Secular trends of age at menarche and age at menopause in women born since 1951 from a county of Shandong Province, China / 北京大学学报(医学版)

OBJECTIVE@#To describe the secular trends of age at menarche and age at natural menopause of women from a county of Shandong Province.@*METHODS@#Based on the data of the Premarital Medical Examination and the Cervical Cancer and Breast Cancer Screening of the county, the secular trends of age at menarche in women born in 1951 to 1998 and age at menopause in women born in 1951 to 1975 were studied. Joinpoint regression was used to identify potential inflection points regarding the trend of age at menarche. Average hazard ratios (AHR) of early menopause among women born in different generations were estimated by performing multivariate weighted Cox regression.@*RESULTS@#The average age at menarche was (16.43±1.89) years for women born in 1951 and (13.99±1.22) years for women born in 1998. The average age at menarche was lower for urban women than that for rural women, and the higher the education level, the lower the average age at menarche. Joinpoint regression analysis identified three inflection points: 1959, 1973 and 1993. The average age at menarche decreased annually by 0.03 (P < 0.001), 0.08 (P < 0.001), and 0.03 (P < 0.001) years respectively for women born during 1951-1959, 1960-1973, and 1974-1993, while it remained stable for those born during 1994-1998 (P=0.968). As for age at menopause, compared with women born during 1951-1960, those born during 1961-1965, 1966-1970 and 1971-1975 showed a gradual decrease in the risk of early menopause and a tendency to delay the age at menopause. The stratified analysis presented that the risk of early menopause gradually decreased and the age of menopause showed a significant delay among those with education level of junior high school and below, but this trend was not obvious among those with education level of senior high school and above, where the risk of early menopause decreased and then increased among those with education level of college and above, and the corresponding AHRs were 0.90 (0.66-1.22), 1.07 (0.79-1.44) and 1.14 (0.79-1.66).@*CONCLUSION@#The age at menarche for women born since 1951 gradually declined until 1994 and leveled off, with a decrease of nearly 2.5 years in these years. The age at menopause for women born between 1951 and 1975 was generally delayed over time, but the trend of first increase and then decrease was observed among those with relatively higher education levels. In the context of the increasing delay in age at marriage and childbearing and the decline of fertility, this study highlights the necessity of the assessment and monitoring of women' s basic reproductive health status, especially the risk of early menopause.

Study on the correlation between meibomian gland dysfunction and sleep quality / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To study the correlation between meibomian gland dysfunction(MGD)patients and their sleep quality.METHODS: Retrospective case-control study. A total of 150 MGD patients treated in our hospital from January 2021 to October 2022 were selected and divided into sleep disorder group(75 cases, PSQI&#x003E;10 points)and control group(75 cases, PSQI≤10 points)according to the Pittsburgh sleep quality index(PSQI). Both groups were scored using the ocular surface disease index(OSDI), underwent meibomian gland-related examinations(eyelid margin morphology, meibomian gland secretion ability, meibomian gland secretion quality score), corneal fluorescein staining(FL)score, Schirmer Ⅰ test(SⅠt), tear film break-up time(BUT)was measured, and sleep indicators(sleep quality, sleep latency, subjective sleep quality, sleep time)were evaluated.RESULTS: There were significant differences in OSDI score, FL score, SⅠt, BUT, eyelid margin morphology score, meibomian gland secretion ability score, and meibomian gland secretion quality score between the two groups(P&#x003C;0.05). In the sleep disorder group, PSQI score, sleep latency score, subjective sleep quality score, and sleep time score were significantly positively correlated with OSDI score, FL score, meibomian gland secretion ability score, and meibomian gland secretion quality score(P&#x003C;0.05); PSQI score, subjective sleep quality score, and sleep time score were significantly positively correlated with eyelid margin morphology score(P&#x003C;0.05); PSQI score, sleep latency score, and subjective sleep quality score were significantly negatively correlated with BUT and SⅠt(P&#x003C;0.05); sleep time score was significantly negatively correlated with BUT(P&#x003C;0.05); sleep latency score was not significantly correlated with eyelid margin morphology score(P&#x003E;0.05); sleep time score was not significantly correlated with SⅠt(P&#x003E;0.05).CONCLUSION:The ocular surface condition of MGD patients is correlated with multiple sleep quality indicators, and a decline in sleep quality may increase the risk of MGD.

