Pretreatment prediction of cervical lymph node metastasis in salivary gland carcinoma based on 18F-FDG PET/CT radiomics / 中华放射医学与防护杂志

Objective:To explore the value of 18F-FDG PET/CT radiomics in predicting the cervical lymph node metastasis in salivary gland cancer. Methods:Sixty-eight patients with salivary gland carcinoma treated in the Peking University School and Hospital of Stomatology were retrospectively studied. They were randomly divided into training group ( n=40), validation group ( n=14), and test group ( n=14). The primary tumor lesions were semi-automatically delineated on PET images as regions of interest (ROIs) and the radiomic features were extracted from ROIs. After feature selection and dimension reduction, an artificial neural network (ANN) prediction model was constructed. The prediction performance of the model was assessed using receiver operating characteristic (ROC) curves, the area under ROC curves (AUC), accuracy, sensitivity, and specificity. Moreover, the performance of various models was compared using the Delong test. Results:The radiomic model yielded an AUC of 0.88 (95% CI: 0.78-0.95), a sensitivity of 75%, specificity of 92.3%, and accuracy of 88.2%. By contrast, the combined model constructed based on the clinical node status (cN) reported by PET/CT and radiomic features yielded an AUC of 0.97 (95% CI: 0.89-0.99), a sensitivity of 87.5%, specificity of 100%, and accuracy of 97.1%. The Delong test showed that there was a statistically significant difference between the combined model and cN ( Z=2.27, P<0.05), but there was no statistically significant difference between the radiomic model and cN ( P>0.05). Conclusions:The ANN model based on 18F-FDG PET/CT radiomics combined with cN reported by PET/CT can more accurately predict cervical lymph node metastasis in patients with salivary gland carcinoma.

Research Progress on Mechanism of Mitochondrial DNA in Occurrence and Development of Digestive System Malignant Tumors / 肿瘤防治研究

Mitochondrial DNA (mt-DNA) is an important carrier of extranuclear genetic information. Recent research results show that mt-DNA is closely related to the occurrence and metastasis of various malignant tumors, and can be used for early diagnosis and targeted therapy of cancer. Therefore, further research on the mechanism of mt-DNA in digestive system malignant tumors has important clinical significance for screening and identifying tumor molecular markers for anti-tumor drug targets, cancer diagnosis and prognosis analysis. This article reviews the research progress on the potential relationship, clinical application and therapeutic targets of mt-DNA and digestive system malignancies.

Evaluation of individual and ensemble probabilistic forecasts of COVID-19 mortality in the US

Short-term probabilistic forecasts of the trajectory of the COVID-19 pandemic in the United States have served as a visible and important communication channel between the scientific modeling community and both the general public and decision-makers. Forecasting models provide specific, quantitative, and evaluable predictions that inform short-term decisions such as healthcare staffing needs, school closures, and allocation of medical supplies. Starting in April 2020, the US COVID-19 Forecast Hub (https://covid19forecasthub.org/) collected, disseminated, and synthesized tens of millions of specific predictions from more than 90 different academic, industry, and independent research groups. A multi-model ensemble forecast that combined predictions from dozens of different research groups every week provided the most consistently accurate probabilistic forecasts of incident deaths due to COVID-19 at the state and national level from April 2020 through October 2021. The performance of 27 individual models that submitted complete forecasts of COVID-19 deaths consistently throughout this year showed high variability in forecast skill across time, geospatial units, and forecast horizons. Two-thirds of the models evaluated showed better accuracy than a naive baseline model. Forecast accuracy degraded as models made predictions further into the future, with probabilistic error at a 20-week horizon 3-5 times larger than when predicting at a 1-week horizon. This project underscores the role that collaboration and active coordination between governmental public health agencies, academic modeling teams, and industry partners can play in developing modern modeling capabilities to support local, state, and federal response to outbreaks. Significance StatementThis paper compares the probabilistic accuracy of short-term forecasts of reported deaths due to COVID-19 during the first year and a half of the pandemic in the US. Results show high variation in accuracy between and within stand-alone models, and more consistent accuracy from an ensemble model that combined forecasts from all eligible models. This demonstrates that an ensemble model provided a reliable and comparatively accurate means of forecasting deaths during the COVID-19 pandemic that exceeded the performance of all of the models that contributed to it. This work strengthens the evidence base for synthesizing multiple models to support public health action.

