ZHANG Wei-hua's experience in clinical treatment of somatalgia with "point-zone-strip stimulation technique" of acupuncture / 中国针灸

The clinical experience in treatment of somatalgia with "point-zone-strip stimulation technique" of acupuncture of professor ZHANG Wei-hua was summarized. Professor ZHANG integrates the theories of the cutaneous region of meridian, biaoben, "taking tender point as acupoint" and local holography as a whole in treatment of somatalgia. The "point-stimulation technique" of acupuncture (subcutaneous needling technique) is adopted for the painful site less than 3 cm in diameter, the "zone-stimulation technique" (surrounding needling technique) is for the site larger than 3 cm in diameter and the "strip-stimulation technique" (cubit-tibia needling technique) is for various acute and chronic somatalgia. These three needling techniques are applicable singly or in combination in clinical practice.

Potential Role of Right Cerebellum in Post-stroke Aphasia: A Preliminary Study Based on Granger Causality Analysis / 中国康复理论与实践

Objective To explore the recovery mechanism of language network among post-stroke aphasic patients by investigating the difference of whole-brain amplitude of low frequency fluctuations (ALFF) and the Granger causality analysis (GCA) between the patients and the controls. Methods From May, 2019 to May, 2021, 19 patients with aphasia after left hemispheric stroke and 17 age- and sex- matched healthy controls finished functional magnetic resonance imaging scanning. All the patients assessed with Chinese version of Western Aphasia Battery (WAB). Restplus was used for fMRI data analysis. Regions with significant difference of ALFF between groups were chosen as regions of interests (ROI) for the following GCA analysis. Results ALFF in left inferior frontal gyrus triangle (LIFGtri) and left medial frontal gyrus (LMFG) were significantly lower in the patients than in the controls. Effective connectivity from LIFGtri to LMFG and from LMFG to the right cerebellar Crus I were significantly lower in the patients. Effective connectivity from right cerebellar Crus II to LIFGtri, from right cerebellar Crus I to LMFG were significantly greater in the patients. Conclusion Unidirectional negative regulatory pathway such as LIFGtri→LMFG might be injured in post-stroke aphasia, while, connectivities between right cerebellar Crus II→LIFGtri and right cerebellar Crus I →LMFG enhanced. Right cerebellum might be the potential target for the language recovery.

Potential Role of Right Cerebellum in Post-stroke Aphasia: A Preliminary Study Based on Granger Causality Analysis / 中国康复理论与实践

Objective To explore the recovery mechanism of language network among post-stroke aphasic patients by investigating the difference of whole-brain amplitude of low frequency fluctuations (ALFF) and the Granger causality analysis (GCA) between the patients and the controls. Methods From May, 2019 to May, 2021, 19 patients with aphasia after left hemispheric stroke and 17 age- and sex- matched healthy controls finished functional magnetic resonance imaging scanning. All the patients assessed with Chinese version of Western Aphasia Battery (WAB). Restplus was used for fMRI data analysis. Regions with significant difference of ALFF between groups were chosen as regions of interests (ROI) for the following GCA analysis. Results ALFF in left inferior frontal gyrus triangle (LIFGtri) and left medial frontal gyrus (LMFG) were significantly lower in the patients than in the controls. Effective connectivity from LIFGtri to LMFG and from LMFG to the right cerebellar Crus I were significantly lower in the patients. Effective connectivity from right cerebellar Crus II to LIFGtri, from right cerebellar Crus I to LMFG were significantly greater in the patients. Conclusion Unidirectional negative regulatory pathway such as LIFGtri→LMFG might be injured in post-stroke aphasia, while, connectivities between right cerebellar Crus II→LIFGtri and right cerebellar Crus I →LMFG enhanced. Right cerebellum might be the potential target for the language recovery.

