A Randomized Phase III Study of Patients With Advanced Gastric Adenocarcinoma Without Progression After Six Cycles of XELOX (Capecitabine Plus Oxaliplatin) Followed by Capecitabine Maintenance or Clinical Observation

Purpose@#Oxaliplatin, a component of the capecitabine plus oxaliplatin (XELOX) regimen, has a more favorable toxicity profile than cisplatin in patients with advanced gastric cancer (GC). However, oxaliplatin can induce sensory neuropathy and cumulative, dose-related toxicities. Thus, the capecitabine maintenance regimen may achieve the maximum treatment effect while reducing the cumulative neurotoxicity of oxaliplatin. This study aimed to compare the survival of patients with advanced GC between capecitabine maintenance and observation after 1st line XELOX chemotherapy. @*Materials and Methods@#Sixty-three patients treated with six cycles of XELOX for advanced GC in six hospitals of the Catholic University of Korea were randomized 1:1 to receive capecitabine maintenance or observation. The primary endpoint was progression-free survival (PFS), analyzed using a two-sided log-rank test stratified at a 5% significance level. @*Results@#Between 2015 and 2020, 32 and 31 patients were randomized into the maintenance and observation groups, respectively. After randomization, the median number of capecitabine maintenance cycles was 6. The PFS was significantly higher in the maintenance group than the observation group (6.3 vs. 4.1 months, P=0.010). Overall survival was not significantly different between the 2 groups (18.2 vs. 16.5 months, P=0.624). Toxicities, such as hand-foot syndrome, were reported in some maintenance group patients. Maintenance treatment was a significant factor associated with PFS in multivariate analysis (hazard ratio, 0.472; 95% confidence interval, 0.250–0.890; P=0.020). @*Conclusions@#After 6 cycles of XELOX chemotherapy, capecitabine maintenance significantly prolonged PFS compared with observation, and toxicity was manageable. Maintenance treatment was a significant prognostic factor associated with PFS.

Efficacy of the granisetron transdermal system for the control of nausea and vomiting induced by highly emetogenic chemotherapy: a multicenter, randomized, controlled trial

Background/Aims@#We compared the efficacy of the granisetron transdermal system (GTS) with that of ondansetron for controlling chemotherapy-induced nausea and vomiting (CINV) in patients treated with highly emetogenic chemotherapy (HEC). @*Methods@#We randomized a total of 389 patients to groups treated by GTS and ondansetron before HEC. The primary endpoint was the percentage of patients achieving complete response (CR; no retching/vomiting/rescue medication) of CINV from the time of chemotherapy initiation to 24 hours after the last administration of chemotherapy (prespecified non-inferiority margin of 15%). Quality of life (QoL) was also assessed using the Functional Living Index-Emesis (FLIE). @*Results@#The per protocol analysis included 152 (47.80%) and 166 patients (52.20%) in the GTS and ondansetron groups, respectively. In the full analysis set, the most common diagnosis, regimen, and period of chemotherapy were lung cancer (149 patients, 40.27%), cisplatin-based regimen (297 patients, 80.27%), and 1 day chemotherapy (221 patients, 59.73%). The CR rates were 86.84% and 90.36% in the GTS and ondansetron groups, respectively; the treatment difference was −3.52% (95% confidence interval, −10.52 to 3.48) and met the primary endpoint, indicating that GTS was not inferior to ondansetron. Patient satisfaction, assessed on the FLIE, showed significantly higher scores in the GTS group compared to the ondansetron group (mean ± standard deviation, 1,547.38 ± 306.00 and 1,494.07 ± 312.05 mm, respectively; p = 0.0449). @*Conclusions@#GTS provided effective, safe, and well-tolerated control of CINV and improved the QoL in HEC.

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.

Clinical manifestation and treatment strategy of intervertebral space infection after radiofrequency ablation of lumbar nucleus pulposus / 中国骨伤

