the effects of endurance training on the content of ω-3 polyunsaturated fatty acids (PUFAs) and their distribution among lipid classes in skeletal muscle in middle aged, high-fat diet fed rats. METHOD: Thirty 10-month old male Sprague Dawley (SD) rats were assigned to four groups. Two groups of rats remained sedentary and were fed chow diet (C group), or high-fat diet (H group), respectively. The other two groups of rats were subjected to endurance training while maintaining their chow diet (EC group), or high-fat diet (EH group). After 16 weeks endurance training and/or diet intervention, the content of ω-3 PUFAs and ω-3 PUFA-containing lipids in rat soleus muscle were analyzed by lipidomics. RESULTS: Rats fed a high-fat diet exhibited decreased overall amount of ω-3 PUFAs in soleus muscle, while endurance training preserved the total amount of ω-3 PUFAs. Both the endurance training and high-fat diet alone changed the profiles of ω-3 PUFAs in different lipid classes. Specifically, the amount of triacylglycerol (TG), lysophosphatidylcholine (LPC), phosphatidylcholine (PC), and phosphatidylglycerol (PG) containing ω-3 PUFAs in soleus muscle was increased by endurance training, but the amount of lysophosphatidylenthanol (LPE), lysophosphatidylinositol (LPI), lysophosphatidylserine (LPS), cardiolipin (CL), phosphatidic acid (PA), and phosphatidylinositol (PI) was decreased. The high-fat diet induced a decrease of ω-3 PUFAs in TG, LPE, LPS, CL, platelet activating factor (PAF), PC, phosphatidylethanolamine (PE), and phosphatidylserine (PS), and an increase in LPC, LPI, PA, and PG. In addition, the effects of the endurance training on ω-3 PUFAs in skeletal muscle was also evident in high-fat diets fed rats, which counteracts the profiling changes caused by high-fat diet feeding. CONCLUSION: The beneficial effects of endurance training on skeletal muscle may be achieved to some extent through recovering the content of ω-3 PUFAs that has been decreased by high-fat diet feeding.

Expression of PHLPP2 correlates with clinicopathologic characteristics and prognosis in colorectal cancer.

PH domain leucine-rich repeat protein phosphatase 2 (PHLPP2) belongs to the phosphokinase family, that has been reported to play an important role in several cancers. However, the expression of PHLPP2 and its correlation with clinicopathologic characteristics in colorectal cancer (CRC) have yet to be determined. The aim of this study is to investigate the expression of PHLPP2 and explore its role in CRC. The expression of PHLPP2, PTEN, PI3KCA, and PI3KCB in 130 cases of CRC and normal tissues was assessed by immunohistochemistry. In addition, the expression of PHLPP2, PTEN, PI3KCA, and PI3KCB in 32 pairs of CRC tissues and their corresponding normal tissues was determined by RT-PCR and western blotting, respectively. PHLPP2 expression in CRC was significantly lower than that of normal tissues. However, PHLPP2 mRNA shows no significant difference between CRC and normal tissue. PTEN expression in left colorectal cancer (LCC) was absent, while PI3KCA and PI3KCB in right colorectal cancer (RCC) were significantly higher than those in LCC. PHLPP2 was negatively correlated with p-Akt1 in CRC. The expression of p-Akt1 in PHLPP2 (+)/PTEN (+) in CRC tissues was significantly lower than that in other groups. PHLPP2 expression was correlated with differentiation, invasion, and lymph node metastasis. Kaplan-Meier analysis and multivariate analysis reveal that PHLPP2 is closely related to prognosis; more importantly, it is an independent prognostic factor for CRC. In conclusion, PHLPP2 may play a major role in the development, metastasis, and prognosis of CRC.

[Role of skeletal muscle fat ectopic deposition in insulin resistance induced by high-fat diet].

Consumption of high-fat diet leads to the increase of fat intake and consequent excess storage of fat in the body. When the regular adipose tissues reach their capacity to store fat, ectopic fat is stored around and within non-adipose tissues, such as the liver and skeletal muscle, which plays important roles in glucose metabolism. Hence ectopic fat accumulation in major insulin target tissues is a critical determinant of insulin resistance (IR) and various related metabolic syndromes. Recent studies have shown that skeletal muscle lipid accumulation is more closely related with IR than general obesity and accounts for approximately 80%-90% type 2 diabetes, since the skeletal muscle is the largest glucose disposal site. Therefore, the association between skeletal muscle lipid and IR has attracted more and more research interest. This review summarized the role of ectopic skeletal muscle lipid in IR induced by high-fat diet and its possible mechanisms.