Effect of Danggui Yinzi on Relieving Allergic Reaction in CU Model Mice by Autophagy Pathway / 中国实验方剂学杂志

Objective:To investigate the effect of Danggui Yinzi on allergic reaction in chronic urticaria (CU) mice model and the mechanism of autophagy intervention. Method:The SPF BALB/c mice were used to replicate the CU mice model by intraperitoneal injection of ovalbumin and aluminum hydroxide suspension. The animals were randomly allocated into six groups: a normal group (normal saline 20 mL·kg-1·d-1), a model group (normal saline 20 mL·kg-1·d-1), a loratadine group(0.001 3 g·kg-1·d-1), a Danggui Yinzi high，medium and low-dose group（39.3，19.6，9.8 g·kg-1·d-1）. The pathological changes of skin tissues were observed by hematoxylin-eosin (HE) staining. Morphological changes of autophagy in skin tissues epithelial cells were observed by transmission electron microscope. The mRNA levels of microtubule-associated protein 1 light chain 3B(LC3B) and ubiquitin-binding protein p62 mRNA in skin tissues were detected by real-time quantitative polymerase chain reaction (Real-time PCR). The expressions of LC3B and p62 in skin tissues were detected by immunohistochemistry (IHC). Result:Danggui Yinzi can significantly improve the pathological manifestations of dermal edema, collagen bundles separation, telangiectasia in CU mice， it can also improve autophagosomes formation and abnormal cell ultrastructure such as nuclear chromatin condensation, mitochondrial swelling, endoplasmic reticulum expansion, etc. Compared with the normal group, the protein expressions of LC3B in skin tissues of the model group was significantly increased (P<0.01), LC3B mRNA level was increased too, while p62 mRNA levels and its protein expressions were decreased-regulated (P<0.01). Compared with the model group, levels of LC3B mRNA and protein expressions of the Danggui Yinzi groups were significantly increased (P<0.05,P<0.01), while p62 mRNA levels and its protein expressions were significantly decreased-regulated (P<0.05,P<0.01). Conclusion:Danggui Yinzi can regulate the expression of LC3B, p62 mRNA and protein expressions, enhance the level of autophagy, and improve the pathological state of CU mice.

Relationship between skeletal muscle reduction and quality of life and mental status in maintenance dialysis patients / 第二军医大学学报

Objective To investigate the current status of skeletal muscle reduction (abbreviated as sarcopenia), quality of life and mental status of maintenance dialysis (MHD) patients, and to explore the relationship between sarcopenia and the quality of life and mental status. Methods According to the diagnostic criteria developed by the European Working Group on Sarcopenia in Older People, 101 MHD patients treated in our hospital in Dec, 2017 were divided into sarcopenia group (n＝51) and non-sarcopenia group (n＝50). The body composition was measured by human body composition monitor in all the patients. The quality of life was assessed using the SF-36 scale. The anxiety and depression were assessed with the hospital anxiety and depression scale (HADS). Multivariate linear regression analysis was used to explore the relationship between sarcopenia and the quality of life and mental status of the MHD patients. Results There were significant differences in the age, gender, body mass index (BMI), Charlson comorbidity index, grip strength, walking speed, somatic cell mass, extra-cellular fluid/total body fluid ratio (ECF/TBF), high-sensitivity C-reactive protein (hsCRP), urea clearance index (Kt/V), anxiety, depression, physical function, bodily pain, general health status and mental health between the two groups (P0.05, P0.01). While there were no significant differences in the marital status, education, annual income, dialysis age, primary disease, hemoglobin, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, prealbumin, albumin, serum calcium, blood phosphorus, intact parathyroid hormone, physical role, vitality, social function and emotion role between the two groups (all P0.05). Multivariate linear regression analysis showed that skeletal muscle mass, marital status and comorbidity were the influencing factors of the quality of life of MHD patients with sarcopenia (all P0.05), and skeletal muscle mass, BMI and annual income were the influencing factors of mental status of MHD patients with sarcopenia (P0.05, P0.01). Conclusion The incidence of sarcopenia is high in MHD patients. Sarcopenia is related to poor quality of life, and anxiety and depressive symptoms, highlighting the importance of early detection and attention to sarcopenia.

