Recanalization of a long segment occluded superior vena cava by puncturing the remnant calcified fibrin sheath of the internal jugular vein: A case report.

A fibrin sheath with central venous occlusion is a common complication after central venous catheterization, and these patients often experience catheter dysfunction. A calcified fibrin sheath can cause a catheter to be stuck, and typically necessitates catheter removal or replacement. From another point of view, a calcified fibrin sheath can be seen in ultrasound and computed tomography, and the original fibrin sheath channel between the internal jugular vein and the atrium is unusually strong. When central vein occlusion occurs, the remnant calcified fibrin sheath of the internal jugular vein can be punctured under ultrasound guidance, allowing the guidewire to enter the atrium directly through the fibrin sheath. Here, we report a case in which we achieved easy recanalization of a long segment occluded superior vena cava by puncturing the remnant calcified fibrin sheath of the internal jugular vein.

Model and online calculator for prediction of fistula maturation based on vein dilation and age: A retrospective cohort study in a single-center.

OBJECTIVE: A model that considers the characteristics of dialysis patients may help predict successful fistula maturation. We evaluated factors associated with radiocephalic arteriovenous fistula (RCAVF) maturation at 3 months in dialysis patients with end-stage renal disease (ESRD). METHODS: A total of 184 patients who received an initial RCAVF at Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital) were recruited. Fistula maturation was assessed within 3 months. Patient characteristics and preoperative vascular assessment indices were examined. Factors associated with fistula maturation were analyzed using logistic regression and least absolute shrinkage and selection operator (LASSO) binary logistic regression. Boostrapping was used for internal validation. RESULTS: The development data consisted of 184 ESRD patients receiving an initial RCAVF, 140 (76%) of whom achieved fistula maturation. The main predictors of RCAVF maturation in the final model were sex, age-adjusted vein dilation (eVD), radial artery volume (Vartery), and diastolic blood pressure. The difference of vein diameter with and without a tourniquet was significantly larger in the mature RCAVF group (3.0 ± 0.5 vs. 2.2 ± 0.5 mm). The area under receiver operating characteristic (AUROC) curve for prediction of fistula maturation was 0.77, and the Hosmer-Lemeshow statistic indicated agreement between observed and predicted values (P = 0.792). Analysis of internal validation using bootstrapping indicated the C-index was 0.75. CONCLUSION: The ratio of vein dilation and age were the major predictors of fistula maturation at 3 months in our patients. The resulting online prediction model may help in clinical decision-making for patients receiving a RCAVF.

Creation of an arteriovenous graft for hemodialysis using a previously placed stent graft: A case report.

Successful hemodialysis (HD) treatment depends on well-functioning arteriovenous access. Thrombosis and stenosis are the main causes of access failure. The current report describes the successful establishment of an arteriovenous graft for HD using a previously placed stent graft in an HD patient who developed multiple episodes of access stenosis and thrombosis.

Study on mechanism of cryptotanshinone against non-small cell lung cancer based on network pharmacology / 中国药理学通报

Aim To explore the mechanism of cryptotanshinone (CTS) against non-small cell lung cancer (NSCLC) by using network pharmacology and bioinformatics methods. Methods Taking CTS as the research object, TCMSP database, SwissTargetPrediction and PharmMapper target prediction platform were used to collect CTS related targets; OMIM database, Gene-Cards data-base and TCGA database were employed to collect NSCLC related targets; String database and Cytoscape software were applied to construct PPI of intersection targets Network diagram, the hub targets were screened out, and AutoDock Vina was used for molecular docking verification; the R language clusterProfiler package was used to perform GO and KEGG enrichment analysis on the intersection targets; Cytoscape software was employed to construct the "CTS intersection targets-KEGG pathway" network. Results As a result, 75 intersecting targets were obtained, mainly involving various biological processes such as signal transduction, phosphorylation and dephosphorylation, apoptosis and vascular regulation, mainly through pancreatic cancer, colorectal cancer, cancer pathways and JAK-STAT signaling pathways. And cellular pathways such as apoptosis and natural killer cell-mediated cytotoxicity exerted their anti-NSCLC effects. Conclusions CTS exerts its anti-NSCLC effect through multiple targets and multiple pathways, which provides the theoretical support for further in-depth research.

