Cavernous Sinus MRI Findings in Inflammatory and Ischemic Oculomotor Cranial Nerve Palsies.

BACKGROUND: The significance of asymmetric enhancement on cavernous sinus MRIs in the differential diagnosis of ischemic and inflammatory oculomotor cranial nerve (OCN) palsies remains controversial. This study explored the cavernous sinus MRI findings for cavernous sinus idiopathic inflammation (inflammation group), microvascular ischemic OCN palsy (ischemic group), and ocular myasthenia gravis (OMG group) patients. METHODS: A total of 66, 117, and 60 patients were included in the inflammation, ischemic, and OMG groups, respectively. Cavernous sinus MRIs were retrospectively analyzed. RESULTS: The abnormality rates of cavernous sinus MRIs for OMG and ischemic groups were 41.7% (25/60) and 61.5% (72/117), respectively. Inconsistency rates between clinical topical diagnosis and imaging findings for inflammation and ischemic groups were 3.0% (2/66) and 13.7% (16/117), respectively (P = 0.020). In the inflammation group, cavernous sinus thickness, thickening enhancement, and enhancing adjacent lesions were noted in 90.9% (60/66), 71.2% (47/66), and 25.8% (17/66) of the patients, whereas in the ischemic group, they were noted in 51.3% (60/117), 38.5% (45/117), and 0.9% (3/117) of the patients, respectively (P < 0.001). Among ischemic CN III palsy patients, 55.5% (15/27) and 16.7% (2/12) of the cases had CN III enlargement and enhancement in the diabetic and nondiabetic groups, respectively (P = 0.037). CONCLUSIONS: Cavernous sinus MRI abnormalities can be explained by specific pathologic mechanisms of the primary disease based on the complex neuroanatomy. However, suspicious inflammatory changes cannot exclude the possibility of ischemia and over reliance on these findings should be avoided.

TCN1 Deficiency Inhibits the Malignancy of Colorectal Cancer Cells by Regulating the ITGB4 Pathway

Background/Aims@#This study aimed to investigate the biological function and regulatory mechanism of TCN1 in colorectal cancer (CRC). @*Methods@#We studied the biological function of TCN1 by performing gain-of-function and loss-offunction analyses in HCT116 cell lines; examined the effects of TCN1 on the proliferation, apoptosis, and invasion of CRC cells; and determined potential molecular mechanisms using HCT116 and SW480 CRC lines and mouse xenotransplantation models. Tumor xenograft and colonization assays were performed to detect the tumorigenicity and metastatic foci of cells in vivo. @*Results@#TCN1 knockdown attenuated CRC cell proliferation and invasion and promoted cell apoptosis. Overexpression of TCN1 yielded the opposite effects. In addition, TCN1-knockdown HCT116 cells failed to form metastatic foci in the peritoneum after intravenous injection. Molecular mechanism analyses showed that TCN1 interacted with integrin subunit β4 (ITGB4) to positively regulate the expression of ITGB4. TCN1 knockdown promoted the degradation of ITGB4 and increased the instability of ITGB4 and filamin A. Downregulation of ITGB4 at the protein level resulted in the disassociation of the ITGB4/plectin complex, leading to cytoskeletal damage. @*Conclusions@#TCN1 might play an oncogenic role in CRC by regulating the ITGB4 signaling pathway.

Fetal RHD screening from circulating cell-free DNA in RhD-negative pregnant women / 中华围产医学杂志

