Research Status of Deubiquitinating Enzymes and JOSD2 in Malignant Tumors / 肿瘤防治研究

Ubiquitination is a crucial post-translational modification process that can degrade proteins within cells and plays a vital role in maintaining protein homeostasis and abundance. Deubiquitinating enzymes (DUBs) are important proteases in the ubiquitin system. They reverse the ubiquitination process by cleaving protein chains and recycling ubiquitin molecules to regulate protein stability. Abnormal deubiquitinating enzyme activity is related to the occurrence and development of many malignant tumors. JOSD2, a DUB, is a member of the Machado-Joseph disease protein domain protease (MJD) family and characterized by a single highly conserved catalytic Josephin domain. Increasing studies have revealed a connection between JOSD2 and malignant tumors. This article elaborates on the current research status of DUBs, particularly JOSD2, in malignant tumors. Results suggest that JOSD2 is a potential target for the treatment of malignant tumors.

Computed tomography features and prediction model of stage-IA solitary nodular invasive mucinous lung adenocarcinoma / 中国辐射卫生

@#<b>Objective</b> To investigate the computed tomography (CT) features of solitary nodular invasive mucinous lung adenocarcinoma (IMA) in stage IA and establish its prediction model. <b>Methods</b> We included 53 lesions of 53 patients with stage-IA IMA and 141 control lesions of 141 patients with invasive non-mucinous lung adenocarcinoma (NIMA) that were confirmed by surgical pathology in our hospital from January 2017 to December 2019. Univariable analysis was used to compare the demographics and CT signs of the two groups. Multivariable logistic regression analysis was performed to determine the main factors influencing solitary nodular IMA. A risk score prediction model was constructed based on the regression coefficients of the main influencing factors. A receiver operating characteristic (ROC) curve was used to assess the performance of the model. <b>Results</b> The univariable analysis showed significant differences between the two groups in age, largest nodule diameter, tumor-lung interface, lobulation, spiculation, air-bronchogram or vacuole sign, vessel abnormalities (<i>P</i> < 0.05). The spiculation sign was different between the two groups, which was longer and softer in the IMA group while shorter and harder in the NIMA group. There was no significant difference in sex, nodule shape, or pleural retraction (<i>P</i> > 0.05), but irregular shapes were slightly more frequent in the IMA group. The multivariable logistic regression analysis showed that obscure tumor-lung interface (odds ratio (<i>OR</i> = 20.930, <i>P</i> < 0.05), air-bronchogram or vacuole sign (<i>OR</i> = 7.126, <i>P</i> < 0.05), spiculation sign (<i>OR</i> = 4.207, <i>P</i> < 0.05), and vessel abnormalities (<i>OR</i> = 0.147, <i>P</i> < 0.05) were the main influencing factors. The prediction model based on those factors’ regression coefficients had an area under the ROC curve of 0.829 (<i>P</i> < 0.05). <b>Conclusion</b> Compared with those with NIMA, patients with solitary nodular IMA in stage IA were older and more likely to have the CT features of obscure tumor-lung interface, air-bronchogram or vacuole sign, and longer and softer spiculation. Based on the regression coefficients of tumor-lung interface, air-bronchogram or vacuole sign, spiculation, and vessel abnormalities, the risk score prediction model showed good predictive performance for solitary nodular IMA.

Effect of transcutaneous acupoint electrical stimulation at Neiguan (PC 6) on general anesthesia under preserving spontaneous breathing in thoracoscopic lobectomy / 中国针灸

