Clinical application and progress of yttrium 90 microsphere selective internal radiation therapy in primary hepatic cancer / 中华消化外科杂志

Primary hepatic cancer is one of the major problems that need to be solved urgently in the field of public health, seriously endangering the life and health of Chinese people. Its treatment mode is multidisciplinary participation and synergy of multiple therapeutic methods. Even though there are many common clinical treatments for liver cancer in China, its therapeutic outcome is still unsatisfactory. yttrium-90 has been applied for more than 20 years, and a large amount of foreign clinical data have been accumulated. Combining the latest literature and clinical practice, the authors describe the clinical application and research progress of yttrium-90 micro-sphere selective internal radiation therapy in primary liver cancer.

Application of metagenomic next-generation sequencing in the outbreak of healthcare-associated infection with carbapenem-resistant Acinetobacter baumannii / 中国感染控制杂志

Objective To explore the application of metagenomic next-generation sequencing(mNGS)technology in the investigation of healthcare-associated infection(HAI)outbreaks of carbapenem-resistant Acinetobacter bau-mannii(CRAB).Methods Pathogenic detection by mNGS and conventional pathogen culture were performed on 5 patients in the intensive care unit(ICU)of a hospital from June 8 to 22,2023 from whom CRAB were detected.Microbial sampling was carried out in potentially contaminated environment.Bacterial culture,identification,and antimicrobial susceptibility testing were conducted.Comprehensive control measures were taken,and the effect was evaluated.Results The time required for reporting results by mNGS was shorter than the culture time([3.92± 1.05]days vs[6.24±0.25]days,P＜0.001).CRAB was isolated from the specimens of 5 patients.mNGS de-tected OXA-23 resistance genes from all patients.After comprehensive assessment by experts,4 patients were HAI and 1 patient was due to specimen contamination.According to the definition from Guidelines for HAI outbreak control,this event was considered an outbreak of HAI.The monitoring results of environmental hygiene showed that the detection rate of CRAB in the environment during the outbreak was 51.30％(59/115),mainly from the hands of health care workers and the surface of ventilators.After implementing multidisciplinary infection control measures,clinicians'hand hygiene compliance rate and implementation rate of ventilator disinfection increased from 40.83％(49/120)and 33.33％(16/48)to 82.61％(95/115)and 83.33％(30/36),respectively.The prognosis of patients was good,and no new case emerged during subsequent monitoring.The outbreak of HAI in this hospital has been effectively controlled.Conclusion mNGS is characterized by high precision,less time consumption,and high accuracy,and can be applied to the prevention and control of HAI outbreak and the study of antimicrobial-re-sistant genomes.It is of great significance for the anti-infection treatment of patients with multidrug-resistant orga-nism infection as well as the formulation of HAI prevention and control measures.Continuous improving disinfec-tion effectiveness and hand hygiene compliance is important for preventing and controlling CRAB infection.

Efficacy and safety of recombinant human anti-SARS-CoV-2 monoclonal antibody injection(F61 injection)in the treatment of patients with COVID-19 combined with renal damage:a randomized controlled exploratory clinical study / 中国感染控制杂志

Objective To explore the efficacy and safety of recombinant human anti-severe acute respiratory syn-drome coronavirus 2(anti-SARS-CoV-2)monoclonal antibody injection(F61 injection)in the treatment of patients with coronavirus disease 2019(COVID-19)combined with renal damage.Methods Patients with COVID-19 and renal damage who visited the PLA General Hospital from January to February 2023 were selected.Subjects were randomly divided into two groups.Control group was treated with conventional anti-COVID-19 therapy,while trial group was treated with conventional anti-COVID-19 therapy combined with F61 injection.A 15-day follow-up was conducted after drug administration.Clinical symptoms,laboratory tests,electrocardiogram,and chest CT of pa-tients were performed to analyze the efficacy and safety of F61 injection.Results Twelve subjects(7 in trial group and 5 in control group)were included in study.Neither group had any clinical progression or death cases.The ave-rage time for negative conversion of nucleic acid of SARS-CoV-2 in control group and trial group were 3.2 days and 1.57 days(P=0.046),respectively.The scores of COVID-19 related target symptom in the trial group on the 3rd and 5th day after medication were both lower than those of the control group(both P＜0.05).According to the clinical staging and World Health Organization 10-point graded disease progression scale,both groups of subjects improved but didn't show statistical differences(P＞0.05).For safety,trial group didn't present any infusion-re-lated adverse event.Subjects in both groups demonstrated varying degrees of elevated blood glucose,elevated urine glucose,elevated urobilinogen,positive urine casts,and cardiac arrhythmia,but the differences were not statistica-lly significant(all P＞0.05).Conclusion F61 injection has initially demonstrated safety and clinical benefit in trea-ting patients with COVID-19 combined with renal damage.As the domestically produced drug,it has good clinical accessibility and may provide more options for clinical practice.