Objective:To investigate the RHD genotypes of RhD-negative pregnant women and explore the optimum strategy for fetal RHD screening among this population in the region. Methods:This prospective study recruited 33 cases of RhD-negative singleton pregnancies at ≥12 weeks of gestation in Nanjing Drum Tower Hospital from March to November 2021. On the basis of RHD genotyping, quantitative real-time polymerase chain reaction (PCR) was used to amplify the exons 5 and 10 of RHD gene in the circulating cell-free DNA of RhD-negative pregnant women harboring whole RHD gene deletion and RHD-CE(2-9)- D. High-throughput sequencing was performed to detect chr1:25648453 locus from circulating cell-free DNA in plasma of RhD-negative pregnant women harboring RHD 1227A mutation to screen the fetal RhD blood group. Neonatal umbilical cord blood samples were collected for verifying fetal RHD genotyping. Descriptive statistical analysis was used. Results:Whole RHD gene deletion homozygous genotype ( n=20, 60.6%), RHD-CE(2-9) -D/whole RHD gene deletion heterozygous genotype ( n=5, 21.2%), RHD 1227A/whole RHD gene deletion heterozygous genotype ( n=7, 15.2%) and RHD 711delC/whole RHD gene deletion heterozygous genotype ( n=1) were identified in the 33 RhD-negative pregnant women. In the 25 cases with whole RHD gene deletion homozygous genotype or RHD-CE(2-9)- D/whole RHD gene deletion heterozygous genotype, 22 fetuses were RhD-positive and three were RhD-negative based on prenatal screening, which were confirmed by the neonatal serological test results after birth. In the seven cases carrying RHD 1227A/whole RHD gene deletion heterozygous genotype, all fetuses were RhD-positive, which were consistent with the results of serological detection after delivery. The case harboring RHD 711delC/whole RHD gene deletion heterozygous genotype did not receive fetal RHD screening. Conclusions:This study suggests that whole RHD gene deletion homozygous genotype is the most common allele in RhD-negative population in this area, followed by RHD 1227A/whole RHD gene deletion heterozygous genotype and RHD- CE(2-9)- D/whole RHD gene deletion heterozygous genotype. For women with whole RHD gene deletion homozygous genotype, RHD- CE(2-9)- D, or RHD 1227A mutation, fetal RHD screening with quantitative real-time PCR and high-throughput sequencing are important for the management of RhD-negative pregnant women.

Multidisciplinary team strategy for treatment of diabetic foot / 中华普通外科杂志

Objective:To explore the team construction and treatment strategy of the Diabetic Foot-Multidisciplinary Team.Methods:The clinical data of 19 patients with severe ischemic diabetic foot treated by our Diabetic Foot-Multidisciplinary Team Center from Apr 2021 to Mar 2022 were collected, and the overall amputation rate, above-ankle major amputation rate, minor amputation rate and mortality, Diabetic Foot-Multidisciplinary Team consultation discipline participation rate and treatment participation degree were retrospectively analyzed.Results:Nineteen patients (15 males and 4 females) were enrolled, aged 26 to 94 (68.6±14.2). All were with severe ischemic diabetic foot ulcer:Rutherford grade 5 or up and dysfunction in 2 or more organs. Complications included arteriosclerosis obliterans of the lower extremities in 18 cases, heart diseases in 18, hypertension in 15, and renal insufficiencies in 10. The overall amputation rate was 36.8%, major amputation rate in 21.1%, minor amputation rate in 15.8%, and mortality rate was 15.8%. A total of 16 disciplines participated in Diabetic Foot-Multidisciplinary Team; the main participating disciplines were vascular surgery (19 times), endocrinology (12 times), and cardiology (11 times). The main treatment disciplines were vascular surgery (14 times), plastic surgery (3 times), and cardiology (2 times).Conclusion:For the diagnosis and treatment of diabetic foot, it is necessary to set up a multidisciplinary team as early as possible to control the causes of diabetic foot ulcer, prevent the recurrence of diabetic foot ulcer, reduce the mortality and amputation rate, and improve the quality of life of patients.

CD31 and D2-40 Contribute to Peritoneal Metastasis of Colorectal Cancer by Promoting Epithelial-Mesenchymal Transition

Background/Aims@#Colorectal cancer (CRC) patients often exhibit peritoneal metastasis, which negatively impacts their prognosis. CD31 and D2-40 have recently been suggested to be predictors of breast cancer prognosis, but their role in colorectal peritoneal metastasis (CRPM) remains unknown. @*Methods@#The expression profiles of CD31 and D2-40 were analyzed in CRC patients with or without CRPM and in CRC cell lines with increasing metastatic potential. Overexpression and short hairpin RNA knockdown assays were performed in CRC cells, and the effects of these alterations on epithelial-mesenchymal transition (EMT) in vitro, growth of xenograft tumors in vivo, and peritoneal metastasis potential in a mouse model of CRPM were examined. @*Results@#The expressions of CD31 and D2-40 were upregulated in CRC tumor tissues and was elevated further in tumor tissues from patients with CRPM. CD31 and D2-40 expression levels exhibited increasing trends parallel to the EMT potential of CRC cells. CD31 and D2-40 are essential for CRC cell EMT in vitro as well as for xenograft tumor growth and peritoneal metastasis in vivo. @*Conclusions@#CD31 and D2-40 contribute to CRPM by promoting EMT and may serve as prognostic markers and therapeutic targets for CRC, particularly in patients with peritoneal metastasis.