Nitric oxide mediated TNF-α, IL-1β gene expression in liver induced by crush injury of rat's soft tissues / 法医学杂志

OBJECTIVE@#To explore the effect of nitric oxide (NO) on the gene expression of hepatic TNF-α and IL-1β by crush injury of rat's soft tissues.@*METHODS@#Rats were randomly divided into sham group, crush group, crush+aminoguanidine (AG) group, and crush+L-arginine (L-Arg) group. Activities of ALT and AST as well as NO level in serum were measured. Gene expressions of TNF-α and IL-1β were detected with RT-PCR.@*RESULTS@#Obvious increase in TNF-α and IL-1β mRNA expression was detected in the crush group compared with the sham group (P<0.05). After pretreated L-Arg, expressions of TNF-α and IL-1β mRNA were markedly increased (P<0.05). After pretreated AG, those indices obviously decreased (P<0.05). Activities of ALT and AST enhanced and NO level increased in the crush group compared with the sham group (P<0.05). Pretreatment with L-Arg or AG led to substantial increased or reduced activities of ALT and AST as well as NO levels, respectively.@*CONCLUSION@#Endogenous NO mediated TNF-α, IL-1β mRNA up expression in liver induced by increased production of NO after crush injury of rat's soft tissues.

Therapeutic effects and prognostic factors for the limited-stage small cell lung cancer treated with multidisciplinary therapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the differences of objective response rate (ORR), side effects and survival among patients with limited-stage small cell lung cancer (LD-SCLC), who received concurrent chemoradiotherapy, sequential chemoradiotherapy or chemotherapy alone, and to analyze the influencing factors on their survival.</p><p><b>METHODS</b>One hundred and sixty-six patients diagnosed as LD-SCLC in Peking Union Medical College Hospital from January 2000 to December 2009 were included in this study. The differences of objective response rates, side effects and survival rates were analyzed by χ2 test. Kaplan-Meier test was used to calculate the overall survival (OS) and progress-free survival (PFS). Cox regression was used to detect the influencing factors on survival time of the patients.</p><p><b>RESULTS</b>The patients were divided into three groups: concurrent chemoradiotherapy (49 cases), sequential chemoradiotherapy (62 cases) and chemotherapy alone (55 cases). The chemotherapy was based on CE/EP regimen, with an average cycle of 5.2. Radiotherapy was of a common or 3-dimensional conformal technology, for regular segmentation irradiation with an average dose of 49.6 Gy. The total ORR was 73.4%, OS and PFS were 22.9 months and 10.8 months, 1, 3, 5-year survival rates were 82.7%, 31.8%, 18.6%, respectively. For the concurrent group, sequential group and chemotherapy alone group, the ORR was 89.4%, 67.2% and 66.0%, respectively. Compared the chemotherapy alone group and concurrent group with the sequential group, there were significant differences (P<0.05). For the concurrent group, sequential group and chemotherapy alone group, the median OS was 29.7 months, 22.6 months, and 19.5 months; the median PFS was 12.7 months, 10.8 months, and 9.8 months, respectively, with a non-significant difference between each two groups (P>0.05). For the concurrent group, sequential group and chemotherapy alone group, the 1-year survival rates were 91.1%, 86.3%, and 65.6%, the 3-year survival rates were 44.2%, 28.3% and 22.8%, and the 5-year survival rates were 24.2%, 21.4% and 11.1%, respectively, with significant differences among them (P<0.05). The major side effects were myelosuppression, gastrointestinal reactions, radiation pneumonia and radiation esophagitis. For the concurrent group, sequential group and chemotherapy alone group, the incidence of myelosuppression were 84.4%, 76.8% and 60.0%, respectively, with a significant difference (P=0.008) between the concurrent group and chemotherapy alone group. For the concurrent group and sequential group, the incidences of radiation pneumonia were 22.2% and 22.9%, with a non-significant difference (P=0.940). The incidences of radiation esophagitis were 47.2% and 16.7%, respectively, with a significant difference (P=0.002). Multivariate analysis showed that OS was significantly associated with gender (P=0.018) and ECOG score (P=0.009), and PFS was significantly associated with gender (P=0.050).</p><p><b>CONCLUSIONS</b>For LD-SCLC, concurrent chemoradiotherapy can significantly increase the objective response rate. Concurrent chemoradiotherapy and sequential chemoradiotherapy compared with chemotherapy alone can extend survival, and concurrent chemoradiotherapy is better, but the differences among the three regimens are not significant. Gender and ECOG score are important influencing factors of survival.</p>

Analysis of 54 mental disability reappraisal cases due to brain damage / 法医学杂志

OBJECTIVE@#To investigate the different kinds of controversial cases of mental disability after brain damage, to analysis the problems in the first appraisal, and to explore solutions of the problems.@*METHODS@#The reappraisals of mental disorders after traumatic brain damage were collected from 2007-2011 in Shanghai forensic center, and the first appraisal and reappraisal cases were analyzed and compared.@*RESULTS@#The changes of conclusion in reappraisal cases showed the following major reasons: inappropriate appraisal time, not comprehensive and object investigation of mental state of patients in first appraisal, misunderstanding the standards, etc.@*CONCLUSION@#The quality improvement of appraisal should adopt the following measures: regulating the practice, improvement of the professional skills of experts, choosing appropriate appraisal time, improvement of appraisal standards, etc.

