Influence of different depths of anesthesia under the guidance of anesthesia depth detector on awakening quality of elderly patients with colon cancer after laparoscopic surgery / 中国医学装备

Objective:To explore the influence of different depths of anesthesia under guidance of anesthesia depth detector on the awakening quality of elderly patients with colon cancer after laparoscopic surgery.Methods:A total of 96 elderly patients with colon cancer who underwent surgical resection and admitted to Beijing Changping District Hospital from February 2017 to June 2020 were selected.They were randomly divided into mild anesthesia group,moderate anesthesia group and deep anesthesia group according to the random sampling,with 32 in each group.The bispectral index(BIS)of deep anesthesia group was within 30-39 interval,and the BIS of moderate anesthesia group was within 40-49 interval,and the BIS of mild anesthesia group was within 50-60 interval.The Prince-Henry pain scale scores of patients with different depths of anesthesia under anesthesia depth detector were observed.The stress response-related indicators included adrenocorticotropic hormone(ACTH),cortisol(Cor)and interleukin-6(IL-6)of patients at three different time points:pre operation(S1),intra operation(S2)and post operation(S3)were monitored.Additionally,the differences of the incidences of complications and the cognitive function also were analyzed.Results:The postoperative Prince-Henry pain scores of the three groups of patients with colon cancer showed there were no statistically significant differences among anesthesia groups with different depths(P>0.05).The stress response indicators included ACTH,Cor and IL-6 appeared significant time-dependent changes among anesthesia groups with different depths.The stress response indicators of all groups significantly increased at S2 point,and the ACTH,Cor and IL-6 levels of mild anesthesia group were respectively(13.73±1.63)nmol/L,(269.24±31.46)nmol/L and(83.67±3.44)μg/L,and these of moderate anesthesia group were respectively(18.26±2.52)nmol/L,(242.56±36.75)nmol/L and(109.35±6.44)μg/L,and these of deep anesthesia group were respectively(19.42±2.42)nmol/L,(432.35±31.34)nmol/L and(132.42±2.31)μg/L.There were significant differences in these indicators in same group between S2 point and S1 point(tmild group=7.99,12.48,16.48,tmoderate group=2.19,6.82,3.03,tdeep group=14.21,5.11,20.14,P＜0.05),respectively.The differences of the incidence rates of complication between the mild anesthesia group and the moderate anesthesia group,and between the mild anesthesia and the deep anesthesia group were statistically significant(x2=6.342,5.238,P<0.05),respectively.The MMSE scores 24 hours after surgery indicated that the difference of that between mild anesthesia group and deep anesthesia group,and between moderate anesthesia group and deep anesthesia group were significant(t=4.74,3.77,P<0.05),respectively.Conclusion:The depth of anesthesia has a significant influence on postoperative recovery quality,stress response and cognitive function.Using anesthesia depth detector to adjust the different depth of anesthesia can help to improve the awakening quality of elderly patients with colon cancer post-surgery and reduce the incidence of adverse reactions.

Clinical study of using basement membrane biological products in pelvic floor reconstruction during pelvic exenteration / 中华胃肠外科杂志