Clinical analysis of percutaneous transluminal angioplasty combined with stent implantation in the treatment of transplant renal artery stenosis / 器官移植

Objective To evaluate the clinical efficacy of percutaneous transluminal angioplasty (PTA) combined with stent implantation in the treatment of transplant renal artery stenosis (TRAS) after renal transplantation. Methods Clinical data of 21 patients with TRAS after renal transplantation undergoing PTA combined with stent implantation were retrospectively analyzed. The incidence of TRAS in renal transplant recipients was summarized. The changes of relevant indexes in patients with TRAS were statistically compared before and after interventional treatment. Clinical prognosis of patients with TRAS was evaluated. Results The incidence of TRAS in renal transplant recipients was 4.1%(21/507). TRAS was diagnosed at postoperative 5 (4, 7) months, and 67% (14/21) of patients developed TRAS within postoperative 6 months. Compared with the values before interventional therapy, the serum creatinine level, systolic and diastolic blood pressure and peak flow velocity of transplant renal artery of patients with TRAS were significantly decreased, and the estimated glomerular filtration rate (eGFR) and interlobar arterial resistance index were significantly increased at 1 week and 1 month after interventional therapy (all P < 0.05). During postoperative follow-up after PTA combined with stent implantation, 1 patient suffered re-stenosis of the transplant renal artery, which was improved after simple balloon dilatation. One patient developed pseudoaneurysm formation at the puncture site of the right femoral artery. One patient presented with renal atrophy and loss of function due to atresia of the transplant renal artery. All the remaining 18 patients were well recovered after surgery. Conclusions PTA combined with stent implantation is the optimal treatment of TRAS after renal transplantation, which can significantly improve the function of transplant kidney and considerably prolong the survival time of transplant kidney.

Treatment of refractory Her-2 positive metastatic young breast cancer with pyrrolidine combined with capecitabine: a case report / 中国综合临床

In order to explore the treatment of Her-2 positive breast cancer patients who failed in multi-line treatments, we retrospectively analyzed the clinical data of a patient with refractory Her-2 positive breast cancer.The patient was initially diagnosed as Her-2 positive advanced breast cancer.After six line treatment in the outer hospital, the patient′s condition was basically in a progressive state.The breast tumor was broken and purulent, the lung metastasis increased, and the patient′s quality of life was poor.The patient was admitted to Department of Breast Surgery of Affiliated Suqian Hospital of Xuzhou Medical University, after MDT discussion, we gave pyrrolotinib combined with capecitabine treatment, the chest wound healed gradually, the lung metastasis gradually reduced, and the quality of life was better.A retrospective analysis of this case showed that pyrrolidine combined with capecitabine may bring hope to Her-2 positive breast cancer patients who failed to receive multi-line therapies, especially those who failed to target therapy.

An animal experiment regarding the effect of lipopolysaccharide intervention program on Legionella pneumonia / 中华流行病学杂志

Objective@#To explore the effect of lipopolysaccharide intervention program on Legionella pneumonia.@*Methods@#C3H/HeN mice (6-8 weeks old) were used as experimental animals. The mice were randomly divided into lipopolysaccharide intervention, non-lipopolysaccharide intervention and control groups. Each group was again divided into three time points: 12 h, 24 h and 48 h. Mice in the lipopolysaccharide intervention group were intraperitoneally injected with E. coli lipopolysaccharide (100 ng per mice), and the rest groups were intraperitoneally injected with normal saline. After 24 hours, mice in the lipopolysaccharide intervention and the non-intervention groups mice were infected with Legionella by tracheal injection and the control group was given the same amount of saline. All the mice were killed at 12, 24 and 48 hours respectively. The mice were anatomized, lungs of the mice were separated and weighed. Organ coefficients (lung weight/body weight of mice) were calculated. 1 ml Orbital blood was collected. Toll-like receptor 4 (TLR4) levels of peripheral blood mononuclear cells were measured by flow cytometry. The contents of TNF-α and IL-1β in the upper left lung lobe were measured by ELISA.@*Results@#In the lung organs, the coefficients of lipopolysaccharide non-intervention group were higher than the other groups and there was no significant difference seen between the lipopolysaccharide intervention group and the controls. TLR4 peaked at 12 hours in both the lipopolysaccharide intervention and the non-intervention groups while the TLR4 level in the intervention group was higher than that in the non-intervention group. There were no significant differences appeared on the TLR4 expression levels between the two Legionella pneumonia modelled groups at 24 or 48 hours. There was no significant difference seen regarding the concentration of TNF-α and IL-1β between the intervention and the control groups. The secretion levels of TNF-α and IL-1β in the non-intervention group were higher than those in the intervention group at each time point.@*Conclusion@#The lipopolysaccharide intervention program may alleviate the inflammatory symptoms of Legionella infection.