Xuebijing injection inhibits the degradation of pulmonary vascular endothelial calyx to improve acute lung injury induced by severe heatstroke / 解放军医学杂志

Objective To investigate the possible mechanism of Xuebijing injection in regulating abnormal degradation of pulmonary vascular endothelial calyx to improve acute lung injury induced by severe heatstroke.Methods Forty-eight Wistar rats were randomly divided into control group,heatstroke group and Xuebijing group.Before heatstroke induction,rats in Xuebijing group were administrated with Xuebijing injection(2 ml/kg,2 times/d)for 3 days.All rats were exposed to an environment with temperature of(40±2)℃and humidity of 65%±5%for 60 minutes to induce heatstroke.Two hours later,the lung wet/dry weight ratio was recorded;the concentration of proteins in BALF was measured;the pulmonary vascular permeability was measured by Evans blue(EB);HE staining was used to observe the pathological changes of lung tissue;the changes of hyaluronic acid(HA)on the surface of pulmonary vessels were observed by immunofluorescence;Western blotting was used to detect the expression of Syndecan-1,Glypican-1,VE-Cadherin,Occludin,VCAM-1 and E-selectin in lung tissues;Enzyme-linked immunosorbent assay(ELISA)was utilized to quantify the concentration of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)in serum and heparanase(HPA)in lung tissue.Results Xuebijing could decrease the lung wet/dry weight ratio,reduce protein exudation and improve pulmonary vascular permeability(P<0.01);reduce the histological injury(P<0.01);reduce the degradation of HA,Syndecan-1 and Glypican-1 on the surface of pulmonary vessels(P<0.01);increase the expression of VE-Cadherin and Occludin(P<0.01);regulate the overexpression of VCAM-1 and E-selectin(P<0.01);down-regulate the expression of TNF-α,IL-6 and HPA(P<0.01).Conclusion Xuebijing injection decrease the expression of HPA,improve the disintegration of pulmonary vascular endothelial calyx,repair the integrity of pulmonary vessels,reduce the damage of cell connections,down-regulate the expression of adhesion molecules,inhibit the inflammatory reaction,relieving acute lung injury caused by severe heat stroke.

Research on the health policy of early life:Based on analysis of policy texts of Beijing city / 中国卫生政策研究

Objective:This paper mainly discusses the health policy of early life of pregnant women and infants in Beijing as an example,and to provide the basis for policy formulation and optimization.Methods:By using the content analysis method,149 policy texts are divided into two dimensions:policy objectives and policy instruments.The results are described by manual coding,cross analysis and trend analysis.Results:In regard to Policy Objectives,improvement of maternal and child health service levels accounts for the biggest proportion(61.7%),whereas improvement of research level accounts for the least(8.1%).In the four dimensions of policy instruments,mandatory,spontaneous,capacity-building,and incentive tools account for 90%,55%,48%and 42%respectively.According to the trend analysis,integrity of policy system has been continuously improved and the proportion of infant and child care has also increased.Both cross-analysis and trend analysis have showed the strong use of coercive and incentive tools by relevant policies;The use of spontaneous and capacity-building tools is low and decreases over time.Conclusion:Improving the level of maternal and child health services is the core concern of Beijing's early life health policy.However,relatively little attention is paid to the family,infant and child care,and scientific research construction.As for Policy Instruments,mandatory tools are widely used;Incentive Tools and Spontaneous Tools are mainly applied in well-being and soft guidance;insufficient use of Capacity-building Tools.Suggestions:In the future,the policy system should be further improved,which should be targeted and deficiency-mending.It is suggested that more resources should be increased for the family system,more attention should be paid to vulnerable groups early in life,and more financial support should be applied to scientific research on maternal and child health.

