Clinical characteristics and risk factors of COVID-19 patients with chronic hepatitis B: a multi-center retrospective cohort study / 医学前沿

The Coronavirus disease 2019 (COVID-19) has spread globally. Although mixed liver impairment has been reported in COVID-19 patients, the association of liver injury caused by specific subtype especially chronic hepatitis B (CHB) with COVID-19 has not been elucidated. In this multi-center, retrospective, and observational cohort study, 109 CHB and 327 non-CHB patients with COVID-19 were propensity score matched at an approximate ratio of 3:1 on the basis of age, sex, and comorbidities. Demographic characteristics, laboratory examinations, disease severity, and clinical outcomes were compared. Furthermore, univariable and multivariable logistic and Cox regression models were used to explore the risk factors for disease severity and mortality, respectively. A higher proportion of CHB patients (30 of 109 (27.52%)) developed into severe status than non-CHB patients (17 of 327 (5.20%)). In addition to previously reported liver impairment markers, such as alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total bilirubin, we identified several novel risk factors including elevated lactate dehydrogenase (⩾ 245 U/L, hazard ratio (HR) = 8.639, 95% confidence interval (CI) = 2.528-29.523; P < 0.001) and coagulation-related biomarker D-dimer (⩾ 0.5 µg/mL, HR = 4.321, 95% CI = 1.443-12.939; P = 0.009) and decreased albumin (< 35 g/L, HR = 0.131, 95% CI = 0.048-0.361; P < 0.001) and albumin/globulin ratio (< 1.5, HR = 0.123, 95% CI = 0.017-0.918; P = 0.041). In conclusion, COVID-19 patients with CHB were more likely to develop into severe illness and die. The risk factors that we identified may be helpful for early clinical surveillance of critical progression.

Melatonin Alleviates Cardiac Dysfunction Via Increasing Sirt1-Mediated Beclin-1 Deacetylation and Autophagy During Sepsis.

Cardiac dysfunction is a major cause leading to multiple organ failure in sepsis. Beclin-1-dependent autophagy has been evidenced to exert protective effects on hearts in sepsis. However, the mechanisms on how Beclin-1 and autophagy are regulated remains enigmatic. To explore the detailed mechanisms controlling Beclin-1-dependent autophagy in septic heart and whether melatonin could protect against sepsis via regulating cardiac autophagy, adult Sprague-Dawley (SD) rats were subjected to cecal ligation and puncture (CLP) to induce sepsis. Rats were intraperitoneally administrated with 30 mg/kg melatonin within 5-min post-CLP surgery. Our data showed that sepsis induced Becline-1 acetylation and inhibited autophagy in hearts, resulting in impaired cardiac function. However, melatonin treatment facilitated Beclin-1 deacetylation and increased autophagy in septic hearts, thus improved cardiac function. Moreover, melatonin increased the expression and activity of Sirtuin 1 (Sirt1), and inhibition of Sirt1 abolished the protective effects of melatonin on Beclin-1 deacetylation and cardiac function. In conclusion, increased Beclin-1 acetylation was involved in impaired autophagy in septic hearts, while melatonin contributed to Beclin-1 deacetylation via Sirt1, leading to improved autophagy and cardiac function in sepsis. Our study sheds light on the important role of Beclin-1 acetylation in regulating autophagy in sepsis and suggests that melatonin is a potential candidate drug for the treatment of sepsis.

Effect of Electroacupuncture at Fengchi on Astrocytes and Neurons in Rats with Acute Cerebral Infarction / 中国康复理论与实践

