Clinical characteristics and prognostic characterization of endometrial carcinoma: a comparative analysis of molecular typing protocols.

BACKGROUND: Endometrial carcinoma (EC) is one of the most common gynecological malignancies in China and globally, accounting for the fourth-prevalent cancer in women. Although numerous studies have confirmed prognostic value of The Cancer Genome Atlas (TCGA) molecular subgroups, it is unclear how they are combined with histological features. The main objective of this study was to compare ProMisE and TCGA classification for the rapid and accurate prediction of prognosis within EC patients, together with the provision of a revised strategy for individualized diagnosis and treatment of patients. METHODS: Within this study, 70 patients with EC from Beijing Tsinghua Changgeng Hospital (affiliated to Tsinghua University) were retrospectively examined between July 2015 and December 2021. Samples were processed for determination of clinical markers, together with ProMisE and TCGA classification. RESULTS: Comparative analysis across four TCGA types (POLE, Low-CN, High-CN, and MSI-H) and age, was statistically significant (χ²= 7.000, p = 0.029). There was no significant difference observed among the four TCGA types and FIGO stage, vascular invasion and depth of invasion, or lymph node metastasis and tumor area. There was no significant association between the expression of Vimentin, Ki-67, PTEN, MSH2, PAX-8, ß-catenin, CD10, ER, PR, P16, MLH1, and PMS2 with the four TCGA types. In addition, p63 expression (χ²= 11.09, p = 0.029) and p53 expression (χ²= 11.585, p = 0.005) were statistically significant. Numerous models demonstrated that patients with POLE mutations and low-CN had higher progression free survival (PFS) and overall survival (OS), whereas those with high-CN had lowest values. The log-rank test revealed that the survival rate of PR-positive and ER-positive patients was significantly higher (p < 0.001). CONCLUSION: Overall, these results can be of additional benefit for clinical applications, in comparison to the ProMisE classification method. In addition, PR, ER, vascular infiltration, hyperlipidemia and atherosclerosis were found to be the key factors affecting EC prognosis.

Activation of FXR receptor reduces damage of ET-1 on H9C2 cardiomyocytes by activating AMPK signaling pathway.

BACKGROUND: To investigate the effect of Farnesoid X receptor (FXR) on oxidative stress injury of H9C2 cardiomyocytes induced by endothelin-1 (ET-1), and to explore the possible mechanism. METHODS: H9C2 cardiomyocytes were treated with ET-1 at concentrations of 10-8, 10-7 and 10-6 mmol/L for 12, 24, 36, and 48 h, respectively. At the same time, oxidative stress injury models were established. After the oxidative stress injury model was established, GW4064 (FXR agonist), siRNA-FXR (the virus interfered with FXR expression) and FXR empty virus were treated for 48 h. CCK-8 method was used to observe the survival rate of cardiomyocytes. Biochemical kit method was used to detect Creatine Kinase (CK) contents, CAT and mitochondrial activity. Western blot was used to detect the protein expression of SOD1, AMPK and p-AMPK. And real-time PCR was used to detect GPX1 mRNA, GPX3 mRNA, Sirt1 mRNA, PGC-1α mRNA expression levels. RESULTS: At the concentrations of 10-8, 10-7 and 10-6 mmol/L, ET-1 could induce the decrease of mitochondrial complex I and III activity, and increase of CK content in H9C2 cardiomyocytes. Moreover, with the increase of ET-1 concentration and the extension of culture time, the oxidative stress damage of cardiomyocytes became more serious. After ET-1 intervention, the expressions of p-AMPK protein, Sirt1 mRNA and PGC-1α mRNA were decreased. The 2 µmol/L GW4064 could effectively improve the oxidative stress induced by ET-1, and compared with the ET-1 group, the survival rate of H9C2 cardiomyocytes increased obviously. In addition, the CK content was decreased. On the contrary, the mitochondrial complex I and III, and CAT activity increased significantly, and the expressions of SOD1 and p-AMPK protein, Sirt1 mRNA and PGC-1α mRNA increased obviously. However, siRNA-FXR can partially block the improvement effect of FXR agonist on cardiomyocytes injury. CONCLUSIONS: Activation of FXR receptor may reduce the damage of ET-1 on H9C2 cardiomyocytes by activating AMPK signaling pathway.

Epithelioid hemangioendothelioma of the sternum.

Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor composed of dendritic and endothelial cells, and accounts for less than 1% of all vascular tumors. The tumor may arise from any location in the body, but it has a predilection for veins of the extremities, the liver, bone, and skin. Herein, we report a case of a 43-year-old man who presented with a chest mass accompanied by chest pain. Computed tomography (CT) scan of the chest showed a 3 cm × 2 cm sternal mass in the chest wall. We performed tumor resection and reconstruction of the chest wall. EHE was confirmed via postoperative pathology. The patient underwent postoperative adjuvant radiotherapy, and no evidence of tumor recurrence was discovered during the one-year follow up.