OBJECTIVE@#To evaluate the effect of transcutaneous acupoint electrical stimulation (TEAS) at Neiguan (PC 6) on general anesthesia under preserving spontaneous breathing in thoracoscopic lobectomy.@*METHODS@#A total of 66 patients of primary lung cancer undergoing thoracoscopic lobectomy were divided to an observation group (33 cases, 1 case discontinued) and a control group (33 cases). In the observation group, TEAS at Neiguan (PC 6) was used 30 min before anesthesia induction till the end of surgery. The surgery time, maximum value of partial pressure of end-tidal carbon dioxide (PETCO2) and minimum value of oxygen saturation (SpO2) of the two groups were recorded. The dosage of propofol, sufentanil, remifentanil and dexmedetomidine were analyzed. Separately, before induction (T0), at the start of surgery (T1), thoracic exploration (T2) and lobectomy (T3), as well as 30 min (T4) and 60 min (T5) after lobectomy, the mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), serum cortisol (Cor) and norepinephrine (NE) were measured. The time of post anesthesia care unit (PACU) stay, ambulation, flatus, chest drainage and the incidence of nausea and vomiting were compared between the two groups.@*RESULTS@#The maximum value of PETCO2, the dosage of propofol and remifentanil in the observation group were lower than those in the control group (P < 0.05, P < 0.01), the minimum value of SpO2 in the observation group was higher than that of the control group (P < 0.01). At T1-T5, the MAP, HR, serum Cor and NE levels in the observation group were all lower than those in the control group (P < 0.05). The ambulation time, the time for the flatus, chest drainage time, and the incidence of nausea and vomiting in the observation group were all lower than those in the control group (P<0.001, P < 0.01).@*CONCLUSION@#For the general anesthesia under preserving spontaneous breathing in thoracoscopic surgery, TEAS at Neiguan (PC 6) relieves stress response, reduces opioids dosage and promotes postoperative recovery.

Epidemiological research progress of adiposity peak and adiposity rebound in early life / 中国学校卫生

Abstract@#The adiposity peak (AP) and adiposity rebound (AR) are the highest and lowest points of the body mass index (BMI) growth trajectory in early life. They are also the most significant characteristics. Epidemiological studies have reported the timings and BMI magnitudes of AP and AR in different populations worldwide. Others have observed the impacts of prenatal, postpartum, feeding, economic and social factors on the timing and magnitude of them. In addition, longitudinal studies have tracked the health effect of the timing and magnitude of them on many adverse health outcomes in later life. Based on literature reviews, we summarize the global epidemiological characteristics of AP and AR, while identifying pre and early life determinants as well as their possible long term health effects, so as to provide scientific evidence for the prevention and management of obesity and related chronic diseases. We also highlight current controversies regarding this issue, while outlining directions for future research.

Expressions of CD200 and inducible costimulator in angioimmunoblastic T-cell lymphoma and their significances / 白血病·淋巴瘤

