The incidence and clinical characteristics of impulse control disorders in patients with prolactinoma receiving dopamine agonist / 中华内分泌代谢杂志

Objective:To understand the incidence and clinical characteristics of dopamine agonist(DA) therapy-related impulse control disorders(ICDs) in prolactinoma patients.Methods:Outpatients diagnosed with prolactinoma from the Department of Endocrinology in Huashan Hospital from December 2019 to June 2020 were consecutively included and clinical data were collected. Impulse control disorders were screened with Questionnaire for Impulsive-Compulsive Disorders in Parkinson′s Disease(QUIP). Barratt Impulsiveness Scale 11(BIS-11) was used to evaluate personality construct of impulsiveness from three sub-factors . Health related quality of life was evaluated by the MOS 36-Item Short Form Health Survey(SF-36).Results:Among the 111 cases included, 40 were male and 53 were female, with an average age of(34.74±9.05) years and an average disease duration of(66.69±50.70) months. The initial prolactin level was 147.25(89.97, 470) ng/mL and the percentage of macroadenoma was 46.8%. Ninety cases received DA while 21 cases didn′t. According to the QUIP, any ICD was screened positive in 22 cases(24.7%) in the DA group and 3 cases(14.3%) in the untreated group. The attention impulsiveness scores of BIS-11 in the DA group were higher than the untreated group(23.32±3.67 vs 21.71±2.55, P=0.022). Among the ICDs positive cases in the DA group, the most common disorders were pathological gambling(40.6%) and hypersexuality(40.6%). Compared with the negative group, the non-planning impulsiveness scores of BIS-11 in the positive group were higher, while the scores of social function(69.32±24.62 vs 83.08±17.11, P=0.021), role emotional(50.00±45.72 vs 71.10±40.68, P=0.043) and mental health(55.27±22.75 vs 64.59±17.53, P=0.048) in SF-36 scale were lower in the positive group. Besides, the percentage of male(68.2% vs 38.2%, P=0.014) and initial prolactin level[470.00(130.00, 3 770.00) vs 140.29(79.50, 465.59) ng/mL, P=0.028] in the positive group were higher. Male was an independent risk factor of the presence of ICDs( OR=3.46, 95% CI 1.24-9.61, P=0.017). No significant difference was found in the type of drugs, duration, maximal or cumulative dose of treatment with DA between the two groups. Conclusion:Impulse control disorders may occur in prolactinoma patients receiving DA treatment and affect the quality of life. Endocrinologists should screen impulse control disorders in this patient set.

Effect of High Suspension and Low Incision Surgery Based on Traditional Ligation of Chinese Medicine in Treatment of Mixed Haemorrhoids: A Multi-centre, Randomized, Single-Blind, Non-inferiority Clinical Trial / 中国结合医学杂志

OBJECTIVE@#To observe the clinical effect of high suspension and low incision (HSLI) surgery on mixed haemorrhoids, compared with Milligan-Morgan haemorrhoidectomy.@*METHODS@#A multi-centre, randomized, single-blind, non-inferiority clinical trial was performed. Participants with mixed haemorrhoids from Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing Rectum Hospital, Air Force Medical Center of People's Liberation Army of China, and Puyang Hospital of Traditional Chinese Medicine were enrolled from September 2016 to March 2018. By using a blocked randomization scheme, participants were assigned to two groups. The experimental group was treated with HSLI, while the control group was treated with Milligan-Morgan haemorrhoidectomy. The primary outcome was the clinical effect evaluated at 12 weeks after operation. The secondary outcomes included the number of haemorrhoids treated during the operation, pain scores, use of analgesics, postoperative oedema, wound healing, incidence of anal stenosis, anorectal manometry after operation, as well as surgical duration, length of stay and total hospitalization expenses. A safety evaluation was also conducted.@*RESULTS@#In total, 246 eligible participants were enrolled, with 123 cases in each group. There was no significant difference in the clinical effect between the two groups (100.00% vs. 99.19%, P>0.05). Compared with the control group, the number of external haemorrhoids treated during the operation and the pain scores after operation were significantly reduced in the experimental group (P0.05). The surgical duration and length of stay in the experimental group were significantly longer than those in the control group, and the total hospitalization expense was significantly higher than that in the control group (all P<0.05). No adverse events were reported in either group during the whole trial or follow-up period.@*CONCLUSION@#HSLI had the advantages of preserving the skin of anal canal completely, alleviating postsurgical pain and promoting rapid recovery after operation. (Registration No. ChiCTR1900022883).

Progress in understanding hepatic fibrosis and renal fibrosis based on the gut-liver-kidney axis / 药学学报

Fibrosis is a pathological process of abnormal hyperplasia and excessive deposition of extracellular matrix during the process of repair after tissue and organ damage. Injury/inflammation caused by variously chronic diseases is a major trigger for fibrogenesis. Fibrosis of the liver and kidney is a common organ fibrosis. Recently, the intestinal microbiota has been shown to be extensively involved in the development of liver and kidney diseases, which may follow from changes in the intestinal microbial composition and intestinal integrity. This promotes the development of liver and/or kidney fibrosis through endocrine, cell signaling and other pathways. This paper reviews the research progress in understanding liver fibrosis and kidney fibrosis based on the gut-liver-kidney axis, which may be helpful for providing new strategies and theoretical basis for the diagnosis and treatment of hepatic and renal fibrosis.