Long-term outcome of transcatheter repair of paravalvular leak post surgical mitral valve replacement / 中华心血管病杂志

Objective: To explore the long-term clinical efficacy of transcatheter repair of mitral paravalvular leak (PVL) post surgical mitral valve replacement. Methods: This study is a retrospective study. Patients who completed transcatheter repair of paravalvular leak after surgical mitral valve replacement at Shanghai Chest Hospital, Shanghai Jiaotong University School of Medicine from March 2010 to December 2018 were included. Technical success was defined as the occluder being stably implanted in the paravalvular leak site without affecting the function of the mitral valve and surrounding tissues; and there were no intervention-related complications, such as new hemolysis or aggravated hemolysis, and echocardiography confirmed mitral paravalvular regurgitation reduced by more than 1 grade. Patients were followed up at 30 days, 1, and 3 years after the intervention. The main endpoints were all-cause death and re-surgery due to interventional failure or serious complications. The occurrence of occluder-mediated hemolysis and chronic renal insufficiency was recorded, and patients were monitored with echocardiography during follow up. Results: A total of 75 patients were included, aged (54.3±22.9) years old, and 38 patients were males. All patients had decreased cardiac function and/or hemolysis before intervention. Procedural success was achieved in 54 patients (72.0%). Incidence of device-mediated hemolysis was 18.7% (14/75). During the follow-up period, all-cause death occurred in 7 patients (9.3%), and 3 were cardiac deaths.The 3-year event-free survival rate was 81.3% (61/75). The need for cardiac surgery was 9.3% (7/75): 3 cases due to severe device-mediated hemolysis, 2 cases due to prosthetic valve failure and 2 cases due to moderate to severe residual regurgitation. The echocardiography follow-up results showed that the position of the occluder was stable, there was no impact on the artificial valve function and surrounding structures, and the residual regurgitation was stable without progressive increase in event-free patients. Compared with pre-intervention, the left ventricular end systolic diameter ((33.9±7.4)mm vs. (38.3±8.9) mm, P=0.036), end diastolic diameter ((53.7±8.3) mm vs. (58.4±9.1) mm, P=0.045) and left atrial diameter (59.3 (44.5, 90.7) mm vs. 64.3 (44.8, 96.6) mm, P=0.049) were significantly reduced, pulmonary artery systolic pressure was also significantly decreased ((36.5±15.8) mmHg vs. (46.3±14.9) mmHg, P=0.022, 1 mmHg=0.133 kPa). There was no significant difference between 3 years and 1 year after transcatheter repair of mitral paravalvular leak post surgical mitral valve replacement (all P>0.05). Conclusion: Transcatheter repair of mitral paravalvular leak post surgical mitral valve replacement is an effective treatment option in selective patients.

Efficacy and safety of Anlotinib in the treatment of advanced sarcoma / 中华肿瘤杂志

Objective: Patients with advanced sarcomas have a dismal prognosis with few effective therapies. The purpose of this study was to evaluate the efficacy and safety of anlotinib in the treatment of advanced sarcoma and to explore the relationship between adverse events (AEs) and efficacy. Methods: Data from 45 advanced sarcoma patients who received anlotinib monotherapy at Affiliated Cancer Hospital of Zhengzhou University between June 2018 and August 2021 were retrospectively analyzed. According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1, the objective remission rate (ORR) and disease control rate (DCR) were calculated, and the progression free survival (PFS) and treatment-related AEs were recorded and analyzed. Survival analysis was conducted using the Kaplan-Meier survival rates were compared using the Log rank test. Results: Forty patients were treated for more than 1.5 months and received efficacy evaluation. The ORR and DCR after 3 months were 7.5%(3/40) and 80.0%(32/40), respectively. The overall ORR was 2.5%(1/40), the total DCR was 27.5%(11/40), and the median progression-free survival (m-PFS) was 6.70 months; The m-PFS of alveolar soft tissue sarcoma (ASPS) was 10.27 months, which was significantly longer than that of other subtypes of sarcoma (P=0.048). In addition, the DCR of ASPS and synovial sarcoma (SS) was significantly better than that of osteosarcoma (P<0.05). The most common AEs were elevated thyroid stimulating hormone (17.8%, 8/45), anemia (15.6%, 7/45), fatigue (11.1%, 5/45). Five patients developed grade 3 AEs after treatment; The PFS of patients with hand-foot syndrome after treatment was significantly longer than that of patients without hand-foot syndrome (14.10 vs 6.00, P=0.024). Conclusions: The efficacy of anlotinib in the treatment of ASPS and SS is better than that of other subtypes. The PFS in the group with hand-foot syndrome was significantly longer than that of the group without hand-foot syndrome.

