Bear bile powder alleviates Parkinson's disease-like behavior in mice by inhibiting astrocyte-mediated neuroinflammation / 中国天然药物

Parkinson's disease (PD) is a common neurodegenerative disease in middle-aged and elderly people. In particular, increasing evidence has showed that astrocyte-mediated neuroinflammation is involved in the pathogenesis of PD. As a precious traditional Chinese medicine, bear bile powder (BBP) has a long history of use in clinical practice. It has numerous activities, such as clearing heat, calming the liver wind and anti-inflammation, and also exhibits good therapeutic effect on convulsive epilepsy. However, whether BBP can prevent the development of PD has not been elucidated. Hence, this study was designed to explore the effect and mechanism of BBP on suppressing astrocyte-mediated neuroinflammation in a mouse model of PD. PD-like behavior was induced in the mice by intraperitoneal injection of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) (30 mg·kg-1) for five days, followed by BBP (50, 100, and 200 mg·kg-1) treatment daily for ten days. LPS stimulated rat C6 astrocytic cells were used as a cell model of neuroinflammation. THe results indicated that BBP treatment significantly ameliorated dyskinesia, increased the levels of tyrosine hydroxylase (TH) and inhibited astrocyte hyperactivation in the substantia nigra (SN) of PD mice. Furthermore, BBP decreased the protein levels of glial fibrillary acidic protein (GFAP), cyclooxygenase 2 (COX2) and inducible nitric oxide synthase (iNOS), and up-regulated the protein levels of takeda G protein-coupled receptor 5 (TGR5) in the SN. Moreover, BBP significantly activated TGR5 in a dose-dependent manner, and decreased the protein levels of GFAP, iNOS and COX2, as well as the mRNA levels of GFAP, iNOS, COX2, interleukin (IL) -1β, IL-6 and tumor necrosis factor-α (TNF-α) in LPS-stimulated C6 cells. Notably, BBP suppressed the phosphorylation of protein kinase B (AKT), inhibitor of NF-κB (IκBα) and nuclear factor-κB (NF-κB) proteins in vivo and in vitro. We also observed that TGR5 inhibitor triamterene attenuated the anti-neuroinflammatory effect of BBP on LPS-stimulated C6 cells. Taken together, BBP alleviates the progression of PD mice by suppressing astrocyte-mediated inflammation via TGR5.

Comprehensive evaluation method of real-time non-reference ultrasound image involving soft tissue deformation / 生物医学工程学杂志

Ultrasound guided percutaneous interventional therapy has been widely used in clinic. Aiming at the problem of soft tissue deformation caused by probe contact force in robot-assisted ultrasound-guided therapy, a real-time non-reference ultrasound image evaluation method considering soft tissue deformation is proposed. On the basis of ultrasound image brightness and sharpness, a multi-dimensional ultrasound image evaluation index was designed, which incorporated the aggregation characteristics of the organization. In order to verify the effectiveness of the proposed method, ultrasound images of four different models were collected for experiments, including prostate phantom, phantom with cyst, pig liver tissue, and pig liver tissue with cyst. In addition, the correlation between subjective and objective evaluations was analyzed based on Spearman's rank correlation coefficient. Experimental results showed that the average evaluation time of a single image was 68.8 milliseconds. The evaluation time could satisfy real-time applications. The proposed method realizes the effective evaluation of real-time ultrasound image quality in robot-assisted therapy, and has good consistency with the evaluation of supervisors.