Objective:To investigate the effect of electroacupuncture at Fengchi (GB20) on astrocytes and neurons in rats with acute cerebral infarction. Methods:A total of 64 male Sprague-Dawley rats were randomly divided into sham group (n = 16), model group (n = 16), non-acupoint group (n = 16) and Fengchi group (n = 16). The latter three groups were modeled with middle cerebral artery occlusion (MCAO), and the latter two groups were treated with electroacupuncture after modeling, at the point near Fengchi and Fengchi, respectively, for seven days. All the rats were assessed with neurological deficit score after treatment, while the cerebral infarction area and water content were measured, the histopathology of hippocampus was observed by HE staining, the expression levels of brain-derived neurotrophic factor (BDNF), glial fibrillary acidic protein (GFAP) and neuron-specific enolase (NSE) in hippocampus were detected with ELISA, the apoptosis of brain neurons were measured with TUNEL, and the expression levels of caspase-3 and Bcl-2 in brain homogenate were detected with Western blotting and reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR). Results:Compared with the sham group, the neurological deficit score, cerebral infarction area and water content increased significantly (P < 0.05) in the other groups; while the the expression of GFAP and NSE in hippocampus increased (P < 0.05) and the expression of BDNF decreased (P < 0.05); the number of apoptosis in hippocampus increased (P < 0.05), and the expression of caspase-3 increased (P < 0.05) and the expression of Bcl-2 decreased (P < 0.05). Compared with the model group and non-acupoint group, the neurological deficit score, cerebral infarction area and water content decreased in the Fengchi group (P < 0.05); while the the expression of GFAP and NSE in hippocampus decreased (P < 0.05) and the expression of BDNF increased (P < 0.05); the number of apoptosis in hippocampus decreased (P < 0.05), and the expression of caspase-3 decreased (P < 0.05) and the expression of Bcl-2 increased (P < 0.05). Conclusion:Electroacupuncture at Fengchi can protect the brain from acute cerebral infarction, adjust the expression of GFAP, NSE and BDNF, and reduce the neuronal apoptosis.

Aretrospective cohort study of pregnancy after kidney transplantation / 中华器官移植杂志

Objective:To evaluate the safety of pregnancy after kidney transplantation and summarize the optimal timing of pregnancy and the experience in the management during pregnancy and peripartum.Methods:A total of 25 kidney transplant recipients were pregnant during March 2013 to February 2020. A matched cohort of 75 general pregnant women wasincluded as control.Results:Twenty-five women successfully delivered healthy babies in the transplant group. The mean age at kidney transplantationwas (25.6 ±3.2) years old, and the mean interval between transplantation and conception was (54.0±23.1) months. 92% (23 / 25) of recipients had cesarean surgery and all infants were singletons.During pregnancy, the incidence of preeclampsia was significantly higher in the transplant group(20.0%VS. 1.3%, P=0.001)compared with matched control. Compared with pre-pregnancy, the serum creatinine levels of the recipients decreased in the second trimester( P<0.001)and increased in the third trimester( P=0.019), which was similar with the control group. In the third trimester, 40%(10/25)of recipients in the transplant group had proteinuria, which decreased to negative(5/10) or 1+ (4/10) within 6 months after delivery. No rejection occurred in all patients during pregnancy and 6 months after delivery. A higher dose of tacrolimus was needed to maintain the normal trough level after pregnancy, which returned to routine dose postpartum. Conclusions:Although the risk of pregnancy was higher in kidney transplant recipients than that in non-transplant women, the overall risk was acceptable. Strict screening of patients preparing for pregnancy, adjustment of immunosuppressive drugs, and multi-disciplinary collaboration are important for safe pregnancy and delivery.

No Statistically Apparent Difference in Antiviral Effectiveness Observed Among Ribavirin Plus Interferon-Alpha, Lopinavir/Ritonavir Plus Interferon-Alpha, and Ribavirin Plus Lopinavir/Ritonavir Plus Interferon-Alpha in Patients With Mild to Moderate Coronavirus Disease 2019: Results of a Randomized, Open-Labeled Prospective Study.