Antidiastole Value of Three-dimensional Ultrasonography and Power Doppler between Uterine Parenchyma Lumps and Endometrial Cancer: A Retrospective Study.

Sometimes endometrial polyps, submucosal myomas, and endometrial cancer show similar findings under ultrasonography. The aim of this study was to assess the antidiastole value of blood flow parameters using three-dimensional (3D) power Doppler ultrasonography angiography (PDA) between endometrial cancer and uterine parenchyma lumps. The data of the blood flow indices in 3D-PDA including the vascularization index (VI), flow index (FI), and vascularization flow index (VFI) in 40 patients with endometrial cancer and 41 patients with uterine parenchyma lumps (endometrial polyps and submucosal myomas) were retrospectively analysed and compared utilizing Virtual Organ Computer-aided AnaLysis (VOCAL) software. The results showed that all the blood flow parameters (VI, FI, VFI) were significantly higher in women with endometrial cancer than in those with uterine parenchyma lumps (P<0.001). The area under the curve of ROC of VI, FI, and VFI was 0.98, 0.84, and 0.97, respectively. Thus, the best predictor of endometrial carcinoma was VI with a sensitivity of 97.0% and a specificity of 91.0%. The optimal cutoff value of VI was 4.06%. Our data demonstrated that all of the blood flow signal parameters (including VI, FI, and VFI) in 3D power Doppler ultrasonography had significant antidiastole values between endometrial cancer and uterine parenchyma lumps to assist clinicians in properly diagnosing patients.

Factors influencing the severity of alcohol use disorder and the construction of risk prediction model / 四川精神卫生

BackgroundAlcohol use disorder （AUD） is a common chronic and relapsing psychiatric disorders. Identifying severe AUD early and intervening promptly is crucial to prevent irreversible harm. Currently， the assessment of AUD severity primarily relies on psychiatric examination by clinicians， and there is limited research on the factors influencing AUD severity and the development of prediction models. ObjectiveTo analyze the factors influencing AUD severity， and construct a risk prediction model to aid in the assessment of disease progression in AUD patients. MethodsA retrospective analysis was conducted on 1 358 first-time hospitalized patients admitted to Nanning Fifth People's Hospital from January 1， 2017 to December 31， 2022. These patients met the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） criteria for AUD. Basic patient data was collected， and the patients were divided into two groups based on disease severity： mild-moderate group （n=330） and severe group （n=1 028）. The patients were randomly divided into training and test sets in a 7∶3 ratio. A Logistic regression model was constructed in the training set， and the predictive ability of the model for disease severity was evaluated using the receiver operating characteristic （ROC） curve in the test set. ResultsCompared with the mild-moderate group， the severe group had a higher proportion of patients living in urban areas （χ2=7.804）， were farmers （χ2=17.991）， had a higher frequency of alcohol consumption （more than 1 to 2 drinks/day） （χ2=35.267）， had a higher age at first drinking （t=-3.858）， had a greater number of comorbid somatic disorders （Z=-22.782）， and had higher proportions of γ-Glutamyl transpeptidase （χ2=259.940） and total bilirubin abnormalities （χ2=148.552） （P<0.01）. Logistic analysis conducted in the training set showed that being a farmer （OR=2.024， 95% CI： 1.352~3.029）， having an older age at first drinking （OR=1.075， 95% CI： 1.025~1.129）， drinking outside of mealtimes （OR=3.988， 95% CI： 2.408~6.606）， having total bilirubin abnormalities （OR=1.034， 95% CI： 1.000~1.069）， and having more comorbid somatic diseases （OR=4.386， 95% CI： 2.636~7.298） were identified as risk factors for disease severity in AUD patients. The area under curve （AUC） for this model in the test set was 0.906. ConclusionIn psychiatric hospitals， being a farmer， having an older age at first drinking， drinking outside of mealtimes， having abnormal total bilirubin levels， and having comorbidities with somatic illnesses may be risk factors for severe AUD.