Ziprasidone Injection for Agitation in Schizophrenic Patients：A Meta-Regression Analysis / 中山大学学报(医学科学版)

@#【Objective】To evaluate the efficacy of ziprasidone injection and the related influencing factors for treating agitation in schizophrenic patients based on published literature in English or Chinese. 【Methods】We searched PubMed， EMBASE， Web of Knowledge， Cochrane Library， Wanfang data， Chinese Journal Full- Text Database（CJFD），Chinese Biomedical Literature Database（CBMdisc）and VIP Chinese Technology Periodical Database（VIP）. The Consolidated Standards of Reporting Trials（CONSORT）statement was used as a criterion for screening and assessing the literature. Meta-analysis and meta-regression were conducted by using STATA. With the effect size as the dependent variable and sex，age，baseline PANSS scale total score and oral antipsychotics as the covariates ，the meta- regression model was analyzed. 【Results】The Grades of Recommendation ，Assessment ，Development and Evaluation（GRADE） approach was employed to rate the overall quality of evidence. A total of 14 studies（5 in English and 9 in Chinese）were included in meta analysis and meta regression. The samples were ，respectively，1 197 and 1 149 at baseline and after treatment. Random effect Meta analysis showed that ziprasidone injection had significant efficacy in the treatment of agitation symptoms［SMD=2.04，95%CI（1.47，2.61），P = 0.000］. Meta regression revealed that the efficacy was related to baseline PANSS scores（t = 5.57 ，P = 0.011）and oral antipsychotics（t = 4.07 ，P = 0.027），but irrelevant to age（t = 0.74，P = 0.539）and language published（t = -0.57，P = 0.625）. The efficacy was better in female patients than that in male patients （t = -2.95 ，P = 0.060）. 【Conclusion】 Ziprasidone injection has significant efficacy in schizophrenia patients with agitation symptoms and the efficacy may be enhanced in those patients with higher baseline PANSS score and added with oral antipsychotics.

Molecular characteristics of Acinetobacter baumannii and the changes of efflux pump expression under tigecycline pressure / 医学研究生学报

Objective　Acinetobacter baumannii (A. baumannii) is a commonly infective bacterium in the hospital. This study aims to analyze its molecular epidemiological characteristics, detect the carrying rate of efflux pump and regulatory protein genes, and investigate the effects of tigecycline on the efflux pump and expression of regulatory protein genes.　Methods　A total of 183 A. baumannii strains were collected from inpatients of the affiliated hospital of Jiangsu University from May 2017 to March 2019. They were divided into an antimicrobial-resistant group (one or more antimicrobial-resistant strains, 139 strains) and a sensitive group (the drugs in the drug sensitivity test were all non-resistant strains, 44 strains). Repeated sequence PCR was used for homology analysis of the strains, and pulse-field gel electrophoresis (PFGE) was used as the gold standard for homology analysis to verify and compare some strains. PCR was used to detect the occurrence of drug resistance-related genes. Based on homology analysis, efflux pump carrying rate detection and antibiotics sensitivity test results, 6 clinical strains carrying all efflux pump genes but different resistance phenotypes were selected as experimental strains, including sensitive strains (SAB), the multidrug resistance strain (MDRAB) and the extensively drug-resistant strain (XDRAB). All strains were induced in vitro with the minimum inhibitory concentration (MIC) of tigecycline. The induced strains were categorized as induction group, and the same strains cultured in LB agar without tigecycline was used as a control group. MIC was used to analyze the tigecycline susceptibility, and RT-qPCR was used to detect the gene expression of efflux pumps, such as TetB, AbaQ and regulatory proteins (AdeS and BaeS), in drug-resistant strains.　Results　Homology analysis showed that there were 45 clonal groups in the detected clinical isolates, with no obvious outbreak of epidemic clonal groups. Efflux pumps and regulatory proteins were widely distributed in the clinical isolates, and the expression of AdeB, TetB, AbeS, AdeS in MDRAB and XDRAB is significantly higher than that insensitive group SAB. Continuous in vitro induction with tigecycline could increase the antimicrobial resistance of some clinical strains and even significantly increase the expression levels of efflux pumps and regulatory proteins.　Conclusion　A. baumannii is widely distributed in the clinic, and efflux pumps and regulatory proteins might play an important role in drug resistance process. The unreasonable use of tigecycline could enhance the tolerance of A. baumannii by up-regulating the expression of some bacterial efflux pumps.

