Animal Model of Cystitis Based on Clinical Characteristics of Traditional Chinese and Western Medicine / 中国实验方剂学杂志

Cystitis， one of the most common diseases in the urinary system， is manifested by urinary frequency， urinary urgency， and bladder pain， which are known as the classic symptom triad of bladder irritation， especially in women. In recent years， with the change of the lifestyle， the prevalence of bladder diseases in China is increasing year by year. According to the characteristics of etiology， pathogenesis， and clinical symptoms of cystitis， this paper listed the clinical diagnostic criteria in traditional Chinese medicine （TCM） and western medicine after consulting the relevant literature. Through the analysis of the existing animal model of cystitis， the fit between the model and clinical manifestations was evaluated， and the advantages and disadvantages were summarized. The models induced by "intraperitoneal injection of cyclophosphamide" and "Freund's complete adjuvant combined with bladder catheterization" were proved highly matched with manifestations despite some shortcomings such as long time and high cost. At present， the diagnostic criteria of cystitis are mainly based on western medicine， and the definitive diagnosis of the relevant types still depends on cystoscopy and tissue biopsy. The lack of TCM syndrome model limits the TCM research. Additionally， four diagnostic methods in TCM cannot be well applied to animal models because of the susceptibility to subjective factors. Behavioral tests can be used to determine the model index and develop the relevant behavior rating scale. Therefore， it is necessary to establish an animal model of cystitis in line with the clinical characteristics of western medicine and TCM syndrome differentiation， so as to better promote the study of cystitis.

Analysis of Pulmonary Fibrosis Animal Models Based on Clinical Characteristics in Traditional Chinese Medicine and Western Medicine / 中国实验方剂学杂志

This paper collated the western medicine and traditional Chinese medicine （TCM） diagnostic criteria of pulmonary fibrosis （PF） based on its clinical characteristics and relevant literature reports and summarized the inductive agents， methods， objects， and mechanisms for replicating the PF animal models as well as their respective advantages and disadvantages. By analyzing the consistency of symptoms among successfully modeled animal models with the clinical characteristics in TCM and western medicine， we found that the intratracheal injection of bleomycin was the most frequently employed method for modeling， and the resulting outcomes were very similar to clinical characteristics in TCM and Western Medicine. Besides， considering the time-saving process， high stability， good repeatability， and low cost， such method was suitable for the rapid screening of drugs. The second preferred method was intraperitoneal injection of paraquat， which exhibited the advantages of high degree of consistency with clinical characteristics of PF caused by paraquat poisoning， low cost， high success rate， and easy operation， which allowed it to be suitable for exploring the mechanism of paraquat poisoning and developing the antidotes. The existing PF animal models shared a fairly high degree of consistency in symptoms with patients diagnosed as having PF in western medicine. However， the criteria for TCM syndrome differentiation remained unclear， and the animal models failed to reflect TCM pathogenesis. It is necessary to establish more accurate TCM diagnostic criteria that focus on syndrome differentiation and reveal TCM etiology and pathogenesis and carry out more experiments concerning TCM syndromes of PF in the future， so as to better treat PF with integrated TCM and Western Medicine.

Mechanism of Fuzheng Qufeng Prescription in Suppressing Epithelial-mesenchymal Transition of Podocytes in Membranous Nephropathy Rats via TGF-β1/Smad Pathway / 中国实验方剂学杂志