Comparison between endovascular versus hybrid thrombectomy for arteriovenous graft under complete ultrasound guidance.

BACKGROUND: Endovascular treatment of acute thrombosed arteriovenous grafts performed completely under ultrasound guidance has rarely been reported. We compared the efficacy of a new endovascular thrombectomy technique (percutaneous manual thromboaspiration through the introducer sheath) with classical hybrid thrombectomy (minimally invasive surgical thrombectomy combined with high-pressure angioplasty) performed completely under ultrasound guidance, for arteriovenous graft thrombosis. METHODS: This was a retrospective cohort study involving patients receiving hemodialysis who underwent arteriovenous graft thrombectomy between January 2014 and December 2017. We divided 130 participants into an intervention (endovascular) group (N.=65) and a control (classical hybrid) group (N.=65) according to the thrombectomy technique. The procedural success rate, immediate outcomes and patency were compared between the groups. RESULTS: There was no significant difference in the procedural success rate (92.31% vs. 89.23%, P=0.55) between the intervention and control groups, respectively. No major complications were noted, but two cases of vessel rupture occurred in the control group and three cases of vessel rupture occurred in the intervention group. The procedure time in the intervention group was significantly shorter than that in the control group (74±14.21 min vs. 109.05±19.20 min, respectively; P<0.05). During the 6-month follow-up, we found no significant difference in the postintervention primary patency rate (48.33% vs. 55.17%; P=0.51) or the postintervention second patency rate (83.33% vs. 84.49%; P=0.79) between the intervention and control groups, respectively. Dialysis clearance and ≥50% stenosis were predictors of postintervention primary patency (hazard ratio, 7.80; 95% confidence interval: 1.75-34.81; P=0.01; and hazard ratio, 6.43; 95% confidence interval: 2.43-17.03; P<0.001), respectively. CONCLUSIONS: Completely ultrasound-guided percutaneous manual thromboaspiration through the introducer sheath can be used for thrombosed arteriovenous grafts. This approach has the advantage of shorter operative time compared with hybrid treatment.

Tunneled dialysis catheter exchange through fibrin sheath crevice vs in situ catheter exchange for the treatment of catheter dysfunction.

Our aim is to evaluate the safety and efficacy of tunneled dialysis catheter (TDC) exchange through fibrin sheath crevice vs in situ catheter exchange in hemodialysis patients with fibrin-sheath-related catheter dysfunction. Patients with fibrin-sheath-related catheter dysfunction who underwent TDC exchange in our center between 2012 January and 2017 December were retrospectively screened. The included patients were divided into the sheath-crevice group (catheter was exchanged through fibrin sheath crevice) and the in situ group (catheter was exchanged in situ). The blood volume, Kt/V values, and complications were assessed as outcomes. Of the 44 included patients, 25 underwent in situ catheter exchange and 19 underwent catheter exchange through the fibrin sheath crevice. The stabilized maximal blood flow during the first hemodialysis after the catheter replacement reached 250 mL/min in all of the included patients. After 3 months, the stabilized maximal blood flow of the in situ group and the sheath-crevice group were 245.3 ± 9.0 and 244.8 ± 10.05 mL/min (P = .963), respectively. However, after 6 months, the stabilized maximal blood flow during hemodialysis (P = .048) and the Kt/V value (P < .001) of the patients in the sheath-crevice group were significantly higher than the in situ group. No severe complication related to the catheter exchange surgery was observed in either group. For patients with TDC dysfunction caused by fibrin sheath, catheter exchange through the fibrin sheath crevice most likely is a safe and effective alternative strategy for in situ catheter exchange.