OBJECTIVE@#To study the clinical manifestations and treatment of intervertebral space infection after percutaneous lumbar radiofrequency ablation of nucleus pulposus.@*METHODS@#A retrospective analysis was performed of 496 patients who underwent percutaneous lumbar disc decompression using low-temperature plasma radiofrequency ablation nucleus pulposus from June 2009 to June 2019. Six patients had lumbar infection, and the infection rate was 1.21%. All patients were male, ranging in age from 20 to 61 years old. Three patients underwent single segment radiofrequency ablation, two patients underwent dual segments ablation;and one patient underwent three segment ablation, totaling 10 intervertebral discs. One patient was complicated with type 2 diabetes before operation. The interval between infection occurrence ranged from 21 to 65 days.@*RESULTS@#All 6 patients were followed up, and the duration ranged from 18 to 40 months, with an average of 24 months. Among them, 2 patients presented with symptoms of low back pain accompanied by fever, and imaging examination showed intervertebral space infection accompanied by abscess. In addition, 4 patients experienced low back pain but no fever, and MRI showed abnormal signals of the infected intervertebral endplate or vertebral body. One patient showed staphylococcus aureus in blood culture, while the remaining 5 patients showed negative bacterial culture. All the patients were treated with antibiotics after diagnosis. Four patients were treated with conservative management to control infection;1 patient was treated with debridement of posterior lumbar infection focus, and 1 patient was treated with debridement of posterior lumbar infection focus combined with interbody fusion and internal fixation.@*CONCLUSION@#The occurrence of intervertebral space infection during lumbar radiofrequency ablation nucleoplasty should be given sufficient attention. Strict aseptic technique, avoiding repeated multi segment puncture, realizing early detection and treatment, and selecting appropriate treatment methods according to the severity of infection is the guarantee of achieving curative effect.

Guidelines for management of pediatric acute hyperextension spinal cord injury / 中华创伤杂志(英文版)

Pediatric acute hyperextension spinal cord injury (SCI) named as PAHSCI by us, is a special type of thoracolumbar SCI without radiographic abnormality and highly related to back-bend in dance training, which has been increasingly reported. At present, it has become the leading cause of SCI in children, and brings a heavy social and economic burden. Both domestic and foreign academic institutions and dance education organizations lack a correct understanding of PAHSCI and relevant standards, specifications or guidelines. In order to provide standardized guidance, the expert team formulated this guideline based on the principles of science and practicability, starting from the diagnosis, differential diagnosis, etiology, admission evaluation, treatment, complications and prevention. This guideline puts forward 23 recommendations for 14 related issues.

Prognostic analysis of different comprehensive treatment models for locally advanced esophageal squamous cell carcinoma based on propensity score matching / 中华外科杂志

Objective: To compare the effects of preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy on the long-term survival of patients with radical resection for esophageal squamous cell carcinoma. Methods: Totally 1 082 patients with stage T3-4aN0-3M0 thoracic esophageal squamous cell carcinoma were recruited in this study who underwent radical resection at Department of Thoracic Surgery, Fourth Hospital, Hebei Medical University from January 2005 to January 2015. There were 798 males and 284 females, with a median age of 61 years (range: 37 to 86 years). There were 138 patients undergoing preoperative neoadjuvant chemotherapy, 392 patients postoperative adjuvant chemotherapy, and 552 patients surgery alone. The neoadjuvant chemotherapy group was used as the benchmark group to match the propensity score with the adjuvant chemotherapy group and the surgery-only group respectively at a ratio of 1∶3. A total of 7 covariates including tumor location, number of positive lymph nodes, tumor invasion depth, tumor differentiation degree, surgical procedure, vascular tumor thrombus and nerve invasion were included, and the caliper value was taken as 0.1. After matching, a total of 699 patients were included for the analysis, including 128 patients in the neoadjuvant chemotherapy group, 267 patients in the adjuvant chemotherapy group, and 304 patients in the surgery alone group. The Kaplan-Meier method was used to generate the survival curves which was tested by the Log-rank method for survival analysis. Results: After matching analysis, the 5-year overall survival rate was 41.5% in the neoadjuvant chemotherapy group with a median overall survival time of 43 months (95%CI: 27 to 59 months), 57.6% in the adjuvant chemotherapy group with a median overall survival time unreached, and 24.9% in the surgery alone group with a median overall survival time of 28 months (95%CI: 25 to 31 months) (χ²=60.475, P<0.01). For overall survival after matching, the adjuvant chemotherapy group was better than the neoadjuvant chemotherapy group (χ²=11.384, P=0.001), the neoadjuvant chemotherapy group was better than the surgery alone group (χ²=8.654, P=0.003), and the adjuvant chemotherapy group was better than surgery alone group (χ²=60.234, P<0.01). Conclusion: Both preoperative neoadjuvant chemotherapy and postoperative adjuvant chemotherapy can improve the long-term survival of patients with locally advanced esophageal squamous cell carcinoma undergoing radical resection, and the improvement effect of postoperative adjuvant chemotherapy is more obvious.