Objective:To study the effect of Fuzheng Qufeng prescription （FZQP） on transforming growth factor-<italic>β</italic>₁ （TGF-<italic>β</italic>₁）/Smad signaling pathway and epithelial-mesenchymal transition of podocyte in membranous nephropathy （MN） rats and to explore its molecular mechanism for podocyte protection. Method:The rats were randomly divided into normal control group （NC） and modeling group. Rats in modeling group induced by bovine serum albumin （C-BSA） were randomly divided into model group （MN）， losartan potassium group （LP， 0.05g·kg^-1）， and FZQP high dose （FZQPH， 41 g·kg^-1）， medium dose （FZQPM， 20.5 g·kg^-1）， and low dose （FZQPL， 10.25 g·kg^-1） groups. The administration lasted for 4 weeks. In week 0， 2， and 4 of administration， the levels of 24 hours urine protein （24 h-Upro） were tested. At the end of 4th week， the levels of blood urea nitrogen （BUN） and serum creatinine （SCr） were detected， and the rats in each group were sacrificed and the renal pathological morphology changes were observed by light microscope with hematoxylin-eosin （HE）， Masson and periodic acid-silver metheramine （PASM） staining. The deposition of immune complex， the thickening of glomerular basement membrane （GBM） and podocyte foot process were observed by transmission electron microscope （TEM）. The distribution and expression intensity of Desmin in renal tissues were detected by immunohistochemistry （IHC）. The mRNA and protein expression levels of TGF-<italic>β</italic>₁， Smad2/3， phospho（p）-Smad2/3， Smad7 and Desmin in renal tissues were respectively detected by Western blot （WB） and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. Result:Compared with NC group， the levels of 24 h-Upro， BUN and SCr significantly increased in model group （<italic>P</italic><0.01）， with increased deposition of immune complex， significantly thickened GBM and fusion of foot processes， significantly increased Desmin mRNA and protein expression （<italic>P</italic><0.01） and increased TGF-<italic>β</italic>₁， Smad2， and Smad3 mRNA and protein expression （<italic>P</italic><0.05）， and decreased Smad7 mRNA and protein expression （<italic>P</italic><0.05，<italic>P</italic><0.01）. Compared with model group， 24 h-Upro and BUN decreased in FZQP groups and LP group （<italic>P</italic><0.05）， levels of serum SCr in FZQPM group decreased （<italic>P</italic><0.05）， deposition of immune complex， thickening of GBM and fusion of foot process were all alleviated in FZQP groups and LP group. Distribution of Desmin along GBM decreased in FZQPH group， FZQPM group and LP group （<italic>P</italic><0.05）. Both mRNA and protein expression levels of TGF-<italic>β</italic>₁ and p-Smad2/Smad2 in FZQPM group decreased， while mRNA and protein expression levels of Smad7 increased （<italic>P</italic><0.05）. Both mRNA and protein expression levels of p-Smad3/Smad3 in FZQPH group decreased （<italic>P</italic><0.05）. Both mRNA and protein expression levels of Desmin in podocyte in FZQPH group， FZQPM group and LP group decreased （<italic>P</italic><0.05）. Conclusion:FZQP might realize podocyte protection effect in MN via suppressing EMT mediated by overactivated TGF-<italic>β</italic>₁/Smad signaling pathway.

Understanding the dual character of negative and positive results in acupuncture-moxibustion clinical trials in foreign countries / 中国针灸

The differences in the objective, starting point, disease spectrum and interventions of acupuncture-moxibustion clinical trials at home and abroad are collected. By taking two articles of acupuncture-moxibustion clinical trials in foreign countries accepted by

Applicable Value of AMSS-PCR in Lung Cancer Gene Mutation Detection / 中国肺癌杂志

BACKGROUND@#The detection of driver oncogenes of lung cancer is of great importance. There are various gene detection techniques nowadays which are different from each other. We carried out this study to investigate the specificity and sensitivity of assay panels based on an Amplification Refractory Mutation System-polymerase chain reaction (ARMS-PCR) technique of Amplification Mutation Specific System (AMSS) in detection of lung cancer gene mutation. To estimate the applicable value of assay panels in clinical settings.@*METHODS@#We collected cancer tissue specimens or fluid specimens from 309 patients. Mutation results were presented for those samples previously detected by ARMS-PCR. In comparison, we carried out AMSS-PCR using (epidermal growth factor receptor, EGFR) assay panel and Six-Alliance assay panel as well as Sanger sequencing. Software SPSS 22.0 (SPSS IBM) was used for statistical analysis.@*RESULTS@#The rates of consistency between the results by assay panels and Sanger sequencing or ARMS-PCR were 97.41% and 97.73%, respectively. Besides, EGFR assay panel had higher consistency rates with other detection methods than Six-Alliance assay panel. As for consistency test, the Kappa values of assay panels with Sanger sequencing, assay panels with ARMS-PCR, and ARMS-PCR with Sanger sequencing were 0.946, 0.953, and 0.913, respectively. The receiver operating characteristic curve (ROC) area under curve (AUC) of assay panels was 0.976 referring to Sanger sequencing, and 0.975 as ARMS-PCR was referred to.@*CONCLUSIONS@#AMSS-PCR can make an optimal cancer gene mutation detection method for clinical settings.