Differential temporal neural responses of pain-related regions by acupuncture at acupoint ST36: a magnetoencephalography study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous neuroimaging studies primarily focused on the spatial distribution of acupuncture needling stimulation. However, a salient feature of acupuncture was its long-lasting effect. This study attempted to detect the spatial-temporal neural responses evoked by acupuncture at an analgesia acupoint ST36 by using magnetoencephalography. To further verify its functional specificity, we also adopted acupuncture at Pericardium 6 and nonacupoint as separated controls.</p><p><b>METHODS</b>Forty-two college students, all right-handed and acupuncture naïve, participated in this study. Every participant received only one acupoint stimulation, resulting in 14 subjects in one group. Both magnetoencephalography data (151-channel whole-head system) and structural functional magnetic resonance imaging data (3D sequence with a voxel size of 1 mm(3) for anatomical localization) were collected for each subject. All processing procedures were performed in BrainStorm Toolbox.</p><p><b>RESULTS</b>Acupuncture at ST36 showed a significantly time-varied brain activities with different onset time. Our results presented that acupuncture at different acupoints (or comparing with nonacupoint) can specifically induce neural responses in different brain areas-acupuncture at ST36 can specifically induce the neural responses of pain-inhibition areas, while acupuncture at PC6 can specifically induce the activities of the insula and amygdala.</p><p><b>CONCLUSIONS</b>In the present study, we attempted to detect the temporal neural responses underlying the functional specificity of acupuncture at ST36, using acupoint belonging to different meridians and non-acupoint with efficacy-irreverent as separate controls. The specific neural substrates involving acupuncture at different acupoints may be related to its functional specificity in clinical settings.</p>

Comparison of the ability of wavelet index and bispectral index for reflecting regain of consciousness in patients undergone surgery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Wavelet index (WLI) is a new parameter for monitoring depth of anesthesia based on Wavelet analysis. We observed the change of WLI and bispectral index (BIS) in patients regain of consciousness (ROC) in the absence of frontalis electromyographic (EMG) interference. The aim of this study was to compare the ability of WLI and BIS for reflecting ROC in patients undergone surgery.</p><p><b>METHODS</b>Twelve patients who were scheduled for maxillofacial surgeries were enrolled in the study. BIS and WLI values were monitored continually. After being given midazolam and remifentanil, patients were asked to squeeze the investigator's hand ever 30 seconds. Patients were continuously given propofol until loss of consciousness (LOC1). Tunstall's isolated forearm technique was used to test the surgical consciousness in patients. After total muscle relaxation, endotracheal intubations were performed, and the patients were connected to a ventilator. Then, propofol was withdrawn until the patients showed regain of consciousness (ROC1) and an awareness reaction. After the command test, patients were readministered with propofol until loss of consciousness (LOC2). After surgery, all of the sedatives were withdrawn, and the patients were let to regain consciousness (ROC2).</p><p><b>RESULTS</b>The BIS values of twelve patients at ROC1 after using muscle relaxant were much lower than those at LOC1 and ROC2 without using muscle relaxant, showing statistical significance (P < 0.05). Meanwhile, the WLI values of twelve patients at ROC1 after using muscle relaxant were much higher than those at LOC1 and equal to ROC2 without using muscle relaxant, showing statistical significances (P < 0.05) between ROC1 and LOC1.</p><p><b>CONCLUSIONS</b>This study showed that under muscle relaxation or facial paralysis, when there is no EMG signal, BIS can not accurately reflect regain of consciousness in surgical patients, but WLI can reflect it accurately. So WLI may have advantages for reflecting state of consciousness in surgical patients.</p>