Design, synthesis, and antitumor activity of oleanolic acid derivatives.

Using the techniques of computer-aided drug design, the docking of survivin and known active small molecules was simulated and then the key amino acid residue fragments of the target protein were analyzed. It led to the discovery of active groups capable of binding to the critical sites. Through the use of the natural product, oleanolic acid, as a lead compound, the introduction of the active groups onto the A-ring, and the modification of the carboxyl group at the C-28 position using esterification or amidation, 20 new oleanolic acid derivatives had been designed and synthesized. HepG2 and SGC-7901 cells were used to screen the antitumor activity through the standard MTT method. The compounds, II3, III5 and IV4, exhibited more potent cytotoxicity than positive drugs. Western blot experiment demonstrated that compound II3 can effectively inhibit the proliferation of HepG2 cells.

Textual research of "Huangbo" in classical prescriptions / 中国中药杂志

"Huangbo" is a commonly used traditional Chinese medicine in clinic,which is mainly divided into " Chuanhuangbo" and " Guanhuangbo" in the market today. It's better to use thick and dark stem bark as medicine. This study combed the germplasms of " Huangbo" in Chinese herbal medicines and ancient medical books,which showed that the name,origin and processing of " Huangbo" had undergone evolution and changes since the ancient times. The results showed that " Huangbo" was first known as " Bomu" from " Sheng Nong's Herbal Classic". There was an attached name " Tanhuan" and the alias " Huangbo" besides " Bomu" in herbal books in Tang and Song Dynasty. Before Tang Dynasty, " Bomu" was mainly originated from stems or roots of Berberis species in Berberiaceae,and then it was mainly derived from the dry bark of Phellodendron chinense in Rutaceae since Song Dynasty. In Ming Dynasty,some herbal books recorded it name as " Huangbo",whose origin and medicinal parts remained unchanged,taking Sichuan as the best producing area. During the Republic of China era,the name " Huangbo" has evolved to " Huangbo",and the variety differentiation of " Chuanhuangbo", " Guanhuangbo" and " Yanghuangbo" appeared,in which " Guanhuangbo" was mainly derived from Ph. amurense Rupr.. In modern times,although species differentiation still exists in " Huangbo",the market is still dominated by " Chuanhuangbo".

Transferrin-functionalized co-delivery microemulsion of β-elemene and celastrol for synergistic anti-colorectal cancer treatment / 中草药

Objective To verify the synergistic effect of transferrin modified β-elemene and celastrol co-loaded microemulsion (Tf-EC-MEs) on anti-colorectal cancer treatment. Methods The optimal mass ratio of β-elemene and celastrol to growth inhibition of Lovo and HT-29 colorectal cancer cells was optimized by MTT staining method in vitro. Tf-EC-MEs was prepared by “mixing-dripping” method, and the preparation and physicochemical properties of the particles were characterized by high performance liquid chromatography (HPLC), laser particle analyzer, and transmission electron microscope. The MTT staining, HPLC-BCA combined method, and Annexin V-PE/7-Aminoactinomycin D (Annexin V-PE/7-AAD) kit were used to investigate the antitumor activity of Tf-EC-MEs in vitro, and its effect on cell uptake, and apoptosis of tumor cells. The tumor-bearing nude mice model was established by subcutaneous injection of Lovo cells, and the tumor growth, weight, and survival time were observed after intravenous injection of β-elemene + celastrol, β-elemene-celastrol co-loaded microemulsion (EC-MEs), and Tf-EC-MEs. Results The combined administration of β-elemene and celastrol (40:1) had significant synergistic effect on the anti-colorectal cancer of Lovo and HT-29 cells. IC50 of β-elemene + celastrol in Lovo and HT-29 cells were (17.5 ± 2.9) and (36.4 ± 3.6) μg/mL, with the CI as 0.89 and 0.96, respectively. IC50 of Tf-EC-MEs in Lovo and HT-29 cells were (11.7 ± 0.6) and (27.4 ± 1.2) μg/mL, with the CI as 0.61 and 0.72 respectively. The 4 h of Lovo uptake of Tf-EC-MEs was 7.2 μg/mg, which was 3.3 times higher than that of β-elemene + celastrol. Tf-EC-MEs induced apoptosis in 59.2% of Lovo cells, which was significantly higher than that in beta-elemene + celastrol and EC-MEs groups. Tf-EC-MEs showed the overwhelming inhibition of growth of Lovo tumor-bearing tumors. The survival rate of Tf-EC-MEs-treated mice was 37.5% at day 60. In Tf-EC-MEs treated group, HE staining sections of tumor tissues showed substantial cell necrosis and the Ki-67 immunohistochemical sections displayed the significant inhibition of proliferation of tumor cells. Conclusion Compared with the combination group (beta-elemene and celastrol) and EC-MEs groups, Tf-EC-MEs has a promising potential in the synergistic anti-colorectal cancer treatment.