Circumcision reduces the incidence of human papillomavirus infection in men / 中华男科学杂志

<p><b>Objective</b>To investigate the association of circumcision with the incidence of human papillomavirus (HPV) infection in men.</p><p><b>METHODS</b>We collected the samples from the surface of the coronal sulcus, glans penis, penile shaft and scrotum of 351 males examined for HPV infection in our hospital from January 2016 to August 2017, of whom 118 had received circumcision while the other 233 had not. We compared the incidence rate of HPV infection between the circumcision and non-circumcision groups and analyzed the association of the age of circumcision with the incidence of HPV infection.</p><p><b>RESULTS</b>HPV infection was found in 135 (38.46%) of the males, 29 (24.58%) in the circumcision group and 106 (45.49%) in the non-circumcision group, significantly lower in the former than in the latter (χ² = 14.48, P < 0.01). The incidence rate of HPV infection was also remarkably lower in the males circumcised at ≤17 years (13.16% ［5/38］) than in those circumcised at >17 years of age (30.0% ［24/80］) (χ² = 3.942, P = 0.047).</p><p><b>CONCLUSIONS</b>Male circumcision helps reduce the incidence rate of HPV infection in men and earlier surgery may achieve even better effect.</p>

Penile erectile strength measurement band for differentiation and classification of erectile dysfunction / 中华男科学杂志

<p><b>Objective</b>To study the clinical application value of the penile erectile strength measurement (PESM) band in the differentiation of psychogenic from organic erectile dysfunction (ED).</p><p><b>METHODS</b>Eighty ED patients unable to achieve or maintain adequate penile erection to complete sexual intercourse were included in the experimental group and another 40 healthy subjects with normal erectile function enrolled as controls. The ED cases were classified into mild, moderate and severe ED according to the IIEF-5 scores and divided into psychogenic and organic ED based on the results of the nocturnal penile tumescence (NPT) test. Then all the subjects underwent a three-night continuous monitoring with the PESM band and, according to the band fracture rate, the ED cases were also classified into psychogenic and organic ED. The rates of missed diagnosis, misdiagnosis and diagnostic coincidence of PESM were calculated with the results of NPT as the standard for differentiating psychogenic from organic ED.</p><p><b>RESULTS</b>The results of NPT tests revealed 51 cases of psychogenic and 29 cases of organic ED in the experimental group. The band fracture rate in PESM was 95.0% in the mild, 80.9% in the moderate and 52.8% in the severe ED patients. Of the 51 cases of psychogenic ED detected by NPT test, 43 were diagnosed as psychogenic and the other 8 as organic ED with the PESM band, with a coincidence rate of 84.3%. Of the 29 cases of organic ED revealed by NPT test, 5 were diagnosed as psychogenic and the other 24 as organic ED by PESM, with a coincidence rate of 82.8%. Normal erectile function with three-level fracture of the band was observed in the PESM of the normal controls, which showed a coincidence rate of 100% with the results of NPT tests. Based on the standard of the NPT test, the rates of missed diagnosis, misdiagnosis and diagnostic coincidence of the PESM band in differentiating psychogenic from organic ED were 15.7%, 17.2%, and 83.8%, respectively, with a Kappa value of 0.656 (P <0.05).</p><p><b>CONCLUSIONS</b>The penile erectile strength measurement band can be used as a screening tool for initial differentiation of psychogenic from organic ED.</p>

In vivo transdermal penetration enhancing activity of essential oil from Zanthoxyli Pericarpium by using microdialysis technique / 中国中药杂志