The p21-activated kinases in neural cytoskeletal remodeling and related neurological disorders

The serine/threonine p21-activated kinases (PAKs), as main effectors of the Rho GTPases Cdc42 and Rac, represent a group of important molecular switches linking the complex cytoskeletal networks to broad neural activity. PAKs show wide expression in the brain, but they differ in specific cell types, brain regions, and developmental stages. PAKs play an essential and differential role in controlling neural cytoskeletal remodeling and are related to the development and fate of neurons as well as the structural and functional plasticity of dendritic spines. PAK-mediated actin signaling and interacting functional networks represent a common pathway frequently affected in multiple neurodevelopmental and neurodegenerative disorders. Considering specific small-molecule agonists and inhibitors for PAKs have been developed in cancer treatment, comprehensive knowledge about the role of PAKs in neural cytoskeletal remodeling will promote our understanding of the complex mechanisms underlying neurological diseases, which may also represent potential therapeutic targets of these diseases.

Clinical Study on Modified Guipitang Combined with Xuefu Zhuyutang in Treating Mild Cognitive Impairment After Cerebral Infarction / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy and anti-inflammatory and anti-oxidant effect of modified Guipitang combined with Xuefu Zhuyutang in the treatment of mild cognitive impairment （MCI） after cerebral infarction with syndromes of heart and spleen deficiency and blood stasis blocking collateral. MethodA total of 114 eligible patients were randomly divided into a control group and an observation group，with 57 cases in each group. Patients in the control group were given red deer ginseng tablets （po），4 tablets/time，2 times/day. Patients in the observation group were given modified Guipitang combined with Xuefu Zhuyutang （po，1 dose/day）for continuous 8 weeks. This study compared the scores of montreal cognitive assessment （MoCA） scale，Rivermead behavioral memory test （RBMT），activities of daily living （ADL），trail making test B （TMT-B），neuropsychiatric inventory questionnaire （NPI） and scores of traditional Chinese medcine（TCM） syndrome with syndromes of heart and spleen deficiency and blood stasis blocking collateral before and after treatment. Then we further detected the levels of 8-hydroxydeoxyguanosine （8-OHDG），malondialdehyde （MDA），oxidized low density lipoprotein （ox-LDL），superoxide dismutase （SOD），homocysteine （Hcy），interleukin-8 （IL-8），C-reactive protein （CRP） and fibrinogen （FIB） levels before and after treatment. ResultThe total effective rate for the treatment of cognitive function impairment in the observation group was 92.98% （53/57），which was higher than 78.95% （45/57） in the control group （χ2＝4.653，P<0.05）. The recovery rate of cognitive function in the observation group was 54.39% （31/57），which was higher than 33.33% （19/57） in the control group （χ2＝5.130，P<0.05）. The MoCA，RBMT and ADL scores of the observation group were higher than those of the control group （P<0.01），and the TMT-B time of the former was shorter than that of the latter （P<0.01）. In addition， the observation group showed lower scores of TCM syndrome，NPI-1 and NPI-2 scores than the control group （P<0.01）. The SOD level of the observation group was higher than that of the control group （P<0.01），and the levels of 8-OHDG，ox-LDL，MDA，Hcy，IL-8，CRP and FIB were lower than those of the control group （P<0.01）. ConclusionModified Guipitang combined with Xuefu Zhuyutang can improve cognitive function in MCI patients after cerebral infarction with syndromes of heart and spleen deficiency and blood stasis blocking collateral， with anti-inflammatory and anti-oxidant effect， and yield superior efficacy than red deer ginseng tablets.

Revealing characteristics and rules of acupoint sensitization phenomena: based on knee osteoarthritis / 中国针灸