Efficacy and safety of Anlotinib in the treatment of advanced sarcoma / 中华肿瘤杂志

Objective: Patients with advanced sarcomas have a dismal prognosis with few effective therapies. The purpose of this study was to evaluate the efficacy and safety of anlotinib in the treatment of advanced sarcoma and to explore the relationship between adverse events (AEs) and efficacy. Methods: Data from 45 advanced sarcoma patients who received anlotinib monotherapy at Affiliated Cancer Hospital of Zhengzhou University between June 2018 and August 2021 were retrospectively analyzed. According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1, the objective remission rate (ORR) and disease control rate (DCR) were calculated, and the progression free survival (PFS) and treatment-related AEs were recorded and analyzed. Survival analysis was conducted using the Kaplan-Meier survival rates were compared using the Log rank test. Results: Forty patients were treated for more than 1.5 months and received efficacy evaluation. The ORR and DCR after 3 months were 7.5%(3/40) and 80.0%(32/40), respectively. The overall ORR was 2.5%(1/40), the total DCR was 27.5%(11/40), and the median progression-free survival (m-PFS) was 6.70 months; The m-PFS of alveolar soft tissue sarcoma (ASPS) was 10.27 months, which was significantly longer than that of other subtypes of sarcoma (P=0.048). In addition, the DCR of ASPS and synovial sarcoma (SS) was significantly better than that of osteosarcoma (P<0.05). The most common AEs were elevated thyroid stimulating hormone (17.8%, 8/45), anemia (15.6%, 7/45), fatigue (11.1%, 5/45). Five patients developed grade 3 AEs after treatment; The PFS of patients with hand-foot syndrome after treatment was significantly longer than that of patients without hand-foot syndrome (14.10 vs 6.00, P=0.024). Conclusions: The efficacy of anlotinib in the treatment of ASPS and SS is better than that of other subtypes. The PFS in the group with hand-foot syndrome was significantly longer than that of the group without hand-foot syndrome.

Orange-derived extracellular vesicles nanodrugs for efficient treatment of ovarian cancer assisted by transcytosis effect

Extracellular vesicles (EVs) have recently received much attention about the application of drug carriers due to their desirable properties such as nano-size, biocompatibility, and high stability. Herein, we demonstrate orange-derived extracellular vesicles (OEV) nanodrugs (DN@OEV) by modifying cRGD-targeted doxorubicin (DOX) nanoparticles (DN) onto the surface of OEV, enabling significantly enhancing tumor accumulation and penetration, thereby efficiently inhibiting the growth of ovarian cancer. The obtained DN@OEV enabled to inducement of greater transcytosis capability in ovarian cancer cells, which presented the average above 10-fold transcytosis effect compared with individual DN. It was found that DN@OEV could trigger receptor-mediated endocytosis to promote early endosome/recycling endosomes pathway for exocytosis and simultaneously reduce degradation in the early endosomes-late endosomes-lysosome pathway, thereby inducing the enhanced transcytosis. In particular, the zombie mouse model bearing orthotopic ovarian cancer further validated DN@OEV presented high accumulation and penetration in tumor tissue by the transcytosis process. Our study indicated the strategy in enhancing transcytosis has significant implications for improving the therapeutic efficacy of the drug delivery system.

Role of N / 临床肝胆病杂志

The phenomenon of N 6 -methyladenosine (m 6 A)-methylation is commonly observed in various tissues and cells of the human body and is the most common type of internal modification in eukaryotic mRNA. m 6 A-methylation is dynamic and reversible, which is regulated by various methyltransferases, demethylases, and m 6 A binding protein. Recent studies have shown that m 6 A modification can affect viral gene expression and plays an important role in the process of HBV infection. This article summarizes the current research status and mechanism of m 6 A-methylation, especially its association with HBV infection. This article also elaborates on the effect of m 6 A modification on HBV transcripts, reviews the research findings of m 6 A in immune response of HBV infection, and summarizes the effect of HBV infection on m 6 A modification in normal host hepatocytes and hepatitis B liver cancer, so as to discuss the development direction and potential value of m 6 A in HBV infection.