Caution on Kidney Dysfunctions of 2019-nCoV Patients

BackgroundTo date, large amounts of epidemiological and case study data have been available for the Coronavirus Disease 2019 (COVID-19), which suggested that the mortality was related to not just respiratory complications. Here, we specifically analyzed kidney functions in COVID-19 patients and their relations to mortality. MethodIn this multi-centered, retrospective, observational study, we included 193 adult patients with laboratory-confirmed COVID-19 from 2 hospitals in Wuhan, 1 hospital in Huangshi (Hubei province, 83 km from Wuhan) and 1 hospital in Chongqing (754 km from Wuhan). Demographic data, symptoms, laboratory values, comorbidities, treatments, and clinical outcomes were all collected, including data regarding to kidney functions. Data were compared among three groups: non-severe COVID-19 patients (128), severe COVID-19 patients (65) and a control group of other pneumonia (28). For the data from computed tomographic (CT) scans, we also included a control group of healthy subjects (110 cases, without abnormalities in the lung and without kidney diseases). The primary outcome was a common presence of kidney dysfunctions in COVID-19 patients and the occurrence of acute kidney injury (AKI) in a fraction of COVID-19 patients. Secondary outcomes included a survival analysis of COVID-19 patients in conditions of AKI or comorbid chronic illnesses. FindingsWe included 193 COVID-19 patients (128 non-severe, 65 severe (including 32 non-survivors), between January 6th and February 21th,2020; the final date of follow-up was March 4th, 2020) and 28 patients of other pneumonia (15 of viral pneumonia, 13 of mycoplasma pneumonia) before the COVID-19 outbreak. On hospitaladmission, a remarkable fraction of patients had signs of kidney dysfunctions, including 59% with proteinuria, 44% with hematuria, 14% with increased levels of blood urea nitrogen, and 10% with increased levels of serum creatinine, although mild but worse than that in cases with other pneumonia. While these kidney dysfunctions might not be readily diagnosed as AKI at admission, over the progress during hospitalization they could be gradually worsened and diagnosed as AKI. A univariate Cox regression analysis showed that proteinuria, hematuria, and elevated levels of blood urea nitrogen, serum creatinine, uric acid as well as D-dimer were significantly associated with the death of COVID-19 patients respectively. Importantly, the Cox regression analysis also suggested that COVID-19 patients that developed AKI had a [~]5.3-times mortality risk of those without AKI, much higher than that of comorbid chronic illnesses ([~]1.5 times risk of those without comorbid chronic illnesses). InterpretationTo prevent fatality in such conditions, we suggested a high degree of caution in monitoring the kidney functions of severe COVID-19 patients regardless of the past disease history. In addition, upon day-by-day monitoring, clinicians should consider any potential interventions to protect kidney functions at the early stage of the disease and renal replacement therapies in severely ill patients, particularly for those with strong inflammatory reactions or a cytokine storm. FundingNone.

Analysis of impact factors on prognosis of patients with gallbladder adenocarcinoma after surgery / 中华肝胆外科杂志

Objective To study the impact factors on prognosis of patients with gallbladder adenocarcinoma after surgery.Methods The clinicopathological data of 1 285 patients who underwent surgery and were histologically confirmed to have gallbladder adenocarcinoma from 2004 to 2014 was extracted from the SEER database of US National Cancer Institute.Life table was used to calculate the survival rate.Kaplan-Meier was used to construct the survival curves.Univariate and Cox multivariate regression analysis were applied to evaluate the prognostic factors.The univariate analysis was evaluated by the log-rank x2 test.Results The median survival of 1 285 patients with gallbladder adenocarcinoma was 32 months.The 1-,3-and 5-year survival rates were 77.5％,46.8％ and 36.5％,respectively.The 5-year survival rates of stage Ⅰ,Ⅱ,ⅢA,ⅢB,ⅣA,ⅣB were 72.7％,63.2％,24.6％,20.5％,0 and 5.1％,respectively.The median survival of stage ⅢA,ⅢB,ⅣA and ⅣB were 22 months,19 months,12 months and 16 months,respectively.The differences were statistically significant (P ＜ O.05).Univariate analysis showed that sex,age,degree of differentiation,tumor size,T staging,N staging,number of lymph nodes detected,lymph node metastasis rate,location of lymph node metastasis,and American Joint Commission on cancer (AJCC) staging were significantly associated with prognosis (P ＜ 0.05).There was no significant differences among race and marital status with prognosis (P ＞ 0.05).Multivariate Cox regression analysis showed that sex (male),age (≥ 65 years),degree of differentiation,T staging,number of lymph nodes detected (＜ 4)and AJCC staging were independent risk factors affecting prognosis of patients with gallbladder adenocarcinoma (P ＜ 0.05).Conclusions With increase in AJCC staging,the survival rates in patients with gallbladder adenocarcinoma after surgery decreased gradually.Parameters including sex,age,T staging,number of lymph nodes detected and AJCC staging were independent factors affecting prognosis of patients with gallbladder adenocarcinoma after surgery.

The pathological types of pancreatic carcinoma: an analysis based on US SEER database / 中华肝胆外科杂志