Efficacy and safety of erlotinib as monotherapy for advanced non-small cell lung cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the efficacy and safety of erlotinib monotherapy for advanced non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Totally 50 patients with advanced NSCLC received oral erlotinib 150 mg/d treatment, and tumor specimen in 19 patients were collected for epidermal growth factor receptor (EGFR) gene mutation tests. Median survival (MS) was calculated using the Kaplan-Meier method.</p><p><b>RESULTS</b>The most common adverse events (AEs) were skin rash (96%) and diarrhea (32%). The overall survival (OS) of all patients was 21.8 months 95% confidential interval (CI): 17.1-26.4 months and the median progression-free survival (PFS) of all patients was 7.0 months (95% CI: 3.9-10.1 months). EGFR mutation analysis showed gene mutation in 8 cases and wild type in 11 cases. The objective response rate in patients with or without EGFR gene mutations were 62.5% and 9.1%, respectively (chi(2)=6.631, P=0.036). PFS in patients with or without EGFR gene mutations were 16.330 (95% CI: 2.803-29.857 months) and 5.570 months (95% CI: 2.441-8.699 months), respectively (chi(2)=8.799, P=0.003).</p><p><b>CONCLUSION</b>Erlotinib monotherapy is safe and effective for some Chinese NSCLC patients after failure of prior chemotherapy.</p>

Investigation of clinical pathology and treatments on the auricle pseudocyst / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To study the clinical pathology and treatments on the pseudocyst of auricle.</p><p><b>METHODS</b>Sixty cases of auricular pseudocyst were treated by surgery from 1993 to 2008 in our hospital. Their operation effects and the clinic pathological features were analyzed.</p><p><b>RESULTS</b>The clinic pathological data showed that the source of serous effusion of auricular pseudocyst origin from cartilage membrane in the top wall. In the early stage of the cyst, the top wall of auricular pseudocyst was the cartilage membrane. With the course progresses, the cartilage membrane in the top wall of auricular pseudocyst was proliferating, thickened and generated new cartilage. The new cartilage was formed from small piece to the big one, and eventually became an entire new cartilage on the top wall of auricular pseudocyst. Serous effusion at this time was terminated, and this cyst became intra-cartilaginous effusion of auricle. Finally the fluid between cartilages was absorbed and organized. In the cyst, the new cartilage and auricle cartilage were organized and adhered together each other. The auricle became thickened and deformed. The observation of capsule wall under light microscope showed that there were a few fibrous desmoplasia, anapetia and lymphocyte infiltrating in the fibrous tissue, as well as that there were cartilage cell layers from firmness to thicker. The cartilage cells and their lacunes were small, and the cartilage capsule and the basilaris substantia was showed as eosin. This data indicated that the cartilage was neogenesis but not degenerating. Sixty patients were followed up from 3 months to 1 year. The effect of surgical treatment for the auricular pseudocyst was satisfactory. There was no auricular deformation in these patients with the operation.</p><p><b>CONCLUSIONS</b>Auricular pseudocyst can be divided into the early period (acute exudative period), the medium period (cartilage formation period) and the late period (proliferative and organized period). The treatment should be based on the pathological findings of auricular pseudocyst. The operation is easy, safe and reliable. The key of the operation is the complete removal of perichondrium and cartilage at the top of auricular pseudocyst.</p>

Efficacy and safety of gefitinib in maintenance therapy for patients with advanced non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of gefitinib as maintenance therapy for patient with advanced non-small lung cancer (NSCLC).</p><p><b>METHODS</b>From Oct. 2002 to Apr. 2006, 173 patients with advanced NSCLC received oral gefitinib 250 mg per day after completion of induction chemotherapy (62 patients, maintenance therapy group) or recurrence after one or more regimens of chemotherapy (111 patients, recurrent group). Median survival (MS) and progress free survival (PFS) were calculated using the Kaplan-Meier method, and Cox regression analysis was used to analyze the difference between the sub-groups stratified by smoking, pathological type, liver metastasis and gefitinib treatment result.</p><p><b>RESULTS</b>MS of maintenance therapy group and recurrent group were 25.0 months (95% CI: 19.3-30.7) and 12.5 months (95% CI: 9.3-15.7), respectively. There was a statistically significant difference between the above two groups (P = 0.0004). PFS of maintenance therapy group and recurrent group was 16.5 months (95% CI: 8.7-24.3) and 9.2 months (95% CI: 7.5-10.9), respectively. There was also a statistically significant difference between these two groups (P = 0. 0000). It was found that median MS in maintenance therapy group was significantly correlated with smoking status, pathology type, liver metastasis and objective response of gefitinib.</p><p><b>CONCLUSION</b>Maintenance therapy with gefitinib after induction chemotherapy may improve overall survival in patient with non-small cell lung cancer.</p>