Objective: To investigate the value of reconstruction of pelvic floor with biological products to prevent and treat empty pelvic syndrome after pelvic exenteration (PE) for locally advanced or recurrent rectal cancer. Methods: This was a descriptive study of data of 56 patients with locally advanced or locally recurrent rectal cancer without or with limited extra-pelvic metastases who had undergone PE and pelvic floor reconstruction using basement membrane biologic products to separate the abdominal and pelvic cavities in the Department of Anorectal Surgery of the Second Affiliated Hospital of Naval Military Medical University from November 2021 to May 2022. The extent of surgery was divided into two categories: mainly inside the pelvis (41 patients) and including pelvic wall resection (15 patients). In all procedures, basement membrane biologic products were used to reconstruct the pelvic floor and separate the abdominal and pelvic cavities. The procedures included a transperitoneal approach, in which biologic products were used to cover the retroperitoneal defect and the pelvic entrance from the Treitz ligament to the sacral promontory and sutured to the lateral peritoneum, the peritoneal margin of the retained organs in the anterior pelvis, or the pubic arch and pubic symphysis; and a sacrococcygeal approach in which biologic products were used to reconstruct the defect in the pelvic muscle-sacral plane. Variables assessed included patients' baseline information (including sex, age, history of preoperative radiotherapy, recurrence or primary, and extra-pelvic metastases), surgery-related variables (including extent of organ resection, operative time, intraoperative bleeding, and tissue restoration), post-operative recovery (time to recovery of bowel function and time to recovery from empty pelvic syndrome), complications, and findings on follow-up. Postoperative complications were graded using the Clavien-Dindo classification. Results: The median age of the 41 patients whose surgery was mainly inside the pelvis was 57 (31-82) years. The patients comprised 25 men and 16 women. Of these 41 patients, 23 had locally advanced disease and 18 had locally recurrent disease; 32 had a history of chemotherapy/immunotherapy/targeted therapy and 24 of radiation therapy. Among these patients, the median operative time, median intraoperative bleeding, median time to recovery of bowel function, and median time to resolution of empty pelvic syndrome were 440 (240-1020) minutes, 650 (200-4000) ml, 3 (1-9) days, and 14 (5-105) days, respectively. As for postoperative complications, 37 patients had Clavien-Dindo < grade III and four had ≥ grade III complications. One patient died of multiple organ failure 7 days after surgery, two underwent second surgeries because of massive bleeding from their pelvic floor wounds, and one was successfully resuscitated from respiratory failure. In contrast, the median age of the 15 patients whose procedure included combined pelvic and pelvic wall resection was 61 (43-76) years, they comprised eight men and seven women, four had locally advanced disease and 11 had locally recurrent disease. All had a history of chemotherapy/ immunotherapy and 13 had a history of radiation therapy. The median operative time, median intraoperative bleeding, median time to recovery of bowel function, and median time to relief of empty pelvic syndrome were 600 (360-960) minutes, 1600 (400-4000) ml, 3 (2-7) days, and 68 (7-120) days, respectively, in this subgroup of patients. Twelve of these patients had Clavien-Dindo < grade III and three had ≥ grade III postoperative complications. Follow-up was until 31 October 2022 or death; the median follow-up time was 9 (5-12) months. One patient in this group died 3 months after surgery because of rapid tumor progression. The remaining 54 patients have survived to date and no local recurrences have been detected at the surgical site. Conclusion: The use of basement membrane biologic products for pelvic floor reconstruction and separation of the abdominal and pelvic cavities during PE for locally advanced or recurrent rectal cancer is safe, effective, and feasible. It improves the perioperative safety of PE and warrants more implementation.

Clinical application value of surgical classification and pelvic floor reconstruction in pelvic exenteration for locally recurrent or advanced rectal cancer / 肿瘤

Objective:To investigate the value of surgical classification and pelvic floor reconstruction in pelvic exenteration for locally recurrent or locally advanced rectal cancer. Methods:A retrospective descriptive study method was used.Perioperative data were collected from 67 consecutive patients with locally advanced or locally recurrent rectal cancer who underwent pelvic exenteration at the Department of Anorectal Surgery,the Second Affiliated Hospital of Navy Military Medical University between November 2021 and November 2022 through the Chinese Combined Pelvic Exenteration Case Database for rectal cancer.The surgical range was divided into two categories:mainly localized in the pelvic cavity(48 cases)and combined with resection of the main tissue of the pelvic wall(1 9 cases).Outcome indexes included:(1)preoperative general data of patients;(2)intraoperative conditions;(3)postoperative recovery and complications(postoperative complications were evaluated by international Clavien-Dindo classification);(4)follow-up(outpatient and telephone follow-up were used to understand the postoperative survival,tumor recurrence and metastasis of patients,and the follow-up time was up to February 28,2023 or the case died).Measurement data are expressed by median(range),and enumeration data are expressed by example(％). Results:In the pelvic resection group,the median age of 48 patients was 57.5 years(range:31-82 years);29 were males and 19 were females;26 of them had locally advanced rectal cancer and 22 had locally recurrent rectal cancer;39 had a history of chemotherapy,immunotherapy or targeted therapy,and 26 had a history of radiotherapy;the median operation time was 425 min(range:240-1 020 min);the median intraoperative blood loss was 500 mL(range:200-4 000 mL);the median time to recovery of intestinal function was 3 d(range:1-9 d);the median recovery time of empty pelvis syndrome was 25.3 d(range:5-105 d);43 patients had postoperative complications＜grade Ⅲ,and of the 5 patients with ≥ grade Ⅲcomplications,2 died of multiple organ failure 7 d after operation,2 patients had surgical hemostasis for massive hemorrhage of pelvic floor wounds after operation,and 1 patient recovered from postoperative respiratory failure after rescue.In the combined pelvic wall resection group,the median age of 1 9 patients was 54.5 years(range:43-76 years);9 were males and 10 were females;4 patients had locally advanced rectal cancer and 15 patients had locally recurrent rectal cancer,all of whom had a history of chemotherapy,immunotherapy or targeted therapy,and 1 5 patients had a history of radiotherapy;the median operation time was 580 min(range:360-960 min);the median intraoperative blood loss was 1 600 mL(range:400-4 000 mL);the median intestinal function recovery time was 3 d(range:2-7 d);the median empty pelvis syndrome recovery time was 62.3 d(range:7-120 d);15 patients had postoperative complications＜grade Ⅲ,and of the 4 patients with grade ≥ Ⅲ,3 patients had surgical hemostatis for postoperative pelvic floor wound bleeding and 1 patient recovered after the second operation for intestinal obstruction.As of February 28,2023 or death,67 patients were followed up for a median of 7.5 months(range:3-1 5 months),and 3 patients died 3-8 months after operation due to rapid tumor progression,severe urinary tract infection,and sudden heart disease during the follow-up period.The remaining 62 cases survived. Conclusion:The surgical classification has guiding significance for preoperative surgical planning in patients with locally advanced or locally recurrent rectal cancer who undergo combined pelvic exenteration,and the method of pelvic floor reconstruction based on biological mesh is safe and feasible in combined pelvic exenteration for locally advanced or locally recurrent rectal cancer.

