Methamphetamine: Mechanism of Action and Chinese Herbal Medicine Treatment for Its Addiction / 中国结合医学杂志

With the proliferation of synthetic drugs, research on the mechanism of action of addictive drugs and treatment methods is of great significance. Among them, methamphetamine (METH) is the most representative amphetamine synthetic drug, and the treatment of METH addiction has become an urgent medical and social problem. In recent years, the therapeutic effects of Chinese herbal medicines on METH addiction have gained widespread attention because of their non-addictiveness, multiple targets, low side effects, low cost, and other characteristics. Previous studies have identified a variety of Chinese herbal medicines with effects on METH addiction. Based on the research on METH in recent years, this article summarizes the mechanism of action of METH as the starting point and briefly reviews the Chinese herbal medicine-based treatment of METH.

Adverse drug reactions induced by hydroxychloroquine in the treatment of oral lichen planus: a report of 13 cases / 口腔疾病防治

Objective @# To analyze the adverse drug reaction（ADR） reports of hydroxychloroquine for clinical medication safety. @* Methods@#The ADR reports of hydroxychloroquine between May 2019 and May 2021 were analyzed. Age, reasons for drug use, time of ADR, combined drug use, and ADR outcomes were statistically analyzed. @*Results@# No severe ADR was reported. Patients over 60 years old accounted for 53.85% of the total cases, and the time of ADR appearance was significantly earlier among those under 60 years old. A total of 61.54% of ADRs were involved in multiple organs, and optic neurotoxicity was reported in 46.15% of cases. @*Conclusion@# In the treatment of oral lichen planus with hydroxychloroquine, adverse drug reactions should be monitored, and increased attention should be given to patients over 60 years old to ensure the safety of this medication.

Advances in targeted therapy combined with immunotherapy for advanced hepatocellular carcinoma / 临床肝胆病杂志

The IMbrave 150 study opened the door of immunotherapy combined with targeted therapy, and then the data of ORIENTAL-32, a Phase Ⅲ clinical trial for Chinese patients, was released, which confirmed the efficacy of immunotherapy combined with targeted therapy, especially significant survival benefits in Chinese patients. At present, there are many ongoing studies on PD-1/PD-L1 inhibitors combined with small-molecule tyrosine kinase inhibitors, and their corresponding early data provide a considerable objective response rate, which provides an opportunity for conversion therapy/sequential therapy for hepatocellular carcinoma in different stages and courses, as well as a basis for further exploration of neoadjuvant/adjuvant therapy. Combined immunotherapy has entered the era of version 3.0, in which reasonable local therapy can be implemented at different stages in combination with targeted drugs. However, there are still no accurate predictive indicators for efficacy, and it requires comprehensive consideration of the features such as the natural course of the disease, clinicopathological parameters, genomics, and radiomics. Compared with single-drug immunotherapy or single-drug targeted therapy, immunotherapy combined with targeted therapy had a relatively complex spectrum of adverse reactions and difficult identification of correlation, and whole-process management, comprehensive judgment, and timely treatment should be performed within the framework of multidisciplinary team.

Multidisciplinary and Comprehensive Chinese Medicine for Advanced Non-Small Cell Lung Cancer Patients: A Retrospective Study of 855 Cases / 中国结合医学杂志

OBJECTIVE@#To investigate the effects of multidisciplinary and comprehensive Chinese medicine (CM) treatments on progression-free survival (PFS) and median survival time (MST) in patients with advanced non-small cell lung cancer (NSCLC) and identify factors that influence progression and prognosis.@*METHODS@#Clinical data of 855 patients with advanced NSCLC who received multidisciplinary and comprehensive CM treatments at Longhua Hospital from January 2009 to December 2018 were retrospectively analyzed. Univariate analysis was performed by the Kaplan-Meier method and log-rank sequential inspection. Multivariate analysis of significant variables from the univariate analysis was performed with Cox regression modeling. Key factors correlated to progression and prognosis were screened out, and a Cox proportional hazard model was established to calculate the prognostic index.@*RESULTS@#The PFS and MST of 855 advanced NSCLC patients were 9.0 and 26.0 months, respectively. The 1-, 2-, 3-, and 5-year survival rates were 79.2%, 54%, 36.2%, and 17.1%, respectively. Gender, pathologic type, and clinical stage were independent prognostic risk factors; surgical history, radiotherapy, treatment course of Chinese patent medicine, intravenous drip of Chinese herbal preparation, duration of oral administration of Chinese herbal decoction (CHD), and intervention measures were independent prognostic protective factors. Gender was an independent risk factor for progression, while operation history and oral CHD administration duration were independent protective factors (all P<0.05). Women with stage IIIb-IIIc lung adenocarcinoma had the best outcomes.@*CONCLUSIONS@#Female patients have lower progression risk and better prognoses than male patients, younger patients have higher progression risk but better long-term prognoses than the elderlys, and patients with lower performance status scores are at lower risk for progression and have better prognoses. Comprehensive CM treatments could significantly reduce progression risk, improve prognosis, and prolong survival time for patients with advanced NSCLC. This treatment mode offers additional advantages over supportive care alone.