Expression of Midkine in cholangiocarcinoma and its value in predicting prognosis based on bioinformatics analysis / 临床肝胆病杂志

ObjectiveTo investigate the expression of Midkine （MDK） in cholangiocarcinoma （CCA） and its value in predicting the prognosis of CCA， as well as the potential mechanism of the effect of MDK on the progression of CCA. MethodsThe data of CCA samples were obtained from TCGA database to analyze the difference in the expression of MDK between cancer tissue and paracancerous tissue and its association with clinical features， and the data collected from GEO database and 11 CCA patients who underwent surgical resection in The Fifth Medical Center of Chinese PLA General Hospital from June 2018 to September 2021 were used for validation. STRING and Cytoscape were used to construct a protein-protein interaction network， and gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses were used to investigate the biological functions and tumor-related pathways involving MDK-related genes. In addition， TIMER and TISIDB databases were used to analyze the correlation between MDK expression and immune cell infiltration in CCA tissue. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the Fisher’s exact test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves， and the Log-rank test was used for comparison between groups. The Spearman correlation analysis was used to investigate the correlation between two variables. ResultsThe expression level of MDK in cancer tissue and paracancerous tissue of CCA patients was compared based on TCGA database， and the results of the non-paired and paired analyses showed that the expression level of MDK in CCA tumor tissue was significantly higher than that in paracancerous tissue （P<0.001）. Transcriptome sequencing was performed for the tumor tissue and its corresponding paracancerous tissue from 11 CCA patients， and the results showed that the expression level of MDK in CCA tumor tissue was significantly higher than that in corresponding paracancerous tissue （P<0.01）. High expression of MDK was associated with lymph node metastasis （P=0.045） and vascular invasion （P=0.044）. Survival analysis showed that compared with the CCA patients with low MDK expression， the CCA patients with high MDK expression had significantly shorter overall survival time （χ2=5.30， P=0.028） and disease-specific survival time （χ2=6.25， P=0.019）. The GO and KEGG enrichment analyses showed that the 30 MDK-related genes were closely associated with ubiquitin-mediated proteolysis and affected the prognosis of CCA patients. The TIMER analysis showed that the expression level of MDK was positively correlated with the infiltration of B cells （r=0.356， P=0.035 6） and dendritic cells （r=0.409， P=0.014 7） in tumor microenvironment of CCA； the TISIDB analysis showed that the expression level of MDK was positively correlated with CXCL16 （r=0.465， P=0.004 67） and was negatively correlated with CXCL12 （r=-0.389， P=0.019 7） and CXCR5 （r=-0.393， P=0.018 5）， and it was also negatively correlated with the immune checkpoint regulators VTCN1 （r=-0.393， P=0.018 3）， LTA （r=-0.380， P=0.022 7）， and PVR （r=-0.350， P=0.037 3）. ConclusionHigh expression of MDK is associated with poor prognosis in CCA patients， and MDK has the potential of being used as a molecular marker for predicting the prognosis of CCA. MDK may promote the development and progression of CCA by regulating ubiquitin-mediated proteolysis and the infiltration of B cells and dendritic cells.

Correlation Analysis Between Anti-cerebral Ischemia Oxidative Damage and Contents of Active Components in Characteristic Processed Products with Porcine Cardiac Blood and Other Processed Products of Salviae Miltiorrhizae Radix et Rhizoma from Menghe Medical School / 中国实验方剂学杂志