Correlation between serum vitamin D level and glucose and lipid metabolism among primary and middle school students in Inner Mongolia / 中国学校卫生

Objective@#To explore the correlation between serum vitamin D level and glucose and lipid metabolism among primary and middle school students in Inner Mongolia, so as to providing a scientific basis for guiding rational vitamin D supplementation among primary and middle school students in Inner Mongolia Region.@*Methods@#A total of 2 206 students of primary and middle school students from 8 counties (districts) in Inner Mongolia were enrolled for a questionnaire survey, physical examination, and laboratory test by a multi stage stratified random sampling approach.The levels of fasting blood glucose, blood lipid and other related indexes with different vitamin D levels were analyzed, and their correlation was further discussed.@*Results@#The deficiency and insufficiency rates of vitamin D among primary and middle school students were 33.2% and 42.8%, respectively, and the suitable rate was 24.0%. The body mass index (BMI) and waist height ratio (WHtR) of the vitamin D deficiency group [(22.87±7.41) kg/m 2 , 0.46±0.08)]were higher than the insufficiency [(20.59±8.00)kg/m 2, 0.44±0.09)] and suitable group [(18.01±7.38)kg/m 2, 0.43 ±0.08)] ( P <0.05). Compared with the vitamin D suitable group [(3.87±0.85) mmol/L], the total cholesterol (TC) level in the deficiency group [(3.73±0.67)mmol/L] decreased, with a statistically significant difference ( P <0.05). The levels of high density lipoproteins (HDL) in the vitamin D insufficiency[(1.40±0.33)mmol/L] and deficiency groups [(1.34±0.31)mmol/L] were lower than the suitable group [(1.48±0.34)mmol/L], with a statistically significant difference ( P <0.05). The detection rate of hyperuricemia (HUA) in the vitamin D deficiency group (22.95%) was higher than the suitable group (17.20%), with a statistically significant difference ( P <0.016 7). Pearson correlation analysis showed that vitamin D was negatively correlated with BMI and WHtR ( r =-0.23, -0.11), and positively correlated with TC and HDL level ( r =0.06, 0.16) ( P <0.05).@*Conclusions@#The deficiency and insufficiency rates of serum vitamin D among primary and middle school students in Inner Mongolia are high which are associated with several indicators of blood lipids. Therefore, it is recommended to supplement vitamin D preparations in moderation in daily life.

The efficacy of salbutamol combined with budesonide suspension nebulization in the treatment of AECOPD with respiratory failure and its impact on inflammatory related factors, C3a, and C3aR levels / 中国医师杂志