Ultrasound-guided continuous fascia iliaca compartment block for perioperative pain management in elderly patients undergoing hip fracture surgery / 中国骨伤

OBJECTIVE@#To study the effect of ultrasound-guided fascia iliaca compartment block on perioperative analgesia and postoperative complications in geriatric patients with hip fractures.@*METHODS@#A total of 127 elderly patients undergoing hip fracture surgery from January 2021 to September 2021 were randomized to receive ultrasound-guided continuous fascia iliaca compartment block(group F) either intravenous analgesia control group(group C). There were 62 cases in group F, including 19 males and 43 females with an average age of (82.4±7.2) years old ranging from 66 to 95 years old, involving 25 femoral neck fractures and 37 femoral intertrochanteric fractures. There were 65 cases in control group, including 18 males and 47 females, with an average age of (81.4±8.7) years old ranging from 65 to 94 years old, involving 29 femoral neck fractures and 36 femoral intertrochanteric fractures. The visual analogue scale(VAS), minimental state examination (MMSE), observer's assessment of alertness/sedation(OAA/S) scale, modified Bromage score, postoperative complications and general conditions during hospitalization in two groups were observed.@*RESULTS@#The resting and exercise VAS at 30 min after block, anesthesia placement and 6, 24 and 48 h after surgery were lower than those in group C(P<0.05). In group F, MMSE scores at 12 h before surgery, and 1, 3 d after surgery and OAA/S scores at 3 d after surgery were higher than those in group C(P<0.05). The incidence of adverse effects and the number requiring additional analgesia were lower than those in group C(P<0.05). Group F had better perioperative analgesia satisfaction and hospital stay than group C(P<0.05). But there was no significant difference regarding Bromage score and 30-day mortality between two group(P>0.05).@*CONCLUSION@#Ultrasound-guided continuous fascia iliacus space block was safe and effective for elderly patients with hip fracture, and could significantly reduce perioperative pain, improve postoperative cognitive function, and reduce postoperative complications, thereby shortening hospital stay and improving the quality of life during hospitalization.

Risk factors and prognosis of preoperative herat failure after hip fracture / 中国骨伤

OBJECTIVE@#To explore incidence, risk factors and the relationship between preoperative heart failure and prognosis in elderly patients with hip fracture.@*METHODS@#A retrospective analysis was performed on 1 569 elderly patients with hip fracture treated from January 2012 to December 2019, including 522 males and 1 047 females, aged 81.00 (75.00, 90.00) years old;896 intertrochanteric fractures and 673 femoral neck fractures. Patients were divided into heart failure and non-heart failure groups according to whether they developed heart failure before surgery, and heart failure was set as the dependent variable, with independent variables including age, gender, fracture type, comorbidities and hematological indicators, etc. Univariate analysis was performed at first, and independent variables with statistical differences were included in multivariate Logistic regression analysis. Independent risk factors for preoperative heart failure were obtained. The length of hospital stay, perioperative complications, mortality at 30 days and 1 year after surgery were compared between heart failure and non-heart failure groups.@*RESULTS@#There were 91 patients in heart failure group, including 40 males and 51 females, aged 82.00 (79.00, 87.00) years old;55 patients with intertrochanteric fracture and 36 patients with femoral neck fracture. There were 1 478 patients in non-heart failure groups, including 482 males and 996 females, aged 81.00(75.00, 86.00) years old;841 patients with intertrochanteric fracture and 637 patients with femoral neck fracture. There were significant differences in age, sex, coronary heart disease, arrhythmia and dementia between two groups(P<0.05). Multivariate Logistic analysis of statistically significant factors showed that males(OR=1.609, P=0.032), age(OR=1.032, P=0.031), arrhythmia(OR=2.045, P=0.006), dementia (OR=2.106, P=0.014) were independent risk factor for preoperative heart failure. The 30-day and 1-year mortality rates were 9.9% and 26.4% in heart failure group and 3.6% and 13.8% in non-heart failure group, respectively;and had statistical significance between two groups (P<0.05). There were significant differences in pulmonary infection, cerebrovascular complications and cardiovascular complications between two groups (P<0.05). The duration of hospitalization in heart failure group was (16.21±10.64) d compared with that in non-heart failure group (13.26±8.00) d, and the difference was statistically significant (t=2.513, P=0.012).@*CONCLUSION@#Male, old age, arrhythmia and dementia are independent risk factors for heart failure after hip fracture in elderly patients. Patients with preoperative heart failure have a higher incidence of postoperative pulmonary infection, cerebrovascular and cardiovascular complications, higher mortality at 30 d and 1 year after surgery, and longer hospital stay.