Electroconvulsive treatment for geriatric depression: a systematic review of randomized clinical trials / 上海交通大学学报（医学版）

Objective: To explore the clinical effectiveness and safety of electroconvulsive therapy (ECT) in elderly patients with depression. Methods: Searches were made in PubMed, EMBase, Web of Knowledge, CNKI, Wanfang, VIP, CBMDisc databases and etc. CONSORT (Consolidated Standards of Reporting Trials) statement were used to assess the methodological quality of the studies. RevMan and STATA were used to do meta analysis. Results: Ten studies were included in this systematic review. The studies which used Hamilton depression rating scale (HAMD, n=5) and MontgomeryÅsberg depression rating scale (MADRS, n=3) to access depressed symptom were analyzed. Sample size was 306 and 290 before and after treatment, respectively. The depressive symptoms were significantly improved after ECT treatment estimated by either HAMD (Z=6.39, SMD=3.64, P=0.000) or MADRS (Z=15.47, SMD=2.12, P=0.000). There was no difference of Mini-mental State Examination (MMSE) scores before and after the treatment (Z=1.47, P=0.140). The incidence of adverse events of headache, confusion, drowsiness, nausea and vomiting was more than 5%. Conclusion: Depressed symptoms are significantly improved in geriatric depression after ECT. The overall cognitive impairment is not obvious, but headache and disturbance of consciousness are common.

Case-control study on a new Kirschner wire tension band with hole in the treatment of adult olecranon fractures in adults / 中国骨伤

<p><b>OBJECTIVE</b>To compare the efficacy of Kirschner wire tension band with hole and common Kirschner wire tension band in the treatment of olecranon fractures in adults, so as to guide the selection of clinical surgical procedures.</p><p><b>METHODS</b>From July 2011 to October 2015, a total of 49 patients with olecranon fractures underwent open reduction and fixation with Kirschner wire tension band, which were retrospectively analyzed. Of the 49 patients, 21 patients(group A) were treated with Kirschner wire tension band with hole, including 12 males and 9 females, with an average age of(37.6 ±8.2) years old;28 patients(group B) were treated with common Kirschner wire, including 18 males and 10 females, with an average age of(38.9±7.3) years old. There were no statistically significant differences between the two groups in general data. The differences of operative duration, frequency of radiation, fracture healing time, complications and postoperative elbow function scores between the two groups were observed and analyzed by parallel statistical analysis.</p><p><b>RESULTS</b>In group A, the operative duration was(60.4±10.7) min, the average number of radiation times was (12.5±2.9); in group B, the operative duration was (62.3±11.8) min, and the average radiation times was(13.7±3.8); there was no significant difference in operative time and radiation times between the two groups (P >0.05). In group A, the fracture healing time was (13.2±2.6) weeks without K-wire migration, skin irritation and other complications; and fracture healing time in group B was(14.6±1.8) weeks with complications(K-wire migration in 6 cases, skin irritation in 7 cases, internal fixation failure in 2 cases);the fracture healing time of group A was shorter than that in group B. Evaluation of elbow joint function in two groups of patients after operation showed that in group A, pain score was 41.0±3.5, movement function score was 18.0±2.1, stability score was 9.0±0.8, daily activities score was 18.0±4.3, the total average score was 87.0±7.8; and in group B, the pain score was 39.0±5.6, movement function score was 17.0±3.2, the stability score was 8.0±2.4, daily activities score was 16.0±5.2, the total average score was 83.0±10.7. There were no statistically significant in the scores between the two groups.</p><p><b>CONCLUSIONS</b>Compared with ordinary Kirschner wire, the treatment of olecranon fracture with Kirschner tension band with hole can shorten the time of fracture healing, significantly reduce the occurrence of complications, and do not affect the recovery of postoperative function, which is suitable for clinical use.</p>

Electroconvulsive treatment for geriatric depression: a systematic review of randomized clinical trials / 上海交通大学学报（医学版）

Objective·To explore the clinical effectiveness and safety of electroconvulsive therapy (ECT) in elderly patients with depression.Methods·Searches were made in PubMed,EMBase,Web of Knowledge,CNKI,Wanfang,VIE CBMDisc databases and etc.CONSORT (Consolidated Standards of Reporting Trials) statement were used to assess the methodological quality of the studies.RevMan and STATA were used to do meta analysis.Results·Ten studies were included in this systematic review.The studies which used Hamilton depression rating scale (HAMD,n=5) and Montgomery-(A)sberg depression rating scale (MADRS,n=3) to access depressed symptom were analyzed.Sample size was 306 and 290 before and after treatment,respectively.The depressive symptoms were significantly improved after ECT treatment estimated by either HAMD (Z=6.39,SMD=3.64,P=0.000) or MADRS (Z=15.47,SMD=2.12,P=0.000).There was no difference of Mini-mental State Examination (MMSE) scores before and after the treatment (Z=1.47,P=0.140).The incidence of adverse events of headache,confusion,drowsiness,nausea and vomiting was more than 5％.Conclusion·Depressed symptoms are significantly improved in geriatric depression after ECT.The overall cognitive impairment is not obvious,but headache and disturbance of consciousness are common.