Objective:To investigate the expressions of CD200 and inducible costimulator (ICOS) protein in angioimmunoblastic T-cell lymphoma (AITL) and the relationship with prognosis as well as their significances in the differential diagnosis of AITL.Methods:A total of 39 AITL patients in the First People's Hospital of Chenzhou, the Fourth People's Hospital of Chenzhou, Xiangnan College Affiliated Hospital and Chenzhou 3rd People's Hospital from June 2012 to December 2019, and 10 patients with classic Hodgkin lymphoma (CHL) and 10 patients with peripheral T cell lymphoma, not otherwise specified (PTCL-NOS) from August 2016 to July 2019 in the First People's Hospital of Chenzhou were selected. Immunohistochemistry was used to detect the expressions of CD200, ICOS, CD10, programmed death 1 (PD-1), bcl-6 and CXC chemokine receptor-13 (CXCL13) proteins, and the correlation of CD200 and ICOS with clinicopathological features and prognosis of AITL patients was analyzed, and the diagnostic significance of both in differentiating AITL from PTCL-NOS and CHL was also analyzed.Results:The positive rates of CD200 and ICOS in 39 AITL patients were 71.79% (28/39) and 61.54% (24/39), respectively. There were 7 cases of CD200 weak and moderate positive in 10 CHL patients, and ICOS proteins were all negative. Among 10 PTCL-NOS patients, 4 patients had CD200 positive and 1 patient had ICOS positive. The differences in positive rates of ICOS protein between AITL patients and CHL, PTCL-NOS patients were statistically significant (all P < 0.05); the differences in positive rates of CD200 protein between AITL patients and CHL, PTCL-NOS patients were not statistically significant ( χ2=0.013, P=0.911; χ2=3.551, P=0.060). The positive rate of CD200 in AITL patients with elevated lactate dehydrogenase (LDH) and international prognostic index (IPI) score of 3-4 was higher than that in AITL patients with normal LDH and IPI score of 0-2 (both P < 0.05); The positive rate of ICOS in AITL patients with elevated LDH and PD-1 positive was higher than that in AITL patients with normal LDH and PD-1 negative (both P < 0.05). CD200 negative AITL patients had better 3-year overall survival (OS) rate (4.2% vs. 66.7%) and 3-year progression-free survival (PFS) rate (5.3% vs. 77.1%) compared with those in CD200 positive AITL patients, and the differences between both groups were statistically significant (both P < 0.01); there was a statistically significant difference in 3-year OS rate between ICOS positive AITL patients and ICOS negative AITL patients (15.3% vs. 38.6%, P=0.011), while there was no statistically significant difference in 3-year PFS rate of both groups (18.6% vs. 41.5%, P=0.059). Multivariate analysis showed CD200 ( HR=0.076, 95% CI 1.555-79.497, P=0.001), extranodal involvement or not ( HR=11.117, 95% CI 1.555-79.497, P=0.016) and LDH ( HR=2.147, 95% CI 0.844-5.459, P=0.109) were independent influencing factors of OS in AITL patients; CD200 ( HR=0.075, 95% CI 0.016-0.357, P=0.001) and LDH ( HR=2.335, 95% CI 0.929-5.870, P=0.071) were independent influencing factors of PFS in AITL patients. Conclusions:CD200 and ICOS can be used as immunohistochemical indicators to assist the diagnosis of AITL patients. ICOS protein helps to differentiate AITL from CHL and PTCL-NOS; CD200 can be used as indicators to judge the prognosis and deterioration of AITL patients.

Microalbuminuria level in patients with rheumatoid arthritis and its correlation with disease activity / 中华风湿病学杂志

Objective:To investigate the change of microalbuminuria (MA) in patients with RA and its clinical significance.Methods:From January 2018 to December 2019, data of 75 cases of RA patients were collected from outpatient and inpatient wardsof our hospital, and the data of 75 cases of physical examination wascollected as control. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) anti-cyclic citrullinated peptide (CCP) antibody, blood lipid, Homeostasis model assessment for insulin resistance (HOMA-IR), rheumatoid factor (RF), anti-CCP antibodyand MA levels were measured respectively. RA patients were obtained by ultrasound Carotid intima-media thickness (cIMT) and brachial artery flow mediated diastolic function (FMD) were measured. The statistical analysis was carried out with independent t-test, analysis of variance, Pearson correlation analysis and multiple stepwise regression. Results:The MA level of RA patients was significantly higher than that of the healthy control group [(31±5) mg/L vs (25±4) mg/L, t=5.982, P<0.05]. In RA patients, MA level was positively correlated with course of disease ( r=0.327, P=0.015), HOMA-IR ( r=0.576, P<0.01], CRP ( r=0.212, P=0.027), RF ( r=0.585, P<0.01), disease activity score in 28 joints (DAS28) ( r=0.472, P=0.013), cIMT ( r=0.611, P<0.01) and duration of nonsteroidal anti-inflammatory drugs (NSAIDs) use ( r=0.274, P<0.01), and urineMA level( OR=1.763, P<0.01) were independent correlation factors affecting cIMT. Conclusion:The level of MA in RA patients is significantly higher than that in normal controls, and is correlated with disease activity and subclinical atherosclerosis, which could be another important predictor of disease follow-up and early screening of subclinical atherosclerosis in RA patients.