Using electroencephalogram for emotion recognition based on filter-bank long short-term memory networks / 生物医学工程学杂志

Emotion plays an important role in people's cognition and communication. By analyzing electroencephalogram (EEG) signals to identify internal emotions and feedback emotional information in an active or passive way, affective brain-computer interactions can effectively promote human-computer interaction. This paper focuses on emotion recognition using EEG. We systematically evaluate the performance of state-of-the-art feature extraction and classification methods with a public-available dataset for emotion analysis using physiological signals (DEAP). The common random split method will lead to high correlation between training and testing samples. Thus, we use block-wise

Relationship between mental health status and vision-related quality of life in the students with moderate and high myopia / 预防医学

Objective@#To understand the relationship between mental health status and vision-related quality of life( VRQL ) of students with moderate and high myopia, and to provide basis for the optimization of VRQL.@*Methods@#Using convenient sampling method, the 8-18 years old students with moderate and high myopia were selected from Sichuan, Chongqing and Zhejiang. The mental health status and VRQL of students with moderate and high myopia were evaluated with Hospital Anxiety and Depression Scale and Quality of Life Scale for Ametropia. The multiple linear regression model was used to analyze the influencing factors for VRQL.@*Results@# A total of 360 questionnaires were sent out and 354 were effectively recovered, with an effective rate of 98.33%. There were 116 ( 32.77% ) boys and 238 ( 67.23% ) girls; the median age was 16.65 years old. There were 211 ( 59.60% ) cases of moderate myopia and 143 (40.40%) cases of high myopia.There were 141 ( 39.83% ) found to be anxious and 176 ( 49.72% ) depressed. The median score of Quality of Life Scale for Ametropia was 64. The results of multiple linear regression analysis showed that sex ( β＇= -0.179 ), diopter ( β＇= 0.208 ), eyesight with glasses ( β＇= -0.229 ) and anxiety ( β＇= 0.439 ) were influencing factors for VRQL.@*Conclusion@#The mental health problems of the students with medium and high myopia are prominent; anxiety has a significant impact on the VRQL of the students.

Surgical technique and efficacy of P. R.E.S.S. bladder cuff excision / 中华泌尿外科杂志

Objective:To explore the surgical technique and efficacy of pure retroperitoneoscopic extravesical standardized seeable (P.R.E.S.S.) technique for bladder cuff excision (BCE).Methods:Ninety five patients with UTUC from five domestic centers (30 cases from Changzheng Hospital, 21 cases from Peking University First Hospital, 20 cases from Yuhuangding Hospital, 21 cases from Dalian Medical University affiliated No.2 Hospital and 3 cases from General Hospital of Eastern Theater Command)between August 2017 and December 2020 were retrospectively analyzed. There were 57 males and 38 females with a mean age of (67.7±10.0) years and median tumor size of 3.0 cm. All patients underwent pure retroperitoneoscopic radical nephroureterectomy with a single surgical position and four (36 cases) or five (59 cases) trocar layout according to the surgeon’s prefer habit and experience. The demographics of the two groups were the age of [(66.3±11.2)years vs. (68.6±9.1)years], male/female ratio of (25/11 cases vs. 32/27 cases), body mass index of [(25.0± 3.0)kg/m 2 vs. (24.8±3.4)kg/m 2], tumor maximum diameter of [2.8(1.6, 3.5)cm vs. 3.0(2.0, 4.0)cm], left/right side tumor of(19/17 cases vs. 34/25 cases), T 1-2/T 3-4/Tis stage of(25/10/4 cases vs. 49/10/0 cases), and multifocal tumors of(3 cases vs. 2 cases), and the difference was not statistically significant( P>0.05). On the other hand, the differences of hydronephrosis of the operated kidney(13 cases vs. 39 cases, P=0.004), and tumor location (in renal pelvis or calyx or upper/middle/lower ureter being 23/9/4 cases vs. 35/4/20 cases, P=0.005), were statistically significant. The umbilical artery cord was used as anatomical landmark in the process of P. R.E.S.S. bladder cuff excision. The pelvic floor and extraperitoneal space around the ureter were expanded, the bladder wall was opened to form pneumovesicum, and a sufficient bladder cuff resection and exact bladder cuff closure was performed. Perioperative outcomes and follow-up data were analyzed, and the clinical outcomes between the four and five trocars were compared to evaluate the impact of trocar layout on the surgical outcomes. Results:There were 91(95.8%) cases successfully undergoing P. R.E.S.S. BCE technique, with one case converted to open BCE due to bleeding and three cases converted to distal ureter Hem-o-lok clipping because of poor exposure. Median operative time was 180(125, 230)min, and estimated blood loss was 100(50, 100)ml. The overall complication rate was 10.5%(10/95), including 2 cases(2.1%) of intraoperative bleeding, with 1 case treated by transfusion (400 ml), the other case converted to open surgery without transfusion. There were 8 cases of postoperative complications(8.4%), including 7 cases of Clavien-Dindo grade Ⅱ(3 cases of secondary hemorrhage, one case for each of drug allergy, acute renal insufficiency, blood creatinine increased to 490 μmol/L, or lung infection with lymphatic leakage), 1 case of grade Ⅲa(intestinal obstruction treated with insertion of the intestinal obstruction catheter under local anesthesia), and all these patients were discharged smoothly. The difference between the four and five trocars was not statistically significant in the following variables, including the rate of surgical conversion(8.3% vs. 1.7%), estimated intraoperative blood loss(100 ml vs. 60 ml), ratio of intraoperative lymph node dissection (25.0% vs.20.3%), P. R.E.S.S. bladder cuff excision success rate(91.7% vs.98.3%), the incidence of intraoperative and postoperative complications (13.8% vs.8.5%), pT 1-2/pT 3-4/pTis stage(22/11/3 cases vs.37/19/3 cases) and the proportion of recurrence or metastasis(8.3% vs.3.4%)(all P>0.05). However, the differences in the operation time(190 min vs.170 min, P=0.011)and postoperative hospital stay(5 d vs.6 d, P=0.005) were statistically significant. Conclusions:P. R.E.S.S. bladder cuff resection technique is safe and feasible during the procedure of pure retroperitoneoscopic radical nephroureterectomy by a single surgical position and facilitates seeable adequate bladder cuff excision by establishing an enlarged pelvic lateral extraperitoneal space and pneumovesicum. Five-trocar technique is more suitable for patients with lower ureteral tumors but may be associated with a longer postoperative hospital stay compared with the four-trocar technique.