Clinical value of central lymph node dissection and intraoperative frozen-section examination in the treatment of papillary thyroid microcarcinoma / 上海交通大学学报（医学版）

Objective·To evaluate central lymph node dissection (CLND) and intraoperative frozen-section examination in the treatment of papillary thyroid microcarcinoma (PTMC).Methods· Clinical data and neck lymph node metastasis of 187 PTMC patients treated by the same surgeon from October 2012 to November 2015 in Department of Endocrine Breast Surgery,First Affiliated Hospital of Chongqing Medical University were analyzed retrospectively.Results · Postoperative pathology inspection confirmed that 94 of the 187 patients were accompanied with lymph node metastasis in central region,and the metastasis rate was 50.2％.Furthermore,lymph node metastasis rate in central region was not associated with gender and age (P＞0.05),but the metastasis rates of the patients with multifocal lesion,tumor diameter greater than 5 mm,capsular invasion,or tumor location in the lower third of thyroid lobe were higher (P＜0.05).Twenty-two cases of the 69 patients who underwent CLND were confirmed to have lymph node metastasis in this region.When the number of lymph node metastases in the central region was greater than or equal to 2,the cases were accompanied by increased risk of lymph node metastasis in the cervical region (P＜0.05).The diagnosis level of lymph node metastasis in central region by intraoperative frozen-section examination was relatively higher than current cervical lymph node-negative (cN0) standard (P＜0.05),which had lower false negative rate (20.2％) than current cN0 standard (88.8％) and was highly consistent with the postoperative pathology in central lymph node metastasis diagnosis (K=0.765,P=0.000).Conclusion· PTMC has high lymph node metastasis rate in the central region.Regular CLND is recommended.Intraoperative frozen-section examination can accurately evaluate cervical lymph node metastasis to help guide operation scope of thyroid and cervical lymph nodes.

Stenting of the Portal Vein Combined with Different Numbers of Iodine-125 Seed Strands: Dosimetric Analyses / 中华医学杂志(英文版)

<p><b>Background:</b>Portal-vein stent combined with one iodine-125 (I) seed strand has become a new treatment for portal vein tumor thrombosis. However, dosimetric aspects of this irradiation stent have not been reported. Therefore, we aimed to undertake dosimetric analyses comparing portal-vein stents combined with different numbers ofI seed strands.</p><p><b>Methods:</b>A water cylinder was created by a treatment-planning system to simulate a portal-vein stent. The stent was combined with one, two, or threeI seed strands (Groups I, II, and III, respectively). At different prescribed doses (PDs),I seeds of identical activities were loaded on Groups I-III. Conformation number (CN), external volume index, and homogeneity index were calculated. Linear regression analyses were used to evaluate the obtained data.</p><p><b>Results:</b>For identicalI seed activity, when theI seed strand increased from one chain to two, D(dose delivered to 90% of the target volume) increased by ≥184%; when it increased from two chains to three, Dincreased by ≥63%. When the PD was 105 Gy andI seed strands increased from one chain to two, V(percentage of the target volume receiving ≥90% of the PD) increased by 158-249%; when it increased from two chains to three, Vincreased by 7-175%. CN was correlated positively withI seed activity (B = 0.479, P < 0.001) and number ofI seed strands (B = 0.201, P < 0.001) and was independent of PD (B = -0.002, P = 0.078).</p><p><b>Conclusions:</b>A portal-vein stent combined with a singleI seed strand could not meet dosimetry requirements. For a stent combined with twoI seed strands, when the PD was 105 Gy and seed activity was 0.7 mCi, the dose distribution could satisfy dosimetry requirements. For a stent combined with threeI seed strands, if the PD was 105, 125, or 145 Gy, the recommended seed activities were 0.5, 0.5, and 0.6 mCi, respectively.</p>

Establishment and application of a rapid PCR detection method of Brucella spp / 国际检验医学杂志

Objective To establish a polymerase chain reaction (PCR) method for detecting Brucella spp .and to evaluate its ap‐plication .Methods The PCR primer aiming at the outer membrane protein(omp‐2) coding gene were designed and the PCR method for detecting Brucella spp .was established .By using DNA of 19 kinds of common bacteria and Brucella spp .,the specificity and sensitivity were evaluated .Three strains of suspected Brucella spp .were performed the nucleic acid detection .Then ,3 suspected strains of Brucella spp .were amplified by the PCR method with omp‐2 gene ,and the results were compare to the those by the cul‐ture method .Results The established Brucella spp .PCR detection method could only detect the Brucella spp .positive strain ,the control bacterium DNA did not appear the target band ;the sensitivity was 100 copies/response;the PCR method detected omp‐2 gene band in 3 strains of suspected Brucella spp .,which was identified as Brucella spp .and was same to the results by the isolation culture method .Conclusion The established PCR method for detecting Brucella spp .is accurate and rapid compare with the isola‐tion and culture method ,which is suitable for the rapid detection of brucellosis epidemic situation .