Preliminary adipose removal did not prevent diet-induced metabolic disorders in mice / 中华医学杂志(英文版)

BACKGROUND@#Obesity is a fundamental factor in metabolic disorders such as hyperlipidemia, insulin resistance, fatty liver, and atherosclerosis. However, effective preventive measures are still lacking. This study aimed to investigate different surgical protocols for removing partial adipose tissue before the onset of obesity and determine whether, and by which protocol, preliminary adipose removal could exert potent preventive effects against diet-induced metabolic disorders.@*METHODS@#Male low-density lipoprotein receptor (LDL-R) knockout (KO) mice were randomly divided into four groups and subjected to epididymal fat removal (Epi-FR) surgery, subcutaneous fat removal (suQ-FR) surgery, both subcutaneous and epididymal fat removal (Epi + suQ-FR) surgery, or sham-operation. After 1 week of recovery, all mice were given a high-fat diet (HFD) for 10 weeks to induce metabolic disorders.@*RESULTS@#In the Epi-FR group and the sham-operated group, the mean numbers of the residual subcutaneous fat were 28.59 mg/g and 18.56 mg/g, respectively. The expression of relative genes such as Pparg, Cebpa, Dgat2, Fabp4 and Cd36 in the residual subcutaneous fat increased 2.62, 3.90, 3.11, 2.06, 1.78 times in the Epi-FR group compared with that in the sham-operated group. Whereas in the other fat-removal groups, the residual fat depots had no significant change in either size or gene expression, as compared with those of the sham-operated group. Plasma lipid and glucose levels and insulin sensitivity, as detected by the glucose tolerance test, were not significantly alleviated in the three fat removal groups. Liver mass or lipid content was not attenuated in any of the three fat removal groups. The atherosclerosis burdens in the entire inner aorta and aortic root did not decrease in any of the three fat removal groups.@*CONCLUSIONS@#Our data suggest that removal of epididymal adipose or subcutaneous adipose alone or in combination before the onset of obesity did not protect against hyperlipidemia, insulin resistance, fatty liver, or atherosclerosis in LDL-R KO mice fed with a HFD. Hence, adipose removal possibly does not represent a potential approach in preventing obesity-related metabolic disorders in the obesity-susceptible population.

Quality Difference Characteristics of Bupleurum Formulae Granules Based on the Analysis of Dual-Wavelength Fingerprint Profiles and Chemometric Methods / 中国药学杂志

OBJECTIVE: To distinguishing the Bupleurum formulae granules from different origins and promoting the consistency of quality of them,with the analysis of fingerprint profiles and chemometric methods. METHODS: In the study, a method of dual-wavelength (210 & 254 nm) HPLC fingerprint of Bupleurum formulae granules was developed. Based on the fingerprint method, the quality differences of the samples of Bupleurum formulae granules were analyzed by similarity analysis, hierarchical cluster analysis, principal component analysis and partial least squares discriminant analysis. RESULTS: The fingerprints of 12 batchs of Bupleurum formulae granules are established. The results indicated that the fingerprints of Bupleurum formulae granules from different origins could be differentiated well and the characteristic peaks could be marked. CONCLUSION: The 210 nm fingerprints of Bupleurum formulae granule have the most characteristic differences; It is recommended that the dual-wavelength fingerprints could be combined for analysis and application. Saikosaponin a, saikosaponin b2 and saikosaponin b1 are the key components of the quality difference, which should be focused on in the quality evaluation and control of Bupleurum formula granules.

Establishment and Application of HPA1-6, 15 Platelet Donor Bank in Beijing Area / 中国实验血液学杂志