[AMPK regulates mitochondrial oxidative stress in C2C12 myotubes induced by electrical stimulations of different intensities].

OBJECTIVE: To study effect of electrical stimulations of different intensities on mitochondrial oxidative stress in C2C12 myotubes and explore the molecular mechanisms. METHODS: After 7 days of differentiation, C2C12 myotubes were subjected to electrical stimulations (15 V, 3Hz, 30 ms) for 60, 120, or 180 min, and the morphological changes of muscular tubes were observed under inverted microscope. The levels of MDA and SOD activity of the cells were detected, and flow cytometry was used to detect mitochondrial reactive oxygen species (ROS) and membrane potential. Western blotting was used to detect the expression of PGC1, AMPK-Ser485, AMPK-Thr172, and AMPK in the cells. RESULTS: No significant changes occurred in the morphology of C2C12 myotubes in response to electrical stimulations. Electrical stimulation for 60 min resulted in significantly increased levels of MDA, AMPK-Ser485 and AMPK-Thr172 in the cells (P<0.05); simulations of the cells for 120 and 180 min caused significantly increased MDA, ROS, mitochondrial ROS, AMPK-Ser485 and PGC1 along with marked reduction of mitochondrial membrane potential (P<0.05). CONCLUSION: Electrical stimulation significantly activates oxidative stress, and a longer stimulation time causes stronger mitochondrial oxidation. AMPK-Thr172 regulates oxidative stress induced by stimulations for a moderate time length, while AMPK-Ser485 and PGC1 function to modulate oxidative stress following prolonged stimulations.

Downregulation and DNA methylation of ECRG4 in gastric cancer.

BACKGROUND: Esophageal cancer-related gene 4 (ECRG4) is a novel candidate tumor suppressor gene. Our study investigated the expression and function of ECRG4 in gastric cancer and highlighted the role of DNA hypermethylation at the promoter in silencing the ECRG4 expression. METHODS: The GSE63089 data set was obtained from the Gene Expression Omnibus and analyzed for differentially expressed genes. Carcinoma and para-carcinoma tissues of 102 patients with gastric cancer were collected from January 2010 to July 2011. Immunohistochemistry, real-time polymerase chain reaction (PCR), and western blot analyses were performed to evaluate the expression of ECRG4. After measuring the change in the level of ECRG4 expression, CCK-8, Transwell, and flow cytometric cell cycle assays were performed. In addition, methylation-specific PCR was performed to detect the methylation state of ECRG4, and 5-aza-2'-deoxycytidine was used for demethylation of ECRG4. All statistical analyses were performed using the SPSS 17.0 software. RESULTS: We found that ECRG4 expression was downregulated in gastric cancer, and this was closely related to lymph node metastasis. After ECRG4 was silenced using a specific small interfering RNA, the BGC-823 cell line became highly aggressive and proliferative. In addition, we verified whether downregulation of ECRG4 was highly correlated with DNA methylation of the ECRG4 promoter and found that the demethylating agent 5-aza-2'-deoxycytidine could effectively enhance ECRG4 expression. CONCLUSION: The aberrant expression of ECRG4 is associated with hypermethylation in the promoter region and plays an important role in the malignancy of gastric cancer. Therefore, ECRG4 may be a potential biomarker for molecular diagnosis of gastric cancer, and the use of 5-Aza-dC to reverse the hypermethylation of ECRG4 may be a new approach to the treatment of gastric cancer.

Multi-drug resistant uropathogenic Escherichia coli and its treatment by Chinese medicine.

OBJECTIVES: To investigate the resistance and virulence profiles of uropathogenic Escherichia coli (UPEC) and its treatment by Chinese medicine (CM) Fuzheng Qingre Lishi Formula (, FQLF). METHODS: UPEC strains were isolated from recurrent urinary tract infections (UTIs) patients. Patient sensitivities to 17 antibiotics were tested by the disk diffusion method. Virulence genes were screened by plolymerase chain reaction. A mouse model was constructed using a multi-drug resistant and virulent UPEC strain and treated with FQLF or the antibiotic imipenem. The treatment efficacy was evaluated by bacterial clearance from urine and the urinary organs. RESULTS: A total of 90 UPEC strains were collected, and 94.4% of the isolates were resistant to at least 1 antibiotic. Approximately 66.7% of the UPEC strains were multi-drug resistant. More than one virulence gene was found in 85.6% of the isolates. The extended-spectrum ß-lactamases (ESBL)-positive strains were more resistant than the negative ones. The virulence gene number was positively correlated with the resistance number (P<0.05). A mouse model was successfully constructed using UPEC10. Treatment with either FQLF or antibiotics significantly cleared bacteria from the mouse urine after 14 days. In the untreated control, the bacteria lasted for 28 days. FQLF treatment of the UTI mouse model greatly reduced the bacterial number in the kidney and bladder, but could not completely clear the bacteria. CONCLUSIONS: Multi-drug resistance is common among UPEC isolates, and the resistance is positively related with virulence. FQLF could treat UPEC UTIs, but could not completely clear the bacteria from the host.