Study on sleep disturbances of preschool children in Haikou City and its influencing factors / 中国学校卫生

Objective@#To explore current status of sleep disturbances and its influencing factors in preschool children in Haikou city, and to provide a reference for improving chidlren sleeping quality by taking effective measures.@*Methods@#Layered random cluster sampling method was used to select 1 200 preschool children from kindergartens in Haikou city in 2018. Sleep status questionnaire was used to investigate children’s sleep disorders and analyze the influencing factors.@*Results@#The detection rate of sleep disturbances was 50.00%, the rates in each group were 50.90% for boys, 48.87% for girls(χ2=0.49, P>0.05), and 48.45% for 3 years old group, 50.33% for 4 years old group, 50.55% for 5 years old group, and 49.55% for 6 years old group(χ2=0.24, P=0.97). The total daily sleep time of children was(10.53±1.05)h, and the duration of continuous sleep at night was(8.69±0.78)h, the length of sleep during the day was(1.84±0.67)h, sleep time decreased with the increase of age(F=7.52, 3.04, 7.88, P<0.05). The univariateand multivariate Logistic regression showed that, asthma(OR=2.65), frequent cold(OR=1.67), carpet at home(OR=1.40), poor appetite(OR=1.18), changing caregivers(OR=1.25), inconsistent rearing ideas(OR=1.42), parents falling asleep late (OR=1.39) and mothers with sleep problems (OR=1.73) were the risk factors for sleep problems, children and parents sleeping separately(OR=0.75), children’s sleeping rule (OR=0.32) were the protection factors(P<0.05).@*Conclusion@#It is necessary to do a good job in the sleep management of preschool children and reduce the detection rate of sleep problems from many aspects, such as family rearing environment, health knowledge of caregivers, parents undefined sleep habits, children undefined sleeping style and so on.

Magnetic resonance imaging-transrectal ultrasound cognitive fusion targeted biopsy on the diagnosis of prostate cancer: a research of 614 cases in single center / 生物医学工程学杂志

This study aims to compare the prostate cancer detection rate between magnetic resonance imaging (MRI)-transrectal ultrasound (TRUS) cognitive fusion targeted biopsy and systematic biopsy. A total of 614 patients who underwent transrectal prostate biopsy during 2016-2018 with multiparametric magnetic resonance imaging (mpMRI) were included. All patients with a PI-RADS V2 score ≥ 3 accepted both targeted biopsy and systematic biopsy, and those with a PI-RADS V2 score ≤ 2 only accepted systematic biopsy. Overall prostate cancer detection rate between the two biopsies was compared. MRI-TRUS cognitive fusion targeted biopsy identified 342 cases (75.7%) of prostate cancer while systematic biopsy identified 358 cases (79.2%). There was no significant difference in the detection rate between the two groups ( = 1.621, = 0.203). Targeted biopsy had significant fewer biopsy cores compared with systematic biopsy, reducing (9.3 ± 0.11) cores ( < 0.001) in average. Targeted biopsy had about 10.8% ( < 0.001) more tumor tissues in positive cores compared with systematic biopsy. The results show that both MRI-TRUS cognitive fusion targeted biopsy and systematic biopsy have good detection rate on prostate cancer. Cognitive targeted biopsy may reduce biopsy cores and provide more tumor tissues in positive cores.