BACKGROUND: Currently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally, causing an unprecedented pandemic. However, there is no specific antiviral therapy for coronavirus disease 2019 (COVID-19). We conducted a clinical trial to compare the effectiveness of three antiviral treatment regimens in patients with mild to moderate COVID-19. METHODS: This was a single-center, randomized, open-labeled, prospective clinical trial. Eligible patients with mild to moderate COVID-19 were randomized into three groups: ribavirin (RBV) plus interferon-α (IFN-α), lopinavir/ritonavir (LPV/r) plus IFN-α, and RBV plus LPV/r plus IFN-α at a 1:1:1 ratio. Each patient was invited to participate in a 28-d follow-up after initiation of an antiviral regimen. The outcomes include the difference in median interval to SARS-CoV-2 nucleic acid negativity, the proportion of patients with SARS-CoV-2 nucleic acid negativity at day 14, the mortality at day 28, the proportion of patients re-classified as severe cases, and adverse events during the study period. RESULTS: In total, we enrolled 101 patients in this study. Baseline clinical and laboratory characteristics of patients were comparable among the three groups. In the analysis of intention-to-treat data, the median interval from baseline to SARS-CoV-2 nucleic acid negativity was 12 d in the LPV/r+IFN-α-treated group, as compared with 13 and 15 d in the RBV+IFN-α-treated group and in the RBV+LPV/r+ IFN-α-treated group, respectively (p=0.23). The proportion of patients with SARS-CoV-2 nucleic acid negativity in the LPV/r+IFN-α-treated group (61.1%) was higher than the RBV+ IFN-α-treated group (51.5%) and the RBV+LPV/r+IFN-α-treated group (46.9%) at day 14; however, the difference between these groups was calculated to be statistically insignificant. The RBV+LPV/r+IFN-α-treated group developed a significantly higher incidence of gastrointestinal adverse events than the LPV/r+ IFN-α-treated group and the RBV+ IFN-α-treated group. CONCLUSIONS: Our results indicate that there are no significant differences among the three regimens in terms of antiviral effectiveness in patients with mild to moderate COVID-19. Furthermore, the combination of RBV and LPV/r is associated with a significant increase in gastrointestinal adverse events, suggesting that RBV and LPV/r should not be co-administered to COVID-19 patients simultaneously. CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, ID: ChiCTR2000029387. Registered on January 28, 2019.

The exploration on clinical value of MRI fat quantification in patients with thyroid associated ophthalmopathy / 中华内分泌代谢杂志

Objective:To quantify the fat of extraocular muscle in TAO patients with MRI fat-water separation technique.Methods:66 patients (129 eyes) with TAO were included in this study from November 2017 to July 2019. The age, gender, course of disease, disease activity and severity were collected. Fat fraction(FF) of the heaviest inflamed extraocular muscle was used as FFmax, the average FF of each orbital was recorded as FFmean. FF differences between groups of severity and activity were compared, the correlation between FF and clinical characteristics was also analyzed. Meanwhile, the changes of FF in follow-up patients before and after treatment were compared.Results:FFmean and FFmax of mild group were higher than moderate-to-severe as well as sight-threatening group. In male patients, active group′s FFmean and FFmax were lower. FF was different in groups which based on disease course ( P<0.05). Spearman correlation analysis showed a positive correlation between FF and disease course. Besides, there was a negative correlation between FF, disease activity, and disease severity ( P < 0.05). FF increased after treatment(FFmean: 34.03%±6.75% vs 32.26%±6.06%, P=0.040; FFmax: 33.43%±9.44% vs 29.04%±8.45%, P=0.006). Conclusion:MRI fat fraction can quickly and objectively quantify the fat of extraocular muscle, providing a new reference index for TAO′s disease evaluation.

Impact of catheter-tissue contact force on lesion size during right ventricular outflow tract ablation in a swine model / 中华医学杂志(英文版)