TP and FAC effect on patients with primary tumor molecular typing luminal A, axillary lymph node metastasis three negative breast cancer / 中国综合临床

Objective To explore the application of paclitaxel or docetaxel combined with cisplatin (TP) with cyclophosphamide,pirirubicin and fluorouracil (FAC) in the primary tumor molecular typing Luminal A,axillary lymph node metastasis three negative breast cancer. Methods From January 2012 to January 2014, the clinical data of forty-nine patients with were selected. All patients were divided into two groups by balance randomization method, TP group and FAC group. Twenty-five patients were treated with TP regimen and 24 patients were treated with FAC regimen. The clinical efficacy was evaluated after six cycles of chemotherapy. Chemotherapy effects,adverse reactions and survival rates of two groups were compared. Results All patients were given intravenous chemotherapy according to the plan and were evaluated for clinical efficacy. The response rate (RR) was 64. 0％ in TP group,including 4 cases of complete remission (CR),12 cases of partial remission (PR),7 cases of stable disease(SD) and 2 cases of progressive disease(PD). The adverse reactions were gastrointestinal reactions and granulocytopenia. The median progression-free survival ( PFS) and overall survival ( OS) were respectively 12. 4 months and 34. 1 months. In FAC group,the response rate ( RR) was 33. 3％,including 2 cases of CR,6 cases of PR,11 cases of SD and 5 cases of PD. The adverse reactions were gastrointestinal reactions,granulocytopenia and premature atrial contraction. The median PFS and OS were 7. 2 months and 20. 7 months respectively. The effective rate of TP group was higher than that of FAC group (χ2=4. 608,P=0. 032),and the progression-free survival time and total survival time were longer than those of FAC group (χ2 =8. 317, 8. 563, P=0. 004, 0. 003 ) . Conclusion Compared to FAC regimen, TP regimen could improve the survival rate of patients better with breast cancer of Primary tumor Luminal A and Axillary Lymph Node Metastasis Triple negative type, and adverse reactions were tolerated, it may be an optimized chemotherapy.

Elevated serum concentrations of FGF23 and Klotho in patients with Graves disease and their significance / 中国综合临床

Objective To investigate the relationship between FGF23 and Klotho in GD patients. Methods From March 2016 to November 2016, forty-three newly diagnosed and untreated Grave disease patients (GD group) and 27 healthy subjects were selected. Meanwhile,Peripheral venous serum was collected to detect serum calcium, phosphorus and thyroid function in GD group. The levels of FGF23, Klotho protein and 1 in each group were detected by enzyme-linked immunosorbent assay ( ELISA ) . The expression levels of FGF23,Klotho protein and 1,25-dihydroxyvitamin D3 were detected by enzyme-linked immunosorbent assay ( ELISA ) . The differences of FGF23, Klotho protein, 1, 25-dihydroxyvitamin D3, serum calcium and phosphorus between GD group and normal control group were compared,and the correlation between each index was analyzed. The relationship between FGF23 and Klotho protein and the pathogenesis of GD was explored. Results ( 1) Thyrotropin in thyroid function was significantly lower in GD group than that in normal group,and the difference was statistically significant ( 0. 003 ( 0. 002, 0. 004 ) mU/L vs. 1. 650 ( 0. 81, 2. 14 ) mU/L, Z=- 7. 587,P<0. 05] . Thyrotropin receptor antibodies,free triiodothyronine and free thyroxine in GD group were significantly higher than those in normal group. There were [ thyroid stimulating hormone receptor antibodies:9. 03(3. 89,21. 29)) U/L vs. 0. 60(0. 38,0. 97)) U/L,free triiodothyronine:23. 36(11. 61,38. 00)) pmol/L vs. 4. 63(4. 03,4. 92)) pmol/L,free thyroxine:4. 34(33. 94,100. 00) pmol/Lvs. 17. 69(15. 80,20. 35) pmol/L;Z=-6. 694,-6. 878,-6. 836,P<0. 05];( 2) The serum levels of FGF23,Klotho and phosphorus in patients with hyperthyroidism were significantly higher than those in the normal group,and the difference was statistically significant [FGF23:(524. 2±66. 7) ng/L vs. (467. 2±64. 5) ng/L,Klotho:8. 29(6. 89,11. 37) pg/ml vs. 6. 69 (6. 36,7. 53) pg/ml,phosphorus:1. 33(1. 03,1. 52) mmol/L vs. 1. 02(0. 84,1. 20) mmol/L; t=3. 517,Z=-3. 936,-3. 795,P<0. 05]. The Results of correlation analysis showed that: (1) There was no correlation among FGF23 and Klotho,thyroid stimulating hormone receptor antibody,free thyroxine,1,25-dihydroxyvitamin D3,phosphorus and calcium a ( P>0. 05);( 2) There was no correlation among Klotho and thyroid stimulating hormone receptor antibody, free thyroxin, 1, 25-dihydroxyvitamin D3, phosphorus and calcium ( P>0. 05 ) . Conclusion The elevated expression of FGF23 in GD may be involved in the pathogenesis of GD, and the elevated expression of Klotho in GD may be due to the abnormal immune status in GD patients,which may play a protective role.