Surgical resection of locally recurrent renal cell carcinoma after radical or partial nephrectomy: feasibility and prognostic analysis / 中华泌尿外科杂志

Objective:To evaluate the feasibility and prognostic features of surgical resection of locally recurrent renal cell carcinoma patients after initial radical or partial nephrectomy.Methods:The data of the patients treated for postoperative locally recurrent renal cell carcinoma from Jan 2005 to Dec 2019 in the Department of Urology, Peking University First Hospital, were analyzed retrospectively. Postoperative locally recurrent of renal cell carcinoma is defined as disease recurring in the remnant kidney, renal fossa, adjacent abdomen, ipsilateral adrenal or retroperitoneal lymph nodes. Secondary surgery includes radical nephrectomy, partial nephrectomy, recurrent mass resection or radiofrequency ablation. The adjuvant therapy and prognostic information after secondary surgery were obtained and analyzed. Ninety-five patients were included in the study, with the median age of 56 years old (14-82 years old). The overall median recurrent interval was 25 months (2-164 months) and the median recurrent interval for radical and partial nephrectomy patients were 30 months and 25 months, with no significant difference. As for the secondary surgery, 63 patients underwent open surgery, 22 patients with laparoscopic surgery and 10 patients with radiofrequency ablation therapy.Result:The median operation time of secondary surgery was 148 minutes (35-330 minutes) and median intraoperative blood loss of 150 ml (20-3 000 ml). There were 8 cases of stage Ⅰ or stage Ⅱ postoperative complication, including wound infection and anemia. A stage Ⅲ complication of postoperative hematuria occured. The patient underwent renal artery embolization to control the hematuria. Eight patients suffered local recurrence and 10 patients experienced distant metastasis after the secondary surgery. During the follow-up, 6 patients died. The overall 3-year, 5-year disease free survival rate was 85.8% and 53.3%, respectively. The median survival time of patients with remnant kidney, renal fossa, and adjacent abdomen recurrence was 78 months, while 49 months for patients with ipsilateral adrenal and retroperitoneal lymph nodes recurrence ( P=0.141). Conclusions:With sufficient evaluation and preparation, the resection of the recurrent mass could be feasible and safe. With completion resection and negative surgery margin, patients could obtain relative long-term survival.

Association of oxidative stress markers and MRI overall burden with vascular cognitive impairment in patients with ischemic cerebral small-vessel diseases / 中华行为医学与脑科学杂志

Objective:To explore the correlation between oxidative stress markers malondialdehyde(MDA), superoxide dismutase(SOD), magnetic resonance burden and vascular cognitive impairment in patients with ischemic cerebrovascular disease (CSVD).Methods:Totally 300 patients with ischemic cerebral small vessel diseases who were admitted to the Department of Neurology, North China University of Science and Technology Affiliated Hospital were selected as the research subjects, and 60 healthy outpatients in the same period were selected as the control group.According to the results of mini mental state examination(MMSE), patients with ischemic cerebral small vessel diseases were divided into cognitive normal group (106 cases) and cognitive impairment group (194 cases). The cognitive impairment group was further divided into mild cognitive impairment group (101 cases), moderate cognitive impairment group (58 cases ) and severe cognitive impairment group (35 cases) according to Montreal cognitive assessment (MoCA). MDA and SOD were determined by double antibody sandwich method and the results were compared and analyzed.Results:(1) Compared with the control group(MDA: (8.40±1.81)μmol/L, SOD: (112.73±83.48)U/ml), the level of MDA increased while the level of SOD decreased significantly in normal group(MDA: (8.46±2.05)μmol/L, SOD: (108.90±88.72)U/ml) and cognitive impairment group(MDA: (12.19±7.02)μmol/L, SOD: (62.64±20.34)U/ml). Compared with the cognitive normal group, the level of SOD decreased significantly and MDA increased significantly in cognitive impairment group, the differences were statistically significant (all P<0.05). Compared with the normal cognitive group (1.18±1.10), the cognitive impairment group (1.93±1.05) had a higher MRI burden score ( P<0.05). (2)Multivariate analysis showed that the decrease of plasma SOD level( β=-0.024, OR=0.977, 95% CI=0.961-0.992)and the increase of plasma MDA level( β=0.110, OR=1.117, 95% CI=1.005-1.241)and the MRI overall burden( β=0.453, OR=1.573, 95% CI=1.011-2.446)were independent protective factors of vascular cognitive impairment in patients with ischemic CSVD.(3) Compared with mild cognitive impairment group(MDA: (9.79±5.79)μmol/L, SOD: (81.64±58.09)U/ml, MRI overall burdern (1.69±0.99)), the level of SOD decreased significantly and the level of MDA and the MRI overall burden increased significantly in moderate cognitive impairment group and severe cognitive impairment group(MDA: (7.95±2.44)μmol/L, SOD: (76.13±46.00)U/ml, MRI overall burden: (1.78±0.86)), (MDA: (11.16±6.68)μmol/L, SOD: (63.49±20.04)U/ml, MRI overall burden: (2.89±1.02). Compared with the moderate cognitive impairment group, the level of SOD decreased significantly and the level of MDA and the MRI overall burden increased significantly in the severe cognitive impairment group (all P<0.05). Conclusion:Increased plasma MDA level, MRI burden score and decreased SOD level in patients with CSVD are all risk factors for the occurrence of cognitive impairment.It is suggested that oxidative stress injury and cerebral small vessel lesions may be involved in the occurrence and development of cognitive impairment of CSVD from multiple aspects.