The aim of this paper is to investigate the topical pharmacodynamics behavior of different lipophilic model drugs after treatment with essential oil from Zanthoxyli Pericarpium by using the cutaneous microdialysis technique, and then evaluate its in vivo transdermal penetration enhancing properties. Two traditional Chinese medicine active components, namely tetramethylpyrazine and puerarin, were chosen as lipophilic and hydrophilic model drugs, respectively. Firstly, the concentration difference method was employed to measure the in vitro recovery rate and loss of the microdialysis probe, and the in vivo recoveries of two model drugs were determined by using the retrodialysis method. Secondly, the skin pharmacodynamics behaviors of two model drugs were studied after treatment with different concentrations of the essential oil, and the well-established and standard penetration enhancer Azone was selected as a positive control. It was found that the recovery of microdialysis probe was equal to its loss for two model drugs, with no interaction between drugs in dialysis membranes. The retrodialysis studies revealed that the in vivo recovery of tetramethylpyrazine and puerarin were 59.17%, 19.85%, respectively. The skin pharmacodynamics studies showed that the essential oil could facilitate the transdermal absorption of tetramethylpyrazine in a concentration-dependent manner, and the enhancement ratio (ER) for 5% essential oil was 98.64, which was higher than that of the optimum concentration of Azone (3% Azone, ER=89.11). Meanwhile, the Zanthoxyli Pericarpium could effectively promote the transdermal permeation of the puerarin in a concentration-dependent manner. Hence, this study further confirmed that the Zanthoxyli Pericarpium had excellent penetration-enhancing activity as a natural transdermal penetration enhancer, providing data support for its application in traditional Chinese medicine external preparations.

Value of the serum free testosterone level in detecting erectile dysfunction / 中华男科学杂志

Objective@#To investigate the values of serum calculated free testosterone (cFT), testosterone secretion index (TSI), and free testosterone index (FTI) in the diagnosis of ED with androgen deficiency by observing their changes in the patient.@*METHODS@#We conducted this study among 185 men complaining of ED and 35 20－40 years old healthy males presenting at the clinic for premarital medical checkup. We asked them about their medical history, to fill in the International Index of Erectile Function (IIEF-5) Questionnaire, and to complete the nocturnal penile tumescence (NPT) test. According to the data obtained, 150 of the complainants were diagnosed as ED patients and 25 of the healthy examinees were included in the control group. We determined the levels of total serum testosterone (TT), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), serum albumin (ALB), cFT, bio-available testosterone (bio-T), TSI, and FTI in the two groups of subjects. Using cFT ≤0.3 nmol/L, TSI ≤2.8, and FTI ≤0.4 as the critical values and TT ≤11.5 nmol/L as the gold standard for androgen deficiency, we calculated cFT-, TSI-, and FTI-related rates of missed diagnosis, misdiagnosis, and diagnostic coincidence.@*RESULTS@#With TT ≤11.5 nmol/L as the criterion, the cFT-, TSI-, and FTI-related rates of coincidence in the diagnosis of androgen deficiency in the ED patients were 90.8%, 85.8%, and 80.8%, those of missed diagnosis were 4.0%, 33.3%, and 44.0%, and those of misdiagnosis were 10.5%, 19.4%, and 12.6%, with the Kappa of values 0.755, 0.564, and 0.427, respectively (P <0.05). The levels of serum TT, cFT, Bio-T, TSI, and FTI were decreased with increased age of the 20－40 years old ED patients, with statistically significant differences among different age groups except the serum TT level. However, no statistically significant differences were found in the levels of TT, cFT, Bio-T, TSI, and FTI among the patients with different IIEF-5 scores.@*CONCLUSIONS@#The level of cFT has a higher value than those of TT, TSI, and TSI in the diagnosis of ED with androgen deficiency in 20－40 years old men.