Novel tumor-suppressor gene epidermal growth factor-containing fibulin-like extracellular matrix protein 1 is epigenetically silenced and associated with invasion and metastasis in human gastric cancer.

The present study aimed to investigate the role of histone modification and DNA methylation in epidermal growth factor-containing fibulin-like extracellular matrix protein 1 (EFEMP1) silencing in gastric cancer (GC). In the present study, four GC cell lines, and 45 paired normal and GC tissue samples were used to assess EFEMP1 expression using quantitative polymerase chain reaction (PCR), and EFEMP1 gene methylation status was evaluated by methylation-specific PCR. The involvement of histone modification in GC cell lines was examined by a chromatin immunoprecipitation (ChIP) assay. The results demonstrated that EFEMP1 mRNA level and methylation status in the EFEMP1 promoter region was associated with tumor differentiation, depth of tumor invasion and lymph node metastasis. DNA methyltransferase inhibitor 5-aza-2'-deoxycytidine (DAC) rapidly reduced DNA methylation and histone H3-K9 trimethylation at the silenced loci and reactivated EFEMP1 expression. By contrast, the histone deacetylase inhibitor trichostatin A markedly increased histone H3-K9 acetylation. However, it had no effect on DNA methylation, histone H3-K9 trimethylation or gene expression. In conclusion, the results suggested that EFEMP1 may function as a tumor suppressor in GC. Aberrant DNA methylation and histone H3-K9 trimethylation of EFEMP1 may be responsible for its downregulation in GC, and thus have an important role in tumor invasion and metastasis.

Toll-like receptor 4 is involved in myocardial damage following paraquat poisoning in mice.

The ingestion of the herbicide paraquat (PQ) can cause multiple organ injury including cardiac lesions. However, the underlying mechanism of myocardial damage is not known. Toll-like receptor 4 (TRL4) is a pattern-recognition receptor in the innate immune response to microbial pathogens. TLR4 is involved in heart dysfunction such as septic shock or myocardial ischemia. We investigated whether TLR4 would be linked to the pathogenesis of heart disease due to PQ exposure. Wild type mice (WT) and TLR4-deficient mice were injected intraperitoneally with 75mg/kg of PQ to induce myocardial damage and tested for echocardiographic assessment, histopathology, pro-inflammatory cytokine and TLR4 expression. WT mice after PQ exposure displayed deteriorate cardiac function, pathological damages, increased TLR4 mRNA and protein levels as well as myocardial TNF-α and IL-1ß levels. Compared with WT mice, TLR4-deficient mice were significantly resistant to the PQ-induced injury. We concluded that the TLR4 was required as a mediator and played an important role in myocardial damage due to PQ.

The value of delayed (18)F FDG-PET imaging in diagnosis of solitary pulmonary nodules: A preliminary study on 28 patients.

OBJECTIVE: The aim of this study was to investigate whether adding delayed phase imaging can improve diagnostic ability of (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) in evaluating solitary pulmonary nodules (SPNs). MATERIALS AND METHODS: 28 patients with SPNs received dual-phase (18)F-FDG PET at 1h and 2h after (18)F-FDG injection during Feb 2009 to Jun 2011were included in this retrospective study. Their final diagnosis was confirmed by pathological examination in 27 cases and clinical follow-up in 1 case. The standardized uptake value (SUV) of early and delayed phases of all lesions was measured. RESULTS: The 28 SPNs included 9 benign lesions and 19 malignant lesions. Using SUV ≥2.5 as a criteria for malignancy, the sensitivity, specificity, and accuracy were 52.6%, 55.6% and 53.6% respectively at early phase; 68.4%, 55.6% and 64.3% respectively at early and delayed phases combined. Combined early and delayed phase scans combined picked up 3 additional malignant lesions from the 14 lesions with an initial SUV value less than 2.5, and there was no additional false positive result with the benign lesions. CONCLUSION: Adding delayed phase scanning resulted in correct diagnosis of three malignant lesions with an initial SUV value less than 2.5. Delayed phase scanning can be recommended in the SPNs with SUV less than 2.5 at early phase.