Comparative Study of ROCK1 and ROCK2 in Hippocampal Spine Formation and Synaptic Function / 神经科学通报·英文版

Rho-associated kinases (ROCKs) are serine-threonine protein kinases that act downstream of small Rho GTPases to regulate the dynamics of the actin cytoskeleton. Two ROCK isoforms (ROCK1 and ROCK2) are expressed in the mammalian central nervous system. Although ROCK activity has been implicated in synapse formation, whether the distinct ROCK isoforms have different roles in synapse formation and function in vivo is not clear. Here, we used a genetic approach to address this long-standing question. Both Rock1 and Rock2 mice had impaired glutamatergic transmission, reduced spine density, and fewer excitatory synapses in hippocampal CA1 pyramidal neurons. In addition, both Rock1 and Rock2 mice showed deficits in long-term potentiation at hippocampal CA1 synapses and were impaired in spatial learning and memory based on the water maze and contextual fear conditioning tests. However, the spine morphology of CA1 pyramidal neurons was altered only in Rock2 but not Rock1 mice. In this study we compared the roles of ROCK1 and ROCK2 in synapse formation and function in vivo for the first time. Our results provide a better understanding of the functions of distinct ROCK isoforms in synapse formation and function.

MRI features and related factors of ankle injury in amateur marathoners / 中华放射学杂志

Objective@#To explore the factors, characteristics and imaging manifestations of ankle joint injury in amateur marathoners (no formal training and no marathon career).@*Methods@#From December 2018 to March 2019, the amateur marathon runners in Guangdong Zhuhai had been recruited as research subjects according to the study inclusion and exclusion criteria. The questionnaires were used to collect relevant data, and the subjects underwent MRI scans of the ankle joint. The ankle joint special phased array coils were used to perform fast spin echo sequence (TSE) coronal T1WI and proton density-weighted fat-suppression sequence (PDWI-FS). Axial, coronal and sagittal scans, three-dimensional-double echo steady-state sequence (3D-DESS) and three-dimensional variable flip angle fast spin echo sequence (3D-SPACE) scans were also acquired. The results of the examination were independently analyzed by two radiologists (5 and 17 years of work experience, respectively) on the ligament, tendon, bone marrow and ankle joint injuries. When they had inconsistent views, the diagnosis provided by the third radiologist (27 years of work experience) was considered a final diagnosis. The relationship between ankle injury and different running postures, the number of participating in marathons and training intensity was analyzed, and the independent sample χ2 was used for statistical analysis. The consistency of two radiologists was tested by Kappa test.@*Results@#According to the inclusion and exclusion criteria, 39 subjects were included, with 64 ankles totally, 35 right ankles and 29 left ankles. MRI showed that (1) Ligament injuries: 28 ankles were anterior talofibular ligament injuriy;50 ankles were posterior talofibular ligament injury; 60 ankles the calcaneofibular ligament injuries and 54 ankles were deltoid ligament injuries, without complete injury. (2) Tendon sheath effusion and injuries: peritendinous effusion was common, with 47 flexor hallucis longus tenosynovitis, 49 posterior tibialis tenosynovitis, 37 flexor digitorum longus tenosynovitis, 7 peroneus longus tenosynovitis and 5 peroneus brevis tenosynovitis. (3) Synovitis effusion: 43 posterior ankle synovitis and local effusion. (4) Others: cartilage injury in 2 ankles, bone marrow edema in 8 ankles, and among them stress fracture in 2 ankles. The two radiologists had good consistency with the Kappa value of 0.91. Regarding the running posture, the incidence of ligaments injuries was obviously higher in those who landed on the hind foot than in those landed on front and middle foot,and the difference was statistically significant(P=0.013, χ2 value was 6.191).The incidence of tendon injuries was higher in those who landed on the front middle foot than in those landed on the hind foot, and the difference was statistically significant (P=0.029, χ2 value was 4.775). Those with larger training (training running ≥300 km/month) had significant ankle injury (P=0.005, χ2 value was 7.844).@*Conclusion@#The MRI features of ankle joint injuries in amateur marathon volunteers are related to different running postures and training intensity.