Gait analysis combined with the expression of TGF-β1, TGF-β3 and CREB during Achilles tendon healing in rat / 中华创伤杂志(英文版)

PURPOSE@#To observe the changes of gait behavior and the expression of wound healing factors of transforming growth factor-β1 (TGF-β1), TGF-β3 and cAMP response element binding protein-1 (CREB-1) during the healing of Achilles tendon in a rat model, and to investigate whether gait analysis can be used to evaluate the tendon healing.@*METHODS@#Achilles tendon of 40 healthy male Sprague-Dawley rats were transected and sutured to establish the Achilles tendon injury (ATI) model. They were randomly divided into 4 groups based on the observational time point at 1, 2, 4 and 6 weeks after injury (n = 10 for each group). Before modeling, 9 rats were randomly selected for CatWalk gait analysis, which contained step cycle, single stance time and average speed. Data were recorded as the normal controls. After then, ATI models were established in the left hind limbs of the all 40 rats (ATI group), while the right hind limbs were only cut and sutured without injury of the Achilles tendon (sham operation group). At 1, 2, 4 and 6 weeks after injury, the gait behavior of the corresponding group of rats (n = 9) as observed and recorded by CatWalk platform. After then, the rats were sacrificed and Achilles tendon of both limbs was harvested. The tendon healing was observed by gross anatomy and histological examination, and the protein and mRNA expression of TGF-β1, TGF-β3, CREB-1 were observed by immunohistochemistry and qPCR. The results of tendon gross grading were analyzed by Wilcoxon rank sum test, and other data were analyzed by one-way analysis of variance among multiple groups.@*RESULTS@#Compared with normal controls, all gait indexes (step cycle, single stance time and average speed) were greatly affected following ATI, which however improved with time. The step cycle was significantly lower at 1, 2 and 4 weeks after ATI (compared with normal controls, all p  0.05). The single stance time of the ATI group was significantly shorter at 1 and 2 weeks after operation ((0.078 ± 0.010) s at 1 week, (0.078 ± 0.020) s at 2 weeks, all p < 0.001) and revealed no significant difference at 4 weeks (p = 0.120). The average speed of ATI group at 1, 2, 4, 6 weeks was significantly lower than that in the normal control group (all p < 0.001). Gross observation showed that the grade of local scar adhesion in ATI group increased significantly at 2, 4 and 6 weeks, compared with the sham operation group (all p < 0.001). Extensive adhesion was formed at 6 weeks after ATI. The results of HE staining showed that the number of fibroblast increased gradually and arranged more orderly in ATI group at 1, 2 and 4 weeks (all p < 0.001), and decreased at 6 weeks, but it was still significantly higher than that of the sham operation group (p < 0.001). Immunohistochemistry showed that the positive expression of TGF-β1, TGF-β3, CREB-1 in ATI group was higher than that in the sham operation group at 4 time points (all p < 0.05), which reached the peak at 2 weeks after operation and decreased at 4 weeks (p = 0.002, p < 0.001, p = 0.041, respectively). The results of qPCR suggested that the mRNA expression of TGF-β1, TGF-β3, CREB-1 in ATI group was higher than that in the sham operation group at all-time points (all p < 0.05), which reached the peak at 2 weeks after operation, decreased at 4 weeks, and significantly decreased at 6 weeks (all p < 0.001).@*CONCLUSION@#Gait behavior indexes are associated with Achilles tendon healing. The study gives an insight of TGF-β1, TGF-β3, CREB-1 changes in the coursing of Achilles tendon healing and these cytokines may be able to be used to regulate the Achilles tendon healing.

Arthroscopic treatment of schatzker type III tibial plateau fractures with hydroxylapatite rods: 6-month follow-up / 中国组织工程研究