Effect of electroacupuncture at Neiguan (PC 6) on pulmonary function during one-lung ventilation in patients with lobectomy / 中国针灸

OBJECTIVE@#To observe the protective effect of electroacupuncture (EA) at Neiguan (PC 6) on pulmonary function during one-lung ventilation (OLV) in patients with lobectomy, and explore its action mechanism.@*METHODS@#Sixty patients with lobectomy were randomly divided into an observation group and a control group, 30 cases in each one. The patients in the control group were treated with general anesthesia, and OLV was given when surgery began; when the surgery finished, air was removed from the thoracic cavity and two-lung ventilation was performed. On the basis of the treatment in the control group, the patients in the observation group were treated with EA (disperse-dense wave, 2 Hz/100 Hz of frequency) at Neiguan (PC 6) 30 min before anesthesia induction until the end of the surgery. The pulmonary function indexes [arterial partial pressure of oxygen (PaO@*RESULTS@#Compared with T@*CONCLUSION@#EA at Neiguan (PC 6) has protective effects on lung injury induced by OLV after lobectomy, and its mechanism may be related to the improvement of oxidative stress and inflammatory response.

Application of endoscopic ultrasonography in colorectal submucosal lesions / 中华消化内镜杂志

Objective:To evaluate the diagnostic value of endoscopic ultrasonography (EUS) in colorectal submucosal lesions, and provide evidence for clinical diagnosis and treatment strategies.Methods:A retrospective analysis was performed on data of 229 patients with colorectal submucosal lesions discovered by electronic colonoscopy and EUS. The diagnosis was confirmed by pathology. The location, type, EUS features of lesions and the coincidence rate of EUS and histopathological diagnosis were analyzed.Results:Colorectal submucosal lesions were common in the rectum (44.98%, 103/229) and ascending colon (15.28%, 35/229). Lipoma was the most common pathological type of colorectal submucosal lesions (34.93%, 80/229), which was commonly located in transverse colon (22.50%, 18/80) and ascending colon (20.00%, 16/80). Neuroendocrine tumor was the second one, accounting for 33.63% (77/229), and was commonly located in rectum (96.10%, 74/77), followed by cyst (18.78%, 43/229). Under EUS, 229 cases of lesions originated from submucosa in 215 cases, muscularis mucosa in 11 cases, and muscularis propria in 3 cases. The overall coincidence rate of EUS and pathological diagnosis was 89.08% (204/229). The coincidence rate of EUS diagnosis was 100.00% (80/80) for lipoma, 5/5 for air-cyst, 3/3 for intestinal stromal tumor, 81.82% (72/88) for neuroendocrine tumor, 89.13% (41/46) for cyst, 1/4 for leiomyoma, 2/5 for lymphangioma, and granulosa cell tumor and neurofibroma were both 0.Conclusion:EUS has a more accurate diagnosis of the origin, echogenicity and pathological properties of colorectal submucosal lesions, but it has certain limitations for the diagnosis of rare tumors such as granulosa cell tumor and neurofibroma.

Expressions of bcl-2, programmed death-1 and programmed death ligand-1 in diffuse large B-cell lymphoma and their prognostic significances / 白血病·淋巴瘤

Objective:To investigate the expressions and correlation of bcl-2, programmed death-1 (PD-1) and programmed death ligand-1(PD-L1) in diffuse large B-cell lymphoma (DLBCL) tissue specimens, and the relationship between chemotherapy efficacy and prognosis of DLBCL patients.Methods:The expressions of bcl-2, PD-1 and PD-L1 in 82 patients with DLBCL who were admitted to Chenzhou First People's Hospital of Hunan Province from May 2011 to April 2014 were detected by using immunohistochemistry, and the correlation of the expressions of bcl-2, PD-1 and PD-L1 with clinicopathological characteristics and prognosis was analyzed.Results:The positive rate of bcl-2, PD-L1 and PD-1 in cancer tissues of DLBCL patients was 53.7% (44/82), 56.1% (46/82) and 32.9% (27/82), respectively. There was a correlation between bcl-2 and PD-L1 expression ( r = 0.306, P = 0.005). Bcl-2 was highly expressed in patients with international prognosis index (IPI) score 3-4 points, non-germinal center B-cell-like (non-GCB) subtype and B symptoms (all P < 0.05); PD-1 was highly expressed in patients with IPI score 3-4 points ( P < 0.05); PD-L1 was highly expressed in patients with IPI score 3-4 points, tumor stage Ⅲ-Ⅳ, B symptoms, ≥60 years old, and non-GCB (all P < 0.05). The overall survival (OS) and progression-free survival (PFS) in bcl-2-negative group were better than those in the bcl-2-positive group, and the differences were statistically significant (both P < 0.05); OS and PFS in PD-L1-negative group were better than those in PD-L1-positive group, and the differences were statistically significant(both P < 0.01). There were no statistical differences in OS and PFS between PD-1-positive group and PD-1-negative group (both P > 0.05). OS and PFS in bcl-2 and PD-L1 co-expression group were worse than those in both negative or any negative group (all P < 0.01), and PFS in bcl-2 and PD-1 co-expression group was worse than those in both negative or any negative group ( P = 0.044). Cox multivariate analysis showed IPI score 3-4 points and B symptoms were the independent influencing factors of OS in DLBCL patients (both P < 0.01); IPI score 3-4 points, B symptoms and PD-L1-positive were the independent influencing factors of poor PFS in DLBCL patients (all P < 0.05). Conclusion:The positive expressions of bcl-2 and PD-L1 are the independent factors for the poor prognosis of DLBCL patients, which may become new targets for the treatment of DLBCL.