Objective To study the component ratios of pancreatic carcinoma,and prognosis of patients with the different pathological types.Methods The data of 92 011 pancreatic carcinoma patients who were diagnosed by the definite pathological method from 2004 to 2014 were extracted from the US SEER database.The life table was used to calculate the 1-,3-and 5-year survival rates.The Kaplan-Meier was used to construct the survival curves of the patients.The Cox univariate analysis was applied to evaluate the HR of the different pathological types,and the x2 test and independent sample t-test were used to evaluate the base line data.Results The overall 5-year survival of 92 011 pancreatic carcinoma patients was 7.6％.The median survival time was 8.8 months and the component ratios of the pancreatic ductal adenocarcinoma (PDAC),pancreatic epithelium cancer bedside the PDAC,neuroendocrine tumors,undifferentiated carcinoma,mesenchymal carcinoma and rare cancer unclassified were 85.78％,6.40％,6.67％,0.97％,0.10％ and 0.08％,respectively.The differences were statistically significant between the baseline data such as age,gender,race and position (P ＜ 0.05).The overall 5-year survivals of the PDAC,pancreaticepithelium cancer beside the PDAC,neuroendocrine tumors,undifferentiated carcinoma,mesenchymal carcinoma and rare cancer unclassified were 4.2％,13.4％,49.2％,5.0％,29.2％ and 24.5％,respectively,and the median survival times were 5 months,7 months,58 months,2 months,26 months and 7 months respectively.The distant metastasis rate of neuroendocrine carcinoma was the lowest (35.0％).The undifferentiated carcinoma was the most prone to distant metastases (65.2％).Basically,half of the other types of pancreatic cancer had metastasis at the time of diagnosis.In pancreatic epithelium cancer beside the PDAC,the high to low 5-year survival rates were solid pseudopapillary carcinoma (87.3％),cystadenocarcinoma (36.8％),intraductal papillary mucinous neoplasm (36.5％),acinar cell carcinoma (20.0％),and pancreatic adenocarcinoma mixed with other subtypes (19.7％).The incidence of the other types of pancreatic carcinoma was less than 8％,such as mucinous carcinoma,squamous cell carcinoma,adenosquamous carcinoma and signet ring cell carcinoma.In neuroendocrine tumor,the 5-year survival rate of insulinoma (77.1％) was higher than those of neuroendocrine tumor (malignant) (NET,62.0％) and neuroendocrine carcinoma (NEC,46.5％).Conclusion The prognosis of pancreatic carcinoma was poor,and the pathological types had a significant impact on the prognosis of the patients.

Prognostic factors for patients with pancreatic head carcinoma undergoing operation: a retrospective study on Surveillance, Epidemiology, and End Results using population-based data / 中华肝胆外科杂志

Objective To study the survival of patients with pancreatic head carcinoma undergoing surgery,and to evaluate the clinicopathological factors associated with prognosis.Methods The data of 4 814 patients who underwent surgery for pancreatic head carcinoma from 2004 to 2009 were extracted from the US SEER database.The life table was used to calculate the survival rate at 5-years.The Kaplan-meier method was used to construct the survival curves of the patients.The univariate and Cox multivariate regression analysis were applied to evaluate the prognostic factors.and the univariate analysis was evaluated by the log-rank x2 test.Results The overall 5-year survival of 4 818 pancreatic head carcinoma patients was 16.3％.The median survival was 18.9 months,and the 5-year survival rates of the stage Ⅰ A,Ⅰ B,Ⅱ A,Ⅱ B,Ⅲ and Ⅳ patients were 38.8％,35.3％,21.8％,12.2％,9.1％,and 7.3％,respectively.The difference was statistically significant (x2 =287.702;P ＜ 0.05).The factors including sex,age,years of diagnosis,pathological grading,tumor size,extent of invasion,lymph node metastasis,distant metastasis,and pathological pattern (all P ＜ 0.05) influenced the survival rate on univariate analysis.There was no clear correlation between race,number of lymph node examined and prognosis.The factors including sex,age,years of diagnosis,pathological grading,tumor size (AJCC 8th),range,extent of invasion,lymph node metastasis,distant metastasis,and pathological pattern (all P ＜ 0.05) were independent prognostic factors on multivariate analysis.Conclusions With the increase of TNM staging,the overall survival of patients with pancreatic head carcinoma undergoing surgery gradually decreased.Factors including sex,age,years of diagnosis,pathological grading,tumor size,extent of invasion,lymph node metastasis,distant metastasis,and pathological pattern were independent prognostic factors of overall survival.

The Prognostic Significance of Notch1 and Fatty Acid Binding Protein 7 (FABP7) Expression in Resected Tracheobronchial Adenoid Cystic Carcinoma: A Multicenter Retrospective Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Adenoid cystic carcinoma (ACC) of the trachea and bronchus is a rare tumor. Although MYB-NFIB oncogene fusion and Notch1 mutation have been identified in ACC, little is known about the expression and clinical significance of Notch1 and its target gene fatty acid binding protein 7 (FABP7) in tracheobronchial ACC. MATERIALS AND METHODS: Primary tracheobronchial ACC that were resected between 1998 and 2014 were identified through the pathology and oncology database from five thoracic oncology centers in China. A tissue array was constructed from the patients’ samples and the expressions of Notch1 and FABP7 were evaluated by immunohistochemistry. The association between the expression of both markers and survival was determined. RESULTS: Overexpression of Notch1 and FABP7, detected in 37.8% and 38.3% of 368 patients with tracheobronchial ACC, respectively, was an independent prognostic indicator for recurrencefree survival (RFS) by multivariable Cox proportional hazard model (p=0.032 and p=0.048, respectively). Overexpression of Notch1, but not of FABP7, predicted overall survival (OS) (p=0.018). When categorized into four groups according to coexpression of Notch1 and FABP7, patients with overexpression of both Notch1 and FABP7 belonged to the group with the shortest RFS and OS (p=0.01 and p=0.048, respectively). CONCLUSION: Expression of Notch1 and FABP7, and coexpression of Notch1 and FABP7, is strongly associated with poor survival in resected tracheobronchial ACC. These data are consistent with the hypothesis that poor differentiation of tracheobronchial ACC correlates with the activation of Notch signaling.