Effects of resuscitation with different kinds of colloids on pulmonary edema in swine in shock stage of severe burn injury / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe and compare the effects of natural colloid and artificial colloid on pulmonary edema of swine during shock stage of severe burn injury.</p><p><b>METHODS</b>Twelve Guangxi Bama miniature swine were inflicted with 40% TBSA full-thickness burn on the back, and then they were divided into natural colloid group (N) and artificial colloid group (A) according to the random number table, with six swine in each group. At post injury hour (PIH) 2, fluid resuscitation was begun. The main part of electrolyte was lactic acid Ringer's solution. The colloids included swine plasma and hydroxyethyl starch 130/0.4. Before injury and at every hour within PIH 48, heart rate, blood pressure, urine volume, central venous pressure (CVP), and pulmonary arterial wedge pressure (PAWP) were recorded. The mean heart rate, blood pressure, urine volume per hour per kg of body weight, CVP, PAWP, resuscitation liquid volume, and the ratio of fluid intake to output during the first and second PIH 24 were calculated. At PIH 48, lung tissue was harvested for histopathological observation and calculation of lung water ratio. Data were processed with one-way analysis of variance, analysis of variance of repeated measurement, LSD test and independent sample t test.</p><p><b>RESULTS</b>(1) There were no statistically significant differences between two groups in heart rate, blood pressure, and urine volume before injury and during the first and second PIH 24 (P values all above 0.05); during the first PIH 24, the CVP and PAWP of group A were significantly higher than those of group N (P values all below 0.05). Compared with those before injury, the heart rate, CVP and PAWP of two groups during the first and second PIH 24 were significantly higher (P < 0.05 or P < 0.01); the urine volume of group N was decreased during the first PIH 24 (P < 0.05), while there was no significant change in group A (P > 0.05); the urine volumes of two groups during the second PIH 24 were increased, while no statistically significant differences were observed (P values all above 0.05). There were no statistically significant differences in blood pressure of two groups between the first, second PIH 24 and before injury (P values all above 0.05). (2) There were no statistically significant differences in the resuscitation liquid volume and fluid intake to output ratio between two groups during the first and second PIH 24 (P values all above 0.05). (3) The alveolar septum was found widened in varying degrees, and there were edema fluid accumulating and inflammatory cell infiltrating within the pulmonary interstitial of lung tissue sections in both two groups. (4) The lung water ratio of group N [(71 ± 10)%] was not statistically significant different from that of group A [(79 ± 4)%, t = -1.753, P > 0.05].</p><p><b>CONCLUSIONS</b>The natural colloid or artificial colloid (hydroxyethyl starch 130/0.4) applied during shock stage had similar effects on pulmonary edema in swine with severe burn.</p>

Effect of artificial colloids on blood coagulation during shock stage of severe burn injury / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>There are controversies about the use of artificial colloids. This research was aimed to determine the effect of various artificial colloids on blood coagulation in the shock stage of severe burn injury.</p><p><b>METHODS</b>Totally, 18 female Ba-Ma mini-pigs were subjected to a 40% total body surface third-degree flame burn under anesthesia. Resuscitation therapy was applied 2 hours after the injury, using the burn shock fluid resuscitation formula commonly accepted in the surgical treatment of burns. The Ba-Ma mini-pigs were randomly assigned to three groups (six pigs in each group): succinylated gelatin group (the artificial colloid used was succinylated gelatin Injection), hydroxyethyl starch group (the artificial colloid used was hydroxyethyl starch (130/0.4)), and allogeneic plasma group (the colloid used was allogeneic plasma). Blood samples were collected from the animals prior to the burn injury and again at intervals of 4, 8, 24 and 48 hours post-injury. The platelet count (PLT), prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), and fibrinogen (Fib) were measured, followed by a statistical analysis of all results.</p><p><b>RESULTS</b>The PLT of succinylated gelatin group and hydroxyethyl starch group at intervals of 24 and 48 hours were (124.3 ± 52.7), (78.8 ± 16.4) × 10(9)/L and (159.0 ± 62.8), (87.3 ± 32.0)× 10(9)/L respectively. But in the allogeneic plasma group at intervals of 8, 24, and 48 hours were (234.3 ± 52.6), (136.0 ± 47.4), (75.8 ± 31.0) × 10(9)/L. The decrease were all statistically significant (P < 0.05, P < 0.01) when compared to pre-burn ((383.3 ± 77.9), (382.7 ± 65.7), (381.0 ± 49.4)× 10(9)/L). The PLT among the three groups, at all the time points, had no statistical difference (P > 0.05). Compared to pre-burn ((10.8 ± 0.9), (11.4 ± 0.8), (10.6 ± 0.7) seconds), the PT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were (14.5 ± 1.5) and (16.2 ± 1.3) seconds, whereas in the allogeneic plasma group at 8 and 24 hours the PT were (13.0 ± 0.9) and (14.5 ± 1.5) seconds, i.e., an increase in the statistical significance (P > 0.01). Statistical significance was observed at 8 and 48 hours between the succinylated gelatin group and hydroxyethyl starch group, and at 48 hours between the hydroxyethyl starch and allogeneic plasma group (P < 0.05). The INR at 24 hours were (1.26 ± 0.13) in the succinylated gelatin group, (1.40 ± 0.11) in the hydroxyethyl starch group, and (1.13 ± 0.07) and (1.26 ± 0.13) at 8 and 24 hours in the allogeneic plasma group. When compared with pre-burn ((0.94 ± 0.08), (0.99 ± 0.07), and (0.92 ± 0.06) seconds), the other groups have increased significantly (P > 0.01). The comparison at 8 and 48 hours between the succinylated gelatin group and the hydroxyethyl starch group, at 48 hours between hydroxyethyl starch group and allogeneic plasma group showed statistical difference (P < 0.01). The APTT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were (13.1 ± 1.1) and (14.6 ± 2.9) seconds. The APTT of the allogeneic plasma group at 4, 8 and 24 hours were (10.9 ± 1.4), (11.8 ± 1.1), and (13.7 ± 1.5) seconds. Compared to pre-burn ((11.5 ± 4.2), (11.2 ± 3.3), (10.1 ± 1.4) seconds), they were statistically significant (P < 0.05). There was no statistical difference in the APTT between the three groups, at all the time points. The Fib of the succinylated gelatin group at 24 and 48 hours were (4.3 ± 0.3) and (4.7 ± 0.2) g/L, (4.1 ± 0.3), and (5.0 ± 0.1) g/L in allogeneic plasma group, and at 8, 24, and 48 hours the Fib for the hydroxyethyl starch group was (2.9 ± 0.4), (4.0 ± 0.5), and (4.6 ± 0.6) g/L. Compared to pre-burn ((2.4 ± 0.2), (2.5 ± 0.3), (2.6 ± 0.5) g/L), they were all statistically significant (P < 0.01). There was no statistical difference in APTT between the three groups, at all time points.</p><p><b>CONCLUSION</b>The changes of the indices in blood coagulation during the shock phase of a severe burn injury correlate with the stress response to the burn, rather than to the application of HES (130/0.4) and succinylated gelatin.</p>