Lung pathology of complex congenital heart defect with diminished pulmonary blood flow but without aortopulmonary collateral artery and patent ductus arteriosus in infants and young children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>The development of pulmonary vascular bed is strongly flow-dependent. Abnormal pulmonary blood flow leads to pulmonary pathological changes. This study aimed to observe the pathological changes of small pulmonary arteries and alveoli in complex congenital heart defect with diminished pulmonary blood flow but without aortopulmonary collateral artery (APCA) and patent ductus arteriosus (PDA) in infants and young children.</p><p><b>METHODS</b>Autopsy pulmonary specimens obtained from 5 children who died of non-cardiovascular diseases were used as the control group (age: 4-18 months). Fifty-six children (age: 4-36 months) with complex congenital heart defect with diminished pulmonary blood flow but without APCA and PDA served as the study group, including 34 cases of tetralogy of Fallot, 7 cases of double outlet right ventricle with pulmonary stenosis, 9 cases of single ventricle with pulmonary stenosis, 4 cases of tricuspid atresia with pulmonary stenosis and 2 cases of complete atrioventricular septal defect with pulmonary stenosis. Pulmonary specimen sections were stained by hematoxylin-eosin and Weigert-Van Gieson. Percentage of media thickness (MT%), percentage of media section area (MS%), number of small arterial per square centimeter (APSC), mean alveolar number (MAN), mean linear intercept (MLI), proportion of parenchyma area in total area (PPA%) and alveolar to small arterial ratio per unit area (AAR) were measured by morphologic quantitative analysis.</p><p><b>RESULTS</b>MT% (10.93+/-2.87% vs 15.08+/-2.51%), MS% (18.97+/-5.56% vs 25.04+/-3.87%) and APSC (202.43+/-67.45 vs 441.69+/-65.29) decreased significantly in the study group compared with the control group (P<0.01). The internal diameter of small pulmonary artery (80.26+/-21.57 microm vs 58.53+/-10.29 microm; P<0.05), AAR (46.59+/-14.43 vs 34.46+/-4.98; P<0.01) and MLI (144.98+/-44.87 microm vs 108.39+/-20.76 microm; P<0.05) increased significantly compared with the control group.</p><p><b>CONCLUSIONS</b>The media of small pulmonary arteries becomes thinner, the lumen of small pulmonary arteries becomes larger, and the number of small arterial per square centimeter and the mean alveolar number are reduced in infants and young children with complex congenital heart defect with diminished pulmonary blood flow but without APCA and PDA.</p>

Observation on acupuncture at "Neitinggong" for antagonisting ototoxicity caused by gentamicin / 中国针灸

<p><b>OBJECTIVE</b>To explore the effect of acupuncture at "Neitinggong" drug-induced deafness.</p><p><b>METHODS</b>Guinea pig deafness model was prepared by injection of gentamicin (GM). Acupuncture was respectively given at the points "Neitinggong" "Tinggong" (SI 19) and non-acupoints on the auricle in the experimental animals in different groups and the effects of different points on the auditory brainstem response and cochlear hair cells were observed.</p><p><b>RESULTS</b>There was a significant difference between GM group and Neitinggong group, and between GM group and Tinggong group. There was no significant difference between GM group and the auricle group, and between Neitinggong group and Tinggong group.</p><p><b>CONCLUSION</b>Acupuncture at "Neitinggong" can strength the function of the internal ear, and relieve the injury of cochlear hair cells caused by gentamicin, which is an effective acupoint for treatment of drug-induced deafness.</p>