Effect of Pinggan Qianyang Recipe Containing Serum on Angiotensin II Induced Vascular Smooth Muscle Cell Proliferation and Migration and DNA Methylation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Pinggan Qianyang Recipe (PQR) on inhibiting angiotensin II (Ang II) induced proliferation and migration of vascular smooth muscle cells (VSMCs) and changes of DNA methylation.</p><p><b>METHODS</b>VSMCs were cultured using tissue explant method, and PQR containing serum was prepared. Primarily cultured VSMCs were divided into four groups, the normal group, the model group, the folate group (folic acid intervention) , and the PQR group. The proliferation and migration of VSMCs was duplicated by Ang II. After 24-h Ang II induced culture, 40 microg/mL folic acid was added to the folate group for 48 h, while 5% PQR containing serum was added to the PQR group for 48 h. The cell growth curve of VSMCs was drawn by using Cell Counting Kit (CCK-8). The proliferative activity of VSMC was determined by MTT assay. The migration of VSMCs was measured by Millicell chamber. The general level of cytosine methylation in cell nucleus was detected via 5-mC antibodies immunofluorescence, and mRNA expression levels of DNA methyltransferase 1 (DNMT1) were measured by Real-time q-polymerase chain reaction (q-PCR).</p><p><b>RESULTS</b>VSMCs were promoted by Ang II at 10(-6) mol/L for 24 h. Compared with the normal group, the proliferative activity and migration quantity of VSMCs obviously increased, and DNA methylation level obviously decreased (P < 0.05, P < 0.01). Compared with the model group, the cell growth, proliferative activity and migration quantity of VSMCs obviously decreased and the general DNA methylation level increased in the folate group and the PQR group (P < 0.05, P < 0.01). Compared with the normal group, the mRNA expression of DNMT1 decreased in the model group (P < 0.01). Compared with the model group, mRNA expression of DNMT1 in Ang II induced VSMCs was obviously enhanced in the folate group and the PQR group (P < 0.01).</p><p><b>CONCLUSIONS</b>PQR could inhibit Ang II induced proliferation and migration of VSMCs, and cause high genomic DNA methylation level. Changes of DNA methylation might be associated with DNMT1 expression.</p>

Analysis of learning process of video-assisted minimally invasive esophagectomy for thoracic esophageal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the learning process of video-assisted minimally invasive esophagectomy (MIE).</p><p><b>METHODS</b>One hundred consecutive patients with thoracic esophageal carcinoma were treated by a same team of surgeons, and were divided into 3 groups in chronological order. The former two groups both consisted of 25 patients with thoracoscopy plus laparotomy. The remaining 50 patients were enrolled in the third group with thoracoscopy plus laparoscopy. Clinicopathological data including operative time, blood loss, protection of normal structures, complications, length of ICU stay, postoperative stay, and lymph nodes harvest, were collected and compared between groups.</p><p><b>RESULTS</b>Procedures were accomplished successfully in 96 patients. Only 4 cases were converted to open thoracotomy and none to laparotomy. The median operative time was 310 min and blood loss was 200 ml. The median number of lymph node harvest was 22. The overall complication rate was 50%. Comparison of first two groups revealed that significant differences existed in the preservation rate of arch of azygos vein (P=0.010), bronchial vessels (P=0.038), and exposure rate of thoracic part of left recurrent laryngeal nerve( P=0.048). Comparison of the former and latter 50 patients revealed that significant differences existed in thoracic operative time (P<0.001), blood loss (P=0.025), preservation rate of arch of azygos vein (P=0.001) and bronchial vessels (P<0.001), the number of lymph node harvest in thoracoscopy (P=0.022) and in left recurrent laryngeal nerve chain (P<0.001), and exposure rate of initiate part of left recurrent laryngeal nerve (P=0.002).</p><p><b>CONCLUSION</b>The learning curve of MIE is long and beginners should proceed step by step.</p>

Serum APPL1 level is elevated in newly diagnosed cases of type 2 diabetes mellitus / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate serum APPL1 level in patients with newly diagnosed type 2 diabetes mellitus (T2DM) and analyze its correlation with body mass index (BMI), waist-to-hip ratio (WHR), blood pressure, fasting plasma glucose, fasting blood insulin, HbA1c, and insulin resistance (HOMA-IR).</p><p><b>METHOD</b>Serum APPL1 levels were determined using ELISA in 22 normal control subjects and 63 patients with newly diagnosed T2DM, and HOMA-IR of the subjects was calculated using the HOMA model.</p><p><b>RESULTS</b>The diabetic patients had significantly elevated levels of serum APPL1 compared with the control subjects (85.71∓27.39 vs 64.52∓16.28 pg/ml, P<0.01), with also significantly increased BMI, WHR, SBP, FINS, LgHOMA-IR (P<0.01) and LDL-C (P<0.05) but lowered HDL-C (P<0.01). Fasting serum APPL1 levels were positively correlated with FPG, FINS, and HOMA-IR (r=0.215, 0.297, 0.334, P=0.014, 0.006, 0.002, respectively). In multiple linear regression analysis with APPL1 as the dependent variable, HOMA-IR (β=0.329, P=0.002) was included in the equation.</p><p><b>CONCLUSION</b>Patients with newly diagnosed T2DM have elevated serum APPL1 levels, suggesting the involvement of APPL1 in the development of T2DM.</p>