OBJECTIVE@#To establise the bank of platelet donors with the human platelet antigen (HPA) 1-6, 15 genes so as to provide the HPA-matched platelets for the patients.@*METHODS@#The HPA genotyping of platelets donors and patients with platelet antibody positive confirmed by sercening was performed by using the SSP-PCR; the efficacy of transfusing the HPA-matched platelets for 37 cases platelet antibody positive was analyzed.@*RESULTS@#The most common genotype in platelet donors were HPA-1a/1a-2a/2a-3a/3b-4a/4a-5a/5a-6a/6a-15a/15b, followed by HPA-1a/1a-2a/2a-3a/3a-4a/4a-5a/5a-6a/6a-15a/15b; the most common genotype in 53 cases of platelet antibody positive confirened by screening were HPA-1a/1a-2a/2a-3a/3b-4a/4a-5a/5a-6a/6a-15a/15b. Among 37 patients with platelet antibody positive confirened by screeming, 28 showed that the transfusion of HPA-matched platelets was effective with statistically significant difference in comparison with random transfusion group. The HPA-3, HPA-15 were the main factors leading to polymorphisms.@*CONCLUSION@#HPA-3 and HPA-15 are polymorphic, which should be focused on. HPA-matched platelets can improve the efficiency of platelet transfusion, and avoid the waste of blood resources. The genotypes of platelet donors can basically meet the requirements for common genotype transfusion.

Comparison of clinical effects of total artificial hip replacement and cannulated screw fixation for the treatment of displaced femoral neck fractures in elderly patients / 中国骨伤

<p><b>OBJECTIVE</b>To compare of clinical effects of different surgical methods in the treatment of elderly femoral neck fractures.</p><p><b>METHODS</b>From January 2013 to June 2016, 144 elderly patients with femoral neck were treated and divided into artificial hip replacement group and cannulated screw fixation group according to the surgical methods. In the total hip arthroplasty group, there were 89 cases, 28 males and 61 females, with an average age of(84.10±3.10) years old;Hollow nail fixation group 55 cases, 20 males and 35 females, with an average age of (86.80±2.88) years. Preoperative patients data, postoperative complications, mortality and postoperative Harris hip score were compared between the two groups.</p><p><b>RESULTS</b>A total of 144 cases were followed up for 12 to 36 months with an average of 18 months. There was no significant difference between two groups in gender, fracture side, preoperative complications, osteoporosis, ASA score, injury to surgery interval, the number of patients admitted to ICU and perioperative death. However, the patients in hollow screw fixation group was older than the joint replacement group(=5.311,<0.05);The degree of preoperative fracture displacement in the joint replacement group was higher than that in the hollow nail fixation group(χ²=6.894,=0.009<0.05);Hollow nail fixation group in operation time, hospital stay, intraoperative blood loss, perioperative blood transfusion was significantly better than the number of joint replacement group(<0.05);The Harris score of the joint replacement group was higher than that of the hollow screw fixation group(<0.05).</p><p><b>CONCLUSIONS</b>For elderly femoral neck patients, if there is a significant shift in the fracture (Garden III, IV), the preferred treatment is hip replacement. Postoperative complications are relatively small, satisfactory joint function recovery. If the fracture displacement is not obvious (Garden type I, II) or patients with more medical diseases, poor physical condition, poor surgical tolerance, postoperative life expectancy is not high, the first choice is closed reduction and cannulated screw fixation.</p>

Efficacy of elastic intramedullary nail versus locking plate fixation in the treatment of middle clavicle fracture / 中国组织工程研究

BACKGROUND: For the treatment of middle clavicle fractures, elastic intramedullary nailing has gradually gained everyone's approval because of its small incision and short operation time. Locking plate fixation is currently the main surgical treatment. At present, there are a few comparative studies on the results of the two surgical treatments, but the results are still controversial. In particular, there is a lack of comparative studies on long-term efficacy and complications. OBJECTIVE: To compare clinical results and complications of locking plate and elastic intramedullary nailing for middle clavicular fracture. METHODS: A retrospective analysis of 85 patients with middle clavicular fractures who were hospitalized at the Army General Hospital of Second Medical College of Southern Medical University from June 2014 to June 2015 undergoing surgeries was performed. They were divided into two groups randomly: locking plate group (n=62) and elastic intramedullary nailing group (n=23). The incision length, operation time, blood loss and time of hospital staying were compared between the two groups. Regular follow-up, radiography assessment and postoperative complications and shoulder function score were measured. RESULTS AND CONCLUSION: (1) Incision length, operation time, blood loss and time of hospital staying were significantly better in the elastic intramedullary nailing group than in the locking plate group (P < 0.05). (2) The complications of the elastic intramedullary nailing group were significantly lower than that of the locking plate group (P < 0.05). The main complications of locking plate group were superficial wound infection, hypesthesia in the local incision and implant protuberance. Only two patients in the intramedullary nailing group experienced complications. (3) The healing rate of elastic intramedullary nailing group was higher than that of the locking plate group, which was not statistically significant (P > 0.05). (4) The DASH scores and the Constant-Murley scores of the two groups after operation were not statistically significant (P > 0.05). (5) The elastic intramedullary nailing and locking plate are both effective methods for the treatment of middle clavicular fracture. Incision length, operation time, blood loss and average length of hospital stay have obvious advantages; the incidence of complications is low; and recovery is fast in the elastic intramedullary nailing group. However, elastic nail may stimulate the local skin, causing some impact for the patients' daily life.