Application of ¹H-NMR-based pattern recognition in serum metabolomics of patients with chronic heart failure / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the feasibility of applying (1)H-NMR-based pattern recognition in the studies of serum metabonomics in chronic heart failure (HF).</p><p><b>METHODS</b>(1)H-NMR technique was applied for examination of the serum samples from 9 patients with chronic heart failure and 6 healthy individuals. The data were analyzed for pattern recognition through principal component analysis (PCA) and Orthogonal Partial Least Square (OPLS) to determine the differences in serum metabolites between the two groups. The recognition ability of the two analysis methods were compared.</p><p><b>RESULTS</b>The serum (1)H-NMR spectra of heart failure patients and healthy individuals were significantly different. The PCA method failed to distinguish the patterns between the two groups, but OPLS clearly differentiated the two groups.</p><p><b>CONCLUSIONS</b>(1)H-NMR technique is effective in the study of serum metabolomics in chronic heart failure. The serum metabonomics of patients with chronic heart failure and the healthy individuals are significantly different. OPLS pattern recognition method is superior to PCA method in that the former can remove the influence of non-experimental factors and provide an improved characterization.</p>

Comparison among several foam dressings in the properties of water-absorption, water-locking and air permeability / 中华烧伤杂志

<p><b>OBJECTIVE</b>To compare the properties of water-absorption, water-locking, and air permeability among several foam dressings, and to provide references for clinician in choosing dressings for different types of wounds.</p><p><b>METHODS</b>The comparison was made among Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing that were commonly used in clinic. NaCl and CaCl2·H2O respectively in the weight of 8.3 g and 0.367 g were diluted with distilled water to the volume of 1 L to simulate wound exudation. The simulated wound exudation was used to test the water-absorbing rate of dressings at post immersion hour (PIH) 24, water-absorbing speed of dressings at post immersion minute (PIM) 1, 5, 10, and 20, the diffusion diameter of exudation dripped on the surface of dressings for 5 min to reflect the water-locking capacity of dressings, and the water evaporation capacity of exudation after being sealed up by dressings for 24 h to reflect the air permeability of dressings. Five samples of each dressing were used for each index. Data were processed with one-way analysis of variance and analysis of variance of repeated measurement, and LSD method was applied in paired comparison.</p><p><b>RESULTS</b>(1) The water-absorbing rate at PIH 24 of Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing were respectively (646 ± 18)%, (616 ± 19)%, and (499 ± 11)% (F = 423.854, P < 0.01). The differences between each two dressings in water-absorbing rate were statistically significant (with P values all below 0.01). (2) The water-absorbing speed of Allevyn foam dressing at PIM 1, 5, 10, and 20 were (35.20 ± 2.31), (12.48 ± 0.37), (6.63 ± 0.23), and (3.39 ± 0.08) g×s(-1)×m(-2), which were obviously lower than those of Mepilex foam dressing [(119.68 ± 2.59), (24.39 ± 0.62), (12.33 ± 0.29), and (6.18 ± 0.13) g×s(-1)×m(-2)] and Biatain foam dressing [(121.09 ± 3.41), (24.73 ± 0.52), (12.37 ± 0.25), (6.18 ± 0.13) g×s(-1)×m(-2)], with P values all below 0.01. The water-absorbing speed of each dressing showed the trend of declination among three dressings with prolongation of time. The differences between two adjacent time points within each dressing in water-absorbing speed were statistically significant (with P values below 0.01). (3) Diffusion diameters of exudation dripped on the surface of Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing were respectively (5.66 ± 0.15), (4.84 ± 0.15), (3.94 ± 0.21) cm (F = 124.742, P < 0.01). The differences between each two of the three dressings in diffusion diameter were statistically significant (with P values all below 0.01). (4) The water evaporation capacity of exudation after being sealed up by each dressing for 24 h decreased in succession for Allevyn foam dressing, Mepilex foam dressing, and Biatain foam dressing, which were respectively (31.2 ± 3.1), (29.7 ± 8.7), (5.6 ± 2.8) g×h(-1)×m(-2) (F = 24.324, P < 0.01). The water evaporation capacity of exudation sealed with Biatain foam dressing was significantly lower than that of exudation sealed with Allevyn foam dressing and Mepilex foam dressing (with P values below 0.01).</p><p><b>CONCLUSIONS</b>Among the three kinds of foam dressings, Allevyn performs best in water-absorbing rate, water-locking capacity, and air permeability, while Mepilex and Biatain perform best in water-absorbing speed. For selecting foam dressing in clinic, the properties of foam dressings and wound characteristics should be considered at the same time.</p>