Advance in Intestinal Flora Affecting Central Nervous System Diseases (review) / 中国康复理论与实践

@# Intestinal flora plays an important role in the process of human health and disease conversion. It not only participates in a number of physiological processes in the host, but also affects the central nervous system (CNS) -related diseases, which may involve in neurotransmitter, immune, endocrine, metabolites, etc. Intestinal dysbacteriosis plays a role in the development of CNS diseases, such as ischemic brain injury, Parkinson's disease, Alzheimer's disease, multiple sclerosis, hepatic encephalopathy, and mental disorders, etc. Fecal microbes transplantation, exercise training, acupuncture and Tuina therapy can improve the intestinal flora balance, which may be potential for the treatment and prevention of some nervous system diseases.

Effects of Acupuncture-rehabilitation Therapy on Neurological Function and Expression of Apoptosis-related Proteins in Ischemic Penumbra of Rats with Cerebral Ischemia / 中国康复理论与实践

@#Objective To investigate the effect of acupuncture-rehabilitation therapy on the neurological function and the expression of cleaved-caspase-8, cleaved-caspase-3 and cellular inhibitor of apoptosis 1 (cIAP1) in ischemic penumbra of rats with cerebral ischemia. Methods A total of 90 male Sprague-Dawley rats were randomly divided into sham group, model group, acupuncture group, rehabilitation group and acupuncture-rehabilitation group. Each group was divided into three days, seven days and 14 days subgroups (n=6). The cerebral ischemia model was established with the modified Koizumi suture method. The sham group and the model group received no treatment. The acupuncture group received cluster needling of scalp acupuncture, the rehabilitation group received treadmill training, and the acupuncture-rehabilitation group received both acupuncture and treadmill training. Three days, seven days and 14 days after modeling, their neurological function was assessed with modified Neurological Severity Score (mNSS) and Rota-rod test, and the expression of cleaved-caspase-8, cleaved-caspase-3 and cIAP1 protein in cerebral ischemic penumbra were detected with Western blotting. Results Compared with the model group, the mNSS scores decreased, the retention time of Rota-rod test increased, the expression of cleaved-caspase-8, cleaved-caspase-3 protein decreased and the expression of cIAP1 protein increased in each treatment group at each time point (P<0.05). Compared with the other two treatment groups, the mNSS scores further decreased, the retention time further increased, the expression of cleaved-caspase-8, cleaved-caspase-3 protein further decreased, and the expression of cIAP1 protein further increased (P<0.05) seven days and 14 days after modeling in the acupuncture-rehabilitation group.Conclusion Acupuncture-rehabilitation therapy can improve the neurological function in rats with cerebral ischemia, that is better than the simple acupuncture or exercise, which may relate to the inhibition of caspase-8 and caspase-3 protein activation, and promotion of cIAP1 protein expression, to inhibit the apoptotic caspases cascade reaction.

Evaluation and application of estimation of glomerular filtration rate based on serum creatinine and cystatin C in renal function staging / 中华流行病学杂志

Objective To evaluate the accordance of chronic kidney disease (CKD) staging between the CKD-EPI2009 equation, the CKD-EPI2012 equation and the modification of diet in renal disease (MDRD) equation and compare the predictive value of common cardiovascular disease. Methods A total of 11151 adults from Jurong area, Jiangsu province, were surveyed from September to November in 2015 and their serum creatinine and cystatin C were detected. The glomerular filtration rate (GFR) was estimated by three equations. Results In the individuals with history of chronic renal insufficiency, the results of CKD staging of CKD-EPI2009 equation and CKD-EPI2012 equation were all consistent with that of MDRD equation (P<0.001), and the consistence between CKD-EPI2012 equation and CKD-EPI2009 equation was even higher. In the people without history of CKD, the results of CKD staging of CKD-EPI2009 equation and CKD-EPI2012 equation were also highly consistent with the results of MDRD equation (P<0.001) and Ka ppa values were 0.662 and 0.654 respectively whilst the results of CKD staging estimated by CKD-EPI2012 equation and MDRD equation were only moderately consistent (Ka ppa=0.436, P<0.001). In the whole observational population, the CKD staging results of MDRD equation, CKD-EPI2009 equation and CKD-EPI2012 equation had a good consistency evaluated by Band-Altman method. The consistency of CKD staging between CKD-EPI (2009, 2012) equation and MDRD equation was higher in ≥70 years old group than that in<70 years old group as well as in males than in females. For predicting hypertension, the AUCs of CKD-EPI equations calculated GFRs were significantly higher than that of MDRD equation;the AUCs of CKD-EPI2012 equation calculated GFR for predicting stroke and coronary heart disease were higher than that of MDRD equations whereas no significant difference in GFR prediction result was found between CKD-EPI2009 equation and MDRD equation. Conclusion MDRD equation and CKD-EPI equation for GFR estimation have high consistency in CKD staging whilst the predictive value of chronic cardiovascular disease by CKD-EPI equation estimated GFR was higher than that of MDRD equation.