BACKGROUND@#The catheter-tissue contact force (CF) is one of the significant determinants of lesion size and thus has a considerable impact on the effectiveness of ablation procedures. This study aimed to evaluate the impact of CF on the lesion size during right ventricular outflow tract (RVOT) ablation in a swine model.@*METHODS@#Twelve Guangxi Bama miniature male pigs weighing 40 to 50 kg were studied. After general anesthesia, a ThermoCool SmartTouch contact-sensing ablation catheter was introduced to the RVOT via the femoral vein under the guidance of the CARTO 3 system. The local ventricular voltage amplitude and impedance were measured using different CF levels. We randomly divided the animals into the following four groups according to the different CF levels: group A (3-9 g); group B (10-19 g); group C (20-29 g); and group D (30-39 g). Radiofrequency ablations were performed at three points in the free wall and septum of the RVOT in power control mode at 30 W for 30 s while maintaining the saline irrigation rate at 17 mL/min. At the end of the procedures, the maximum depth, surface diameter, and lesion volume were measured and recorded. A linear regression analysis was performed to determine the relationship between continuous variables.@*RESULTS@#A total of 72 ablation lesions were created in the RVOT of the 12 Bama pigs. The maximum depth, surface diameter, and volume of the lesions measured were well correlated with the CF (free wall: β = 0.105, β = 0.162, β = 3.355, respectively, P < 0.001; septum: β = 0.093, β = 0.150, β = 3.712, respectively, P < 0.001). The regional ventricular bipolar voltage amplitude, unipolar voltage amplitude, and impedance were weakly positively associated with the CF (β = 0.065, β = 0.125, and β = 1.054, respectively, P < 0.001). There was a significant difference in the incidence of steam pops among groups A, B, C, and D (free wall: F = 7.3, P = 0.032; septum: F = 10.5, P = 0.009); and steam pops occurred only when the CF exceeded 20 g. Trans-mural lesions were observed when the CF exceeded 10 g in the free wall, while the lesions in the septum were non-trans-mural even though the CF reached 30 g.@*CONCLUSIONS@#CF seems to be a leading predictive factor for the size of formed lesions in RVOT ablation. Maintaining the CF value between 3 and 10 g may be reasonable and effective for creating the necessary lesion size and reducing the risk of complications, such as steam pops and perforations.

Comparative characterization of putative chitin deacetylases from Tetranychus cinnabarinus.

Considering the challenges of controlling carmine spider mite and protecting pollinators, chitin deacetylase genes (TecCDA1 and TecCDA2) of spider mite were characterized as group I, and were expressed in stage-specific pattern, which imply their role during development. The differences in sequences and structures between T. cinnabarinus and honeybee CDAs offer possibilities to design new selective pesticides protecting pollinator honeybees.

Evaluation of quality of life in patients with Graves orbitopathy and its influencing factors / 中华内科杂志

Objective To evaluate life quality of Graves orbitopathy (GO) patients using Graves orbitopathy quality-of-life questionnaire (GO-QOL) and explore the influence factors of the quality of life of GO patients.Methods This was a cross-sectional study conducted at The Third Affiliated Hospital of Southern Medical University including 145 newly diagnosed GO patients.All the patient answered the GO-QOL and underwent ophthalmic and endocrine assessments.The main outcome measures were the scores on GO-QOL 2 subscales:visual functioning and appearance.Based on the classification in the guideline of European Group on Graves Orbitopathy (EUGOGO),the patients were divided into two groups:mild and moderate to severe groups.Then the scales between these two groups were compared and influencing factors were analyzed.Finally,the floor and ceiling effects were assessed.Results The GO-QOL scores for the subscales of visual functioning and appearance were 70.91±27.83 and 61.29±26.37 respectively in 145 GO patients.Visual functioning and appearance were lower in moderate to severe group (62.71 ±28.77 and 57.52 ± 26.49,respectively) than in mild group (85.58 ± 18.77 and 68.02 ±24.99,respectively).The GO-QOL scores for the visual functioning subscale were significantly correlated with age (P =0.002),clinical active score (P =0.011) and the degree of diplopia (P =0.00,R2=0.373).The GO-QOL scores for the appearance were significantly correlated with sex (P =0.05) and thyroid-stimulating hormone levels (P =0.001,R2 =0.231).No significant ceiling or floor effects were observed for either subscale of the GO-QOL.Conclusions With the aggravation of the disease,the quality of life of GO patients is getting worse and worse.The main influencing factors of the quality of life of GO patients include age,gender,diplopia,clinical active score and thyroid-stimulating hormone levels.Close attention needs to be paid to the quality of life of GO patients.