Analysis of clinical application characteristics of Xingnaojing Injection in treating cerebral hemorrhage in real world / 中国中药杂志

To explore the population characteristics and clinical application characteristics of patients with cerebral hemorrhage treated with Xingnaojing Injection in real world. The model was established by Apriori algorithm, and the general information and medication information of 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection were analyzed by using Clementine 12.0 in the databases of information systems of 33 class Ⅲ grade A hospitals in China. The results showed that among the 8 369 patients with cerebral hemorrhage treated with Xingnaojing Injection, the median age was 59 years old. And the male to female ratio was about 1.74∶1. Most of them did manual labor(31.26%), and were hospitalized in winter(27.46%), especially during the Cold Dew(5.1%). The majority of the patients were in a stable condition(50.94%), and preferred neurosurgery department(48.82%). 29.03% of patients were hospitalized for 15-28 days, and 42.47% of patients spent 10 000-50 000 Yuan of hospitalization expenses. The single dose of Xingnaojing Injection was 10-20 mL at most(46.03%). And the course of medication was mostly 3 days or less(68.60%). Lidocain was the most frequently used Western medicine in drug combination(5.05%), and Huayu Tongmai Ji was the most frequently used traditional Chinese medicine in drug combination(10.73%). The most frequently used one type of traditional Chinese medicine combined with one type of Western medicine was Huayu Tongmai Ji + Dexamethasone(8.08%). The most frequently used two Western medicines in drug combination were Omeprazole + Dexamethasone(5.07%). Prilosec + Dexamethasone + Lidocaine(3.35%) were three Western drugs with the most frequent combination. When the dosage was 10-20 mL and the number of days of treatment was > 15 days, the largest number of the patients was cured and improved(44.78%, 45.85%). The results showed that cerebral hemorrhage patients treated with Xingnaojing Injection were mostly middle-aged and elderly people, with more males than females. Brain hemorrhage often occurred in winter and spring. Xingnaojing Injectiont was often combined with glucocorticoids, proton pump inhibitors and cardiovascular drugs to prevent cerebral hemorrhage complications. The clinical medication met the guidelines for the treatment of cerebral hemorrhage. Some patients had over-treatment use, which can provide a reference for clinicians in treating cerebral hemorrhage.

The relationship between the dark triad and guilt proneness: the mediating role of basic psychological needs satisfaction / 中华行为医学与脑科学杂志