Clinical effect of laparoscopic splenectomy combined with pericardial devascularization for the treatment of 310 patients with portal hypertension / 中华消化外科杂志

Objective To investigate the clinical effect of laparoscopic splenectomy combined with pericardial devascularization for the treatment of portal hypertension.Methods The retrospective cross-sectional study was conducted.The clinical data of 310 patients with portal hypertension who underwent laparoscopic splenectomy combined with pericardial devascularization in the Tangdu Hospital of Fourth Military Medical University between January 2012 and June 2016 were collected.All the patients underwent laparoscopic splenectomy combined with pericardial devascularization.Observation indicators:(1) surgical and postoperative situations;(2) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect the gastrointestinal rebleeding and postoperative survival of patients up to January 2017.Measurement data with normal distribution and skewed distribution were respectively represented as average number (range) and M (range).Results (1) Surgical and postoperative situations:all patients underwent successful operation.Twelve patients converted to open surgery due to intractable bleeding and 298 underwent totally laparoscopic splenectomy combined with pericardial devascularization.Average operation time,average volume of intraoperative blood loss,average time of gastrointestinal function recovery and average time of postoperative abdominal drainage-tube removal of 310 patients were 192.5 minutes (range,120.0-300.0 minutes),402.3 mL (range,150.0-1 200.0 mL),2.4 days (range,1.0-4.0 days) and 4.2 days (range,2.0-8.0 days),respectively.Among 11 of 310 patients with postoperative complications,1 died of acute severe hemorrhage of upper digestive tract,5 with intra-abdominal bleeding received successful hemostasis (3 undergoing reoperation and 2 undergoing conservative treatment),2 with pleural effusion were improved by thoracentesis and drainage,2 with pancreatic leakage and 1 with pulmonary infection were cured by conservative treatment.Other 299 patients didn't have postoperative complications.Duration of postoperative hospital stay of 310 patients was 6.4 days (range,5.0-9.0 days).(2) Follow-up situations:260 of 309 patients were followed up for 6-60 months,with a median time of 26 months.During the follow-up,1 patient died of acute portal vein thrombosis at 1 month postoperatively;15 with gastrointestinal rebleeding and melena were cured by conservative treatment;other patients had survival.Conclusion Laparoscopic splenectomy combined with pericardial devascularization for the treatment of portal hypertension is safe and effective.

"A preliminary establishment of the""single-cell-transplant-tumorigenic-test""model for identifying liver cancer stem cells" / 中国组织工程研究

BACKGROUND: There is no effective method to identify liver cancer stem cells until now, which has become one of the major challenges in this field. OBJECTIVE: To explore a more effective and suitable way for the identification of liver cancer stem cells in hepatocellular carcinoma cell lines. METHODS: Firstly, the single cell separation technique was used to obtain single cells, which were seeded into 96-wel plates one by one. Secondly, cell sublines derived from single cell colonies (tumorigenic colonies) were selected and obtained. At last, the cells from these clones were transplanted into the forelimb armpits of nude mice to observe the tumorigenic ability. RESULTS AND CONCLUSION: The number of holes of single cells obtained was 371 by the single cell separation technique, and the success rate was 96.4%. According to the growth of cell clone, tumorigenic colonies were selected to be transplanted to the forelimb armpits of nude mice, and the tumor formation rate of the colonies was 100%. The identification model of single-cell-transplant-tumorigenic-test for liver cancer stem cells is confirmed to be preliminarily established, which lays the technology and methodological basis for the follow-up research.