COVID-19 reopening strategies at the county level in the face of uncertainty: Multiple Models for Outbreak Decision Support

Policymakers make decisions about COVID-19 management in the face of considerable uncertainty. We convened multiple modeling teams to evaluate reopening strategies for a mid-sized county in the United States, in a novel process designed to fully express scientific uncertainty while reducing linguistic uncertainty and cognitive biases. For the scenarios considered, the consensus from 17 distinct models was that a second outbreak will occur within 6 months of reopening, unless schools and non-essential workplaces remain closed. Up to half the population could be infected with full workplace reopening; non-essential business closures reduced median cumulative infections by 82%. Intermediate reopening interventions identified no win-win situations; there was a trade-off between public health outcomes and duration of workplace closures. Aggregate results captured twice the uncertainty of individual models, providing a more complete expression of risk for decision-making purposes.

Epidemic Model Guided Machine Learning for COVID-19 Forecasts in the United States

We propose a new epidemic model (SuEIR) for forecasting the spread of COVID-19, including numbers of confirmed and fatality cases at national and state levels in the United States. Specifically, the SuEIR model is a variant of the SEIR model by taking into account the untested/unreported cases of COVID-19, and trained by machine learning algorithms based on the reported historical data. Besides providing basic projections for confirmed and fatality cases, the proposed SuEIR model is also able to predict the peak date of active cases, and estimate the basic reproduction number ([Formula]). In particular, the forecasts based on our model suggest that the peak date of the US, New York state, and California state are 06/01/2020, 05/10/2020, and 07/01/2020 respectively. In addition, the estimated [Formula] of the US, New York state, and California state are 2.5, 3.6 and 2.2 respectively. The prediction results for all states in the US can be found on our project website: https://covid19.uclaml.org, which are updated on a weekly basis, and have been adopted by the Centers for Disease Control and Prevention (CDC) for COVID-19 death forecasts (https://www.cdc.gov/coronavirus/2019-ncov/covid-data/forecasting-us.html).

Study on a multidisciplinary continuing management model for hospitalized elderly patients with multimorbidity / 中华老年医学杂志

Objective:To construct a multidisciplinary continuing management model for hospitalized elderly patients with multimorbidity and to assess the effectiveness of this model, thus providing insights and suggestions for the management of elderly patients with co-morbidity.Methods:This was a prospective randomized controlled study.Patients with comorbidity admitted to the geriatric ward of our hospital from November 2015 to July 2017 were selected and received comprehensive geriatric assessment(CGA). Patients were randomly divided into the intervention group receiving continuous multidisciplinary medical treatment and the control group receiving conventional medical treatment.The work flow and characteristics of the intervention group were examined, and the effectiveness of the two models(including cost of hospitalization, duration, patient satisfaction, patient functional status, adverse events, and changes in healthy behavior awareness after 6 months of follow-up)were compared between the two groups.Results:A total of 440 patients with comorbidity were included in the study, with an average age of(76.0±8.1)years, including 226 in the intervention group and 214 in the control group.After multidisciplinary continuing medical intervention, patients in the intervention group were associated with a significantly higher level of satisfaction on physician availability(86.3% vs.74.8%, χ2=9.354, P=0.002), medical care(99.6%vs.86.7%, χ2=4.926, P=0.026)and nursing quality(93.4%vs.86.4%, χ2=5.829, P=0.016), compared with the control group.After 6 months of follow-up, the probability of adverse events in the intervention group was lower than that in the control group(61.1%vs.73.5%, χ2=7.436, P=0.006), and drug-related adverse reactions/events in the intervention group(9.0%vs.22.1%, χ2=13.858, P<0.000)were significantly lower than those in the control group.Furthermore, the proportion of patients with improved healthy behavior awareness was markedly higher in the intervention group than that in the control group(30.3%vs.5.4%, χ2=43.979, P<0.001). Conclusions:The multidisciplinary hospital-community continuity management model with CGA at the core can reduce the occurrence of adverse events, improve patient satisfaction and healthy behavior awareness, and is a worthy exploration of a new medical model for elderly comorbid patients.