Objective:To explore the relationship between the dark triad, basic psychological needs satisfaction and guilty proneness.Methods:Totally 595 college students were randomly selected from Zhengzhou University.They were tested with the dirty dozen(DD), the balanced measure of psychological needs scale(BMPN) and guilt-proneness-5(GP-5). SPSS 22.0 and AMOS 21.0 were used for data analysis, including descriptive analysis, correlation analysis and confirmatory factor analysis. Bootstrap measure was used for mediating effect test.Results:(1)The correlation analysis showed that the dark triad (29(21, 37)), Machiavellianism (4(4, 8)) and psychopathy(5(4, 9)) were negatively correlated with guilty proneness (20(16, 23)), and the correlation coefficients were -0.10, -0.22 and -0.18 respectively(all P<0.01). While narcissism (16(12, 21)) was not correlated with guilty proneness ( r=0.04, P>0.01). The satisfaction of basic psychological needs (56(54, 60)) was positively correlated with guilty proneness ( r=0.31, P<0.01). (2)The relationship between the dark triad and guilty proneness was partially mediated by basic psychological needs satisfaction, and the mediating effect accounted for 62.96%. Conclusion:The dark triad influences guilty proneness through basic psychological needs satisfaction.

Effect of Electroacupuncture on Neural Stem Cell Differentiation via Regulating MicroRNA-34a in Rats with Cerebral Ischemia-reperfusion Injury / 中国康复理论与实践

Objective:To investigate whether electroacupuncture (EA) at Quchi (LI11) and Zusanli (ST36) acupoints may regulate microRNA-34a (miR-34a) to promote neural stem cells differentiation in ischemic peripheral areas in rats with cerebral ischemia-reperfusion injury or not. Methods:A total of 108 rats were randomly assigned into sham group, model group and EA group, and each group was divided into three subgroups (three days, seven days and 14 days), with twelve rats in each subgroup. Besides, 16 rats were randomly divided into EA+dimethyl sulfoxide (DMSO) group and EA+miR-34a inhibitor group, with eight rats in each group. The middle cerebral artery occlusion (MCAO) model was induced for focal cerebral ischemia in rats. EA group was electroacupunctured at the ipsilateral Quchi and Zusanli acupoints on the second day. The dilatational wave was 1/20 Hz, 30 minutes every time, once a day for seven days, totally. At the same time, 5-Bromo-2′-Deoxyuridine (BrdU) was intraperitoneally injected twice a day, with an 8-hours interval. The DMSO and miR-34a inhibitor were injected into the lateral ventricle before modeling. The co-location condition was evaluated by immunofluorescence. The expression of miR-34a in ischemic peripheral areas was detected by reverse transcription real-time quantitative polymerase chain reaction. Results:The Longa's score was lower in EA group than in the model group (t > 2.084, P < 0.05). At the same time points, the paw print areas (right forepaw, right hind paw) and maximum pressures (right forepaw, right hind paw) of the affected limbs decreased in the model group than in the sham group (P < 0.05), and the paw print area of right hind paw gradually increased in the model group (P < 0.05); the paw print areas (right forepaw and right hind paw) of the affected limbs improved in EA group, compared with the model group (P < 0.05); and there was no significant difference in the maximum pressure of the affected limbs three days and seven days after electroacupuncture (P > 0.05); however, it was higher in EA group than in the model group 14 days after electroacupuncture (P < 0.05). And the paw print area of the right hind paw and the maximum pressure of the right forepaw gradually increased in EA group three days and seven days after electroacupuncture, which was in time-dependent manner (P < 0.05). The Nestin+/GFAP+ and BrdU+/GFAP+ cells expressed in ischemic peripheral areas both in the model group and EA group. And the Nestin+/GFAP+ and BrdU+/GFAP+ double positive cells increased in EA group compared to the model group three days, seven days and 14 days after electroacupuncture (t > 3.292, P < 0.05), and they reached peak seven days after electroacupuncture. The expression of miR-34a in ischemic peripheral areas was higher in the model group than in the sham group seven days after modeling (P < 0.01), however, the expression of miR-34a further increased in EA+DMSO group after electroacupuncture (P < 0.05). After injection of miR-34a inhibitor, the expression of miR-34a and BrdU+/GFAP+ cells was lower in EA+miR-34a inhibitor group than in EA group (P < 0.05). Conclusion:Electroacupuncture at Quchi and Zusanli acupoints could promote the neural stem cells differentiation in ischemic peripheral areas by regulation of miR-34a expression.