BACKGROUND: The clinical treatment of Schatzker III tibial plateau fracture is different, including internal fixation, external fixation and arthroscopy. OBJECTIVE: To investigate the effect and influencing factors of arthroscopic treatment of Schatzker type III tibial plateau fracture with nano hydroxylapatite rod. METHODS: Totally 36 cases of Schatzker type III tibial plateau fractures admitted to Hebei Provincial People’s Hospital from July 2017 to July 2019 were enrolled, including 25 males and 11 females, aged 20-57 years. Among them, 18 patients in the observation group received minimally invasive arthroscopic hydroxylapatite rod implantation and 18 patients in the control group received conventional open plate and screw fixation. After 6 months of follow-up, complications and fracture healing time were recorded. Pain was assessed by visual analogue scale score. Knee function was assessed by HSS score. Excellent and good rate was assessed by Lysholm score. The effects of single factors such as age, sex, combined meniscus and ligament injuries, operation time and intraoperative blood loss in the observation group on the efficacy of the postoperative knee joint were analyzed by single factor analysis. The trial was approved by the Ethics Committee of Hebei Provincial People’s Hospital. RESULTS AND CONCLUSION: (1) The incidence rate of postoperative complications such as deep venous thrombosis and traumatic arthritis in the observation group was lower than that in the control group (P < 0.05). (2) The healing time of the observation group was shorter than that of the control group (P < 0.05). The excellent and good rate of clinical treatment was higher in the observation group than that of the control group (P < 0.05). (3) The visual analogue scale scores of the observation group were lower than those of the control group at 1 day, 1 week, 1 and 3 months after operation (P < 0.05). The HSS scores of knee joint function in 1, 3 and 6 months after operation were higher in the observation group than those in the control group (P < 0.05). (4) The single factor analysis showed that the postoperative effect of patients with age < 50 years was better than that of patients with age ≥ 50 years (P < 0.05). (5) The results showed that the minimally invasive treatment of Schatzker type III tibial plateau fracture with nano hydroxyapatite rod under arthroscope could promote fracture healing, alleviate pain and promote joint function recovery, in which the age was an independent factor affecting the postoperative effect.

Clinical efficacy of transsphenoidal approach under neuroendoscopy in treatment of different types of pituitary tumors / 局解手术学杂志

Objective To explore the best indication of neuroendoscopic surgery in patients with pituitary tumors by comparing the clinical effects of neuroendoscopic transsphenoidal surgery on patients with different types of pituitary tumors.MethodsA total of 92 patients with different types of pituitary adenoma received transsphenoidal approach under neuroendoscopy in our hospital from June 2016 to October2017 were selected, the surgical results were evaluated by comparing the postoperative hormone levels were normal or not and the tumor were resected or not.The patients were followed up, the physiological function (PF), physiological function (RP), emotional functions (RE) was determined by health measurement scale (SF-36) to evaluated the quality of life of patients.Results There were differences in clinical efficacy of neuroendoscopy for the treatment of different types of pituitary adenoma, the cure rate from high to low in turn was cortical hormone adenomas, growth hormone adenomas, prolactin adenomas, mixed adenoma, non-functional adenomas, the cure rate of functional pituitary adenoma was obviously higher than that of no functional pituitary adenoma, the difference was statistically significant (P＜0.05).At 6 months after surgery, SF-36 result showed that PF scores was (76.30±8.68), RP scores was (78.37±19.05), RE scores was (71.54±21.54), and at 12 months after surgery, PF scores was (87.20±9.24), RP scores was (78.66±15.18) and RE scores was (87.80±17.67), which were higher in patients with functional pituitary adenoma than those in patients with non-functional pituitary adenoma, the differences were significant (P＜0.05).ConclusionThe treatment of functional pituitary tumor by neuroendoscopic surgery, especially corticosteroid adenoma, has the best effect, and can significantly improve the quality of life of patients.

New SNP variants of MARVELD2 (DFNB49) associated with non-syndromic hearing loss in Chinese population / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Non-syndromic hearing loss (NSHL) is a common defect in humans. Variants of MARVELD2 at the DFNB49 locus have been shown to cause bilateral, moderate to profound NSHL. However, the role of MARVELD2 in NSHL susceptibility in the Chinese population has not been studied. Here we conducted a case-control study in an eastern Chinese population to profile the spectrum and frequency of MARVELD2 variants, as well as the association of MARVELD2 gene variants with NSHL. Our results showed that variants identified in the Chinese population are significantly different from those reported in Slovak, Hungarian, and Czech Roma, as well as Pakistani families. We identified 11 variants in a cohort of 283 NSHL cases. Through Sanger sequencing and bioinformatics analysis, we found that c.730G>A variant has detrimental effects in the eastern Chinese population, and may have relatively high correlation with NSHL pathogenicity.

