Research on the Path of Integrating the Life View of "Human Life is Most Important" in Traditional Chinese Medicine into Medical Ethics Education for Medical Students / 中国医学伦理学

The life view of "human life is the most important" in Traditional Chinese Medicine (TCM) originates from the people-oriented theory of Chinese traditional culture, the benevolence thought of Confucianism, the rebirth thought of Taoism and the compassion thought of Buddhism. Taking the life view of "human life is the most important" as the starting point, it has formed medical ethics thoughts such as the social responsibility of saving the world, the medical practice purpose of treating all patients equally, the meticulous working attitude, the diligent and tireless learning attitude, and the exploration spirit of widely exploring the medical roots, which still has important educational significance. Therefore, the life view of "human life is the most important" should be integrated into the medical ethics education of medical students, and the medical ethics literacy of medical students should be improved through the following ways: strengthen the vocational ideal education of saving the dying and healing the wounded, and enhance the sense of social responsibility of medical students; consolidate the theme of life first classroom education and improve the professional identity of medical students; enrich and innovate the practice forms of protecting life, pay attention to the practicality of medical ethics education.

Application of skin temperature monitoring in early warning of radiodermatitis risks during postoperative radiotherapy for female breast cancer / 中华放射医学与防护杂志

Objective:To analyze the correlation between the skin temperature changes in the radiation area and the occurrence of radiodermatitis during postoperative radiotherapy for female breast cancer and to explore the application value of skin temperature monitoring in the early warning of radiodermatitis risks.Methods:A total of 103 patients who received three-dimensional conformal radiotherapy after radical mastectomy in the Fourth Hospital of Hebei Medical University were continuously enrolled from May to November, 2022 in this study. Their skin temperature in the radiation area and radiodermatitis were recorded weekly. The relationships between relative skin temperature differences and different grades of radiodermatitis were determined. The optimal cut-off values for grade ≥ radiodermatitis were calculated, and the predictive effect was evaluated using the receiver operating characteristic (ROC) curve. Furthermore, the radiodermatitis risks under different skin temperatures were compared using binary logistic regression.Results:There was a positive correlation between the skin temperature in the radiation field and the grade of radiodermatitis. The optimal cut-off values for the average relative skin temperature difference of the chest wall (under 40 Gy/20 fractions), the maximum relative skin temperature difference of the chest wall (under 40 Gy/20 fractions), and the relative skin temperature difference of the supraclavicular block (under 30 Gy/15 fractions) were 0.45℃, 0.55℃, 0.15℃, respectively. The patients were divided into low- and high-risk groups based on the optimal cut-off values (0.45℃, 0.55℃, and 0.15℃). Binary logistic regression result showed that the risks of grade ≥ 2 radiodermatitis in the high-risk group were 5.71, 4.29, and 5.15 times those in the low-risk group, respectively ( OR = 5.71, 95% CI 1.81-17.99, P = 0.003; OR = 4.29, 95% CI 1.65-11.12, P = 0.003; OR = 5.15, 95% CI 2.16-12.31, P < 0.001). Conclusions:Skin temperature monitoring using medical infrared thermometers can be used to effectively predict the occurrence of grade ≥ 2 radiodermatitis. The skin temperature changes in the radiotherapy area should be closely observed. The risk of grade ≥ 2 radiodermatitis will increase when the mean and maximum relative temperature differences of the chest wall increase by 0.45℃ and 0.55℃, respectively under 40 Gy/20 fractions of radiotherapy or when the relative temperature differences of the supraclavicular block increases by 0.15℃ under 30 Gy/15 fractions of radiotherapy.

Expression of interleukin-36 and its regulatory effect on monocyte function in patients with diabetic kidney disease / 中华内分泌代谢杂志