Lipid metabolism in ketosis-prone type 2 diabetes mellitus patients classified by Aβ classification scheme / 中国医师进修杂志

ObjectiveTo investigate the lipid metabolism in ketosis-prone type 2 diabetes mellitus (T2DM) patients classified by Aβ classification scheme.Methods Two hundred and seventy-seven ketosis-prone T2DM patients were classified according to the A β classification scheme which was based on the presence or absence of pancreatic islet β-cell autoantibody and fasting C peptide:A-β- group (78 cases ),A+ β -group (41 cases ),A- β + group ( 113 cases ) and A+ β + group (45 cases).The levels of blood lipid were determined and compared in the four groups.ResultsIn A- β -,A+ β -,A- β + and A+ β +groups,the levels of triglyeride (TG) were separately (1.72 ± 1.07),(1.86 ± 1.04),(2.21 ± 1.66) and (2.60 ± 1.87 )mmol/L,the levels of very low density lipoprotein-cholesterol(VLDL-C) were separately (0.57 ±0.45),(0.61 ±0.48),(0.79 ±0.63) and(0.81 ±0.62) mmol/L,and there were significant differences in TG and VLDL-C among the four groups(P =0.004 and 0.010).There were significant differences in TG and VLDL-C between β + group ( 158 cases) and β - group ( 119 cases) [ (2.32 ± 1.72) mmol/L vs.(1.77 ± 1.06)mmol/L,(0.80 ±0.63) mmol/L vs.(0.58 ±0.46) mmol/L,P =0.001 and 0.001 ].Conclusions Ketosis-prone T2DM patients with different situations of pancreatic islet β-cell autoimmunity and function are different in lipid metabolism,so it is very lmportant to evaluate the blood lipid and perform related lipid-lowering therapy in order to reduce the occurrence of diabetic complication.

Dispute and consensus about surgical approaches and lymph nodes excisional area of esophageal carcinoma / 中华胃肠外科杂志

Surgical approaches for esophageal carcinoma are many and varied. Minimally invasive techniques are increasingly used widely in esophagectomy as they not only ensure patients' therapeutic effects, but also reduce trauma and accelerate recovery. The lymph nodes excisional area of esophageal carcinoma is still in controversy. It is necessary to carry out further researches on selective lymph nodes excision, which can decrease complication rate and improve patients' survival in the meantime.

Effect of mesenchymal stem cell transplantation on immunological injury of the ovary in mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of mesenchymal stem cell (MSC) transplantation in repairing ovarian injury in mice sensitized with porcine ovarian proteins.</p><p><b>METHODS</b>Wild-type female mice with ICR background (6-8 weeks old) were divided randomly into groups A, B and C (n=12). In groups B and C, the mice were treated with the total protein extract from porcine ovary to induce immunological injury of the ovary, while those in group A received no treatment. MSCs-derived from GFP transgenic mice were transplanted into the mice of group C, and equal volume of PBS was injected intraperitoneally in mice of the other two groups. PCR was used to detect GFP gene in the genomic DNA of the ovaries to assess MSCs homing in the ovary, and the reparative effect of MSCs on ovarian injury was evaluated using HE staining and TUNEL analysis.</p><p><b>RESULTS</b>After transplantation, the MSCs could reach the injured ovaries to promote the repair of the ovarian injury, resulting also in reduced apoptosis of the granulosa cells (GCs) in the injured ovaries.</p><p><b>CONCLUSION</b>MSCs transplantation can promote the recovery of the immunological injury of the ovary in mice, the mechanism of which may involve reduced apoptosis of the GCs.</p>