Clinical Study on Mind-regulating Acupuncture in Treating Primary Trigeminal Neuralgia / 上海针灸杂志

Objective To observe the clinical efficacy of mind-regulating acupuncture in treating primary trigeminal neuralgia.Method Sixty-one patients with primary trigeminal neuralgia were randomized into a treatment group of 31 cases and a control group of 30 cases by using random number table method. The control group was intervened by oral administration of Carbamazepine, while the treatment group was additionally given mind-regulating acupuncture. The pain intensity, pain flare-up frequency and quality of life in the two groups were evaluated before and after the treatment, and the clinical efficacies were compared.Result The total effective rate was 90.3％ in the treatment group, versus 70.0％ in the control group, and the between-group difference was statistically significant (P<0.05). The pain score, pain flare-up frequency and quality of life score after the treatment were significantly different from those before the treatment in both groups (P<0.05); there were no significant between-group differences in comparing the pain score and flare-up frequency after the treatment (P>0.05); there was significant between-group difference in comparing the quality of life score after the treatment(P<0.05). The pain score, pain flare-up frequency and quality of life score at the 6-month follow-up were significantly different from those before and after the treatment in both groups (P<0.05); there were significant between-group differences in comparing the pain score, flare-up frequency and the quality of life score at the 6-month follow-up (P<0.05). Conclusion Mind-regulating acupuncture can produce a significant efficacy in treating primary trigeminal neuralgia and obviously enhance the quality of life.

Preparation and evaluation of photo-sensitive reactive oxygen species responsive liposomes / 药学学报

Photo-sensitive reactive oxygen species (ROS) responsive liposomes loaded with 1,4,8,11,15, 18,22,25-octabutoxypalladium phthalocyanine[PdPC(OBu)8] and doxorubicin hydrochloride (DOX) (LPD) were prepared by (NH4)2SO4-gradient method. LPD was characterized with transmission electron microscopy (TEM), dynamic light scattering particle size, zeta potentials, photo-sensitive ROS-responsive DOX release behaviors and the serum stability in vitro. LPD cytotoxicity, DOX uptake and singlet oxygen production in MCF-7 cells were evaluated. The results showed that the particle size of LPD was (169.3 ±1.2) nm, PDI of LPD was 0.198 ±0.003 and zeta potentials of LPD was (-39.8 ±0.8) mV. The accumulated release of DOX reached 95.5% in 5 min under 730 nm laser irradiation (300 mW·cm-2). The DOX uptake of liposome was increased and 1O2 was generated. The half inhibition concentration (IC50) of DOX in LPD with irradiation group was decreased by 85.7% and no irradiation group was decreased by 67.9% compared with free DOX group in MCF-7 cells. Therefore, photo-sensitive ROS-responsive liposomes would be a promising drug delivery system for tumor therapy.

Recent progress of reactive oxygen species-responsive drug delivery systems / 药学学报

Excessive reactive oxygen species (ROS) is associated with an array of pathological conditions, including cancer, diabetes, cardiovascular diseases, and neurodegenerative diseases. However, ROS-responsive materials have drawn attention in the development of drug delivery systems. There are many types of ROS-responsive materials explored in drug delivery applications, including sulfur-based responsive polymers, selenium-based responsive polymers, tellurium-based responsive polymers, oxalate ester-containing polymers, phenylboronic ester-containing polymers and unsaturated lipids. When integrated with ROS-responsive drug delivery systems, a photosensitizer is used as a light-sensitive element to generate ROS, mainly singlet oxygen (1O2), which in turn activates the ROS-triggered drug delivery.