Objective:To analyze the level of interleukin-36(IL-36) family cytokines in peripheral blood, and explore the regulatory role of recombinant human IL-36α in monocyte function in patients with diabetic kidney disease(DKD).Methods:A total of 41 type 2 diabetes mellitus(T2DM) patients, 36 DKD patients, and 20 controls were consecutively enrolled. Plasma and peripheral blood mononuclear cells(PBMCs) were isolated. Enzyme-linked immunosorbent assay(ELISA) was used to measure plasma levels of IL-36α, IL-36β, IL-36γ, and IL-36 receptor antagonist(IL-36Ra). PBMCs were sorted, and real-time quantitative PCR was performed to detect the mRNA expression of IL-36 receptor subunits in monocytes. Monocytes were stimulated with recombinant IL-36α, and levels of cytotoxic molecules and cytokines in the culture supernatant were measured. Flow cytometry was used to assess the expressions of programmed death receptor-1(PD-1) and cytotoxic T-lymphocyte-associated protein 4(CTLA-4). Co-culture of monocytes with Vero cells was performed to evaluate monocyte cytotoxicity.Results:Plasma levels of IL-36α and IL-36β in the T2DM and DKD groups were significantly higher than those in the control group. The DKD group also showed higher plasma levels of IL-36α compared to the T2DM group( P<0.05). There were no significant differences in IL-36γ and IL-36Ra levels among the three groups( P>0.05). The mRNA expression of IL-36 receptor subunits in monocytes was comparable among the three groups( P>0.05). The DKD group had higher level of tumor necrosis factor-alpha(TNF-α) compared to the control and T2DM groups( P<0.05). The levels of PD-1 and CTLA-4 were lower in the DKD group than those in the control and T2DM groups( P<0.05). The proportion of monocyte-induced Vero cell death was significantly higher in the DKD group compared to the control and T2DM groups( P<0.05). After stimulation with recombinant human IL-36α, monocytes from DKD patients showed a significant increase in the secretion of granzyme B and TNF-α( P<0.05), as well as an increased proportion of monocyte-induced Vero cell death( P=0.024). Conclusion:In DKD patients, elevated IL-36α and granzyme B levels in monocytes enhance monocyte function.

Expression of interleukin-37 in patients with diabetic kidney disease and its regulatory activity to the cytotoxic function of CD8 +T lymphocytes / 中华肾脏病杂志

Objective:To investigate interleukin-37 (IL-37) expression in patients with diabetic kidney disease (DKD), and to assess the regulation of exogenous IL-37 on CD8 + T cell function in DKD patients. Methods:A cross-section study was carried out. Twenty healthy controls, thirty-six patients with diabetes mellitus type 2 (T2DM), and forty-seven DKD patients were enrolled in the study. Peripheral blood was collected. Plasma and peripheral blood mononuclear cells were isolated. IL-37 and soluble IL-1 receptor 8 (IL-1R8) levels in the plasma were measured by enzyme-linked immunosorbent assay (ELISA). IL-18 receptor α chain (IL-18Rα), IL-1R8 and immune checkpoint molecules levels in CD8 + T cells were measured by flow cytometry. CD8 + T cells were purified, and were stimulated with recombinant IL-37. CD8 + T cells were co-cultured with HEK293 cells in either direct contact or indirect contact manner. Levels of perforin, granzyme B, interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) were measured by ELISA. The proportion of target cell death was assessed by measuring lactate dehydrogenase level. Results:Plasma IL-37 levels in DKD patients [(63.42±23.30) ng/L] were significant lower than those in healthy controls [(143.02±50.67) ng/L] and T2DM patients [(87.88±40.62) ng/L] ( t=8.848, P<0.001; t=3.456, P<0.001). Plasma IL-37 level had good predictive values for T2DM in health individuals and for DKD in T2DM patients [the area under the curve was 0.797 (95% CI 0.676-0.917, P<0.001) and 0.691 (95% CI 0.576-0.807, P=0.003), respectively]. Plasma IL-37 level was negatively correlated with urea nitrogen ( r=-0.313, P=0.032) and creatinine ( r=-0.477, P<0.001), and positively correlated with estimated glomerular filtration rate (eGFR) ( r s=0.478, P<0.001) in DKD patients. IL-1R8 + CD8 + cell proportion in DKD patients (33.60%±9.47%) was significantly higher compared to healthy controls (16.29%±5.97%) and T2DM patients (17.13%±4.85%) ( t=7.545, 9.516, both P<0.001), but did not correlate with fast blood glucose, urea nitrogen, creatinine, or eGFR (all P>0.05). There were no statistical differences of IL-18Rα + CD8 + cell proportion, soluble IL-1R8 level, or immune checkpoint molecule proportion in CD8 + T cells among healthy controls, T2DM patients, and DKD patients (all P>0.05). Perforin and granzyme B secretions by CD8 + T cells were significantly elevated in DKD patients compared with healthy controls [(108.78±12.42) ng/L vs. (94.60±10.07) ng/L, t=3.096, P=0.005; (261.34±48.79) ng/L vs. (166.28±30.80) ng/L, t=3.387, P=0.002] and T2DM patients [(108.78±12.42) ng/L vs. (92.58±14.71) ng/L, t=3.263, P=0.003; (261.34±48.79) ng/L vs. (170.66±39.24) ng/L, t=2.627, P=0.014]. There were no significant differences of either IFN-γ or TNF-α secretions by CD8 + T cells among healthy controls, T2DM patients, and DKD patients (all P>0.05). In direct contact co-culture manner, CD8 + T cell-induced HEK293 cell death was down- regulated (13.03%±4.97% vs. 17.88%±5.19%, t=2.235, P=0.037). The levels of perforin [(222.02±25.79) ng/L vs. (294.30±25.58) ng/L, t=6.603, P<0.001], granzyme B [(416.27±90.24) ng/L vs. (524.71±115.53) ng/L, t=2.454, P=0.023], IFN-γ [(23.66±4.20) ng/L vs. (35.18±8.51) ng/L, t=4.026, P<0.001] and TNF-α [(1.62±0.29) μg/L vs. (2.09±0.57) μg/L, t=2.302, P=0.034] were also reduced as well. In indirect contact co-culture manner, there were no significant differences of CD8 + T cell-induced HEK293 cell death, perforin, or granzyme B levels between no stimulation and IL-37 stimulation (all P>0.05). IFN-γ and TNF-α levels in the supernatants were reduced in response to IL-37 stimulation [(23.56±6.24) ng/L vs. (32.56±9.90) ng/L, t=2.550, P=0.019; (1.41±0.31) μg/L vs. (2.10±0.44) μg/L, t=4.011, P<0.001]. Conclusion:IL-37 level is reduced in DKD patients.Exogenous IL-37 suppresses the cytotoxicity of CD8 + T cells in DKD patients.