Expression of telomerase & its significance in the diagnosis of pancreatic cancer.

Pancreatic cancer has one of the worst prognoses among all types of cancers. The survival rate is less than 5 per cent; this is due to difficulty in diagnosing at an early stage. Despite the improvements in diagnostic imaging techniques such as computed tomography, magnetic resonance imaging, etc., the early diagnosis of pancreatic cancer is still difficult. Alternative methods of diagnosing pancreatic cancer at an early stage are presently been explored. The detection of telomerase activity has been proposed to be a useful tool in the diagnosis of pancreatic cancer. Telomerase is made up of three major parts namely, human telomerase reverse transcriptase, human telomerase and telomerase -associated protein. Several researchers have shown telomerase activity in tissues and fluids of patients with pancreatic and other types of cancers. About 95 per cent telomerase activity has been detected in pancreatic adenocarcinoma. Since telomerase activity is present in a vast majority of human cancers, it might have a role in the diagnosis and treatment of cancer.

Isolation and characterization of hantavirus carried by Apodemus peninsulae in Jilin, China.

To provide a better understanding of hantavirus epidemiology in China, Korean field mice (Apodemus peninsulae) and striped field mice (Apodemus agrarius) were captured in Jilin province, China, where haemorrhagic fever with renal syndrome (HFRS) is endemic. Hantavirus antigens were detected in eight of the 130 A. peninsulae individuals and in four of the 193 A. agrarius individuals by using an immunofluorescence assay. Partial S and M segments were amplified from all of the antigen-positive samples. Furthermore, two hantaviruses (CJAp89 and CJAp93) were isolated successfully in cell culture and the entire S and M segments were amplified from one of them (CJAp93). Phylogenetic analysis of these sequences (partial or complete) showed that hantaviruses carried by A. peninsulae and A. agrarius form two distinct lineages, although viruses carried by A. peninsulae are similar to those isolated previously from A. agrarius in China and from HFRS patients in Russia. However, the viruses detected in A. peninsulae in China are genetically different from those detected in A. peninsulae in other countries. These data suggest that A. peninsulae is also a natural host for HTNV in north-eastern China.

[Effects of field viewing angles on object judgement [correction of jubgerent] in virtual environment].

OBJECT: To investigate the effect of viewing angle on human judgement reliability for objects in virtual environment. METHOD: Firstly, pre-tests were done with the PC virtual reality ergonomic system to determine difference among observed object and values of viewing angle. Then, one factor, 4-levels full random experiments were done with 45 health human subjects (male and female nearly 1:1). RESULT: It was shown that the reliability of human judgement was significantly influenced by the setting of the viewing angle of virtual environment, and the object judgement including size and angle judgement was the best when the viewing angle of virtual environment was 60 degrees. CONCLUSION: When virtual reality was used in ergonomic design, operation training and other related research, the effect of field viewing angle should be taken into consideration, and 60 degrees is recommended to be optimal for human judgment task.