Research progress inpostoperative brachytherapy for cervical cancer / 中华放射肿瘤学杂志

Radiotherapy is an important part of the postoperative adjuvant therapy of cervical cancer. Along with the persistent development of radiotherapy techniques, the application of brachytherapy has been more and more used as a boost to external beam radiotherapy. In this artical, the indications of postoperative radiotherapy and the application of brachytherapy were reviewed.

Clinical Interpretation of ICRU report No.89——Target Contouring for Adaptive Brachytherapy of Cervical Cancer / 中华放射肿瘤学杂志

Brachytherapy plays a key role in the radical radiotherapy of cervical cancer.The time concept was introduced in the 3D brachytherapy according to ICRU report No.89 for cervical cancer treatment.4D brachtherapy,as an adaptive brachytherapy,was formally proposed in this report.In this article,relevant data were searched based on ICRU report No.89 combined with the experience in our center to analyze,summarize and conclude the chapters related to target contouring,aiming to provide evidence for the colleagues who perform the brachytherapy in patients with cervical cancer.

Developing and testing a symptom experience scale for stroke survivors / 中华物理医学与康复杂志

Objective To develop a symptom experience scale for stroke survivors and to test its reliability and validity. Methods The initial item pool was formulated by combining the results of a literature review with ex-isting stroke-related scales and interviews with stroke patients. Items were added, deleted or modified after expert con-sultation and a pilot study to set up the scale. Then 200 in-patients in the rehabilitation departments of two hospitals in Shanghai were surveyed using the scale. The scale′s reliability and validity were examined. Results The final scale consisted of 19 items. An exploratory factor analysis identified six principal factors which explained 62％ of the total variance in the results. The average scale-level content validity index was 0. 95 and the item content validity index ranged from 0.80 to 1. The scale results correlated well with those using the Stroke Impact Scale. The Cronbach′s αcoefficient was 0.81 and the split-half coefficient was 0.76. Conclusion The symptom experience scale for stroke survivors has good reliability and validity. It can be used to evaluate the symptom experiences of stroke survivors and provide information for the management of symptoms.

Application of next-generation sequencing in the molecular diagnosis of Duchenne muscular dystrophy / 中国当代儿科杂志

The purpose of this study is to analyze the family's clinical data of 22 children who were given an intended clinical diagnosis of Duchenne muscular dystrophy (DMD), and to explore the clinical value of next-generation sequencing (NGS) in the molecular diagnosis of DMD. The probands were simultaneously tested by NGS for a gene panel associated with hereditary neuromuscular disease and multiplex ligation-dependent probe amplification (MLPA) for the Dystrophin gene. The exon deletion/repetition mutations of the Dystrophin gene determined by both methods were compared and the point mutations of the Dystrophin gene were verified by Sanger sequencing. Dystrophin gene mutations were found in all the 22 probands, including 14 exon deletion/repetition mutations and 8 point mutations/minor variations. The results of MLPA detection were consistent with those of NGS. The results of Sanger sequencing showed that the point mutations and minor variations determined by NGS were correct. One missense mutation (c.6290G>T), 1 nonsense mutation (c.3487C>T) and 4 minor deletion-induced frameshift mutations (c.1208delG, c.7497_7506delGGTGGGTGAC, c.9421_9422delAA and c.8910_8913delTCTC) had not been reported in the Human Gene Mutation Database, and thus were considered as novel mutations of the Dystrophin gene. The results of this study showed that NGS can detect variations in the Dystrophin gene, including exon deletion/repetition, point mutation, minor deletion and intron mutation. Therefore, NGS is of certain clinical value in the molecular diagnosis of DMD and is worthy of recommendation.

Research progress inpostoperative brachytherapy for cervical cancer / 中华放射肿瘤学杂志

Radiotherapy is an important part of the postoperative adjuvant therapy of cervical cancer.Along with the persistent development of radiotherapy techniques,the application of brachytherapy has been more and more used as a boost to external beam radiotherapy.In this artical,the indications of postoperative radiotherapy and the application of brachytherapy were reviewed.