Clinical effect of mosapride combined with rabeprazole in the treatment of elderly patients with reflux esophagitis / 中国基层医药

Objective To explore the clinical effect of mosapride combined with rabeprazole in the treatment of elderly patients with reflux esophagitis .Methods Clinical data of 126 elderly patients with reflux esophagitis were retrospectively studied.64 cases in the study group were treated with mosapride combined with rabeprazole ,62 cases in the control group were treated with mosapride combined with omeprazole .The clinical effects between the two groups were compared.Results Before treatment,there were no statistically significant differences in the scores of pain of patients with heartburn,acid reflux and chest between the two groups (t =0.512,0.181,0.228,all P >0.05). After treatment,the symptom scores of the study group were significantly lower than those of the control group (t =3.689,4.892,5.571,all P <0.01).The clinical symptoms and esophageal mucosal total effective rate in the study group were significantly higher than those in the control group (96.88% vs.87.10%,93.75% vs.80.65%,χ2 =4.121,4.479,all P <0.05).The scores of quality of life scale of the study group were significantly higher than those of the control group in cognitive function ,mental function,physical function and social function (t =4.920,6.853, 4.153,6.163,all P <0.01).Conclusion Mosapride combined with rabeprazole in the treatment of elderly patients with reflux esophagitis can effectively relieve symptoms of heartburn ,acid reflux and chest pain,help patients with mucosa recovery as soon as possible ,improve the quality of life of patients,and it is worthy of clinical application .

Relationship between the HBsAg-positive infection status of mothers and the non/low-response to hepatitis B vaccine of their infants / 中华流行病学杂志

Objective To explore the relationship between the status of HBsAg-positive infection of mothers and the non/low-response to hepatitis B vaccine of their infants.Methods A total of 225 pairs of mothers and their infants were recruited in our cohort from June 2011 to July 2013.Infants were given three doses of hepatitis B vaccine at hour 24,first month and month 6th respectively and were followed up for one year after birth.HBV serological markers and HBV DNA in the peripheral blood of both mothers and infants were detected by Electro-chemiluminescence immunoassay and fluorescence quantitative Polymerase Chain Reaction.Results Six HBV infection models were detected in HBsAg-positive mothers,and "HBsAg (+),HBeAg (+),anti-HBc (+)" (model one) and "HBsAg (+),anti-HBe (+),anti-HBc (+)" (model two) accounted for 92.5％ (208/225) of all the models.Rate of non/low-response to hepatitis B vaccine in infants born to mothers in model one was lower than those in model two,the differences are statistically significant (x2=4.80,P=0.029).The rate of non/low-response to hepatitis B vaccine in infants showed a downward trend with the rising of HBeAg level in their mothers (x2=4.86,P=0.028).Results from the unconditional logistic regression analysis showed that the HBeAg of the HBsAg-positive mothers was significantly correlated with the low risk of non/low-response to hepatitis B vaccine in infants (OR=0.598,95％CI:0.378-0.947).The positive rate of serum HBV DNA in HBsAg-positive mothers was 54.2％,while the rate of non/low-response to hepatitis B vaccine in infants born to HBV DNA positive mothers was similar to those infants born to HBV DNA negative mothers (X2=0.22,P=0.640).Conclusions "HBsAg (+),HBeAg (+),anti-HBc (+)" and "HBsAg (+),anti-HBe(+),anti-HBc (+)" were the common models seen in HBsAg-positive mothers,and the rate of non/low-response to hepatitis B vaccine was different between the two models.HBeAg of HBsAg-positive mothers might have positive effects on the immune response to hepatitis B vaccine in infants but the mechanisms remained not clear.HBV DNA of the HBsAg-positive mothers did not seem to be correlated with the immune response to hepatitis B vaccine in infants.