Effects of Exercise or Electroacupuncture Preconditioning on Neurological Deficits and Expression of Laminin in Rats with Cerebral Infarction / 中国康复理论与实践

Objective To investigate the effect of electroacupuncture or exercise preconditioning on neurological function after focal ce-rebral infarction in rats and the possible mechanism. Methods A total of 24 male Sprague-Dawley rats were randomly divided into model group (n=6), sham group (n=6), exercise preconditioning group (n=6) and electroacupuncture preconditioning group (n=6). The model group and the sham group did not accept any treatment, while the exercise preconditioning group and the electroacupuncture precondition-ing group accepted treadmill training and electroacupuncture for two weeks, respectively. Their middle cerebral arteries were occluded with modified Longa's approach, except the sham group that was ligated the same arteries but did not result in infarction. They were evaluated with Neurologic Severity Scores (NSS) 24 hours after modeling, and the laminin expression in the ischemic area was detected with Western blotting. Results There was no neurological deficit in the sham group. The NSS was lower in both preconditioning groups than in the model group (P0.05). The expression of laminin was the most in the sham group, and was more in both preconditioning groups than in the model group (P0.05). Conclusion Preconditioning with exercise or electroacupuncture can both reduce the neurological deficits in rats after focal cerebral infarction, which may associate with the protection of laminin from inhibition in early stage.

Effects of Acupuncture-rehabilitation Therapy on Neurological Function and Extracellular Signal-regulated Ki-nase 1/2 Signaling Pathway after Focal Cerebral Ischemia in Rats / 中国康复理论与实践

Objective To explore the effects of acupuncture-rehabilitation therapy on neurological function recovery and extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway activation after permanent focal cerebral ischemia in rats. Methods Ninty male Sprague-Dawley rats were divided into five groups, namely sham group, model group, acupuncture group, rehabilitation group and acupunc-ture-rehabilitation group, and 18 in each group. Each group was further divided into 3 days, 7 days and 14 days subgroups (n=6). Their mid-dle cerebral arteries were occluded except those of sham group. The sham and model groups accepted no treatment, while the acupuncture group accepted cluster needling of scalp acupuncture, rehabilitation group accepted treadmill training, and the acupuncture-rehabilitation group accepted both acupuncture and treadmill training. They were assessed with modified Neurologic Severity Score (mNSS) 3, 7 and 14 days after modeling, while the expression of ERK1/2 and p-ERK1/2 were determined with Western blotting. Results The neurologic severi-ty score reduced in all three treatment groups (P<0.05) compared with that of the model group at every time point, and was the least in the acupuncture-rehabilitation group (P<0.05) 7 and 14 days after modeling among the treatment groups. Meanwhile, the expression of p-ERK1/2 increased in all three treatment groups (P<0.05), and was the most in the acupuncture-rehabilitation group (P<0.05), as well as the rate of (p- ERK1/2)/(ERK1/2) (P<0.05). Conclusion Acupuncture- rehabilitation therapy can promote the neurological function recovery, which may be associated with activation of ERK1/2 signaling pathway.

Effect of Acupuncture plus Rehabilitation on Neurologic Deficit and VEGF Protein Expression in Cortex on the Infarction Side in Rats with Focal Cerebral Infarction / 上海针灸杂志

Objective To observe the effect of acupuncture plus rehabilitation on neurologic deficit and the expression of vascular endothelial growth factor (VEGF) protein in cortex on the infarction side in rats with focal cerebral infarction, and to explore the action mechanism of acupuncture plus rehabilitation in promoting the recovery of impaired function in rats.Method Ninety healthy male Sprague-Dawley (SD) rats were randomized into a model group, an acupuncture group, a rehabilitation group, an acupuncture-rehabilitation group, and a sham operation group, and the five groups were further divided into three subgroups, i.e. 3 d, 7 d, and 14 d subgroups, 6 rats in each subgroup. The modified Zea-Longa method was adopted to prepare the model of middle cerebral artery occlusion (MCAO) on theright side. Rats in the acupuncture group received simulant scalp-points cluster needling; the rehabilitation group was intervened by treadmill exercise; the acupuncture-rehabilitation group was intervened by scalp-points cluster needling plus treadmill exercise; the model group and sham operation group didn't receive any interventions. The modified Neurological Severity Score (mNSS) was adopted to evaluate the rat's neurologic deficit, and Western blotting was used to detect the expression of VEGF protein in cortex on the infarction side.Result Neurologic deficit wasn't found in rats in the sham operation group. After 3-day treatment, the mNSSs in the acupuncture group, rehabilitation group, and acupuncture-rehabilitation group were insignificantly different from the score in the model group (P>0.05), while the differences were statistically significant respectively after 7-day and 14-day treatment (P0.05). After 3-day treatment, the expression of VEGF protein in each treatment group was insignificantly different from that in the model group (P>0.05), while the expression of VEGF protein in each treatment group was significantly higher than that in the model group respectively after 7-day and 14-day treatment (P0.05).Conclusion Scalp-points cluster needling and rehabilitation both can improve the neurologic function in rat models of focal cerebral infarction, and enhance the expression of VEGF protein in infarction cortex, and the integration of acupuncture and rehabilitation can achieve a better result; the action mechanism is possibly related to the high expression of VEGF which can better promote the reconstruction and regeneration of the vessels in cerebral infarction area.