Correlation between serum level of visfatin and type 2 diabetes mellitus / 中国医师进修杂志

Objective To investigate the correlation between serum level of visfatin and type 2 diabetes mellitus (T2DM). Methods Impaired glucose regulation (IGR) group consisted of 40 patients,T2DM group consisted of 106 patients, while control group consisted of 86 subjects. The serum visfatin levels of all groups were detected by enzyme linked immunosorbent assay (ELISA). Results Fasting serum visfatin levels in IGR group and T2DM group were significantly higher than those in control group [(19.93 ±6.89) μg/L and (29.53 ± 11.33) μg/L vs. (16.12 ± 5.24) μ g/L, P ＜ 0.01]. Fasting serum visfatin levels positively correlated with waist-to-hipratio (WHR) (r = 0.161, P ＜ 0.05); significantly positively correlated with triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (HbA1c),fasting plasma glucose (FPG), fasting insulin (FINS), lg Homeostasis model assessment-insulin resistance index (HOMA-IR) (r = 0.189,0.266,0.643,0.574,0.285,0.526,P ＜ 0.01), and significantly negatively correlated with high density lipoprotein cholesterol (HDL-C)(r =-0.377,P ＜0.01). When visfatin was analyzed as a dependent variable in multiple linear regression, HbA1c (β = 0.512, P = 0.000), lg HOMA-IR (β= 0.172, P = 0.026), WHR (β = 0.119, P = 0.036) were into the equation. Conclusion Visfatin may be involved in glucose and lipid metabolism regulation, and closely related with insulin resistance; visfatin may be a risk factor for T2DM.

Rapid eye movement-related and none rapid eye movement-related classification in obstructive sleep apnea hypopnea syndrome / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the value of a new measurement that divided obstructive sleep apnea-hypopnea syndrome (OSAHS) into rapid-eye-movement (REM) related and non-rapid-eye-movement (NREM) related subgroups.</p><p><b>METHODS</b>According to Siddiqui classification, 137 adult patients with OSHAS were diagnosed as REM-related OSAHS [REM apnea hypopnea index (AHI)/NREM AHI > 1] or NREM-related OSAHS (REM AHI/NREM AHI < 1). Polysomnographic data were compared and discussed.</p><p><b>RESULTS</b>(1) There were 72 cases defined as REM-related OSAHS (52.6%) and 65 cases defined as NREM-related OSAHS (47.4%). (2) In all cases, total AHI and NREM AHI in REM-related OSAHS were significantly lower than those in NREM-related OSAHS, while lowest arterial oxygen saturation (LSaO₂), REM LSaO₂ and NREM LSaO₂ were significantly higher than those in NREM-related OSAHS (t were -6.466, -7.638, 3.426, 2.472, 4.873 respectively, P < 0.05). No significance was found in sleep structure, REM AHI and REM LSaO₂ between REM-related and NREM-related OSAHS (P > 0.05). (3) Given the severity of OSHAS, the constituent ratio of REM-related OSAHS decreased (77.8%, 61.5%, 37.3%) from mild to severe OSAHS, while that of NREM-related OSAHS rose (22.7%, 38.5%, 62.7%; chi² = 16.996, P < 0.01). In mild and moderate groups, REM LSaO₂ of REM-related OSAHS was significantly lower than those in NREM-related OSAHS (t were -4.273 and -2.136, P < 0.05), while the differences of total AHI and LSaO₂, NREM LSaO₂ between these two types were not significant. In severe group, AHI in NREM-related OSAHS was significantly higher than that in REM-related OSAHS, while LSaO₂, REM LSaO₂ and NREM LSaO₂ was significantly lower than those in REM-related OASHS (t were -4.943, 2.574, 1.996, 3.571, P ≤ 0.05). (4) There was no significance in sleeping latency and efficiency between REM-related and NREM-related OSHAS.</p><p><b>CONCLUSIONS</b>REM-related OSHAS mainly exists in mild and moderate OSHAS, while NREM-related one mainly exists in severe OSHAS. NREM-related OSAHS may be more severe in AHI and hypoxia than REM-related one. Whenever obstructive apnea happened in REM or NREM period, its impacts on sleep structure, efficiency and latency have no difference.</p>