Objective:To evaluate the efficacy of salbutamol combined with budesonide suspension nebulization in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and respiratory failure, as well as its impact on inflammation related factors, complement 3a (C3a), C3a receptor (C3aR) levels, and helper T cell 17 (Th17), Th17/regulatory T cell (Treg) levels.Methods:A total of 120 AECOPD patients with respiratory failure admitted to the Jincheng People′s Hospital from March 2017 to March 2022 were selected as the study subjects. They were randomly divided into a control group of 60 cases and an observation group of 60 cases using a simple randomization method. The control group was treated with non-invasive positive pressure ventilation, while the observation group was treated with salbutamol combined with budesonide suspension nebulization on the basis of positive pressure ventilation. Two groups were compared in terms of efficacy, incidence of complications, length of hospital stay, COPD assessment test (CAT) scores, and inflammation related factors [white blood cell count (WBC), tumor necrosis factor-α (TNF-α), interleukin-8 (IL-8), interleukin-23 (IL-23) ], differences in complement (C3a, C3aR), peripheral blood Th17/Treg balance factors, vital signs, and blood gas indicators.Resultsl:The total effective rate of the observation group was 93.33%(56/60), significantly higher than the 80.00%(48/60) of the control group, with a statistically significant difference ( P<0.05). After treatment, the levels of inflammation related factors, complement and Th17, Th17/Treg ratio in both groups were significantly lower than before treatment (all P<0.05), and Treg levels were significantly higher than before treatment (all P<0.05). In addition, the levels of inflammation related factors, complement and Th17, Th17/Treg ratio in the observation group were lower than those in the control group (all P<0.05), and Treg levels were higher than those in the control group (all P<0.05). After treatment, the heart rate (HR), respiratory rate (RR), and arterial partial pressure of carbon dioxide (PaCO 2) levels in both groups were significantly lower than those before treatment (all P<0.05), while blood oxygen saturation (SaO 2), partial pressure of oxygen (PaO 2), and pH levels were significantly higher than those before treatment (all P<0.05). The observation group had better lung function, vital signs, and blood gas indicators than the control group (all P<0.05). The hospitalization time in the observation group was significantly shorter than that in the control group ( P<0.05). After treatment, the CAT scores of both groups were significantly lower than those before treatment (all P<0.05), and the CAT scores of the observation group were lower than those of the control group ( P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the observation group [1.67%(1/60)] and the control group [5.00%(3/60)] ( P>0.05). Conclusions:The combination of salbutamol and budesonide suspension nebulization in the treatment of AECOPD with respiratory failure can correct the Th17/Treg imbalance, alleviate inflammatory reactions, improve blood gas indicators, and promote rehabilitation.

The application value and research progress of urine free DNA in tumor molecular diagnosis / 中华检验医学杂志

Urine cell-free DNA (ucfDNA) contains DNA fragments released from the lysis of cells in the urinary system, and circulating cell-free DNA (ccfDNA) can also enter the urine after glomerular filtration, and the mutation information carried by tumor DNA contained in ucfDNA and ccfDNA is consistent. Therefore, as a biomarker for molecular diagnosis of urological and non-urinary tumors, ucfDNA, has become a research hotspot in the field of liquid biopsy in recent years. UcfDNA has potential application value in individualized treatment, early diagnosis, dynamic monitoring of therapeutic efficacy, and prognosis assessment, etc. However, in order to realize the clinical application of urine ucfDNA, the extraction and accurate detection of ucfDNA still need to be solved.

Clinical study of different administration methods of mouse nerve growth factor in the treatment of occupational noise-induced deafness / 中国医师进修杂志

Objective:To compare the therapeutic effect of drum room injection and intramuscular injection of rat nerve growth factor on occupational noise-induced deafness (ONID).Methods:Sixty-six patients with ONID treatment from January 2018 to December 2019 in the People′s Hospital of Liaoning Province were divided into control group and study group by random number table, with 33 patients in each group. On the basis of conventional treatment, all patients in the study group were injected with 20 μg rat nerve growth factor in the drum room, and each ear was injected once every other day. The control group was given intramuscular injection of rat nerve growth factor 20 μg per day, and the patients in two groups were treatment for 28 d. The hearing threshold of left and right whisper frequency of the two groups were compared. The improvement of tinnitus, dizziness, headache, insomnia, other symptoms and the scores of Hamilton Depression Scale (HAMD) was compared between the two groups.Results:Before treatment, the hearing thresholds of left whisper frequency and right whisper frequency in two groups had no significant differences ( P>0.05). After treatment, the hearing thresholds of left whisper frequency and right whisper frequency in the study group were significantly lower than those in the control group: (23.8 ± 4.2) dB/HL vs. (34.5 ± 3.9) dB/HL, (23.2 ± 4.4) dB/HL vs. (35.9 ± 5.1) dB/HL, and there were statistical differences ( P<0.05). After treatment, tinnitus and dizziness symptom improvement rate in the study group were higher than those in the control group: 93.3% (28/30) vs. 72.4% (21/29), 15/17 vs. 8/16, and there were statistically significant differences ( χ2 = 4.584 and 5.705, P<0.05). There was no statistically significant difference in the improvement rate of headache and insomnia symptoms between 2 groups ( P>0.05). The total effective rate in the treatment group was significantly higher than that in the control group: 90.9% (30/33) vs. 69.7% (23/33), and there was statistical difference ( χ2 = 4.694, P<0.05). After treatment, the scores of HAMD of 2 groups were significantly decreased, and the scores of HAMD in the study group was lower than that in control group: (8.46 ± 3.13) scores vs. (10.55 ± 3.83) scores, and there was statistical difference ( P<0.05). The incidence of total adverse reactions between 2 groups had no significant difference ( P>0.05). Conclusions:The injection of mouse nerve growth factor into drum room to treat ONID can effectively improve the hearing level of patients, alleviate tinnitus and dizziness symptoms and improve adverse mood without obvious adverse reactions.