Effects of electroacupuncture preconditioning on cerebral infarct volume and contents of TNF-α, IL-10 in serum of rats after cerebral ischemia-reperfusion injury / 中国针灸

<p><b>OBJECTIVE</b>To explore the effect of electroacupuncture(EA) preconditioning on cerebral infarct volume and the contents of TNF-α, IL-10 in serum of rats with cerebral ischemia-reperfusion injury.</p><p><b>METHODS</b>Thirty-six rats were randomly divided into a sham operation group, a model group and an EA preconditioning group, 12 rats in each group, which were further divided into 12 h and 24 h after reperfusion subgroups, 6 rats in each one. EA was used before model establishment for 2 weeks in the EA preconditioning group. The model of cerebral ischemia-reperfusion injury in rats was established with modified Longa suture method. 12 h and 24 h after reperfusion, the degree of neurological deficit was assessed by the modified behavioral scoring scale; the cerebral infarct volume was measured by TTC method and the contents of TNF-α, IL-10 in serum were detected by ELISA method.</p><p><b>RESULTS</b>Compared with the model group, the neurological severity scores in the EA preconditioning group significantly reduced 12 h and 24 h after reperfusion (both<0.05), the cerebral infarct volume in the EA preconditioning group significantly reduced 12 h and 24 h after reperfusion (both<0.05). Compared with the sham operation group, the serum TNF-α, IL-10 contents in the model group increased 12 h and 24 h after reperfusion (both<0.05). Compared with the model group, the serum TNF-α content reduced, while the serum IL-10 content increased in the EA preconditioning group 12 h after reperfusion (both<0.05). Compared with the model group, the serum TNF-α, IL-10 contents reduced in the EA preconditioning group 24 h after reperfusion (both<0.05).</p><p><b>CONCLUSION</b>EA preconditioning can improve neurological deficit, reduce cerebral infarct volume after cerebral ischemia-reperfusion injury in rats. The mechanism may be related to the regulation of EA on the dynamic balance between pro-inflammatory cytokine TNF-α and anti-inflammatory cytokine IL-10 in peripheral blood of cerebral ischemia-reperfusion injury in acute phase, thus alleviate acute cerebral ischemia-reperfusion inflammatory response.</p>

BRAF-V600E mutation in pediatric patients with Langerhans cell histiocytosis and ts clinical features / 实用医学杂志

Objective To investigate the BRAF-V600E mutation in pediatric patients with Langerhans cell histiocytosis and its clinical features. Methods A retrospective study was conducted among 27 children who were diagnosed in our hospital between August 2009 and June 2015 ,including 17 males and 10 females. BRAF-V600E was amplified from tissue samples of the 27 children with LCH by PCR and the relationship was analysed between the mutation and clinical features ,outcome. Results BRAF-V600E mutation was found in 9 cases within all 27 tested cases(33.3%). Significant difference was not found in age ,gender ,system involvement ,6-week reaction ,3-year overall survival and event-free survival between BRAF-V600E positive and negative groups. Conclusions BRAF-V600E mutation was found in Chinese pediatric LCH patients with positive rate of 33.3%, that indicates LCH might be a neoplastic disease. However ,its definite role on disease onset ,system involvement and disease progression remains unknown.

Evaluation and application of estimation of glomerular filtration rate based on serum creatinine and cystatin C in renal function staging / 中华流行病学杂志

Objective To evaluate the accordance of chronic kidney disease (CKD) staging between the CKD-EPI2009 equation, the CKD-EPI2012 equation and the modification of diet in renal disease (MDRD) equation and compare the predictive value of common cardiovascular disease. Methods A total of 11151 adults from Jurong area, Jiangsu province, were surveyed from September to November in 2015 and their serum creatinine and cystatin C were detected. The glomerular filtration rate (GFR) was estimated by three equations. Results In the individuals with history of chronic renal insufficiency, the results of CKD staging of CKD-EPI2009 equation and CKD-EPI2012 equation were all consistent with that of MDRD equation (P<0.001), and the consistence between CKD-EPI2012 equation and CKD-EPI2009 equation was even higher. In the people without history of CKD, the results of CKD staging of CKD-EPI2009 equation and CKD-EPI2012 equation were also highly consistent with the results of MDRD equation (P<0.001) and Ka ppa values were 0.662 and 0.654 respectively whilst the results of CKD staging estimated by CKD-EPI2012 equation and MDRD equation were only moderately consistent (Ka ppa=0.436, P<0.001). In the whole observational population, the CKD staging results of MDRD equation, CKD-EPI2009 equation and CKD-EPI2012 equation had a good consistency evaluated by Band-Altman method. The consistency of CKD staging between CKD-EPI (2009, 2012) equation and MDRD equation was higher in ≥70 years old group than that in<70 years old group as well as in males than in females. For predicting hypertension, the AUCs of CKD-EPI equations calculated GFRs were significantly higher than that of MDRD equation;the AUCs of CKD-EPI2012 equation calculated GFR for predicting stroke and coronary heart disease were higher than that of MDRD equations whereas no significant difference in GFR prediction result was found between CKD-EPI2009 equation and MDRD equation. Conclusion MDRD equation and CKD-EPI equation for GFR estimation have high consistency in CKD staging whilst the predictive value of chronic cardiovascular disease by CKD-EPI equation estimated GFR was higher than that of MDRD equation.