Clinical Study on Mind-regulating Acupuncture in Treating Primary Trigeminal Neuralgia / 上海针灸杂志

Objective To observe the clinical efficacy of mind-regulating acupuncture in treating primary trigeminal neuralgia.Method Sixty-one patients with primary trigeminal neuralgia were randomized into a treatment group of 31 cases and a control group of 30 cases by using random number table method. The control group was intervened by oral administration of Carbamazepine, while the treatment group was additionally given mind-regulating acupuncture. The pain intensity, pain flare-up frequency and quality of life in the two groups were evaluated before and after the treatment, and the clinical efficacies were compared.Result The total effective rate was 90.3％ in the treatment group, versus 70.0％ in the control group, and the between-group difference was statistically significant (P<0.05). The pain score, pain flare-up frequency and quality of life score after the treatment were significantly different from those before the treatment in both groups (P<0.05); there were no significant between-group differences in comparing the pain score and flare-up frequency after the treatment (P>0.05); there was significant between-group difference in comparing the quality of life score after the treatment(P<0.05). The pain score, pain flare-up frequency and quality of life score at the 6-month follow-up were significantly different from those before and after the treatment in both groups (P<0.05); there were significant between-group differences in comparing the pain score, flare-up frequency and the quality of life score at the 6-month follow-up (P<0.05). Conclusion Mind-regulating acupuncture can produce a significant efficacy in treating primary trigeminal neuralgia and obviously enhance the quality of life.

Clinical analysis of rhabdomyolysis syndrome caused by alcohol withdrawal syndrome / 中国医师进修杂志

Objective To analyze the characteristics of rhabdomyolysis (RM) caused by alcohol withdrawal syndrome (AWS). Methods The clinical data of 7 patients with RM induced by AWS were analyzed retrospectively. Results All 7 patients were male;the age was 38-63 (51.3 ± 9.8) years. All of the 7 patients showed obvious myalgia and fatigue, of whom 4 patients had limb swelling, and 3 patients had epigastric pain. Creatine kinase and myoglobin levels of 7 cases were significantly increased. One case had acute renal failure. Seven patients were improved after treatment with a large amount of fluid infusion. Conclusions For patients with AWS who have generalized withdrawal seizures and epileptic seizures, muscle cells can be damaged due to prolonged muscle contraction, which can cause RM. Changes of myoglobin, creatine kinase, renal function and liver function in patients with AWS should be monitored at clinical admissions. If RM occurs, the patients should be given early fluid therapy.

Effects of tranexamic acid combined with temporary drain clamping on postoperative blood loss in total knee arthroplasty / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of one dose tranexamic acid combined with temporary drain lamping in primary unilateral total knee arthroplasty.</p><p><b>METHODS</b>Total 160 patients undergoing unilateral primary total knee arthroplasty between January 2012 and December 2013 were randomly divided into four groups(40 cases in each group):group A (the drain was clamped for 2 hours after the operation and the patients received 20 ml physiological saline), group B(the drain was clamped for 2 hours after the operation and the patients received 10 ml tranexamic acid and 10 ml physiological saline), group C (the drain was clamped for 4 hours after the operation and the patients received 20 ml physiological saline) and group D(the drain was clamped for 4 hours after the operation and the patients received 10 ml tranexamic acid and 10 ml physiological saline). The postoperative hemoglobin level, maximum hemoglobin loss, wound drainage, blood loss, the volume of blood transfusion, the number of patients inquiring blood transfusion, venous thrombo embolism rate, and ecchymosis rate were recorded and compared among the four groups.</p><p><b>RESULTS</b>There was no incision infection, severe hypoxia, and symptomatic pulmonary embolism in these groups. There were significant differences in hemoglobin content one day after operation in each group(=12.26,=0.000), in the hemoglobin content 7 days after operation in each group(=20.74,=0.000), in postoperative drainage in each group(=38.71,=0.000);in the amount of invisible red blood cell loss in each group(=83.41,=0.000), and in total red blood cell loss in each group(=102.68,=0.000). Color Doppler ultrasound examination found that the total incidence of VTE was 3%(5/160) and there were no significant differences in each group(=0.892). There were no significant differences in postoperative subcutaneous ecchymosis area>1% incidence(=0.143).</p><p><b>CONCLUSIONS</b>Topical tranexami acid treatment combined with temporary clamping of drain for 4 hours could reduce postoperative blood loss, blood transfusion, and ecchymosis rate without increasing the risk of thromboembolic event after total knee arthroplasty.</p>