OBJECTIVE@#To explore the characteristics and rules of acupoint sensitization phenomena based on knee osteoarthritis (KOA), one of the clinical dominant diseases of acupuncture-moxibustion.@*METHODS@#In combination with literature and expert experiences, the acupoints with the highest use frequency in treatment of KOA were screened, e.g. Heding (EX-LE 2), Liangqiu (ST 34), Mingmen (GV 4), Neixiyan (EX-LE 4), Ququan (LR 8) and Dubi (ST 35). In 814 patients with KOA and 217 healthy subjects, the acupoint temperature, mechanic pain threshold and pressure pain threshold were detected separately. Using machine learning method, the sensitization was judged at each acupoint.@*RESULTS@#Compared with healthy subjects, the acupoint temperature was increased and the mechanic pain threshold and pressure pain threshold were reduced in KOA patients (P<0.05). Besides, the cut-off value was presented to distinguish whether the acupoint was sensitized or not. The results of machine learning showed that the highest prediction accuracy of acupoint sensitization was 86.7% (Shenshu [BL 23]) and the lowest one was 73.9% (Heding [EX LE 2]). The prediction accuracy at the third clinical stage trial was higher, the highest was 93.3% (Ququan [LR 8]) in KOA patients.@*CONCLUSION@#It is confirmed that the acupoint sensitization reflects the characteristics of disease and is correlative with the conditions of illness, which may provide the reference for the auxiliary diagnosis and condition assessment of KOA.

Distinctive quality control method for solid-state fermented Isaria cicadae from strain Ic-17-7 and application in a rat model of type 2 diabetes / 中国天然药物

This work was aimed to establish a quality control method for evaluating the effects on glucose and lipids of the fruiting body of Isaria cicadae Miquel from strain Ic-17-7 (Ic-17-7fb) using a rat model of type 2 diabetes (T2DM). Random amplified polymorphic DNA, sequence-characterized amplified region, and high-performance liquid chromatography (HPLC) were used for the quality control of Ic-17-7fb. The pharmacological effects on streptozocin (STZ)-induced high fat diet (HFD)-fed Albino Wistar rats were evaluated. The rats underwent the following treatments: control, metformin, Ic-17-7fb (0.166 and 0.5 g·kg

Comparison and analysis of early effect of tri-focal and mono-focal intraocular lens implantation on the visual quality of patients with age-related cataract after surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the early visual quality of the tri-focal and the mono-focal intraocular lens(IOLs)implantation in patients with age-related cataract, under comparison and analysis.<p>METHODS: A retrospective research design. Totally 168 eyes of 119 age-related cataract patients who underwent cataract phacoemulsification combined with tri-focal and mono-focal IOLs implantation surgery in the cataract department from June 2018 to January 2021 were enrolled. In tri-focal and mono-focal group, 61 eyes of 44 cases and 107 eyes of 75 cases. One month after phacoemulsification combined with IOLs implantation, visual acuity, visual quality and contrast sensitivity were inspected. All data were under statistical analysis.<p>RESULTS: On LogMAR uncorrected distance visual acuity(UDVA),uncorrected intermediate visual acuity(UIVA), uncorrected near visual acuity(UNVA), best corrected distance visual acuity(BDVA), distance corrected intermediate visual acuity(DIVA), distance corrected near visual acuity(DNVA), tri-focal group were extremely better than mono-focal group(all <i>P</i><0.001). In terms of visual quality, the scores of modulation transfer function(MTF)cut-off frequency, optical scatter index(OSI), Strehl ratio(SR), tri-focal group were significantly higher than mono-focal group(all <i>P</i><0.05). On 18 cycle/degree(cpd)spatial frequency under dark and light adaptation conditions, contrast sensitivity scores of the mono-focal group was significantly better than those of the tri-focal group(<i>P</i><0.001). Based on the questionnaire with the VF/QOF scale, the daily life experience scores and off-glass index, the tri-focal group was significantly better than that of the mono-focal group(<i>P</i><0.05), and incidence of glare was no significant difference between the two groups(<i>P</i>>0.05).<p>CONCLUSION: Tri-focal IOLs can provide a full range of relatively better vision and visual quality in patients after age-related cataract phacoemulsification combined with IOLs implantation, and perform well under different conditions.

Effect of Erjingwan on Hippocampal Proteomics in AD Rats with Kidney Yin Deficiency Induced by Ovariectomy+ D-Galactose Combined with Aβ1-40 / 中国实验方剂学杂志