Systematic review and Meta-analysis of efficacy and safety of Compound Glycyrrhizin Injection in improving chronic hepatitis B liver damage / 中国中药杂志

To evaluate the efficacy and safety of Compound Glycyrrhizin Injection(CGI) in improving liver damage in chronic hepatitis B(CHB). PubMed, Web of Science, SinoMed, CNKI, Wanfang and VIP databases were retrieved from their inception to February 10, 2020. The randomized controlled trial(RCT) of CGI in the treatment of CHB was included. Data were independently extracted by two authors, and the methodological quality was evaluated using the Cochrane bias risk assessment tool by other two authors. Statistical analysis was performed using RevMan 5.3 software. A total of 18 two-armed RCTs were included, involving 1 915 participants. The methodological quality of all studies included was generally low. In the comparison between CGI and diammonium glycyrrhizinate, the results showed that CGI was superior to the control group in improving the overall clinical effectiveness, but there was no statistical difference between the two groups in increasing ALT normalization rate, reducing ALT and AST level. In the comparison between CGI and diammonium glycyrrhizinate+other general hepatoprotective drugs, the results showed that CGI was superior to the control group in reducing AST level, while there was no statistical difference between the two groups in reducing ALT level and increasing overall clinical effectiveness. In the comparison between CGI+other commonly used drugs(including energy mixture, glutathione, vitamins, potassium magnesium aspartate) and diammonium glycyrrhizinate+other commonly used drugs, the results showed that CGI combined with other commonly used drugs was better than the control group in reducing ALT and AST level and improving the clinical total effective rate, and there was no statistical difference between the two groups in increasing the rate of ALT normalization. In the comparison between CGI+other commonly used drugs and other commonly used drugs, the results showed that CGI combined with other commonly used drugs was superior to the control group in reducing ALT and AST level and improving the overall clinical effectiveness. In the comparison between CGI+vitamins and diammonium glycyrrhizinate+potassium magnesium aspartate+vitamins, the results showed no statistical difference between the two groups in reducing AST level. A small number of studies included reported that CGI caused mild adverse reactions when used alone or in combination with other drugs. Based on the results, CGI has a certain effect in improving CHB liver damage, but the evidence is not enough to prove that CGI would cause serious adverse events. In the future, more well-designed and strictly-enforced RCT with an adequate sample size are needed to further evaluate the effect CGI in alleviating CHB liver damage.

Relationship between macular microstructure and visual acuity after scleral buckling for macular-off primary rhegmatogenous retinal detachment by 3D-OCT / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the correlation between macular mierostructure changes and visual outcomes after scleral buckling for macular-off primary rhegmatogenous retinal detachment(RRD)by three-dimensional optical coherence tomography(3D-OCT).<p>METHODS: Retrospective case review, the clinical data of scleral buckling in 30 eyes of 30 cases of RRD involving macular area were analyzed retrospectively. The changes of ellipsoid zone(EZ), external 1imiting membrane(ELM), subretinal fluid(SRF)and central retinal thickness(CRT)were observed and the relationship between them and best corrected visual acuity(BCVA)was analyzed by 3D-OCT at 2d, 2wk, 1, 3 and 6mo after operation.<p>RESULTS: Postoperative SRFH and CRT showed a descended trend. Postoperative BCVA showed an ascendant trend. Multiple comparisons: there were significant difference in each groups except SRFH(2wk <i>vs</i> 1mo, <i>P</i>>0.05), CRT(2d <i>vs</i> 2wk, <i>P</i>>0.05), BCVA(2d <i>vs</i> preoperation, 2wk <i>vs</i> preoperation, <i>P</i>>0.05). There are four forms of EZ and ELM::9 eyes, intact ELM and EZ(EZ+ELM+); B: 7 eyes, intact ELM with disrupted EZ:(EZ-ELM+); AC: 6 eyes, intact EZ with disrupted ELM:(EZ+ELM-); D: 8 eyes, disrupted ELM and EZ:(EZ-ELM-), the BCVA of the above four types are 0.15±0.04, 0.50±0.06, 0.54±0.05 and 0.59±0.09, there were significant difference in each groups except(C <i>vs</i> B, <i>P></i>0.05)and(C <i>vs</i> D, <i>P</i>>0.05). The incidence of SRF was 87% 2d after operation, 46.6% patients had persistent SRF at 6mo after operation. Postoperative CRT was positively correlated with postoperative SRFH.<p>CONCLUSION: After scleral buckling, the macular microstructure showed dynamic changes. The effect of SRF may be manifested as BCVA delayed recovery. With the slow absorption of SRF, CRT decreased and BCVA increased. The intact ELM or EZ shows better vision, but the disrupted ELM means worse vision.