Expression of IL-35 and its regulatory effects on Th9 cells in patients with type 1 diabetes mellitus / 中华微生物学和免疫学杂志

Objective:To investigate the changes in IL-35 expression in patients with type 1 diabetes mellitus (T1DM) and to analyze the role of IL-35 in regulating Th9 cells.Methods:Thirty-one T1DM patients and 13 controls were enrolled. Plasma and peripheral blood mononuclear cells (PBMCs) were isolated. The levels of IL-35 and IL-9 in plasma were measured by ELISA. The expression of IL-35 subunits, EBI3 and IL-12p35, as well as Th9 transcription factor PU.1 at mRNA level was detected by real-time PCR. The percentages of Th9 cells were measured by flow cytometry. Changes in cell proliferation, the percentage of Th9 cells, PU.1 expression at mRNA level and IL-9 secretion were detected after stimulating PBMCs from T1DM patients and controls with recombinant human IL-35. CD4 + CCR4 -CCR6 -CXCR3 - cells and CD8 + T cells were isolated from PBMCs of 11 T1DM patients. CD4 + CCR4 -CCR6 -CXCR3 - cells were first stimulated with recombinant human IL-35 and then co-cultured with CD8 + T cells. IFN-γ and TNF-α in the culture supernatants were measured by ELISA. Perforin and granzyme B secretion was measured by enzyme-linked immunospot assay. Student′s t-test, paired t-test or LSD- t test was used for statistical analysis. Results:Plasma IL-35 level was lower in T1DM patients than in controls [(67.13±9.94) pg/ml vs (97.77±23.61) pg/ml, P<0.000 1]. Compared with controls, T1DM patients had decreased expression of EBI3 and IL-12p35 at mRNA level in PBMCs ( P<0.000 1). The percentage of Th9 cells, PU.1 expression at mRNA level and plasma IL-9 level were increased in T1DM patients as compared with those in controls [(3.47±0.99)% vs (2.76±0.75)%, P=0.029; P<0.000 1; (99.08±11.85) pg/ml vs (86.38±12.72) pg/ml, P=0.002 8]. IL-35 had no significant influence on the proliferation of PBMCs from both T1DM patients and controls ( P>0.05). The percentage of Th9 cells and PU.1 expression at mRNA level in PBMCs from T1DM patients were down-regulated in response to IL-35 stimulation ( P<0.01), while no significant difference was observed in the control group ( P>0.05). IL-9 secretion by PBMCs was down-regulated in response to IL-35 stimulation in both T1DM and control groups ( P<0.01). CD4 + CCR4 -CCR6 -CXCR3 - cells promoted the secretion of IFN-γ, TNF-α, perforin and granzyme B by CD8 + T cells from T1DM patients ( P<0.05), but the effects could be inhibited by IL-35 ( P<0.05). Conclusions:Decreased IL-35 in T1DM patients could not exert effective immunosuppressive activity, leading to the enhancement of Th9 cell activity and inflammatory injury.