Gefitinib in the treatment of advanced non-small cell lung cancer with brain metastasis / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Brain metastasis is frequently found in patient with advanced non-small cell lung cancer. Gefitinib is a inhibitor of epidermal growth factor receptor and can be used for the treatment of advanced non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the antitumor efficacy of Gefitinib in advanced NSCLC patients with brain metastasis.</p><p><b>METHODS</b>Forty-four consecutive NSCLC patients with brain metastases were treated with gefitinib, which was administered orally at daily dose of 250 mg. Of these patients, 30 had been treated with WBRT and 42 received chemotherapy one month before enrolled into the study.</p><p><b>RESULTS</b>Partial response (PR) was observed in 14 patients (31.8%), stable disease (SD) in 21 (47.7%) with an overall disease control rate of 79.5%. Median progression-free survival (PFS) was 9 months and median overall survival (OS) was 13.0 months. The difference in disease control rate between the patients who had previous WBRT and those without was not significant (P = 0.566). The toxicity is mild and tolerable.</p><p><b>CONCLUSION</b>Our data shows that Gefitinib is safe and may be effective on brain metastasis, which may become an alternative treatment option for the patient with advanced NSCLC.</p>

Change of nitric oxide in local muscle of crush injury hind-limbs in rats / 法医学杂志

OBJECTIVE@#To investigate the change of nitric oxide (NO) level in local muscles induced by crushing hind-limbs in rats.@*METHODS@#The rat experimental model of hind-limb crushing injury was established by crushing the hind limbs of rats with standard weight for 5 hours, thereafter releving the standard weight for another 5 hours. The rats were randomly divided into sham group, crushing group, crushing and injecting aminoguanidine (AG) group, crushing and injecting L-arginine (L-Arg) group. The NOS activity and NO level in local muscles and serum were spectrophotometrically measured, and iNOS and eNOS protein expressions in local muscles were examined by immunohistochemistry. The weight ratio of wet to dry (W/D) of local muscles was measured and the pathologic changes were observed.@*RESULTS@#The crushing hind-limbs induced serious primary and secondary injuries of local muscles such as rupture and rhadomyolysis of skeletal muscular fibers, interstitial vascular congestion and edema, and marked increase in W/D. The expressions of eNOS and iNOS were upregulated in local muscle in crush group compared with sham group. The NOS activity and NO level in local muscles and serum significantly increased. There was positive relationship between NO level and W/D in local muscles. With the usage of AG and L-arg, the hind-limb injuries seemed alleviated and aggravated, respectively.@*CONCLUSION@#The crushing hind-limbs of rats elicited the upregulation of eNOS and iNOS protein expression, the enhancement of NOS activity and the excess production of NO, the latter of which was involved in the mediation of secondary pathological changes in local muscles.

Relationship between the quantitative structural study of lung and the right ventricle outflow tract reconstruction in infants with tetralogy of Fallot / 中国医学科学院学报

<p><b>OBJECTIVE</b>To analyse the relationship between the quantitative structural study of lung and right ventricle outflow tract reconstruction in infants with tetralogy of Fallot.</p><p><b>METHODS</b>Lung biopsies were taken during the operations in 16 infants suffered from tetralogy of Fallot. Autopsy specimens were obtained from 5 infants died of non-cardiovascular diseases as normal control group. All patients underwent one staged repair. The techniques of right ventricular outflow tract reconstruction included pulmonary valve commissurotomy (n = 3), transanular pericardial patch (n = 4), and transannular homologous monocuspid valve patch (n = 8); homograft was used in one patient because of the abnormal coronary artery. The diameters of main pulmonary artery (MPA), left pulmonary artery (LPA), and right pulmonary artery (RPA) were measured during operation. The tissue was fixed with buffered formalin and routinely impregnated in wax. Sections were stained by hematoxylin-eosin, and Weigert's elastic stain counter-stained by van Gieoson's method. Seven parameters of the small pulmonary arteries were obtained, including percentage of media thickness (% MT), percentage of media section area (% MS), numbers of pulmonary small artery per square centimeter (APSC), mean alveolar number (MAN), mean linear intercept (MLI), proportion of parenchyma area in total area (% PPA), and alveolar/ small arterial ratio per unit area (AAR) by a computer-based image processor for quantitative analysis.</p><p><b>RESULTS</b>In the TOF group, % MT, % MS, and APSC significantly decreased, while MLI and AAR significantly increased (P < 0.05, compared with the control group). APSC decreased in turn after separately using three different techniques of right ventricular outflow tract reconstruction (i. e. pulmonary valve commissurotomy, transannular pericardium patch, and transannular homologous monocuspid valve patch), which was paralleled with the diameters of MPA, LPA, and RPA. RPA correlated with APSC (r = 0.754, P = 0.001).</p><p><b>CONCLUSIONS</b>The development of pulmonary small arteries and alveoli are directly affected by the diminished pulmonary flow in infants with tetralogy of Fallot. Right ventricle outflow tract reconstruction may be indicated according to the developmental degree of central pulmonary artery.</p>