Analysis of expression of NADH dehydrogenase 1, NADH dehydrogenase 3 and taste 2 receptor member 43 genes in severe pneumonia children / 中华实用儿科临床杂志

Objective:To explore the association of expression of NADH dehydrogenase 1 ( ND1), NADH dehydrogenase 3 ( ND3) and taste 2 receptor member 43 ( TAS2R43) genes with severe pneumonia in children. Methods:Thirty severe pneumonia children in the intensive care unit of Zhumadian Central Hospital from May 2016 to May 2018 were enrolled as the severe pneumonia group and 25 healthy children undergoing health examinations in Zhumadian Central Hospital over the same period were selected as the control group.The severe pneumonia group contained 17 boys and 13 girls, with an age of 5.30±1.69.The control group included 13 boys and 12 girls, with an age of 4.96±1.31.Expression of ND1, ND3 and TAS2R43 genes was detected by real-time PCR, and the relative expression of ND1, ND3 and TAS2R43 genes was calculated by 2 -ΔΔCt method. Results:The circulating threshold (Ct) values of ND1, ND3 and TAS2R43 mRNA in the severe pneumonia group were 20.49±0.45, 21.32±0.61 and 32.20±0.46, respectively, and those in the healthy control group were 26.69±0.62, 27.50±0.35 and 26.69±0.49, respectively.The difference between the 2 groups was statistically significant ( t=-14.02, -15.25, -14.19, all P<0.05). The relative expre-ssion of ND1, ND3 and TAS2R43 genes calculated by the 2 -ΔΔCt method in the severe pneumonia group was 51.27 folds, 50.56 folds and 0.02 folds as many as that in the control group. Conclusions:The expression of ND1, ND3 and TAS2R43 genes in severe pneumonia children is abnormal.These 3 genes may be closely related to severe pneumonia in children.

Clinical analysis of 31 cases of 2019 novel coronavirus infection in children from six provinces (autonomous region) of northern China / 中华儿科杂志