MRI features and related factors of ankle injury in amateur marathoners / 中华放射学杂志

Objective To explore the factors, characteristics and imaging manifestations of ankle joint injury in amateur marathoners (no formal training and no marathon career). Methods From December 2018 to March 2019, the amateur marathon runners in Guangdong Zhuhai had been recruited as research subjects according to the study inclusion and exclusion criteria. The questionnaires were used to collect relevant data, and the subjects underwent MRI scans of the ankle joint. The ankle joint special phased array coils were used to perform fast spin echo sequence (TSE) coronal T1WI and proton density?weighted fat?suppression sequence (PDWI?FS). Axial, coronal and sagittal scans, three?dimensional?double echo steady?state sequence (3D?DESS) and three?dimensional variable flip angle fast spin echo sequence (3D?SPACE) scans were also acquired. The results of the examination were independently analyzed by two radiologists (5 and 17 years of work experience, respectively) on the ligament, tendon, bone marrow and ankle joint injuries. When they had inconsistent views, the diagnosis provided by the third radiologist (27 years of work experience) was considered a final diagnosis. The relationship between ankle injury and different running postures, the number of participating in marathons and training intensity was analyzed, and the independent sample χ2 was used for statistical analysis. The consistency of two radiologists was tested by Kappa test. Results According to the inclusion and exclusion criteria, 39 subjects were included, with 64 ankles totally, 35 right ankles and 29 left ankles. MRI showed that (1) Ligament injuries: 28 ankles were anterior talofibular ligament injuriy;50 ankles were posterior talofibular ligament injury; 60 ankles the calcaneofibular ligament injuries and 54 ankles were deltoid ligament injuries, without complete injury. (2) Tendon sheath effusion and injuries: peritendinous effusion was common, with 47 flexor hallucis longus tenosynovitis, 49 posterior tibialis tenosynovitis, 37 flexor digitorum longus tenosynovitis, 7 peroneus longus tenosynovitis and 5 peroneus brevis tenosynovitis. (3) Synovitis effusion: 43 posterior ankle synovitis and local effusion. (4) Others: cartilage injury in 2 ankles, bone marrow edema in 8 ankles, and among them stress fracture in 2 ankles. The two radiologists had good consistency with the Kappa value of 0.91. Regarding the running posture, the incidence of ligaments injuries was obviously higher in those who landed on the hind foot than in those landed on front and middle foot,and the difference was statistically significant(P=0.013, χ2 value was 6.191).The incidence of tendon injuries was higher in those who landed on the front middle foot than in those landed on the hind foot, and the difference was statistically significant (P=0.029, χ2 value was 4.775). Those with larger training (training running ≥300 km/month) had significant ankle injury (P=0.005, χ2 value was 7.844). Conclusion The MRI features of ankle joint injuries in amateur marathon volunteers are related to different running postures and training intensity.

Effect of aripiprazole on prolactinemia induced by antidepressants in patients with depression / 中国神经精神疾病杂志

Objective To investigate the effect and safety of different doses of aripiprazole on hyperprolactinemia (HPL) induced by antidepressants such as Selective Serotonin Reuptake Inhibitor (SSRIs). Methods One hundred and thirty-five depressive patients with SSRIs antidepressant-induced hyperprolactinemia were randomly divided into three groups and 95 cases who finished the study were included in the study. Thirty-three cases in group 1 were treated with aripiprazole 5 mg/d, thirty-two cases in group 2 were treated with aripiprazole 10 mg/d and thirty cases in control group were treated with SSRI alone. All three groups also received cognitive behavioral therapy in addition to antidepressants for 12 weeks. Serum prolactin levels were examined before admission and 4, 8 and 12 weeks after treatment. Hamilton Depression Scale (HAMD), Global Assessment Function (GAF) and Treatment Emergent Symptom Scale (TESS) were used to evaluate the efficacy and adverse reactions. Results At the end of the 4, 8 and 12 weeks, the serum prolactin level in group 1 and group 2 were significantly lower than those in control group (P<0.05). At the end of 8 and 12 weeks, the HAMD scores of group 1 and 2 group were significantly lower than those of the control group (P<0.01). At the end of 4, 8, and 12 weeks, the GAF scores of group 1 and 2 group were significantly higher than those of the control group (P< 0.01). However, there were no significant differences in prolactin levels, HAMD and GAF scores between group 1 and group 2 (P>0.05). There was no significant difference in the rate of adverse reaction among the three groups (P>0.05). Conclusion Aripiprazole can reduce the hyperprolactinemia caused by SSRIs antidepressants and synergistically enhance efficacy of antidepressant.