Clinical Observation of Xiaotan Tongluo Gel Combined with Mecobalamin Tablets in Ttreating Peripheral Neurotoxicity Induced by Chemotherapy / 中国中医药信息杂志

Objective To investigate clinical efficacy of Xiaotan Tongluo Gel combined with mecobalamin tablets in treating chemotherapy-induced peripheral neuropathy (CIPN). Methods Totally 67 cases of CIPN were divided into the treatment group (36 cases) and the control group (31 cases). Both groups were given mecobalamin tablets, 0.5 mg each time, three times a day, orally. Patients in the treatment group were treated with Xiaotan Tongluo Gel for external use at the same time. The patients in control group were treated with placebo gel for external use, 1 mL/cm2, rubbed on the skin 1 cm more than sensory obstruction in diameter. The treatment for both groups lasted for 14 d as a treatment course, and the treatment lasted for 2 courses. The changes of peripheral nerve toxicity, TCM syndrome scores and the nerve conduction velocity were observed in the two groups. Results On the 14th and 28th days of treatment, the total effective rates of peripheral nerve toxicity were 75.00% and 91.67% in the treatment group, and 38.71% and 67.74% in the control group, and the treatment group was significantly better than those of the control group (P=0.002, P=0.005); On the 14th and 28th days of treatment, the total effective rate of TCM efficacy in the treatment group was 75.00% and 94.44% respectively, and that in the control group was 45.16% and 64.52% respectively, and the treatment group was significantly better than the control group (P=0.018, P=0.005). Compared with before treatment, the TCM syndrome scores in both groups were significantly reduced on the 14th and 28th days (P＜0.01); The TCM syndrome scores in the treatment group were significantly lower than those in the control group at the same time points after treatment (P＜0.01). Compared with before treatment, the sensory and motor nerve conduction speeds of the peroneal and median nerves in the two groups at 14th and 28th days were significantly increased (P＜0.01); Comparing the two groups at the same time point after treatment, the sensory and motor nerve conduction velocity of the peroneal and median nerves in the treatment group was significantly better than that in the control group (P＜0.05, P＜0.01). Conclusion Xiaotan Tongluo Gel combined with mecobalamin tablets can effectively improve the peripheral neurotoxicity induced by chemotherapy, TCM syndrome scores, and the nerve conduction velocity.

Acumed intramedullary nail for the treatment of adult diaphyseal both-bone forearm fractures / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the results of Acumed intramedullary nail for the treatment of adult diaphyseal fractures of both-bone forearm fractures.</p><p><b>METHODS</b>From January 2009 to December 2016, 86 adult patients with both forearm fractures were treated by intramedullary nail including 54 males and 32 females with an average age of 36.8 years old ranging from 18 to 72 years old;There were 50 cases were on the right and 36 cases on the left. The operation time, blood loss and X-ray expose time intra-operation, time of fracture union, complications, DASH(Disabilities of the Arm, Shoulder and Hand questionnaire), Grace-Eversman criteria were recorded to evaluate the clinical outcomes of intramedullary nail for the treatment of forearm fractures.</p><p><b>RESULTS</b>All patients were followed up from 48 to 144 weeks with an average of 86.8 weeks; the blood loss intraoperation was 30 to 80 ml with an average of 52 ml; the the X-ray expose time was 1 to 6 min with an average of 2.5 min;the operation time was 31 to 55 min with an average of 46 min; Among them, 85 cases healed successfully, the union time was 10 to 16 weeks with an average of 13.3 weeks. There were 1 case of hypertrophic nonunion, 1 case of ulnar radial bone bridge formation, and 1 case of extensor hallucis longus tendon injury. The DASH score was 4 to 37(means 15.6); according to Grace-Eversman criteria, the results were excellent in 65 cases, good in 15, acceptable in 5, poor in 1.</p><p><b>CONCLUSIONS</b>Intramedullary fixation method in treating both-bone forearm fractures has advantages of closed application, short operation time, little complication, and clinical outcomes is satisfied.</p>