Objective@#To analyze the epidemiological history, clinical manifestations, treatment and the short-term prognosis of 31 cases of 2019 novel coronavirus(2019-nCoV) infection in children from six provinces (autonomous region) in northern China.@*Methods@#A retrospective analysis of the epidemiological history, clinical symptoms, signs, laboratory examinations, chest imaging, treatment and the short-term prognosis of 31 cases of 2019-nCoV was conducted. The patients were diagnosed between January 25th, 2020 and February 21st, 2020 in 21 hospitals in 17 cities of six provinces(autonomous region) of Shaanxi, Gansu, Ningxia, Hebei, Henan and Shandong.@*Results@#The age of the 31 children with 2019-nCoV infection was 7 years and 1 month (6 months -17 years). Nine cases (29%) were imported cases. Other 21 cases (68%) had contact with confirmed infected adults. One case (3%) had contact with asymptomatic returnees from Wuhan. Among the 31 children, 28 patients (90%) were family cluster cases. The clinical types were asymptomatic type in 4 cases (13%), mild type in 13 cases (42%), and common type in 14 cases (45%). No severe or critical type existed. The most common symptom was fever (n=20, 65%), including 1 case of high fever, 9 cases of moderate fever, 10 cases of low fever. Fever lasted from 1 day to 9 days. The fever of fifteen cases lasted for ≤3 d, while in other 5 cases lasted > 3 d. Other symptoms included cough (n=14, 45%), fatigue (n=3, 10%) and diarrhea (n=3, 9%). Pharyngalgia, runny nose, dizziness, headache and vomiting were rare. In the early stage, the total leukocytes count in peripheral blood decreased in 2 cases (6%), the lymphocytes count decreased in 2 cases (6%), and the platelet count increased in 2 cases (6%).Elevation of C-reactive protein (10%, 3/30), erythrocyte sedimentation rate(19%,4/21), procalcitonin(4%,1/28), liver enzyme(22%, 6/27) and muscle enzyme (15%, 4/27) occurred in different proportions. Renal function and blood glucose were normal. There were abnormal chest CT changes in 14 cases, including 9 cases with patchy ground glass opacities and nodules, mostly located in the lower lobe of both lungs near the pleural area. After receiving supportive treatment, the viral nucleic acid turned negative in 25 cases within 7-23 days. Among them, 24 children (77%) recovered and were discharged from hospital. No death occurred.@*Conclusions@#In this case series, 2019-nCoV infections in children from six provinces (autonomous region) in northern China are mainly caused by close family contact. Clinical types are asymptomatic, mild and common types. Clinical manifestations and laboratory examination results are nonspecific. Close contact history of epidemiology, nucleic acid detection and chest imaging are important bases for diagnosis. After general treatment, the short-term prognosis is good.

Frailty progress and related factors in the elderly living in community: a prospective study / 中华流行病学杂志

Objective To investigate frailty progress status and related factors in the elderly living in communities.Methods A cohort of elderly people aged 65 and over in Pingyi community of Dujiangyan,Sichuan province,was established.Face-to-face questionnaire survey was conducted by trained interviewers.The frailty status,cognitive function,nutrition status and other functions of the subjects surveyed were evaluated at baseline survey and during follow-up.The socio-demographic and clinical characteristics of the subjects surveyed were assessed at baseline survey.Binary logistic regressions were used to identify factors associated with frailty progress.Results A total of 653 elderly people were surveyed in January 2014,and 507 elderly people were followed up while 146 elderly people terminated further follow-up in January 2017.The prevalence rates of frailty and pre-frailty at baseline survey were 11.2％ (n=57) and 26.2％ (n=133),respectively.After 3 years,205 subjects (40.4％) surveyed experienced frailty progress,276 (54.5％) remained to be in frailty state at baseline survey,and 26 (5.1％) had improvement.Disability (OR=8.27,95％CI:1.62-42.26),visual problem (OR=2.02,95％CI:1.27-3.22),cognitive impairment (OR=1.94,95％CI:1.08-3.48),poor self-rated health (OR=1.89,95％ CI:1.07-3.31),chronic pain (OR=1.57,95％ CI:1.03-2.40) and older age (OR =1.12,95％CI:1.08-1.17) were independently associated with the progress of frailty.In contract,overweight was a protective factor (OR=0.54,95％CI:0.34-0.85).Conclusions Frailty is a dynamic syndrome affected by several socio-demographic factors and geriatric factors.The results of the study can be used in the prevention of frailty progress in the elderly in communities.

Frailty progress and related factors in the elderly living in community: a prospective study / 中华流行病学杂志