Expression and significance of Twist protein in colorectal cancer / 中华消化外科杂志

Objective To explore the expression of Twist protein in the colorectal cancer (CRC) and its relationship between clinicopathological factors and prognosis of patients.Methods The clinical data of 45 patients with colorectal cancer who were admitted to the First People's Hospital of Shunde from June 2005 to September 2005 were retrospectively analyzed.The colorectal tissue specimens from surgical resection were collected.The expressions of Twist protein in the cancer and paracarcinoma tissues were examined by the immunohistochemistry,and their relationship with clinicopathological factors and prognosis of patients was analyzed.Patients were followed up by outpatient examination and telephone interview until September 2013.The count data were analyzed using the chi-square test and Fisher exact probability.The survival curve was generated using the Kaplan-Meier method,and the survival analysis was conducted using the Log-rank test.The prognosis factors were analyzed by the COX univariate analysis and multivariate analysis.Results The expression of Twist protein in CRC was predominantly detected in the cytoplasm of the tumor cells.The positive expression rates of Twist protein in the CRC and paracarcinoma tissues were 62.2％ (28/45) and 20.0％ (9/45),respectively,with a significant difference (x2 =18.383,P ＜0.05).The positive expression rates of Twist protein were 42.1％ in patients with Ⅰ-Ⅱ stage of CRC and 76.9％ in patients with Ⅲ-Ⅳ stage of CRC.The positive expression rates of Twist protein were 41.7％in patients with N0 stage of CRC and 85.7％ in patients with N1-N2 stage of CRC.The expression of Twist protein in patients with CRC was however associated with the TNM stage and lymph node metastasis (x2=5.662,9.244,P ＜ 0.05).A total of 45 patients were followed up for 10-96 months (median,54 months).The median survival time and 5-year cumulative survival rate in 45 patients with positive expression of Twist protein were 44 months and 10.7％,which were compared with 69 months and 82.4％ in 45 patients with negative expression of Twist protein,with a statical significance in the survival (x2 =26.147,P ＜ 0.05).The results of univariate analysis showed that the expression of Twist protein was an related factor affecting the prognosis of patients [HR =8.669,95％ confidence interval (CI):2.959-25.390,P ＜0.05].The results of multivariate analysis showed that the positive expression of Twist protein was an independent risk factor affecting the prognosis of patients (HR =5.059,95 ％ CI:2.888-8.863,P ＜ 0.05).Conclusiors The increasing expression of Twist protein in the CRC is positively correlated with the occurrence and development of CRC.The positive expression of Twist protein is an independent risk factor affecting the prognosis of patients with CRC.

Posterior fossa decompression combined with resection of the cerebellomedullary fissure membrane and expansile duraplasty: a radical and rational surgical treatment for Arnold-Chiari type I malformation.

This study aims to introduce a new surgical procedure for the treatment of Arnold-Chiari type I malformation (ACM-1) and to compare its effectiveness with the techniques described in previous studies. We performed the following procedures: foramen magnum decompression combined with the removal of both the atlanto-occipital membrane, extended resection of the cerebellomedullary fissure arachnoid membrane, and artificial duraplasty to enlarge the membranic posterior fossa without resecting the cerebellar tonsils and syringosubarachnoid shunting. There were 21 ACM-1 patients: 12 cases had osteo-compression on the cerebellar hemisphere, 18 cases had thickened adhered fabric ring that stretched from arachnoid membrane to cerebellar hemisphere, and 15 cases with syringomyelia. The patients were followed up for 6 months to 3 years after the surgery. All patients showed a remarkable recovery of syringomyelia. There were no morbidity or death related to the surgery. Most of ACM-1 patients, the osteo- and membrane compression on cerebellar hemisphere and tonsil were observed during the operation. Therefore, decompression of foramen magnum and posterior craniocervical combined with the removal of cerebellomedullary fissure arachnoid membrane and placement of an artificial dural graft should be considered as a comprehensive option of minimally invasive surgery and rational and radical treatment of ACM-1. Our experience showed that, by using our procedure, shunting becomes no longer necessary in the treatment of ACM-1-associated syringomyelia.