Effect of BBG on Acute Graft-Versus-Host Disease in Mice after Allogeneic Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of P2X7R antagonist brilliant blue G (BBG) on aGVDH of mice after allo-HSCT.</p><p><b>METHODS</b>aGVHD mouse model after HSCT was established and treated with the P2X7R antagonist BBG of different dosages (50 mg/kg and 75 mg/kg). After treatment, the survival, body weight, pathological and liver function of aGVDH mice were abserved, and the expression levels of P2X7, NLRP3, caspase-1, IL-1β, IL-18 mRNA and protein were evaluated by real-time PCR and Western blot.</p><p><b>RESULTS</b>The allo-HSCT aGVHD mouse model was successfully established, the intraperitoneal injection of BBG alleviated the aGVHD clinical manifestations including roachback, ruffled fur, skin peeling and weight loss of recipient mice, decreased P2X7R and IL-1β expression and reduced the mRNA levels of P2X7R, NLRP3, Caspase-1, IL-1β and IL-18. Furthermore, GVHD group receiving 75 mg/kg BBG showed most significant difference of these indexes.</p><p><b>CONCLUSION</b>BBG alleviates liver inflammatory damage induced by aGVHD after allo-HSCT, and decreases the expression of proinflammatory cytokines. Moreover, the protective effect of that of BBG 75 mg/kg group is better than that of BBG 50 mg/kg group.</p>

Effect of hip fracture at different sites in elderly patients on prognosis / 中国骨伤

<p><b>OBJECTIVE</b>To determine the effect of site of fracture on the prognosis for patients of elderly hip fracture.</p><p><b>METHODS</b>From January 2012 to December 2014, 667 patients with hip fractures were divided into femoral neck fracture group and intertrochanteric fracture group according to the site of fracture. There were 304 cases of intertrochanteric fracture, including 96 males and 208 females, with an average age of (80.33±7.94) years old. There were 217 cases of femoral neck fracture, including 74 males and 143 females, with an average age of (79.82±9.33) years old. Patients' data, mortality and activities of daily living were compared between two groups.</p><p><b>RESULTS</b>There were no significant differences in age, gender, comorbidity, ASA classification, and anesthesia between two groups, but the time of admission to surgery, duration of operation, blood loss of intra-operative, volume of drainage, and the average of transfusion were shown to have significant differences. The levels of White blood cell count (WBC) for intertrochanteric fracture group were shown to be higher than that of femoral neck fracture patients at admission, 1, 3 and 5 days after operation. The levels of hemoglobin, and albumin for intertrochanteric fracture were lower than that of femoral neck fracture patients at all period of time. The mortality of intertrochanteric fracture group during hospitalization, 1, 3, 6, and 12 months were higher than that of femoral neck fracture, but did not reach significant difference. In patients who survived, the scores of ADL for femoral neck fracture were higher than that of intertrochanteric fracture at discharge, 1, 3 months after operation, but there was no significant difference for ADL at 6 and 12 months between two groups.</p><p><b>CONCLUSIONS</b>The response of stress for intertrochanteric fracture were more than femoral neck fracture, but the mortality was similar than that of femoral neck fracture after excluding the influence of age, sex, comorbidity, and other factors. Compared to intertrochanteric fracture, the femoral neck fracture patients had a better functional recovery during early stage, and the two groups reached a similar functional recovery at 1 year after operation.</p>

Traditional Chinese medicine integrated with chemotherapy for stage IV non-surgical gastric cancer: a retrospective clinical analysis / 中西医结合学报