Objective To investigate frailty progress status and related factors in the elderly living in communities.Methods A cohort of elderly people aged 65 and over in Pingyi community of Dujiangyan,Sichuan province,was established.Face-to-face questionnaire survey was conducted by trained interviewers.The frailty status,cognitive function,nutrition status and other functions of the subjects surveyed were evaluated at baseline survey and during follow-up.The socio-demographic and clinical characteristics of the subjects surveyed were assessed at baseline survey.Binary logistic regressions were used to identify factors associated with frailty progress.Results A total of 653 elderly people were surveyed in January 2014,and 507 elderly people were followed up while 146 elderly people terminated further follow-up in January 2017.The prevalence rates of frailty and pre-frailty at baseline survey were 11.2％ (n=57) and 26.2％ (n=133),respectively.After 3 years,205 subjects (40.4％) surveyed experienced frailty progress,276 (54.5％) remained to be in frailty state at baseline survey,and 26 (5.1％) had improvement.Disability (OR=8.27,95％CI:1.62-42.26),visual problem (OR=2.02,95％CI:1.27-3.22),cognitive impairment (OR=1.94,95％CI:1.08-3.48),poor self-rated health (OR=1.89,95％ CI:1.07-3.31),chronic pain (OR=1.57,95％ CI:1.03-2.40) and older age (OR =1.12,95％CI:1.08-1.17) were independently associated with the progress of frailty.In contract,overweight was a protective factor (OR=0.54,95％CI:0.34-0.85).Conclusions Frailty is a dynamic syndrome affected by several socio-demographic factors and geriatric factors.The results of the study can be used in the prevention of frailty progress in the elderly in communities.

Investigation of chronic disease and geriatric syndrome in hospitalized elderly patients with multimorbidity / 中华老年医学杂志

Objective To investigate the distribution of chronic disease and geriatric syndrome in hospitalized elderly patients with multimorbidity by chronic disease investigation and comprehensive geriatric assessment.Methods A total of 176 patients aged ≥60 years admitted into the geriatric department in our hospital were selected,and demographic factors were collected.Their chronic diseases and geriatric syndrome were recorded.The comprehensive geriatric assessment was consummated,and the biochemical indicators for chronic disease and geriatric syndrome were detected.Results All patients suffered from two or more kinds of chronic diseases.The top three most common diseases were hypertension (112 cases),diabetes (94 cases),and respiratory diseases (73cases).The sum of chronic diseases kinds were ≥3 in 137 patients,≥4 in 78 patients,≥5 in 40 patients.The amount of chronic diseases showed an increased tendency along with ageing.Totally 175 patients had more than one geriatric syndrome,the top three most common types were frailty and prefrailty(133 cases),visual impairment (117 cases),impaired daily activities (107 cases).There were significant differences in the number of geriatric syndrome among different age groups(x2 =16.989,P ＜ 0.001).Spearman analysis showed that the number of patients with geriatric syndrome were positively correlated with age(r =0.307,P＜0.001).Conclusions The prevalence of chronic disease and geriatric syndrome is high in hospitalized elderly patients with multimorbidity,which is increased with aging.We should pay attention to the screening of chronic disease and geriatric syndrome in multimorbid elderly patients

Three-dimensional speckle tracking technique in quantitative evaluation of left ventricular systolic function in patients with subclinical hyperthyroidism / 中国医学影像技术

Objective: To investigate the value of three-dimensional speckle tracking imaging (3D-STI) in evaluation of left ventricular systolic function in patients with subclinical hyperthyroidism (SH). Methods: Totally 33 untreated SH patients (SH group) and 35 healthy volunteers (control group) with matched sex and age were enrolled. All the subjects underwent laboratory examination, routine ultrasound and 3D-STI examination. The indexes including thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free thyroxine (FT4), left atrial diameter (LAD), interventricular septal thickness (IVST), left ventricle diameter of end-diastolic (LVEDD), left ventricle diameter of end-systolic (LVEDS), left ventricular ejection fraction (LVEF), longitudinal, radial and area peak strains of the left ventricle as a whole and 17 segments were compared between the two groups. Results: There were significant differences of TSH, T4 and FT4 between SH group and control group (all P0.05). The area peak strain of left ventricular medial inferior wall and apical inferior wall, radial peak strain of apical inferior wall and apical cap had no statistically significant difference between SH group and control group (all P>0.05), while the peak strain of whole heart and other segments in SH group were lower than that in control group (all P<0.05). Left ventricular global area peak strain in SH patients positively correlated with TSH (r=0.82, P<0.01) and negatively correlated with FT4 (r=-0.67, P<0.01). Conclusion: 3D-STI can quantitatively evaluate left ventricular systolic function in SH patients at an early stage, and the strain values of left ventricular segments in these patients decrease diffusely.