Beam smoothing characteristics of multi-central frequency and multi-color smoothing by spectral dispersion.

A multi-central frequency and multi-color smoothing by spectral dispersion (SSD) scheme is presented for better beam smoothing than conventional SSD. One of the difficulties in conventional SSD is the narrow bandwidth limited by efficiency frequency conversion. The new scheme has overcome this problem by using multi-central frequency laser sources and a multi-color beam smoothing system. The multi-central frequency laser sources are incoherent combinations of several pulses in the time domain, each with different central frequencies and independent sinusoidal frequency-modulated components. Then, the laser beams from the multi-central frequency laser sources transmit in the multi-color smoothing system, spatially separated and independently spectrally dispersed by gratings array, independently achieve the third harmonic generation in KDP array with independent phase-matching for efficient conversion. Moreover, by adjusting the dispersion direction of the gratings to be perpendicular to each other, it is an effective way to achieve a 2D beam smoothing effect on the focal plane. Simulation results show that the novel beam smoothing scheme performs better than the conventional SSD.

The expression level of serum IL-7 and its influence on prognosis in patients with acute coronary syndrome / 心血管康复医学杂志

Objective: To explore the expression level of serum interleukin (IL)-7 in patients with acute coronary syndrome (ACS) and analyze the relationship between IL-7 level and prognosis. Methods: A total of 130 ACS patients [ACS group, including 70 cases with acute myocardial infarction (AMI) and 60 cases with unstable angina pectoris (UAP)], 33 cases with stable angina pectoris (SAP，SAP group) and 89 healthy subjects (healthy control group) were selected. IL-7 level was measured using enzyme linked immunosorbent assay (ELISA) and compared among all groups. The 130 ACS patients were followed up, and Logistic regression analysis was used to analyze the relationship between IL-7 level and prognosis. Results: Compared with healthy control group and SAP group, there was significant rise in IL-7 level in UAP group and AMI group [(1.84±0.47) pg/ml, (2.11±0.63) pg/ml vs. (4.87±0.52) pg/ml, (5.15±0.71) pg/ml, P0.05 both); Logistic regression analysis indicated that expression level of serum IL-7 was an independent risk factor for adverse cardiovascular events in ACS patients (OR=1.212, 95%CI:1.061-1.418). Conclusion: Interleukin-7, as an important inflammatory cytokines, its serum level abnormally elevated in patients with acute coronary syndrome, it may have important prognostic value.

Analysis of scatter plots and alarm information in 288 cases of newly diagnosed hematologic malignancies / 中国实验血液学杂志

This study was aimed to explore the role of full-automatic blood analyzer Sysmex XE-2100 in early screening and diagnosing the hematologic malignancies. A total of 288 samples of the patients with hematologic malignancies was examined. Then, the scatter plots, alarm information and blood smears were analyzed. The results indicated that 76% of these samples showed abnormal scatter plots. CMML and AML-M3 patients had their own characteristic scatter plots, while others hadnt's. The coincident rate of CMML and AML-M3 determined by scatter plots with practical diseases was 100%; the coincident rate of ALL determined by scatter plots with practical disease was 67%. The coincident rate of alarm information of blast cells was 92.5%, the coincident rate of immature granulocytes was 77.1%, the coincident rate of nucleated red blood cells was 33.3%, the coincident rate of atypical lymphocytes was 31.3%. It is concluded that the abnormal scatter plots and alarm information are very important for finding the patients with hematologic malignancies and determining the disease type. The alarm information has high reliability for blast cells and immature granulocytes, but has only mirror value for nucleated red blood cells and atypical lymphocytes.