<p><b>OBJECTIVE</b>Traditional Chinese medicine (TCM) is regarded as an important treatment for gastric cancer patients, especially for those in advanced stage. To evaluate the effects of TCM treatment on gastric cancer patients, the authors performed a retrospective study to report the result of the integrated treatment of TCM with chemotherapy for stage IV non-surgical gastric cancer.</p><p><b>METHODS</b>In this study, 182 patients with stage IV and non-surgical gastric cancer were retrospectively analyzed to evaluate the effects of TCM integrated with chemotherapy. Among the 182 cases, 88 cases received integrated therapy consisting of TCM and chemotherapy, while 94 cases received chemotherapy alone. The overall survival and Karnofsky performance status (KPS) score were measured as the main outcome.</p><p><b>RESULTS</b>The median overall survival of the integrated therapy group and chemotherapy group were 16.9 and 10.5 months, respectively. The 1-, 3- and 5-year survival rates of integrated therapy group vs. chemotherapy group were 70% vs. 32%, 18% vs. 4%, and 11% vs. 0%, respectively. There was a significant difference between the two groups (χ= 42.244, P > 0.001). After six-month treatment, KPS scores of the integrated therapy group and the chemotherapy group were 75.00 ± 14.78 and 60.64 ± 21.39, respectively (P > 0.001). The Cox regression analysis showed that TCM treatment is a protective factor for patients' overall survival.</p><p><b>CONCLUSION</b>This study demonstrated that TCM integrated with chemotherapy may prolong overall survival and improve survival rate and life quality of patients with stage IV non-surgical gastric cancer.</p>

The Prognostic Impact of Heat Shock Proteins Expression in Patients with Esophageal Cancer: A Meta-Analysis

PURPOSE: Heat shock proteins (HSPs) are highly conserved molecular chaperones. There are various studies that assess the prognostic value of HSPs in patients with esophageal cancer, but the conclusion remains controversial. This is the first meta-analysis study aiming to summarize the evidence on the suitability of HSPs to predict patients' survival. MATERIALS AND METHODS: Searching PubMed, Web of science and Medline until May 31, 2014, data were compared for overall survival in patients with down-regulated HSPs level with those with up-regulated level. We conducted a meta-analysis of 9 studies (801 patients) that correlated HSPs levels with overall survival. Data were synthesized with hazard ratios (HRs). RESULTS: The estimated risk of death was 2.93-fold greater in HSP27 negative patients than HSP27 positive patients [95% confidence interval (CI), 1.12-7.62]. When limited to esophageal squamous cell carcinoma (ESCC), the risk of death in HSP27 negative patients seemed more significant (HR, 3.90; 95% CI, 2.35-6.49). Decreased expression of HSP70 was also associated with worse survival in esophageal cancer (HR, 2.83; 95% CI, 1.90-4.23) and, when limited to ESCC, HR was 3.21 (95% CI, 1.94-5.30). Data collected, however, were not sufficient to determine the prognostic value of HSP90 in patients with ESCC nor esophageal adenocarcinomas (EADC). CONCLUSION: In this meta-analysis, reduced HSP27 and HSP70 expressions were associated with poor survival in patients with esophageal cancer, especially esophageal squamous cell carcinoma.

Relative Expression of Indicators for Wound Age Estimation in Forensic Pathology / 法医学杂志

OBJECTIVE@#In order to understand which kind of function genes play an important role for estimating wound age, the variation of difference genes' mRNA expression were compared after injury.@*METHODS@#The mRNA expression levels of seven candidate genes (ICAM-1, NF-κB, MX2, MT1, MT2, sTnI, and Cox6c) were analyzed in contused rat skeletal muscle at different time points using real-time fluorescent quantitative PCR (RT-qPCR). The raw Ct values were normalized relative to that of RPL32 mRNA, and converted to standard Ct values. At each time point after injury, the standard deviations (SD) of the standard Ct values were calculated by SPSS.@*RESULTS@#The expression trends of the seven genes were all found to be related to wound age, but there were lower variation coefficients and greater reliability of s TnI and Cox6c when compared with other genes.@*CONCLUSION@#The genes encoding structural proteins or proteins that perform basic functions can be suitable for wound age estimation.

Relation between Injury Time and the Expression of COX6C mRNA in Skeletal Muscle of Rats after Contusion / 法医学杂志

OBJECTIVE@#To investigate the relation between injury time and the expression of cytochrome c oxidase subunit VIc (COX6C) mRNA in skeletal muscle of rat after contusion.@*METHODS@#A total of fifty-four SD rats were divided into the control group and the contusion groups (0.5, 1, 6, 12, 18, 24, 30, and 36 h after contusion), randomly. The contusion model was established by free fall drop of gravity hammer. At corresponding time point after contusion, the regular histology was examined and expression level of COX6C mRNA was tested by real-time PCR after extraction of total RNA from the tissues.@*RESULTS@#The main pathological features of 6 h after injury included edema and hemorrhage in myocytes with no inflammatory cells found. After 6 hours, the findings included myocyte degeneration and necrosis, inflammatory cells infiltration, and fibrous connective tissue proliferation in the contused zone. The expression level of COX6C mRNA was higher than that of the control group within 6 h after contusion. The expression level was lower than that of the control group from 6-36 h after contusion.@*CONCLUSION@#The level of COX6C mRNA expresses in a regular way after contusion. It may be useful for estimating wound age in combination with the results of pathological features.