Preliminary study on the regulation of acute myeloid leukemia by FLT3 gene expression / 中华医学遗传学杂志

OBJECTIVE@#To assess the influence of FLT3 expression on the prognosis of patients with acute myeloid leukemia (AML) by cell experiment and clinical data analysis.@*METHODS@#Models for FLT3 over-expression and interference-expression in AML cells were constructed. The level of BAK gene expression and its protein product was determined, along with the proliferation and apoptosis of leukemia cells. FLT3 gene expression and FLT3-ITD variant were determined among patients with newly diagnosed AML.@*RESULTS@#Compared with the interference-expression group, the level of BAK gene expression and its protein in FLT3 over-expression AML cells was significantly lower (P < 0.001), which also showed significantly faster proliferation (P < 0.001) and lower rate of apoptosis (P < 0.001). The expression level of FLT3 gene among patients with newly diagnosed AML was also significantly higher compared with the healthy controls (P < 0.001). The FLT3 gene expression of FLT3-ITD positive AML patients was higher than that of FLT3-WT patients (P = 0.002). Survival analysis showed that AML patients with high FLT3 expression in the medium-risk group had a lower complete remission rate and overall survival rate compared with those with a low FLT3 expression (P < 0.001).@*CONCLUSION@#Over-expression of FLT3 may influence the course of AML by promoting the proliferation of leukemia cells and inhibiting their apoptosis, which in turn may affect the prognosis of patients and serve as a negative prognostic factor for AML.

Qualitative Study on the Current Situation of Disease Communication between Cancer Patients and Their Families / 中国医学伦理学

To further explore the current situation of disease communication between cancer patients and their families in clinical practice, and provide decision-making reference for the construction of harmonious doctor-patient relationship. From September to November, 2021, 10 oncologists from a third-class A general hospital in X city were selected for semi-structured interviews by objective sampling method, and Colaizzi seven-step analysis was used to analyze, refine and summarize the interview data. The results showed that the current situation of disease communication between cancer patients and their families can be summarized into three themes: concealing information during the diagnosis period, embarrassing decision-making during the treatment period, and difficult in autonomy at the end stage of the disease. Based on this situation, this paper suggested that a clinical communication mode with medical staff as a bridge and patients and their families actively facing and participating together can be constructed from different dimensions such as disease notification, win-win cooperation and psychological care.

Research on the Path of Integrating the Life View of "Human Life is Most Important" in Traditional Chinese Medicine into Medical Ethics Education for Medical Students / 中国医学伦理学

The life view of "human life is the most important" in Traditional Chinese Medicine (TCM) originates from the people-oriented theory of Chinese traditional culture, the benevolence thought of Confucianism, the rebirth thought of Taoism and the compassion thought of Buddhism. Taking the life view of "human life is the most important" as the starting point, it has formed medical ethics thoughts such as the social responsibility of saving the world, the medical practice purpose of treating all patients equally, the meticulous working attitude, the diligent and tireless learning attitude, and the exploration spirit of widely exploring the medical roots, which still has important educational significance. Therefore, the life view of "human life is the most important" should be integrated into the medical ethics education of medical students, and the medical ethics literacy of medical students should be improved through the following ways: strengthen the vocational ideal education of saving the dying and healing the wounded, and enhance the sense of social responsibility of medical students; consolidate the theme of life first classroom education and improve the professional identity of medical students; enrich and innovate the practice forms of protecting life, pay attention to the practicality of medical ethics education.