Relationship between the HBsAg-positive infection status of mothers and the non/low-response to hepatitis B vaccine of their infants / 中华流行病学杂志

Objective To explore the relationship between the status of HBsAg-positive infection of mothers and the non/low-response to hepatitis B vaccine of their infants.Methods A total of 225 pairs of mothers and their infants were recruited in our cohort from June 2011 to July 2013.Infants were given three doses of hepatitis B vaccine at hour 24,first month and month 6th respectively and were followed up for one year after birth.HBV serological markers and HBV DNA in the peripheral blood of both mothers and infants were detected by Electro-chemiluminescence immunoassay and fluorescence quantitative Polymerase Chain Reaction.Results Six HBV infection models were detected in HBsAg-positive mothers,and "HBsAg (+),HBeAg (+),anti-HBc (+)" (model one) and "HBsAg (+),anti-HBe (+),anti-HBc (+)" (model two) accounted for 92.5％ (208/225) of all the models.Rate of non/low-response to hepatitis B vaccine in infants born to mothers in model one was lower than those in model two,the differences are statistically significant (x2=4.80,P=0.029).The rate of non/low-response to hepatitis B vaccine in infants showed a downward trend with the rising of HBeAg level in their mothers (x2=4.86,P=0.028).Results from the unconditional logistic regression analysis showed that the HBeAg of the HBsAg-positive mothers was significantly correlated with the low risk of non/low-response to hepatitis B vaccine in infants (OR=0.598,95％CI:0.378-0.947).The positive rate of serum HBV DNA in HBsAg-positive mothers was 54.2％,while the rate of non/low-response to hepatitis B vaccine in infants born to HBV DNA positive mothers was similar to those infants born to HBV DNA negative mothers (X2=0.22,P=0.640).Conclusions "HBsAg (+),HBeAg (+),anti-HBc (+)" and "HBsAg (+),anti-HBe(+),anti-HBc (+)" were the common models seen in HBsAg-positive mothers,and the rate of non/low-response to hepatitis B vaccine was different between the two models.HBeAg of HBsAg-positive mothers might have positive effects on the immune response to hepatitis B vaccine in infants but the mechanisms remained not clear.HBV DNA of the HBsAg-positive mothers did not seem to be correlated with the immune response to hepatitis B vaccine in infants.

Clinical study of gefitinib plus capecitabine in treatment of recurrent and metastatic triple negative breast cancer / 中华内分泌外科杂志

Objective To evaluate the efficacy and safety of gefitinib plus capecitabine in treatment of recurrent and metastatic triple negative breast cancer.Methods From Jan.2011 to Jun.,41 patients who have recurrent and metastatic triple negative breast cancer after treated by adjuvant chemotherapy were enrolled in this study They were divided into two groups according to their wishes.The 24 cases in the experimental group were treated with gefitinib plus capecitabine.The 17 cases in the control group were treated with capecitabine.The two groups were followed up for 12 months.They were treated until the disease progression or the toxicity could not be tolerated.Results The objective response rate (ORR) in the experimental group and the control group was 70.83％(17/24) vs 35.29％(6/17).The disease control rate (DCR) in the two groups was 91.67％ (22/24) vs 64.71％ (11/17).The difference between the two groups was statistically significant (P＜0.05).The incidence rate of adverse drug reactions in the two groups was similar (P＞0.05),and the reactions were tolerable.Conclusion Gefitinib plus capecitabine is an effective and safe treatment for recurrent and metastatic triple negative breast cancer with tolerable adverse reactions,and some patients were able to survive for more than 12 months.