Sixty-two cases report of surgical treatment of parotid pleomorphic adenoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To define the most appropriate surgical modality for parotid pleomorphic adenoma (PPA).</p><p><b>METHODS</b>Sixty-two cases with PPA who underwent surgical treatment from January 1996 and December 2003 were reviewed retrospectively. The course of disease before treatment, tumor size, surgical modality, post-operative histopathological findings, recurrence and the complications were analyzed.</p><p><b>RESULTS</b>There have been no recurrence in all 44 patients operated by superficial parotidectomy (SP), in all 16 patients operated by partial superficial parotidectomy plus partial deep parotidectomy (PSP + PDP), and in all 2 cases operated by total parotidectomy (TP). Pathological findings showed that in 6 cases (10%) the capsule of PPA was incomplete in focal areas and leaded to instances of positive margins, and in 28 cases (45%) the proliferation and mitosis were found in tumor cells with capsule invasion. 2 cases (4.5%) treated by SP had transient facial nerve dysfunction, while none of the 16 cases treated by PSP + PDP had facial nerve dysfunction. Frey syndrome occurred in 8 cases (18%) treated by SP, in 2 cases (13%) treated by PSP + PDP and in all 2 cases (13%) treated by total parotidectomy. The total rate of Frey syndrome in all 62 cases was 19.3%.</p><p><b>CONCLUSIONS</b>For the superficial PPA smaller than 4 cm, surgical procedure of PSP + PDP is as efficacy as SP, with relatively lower rates of complications like facial nerve dysfunction and Frey syndrome.</p>

Quantitative structural study of pulmonary artery in patients with pulmonary atresia with ventricular septal defect / 中国医学科学院学报

<p><b>OBJECTIVE</b>In order to provide pathologic reference for therapeutic rationale, the pathological changes of the pulmonary vasculature in patients with pulmonary atresia with ventricular defect and patent ductus arteriosus were observed by contrast with normal control group.</p><p><b>METHODS</b>Lung biopsies were taken in the operation in 10 children suffered from pulmonary atresia with ventricular septal defect associated with patent ductus arteriosus (PA group). Autopsy specimens were obtained from 10 children died of non-cardiovascular diseases as normal control group. The tissue was fixed with buffered formalin, routinely prepared by impregnated in wax. Sections were stained by hematoxylin-eosin, Weigert's elastic stain counter-stained by van Gieoson's method. Seven parameters were obtained including percentage of media thickness (MT%), percentage of media section area (MS%), numbers of vascular per square centimeter (VPSC), mean alveolar number (MAN), mean linear intercept (MLI), proportion of parenchyma area in total area (PPA), and alveolar/vascular ratio per unit area (AVR) by a computer image processor by quantitative analysis.</p><p><b>RESULTS</b>There were significant difference between the two groups in MAN, VPSC, and AVR (P < 0.05). VPSC was significantly lower in PA group than in control group (P < 0.01). Other parameters had no significant difference. The mean alveolar diameter had an increased trend in PA group, although there was no significant difference. MS% of nearly 50% patients was closed to the normal value in PA group. The shape of pulmonary arteriole was irregular. There were few muscular arteries in a field of vision.</p><p><b>CONCLUSIONS</b>The density of muscular arteries decreases in patients with pulmonary atresia with ventricular septal defect and patent ductus arteriosus, but percentage of media thickness and percentage of media section area of pulmonary arterioles are close to the normal value. Diminished flow in pulmonary circulation has a significant effect on numbers of pulmonary arterioles per square centimeter that impact the selection of surgical method and the effect of operation because of the reduction pulmonary arterioles. The decrease of mean alveolar number results in compensatory enlargement of alveolar diameter. The impaired lung development is a major cause of abnormal lung function. Feasible and earlier operation, which can increase pulmonary flow and promote development of pulmonary vasculature will be helpful to restore lung function.</p>