Practice of undergraduate students' comprehensive ability training based on scientific research projects / 中华医学教育探索杂志

To explore new forms of undergraduate comprehensive ability training and provide objective basis for it through application of the theoretical research on scientific research project teaching into the undergraduate teaching practice. In the light of the existing theoretical research, a detailed process design was made and carried out in a teaching cycle. The SWOT analysis was done through the questionnaire. The results showed the self-discipline of the project students improved significantly. Compared with other students, the information resources utilization rate of the project students increased 45.6 percentage points , comprehensive quality evaluation of them were 26 percentage points higher. The project completion degree was 87.3％, and one provincial innovation and entrepreneurship project and two school innovation and entrepreneurship projects were approved. The teaching form based on scientific research project has obvious effect in improving the comprehensive ability of undergraduates . Although facing many threats and shortcomings , the new teaching form has strong adaptability and feasibility.

Evaluating inferior vena cava wall invasion in renal cell carcinoma tumor thrombus with MRI / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the diagnostic performance of MRI for the assessment of inferior vena cava (IVC) wall invasion by IVC thrombus in patients with renal cell carcinoma (RCC).@*METHODS@#We retrospectively collected patients who underwent radical nephrectomy and thrombectomy for RCC between 2010 and 2018 at Peking University First Hospital. All the patients underwent imaging on a 1.5 Tesla or 3.0 Tesla MRI scanner. Fifty-six patients met the inclusion criteria. Preoperative imaging was reviewed by two radiologists blinded to details of the patient's surgical procedure and histopathology. Two radiologists measured the maximum anterior-posterior diameter and coronal diameters of the IVC and renal vein, and the craniocaudal extent of tumor thrombus, and evaluated the MRI features of IVC thrombus, including occlusion of the IVC lumen, the margin of the tumor thrombus (smooth vs. irregular), contact of the IVC thrombus and IVC wall, and altered signal of the IVC wall. Univariable and multivariable associations of clinical and radiographic features with IVC wall invasion were evaluated by Logistic regression.@*RESULTS@#Of the 56 patients [male: 43, female: 13, mean age: (55.64±0.43) years], 17 (30.36%) were detected with IVC wall invasion, and most were clear cell carcinoma. Tumor thrombus with IVC wall invasion showed an increase in length of IVC thrombus [(7.91±3.59) cm vs. (5.94±3.57) cm, P=0.049], and more features of complete occlusion of the IVC lumen (P=0.002), irregular margin of the IVC thrombs (P=0.005), contact of the IVC thrombus and IVC wall (P=0.001), and altered signal of the low-intensity vessel wall (P<0.001), with a sensitivity of 94.12% and a specificity of 79.49%.@*CONCLUSION@#The present study indicates that MRI could be a means of evaluating RCC with IVC wall invasion, and the combination of tumor thrombus length and subjective impression of IVC wall invasion achieved a high sensitivity and specificity for diagnosis.