Effect of slow abdominal breathing combined with biofeedback on blood pressure and heart rate variability in prehypertension.

OBJECTIVE: Prehypertension is a new category designated by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) in 2003. Managing prehypertension with nonpharmacological intervention is possibly beneficial to the prevention of hypertension. In this study, we observed the effect of slow abdominal breathing combined with electromyographic (EMG) biofeedback training on blood pressure (BP) in prehypertensives and assessed the changes of heart rate variability (HRV) in order to find an optional intervention to prevent hypertension and acquire some experimental data to clarify the underlying neural mechanism. METHODS: Twenty-two (22) postmenopausal women with prehypertension were randomly assigned to either the experiment group or the control group. The experiment group performed 10 sessions of slow abdominal breathing (six cycles/min) combined with frontal electromyographic (EMG) biofeedback training and daily home practice, while the control group only performed slow abdominal breathing and daily home practice. BP and HRV (including R-R interval and standard deviation of the normal-normal intervals [SDNN]) were measured. RESULTS: Participants with prehypertension could lower their systolic blood pressure (SBP) 8.4 mm Hg (p < 0.001) and diastolic blood pressure (DBP) 3.9 mm Hg (p < 0.05) using slow abdominal breathing combined with EMG biofeedback. The slow abdominal breathing also significantly decreased the SBP 4.3 mm Hg (p < 0.05), while it had no effect on the DBP (p > 0.05). Repeated-measures analyses showed that the biofeedback group + abdominal respiratory group (AB+BF) training was more effective in lowering the BP than the slow breathing (p < 0.05). Compared with the control group, the R-R interval increased significantly during the training in the AB+BF group (p < 0.05). The SDNN increased remarkably in both groups during the training (p < 0.05). CONCLUSIONS: Slow abdominal breathing combined with EMG biofeedback is an effective intervention to manage prehypertension. The possible mechanism is that slow abdominal breathing combined with EMG biofeedback could reduce sympathetic activity and meanwhile could enhance vagal activity.

[Antihypertensive therapy in 357 inpatients of elderly isolated systolic hypertension].

OBJECTIVE: To determine the therapeutic status and rate of reaching target blood pressure in elderly isolated systolic hypertension (EISH) patients who were hospitalized and to discuss the rationality of the drug therapy. METHODS: Three hundred and fifty-seven EISH inpatients were investigated retrospectively. The frequencies of using antihypertensive drugs and the strategy of drug therapy programs were calculated. The drug efficacies were assessed among various drug therapy groups. RESULTS: The frequencies of using antihypertensive medicine categories were calcium channel blocker (CCB) 64. 15%, angiotensin-converting enzyme inhibitor (ACEI) 32.77%, diuretics 26.33%, beta-blocker (BB) 25.77%, angiotensin receptor blocker (ARB) 23.81%, and alpha-blocker 4.20%, respectively. Among the 357 cases 42.86% were treated with monotherapy while 57.14% with combined therapy. Among the combination therapy groups, the diuretic-based multiple therapy occupied 16.53%, and the non-diuretic-based multiple therapy held 40.62%. The systolic blood pressure control rate was 67.79%. The rate of diastolic blood pressure < or = 70 mmHg was 26.89%, 8 cases of them occurred myocardial ischemia. CONCLUSION: How to select the optimal antihypertensive drug therapy for EISH patients is important in achieving the blood pressure goal. While thinking over intervention at lower blood pressure levels to achieve target goals, physicians should prevent from excessively lowering the diastolic blood pressure.

[Women's postpartum sexuality and delivery types].

OBJECTIVE: To investigate the impact of delivery on the sexuality of primiparous women in China, and the association with delivery type. METHODS: We inquired 460 of primiparous women delivering of a live birth at the first affiliated hospital of Chongqing medical university from November 1, 2000 to July 31, 2001. It was a cross-sectional study using obstetric records and postal questionnaire survey by outpatients consultation six months after delivery. RESULTS: Ninety-four point seven percent had resumed sexual activity within six months of the birth. In the first three months after delivery, 70.6% of women experienced sexual problems, it declined to 34.2% at six months, but can not reaching the pre-pregnancy levels. There was no close relation between sexuality postpartum and delivery. (sexual satisfactory, desire, active rate, dyspareunia and pubococcygeal muscle intensity, P > 0.05). CONCLUSIONS: Postpartum sexuality was not significantly associated with delivery types. Sexual problems were very common after childbirth. More consultation and direction of postpartum sexuality recurrence is needed.