ObjectiveTo analyze the correlation between 11 small molecule active components and 1 protein component of characteristic processed products with porcine cardiac blood and other products of Salviae Miltiorrhizae Radix et Rhizoma（SMRR） from Menghe medical school and anti-cerebral ischemic oxidative damage， and to identify its key component markers of characteristic processed products with porcine cardiac blood for anti-cerebral ischemic oxidative damage. MethodHigh performance liquid chromatography（HPLC） was established to simultaneously determine the contents of 11 active ingredients in SMRR and its processed products［processed with porcine cardiac blood， porcine blood， wine and transferrin（Tf） in porcine cardiac blood］， and the content of Tf in different processed products of SMRR was detected by enzyme-linked immunosorbent assay（ELISA）. Furthermore， A zebrafish ischemic stroke model was constructed to evaluate the effects of different processed products of SMRR on the behavioral trajectory of cerebral ischemic zebrafish， the neuronal damage of transgenic zebrafish Tg（elavl3：eGFP） brain， as well as the levels of malondialdehyde（MDA） and superoxide dismutase（SOD） in the brain tissues. The hippocampal neurons oxygen-glucose deprivation/reoxygenation（OGD/R）-induced ischemia-hypoxia model was constructed to evaluate the effects of different processed products of SMRR on oxidative damage of neuronal cells by taking lactate dehydrogenase（LDH）， reactive oxygen species（ROS）， MDA and SOD as indexes. Finally， principal component analysis（PCA）， partial least squares-discriminant analysis（PLS-DA） and Spearman correlation analysis were used to analyze the 11 small molecule active components and 1 protein component with efficacy indicators， in order to screen the key components of the characteristic processed products with porcine cardiac blood for cerebral ischemic oxidative damage. ResultCompared with the raw products， the contents of water-soluble and fat-soluble components in processed products of SMRR increased to different degrees， while the content of salvianolic acid A decreased. Compared with the wine-processed products， the contents of salvianolic acid B， danshensu， rosmarinic acid and other components in the porcine cardiac blood-processed products， porcine blood-processed products， Tf-processed products were increased， while the content of salvianolic acid A was decreased. ELISA results showed that there was no significant difference in Tf content between the porcine cardiac blood-processed products， porcine blood-processed products， Tf-processed products. Pharmacological results showed that different processed products of SMRR could improve the behavioral deficits， brain neuronal injury and oxidative stress after ischemic stroke in zebrafish， and the effect of the porcine cardiac blood-processed products was most pronounced. PCA results showed that salvianolic acid B， salvianolic acid A， rosmarinic acid， lithospermic acid， danshensu， tanshinone ⅡA， caffeic acid， cryptotanshinone and tanshinone Ⅰ were the main contributing components of SMRR and its processed products. And the results of correlation analysis showed that the contents of cryptotanshinone， rosmarinic acid， caffeic acid， dihydrotanshinone Ⅰ， salvianolic acid B， tanshinone ⅡA and tanshinone Ⅰ were negatively correlated with MDA level in zebrafish brain tissue， while the contents of lithospermic acid， protocatechuic aldehyde， rosmarinic acid， dihydrotanshinone Ⅰ， salvianolic acid B and Tf were positively correlated with SOD level， and the contents of rosmarinic acid， caffeic acid， dihydrotanshinone Ⅰ， salvianolic acid B， tanshinone ⅡA， tanshinone Ⅰ， danshensu， Tf were positively correlated with neuronal fluorescence intensity in the zebrafish brain. And the contents of lithospermic acid， protocatechuic aldehyde， rosmarinic acid， dihydrotanshinone Ⅰ， salvianolic acid B， tanshinone ⅡA and Tf were negatively correlated with LDH， ROS and MDA levels and positively correlated with SOD level. ConclusionThere are differences in the anti-ischemic oxidative damage effects of SMRR and its different processed products， among which the porcine cardiac blood-processed products has the strongest effect on improving oxidative damage， which may be related to the content changes of salvianolic acid B， danshensu， rosmarinic acid and other components. This study can provide a basis for clarifying the quality markers of SMRR processed with porcine cardiac blood for cerebral ischemia and elucidating its processing mechanism.

Research progress of GBA1 variation and Parkinson′s disease / 中华神经科杂志

GBA1 is one of the common risk genes of Parkinson′s disease (PD), which encodes glucocerebrosidase. It is difficult to distinguish PD patients with heterozygous variants of GBA1 ( GBA1-PD) from idiopathic Parkinson′s disease patients, but GBA1-PD tends to progress faster, be more severe, and be more likely to be associated with cognitive impairment and other non-motor symptoms. The pathological mechanism of the increased risk of PD in GBA1 heterozygous variant carriers may be related to autophagy-lysosome dysfunction and mitochondrial dysfunction. Targeted therapy for GBA1 is expected to become a new direction of precision therapy for PD. In this article, the epidemiology and clinical features of GBA1-PD, the possible pathogenesis of GBA1 variation, and the therapeutic strategies for GBA1-PD were elaborated.

Research progress of new vaccine adjuvants / 生物工程学报

In recent years, the development of new vaccines such as nucleic acid vaccines, genetically engineered vaccines, and synthetic peptide vaccines has achieved rapid development. However, compared with traditional inactivated or live vaccines, these vaccines often have problems such as poor immunogenicity. Therefore, an adjuvant is needed to enhance its effect, and adjuvants have proven to be a key component in vaccines. There are many types of adjuvants, while currently no unified standard for the classification. At present, the most commonly used adjuvants are Aluminum adjuvant and Freund's adjuvant, but new generation vaccines will probably need new generation adjuvants. Thus, this review aims to showcase the current status of immune adjuvants, with the focus on immunomodulatory molecular adjuvant, antigen delivery adjuvant and compound adjuvant. This review provides new insights for the development of novel vaccine adjuvants.