Genetic variation of YWHAE gene-"Switch" of disease control / 中南大学学报(医学版)

YWHAE gene is located on chromosome 17p13.3, and its product 14-3-3epsilon protein belongs to 14-3-3 protein family. As a molecular scaffold, YWHAE participates in biological processes such as cell adhesion, cell cycle regulation, signal transduction and malignant transformation, and is closely related to many diseases. Overexpression of YWHAE in breast cancer can increase the ability of proliferation, migration and invasion of breast cancer cells. In gastric cancer, YWHAE acts as a negative regulator of MYC and CDC25B, which reduces their expression and inhibits the proliferation, migration, and invasion of gastric cancer cells, and enhances YWHAE-mediated transactivation of NF-κB through CagA. In colorectal cancer, YWHAE lncRNA, as a sponge molecule of miR-323a-3p and miR-532-5p, can compete for endogenous RNA through direct interaction with miR-323a-3p and miR-532-5p, thus up-regulating K-RAS/ERK/1/2 and PI3K-AKT signaling pathways and promoting the cell cycle progression of the colorectal cancer. YWHAE not only mediates tumorigenesis as a competitive endogenous RNA, but also affects gene expression through chromosome variation. For example, the FAM22B-YWHAE fusion gene caused by t(10; 17) (q22; p13) may be associated with the development of endometrial stromal sarcoma. At the same time, the fusion transcript of YWHAE and NUTM2B/E may also lead to the occurrence of endometrial stromal sarcoma. To understand the relationship between YWHAE, NUTM2A, and NUTM2B gene rearrangement/fusion and malignant tumor, YWHAE-FAM22 fusion gene/translocation and tumor, YWHAE gene polymorphism and mental illness, as well as the relationship between 17p13.3 region change and disease occurrence. It provides new idea and basis for understanding the effect of YWHAE gene molecular mechanism and genetic variation on the disease progression, and for the targeted for the diseases.

The change of interleukin -6, soluble interleukin - 6 receptor and soluble glycoprotein 130 levels in patients with lung injury caused by paraquat poisoning and its clinical significance / 中国医师进修杂志

Objective:To investigate the change of interleukin-6(IL-6), soluble interleukin-6 receptor(sIL-6R) and soluble glycoprotein 130(sgp130) levels in patients with lung injury caused by paraquat poisoning and its clinical significance.Methods:Fifty patients with paraquat poisoning and lung injury admitted to Ba′nan District People′s Hospital of Chongqing from December 2017 to December 2019 were selected as the observation group, and 30 healthy patients were selected as the control group. The serum levels of IL-6, sIL-6R and sgp130 in two groups was detected with double-antibody sandwich enzyme-linked immunosorbent assay and compared. Pearson correlation analysis was performed on the relationship between serum IL-6, sIL-6R and sgp130 and the acute physiological and chronic health status assessment(APACHE)- Ⅱ score of patients with lung injury caused by paraquat poisoning. The receiver operating characteristics (ROC) curve was used to analyze the diagnostic value of serum IL-6, sIL-6R and sgp130 on paraquat poisoning-induced lung injury.Results:The serum levels of IL-6, sIL-6R, and sgp130 in the observation group were significantly higher than those in the control group: (108.62 ± 11.39) ng/L vs. (57.41 ± 7.63) ng/L, (73.28 ± 6.94) ng/L vs. (45.13 ± 6.57) ng/L, (435.64 ± 36.52) mg/L vs. (281.71 ± 68.35) mg/L, and the differences were statistically significant ( P<0.05). The results of correlation analysis showed that the serum levels of IL-6, sIL-6R, and sgp130 in the observation group were significantly positively correlated with the APACHE-Ⅱ score ( r = 0.824, 0.937, 1.215, P<0.05). ROC curve analysis results showed that when serum IL-6, sIL-6R and sgp130 had the best diagnostic cut-off values of 83.96 ng/L, 68.51 ng/L and 367.42 mg/L respectively for the lung injury caused by paraquat poisoning, the sensitivity was 84.80%, 78.20% and 87.10%, and the specificity was 70.30%, 85.50% and 81.00%. Conclusions:The expression levels of IL-6, sIL-6R and sgp130 in serum are closely related to the severity of lung injury caused by paraquat poisoning, and IL-6, sIL-6R and sgp130 have good diagnostic value in lung injury caused by paraquat poisoning.