TLR/NF-κB independent signaling pathway in TNF-α suppression of diabetic MyD88-knockout mice after polysaccharides administration / 浙江大学学报·医学版

OBJECTIVE@#: To investigate the effect of polysaccharides (LBPs) on TLR/NF-κB independent pathway and serum tumor necrosis factor (TNF-α) level in diabetic MyD88-knockout mice.@*METHODS@#: Diabetes was induced by feeding high-fat/high-sugar diet and injection of low-dose streptozotocin in MyD88-knockout mice. The diabetic mice were randomly divided into model group, positive control group and LBPs group. The expressions of TRAM, TRIF, TRAF6, RIP1 and TNF-α mRNA and proteins in mouse peritoneal macrophages were detected by real-time RT-PCR and Western blotting after LBPs treatment for 3 month. Serum TNF-α was determined with ELISA kit.@*RESULTS@#: Real time RT-PCR showed that compared with model group, the relative expressions of and mRNA in macrophages of LBPs group were significantly decreased and expression of was significantly increased (all 0.05).@*CONCLUSIONS@#: LBPs may not inhibit serum TNF-α level through TLR/NF-κB independent pathway.

Effect of frailty syndrome on falls in Chinese elderly diabetics in the communities: a prospective cohort study / 中华流行病学杂志

Objective To explore the relationship between frailty syndrome and falls in the elderly diabetics,in the communities.Methods A three-year cohort study involving 653 community-dwelling adults who were over 65 years of age and participated in the Survey of Disease,Psychological and Social Needs in Dujiangyan Pingyi Community.Diabetic patients would include those who self-reported as having histories of diabetes or on anti-hyperglycemic therapies.Frailty,functional and other geriatric status were assessed respectively.Falls was defined as having had multiple falls or at least one event but with injury.Results The highest prevalence of falls was found in the group of frail diabetic group (62.5％).Data showed that baseline frailty was associated with falls in both diabetic and non-diabetic groups but the odds ratio in the diabetic group was higher than that of the non-diabetic group (OR=3.87,95％ CI:1.45-10.28 vs.OR=6.68,95％ CI:1.14-38.99).Conclusion Frailty could be used as a strong clinical predictor to prevent falls,for the elderly diabetic Chinese living in the communities.

Effect of frailty syndrome on falls in Chinese elderly diabetics in the communities: a prospective cohort study / 中华流行病学杂志

Objective To explore the relationship between frailty syndrome and falls in the elderly diabetics,in the communities.Methods A three-year cohort study involving 653 community-dwelling adults who were over 65 years of age and participated in the Survey of Disease,Psychological and Social Needs in Dujiangyan Pingyi Community.Diabetic patients would include those who self-reported as having histories of diabetes or on anti-hyperglycemic therapies.Frailty,functional and other geriatric status were assessed respectively.Falls was defined as having had multiple falls or at least one event but with injury.Results The highest prevalence of falls was found in the group of frail diabetic group (62.5％).Data showed that baseline frailty was associated with falls in both diabetic and non-diabetic groups but the odds ratio in the diabetic group was higher than that of the non-diabetic group (OR=3.87,95％ CI:1.45-10.28 vs.OR=6.68,95％ CI:1.14-38.99).Conclusion Frailty could be used as a strong clinical predictor to prevent falls,for the elderly diabetic Chinese living in the communities.