Magnetic compression anastomosis for treatment of biliary anastomotic stricture after orthotopic liver transplantation / 中华肝胆外科杂志

Objective To study the safety and efficacy of magnetic compression anastomosis (MCA) in treatment of biliary anastomotic stricture after orthotopic liver transplantation (LT).Methods Five patients who were treated unsuccessfully by ERCP were admitted to The First Affiliated Hospital of Xi'an Jiaotong University from 2012 January to 2018 May to undergo MCA.The treatment results were analyzed retrospectively.Results In four patients,the treatment was successful while in one patient it failed.For the four successful patients,the biliary stricture length was 2～4 mm.Re-canalization was achieved within 7～12 days and these patients were discharged home without any adverse events.Multiple plastic stents (in 2 patients) or full-covered self-expansion mental stents (in 2 patients) were inserted into the new fistulae after re-canalization.In two patients whose stents were removed,there was no recurrence of biliary strictures after follow-up for 64 months and 59 months,respectively.Conclusion The MCA technique is a revolutionary and effective method of performing interventional choledochocholedochostomy in patients with biliary anastomotic stricture after LT for whom the conventional endoscopic procedures were not successful.

Effect of oxycodone on function of GABAA receptors in dorsal root ganglion neurons of rats with neuropathic pain / 中华麻醉学杂志

Objective To evaluate the effect of oxycodone on function of GABAA receptors in dor-sal root ganglion ( DRG ) neurons of rats with neuropathic pain ( NP ) . Methods Thirty-six adult male Sprague-Dawley rats, weighing 180-220 g, aged 10 weeks, were allocated into 3 groups ( n=12 each) u-sing a random number table method: sham operation group ( group S ) , group NP and oxycodone group ( group O) . The sciatic nerve was only isolated but not ligated in group S. NP was induced by chronic con-striction injury. The sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 chromic catgut. Oxycodone 15μg∕kg was intraperitoneally injected once a day for 14 con-secutive days from ligating the sciatic nerve to satisfaction in group O. The thermal paw withdrawal latency( TWL) was measured at 1 day before establishing the model ( T0 ) and 3, 5, 7, 10 and 14 days after es-tablishing the model ( T1-5 ) . The rats were sacrificed after measurement of pain threshold at T5 , and DRG neurons were acutely isolated for recording the amplitude of GABAA receptors-activated currents using whole-cell patch-clamp technique. Results Compared with group S, the TWL was significantly shortened at T1-5, and the amplitude of GABAA receptors-activated currents in DRG neurons was decreased in NP and O groups (P<0. 05). Compared with group NP, the TWL was significantly prolonged at T1-5, and the ampli-tude of GABAA receptors-activated currents in DRG neurons was increased in group O ( P<0. 05) . Conclu-sion Oxycodone can enhance the function of GABAA receptors-activated currents in DRG neurons and thus enhance GABAA receptors-mediated presynaptic inhibition, which may be related to the mechanism of oxyc-odone-induced reduction of NP in rats.

Preliminary Analysis of the Three Major Paths in the Action of Vesiculation Moxibustion / 上海针灸杂志

From the three perspectives, skin stress response, medication-acupoint effect and neuroendocrine-immune system, this article discussed the action mechanism of vesiculation moxibustion therapy, to provide scientific evidence for the development of this therapy and to enhance its therapeutic efficacy.

Investigation and analysis of malnutrition after adjuvant chemotherapy in patients with gastrointestinal tumor / 肠外与肠内营养