Status of health examination on public health employees in Beijing / 中华流行病学杂志

Objective@#The aim of this study was to understand the status of health examination on public health employees in Beijing, in order to further standardize the health management of the employees.@*Methods@#Questionnaire surveys and personal interviews were produced to obtain the basic information, physical examination, occupational training, knowledge of health laws and regulations, and satisfaction of employees. Pairwise comparison was conducted by chi-square test. Multivariate linear regression was used for multivariate analysis.@*Results@#The percentage of the public health employees who took the blood tests, X-ray examinations, fecal examinations, and skin examinations were 97.0%, 77.6%, 86.4%, and 51.0%, respectively. After excluding the skin examination, the completion rate of other examination items was 72.1%, and the difference of this rate between public hospitals and private hospitals were statistically significant (χ2=36.22, P<0.001; χ2=9.09, P=0.003; χ2=31.06, P<0.001). The percentage of correct answers to all the five questions was 3.2%, and age, working age and education level were positively correlated with knowledge scores of employees.@*Conclusions@#The problems in Beijing’s health examination of employees included poor examination quality, lack of supervision, inability to trace the source and low awareness rate of health knowledge, which suggested that counter measures should be taken immediately.

Prenatal diagnosis of partial trisomy 3q in a fetus / 中华医学遗传学杂志

OBJECTIVE@#To carry out prenatal diagnosis for a fetus with ultrasonographic abnormality.@*METHODS@#Chromosomal karyotyping and array comparative genomic hybridization (array-CGH) analysis were applied for the diagnosis. Peripheral blood samples were also taken from the parents for chromosome karyotyping analysis.@*RESULTS@#The fetal karyotype showed additional material of unknown-origin attached to Yq. Array CGH analysis confirmed that the material was derived from 3q22.1q29. The father was found to carry a balanced translocation 46, X, t(Y;3)(q12;q23) (which was diagnosed as 46,XY,Y≥18 elsewhere), whilst the mother was found to be normal.@*CONCLUSION@#3q partial trisomy may present as malformation of multiple systems. Combination of chromosome karyotyping and array-CGH can provide reliable diagnosis for fetuses with abnormalities by ultrasonography.

Quantitative Proteomic Analysis Reveals Impaired Axonal Guidance Signaling in Human Postmortem Brain Tissues of Chronic Traumatic Encephalopathy

Chronic traumatic encephalopathy (CTE) is a distinct neurodegenerative disease that associated with repetitive head trauma. CTE is neuropathologically defined by the perivascular accumulation of abnormally phosphorylated tau protein in the depths of the sulci in the cerebral cortices. In advanced CTE, hyperphosphorylated tau protein deposits are found in widespread regions of brain, however the mechanisms of the progressive neurodegeneration in CTE are not fully understood. In order to identify which proteomic signatures are associated with CTE, we prepared RIPA-soluble fractions and performed quantitative proteomic analysis of postmortem brain tissue from individuals neuropathologically diagnosed with CTE. We found that axonal guidance signaling pathwayrelated proteins were most significantly decreased in CTE. Immunohistochemistry and Western blot analysis showed that axonal signaling pathway-related proteins were down regulated in neurons and oligodendrocytes and neuron-specific cytoskeletal proteins such as TUBB3 and CFL1 were reduced in the neuropils and cell body in CTE. Moreover, oligodendrocyte-specific proteins such as MAG and TUBB4 were decreased in the neuropils in both gray matter and white matter in CTE, which correlated with the degree of axonal injury and degeneration. Our findings indicate that deregulation of axonal guidance proteins in neurons and oligodendrocytes is associated with the neuropathology in CTE. Together, altered axonal guidance proteins may be potential pathological markers for CTE.