Clinicopathologic features and prognostic analyses of locally recurrent renal cell carcinoma patients after initial surgery / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the clinicopathologic features and potential prognostic predictors of locally recurrent renal cell carcinoma patients after initial surgery.@*METHODS@#Authors retrospectively analyzed data extracted from 81 patients who were treated for postoperative locally recurrence of renal cell carcinoma from January 2006 to June 2016 in the Department of Urology, Peking University First Hospital. Postoperative locally recurrence of renal cell carcinoma was defined as disease recurring in the remnant kidney, renal fossa, adjacent abdomen, ipsilateral adrenal and retroperitoneal lymph nodes.@*RESULTS@#In the study, 81 patients were finally included, of whom 43 were initially treated in our hospital and 38 were initially treat in other centers. Partial nephrectomy (PN) was performed for 38 cases (26 in our hospital and 12 in other hospitals) as initial treatment and radical nephrectomy (RN) was conducted for the remnant 43 cases (17 in our hospital and 26 in other hospitals). Overall median recurrence time was 26 months (range: 3-164 months), in which 26 months (range: 3-55 months) for PN cases and 30 months (range: 4-164 months) for RN cases (P=0.009). Sixty-nine patients had single site recurrence, including remnant kidney (n=29), renal fossa (n=20), abdomen (n=4), ipsilateral lymph nodes (n=5), ipsilateral adrenal (n=11), while 12 patients had multiple sites recurrence. Seventy-eight patients were managed by complete surgical resection, while three patients were managed by radiofrequency ablation. Postoperative pathological diagnoses included clear cell carcinoma (n=72), papillary renal cell carcinoma (n=8, 7 cases with type 1, 1 case with type 2) and Xp11 translocation/TFE3 gene fusion renal cell carcinoma (n=1). Complete pathologic information of the initial surgery could be extracted from 43 patients who were initially treated in our hospital. Seventeen patients with initial radical nephrectomy were staged as T1a (n=4), T1b (n=2), T2a (n=1), T3a (n=8), and T3b (n=2). Twenty-six patients with initial partial nephrectomy were staged as T1a (n=18), T1b (n=7), and T3a (n=1). For PN cohort, the patients with T1a stage disease had longer median recurrence time than those with beyond T1a stage disease, and the difference was significant (29 months vs. 18 months, P=0.041). At the end of the follow-up, 58 patients were alive, 4 died and 19 lost the follow-up. Overall, 3-year and 5-year disease free survival rates were 81.9%, and 53.6%, respectively.@*CONCLUSION@#The present research reported a large-scale single central experience of locally recurrent renal cell carcinoma. The recurrence time of the PN group is shorter than that of the RN group. For patients after PN surgery, median recurrence time is longer for patients with T1a stage tumor when compared with those with stage beyond T1a. Patients can obtain relative long-term survival after complete secondary surgery resection.

Application of the "Trinity" management mode on operating room efficiency improvement / 中华医院管理杂志

The " Trinity" management model of refined management, PDCA cycle and quality control circle was introduced into operating room ( OR ) management at our hospital since 2017. This practice aims to improve the OR process with refined management, elevate management practice with PDCA cycle, and improve detailed efficiency with quality control circle. 2017 witnessed a significant increase of the hospital in the number of surgical procedures, the punctuality rate of anesthesia, and the punctuality rate of the first surgery, as well as OR turnaround times than 2016. This model plays an important role in improving the efficiency of the OR, thus raising business revenue of the hospital.

Effects of lead exposure and high fat diet on the hippocampal inflammatory factors and learning-memory in male rats / 中国职业医学

OBJECTIVE: To investigate the effects of lead exposure and high fat diet on the hippocampal inflammatory factors and learning-memory in rats. METHODS: A total of 40 specific pathogen free male SD rats were randomly divided into control group,high fat diet group,lead exposure group,combine exposure group,10 rats in each group. Rats in control group were given regular diet and rats in high-fat diet group were given high-fat diet. Rats in lead exposure group were given regular diet and water with 400 mg/L lead acetate. Rats in combine exposure group were given high fat diet and water with 400 mg/L lead acetate. Body weight was measured every other week. The exposure period was 9 weeks. Morris water maze was applied to measure the learning-memory. The content of total cholesterol,triglyceride(TG),low density lipoprotein cholesterol(LDL) and high density lipoprotein cholesterol(HDL) in serum were detected by using microplate reader. The lead content of hippocampus was detected by inductively coupled plasma mass spectrometer. Enzyme-linked immuno sorbent assay was used to detect the content of tumor necrosis factor-α(TNF-α),interleukin(IL)-1β,IL-4,IL-6 and interferon-γ(IFN-γ). RESULTS: Beginning from the third week,the body weight of rats in high fat diet and combine exposure group were significantly higher than that in control group(P < 0. 05). In addition,the body weight of rats in combine exposure group were higher than that in lead exposure group(P < 0. 05). Escape latency and the frequency of crossing platform of rats in high fat diet group,lead exposure group and combine exposure group were significant changed compared with those in control group(P < 0. 05). The escape latency of rats in combine exposure group increased compared with those in high fat diet group and lead exposure group(P < 0. 05). In addition,serum TG and LDL content in high-fat diet group and combine exposure group increased and HDL decreased compared with the control exposure group and lead exposure group(P < 0. 05). Compared with the control group and high fat diet group,the content of lead in hippocampus of lead exposure group and combine exposure group substantially increased(P < 0. 05). The levels of TNF-γ,IL-6,IL-1β,IFN-γ of hippocampus in high fat diet group,lead exposure group and combine exposure group were significantly higher than those in control group(P < 0. 05). Besides,the levels of IL-4 of hippocampus in lead exposure group and combine exposure group were higher than that in control group(P < 0. 05). IL-1β content of rats hippocampus in combine exposure group was higher than that in high-fat diet group or lead exposure group(P < 0. 05). CONCLUSION: Combine lead and high-fat diet exposure can exert a synergy in decrease of learning-memory in rats. IL-1β might involved in the process of synergic neurotoxicity induced by lead and high fat diet.