Objective::To explore the effect of Erjingwan on the biological basis of kidney yin deficiency Alzheimer' s disease(AD)rats induced by ovariectomy+ D-galactose combined with amyloid beta1-40 (Aβ1-40). Method::After ovariectomy, rats were randomly divided into five groups: model group, positive group, Erjingwan high, medium and low dose group, 11 rats in each group, and 11 rats in sham operation group. One week after operation, D-galactose was injected intraperitoneally for 7 weeks, and four weeks after operation, Aβ1-40 was injected unilaterally into hippocampus. The rats in model group and sham-operation group were given saline by intragastric administration 3 weeks after operation. The rats in high, middle and low dose groups of Erjingwan were given corresponding concentration (9.0, 4.5, 2.25 g·kg-1). The rats in positive control group were given Donepezil 1.0 mg·kg-1 with dosage of 10 mL·kg-1 once a day for 35 consecutive days. After 30 days of administration, the learning ability of the rats were examined using a Y-maze. The hippocampus tissues of rats were isolated. The morphology of hippocampus was observed by Nissl staining.The proteins were detected by Nanol-ESI liquid-mass spectrometry system and identified by protein Discovery software. Relative quantitative and qualitative analysis of differential proteins in hippocampus was performed by SIEVE software, and Gene Ontology of differential protein was performed by PANTHER Classification System database. String analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment were performed on the differential proteins. Result::Compared with model group, the correct rate of Y maze in the high and middle dose groups of Erjingwan was significantly raised(P<0.05), and the number of neurons in the hippocampal CA1 area was significantly increased(P<0.01).115 differential proteins (Ratio>1.5 or Ratio<0.5) such as Insulin-like growth factor 1 receptors(IGF-1R) were found in the high-dose group of the Erjingwan group as well as 94 differential proteins such as Synaptophysin expressed in the middle-dose group of the Erjingwan. And there are 87 differential proteins such as Acetyl-CoA acetyltransferase-cytosolic in the positive drug group. It showed that these proteins were mainly divided into tubule-related proteins, heat shock proteins, energy metabolism-related proteins and AD-related proteins with GO analysis. It was found that the above differential proteins involved 93 signaling pathways such as Dopaminergic synaps by KEGG analysis. Conclusion::Erjingwan can improve cognitive impairment and neuronal damage in rats with kidney yin deficiency, possibly by altering the expression of multiple pathway-associated proteins such as phosphatidylinositol 3-kinase/protein kinase B signaling pathway(PI3K/Akt), insulin signaling pathway, and adenylate-activated protein kinase (AMPK)signaling pathway, estrogen signaling pathway, and Dopaminergic synapse.

Clinical Characteristics of Clear Cell Ovarian Cancer: A Retrospective Multicenter Experience of 308 Patients in South Korea / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#The purpose of this study was to evaluate clinical characteristics and treatment pattern of ovarian clear cell carcinoma (OCCC) in Korea and the role of adjuvant chemotherapy in earlystage. @*Materials and Methods@#Medical records of 308 cases of from 21 institutions were reviewed and data including age, performance status, endometriosis, thromboembolism, stage, cancer antigen 125, treatment, recurrence, and death were collected. @*Results@#Regarding stage of OCCC, it was stage I in 194 (63.6%), stage II in 34 (11.1%), stage III in 66 (21.6%), and stage IV in 11 (3.6%) patients. All patients underwent surgery. Optimal surgery (residual disease ≤ 1 cm) was achieved in 89.3%. Majority of patients (80.5%) received postoperative chemotherapy. The most common regimen was taxane-platinum combination (96%). Median relapse-free survival (RFS) was 138.5 months for stage I, 33.4 for stage II, 19.3 for stage III, and 9.7 for stage IV. Median overall survival (OS) were not reached, 112.4, 48.7, and 18.3 months for stage I, II, III, and IV, respectively. Early-stage (stage I), endometriosis, and optimal debulking were identified as favorable prognostic factors for RFS. Early-stage and optimal debulking were also favorable prognostic factors for OS. Majority of patients with early-stage received adjuvant chemotherapy. However, additional survival benefit was not found in terms of recurrence. @*Conclusion@#Majority of patients had early-stage and received postoperative chemotherapy regardless of stage. Early-stage and optimal debulking were identified as favorable prognostic factors. In stage IA or IB, adding adjuvant chemotherapy did not show difference in survival. Further study focusing on OCCC is required.