Objective:This study aims to investigate the incidence and potential cause of the undernutrition in gastrointestinal cancer patients received postoperatively adjuvant chemotherapy.Method:Between July and December 2016,a total of 181 gastrointestinal cancer patients who underwent postoperatively adjuvant chemotherapy in the Department of General Surgery of Nanjing General Hospital were enrolled in this study.Nutritional risks of the patients were screened by the patient-generated subjective global assessment (PG-SGA).Serum albumin concentrations,plasma hemoglobin levels and white blood cell numbers of the patients were determined during the chemotherapy.The patients'clinical data,including gender,age,tumor location,chemotherapy stage and adverse events post the chemotherapy,were recorded.Result:All patients completed the PG-SGA for nutritional risk screening.Among the patients,69 cases (38.1％) had a PG-SGA score of 0 ～ 3 points,showing absence of undernutrition.The remaining 112 cases (61.9％)had a PG-SGA score above 4 points,indicating moderate or severe undernutrition.71cases (39.2％) of them displayed moderate underuutrition (4-8 points),and 41 cases (22.7 ％) showing severe undernutrition (＞ 8 points).The PG-SGA scores in patients with gastric cancer were significantly higher than those in the rectal cancer patients (P ＜ 0.05) and in the colon cancer cases (P ＜ 0.01).In addition,the incidence of undernutrition in the male patients was much higher than in the female cases (P ＜ 0.05).The incidence of undernutrition in the patients aging ＞ 65 years was higher than in the cases below 65 years old (P ＜ 0.05).The levels of plasma hemoglobin and numbers of white blood cells were significantly lower in the patients with undernutrition (PG-SGA score ＞4 points),and adverse events such as nausea and vomiting were also more frequently presented in these cases.No significant difference in the incidence of the patients' undernutrition was observed between different stages of the chemotherapy.Conclusion:The patients with gastrointestinal cancer underwent postoperatively adjuvant chemotherapy had higher incidence ofundernutrition.Gender,age and tumor location were the risk factors for the development of undernutrition.Our findings provide evidence for the utilization of nutrition interventions in these patients.

Neuron-protective effect of subanesthestic-dosage ketamine on mice of Parkinson's disease

OBJECTIVE@#To discuss the neuron-protective effect and possible mechanism of subanesthestic-dosage ketamine on Parkinson's disease mice induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine.@*METHODS@#A total of 30 mice were divided equally into three groups, model control group (MC group), ketamine treatment group (KT group), and blank control group (BC group), respectively. The Parkinson's disease mice of MC group and KT groups were established by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (20 mg/kg/d), while mice in KT group were treated by intraperitoneal injection of subanesthestic-dosage ketamine (8 mg/kg). Differences on behaviors and the number of nigra dopaminergic neurons of mice in each group were compared through the behavioral test and tyrosine hydroxylase immunohistochemistry experiments after the treatments. Furthermore, Western blot was used to test the expression of autophagy-related gene LC3-Ⅱ, Beclin1, Parkin, PINK1, and mTOR.@*RESULTS@#Compared with the BC group, the neuroethology scores were lower and the amount of TH positive cells were less both in MC and MT groups; In KT group, the neuroethology scores were higher and the amount of tyrosine hydroxylase positive cells were significantly more than that in MC group (P < 0.05). Moreover, expression levels of autophagy-related proteins LC3-II, Beclin1, Parkin, and PINK1 were higher, while the mTOR expression level was lower than that in MC group.@*CONCLUSIONS@#The subanesthestic-dosage ketamine has some protective effects on the coordinating ability of movement and cognitive ability of Parkinson's disease mice induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. This is probably due to that the autophagy activity of cells is activated by subanesthestic-dosage ketamine and that the neurons are protected.

Neuron-protective effect of subanesthestic-dosage ketamine on mice of Parkinson's disease

Objective To discuss the neuron-protective effect and possible mechanism of subanesthestic-dosage ketamine on Parkinson's disease mice induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. Methods A total of 30 mice were divided equally into three groups, model control group (MC group), ketamine treatment group (KT group), and blank control group (BC group), respectively. The Parkinson's disease mice of MC group and KT groups were established by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (20 mg/kg/d), while mice in KT group were treated by intraperitoneal injection of subanesthestic-dosage ketamine (8 mg/kg). Differences on behaviors and the number of nigra dopaminergic neurons of mice in each group were compared through the behavioral test and tyrosine hydroxylase immunohistochemistry experiments after the treatments. Furthermore, Western blot was used to test the expression of autophagy-related gene LC3-Ⅱ Beclin1, Parkin, PINK1, and mTOR. Results Compared with the BC group, the neuroethology scores were lower and the amount of TH positive cells were less both in MC and MT groups; In KT group, the neuroethology scores were higher and the amount of tyrosine hydroxylase positive cells were significantly more than that in MC group (P < 0.05). Moreover, expression levels of autophagy-related proteins LC3-II, Beclin1, Parkin, and PINK1 were higher, while the mTOR expression level was lower than that in MC group. Conclusions The subanesthestic-dosage ketamine has some protective effects on the coordinating ability of movement and cognitive ability of Parkinson's disease mice induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine. This is probably due to that the autophagy activity of cells is activated by subanesthestic-dosage ketamine and that the neurons are protected.