Influence of high-density lipoprotein cholesterol on the prognosis of patients with alcohol-related hepatocellular carcinoma after radical treatment / 临床肝胆病杂志

ObjectiveTo investigate the association of high-density lipoprotein cholesterol (HDL-C) with the prognosis of patients with alcohol-related hepatocellular carcinoma (HCC) after radical treatment. MethodsA retrospective analysis was performed for the clinical data of 43 patients with alcohol-related HCC who were admitted to The Fifth Medical Center of Chinese PLA General Hospital and underwent radical treatment from January 2008 to July 2015, and according to HDL-C level, the patients were divided into normal group with 26 patients and abnormal group with 17 patients. The two groups were compared in terms of basic information, laboratory markers, imaging indices, Barcelona Clinic Liver Cancer tumor stage, and Child-Pugh class of liver function. The t-test test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. The Kaplan-Meier method was used to plot survival curves and the log-rank test was used for comparison between groups. Univariate and multivariate Cox proportional hazards models were used to analyze independent risk factors for prognosis. ResultsThere was a significant difference in prealbumin between the two groups (162.38±60.86 mg/L vs 120.06±64.08 mg/L, t=2.184, P=0.035). Number of tumors (hazard ratio ［HR］=2.839, 95%confidence interval ［CI］: 1.120~7.200,P=0.028), tumor size (HR=2.634, 95%CI: 1.062~6.529,P=0037), and HDL-C level (HR=2.400, 95%CI: 1.040~5.537,P=0.040) were independent risk factors for the overall survival of patients with alcohol-related HCC. There were significant differences in 1-, 3-, and 5-year cumulative survival rates between the normal group and the abnormal group (88.5%/72.4%/55.7% vs 70.6%/43.7%/17.5%, χ2=5.881, P=0.015). ConclusionThe reduction in HDL-C level might indicate poor prognosis of patients with alcohol-related HCC.

Impact of thymosin α1 as an immunomodulatory therapy on long-term survival of non-small cell lung cancer patients after R0 resection: a propensity score-matched analysis / 中华医学杂志(英文版)

BACKGROUND@#There is limited information about thymosin α1 (Tα1) as adjuvant immunomodulatory therapy, either used alone or combined with other treatments, in patients with non-small cell lung cancer (NSCLC). This study aimed to evaluate the effect of adjuvant Tα1 treatment on long-term survival in margin-free (R0)-resected stage IA-IIIA NSCLC patients.@*METHODS@#A total of 5746 patients with pathologic stage IA-IIIA NSCLC who underwent R0 resection were included. The patients were divided into the Tα1 group and the control group according to whether they received Tα1 or not. A propensity score matching (PSM) analysis was performed to reduce bias, resulting in 1027 pairs of patients.@*RESULTS@#After PSM, the baseline clinicopathological characteristics were similar between the two groups. The 5-year disease-free survival (DFS) and overall survival (OS) rates were significantly higher in the Tα1 group compared with the control group. The multivariable analysis showed that Tα1 treatment was independently associated with an improved prognosis. A longer duration of Tα1 treatment was associated with improved OS and DFS. The subgroup analyses showed that Tα1 therapy could improve the DFS and/or OS in all subgroups of age, sex, Charlson Comorbidity Index (CCI), smoking status, and pathological tumor-node-metastasis (TNM) stage, especially for patients with non-squamous cell NSCLC and without targeted therapy.@*CONCLUSION@#Tα1 as adjuvant immunomodulatory therapy can significantly improve DFS and OS in patients with NSCLC after R0 resection, except for patients with squamous cell carcinoma and those receiving targeted therapy. The duration of Tα1 treatment is recommended to be >24 months.

CT and MRI features of synovial sarcoma / 实用放射学杂志

Objective To analyze and evaluate the CT and MRI features of synovial sarcoma (SS).Methods Clinical and imaging data of 25 cases with SS confirmed by pathology were retrospectively analyzed.1 5 cases with CT scan,including 1 1 contrastGenhanced CT scan,and 1 2 cases with MRI scan,including 8 contrastGenhanced MRI scan.Results Among 25 cases,1 8 were located in the lower extremities,2 in the upper extremities and in the chest wall respectively,1 case in the lung parenchyma,mediastinum and spine respectively.1 8 cases were deep seated,while 1 9 cases were lobulated.On CT image,most of the lesions were isodense or hypodense to muscle,while 3 cases presented peripheral calcification,and 9 cases showed progressive enhancement.On MRI,10 cases were isointense or slight hypointense on T1 WI,while 9 cases presented hyperintense or slight hyperintense on T2 WI.9 cases showed cystic change (7 of them located in the periphery),and 8 cases showed short T1 signal.3 cases demonstrated "fluidGfluid levels",and 9 cases exhibited hypointense septa.7 cases revealed "triple sign"on T2 WI and 7 cases showed obviously heterogenous enhancement.Conclusion Synovial sarcomas are mostly located in the lower extremities,with clear margins,peripheral cystic changes,intramural hemorrhage,"triple sign"on T2 WI and progressive enhancement.