Prognostic implications of stromal hyaluronic acid protein expression in resected oropharyngeal and oral cavity cancers

Background/Aims@#Hyaluronic acid (HA) regulates cell adhesion, migration and proliferation in various cancers. The clinical implications of HA in resected head and neck squamous cell carcinoma have not been elucidated. We investigated the clinical significance and prognostic value of the expression of tumoral and stromal HA and its related proteins in oropharyngeal and oral cavity cancer. @*Methods@#Resected tissues from oropharyngeal or oral cavity cancer patients undergoing surgery were analysed in tissue microarrays divided into stroma and cancer panels. The expression levels of HA, HA synthases and hyaluronidases were also assessed by immunohistochemistry. @*Results@#A total of 160 resected oropharyngeal or oral cavity cancer tissues were analysed. Stromal HA expression was observed more frequently in human papilloma virus (HPV)-negative tumors, but other clinicopathological characteristics did not differ. In patients with HPV-negative oral cavity cancers, high stromal HA expression was associated with significantly shorter recurrence-free survival and overall survival compared with low stromal HA expression. The expression of HA in both tumors and stroma was significantly correlated with poorer outcomes than other combinations in patients with HPV-negative oral cavity cancers. However, these prognostic roles of HA were not observed in patients with HPV-negative oropharyngeal cancers. In the HPV-stratified multivariate analysis, high stromal HA expression remained an independent indicator of poor prognosis in terms of recurrence-free survival. @*Conclusions@#High stromal HA and expression of HA in both tumors and stroma were correlated with poor prognosis in HPV-negative oral cavity cancer, but not in HPV-negative oropharyngeal cancers.

Effects of Effective Part of Tinospora sinensis on Hippocampus Proteomics of AD Rats Induced by Beta-amyloid Protein and D-galactose / 中国药学杂志

OBJECTIVE: To investigate the effect of the 80% ethanol elution part of Tinospora sinensis macroporous resin extract on the expression of hippocampus proteome in Alzheimer′s disease (AD) model rats induced by D-galactose combined with Aβ2535. METHODS: The AD rats model replicated by D-galactose combined with Aβ2535, The AD rat model was replicated by D-galactose combined with Aβ2535, and randomly divided into sham operation group, model group, Donepezil group (donepezil, 6.0 mg•kg-1), and 80% extraction of Tinospora sinensi group (crude drug 6 g•kg-1). Donepezil group: donepezil 0.1 mL•10 g-1 ig. 80% extraction of Tinospora sinensi group: Tinospora sinensis effective part extraction 0.1 mL•10 g-1 ig. Model group and sham-operation group: physiological saline 0.1 mL•10 g-1 ig. Once a day, continuous administration for 15 d. Separating the hippocampus and extracting the protein, take the system test with nanol-ESI liquid-mass spectrometry, protein discovery software was used for identification, and qualitative analysis different groups of hippocampal proteins by SIEVE software. Take the GO analysis on differential protein with the ANTHER classification system and use IPAD to enrich the pathway. RESULTS: Compared with the model group, the drug-administered group had 66 differential proteins, including tubulin, heat shock proteins, energy metabolism-related proteins, vesicle production/transport related proteins, and brain protection-related proteins, which are closely related to AD. The above differential proteins involve a total of 21 signaling pathways. CONCLUSION: Tinospora sinensis may promote the synthesis and release of neurotransmitters by up-regulating clathrin and vesicle-forming transport and neurotransmitter release, and improve the function of cholinergic function in the brain to achieve the pathological process of AD.

Curative effect of anterolateral spinal canal decompression combined with short segment screw fixation with posterior approach for severe thoracolumbar burst fractures with spinal cord injury / 中国骨伤

OBJECTIVE@#To explore the effect of anterolateral spinal canal decompression combined with short segment screw fixation with posterior approach for severe thoracolumbar burst fractures with spinal cord injury.@*METHODS@#From January 2016 to June 2018, 16 patients with severe thoracolumbar burst fractures (more than 50% of ratio of spinal canal encroachment, reverse fragment at the posterior edge of the vertebral body) with spinal cord injury were retrospectively analyzed, including 10 males and 6 females, ranging in age from 19 to 57 years old. Causes of injury:8 cases of fall injury, 6 cases of traffic accident injury and 2 cases of other injuries. Fracture site:T@*RESULTS@#All 16 patients were followed up, and the average follow up time was (15.9±5.4) months. The average operation time was (234±41) minutes and the average amount of bleeding was (431±93) ml. The loss of anterior height of injured vertebrae was (52.25±10.10)% before operation, (8.93± 3.61)% at 3 days after operation, and (9.25±2.88)% at the latest follow up. The results of 3 days after operation and the latest follow up were better than that before operation, and there was no significant differencesbetween results at the latest follow up and 3 days after operation (@*CONCLUSION@#For severe thoracolumbar burst fracture and spinal cord injury, with more than 50% of ratio of spinal canal encroachment and reverse fragment at the posterior edge of the vertebral body, the anterolateral spinal canal decompression combined with short segment screw fixation with posterior approach has the characteristics of accurate reduction, complete decompression and firm fixation, and the clinical effect is satisfactory.