Practice of chronic disease management model in tertiary hospitals Based on the Internet + doctors as the center / 中华医学教育探索杂志

With the advent of the Internet era, the development of new technology brings new opportunities for chronic disease management. Through long-term observation research, a large number of literature review and clinical practice and thinking, we have built the chronic disease management model of tertiary hospital centered on internet + doctors, and applied it to the management of patients with chronic diseases such as hypertension, and achieved good results, so as to provide decision-making reference for the construction of chronic disease management model in China.

Pak1 gene functioned differentially in different BCR-ABL subtypes in leukemiagenesis and treatment response through STAT5 pathway.

The BCR-ABL fusion gene (BCR-ABL) has different subtypes such as p210 and p190 with p190 appear to lead to a worse prognosis. To explore the mechanism of difference in pathogenesis and prognosis in different BCR-ABL subtype-related leukemia, expression profile microarray analysis was conducted between p190 and p210 patients and verified by RT-PCR. The p21-activated kinase (PAK1) gene was chosen and regulation of the PAK1-STAT5 biological axis and its influence on proliferation and apoptosis in leukemia cells were also analyzed. The results showed that PAK1 might be an important molecular mechanism of the pathogenic difference between different BCR-ABL subtypes. In P210 (+) chronic myelogenous leukemia (CML), down-regulated PAK1 gene expressions may lead to the suppression of cell proliferation and promotion of apoptosis through phosphorylation of STAT5, with a reverse effect in P190 (+) acute lymphoblastic leukemia(ALL), especially acute B lymphoblastic leukemia (B-ALL). Additionally, in P210 (+) CML, down-regulated PAK1 expression may enhance the effect of TKI, whereas the reverse is true in P190 (+) B-ALL, demonstrating that PAK1 might also be an important therapeutic target between different BCR-ABL subtypes.

Observation of the curative effect of ganglioside intravenous injection combined with intrathecal injection after operation on incomplete spinal injury / 中国综合临床

Objective To investigate the clinical effect on incomplete spinal injury by ganglioside intravenous injection combined with intrathecal injection.Methods From January 2011 to January 2015, seventy-nine cases with irreducible articular process interlocking of cervical spine fracture with dislocation of cervical spinal cord injury,underwent one stage anterior and posterior surgical treatment,postoperative routine use of antibiotics to prevent infection,and the hormone,dehydration to promote bone cell growth and neurotrophic drugs treatment.The patients were randomly divided into the intravenous injection group(42 cases),given intravenous injection of monalsialic acid four hexose ganglioside sodium(GM-1)40 mg/d,mecobalamin tablets 0.5 mg/time,3 times/d,30 d oral;the combined intrathecal injection group(37 cases)was given GM-1 40 mg/d,intravenous injection at 15 d after intrathecal injection,1 time a week 40 mg,with a total of 4 weeks.The degree of spinal cord injury was evaluated according to Frankel classification; cervical function was evaluated according to JOA score; bone graft fusion,stability of cervical spine and degree of spinal cord injury were evaluated by imaging.Results The operation time in the intravenous injection group and the combined intrathecal injection group were(4.15 ± 0.65)h and(4.10 ± 0.85)h,and the intraoperative blood loss was(850.50±35.10)ml and(858.60±25.20)ml,respectively,and there were no significant differences between the two groups(t=1.375,1.452,P>0.05).The total dose of GM-1 in the combined intrathecal injection group was(785.20 ± 3.28)mg,significantly higher than that in the intravenous injection group((610.55 ± 5.28) mg),the difference was statistically significant(t=12.542,P<0.05);79 patients were followed up for 12-24 months,with an average of(15.2 ± 1.3)months.The improvement rate of nerve function of the combined intrathecal injection group was(64.35±4.33)%,significantly higher than that in the intravenous injection group (55.50±5.44)%,the difference was statistically significant(t=8.813,P<0.05);the postoperative JOA scores of the intravenous injection group((13.55 ± 1.75)points)and combined intrathecal injection group((12.85 ±1.97)points)were significantly higher than those before the surgery((7.25± 0.83)points,(7.19± 0.93) points),the differences were statistically significant(P<0.05).There was no significant difference in the JOA scores between the two groups before and after the operation(P>0.05).At the last follow-up,X-ray showed bone fusion at the bone graft site,and the internal fixation was good and firm.MR showed that the degeneration signal area of the cervical spinal cord decreased in varying degrees,and edema and inflammatory reaction disappeared.Conclusion Postoperative treatment of ganglioside intravenous injection combined with intrathecal injection is safe and feasible in the treatment of incomplete cervical spinal cord injury caused by cervical fracture dislocation with irreducible articular process interlocking.