Efficacy of ultrasound-guided modified anterior approach to sciatic nerve block for orthopedic sur-gery with general anesthesia / 中华麻醉学杂志

Objective To evaluate the efficacy of ultrasound-guided modified anterior approach to sciatic nerve block ( SNB) for orthopedic surgery with general anesthesia. Methods Ninety American So-ciety of Anesthesiology physical status Ⅰ or Ⅱpatients of both sexes, aged 18-64 yr, weighing 19-28 kg∕m2 , scheduled for elective knee joint or distal orthopedic surgery, were divided into 3 groups ( n=30 each) using a random number table method: modified anterior approach ( the puncture needle was almost perpendicular to the ultrasound beam) group, anterior approach group and posterior approach group. SNB ( injecting 0. 5％ ropivacaine 20 ml) combined with femoral nerve block ( injecting 0. 5％ ropivacaine 15-20 ml) was performed under ultrasound guidance. Surgery was completed under combination of the laryngeal mask and combined intravenous-inhalational anesthesia. When the respiratory rate ≥20 beats∕min and∕or the increase in heart rate was more than 20％ of the baseline value, sufentanil 1μg∕time was intravenously injected. When visual analog scale ( VAS) score ≥4 within 24 h after surgery, celecoxib capsules 0. 2 g was taken orally for analgesia. The depth of sciatic nerve, needling depth, sharpness score of needle ima-ging under ultrasound, and operation time and duration of SNB were recorded. VAS scores at rest and dur-ing activity were recorded at 6, 8, 10, 12 and 24 h after surgery. The amount of sufentanil consumed dur-ing surgery and use of celecoxib capsules within 24 h after surgery were recorded. The development of ad-verse reactions such as hematoma at the puncture site, nausea and vomiting was also recorded after surgery. Results Compared with posterior approach group, the depth of sciatic nerve and needling depth were sig-nificantly increased, the operation time of SNB was prolonged, the duration of SNB was shortened, the in-traoperative consumption of sufentanil was increased, VAS scores at rest and during activity were increased at 10 h after surgery, and the sharpness score of needle imaging was increased in modified anterior approach and anterior approach groups (P<0. 05). Compared with anterior approach group, the sharpness score of needle imaging was significantly increased, and VAS scores during activity were decreased at 24 h after sur-gery in modified anterior approach group ( P<0. 05) . There was no significant difference in the requirement for celecoxib capsules within 24 h after surgery or occurrence of adverse reactions among the three groups ( P>0. 05) . Conclusion Although ultrasound-guided modified anterior approach to SNB provides compara-ble efficacy with anterior approach to SNB and is not as good as posterior approach to SNB when used for or-thopedic surgery with general anesthesia, modified anterior approach to SNB is easy to operate, with clear images under ultrasound.

Efficacy of thunder-fire moxibustion combined with external applicaion of powder for mild and moderate knee osteoarthritis / 中国针灸

OBJECTIVE@#To compare the therapeutic effect between thunder-fire moxibustion combined with external applicaion of powder and thunder-fire moxibustion alone for mild and moderate knee osteoarthritis.@*METHODS@#A total of 70 patients with mild and moderate knee osteoarthritis were randomly divided into an observation group and a control group, 35 cases in each group. In the observation group, thunder-fire moxibustion combined with external applicaion of powder were applied, Thunder-fire moxibustion was applied at Xuehai (SP 10), Liangqiu (ST 34), Neixiyan (EX-LE 4), Yanglingquan (GB 34) and point, external applicaion of powder was given to the affected knee after the treatment of thunder-fire moxibustion. Simple thunder-fire moxibustion was given in the control group. All patients in the two groups were treated once a day, 7 days as one course and the consecutive 4 courses were required, with an interval of 1 day between courses. Before and after treatment, the visual analogue scale (VAS) score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were used to assessed knee pain, stiffness and physical function in the two groups. In addition, the efficacy was evaluated.@*RESULTS@#Compared before treatment, the VAS scores, total scores of WOMAC, pain scores, stiffness scores and physical function scores were reduced after treatment in the two groups (<0.01), and the scores in the observation group were significantly lower than those in the control group (<0.01, <0.05). The total effective rate was 97.0% (32/33) in the observation group, which was superior to 91.2% (31/34) in the control group (<0.05).@*CONCLUSION@#Thunder-fire moxibustion combined with external applicaion of powder are superior to simple thunder-fire moxibustion in improving the symptoms and delaying the development of the disease for mild and moderate knee osteoarthritis.

Construction and application of immunization information system based on children cases collected by vaccination clinic clients in Shandong Province, China / 中华预防医学杂志

Construction and application of immunization information system is an important part of health information, which is very useful to improve the quality, efficiency and safety of vaccination. The background, system architecture, functions and applications, working conditions and characteristics of Shandong province Immunization Information System (IIS) are introduced in this article. It is expected to provide experiences for the development of immunization information system of other provinces.