Descending colon adenocarcinoma with spermatic cord metastasis: report of two cases and review of the literature

Metastatic carcinoma of the spermatic cord from colon cancer is extremely uncommon. The prognosis of metastatic spermatic cord cancer is poor. Resection of the metastasis and systematic chemotherapy may improve the prognosis. We report two cases and review of the literature. A 81-year-old man presented with painless left scrotum mass 60 months after left hemicolectomy for a descending colon cancer. Biopsy of the mass confirmed a metastatic adenocarcinoma. He refused any further treatment. Following 16 months, he was in a poor quality of life with the mass enlarged and ulceration. Another 66-year-old man presented with painless left scrotum mass 25 months after left hemicolectomy for a descending colon cancer. Radical orchidoepididymectomy followed by 7 cycles of FOLFOX4 chemotherapy was performed. Histological examination showed both mucinous adenocarcinoma in primary and secondary tumor. He was free from disease 20 months after diagnosis

A rabbit model of graded primary mechanical injury to brainstem / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To introduce a new animal model of graded mechanical primary brainstem injury (BSI).</p><p><b>METHODS</b>Altogether 45 rabbits were subjected to BSI by type II biological impact machine designed by the Third Military Medical University. The animals were divided into 4 experimental groups (n equal to 10) and 1 control group (n equal to 5) according to different magnitudes of impact pressure imposed on the occipital nodule: Group 1, 500-520 kPa; Group 2, 520-540 kPa; Group 3, 540-560 kPa; Group 4, 560-580 kPa and Group 5, 0 kPa with 20 kPa increase in each grade. The impact depth was a constant 0.5 cm. After injury, the clinical symptoms and signs as well as pathological changes were observed.</p><p><b>RESULTS</b>Rabbits in Group 1 revealed mild physiological reaction of BSI. They had localized cerebral contusion with punctate hemorrhage and subarachnoid hemorrhage (SAH) was limited to the peripheral tissues at the impact area. In Group 2, obvious physiological reaction was observed. Local pathological lesions reached the superficial layer of brainstem tissues; focal hemorrhage and girdle-shaped SAH in basilar pon were observed under microscope. In Group 3, BSI was more severe with a long respiratory depression. Pathological lesions reached the inner portion of brainstem with massive hemorrhage and the whole brainstem was wrapped by subarachnoid hematoma. In Group 4, most rabbits died due to severe BSI. Pathological lesions deepened to the central brainstem with wide pathological change, rapture of the medulla oblongata central canal. Group 5 was the control group, with normal brainstem structure and no lesion observed.</p><p><b>CONCLUSION</b>This model successfully simulates different levels of brainstem mechanical injury and clearly shows the subsequent pathological changes following injury. It takes two external parameters (impact pressure and depth) and has a similar injury mechanism to clinical accelerating BSI. Moreover it is reproducible and stable, thus being be- neficial for exploring pathophysiological mechanism, diagnosis and forensic identification of various degrees of BSI.</p>

Purification and activity evaluation of methionine synthase / 药学学报

Methionine synthase (MS, EC2.1.1.13), a key enzyme in the folate metabolism area catalyzing methyl transfer from N5-methyltetrahydrofolate to homocysteine to give tetrahydrofolate and methionine, takes a core position in folate cycle, one-carbon-unit transfer and sculpture amino acid pathways. Cobalamin-dependent methionine synthase was purified from rat liver. The enzyme was purified 609-fold to near homogeneity by batch chromatography on DE-52, anion-exchange chromatography on Q Sepharose Fast Flow and CHT-I hydroxyapatite column and was identified by SDS-PAGE and Western blotting. The enzyme activity was determined by spectrophotometric assay. In addition, the influencing factor and optimal reaction condition were performed. The steady state kinetic of rat liver methionine synthase was similar to that of other mammalian cobalamin-dependent methionine synthase which employed a Ping-Pong mechanism. The result indicated that cobalamin-dependent methionine synthase purified from rat liver is suitable for screening and studying methionine synthase specific inhibitors.