Driver gene status and first line treatment of advanced lung adenocarcinoma:A single centric real-world study / 实用医学杂志

Objective To analyze driver genes status and its clinical characteristics of advanced lung adenocarcinoma, then evaluate the status of first-line treatment in a single centric real-world. Methods EGFR, ALK, ROS-1 gene in 204 advanced lung adenocarcinoma tissue were tested by ARMS-PCR method. And the relationship between driver genes status and clinical characteristics was analyzed as the first line treatment in real clinical practice. Results The positive rate of driver genes status in 204 advanced lung adenocarcinoma was 53.9％ (110/204) , including EGFR mutation 46.1％ (94/204) , ALK positive 6.4％ (13/204) and ROS1 positive 1.5％ (3/204). The driving genes status was significantly correlated with gender, smoking history, tumor staging and serosal invasion (P < 0.05). There were significantly differences among the proportion of first-line standard treatment in different subgroup (P = 0.000) , the first-line standard treatment rate of EGFR mutation, ALK/ROS1 positive and drive gene negative were 77.7％, 37.5％, and 46.8％ respectively. And the ratio of using 1 st generation EGFR-TKIs in all patients is 70.6％ (60/85). Conclusion More than half of advanced lung adenocarcinoma have driver genes changes, and EGFR-TKI first-line treatment has higher acceptability in real-word.

Network analysis of microRNAs, transcription factors, and target genes involved in axon regeneration / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Axon regeneration is crucial for recovery from neurological diseases. Numerous studies have identified several genes, microRNAs (miRNAs), and transcription factors (TFs) that influence axon regeneration. However, the regulatory networks involved have not been fully elucidated. In the present study, we analyzed a regulatory network of 51 miRNAs, 27 TFs, and 59 target genes, which is involved in axon regeneration. We identified 359 pairs of feed-forward loops (FFLs), seven important genes (Nap1l1, Arhgef12, Sema6d, Akt3, Trim2, Rab11fip2, and Rps6ka3), six important miRNAs (hsa-miR-204-5p, hsa-miR-124-3p, hsa-miR-26a-5p, hsa-miR-16-5p, hsa-miR-17-5p, and hsa-miR-15b-5p), and eight important TFs (Smada2, Fli1, Wt1, Sp6, Sp3, Smad4, Smad5, and Creb1), which appear to play an important role in axon regeneration. Functional enrichment analysis revealed that axon-associated genes are involved mainly in the regulation of cellular component organization, axonogenesis, and cell morphogenesis during neuronal differentiation. However, these findings need to be validated by further studies.

Analysis of pathological mutation in a Chinese pedigree affected with familial exudative vitreoretinopathy / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To detect potential mutation in a Chinese pedigree affected with familial exudative vitreoretinopathy (FEVR).</p><p><b>METHODS</b>Clinical data of the pedigree was collected. Coding regions of candidate genes were amplified by PCR and subjected to next generation sequencing (NGS). Suspected mutations were verified by Sanger sequencing and segregation analysis.</p><p><b>RESULTS</b>Two novel heterozygous mutations (c.1695dupC and c.552-563del) were respectively detected in the LRP5 and ZNF408 genes in the proband. Both mutations were inherited from the affected mother. By Sanger sequencing, the c.552-563del mutation was also detected among unaffected members, while the c.1695dupC mutation was only detected in affected members from the pedigree and was not recorded by the HGMD, NCBI, or 1000 genome database. Upon prenatal diagnosis, the fetus was found to carry the same mutations.</p><p><b>CONCLUSION</b>Combined NGS and Sanger sequencing not only can reduce the time required for diagnosis but also enable accurate prenatal diagnosis for FEVR.</p>

Family medical intervention model of senile dementia with behavioral and psychological symptoms / 上海交通大学学报（医学版）