Catastrophic antiphospholipid syndrome during pregnancy: a case report and literature review / 中华围产医学杂志

ObjectiveTo summarize the diagnosis, management and prognosis of catastrophic antiphospholipid syndrome (CAPS) in pregnant and postpartum women through a case report and literature review.MethodsThe reported case was a gravida who had a history of antiphospholipid syndrome and was admitted to the Peking University First Hospital in July 2017 due to CAPS in the second trimester. She was fully recovered and discharged after effective management. Clinical data was collected and analyzed. Relevant literatures regarding the diagnosis, treatment and prognosis of pregnancy-related CAPS were reviewed. Results(1) Case report: The patient had taken warfarin after the diagnosis of antiphospholipid syndrome but stopped the medication six months before conception. She was admitted at 22 weeks of gestation due to severe upper abdominal pain accompanied by nausea and vomiting and diagnosed with CAPS based on severe low platelet count and remarkably elevated liver enzymes. After a series of treatment, including anticoagulation, glucocorticoid, plasma exchange and cesarean section, the patient became stable and was fully recovered. (2) Literature review: After searching all published literatures, 13 relevant literatures which including 35 patients were finally reviewed. It is found that CAPS was a rare and life-threatening condition with rapid progression and the mortality rate was 6/14 during gestation and 9％ (2/21) after delivery. Anticoagulation, glucocorticoid, plasma exchange and immunoglobulin were the first-line treatment. Termination of pregnancy was required once CAPS was diagnosed.ConclusionsCAPS is a rare but life-threatening disease. Early diagnosis and timely termination of pregnancy are crucial for gravidas with CAPS.

Imaging features and pathological basis of seminoma / 实用放射学杂志

Objective To analyze the imaging findings and pathological basis of seminoma and improve the understanding and diagnostic accuracy.Methods The imaging findings of seminoma in 67 patients proved by histopathology were analyzed retrospectively.The tumor location,size,contour,periphery,density or signal and contrast enhancement patterns were evaluated,and these were compared with the pathological results.Results All of the 67 cases were male.46 cases were located in testicular,10 cases in the pelvic cavity,6 cases in the peritoneal and retroperitoneal,4 cases in the mediastinum,1 case in the brain.On non-enhanced CT,testicular lesions appeared to be nodular or lobular masses with clear margin.Some cases showed cystic-solid masses.And the solid component was located in the edge of the lesion,and the irregular necrosis areas of low density was located in the center.Fat and calcification component were not found in the mass.After contrast administration,the masses showed heterogeneous enhancement.The thickened and tortuous testicular arteries were seen in 11 cases in arterial phase,and thickened and twisted testicular veins were seen in 9 cases in the venous phase.The imaging findings of the mass at the other location were without features.Conclusion Testicular seminoma has significant characteristics,thickened testicular arteries and/or draining veins on enhanced CT can help the diagnosis.Imaging features of extragonadal primary seminoma are not characteristic.Combined with clinical history and signs,it is possible to improve the diagnostiic accuracy of seminoma.

In vitro osteoclast-suppressing effect of sodium ibandronate.

BACKGROUND: Bisphosphonates (BPs) have been reported to reduce local recurrence in giant cell tumor (GCT) of bone because of their osteoclast-suppressing effect; however, the optimal mode of delivery and the dose and duration of treatment of BPs remain to be established. To address these issues, it is first necessary to clarify the manner of action of BPs on osteoclasts. We herein evaluated the osteoclast-suppressing effect of sodium ibandronate in vitro. METHODS: Mouse osteoclasts (OCLs) were generated in vitro using mouse bone marrow mononuclear cells. First, various concentrations of sodium ibandronate and equal amounts of phosphate-buffered saline were added to cell culture media. The number of multinucleated cells (over three nuclei) was recorded in each group, OCL formation was compared, and the most effective concentration of sodium ibandronate was determined. Then, high concentrations of sodium ibandronate were added to the experimental cell culture media; no ibandronate was given in the control group. Comparisons were made between the two groups in terms of OCL adhesion, migration, and bone resorption. RESULTS: OCL formation was suppressed by sodium ibandronate in vitro; the most pronounced effect was observed at the concentration of 10(-5) mol/L. OCL migration and bone resorption were significantly suppressed at this concentration, though there was no effect on OCL adhesion. CONCLUSIONS: Sodium ibandronate was effective in suppressing OCLs and decreasing resorption in GCT. The strong anti-OCL effectiveness at a high concentration in vitro indicates a topical mode of application.