Association of Overlapped and Un-overlapped Comorbidities with COVID-19 Severity and Treatment Outcomes: A Retrospective Cohort Study from Nine Provinces in China / 生物医学与环境科学（英文）

Objective@#Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear.@*Methods@#A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( @*Results@#Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks.@*Conclusion@#Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.

Clinical observation on distribution characteristics and rules of pain sensitivity points on body surface in patients with knee osteoarthritis / 中国针灸

OBJECTIVE@#To observe the distribution characteristics and rules of pain sensitivity points on body surface in patients with knee osteoarthritis (KOA).@*METHODS@#A total of 916 patients with KOA were selected in this study, the pain sensitivity points of local site of knee joint were probed by thumb palpation. Tape was used to measure the distance between the pain sensitivity points and the most nearby acupoints. The Wagner tenderness measuring instrument was used to measure the tenderness threshold of pain sensitivity points.@*RESULTS@#A total of 3618 pain sensitivity points were probed, among them, 3338 pain sensitivity points were sensitized. The minimum sensitization degree was 1.00, the maximum sensitization degree was 3.39, while the average sensitization degree was (2.16±0.60). Pain sensitivity points were distributed 0.37-1.73 @*CONCLUSION@#The pain sensitivity points of patients with KOA may be the expansion effect of acupoint areas in the disease states, pain sensitivity points are more likely to appear on the medial side of knee joint.

Guideline for diagnosis and treatment of spine trauma in the epidemic of COVID-19 / 中华创伤杂志(英文版)

Outbreak of COVID-19 is ongoing all over the world. Spine trauma is one of the most common types of trauma and will probably be encountered during the fight against COVID-19 and resumption of work and production. Patients with unstable spine fractures or continuous deterioration of neurological function require emergency surgery. The COVID-19 epidemic has brought tremendous challenges to the diagnosis and treatment of such patients. To coordinate the diagnosis and treatment of infectious disease prevention and spine trauma so as to formulate a rigorous diagnosis and treatment plan and to reduce the disability and mortality of the disease, multidisciplinary collaboration is needed. This expert consensus is formulated in order to (1) prevent and control the epidemic, (2) diagnose and treat patients with spine trauma reasonably, and (3) reduce the risk of cross-infection between patients and medical personnel during the treatment.

Intra-nucleus accumbens shell injection of baclofen blocks the reconsolidation of conditioned place preference in morphine-addicted mice / 生理学报

Preclinical studies suggest that the GABA receptor is a potential target for treatment of substance use disorders. Baclofen (BLF), a prototypical GABA receptor agonist, is the only specific GABA receptor agonist available for application in clinical addiction treatment. The nucleus accumbens shell (AcbSh) is a key node in the circuit that controls reward-directed behavior. However, the relationship between GABA receptors in the AcbSh and memory reconsolidation was unclear. The aim of this study was to investigate the effect of intra-AcbSh injection of BLF on the reconsolidation of morphine reward memory. Male C57BL/6J mice were used to establish morphine conditioned place preference (CPP) model and carry out morphine reward memory retrieval and activation experiment. The effects of intra-AcbSh injection of BLF on morphine-induced CPP, reinstatement of CPP and locomotor activity were observed after environmental cues activating morphine reward memory. The results showed that intra-AcbSh injection of BLF (0.06 nmol/0.2 μL/side or 0.12 nmol/0.2 μL/side), rather than vehicle or BLF (0.01 nmol/0.2 μL/side), following morphine reward memory retrieval abolished morphine-induced CPP by disrupting its reconsolidation in mice. Moreover, this effect persisted for more than 14 days, which was not reversed by a morphine priming injection. Furthermore, intra-AcbSh injection of BLF without morphine reward memory retrieval had no effect on morphine-associated reward memory. Interestingly, administration of BLF into the AcbSh had no effect on the locomotor activity of mice during testing phase. Based on these results, we concluded that intra-AcbSh injection of BLF following morphine reward memory could erase morphine-induced CPP by disrupting its reconsolidation. Activating GABA receptor in AcbSh during drug memory reconsolidation may be a potential approach to prevent drug relapse.