Objective · To explore family medical intervention model of senile dementia with behavioral and psychological symptoms. Methods · Four streets of Changning District in Shanghai were randomly selected and subjects were enrolled according to the inclusion criteria, who were randomly divided into the intervention group (n=71) and control group (n=70). The intervention group received door-to-door service from psychiatric doctors, given drug treatment and psychological intervention. Subjects were evaluated by several scales, including Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), Mini-Mental State of Examination (MMSE), Activity of Daily Living Scale (ADL), Quality of Life-Alzheimer's Disease (QOL-AD), and Generic Quality of Life Inventory-74 (GQOLI-74), at baseline and by the end of 6 months and 12 months. Results · ① There was no significant difference in the total scores and all factor scores of BEHAVE-AD between the two groups before intervention (P>0.05). Repeated measures analysis of variance revealed a significant main effect of time (P0.05). Repeated measures analysis of variance revealed a significant main effect of time (P<0.001). The between-group effect was significant in the scores of MMSE and QOL-AD (P<0.001). The interactive effect of time×group was significant in the scores of MMSE, ADL, QOL-AD, and GQOLI-74 (P<0.05). ④ Inter-group comparison of MMSE, ADL, QOL-AD, and GQOLI-74 scores indicated that by the end of 6 months, scores of MMSE of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). By the end of 12 months, scores of MMSE, ADL, QOL-AD, and GQOLI-74 of the intervention group were remarkably better than those of the control group and the differences were statistically significant (P<0.05). Conclusion · The family medical intervention model of door-to-door services from psychiatrists integrating multidisciplinary team is effective to attenuate the mental and behavioral symptoms of senile dementia patients, and can improve the quality of life of patients and caregivers. The effect of persistent implementation will be more remarkable.

Recent advance in anti-fingolimod glioblastomas / 中华神经医学杂志

Fingolimod (FTY720) as a new immunosuppressive agent,is the prodrug of an sphingosine-1-phosphate receptor agonist.It is a potent immunosuppressant which has been approved by the US Food and Drug Administration to treat relapsing-remitting multiple sclerosis,and shows its unique and novel mechanism of action.Unlike the traditional immunosuppressive agents,fingolimod exerts immunosuppressive and immunoregulatory functions mainly through interaction with shhingosine-l-phosphate receptors on the cell surface without affecting activation and proliferation of lymphocytes.In addition,FTY720 has been shown to inhibit a variety of cancer related signal transduction pathways.It also presented significant anticancer effects in the in vivo and in vitro experiments.And in the treatment of glioblastoma multiforme (GBM) experiment,FTY720 displayed excellent activity as well had a synergistic effect in addition to temozolomid,the current standard chemotherapeutic agent to treat malignant gliomas.This article reviewed the advances in study on the anti-GBM effect and mechanism of FTY720.

Research progress of related risk factors and treatment of acute gangrenous cholecystitis / 中国综合临床

Acute gangrenous cholecystitis is a histologic diagnosis,mostly diagnosed by intraoperative or postoperative pathology.In China,as the aging population increases,the incidence of the disease increases steadily.AGC is still an indication of surgical treatment for acute cholecystitis(AC),but the diagnosis and treatment of AGC remains a challenge for clinical surgeons.However,preoperative clinical data such as age, gender,hypertension,diabetes,coronary heart disease,cholelithiasis disease history,laboratory examination and radiographic results are helpful in early diagnosis and reasonable surgical timing selection.

Research progress of related risk factors and treatment of acute gangrenous cholecystitis / 中国综合临床

Acute gangrenous cholecystitis is a histologic diagnosis,mostly diagnosed by intraoperative or postoperative pathology.In China,as the aging population increases,the incidence of the disease increases steadily.AGC is still an indication of surgical treatment for acute cholecystitis(AC),but the diagnosis and treatment of AGC remains a challenge for clinical surgeons.However,preoperative clinical data such as age, gender,hypertension,diabetes,coronary heart disease,cholelithiasis disease history,laboratory examination and radiographic results are helpful in early diagnosis and reasonable surgical timing selection.

Challenges and countermeasures of forestry schistosomiasis control pro-grams in ecological priority of Yangtze River economic belt development / 中国血吸虫病防治杂志

Relevant projects carried out within the Yangtze River economic belt on the impact of schistosomiasis epidemic and transmission are important issues for ecological priority in the process of implementing the strategy. The key problems of schistosomiasis epidemic risk,epidemic happening repeatedly,difficulty of rehabilitating Oncomelania hupensis snail control and schistosomiasis prevention forest,lag of evaluation system and platform construction,lack of basic research,et al. were ana-lyzed in the Yangtze River economic belt taking ecological priority as the basis in this paper. Then corresponding countermea-sures to these challenges were put forward so as to provide the reference for the national forestry schistosomiasis control pro-grams,which include:execution of the comprehensive prevention and control strategy,scheming of the new round of forestry schistosomiasis control programs,strengthening schistosomiasis prevention and control,promoting productivity in existing forest-ry to consolidate and improve the achievements of previous forestry schistosomiasis control programs,and promoting the intensi-ty of technological innovation to improve the technological level of forestry schistosomiasis control programs.