Effects of miR⁃145⁃3p on mitophagy in MPP + Ⅳinduced PD cell model by regulating the CaMkkβ/AMPK/CREB pathway / 安徽医科大学学报

Objective @# To investigate the effect and mechanism of miR⁃145 ⁃3p on mitophagy in 1 ⁃methyl⁃4 ⁃pheny⁃lpyridiniumion ( MPP + ) Ⅳinduced Parkinson ′ s disease ( PD) cell model . @*Methods @# Human neuroblastoma cells SH⁃SY5Y) were divided into control group , model group , mimics group , calmodulin⁃dependent protein kinase kinaseβ (CaMkkβ) inhibitor ( STO⁃609) group , mimics + STO⁃609 group , cyclic adenosine monophosphate response element⁃binding protein (CREB) inhibitor (KG⁃501) group , mimics + KG⁃501 group and STO⁃609 + KG⁃501 group . Cell apoptosis was detected by flow cytometry , autophagosome structure was observed by transmission electron microscopy , and apoptosis , autophagy and CaMkkβ/adenylate activated protein kinase ( AMPK) /CREB pathway related protein expression were detected by Western blot . @*Results @#Compared with control group , the apoptosis rate , Bcl⁃2 ⁃associated X protein (Bax) , cysteine proteinase⁃3 (Caspase⁃3) and microtubule⁃associated protein light chain 3 ⁃I (LC3 ⁃ Ⅰ ) protein expression levels in model group increased (P < 0. 01) , and the autophagosome structure decreased . The protein levels of B cell lymphoma⁃2 (Bcl⁃2) , autophagy gene (Beclin⁃1) , microtubule⁃associated protein light chain 3 ⁃ Ⅱ ( LC3 ⁃ Ⅱ ) , phosphorylated calmodulin⁃dependent protein kinase kinaseβ(p⁃CaMkkβ) , phosphorylated cadenylate activated protein kinase ( p⁃AMPK) , and phosphorylated cyclic adenosine monophosphate response element⁃binding protein ( p⁃CREB) decreased ( P < 0. 01) . Compared with model group , the apoptosis rate , Bax , Caspase⁃3 and LC3 ⁃ Ⅰ protein expression levels in mimics group decreased (P <0. 05 ) , and the autophagosome structure increased . The protein levels of Bcl⁃2 , Beclin⁃1 , LC3 ⁃ Ⅱ , p ⁃CaMkkβ , p ⁃AMPK , p ⁃CREB increased (P < 0. 05) . The trend of STO⁃609 group and KG⁃501 group was the same and opposite to mimics group . Compared with mimics group , the apoptosis rate , Bax , Caspase⁃3 and LC3 ⁃ Ⅰ protein expression levels in the mimics + STO⁃609 group and the mimics + KG⁃501 group increased (P < 0. 01) , and the autophagosome structure decreased . The protein levels of Bcl⁃2 , Beclin⁃1 , LC3 ⁃ Ⅱ , p ⁃CaMkkβ , p ⁃AMPK , p ⁃CREB protein levels decreased (P < 0. 01) . Compared with STO⁃609 group , the apoptosis rate , Bax , Caspase⁃3 and LC3 ⁃ Ⅰ pro⁃tein expression levels of STO⁃609 + KG⁃501 group increased ( P < 0. 01) , and the autophagosome structure decreased . The protein levels of Bcl⁃2 , Beclin⁃1 , LC3 ⁃ Ⅱ , p ⁃CaMkkβ , p ⁃AMPK and p ⁃CREB decreased ( P <0. 05) . @*Conclusion @# miR⁃145 ⁃3p can inhibit the apoptosis of MPP + Ⅳinduced PD cell model and promote mitophagy , and its mechanism may be related to the activation of the CaMkkβ/AMPK/CREB pathway .

Characteristics and influencing factors analysis of depressive symptoms among only-child-lost-persons / 重庆医学

Objective To explore the characteristics and influencing factors of depressive symptoms among the only-child-lost persons.Methods A total of 841 only-child-lost persons and 674 controls conforming to entering group condition were selected.The difference of SDS score between the two groups and the demographic characteristics distribution differences of depression severity in only-child-lost persons were compared and the influencing factors were analyzed.Results The SDS score had statistical difference between the only-child-lost persons group and control group(P＜0.05),and was correlated to the only-child-lost years and no physical disease;the proportion of mild to moderate depression in the only-child-lost persons of the low cultural level,somatic diseases and middle income level groups was significantly higher than that in the other groups;the only-child-lost persons with low income level,age≤60 years old and high educational level had a higher proportion of severe depression;the Logistic regression analysis showed that the educational level had a significant influence on the depression onset among the only-child-lost persons,the difference was statistically significant(P＜0.05).Conclusion The characteristics of depressive symptoms among the only-child-lost persons are related to their demographic characteristics.