CT appearances and pathology of pulmonary candidiasis: A case control study / 第二军医大学学报

Objective: To analyze the correlation between CT appearances and pathological findings at acute stage pulmonary candidiasis in rabbits. Methods: Twenty-four New Zealand rabbits were randomly divided into experimental group and control group. Rabbits in the experimental group were inoculated with Candida albicans via percutaneous trachea puncture and those in the control groups were injected with normal saline via the same way. Chest CT scans were performed every other day from the day the inoculations were completed. The scan results were controlled with the pathological findings. Results: Pulmonary candidiasis model were confirmed in 13 rabbits. The early CT appearance of pulmonary candidiasis was found from the second day to the tenth day after inoculation. We found consolidation in 10 cases, including 6 sublobe consolidation (intra-alveolar exudates) and 4 lobe or section consolidation (pulmonary infarct or hemorrhage). Ground-glass attenuation (hemorrhage or exudates) was found in 6 cases and often coincided with other CT signs. Nodules were found in 3 cases and often found surrounding the bronchovascular bundle (granulomatous inflammation). Conclusion: Consolidation is the major CT findings of primary pulmonary candidiasis at acute stage, followed by ground-glass attenuation and nodules. Various signs can occur simultaneously with no specificity.

Evaluation of scalene lymph node or contralateral mediastinum biopsy during mediastinoscopy for non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the clinical indication of N3 lymph node biopsy during mediastinoscopy for non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Cervical mediastinoscopy was performed in 89 patients with clinical stage I-IIIA non-small cell lung cancer prior to thoracotomy. Of those, 12 underwent cervical medistinoscopy combined with right scalene lymph node biopsy and 10 with anterior mediastinotomy.</p><p><b>RESULTS</b>Nine patients were found to have lymph node metastasis (N3 disease) during mediastinosopy. Of those, 6 had contralateral mediastinal lymph node metastasis and 3 cases with right scalene lymph node metastasis. The incidence of N3 disease in the patients with adenocarcinoma, serum CEA > 5 ng/ml and multi-station mediastinal lymph node metastasis was significantly higher than that in those with non-adenocarcinoma, CEA < 5 ng/ml and ipsilateral uni-station mediastinal lymph nodes metastasis (P < 0.05).</p><p><b>CONCLUSION</b>Biopsy of scalene lymph node or contralateral mediastinal lymph node should be performed during mediastinoscopy in order to exclude N3 disease for potentially operable NSCLC patients with adenocarcinoma, serum CEA >5 ng/ml and ipsilateral multi-station mediastinal lymph nodes metastasis.</p>

Value of mediastinoscopy in preoperative staging of non-small cell lung cancer-based on survival analysis / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the value of mediastinoscopy in preoperative staging of non-small cell lung cancer (NSCLC) based on survival analysis.</p><p><b>METHODS</b>152 cases of potentially operable NSCLC were enrolled in this study. All cases underwent CT scan and mediastinoscopy for assessment of the mediastinal lymph node status before initial treatment. The definitive treatment was decided on the basis of mediastinoscopy and the survival rate was analyzed with a median follow-up of 30.5 months. Survival analysis was conducted by comparing the lymph node status which was determined by final pathology (groups pN0, pN1, pN2, pN3), CT scan (group cN0-1, cN2-3) and mediastinoscopy (group mN0-1, mN2, mN3).</p><p><b>RESULTS</b>The 5-year survival rates in group pN0, pN1, pN2 and pN3 were 61.7%, 75.0%, 32.4% and 16.1%, respectively. Both groups pN0 and pN1 had significantly higher survival rates than those in groups pN2 and pN3 (P < 0.05). There were not significant differences between survival rates in groups cN0-1 and cN2-3 (P = 0.670), while the survival rate in group mN0-1 was significantly higher than that in groups mN2 and mN3 (P < 0.05).</p><p><b>CONCLUSION</b>Mediastinoscopy is of great value in preoperative staging of NSCLC. Not only does it detect lymph node metastasis more precisely but also better predict the prognosis than CT scan.</p>