Surgical treatment and prognostic analysis for 57 patients with gastrointestinal lymphoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore clinicopathologic characteristics, surgical features and prognostic factors in patients with primary gastrointestinal lymphoma(PGIL) in order to provide evidence for optimizing surgical treatment.</p><p><b>METHODS</b>Clinicopathological data of 57 PGIL patients undergoing abdominal surgery in Sun Yat-sen University Cancer Center between October 1990 and January 2015 were retrospectively collected. The survival rates were compared among patients with different clinicopathologic characteristics by Kaplan-Meier method, while Cox regression model was employed to analyze the prognostic factors.</p><p><b>RESULTS</b>Among 57 patients, 43 were male and 14 were female, with a median age of 48 (range 16 to 80) years. Seventeen (29.8%) cases were classified as Musshoff I( stage, 19 (33.3%) cases as II( stage, 9 (15.8%) cases as III( stage, and 12(21.1%) cases as IIII( stage. Forty-four (77.2%) cases underwent selective operation, 13(22.8%) cases underwent emergent operation due to acute abdomen. Thirty-two(56.1%) cases had radical resection, 18 (31.6%) cases had partial resection and the rest 7(12.3%) cases failed to perform resection. Four (7.0%) cases received simple surgical operation, and 53 (93.0%) cases received comprehensive treatment, including 5(8.8%) cases with preoperative chemotherapy and surgery, 40 (70.2%) cases with surgery and postoperative chemotherapy, and 8 (14.0%) cases with surgery and perioperative chemotherapy. Stage III( and IIII( accounted for 76.9%(10/13) in patients undergoing emergent operation and accounted for 25.0%(11/44) in patients undergoing selective operation, whose difference was statistically significant (χ=9.503, P=0.002). Univariate prognostic analysis showed that T lymphocyte source pathological cell phenotype (P=0.000), clinical Musshoff stage III( and IIII((P=0.001), emergent operation (P=0.000) and incomplete tumor resection(P=0.007) had worse 5-year overall survival. Multivariate Cox regression analysis indicated that tumor pathological cell phenotype (HR=13.75, 95%CI:3.546-53.308, P=0.000) and surgical timing (HR=7.497, 95%CI:1.163-48.313, P=0.034) were independent prognostic risk factors of patients with stage I( and II(.</p><p><b>CONCLUSIONS</b>Surgical operation is an important part of comprehensive treatment for PGIL. T lymphocyte source and ulcerative lymphoma indicates poorer prognosis.</p>

Effects of Acupuncture-rehabilitation Therapy on Neurological Function and Expression of Vascular Endothelial Growth Factor Receptors, Flt-1 and Flk-1, after Focal Cerebral Ischemia in Rats / 中国康复理论与实践

Objective To explore the effect of acupuncture-rehabilitation therapy on neurological function and expression of Flt-1 and Flk-1, members of vascular endothelial growth factor receptors, after permanent focal cerebral ischemia in rats. Methods Ninety male Sprague-Dawley rats were divided into five groups, namely sham group, model group, acupuncture group, rehabilitation group and acupunc-ture-rehabilitation group, and each group was further divided into 3-day, 7-day and 14-day subgroups, equally. Their middle cerebral arteries were occluded except those of sham group. The sham and model groups accepted no treatment, while the acupuncture group accepted clus-ter needling of scalp acupuncture, the rehabilitation group accepted treadmill training, and the acupuncture-rehabilitation group accepted both acupuncture and treadmill training. They were assessed with modified Neurologic Severity Score (mNSS) 3, 7 and 14 days after model-ing, while the expression of Flt-1 and Flk-1 were determined with Western blotting. Results The mNSS score reduced in all the treatment groups (P<0.05) compared with that of the model group at every time point, and was the least in the acupuncture-rehabilitation group (P<0.05) 7 and 14 days after modeling among the treatment groups. Meanwhile, the expression of Flt-1 and Flk-1 protein increased in all the treatment groups (P<0.05), and was the most in the acupuncture-rehabilitation group (P<0.05). Conclusion Acupuncture-rehabilitation thera-py can promote the neurological function recovery in rat with permanent focal cerebral ischemia, which may be associated with the continu-ous inducement of Flt-1, Flk-1 protein expression in ischemic penumbra cortex.