The effect of antipsychotics on reduced oscillatory gamma-band responses in schizophrenic patients / 中华行为医学与脑科学杂志

ObjectiveTo explore gamma resonance signals in acute medication-free schizophrenics,and the effects of antipsychotics on gamma activity.MethodsSchizophrenia patients( n=56) and normal controls ( n =18 ) underwent auditory steady-state event-related potential testing and were evaluated of their psychopathic syndromes with the positive and negative syndrome scale (PANSS) before and after 8 weeks of medication with oral chlorpromazine or clozapine.Click trains varying in rate of stimulation 40 Hz were presented; EEG-evoked power and intertrial phase synchronization were obtained in response to stimulation frequency.ResultsSchizophrenic patients showed reduced evoked power( Fz:( 5.08 ± 1.48) μV2 vs (6.91 ± 1.64) μV2 ; Cz:(4.70 ± 2.03 ) μV2 vs ( 6.93 ± 1.43 ) μV2 ; P ＜ 0.01 ) and a tendency of reduction in phase synchronization ( Fz:0.14 ± 0.04 vs 0.13 ± 0.04,P =0.051 ; Cz:0.18 ± 0.06 vs 0.17 ± 0.06,P =0.056) in response to 40 Hz stimulation.However significant correlations were not observed between oscillatory responses and clinical parameters in schizophrenic patients.There were no significant differences of gamma power and ITC in patients before and after chlorpromazine or clozapine administered.ConclusionSchizophrenia patients have deficits in the power and coherent of gamma oscillations,and can not be normalized by medication with antipsychotics.

Vascular endothelial growth factor C as a predictor of early recurrence and poor prognosis of resected stage I non-small cell lung cancer

<p><b>INTRODUCTION</b>Stage I non-small cell lung cancer (NSCLC) is potentially curable after completely resection, but early recurrence may infl uence prognosis. This study hypothesises that vascular endothelial growth factor C (VEGF-C) plays a key role in predicting early recurrence and poor survival of patients with stage I NSCLC.</p><p><b>MATERIALS AND METHODS</b>The expression of VEGF-C was immuno-histochemically (IHC) analysed in tumour samples of primary stage I NSCLC and correlated to early recurrence (< 36 months), disease-free survival, and overall survival in all 49 patients.</p><p><b>RESULTS</b>Early recurrence was identifi ed in 16 patients (33%), and the early recurrence rate in strong and weak VEGF-C activity was significantly different (P = 0.016). VEGF-C was also an independent risk factor in predicting early recurrence (HR = 3.98, P = 0.02). Patients with strong VEGF-C staining also had poor 3-year disease-free survival (P = 0.008) and overall survival (P = 0.007).</p><p><b>CONCLUSION</b>Strong VEGF-C IHC staining could be a biomarker for predicting early recurrence and poor prognosis of resected stage I NSCLC, if the results of the present study are confirmed in a larger study. A more aggressive adjuvant therapy should be used in this group of patients.</p>

Comparison of eight equations for estimating glomerular filtration rate in patients with cardiovascular diseases / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the diagnostic value of 8 equations using different variables for determining the estimated glomerular filtration rate (eGFR) in patients with cardiovascular diseases.</p><p><b>METHODS</b>GFR was estimated in 208 patients with cardiovascular diseases by (99m)Tc-DTPA dynamic renal imaging, and the eGFR was derived from 8 equations using different variables.</p><p><b>RESULTS</b>In patients with chronic kidney disease (CKD) stages 1-3, the eGFR calculated suing serum creatinine (SCr)-based equation was better correlated to GFR estimated by (99m)Tc-DTPA renal imaging than that derived from cystatin C (Cys C)-based equations, whereas in patients with CKD stages 4 and 5, the estimates by the latter equation showed a better correlation to GFR. Compared with (99m)Tc-DTPA renal imaging, MDRD-based equation and simple MDRD equation resulted in a higher eGFR in patients with CKD stages 4 and 5, the Rule equation had a lower eGFR in CKD stages 1 and 2, the Macisaac equation yielded a higher eGFR in CKD stages 2-5, and the Tan equation showed a higher eGFR in CKD stages 2 and 3. In patients with mild renal dysfunction, the Scr-based equation had a higher AUC(ROC) than Cys C-based equation, which was reversed in patients with severe renal dysfunction; the AUC(ROC) of the two equations were comparable in patients with moderate renal dysfunction. Compared with (99m)Tc-DTPA renal imaging, the modified MDRD equation and Arnal-Dade equation showed no significant difference in the eGFR in patients with CKD stages 1-5.</p><p><b>CONCLUSION</b>Modified MDRD equation (or simple MDRD equation) and Arnal-Dade equation are superior to other calculation methods for estimating the GFR in Chinese patients with cardiovascular disease.</p>