Effect on heterotopic ossification for Cerus and cucumis polypeptide injection in the treatment of traumatic knee joint fracture after operation / 中国综合临床

Objective To investigate the clinical efficacy of Cerus and cucumis polypeptide injection in the prevention of heterotopic ossification for the drug treatment of traumatic knee joint fracture after operation.Methods To retrospect the analysis about 150 cases with fracture reduction and internal fixation of traumatic around the knee joint fracture from January 2010 to January 2014 in Daliang Hospital of Shunde District of Foshan,including 89 cases of reduction and internal fixation were performed in group A,and with safflower injection infusion therapy,61 cases with allergic constitution were not given by Cerus and cucumis polypeptide injection in group B.According to the activity degree and HSS scoring system,the function of knee joint was evaluated before and after operation.According to the condition of arounding knee joint bone fracture healing and heterotopic ossification in X-ray and CT examination and to compare the correlation of probability between heterotopic ossification and Cerus and cucumis polypeptide injection in traumatic around knee joint fracture.Results All were followed up with 12.0-24.0 months,with average(13.6±2.2)months.Activity of knee joint between group A and B were respectively(47.2±7.3)°,(46.4±6.8)°before treatment,and HSS score of group A and B were respectively(50.8±10.0)points,(51.5±9.6)points,so there were no statistically significant difference(P＞0.05).Activity of knee joint between group A and B were respectively(115.1±6.5)°,(112.1±7.8)°at the time of the last follow-up,and HSS score of group A and B were respectively(86.2±5.0)points,(85.5±7.0)points,so there were no statistically significant difference(P＞0.05).There were statistically significant difference in activity of knee joint and HSS scores in group A or in group B at the time of the last follow-up(t=13.322,12.898,10.052,10.435,P＜0.05).The incidence of heterotopic ossification was 8.99％(8/89)in group A,the incidence of heterotopic ossification was 1.64％(1/61)in group B,there were statistically significant difference between A and B(x2=10.873,P＜0.05).Conclusion During the drug treatment,there is a correlation between heterotopic ossification and Cerus and cucumis polypeptide injection used in traumatic around knee joint fracture after operation.

Azathioprine-induced myelosuppression in a pemphigus patient with a heterozygous mutation in the NUDT15 gene / 中华皮肤科杂志

A 49-year-old male patient presented with repeated oral erosions for 1 year,as well as cutaneous erythema and blisters for 1 month.According to histopathological examination and detection of specific antibodies of pemphigus,the patient was diagnosed with pemphigus vulgaris.After the treatment with oral prednisone and azathioprine for 1 month,the white blood cell count and segmented neutrophilic granulocyte count both decreased.After withdrawal of azathioprine,the patient was subcutaneously injected with 150 μg recombinant human granulocyte colony-stimulating factor for 1 session.Then,the white blood cell count became normal.Genotyping test revealed that the patient carried a heterozygous mutation in the NUDT15 gene (JZ274),and was homozygous for wild-type TPMT*2,TPMT*3C and ITPA genes.The patient was diagnosed with azathioprine-induced myelosuppression.

Study on mifepristone combined with misoprostol in the treatment of missed abortion / 中国基层医药

Objective To explore the clinical efficacy and safety of mifepristone combined with misoprostol in the treatment of missed abortion.Methods According to the digital table,184 patients with missed abortion were randomly divided into study group and control group,92 cases in each group.The control group was given oral diethyl-stilbestrol underwent curettage,while the study group was given mifepristone combined with misoprostol therapy under-went curettage.The clinical therapeutic effect and adverse reaction were compared between the two groups.Results The effective rate of the study group after treatment was 95.65%,which was significantly higher than 86.96% of the control group,the difference was statistically significant(χ2 =4.38,P <0.05).Compared with the control group,in the study group,the operative time[(7.22 ±1.11)minute]observed significant relationship,intraoperative hemorrhage volume[(35.68 ±5.62)milliliter]decreased significantly,pregnancy natural rate of discharge(81.52%)was obvi-ously improved,artificial abortion syndrome incidence rate(3.26%)and again the rate of curettage(5.43%)was obviously decreased,and the differences were statistically significant(t =16.10,12.52,χ2 =7.84,8.87,15.93,all P <0.05).The clinical adverse reaction rate in the study group was 16.30%,which was significantly lower than 29.35% in the control group,the difference was statistically significant(χ2 =4.44,P <0.05).Conclusion Mife-pristone combined with misoprostol plays a complementary role,can improve the treatment of missed abortion and has good operation condition.It also can reduce the adverse reactions,complications and pain of patients.It is worth of clinical promotion.