Application of cerebral venous sinus pressure measurement in guiding stent angioplasty for venous sinus stenosis: evaluation of its curative effect / 介入放射学杂志

Objective To evaluate the efficacy of cerebral venous sinus pressure measurement with a microcatheter in guiding stent angioplasty for the treatment of venous sinus stenosis.Methods A total of 42 patients with idiopathic intracranial hypertension (IIH) complicated by localized venous sinus stenosis were enrolled in this study.Microcatheter venous sinus venography with DSA and venous sinus pressure measurement were performed in all patients.Of the 42 patients,the pressure difference between the distal end and the proximal end of venous sinus ＞12 mmHg was found in 32,for whom balloon dilatation together with stent angioplasty was carried out.The venous sinus pressure was measured again after the treatment.The improvement of postoperative clinical symptoms was evaluated.The occurrence of complications,the symptom relapse and the patency of venous sinus were checked up.Results Successful venous sinus stent angioplasty was achieved in all 32 patients.The symptoms of intracranial hypertension were remarkably relieved,and no procedure-related complications occurred.The postoperative pressure difference between the distal end and the proximal end of venous sinus was significantly different from the preoperative one (P＜0.05),and the pressure showed a parallel correlation with the pressure of lumbar puncture.One week after the treatment,the headache was strikingly rclieved although visual acuity showed no obvious improvement.The patients were followed up for 12 months,no recurrence of clinical symptoms was seen,and magnetic resonance venography (MRV) or DSA examination showed that venous sinus blood flow was unobstructed and no restenosis was detected.Conclusion For the treatment of IIH stenosis complicated by localized venous sinus stenosis,endovascular stent angioplasty is relatively safe and effective,and the cerebral venous sinus pressure measurement with a microcatheter is of clinical significance for the selection of suitable patients as well as for the evaluation of curative effect.

Questionnaire investigation of the awareness of doctors' attitude to geriatric syndrome in old patients with cancer / 中华老年医学杂志

Objective To improve the quality of the management of the elderly patients with cancer in Sichuan province,and to understand the attitudes and perspectives of elderly surgeons and oncologists for the management and treatment of elderly patients with cancer.Methods A face-toface questionnaire interview was conducted with oncologists (n 64) and geriatricians (n =64).128 physicians were involved in this study.Results The cancer management and therapeutics were deemed appropriate at present by 9.38％ (6/64)of the geriatricians and 25.00％ (16/64)of the oncologists.The 39.06％ (25/64) of geriatricians used to notice geriatric syndromes,while 81.25％ (52/64)of oncologists never concerned about the geriatric syndrome(P=0.011).As for the causes of the therapy-associated toxicity,oncologist versus geriatrician payed an attention to malnutrition (100.00％ vs.100.00％ in both groups),to mobility disorders(65.63％ vs.65.63％,84/128 in both groups),to cognitive impairment/mood disorder (89.06％ in geriatrician group vs.75.00％ in oncologist group,P=0.038).For the factors affecting treatment decisions,a physical ability attention (oncologists vs geriatricians:70.31％ vs.92.19％;P =0.002),and comorbidity (oncologists vs geriatricians:62.50％ vs.79.69％,P =0.032) had statistically significant difference.In addition,lack of geriatrics knowledge was also reported by more oncologists.However,one hundred percent of participants wanted very much to cooperate with each other in their clinical work.When responding to the clinical scenario,the 10.94％ (7/64)of geriatricians and 32.81％ (21/64)of oncologists chose modified treatment for 65-74 years old patient with cancer(P =0.003).When the age of the patients was 75-84 years old,only 12.50 ％ (8/64) of geriatricians prefer end-of-life care,while 31.25 ％ (20/64) of oncologists chose it (P =0.010).Conclusions Selection of treatment decisions in the elderly patients with cancer affect by ageing.Both oncologists and geriatricians are concerned with the elderly patients with cancer,ageing syndrome,total sickness and functional status.And these doctors support an establishment of a multi disciplinary team cooperation for the elderly patients with cancer.Therefore,the establishment of mutual cooperation between the two professionals is necessary and feasible.