Anti-angina pectoris combined with anxiolytic-depressive drugs in angina pectoris with anxiety and depression and its influence on psychological fluctuation / 中国生化药物杂志

Objective To analyze the clinical effect of anti-angina pectoris combined with anxiolytic-depressive drugs in patients with angina pectoris and anxiety and depression and its influence on psychological fluctuation .Methods 100 patients with coronary heart disease and angina pectoris who were treated with anxiety and depression were randomly divided into the observation group and the control group according to the digital table method.The control group were treated with conventional angina pectoris, and the control group were treated with anti-anxiety and depression medication.The left ventricular end-systolic volume ( LVESV ) , left ventricular ejection fraction ( LVEF ) , left ventricular end-diastolic volume (LVEDV), left ventricular end-diastolic volume (LVEDV) and left ventricular end-diastolic volume (LVEDV) and anxiety and depression scores were compared between the two groups before and after treatment.Results The total effective rate of the treatment group was significantly higher than that of the control group (P<0.05).There was no serious adverse reaction in the two groups.The treatment compliance rate in the observation group was significantly better than that in the control group (P<0.05), and the level of cardiac function after treatment in the observation group was significantly better than the control group (P<0.05); observation group before and after treatment anxiety and depression scores were statistically significant (P<0.05), while the control group before and after treatment anxiety and depression score was not statistically significant.Results The combination of anti-angina pectoris and anxiety-depression drugs had better clinical curative effect on patients with angina pectoris and anxiety and depressive patients, and could effectively control the onset of angina pectoris.Meanwhile, they had higher safety and could improve the compliance of patients with clinical treatment.Anxiety and depression, so as to improve the quality of life of patients.

Observation on the therapeutic effect of kangfuxin liquid topical treatment on open wound of postoperative perianal abscess / 中国生化药物杂志

Objective To explore the effect of kangfuxin liquid topical treatment on open wound of postoperative perianal abscess.Methods200 cases of patients with open wound abscess surgery in our hospital from February 2014 to September 2016 were randomly divided into control group and experimental group,with 100 cases in each group.The control group was given conventional treatment, the experimental group were treated by kangfuxin liquid.The relevant therapeutic indicators and clinical healing time between two groups were compared.ResultsThe effective rate of the treatment group was 93.0%, which was significantly higher than that of the control group (85.0%), the difference was statistically significant(P<0.05).The granulation growth period of the experimental group was (5.14±1.41) days, and the average healing time was (15.21±2.49) days.Which were significantly shorter than those of the control group[(7.45±1.32) days, (21.16±2.69) days], and the differences were Statistical differences (P<0.05).ConclusionTo improve the treatment effect to a great extent open wound infection of kangfuxin liquid in treatment of perianal abscess after surgery, shorten the healing time, improve the patient's symptoms, with further clinical promotion and application significance.

Effects of thymoquinone on oxidative stress and cytokine expression in brain of type 2 diabetic rats / 复旦学报（医学版）

Objective To investigate the effects of thymoquinone (TQ) on the levels of proteins involved in oxidative stress and cytokine in the brain of rats with type 2 diabetes mellitus.Methods Wistar rats (n=48) were randomly divided into 3 groups:normal control group,model group and TQ treatment group (n =16).The normal control group was fed with clean grade ordinary feed.The model group and TQ treatment group rats were fed with high-glucose and high-fat diet.After 6 weeks' feeding,model group and TQ treatment group rats were administered streptozocin (STZ) (35 mg/kg) to establish type 2 diabetic model by intraperitoneal injection.Then,the model group and TQ treatment group rats were fed with high-glucose and high-fat diet for another 6 weeks.After that,TQ treatment group rats were administered TQ (5 mg/kg) by intraperitoneal injection every other day.The model group rats were injected with an equal dose of ethanol.Six weeks later,all the rats were sacrificed to obtain the hippocampal tissue for the protein extract.The protein levels of nuclear factor erythroid 2-related factor 2 (Nrf2),heme oxygenase-1 (HO-1) and cyclo-oxygenase 2 (COX-2) in the hippocampal tissue were measured by Western blot.Superoxide dismutase (SOD) activity was determined by SOD kit.Blood-glucose meter was used to assess the blood glucose before the rats were sacrificed and after the model was successfully established.All the measurement data was described by the x ± s,measurement data were compared among groups using One Way ANOVA.Results The results by Western blots showed that the levels of the Nrf2 and HO-1 protein were significantly decreased in the model group compared with the normal control group,the levels of the Nrf2 and HO-1 proteins were increased in the TQ treatment group in comparison with the model group (P＜ 0.05).Meanwhile,compared with the normal control group,the SOD activity of the hippocampus in model group was significantly lower (P＜ 0.05);by contrast with the model group,the SOD activity in the TQ treatment group was considerably increased (P＜0.05).By contrast,the COX-2 level in the model group was substantially higher than that in the normal control (P＜0.05),and the COX-2 level in the TQ treatment group was lower than that in the model group (P＜0.05).Conclusions TQ might inhibit inflammation and improve oxidative stress of the brain tissue in the rats with type 2 diabetes mellitus.