Quantitative chemical shift-encoded MRI is an accurate method to quantify marrow fat / 实用放射学杂志

Objective To validate a chemical shift-encoded MRI(CSE-MRI)water-fat imaging for quantifying vertebral marrow fat content using MRS as the reference standard.Methods MRS and CSE-MRI were performed to calculate proton density fat fraction(PDFF) in 83 subjects,including 41 normal bone mass,26 osteopenia and 16 osteoporosis.Eight participants were scanned three times with repositioning to assess the repeatability of CSE-MRI PDFF measurements.Agreements of intra-observer and inter-observer were evaluated by intraclass correlation coefficient(ICC).Linear regression,Bland-Altman 95% limit of agreement and Lin's concordance correlation coefficient were calculated.Results The repeatability for CSE-MRI PDFF measurements expressed as absolute precision error was 1.45%.PDFF was 62.1%±11.1% by MRS and 60.4%±10.1% by CSE-MRI in 83 subjects.There were significant differences in PDFF among the normal bone mass,osteopenia and osteoporosis groups after adjusting for age,years since menopause and body mass index (all P<0.001).The intra-and inter-rater reliability for duplicate measurements at CSE-MRI PDFF were more than 0.993.Pearson correlation coefficient was 0.979 and Lin's concordance correlation coefficient was 0.962.All data points calculated using the Bland-Altman method were within the limits of agreement.Inverse associations were observed between BMD (r=-0.560--0.710)and CSE-MRI-based PDFF,and between BMD (r=-0.539--0.706)and MRS-based PDFF in various groups.Conclusion CSE-MRI with multiple lipids peak model and T2?-correction is equally accurate in characterizing marrow fat content as MRS.

Evidence synthesis of effects of physical exercise on fall prevention in community-dwelling elderly people / 中华护理杂志

Objective To evaluate and summarize the best available evidence of effects of physical exercise on fall prevention in community-dwelling elderly people.Methods We searched Cochrane Library,JBI Library,Registered Nurses' Association of Ontario (RNAO),National Guideline Clearinghouse (NGC),PubMed,EMbase,Scottish Intercollegiate Guideline (SIGN),British Medical Journal Best Practice,British Medical Journal Best Practice,CBM,Wanfang Database and CNKI,to collect literatures including guideline,evidence summary(ES),best practice information sheet (BPIS),recommend practice (RP),system review(SR) and original research.Three authors independently evaluated quality of literatures and extracted data.Results Ten articles were enrolled,including four guidelines,two SRs,one RP,one ES,and two randomized controlled trials.Best evidence included:exercises should aim to provide moderate or high balance function training.Tai Chi and yoga were effective in fall prevention.Multifactorial assessment,group-based or home-based exercises were able to prevent falls.Conclusion Community should provide physical exercise recommendations for the elderly and satisfy the corresponding conditions.Available best evidence is recommended to use according to individual situation of the elderly.

Evidence synthesis of effects of physical exercise on fall prevention in community-dwelling elderly people / 中华护理杂志

Objective To evaluate and summarize the best available evidence of effects of physical exercise on fall prevention in community-dwelling elderly people.Methods We searched Cochrane Library,JBI Library,Registered Nurses' Association of Ontario (RNAO),National Guideline Clearinghouse (NGC),PubMed,EMbase,Scottish Intercollegiate Guideline (SIGN),British Medical Journal Best Practice,British Medical Journal Best Practice,CBM,Wanfang Database and CNKI,to collect literatures including guideline,evidence summary(ES),best practice information sheet (BPIS),recommend practice (RP),system review(SR) and original research.Three authors independently evaluated quality of literatures and extracted data.Results Ten articles were enrolled,including four guidelines,two SRs,one RP,one ES,and two randomized controlled trials.Best evidence included:exercises should aim to provide moderate or high balance function training.Tai Chi and yoga were effective in fall prevention.Multifactorial assessment,group-based or home-based exercises were able to prevent falls.Conclusion Community should provide physical exercise recommendations for the elderly and satisfy the corresponding conditions.Available best evidence is recommended to use according to individual situation of the elderly.