The study on the expression of the p-CREB in a rat model of chronic mild stress.WANG Lingxiao, PENG / 中国神经精神疾病杂志

Objective To better understand the role of CREB signaling pathway in chronic mild stress (CMS), we investigated the alteration of CREB and p-CREB in CMS rats with and without fluoxetine hydrochloride. Methods Fifty adult male Sprague-Dawley rats were randomly divided into three groups:CMS group (26), fluoxtine group (12) and con-trol group (12). The rats in CMS group and fluoxtine group received 8 weeks of chronic mild stress. Rats in fluoxtine group were administered daily injections of fluoxetine 10mg/kg I.P. Sucrose preference tests and open-field test were car-ried out after the 8th week. Based on endpoint sucrose-intake, animals were further divided into 4 groups:CMS sensitive group, CMS resilient group, fluoxtine group and control group. Western blot was used to detect the expression levels of CREB and p-CREB in the hippocampus and prefrontal cortex. Results The sucrose consumption was significantly de-creased in CMS resilience group compared to sensitive group, control group and fluoxetine-intervention group (all P<0.05). Similarly, the numbers in total arm entries, percentage of entries into open arms and time spent in open arms was significantly lower in CMS resilience group compared to control group(all P<0.05), but not different compared to CMS sensitive group(all P<0.05). The p-CREB in the hippocampus was significantly lower in CMS sensitive rat compared to CMS resilience group, control group and fluoxetine-intervention group(all P<0.05), but CREB was not dfferent among the four groups(all P<0.05). Conclusions The elevated phosphorylation of CREB in the hippocampus and prefrontal cortex of resilience CMS rats may contribute to the mood alteration induced by stress.

Competitiveα-amino-3-hydroxyl-5-methyl-4-isoxazole propionic acid receptor antagonists:research advances / 国际药学研究杂志

α-Amino-3-hydroxyl-5-methyl-4-isoxazole propionic acid (AMPA) receptor, a subtype of ionotropic glutamate receptors widely distributed in the central nervous system, mediates the fast excitatory neurotransmission. Meanwhile more and more evidence indicates that AMPA receptor plays an important role in synaptic plasticity as well as central sensitization, and it also has close relationships with nervous system diseases. Over stimulation of AMPA receptor would produce excitotoxicity, leading to neuronal damage and finally resulting in a multitude of nervous system diseases, such as epilepsy, amyotrophic lateral scelerosis,Parkinson′s dis-ease. Competitive AMPA receptor antagonists that downregulate AMPA receptor′s function are of great importance in the prevention and treatment of nervous system diseases. This article reviews the research advances of competitive AMPA receptor antagonists.

Association of plasma t-PA and PAI-1 with carotid atherosclerosis in patients with type 2 diabetes / 中华内分泌代谢杂志

The association of plasma tissue type plasmingogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) with carotid atherosclerosis in patients with type 2 diabetes was explored.The subjects with type 2 diabetes (n =91) and control subjects (n =30) were enrolled for this study.According to carotid artery intima media thickness in Color Doppler Ultrasonography,the subjects with type 2 diabetes were divided into four groups:normal carotid group(group 1,n =25),lining thickening group (group 2,n =30),stable plaques group (group 3,n =23),carotid stenosis group(group 4,n =13).Plasma t-PA and PAI-1 levels were measured by ELISA.Compared with the control group,there was no significant change in the levels of plasma t-PA and PAI-1 in group 1 (P＞0.05),plasma t-PA activity was decreased significantly(P＜0.05) and PAI-1 activity increased obviously (P＜0.05) in group 2,group 3,and group 4.Carotid atherosclerosis degree was negatively correlated with t-PA(r=-0.723,P＜0.01) and positively correlated with PAI-1 (r=0.851,P＜0.01).The results suggested that the abnormal fibrinolysis function may take part in the development of atherosclerosis of carotid arteries in patients with type 2 diabetes.