Construction of the Evaluation System of Man-Oriented Medical Ethics / 中国医学伦理学

Through introducing the reason of constructing the evaluation system of medical ethics,this paper summarized the specific ways of the whole-staff participation,content integration,the procedure standardization,the index digitalization,the assessment normalization,the result openness,the application rigidization and the management informatization in the evaluation of medical ethics.Then it concluded the importance and the positive effects of the evaluation system of man-oriented medical ethics in the hospital management and the construction of medical ethics:grasping the sensitive issues and defining the boundary of behaviors;grasping the core problems and standardizing the medical behaviors;grasping the development problems and improving the academic level,and grasping the ideological problems and constructing the humanistic spirit.

Study on the expression of hormone receptor and human epidermal growth factor receptor 2 in breast cancer primary tumor and axillary lymph node metastasis / 中国综合临床

Objective To explore the expression of HR and Her?2 in breast cancer primary tumor and axillary lymph node metastasis. Methods Four hundred and twenty?eight female patients with unilateral breast cancer combined with axillary lymph node metastasis treated in the Affiliated Suqian Hospital of Xuzhou Medical University from January 2011 to January 2016 were selected in this study. Immunohistochemistry was used to detect the expression of ER,PR,Her?2 and Ki67 in primary tumor and axillary lymph node metastasis. Results The positive rates of ER expression were 75. 9% ( 325/428 ) and 70. 3% ( 301/428 ) respectively in primary tumor and axillary lymph node metastasis. The positive rates of PR expression were 61. 4% ( 263/428) and 56. 1% ( 240/428 ) respectively in primary tumor and axillary lymph node metastasis. The rates of Her?2 overexpression were 20. 1% ( 86/428) in primary tumor and the positive rate of Her?2 in axillary lymph node metastasis was 22. 7%( 97/428 ) . The positive rates of Ki67 expression were 45. 6%( 195/428 ) and 39. 7%(170/428) respectively in primary tumor and axillary lymph node metastasis. The expression of ER,PR,Her?2 and Ki67 in primary and axillary lymph node metastasis showed no statistical significance ( P>0. 05 ) . The molecular typing of primary tumor and axillary lymph node metastasis were not consistent in 31 patients ( 31/428,7. 24%) ,including 14 cases of primary tumor Luminal A,9 cases of Her?2 overexpression in axillary lymph node metastasis and 5 cases of triple negative breast cancer. Primary tumor Luminal B was detected in 10 cases, while 6 cases of Her?2 overexpression in axillary lymph node metastasis and 4 cases of triple negative breast cancer. Primary tumor Her?2 was overexpressed in 4 cases,while 1 case of Luminal A,3 cases of Luminal B in axillary lymph node metastasis. There were 3 cases of primary tumor triple negative breast cancer,while 2 cases of Luminal B in axillary lymph node metastasis and 1 case of Her?2 overexpression. Conclusion The expressions of ER, PR, Her?2 and Ki67 in primary tumor and axillary lymph node metastasis of some breast cancer were different. Immunohistochemistry for primary tumor and axillary lymph node metastasis of stage II?III breast cancer patients should be routinely carried out. Based on molecular typing of primary tumor and axillary lymph node metastasis,individualized treatment plan can be developed,so that patients will benefit from it.

CADASIL with clinical manifestations of baldness, lumbago and Parkinson's symptoms / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate a cerebral autosomal dominant arteriopathy with the subcortical infarcts and leukoencephalopathy (CADASIL) case with clinical manifestations of baldness, lumbago and Parkinson's symptoms.</p><p><b>METHODS</b>Clinical and imaging data of the patient were analyzed. The patient and his family members were also subjected to genetic testing.</p><p><b>RESULTS</b>The symptoms of the patient included recurrent stroke, dementia, and mood disturbance, in addition with lumbago, baldness and Parkinson's symptoms but no migraine. Cranial MRI of the patient showed bilateral symmetric leukoencephalopathy and multiple small subcortical lacunar infarcts. A point mutation in exon 11 of the NOTCH3 gene (R558C) was discovered in the proband and four asymptomatic relatives.</p><p><b>CONCLUSION</b>CADASIL is characterized by recurrent subcortical ischemic stroke, dementia, pseudobulbar palsy, and mood disturbance. Baldness, lumbago and Parkinson's symptoms may also be seen in such patients.</p>