Effect of obstructive sleep apnea syndrome on serum C-reactive protein level, left atrial size and premature atrial contraction / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the changes of serum C-reactive protein (CRP) level, left atrial size and atrial premature contraction (PAC) in patients with obstructive sleep apnea syndrome (OSAS).</p><p><b>METHODS</b>This study involved 277 patients with OSAS diagnosed after an overnight polysomnography, who underwent a 24-h Holter electrocardiography and ambulatory blood pressure monitoring for detection of PAC. According to the apnea-hypopnea index (AHI), 137 patients with PAC identified from these patients were classified into 3 groups, namely the mild (5≥AHI<15), moderate (15≥AHI<30) and severe (AHI≥30) groups. Serum CRP level was assessed by a high-sensitivity radio-immunoassay. The left atrial diameter and echocardiographic parameters were recorded by transthoracic Doppler echocardiography (TTE).</p><p><b>RESULTS</b>We found a high prevalence of PAC in these OSAS patients (137/277, 49.4%). Serum CRP was significantly higher in severe OSAS group (5.01∓4.68 mg/L) than in the moderate (3.03∓1.94 mg/L) and mild OSAS (2.98∓1.82 mg/L) groups (P=0.040 and 0.033, respectively). The left atrial diameter was significantly increased in severe OSAS group (40.1∓7.9 mm) as compared to that in moderate (37.9∓5.5 mm) and mild (33.7 ∓ 3.8 mm) groups (P=0.025 and 0.002, respectively). The severity of OSAS was positively correlated to both CRP (r=0.304, P=0.034) and left atrial diameter (r=0.411, P=0.003). After adjusting for gender, age and body mass index (BMI), a strong correlation was found between the left atrial diameter and CRP (r=0.594, P=0.0005).</p><p><b>CONCLUSION</b>There is a high prevalence of PAC in OSAS patients. The progression of OSAS is associated with increased serum CRP level and left atrial size in patients with premature atrial complexes. Our study suggests that inflammation associated with OSAS might contribute to atrial structural and electrical remodeling in OSAS patients with PAC.</p>

Expression of TLR8 in human cervical cancer HeLa cells and the effect of TLR8 agonist on the cell proliferation and apoptosis / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To observe the expression of Toll-like receptor 8 (TLR8) in human cervical cancer cell-line HeLa cells, and the effects of TLR8 agonist CL075 on the survival and proliferation of HeLa cells.</p><p><b>METHODS</b>PCR and RT-PCR were used to detect the expression of TLR8 in 13 cancer cell lines, and the expression of COX-2, Bcl-2, VEGF mRNA in the HeLa cells stimulated by TLR8 agonist CL075 were also measured by RT-PCR. Immunofluorescence technique was used to determine the exact location of TLR8 in the cells. The percentage of viable cells was determined by trypan blue exclusion after the HeLa cells were stimulated with TLR8 agonist CL075 (0.1 µg/ml, 0.5 µg/ml, 1.0 µg/ml, 2.5 µg/ml), and cell cycle and apoptosis were analyzed by flow cytometry, and the proliferation was measured by MTT.</p><p><b>RESULTS</b>Compared with the other cancer cell lines, the expression of TLR8 in HeLa cells was the highest (703.7 ± 20.6). After stimulation by CL075, the cells had a remarkable increase of the percentage of cells in G(2)/M + S phases. In the control group, the percentage of cells in G(2)/M +S phases was (39.02 ± 2.33)%, whereas after stimulated with 1.0 µg/ml CL075, the percentage of cells in G(2)/M + S phases reached the highest ratio (57.67 ± 1.73)%, and the percentage of cells in G(2)/M + S phases had a less decrease after 2.5 µg/ml CL075 stimulation and the percentage was (56.14 ± 3.73)%. After the CL075 treatment, there was no significant changes of apoptosis compared with that of the control cells (P > 0.05), but after DDP treatment the apoptosis had a significant change (P < 0.01). After stimulation by 1.0 µg/ml CL075 for 24 h, no significant difference (P > 0.05) was found by MTT test, but a significant difference was found at 48 h and 72 h (P < 0.01). An increased expression of COX-2, Bcl-2 and VEGF mRNA was observed in HeLa cells after stimulation by TLR8 agonist CL075 for 24 h and 48 h (P < 0.05).</p><p><b>CONCLUSIONS</b>Expression of TLR8 is significantly increased in HeLa cells. The proportion of cells at different phases has a significant change after CL075 stimulation, which may up-regulate the proliferation of HeLa cells. These data suggested that TLR8 agonist may influence the tumor development and TLR8 may become a potential target in the treatment for cervical cancer.</p>