Efficacy and Safety of Insulin Glargine Combined with Sitagliptin in Elderly Type 2 Diabetes Patients with Poor Glycemic Control / 中国药师

Objective:To investigate the efficacy and safety of insulin glarsine combined with sitagliptin in elderly type 2 diabetic patients whose blood glucose levels were inadequately controlled by oral anti-diabetic drugs ( OAD) . Methods: In the open-labeled, randomized and parallel study, 98patients (≥60 years) were randomly divided into two groups: insulin glargine/sitagliptin combina-tion group (n=52, the observation group ) and insulin Aspart 30 injection group (n=46, the control group). The dose was adjusted according to the blood glucose. The fasting blood glucose (FBG), 2h postprandial blood glucose (2hPBG), glycosylated hemoglobin (HbA1c), the incidence of hypoglycemia and body mass index (BMI) after the 12-week treatment were compared between the two groups. Results:The fasting glucose and the incidence of hypoglycemia in the observation group were lower than those in the control group (P0. 05). Conclusion:The treatment of insulin glargine combined with sitagliptin is safe, effective and convenient in elderly type 2 diabetes patients with poor glycemic control. By diabetic education, the lower incidence of hypoglycemia treatment will be a better choice for elderly type 2 diabetic patients.

Determination of Cinnabar and Realgar in Xiao'er Zhibao Pills / 中国药师

Objective:To establish a method for the determination of cinnabar and realgar in Xiao' er Zhibao pills. Methods:Mercury in cinnabar and arsenic in realgar in Xiao'er Zhibao pills were determined respectively by atomic absorption spectrometry (AAS) and inductively coupled plasma atomic emission spectrometry(ICP-AES). Results: A good linear correlation of mercury and arsenic was observed within the range of 5-100 μg·ml-1(r=0. 999 9) and 2-50 μg·ml-1(r=0. 999 2), and the average recovery was 99. 3% with RSD of 3. 0% (n=6) and 104. 5% with RSD of 2. 1% (n=6) by AAS. A good linear correlation of mercury and arsenic was observed within the range of 0.1-20.0 μg·ml-1(r=0.999 97) and 0.1-20.0 μg·ml-1(r=0.999 99),respectively, and the average recovery was 96. 6% with RSD of 1. 4%(n=6) and 104. 1% with RSD of 1. 1% (n=6) by ICP-AES,respectively. Conclusion:The method is accurate and specific, and can be used for the quality control of Xiao'er Zhibao pills.

Side population cells and progress in cancer stem cell research / 中南大学学报(医学版)

In recent years, cancer stem cells have become a hotspot for global researchers. Cancer stem cell theory deems that cells with self-renewal and differentiation potential play a key role in tumor resistance and relapse. These cells are named cancer stem cells. At present, the sorting methods include the side population cell sorting technique, screening techniques based on cell surface special markers, tumor sphere cultures, label retaining cell, ALDEFLUOR assays and so on. Side population cells are a small part of cells with the capacity of efflux DNA fluorescent dye Hoechst 33342 and present a low staining intensity in flow cytometry plot. Side population cells are rich in cancer stem cells, and its sorting method has been considered simple and effective in cancer stem cell research.

Effect of macrophages on ulcerative colitis-associated carcinogenesis / 中南大学学报(医学版)

Ulcerative colitis is a non-specific colorectal inflammation of unknown causes. It is now known to complicate the dangers of colorectal cancer more than was previously thought. Macrophages are an important part of immune system and play a positive role in immune reaction. But it has been shown that the phenotype and the function of macrophages change in the tumor microenvironment. Through their interaction with colorectal cancer cells and by releasing large quantities of cytokines, macrophages promote colorectal cancer cells by inhibiting angiogenesis and inhibit apoptosis. But the macrophages are also affected by cancer, interact with other inflammatory cells, and become immune suppressed. Thus the changes of macrophages are inseparable with colitis-associated colorectal carcinogenesis.