Progress of the application clinical prediction model in polycystic ovary syndrome.

Clinical prediction models play an important role in the field of medicine. These can help predict the probability of an individual suffering from disease, complications, and treatment outcomes by applying specific methodologies. Polycystic ovary syndrome (PCOS) is a common disease with a high incidence rate, huge heterogeneity, short- and long-term complications, and complex treatments. In this systematic review study, we reviewed the progress of clinical prediction models in PCOS patients, including diagnosis and prediction models for PCOS complications and treatment outcomes. We aimed to provide ideas for medical researchers and clues for the management of PCOS. In the future, models with poor accuracy can be greatly improved by adding well-known parameters and validations, which will further expand our understanding of PCOS in terms of precision medicine. By developing a series of predictive models, we can make the definition of PCOS more accurate, which can improve the diagnosis of PCOS and reduce the likelihood of false positives and false negatives. It will also help discover complications earlier and treatment outcomes being known earlier, which can result in better outcomes for women with PCOS.

Plasma cell-free DNA promise disease monitoring and tissue injury assessment of COVID-19

COVID-19 is a huge threat to global health. Due to the lack of definitive etiological therapeutics currently, effective disease monitoring is of high clinical value for better healthcare and management of the large number of COVID-19 patients. In this study, we recruited 37 COVID-19 patients, collected 176 blood samples upon diagnosis and during treatment, and analyzed cell-free DNA (cfDNA) in these samples. We report gross abnormalities in cfDNA of COVID-19 patients, including elevated GC content, altered molecule size and end motif patterns. More importantly, such cfDNA characteristics reflect patient-specific physiological conditions during treatment. Further analysis on tissue origin tracing of cfDNA reveals frequent tissue injuries in COVID-19 patients, which is supported by clinical diagnoses. Hence, we demonstrate the translational merit of cfDNA as valuable analyte for effective disease monitoring, as well as tissue injury assessment in COVID-19 patients.

Time-series plasma cell-free DNA analysis reveals disease severity of COVID-19 patients

Clinical symptoms of coronavirus disease 2019 (COVID-19) range from asymptomatic to severe pneumonia and death. Detection of individuals at high risk for critical condition is crucial for control of the disease. Herein, for the first time, we profiled and analyzed plasma cell-free DNA (cfDNA) of mild and severe COVID-19 patients. We found that in comparison between mild and severe COVID-19 patients, Interleukin-37 signaling was one of the most relevant pathways; top significantly altered genes included POTEH, FAM27C, SPATA48, which were mostly expressed in prostate and testis; adrenal glands, small intestines and liver were tissues presenting most differentially expressed genes. Our data thus revealed potential tissue involvement, provided insights into mechanism on COVID-19 progression, and highlighted utility of cfDNA as a noninvasive biomarker for disease severity inspections. One Sentence SummaryCfDNA analysis in COVID-19 patients reveals severity-related tissue damage.

Incidence of cholecystolithiasis and influencing factors in 1iver cirrhosis / 实用医学杂志

Objective To investigate the incidence of cholecystolithiasis in 1iver cirrhosis and analyze its influencing factors and clinical significance. Methods We selected 128 patients with 1iver cirrhosis who were di-agnosed and treated in the First Affiliated Hospital of Henan University of Science and Technology from Oct. 2014 to Aug. 2015 as the observation group. Meanwhile, 140 cases received medical examination served as the control group. The liver cirrhosis group were divided into class A (group A), class B (group B), class C (group C) ac-cording to the Child-Pugh grades. We measured the levels of fasting serum albumin (ALB) and cholecystokinin (CCK) of all subjects. The relationship of cholecystolithiasis in 1iver cirrhosis to gender, liver function Child-Pugh classification, ascites, levels of ALB and CCK was analyzed. Results (1) Univariate analysis revealed: compared with the control group, the incidence of cholecystolithiasis in 1iver cirrhosis group was higher (35.2%vs 8.6%, P0.05). (2) Multiple Logistic regression analysis re-vealed that the level of ALB is the main influencing factor (P<0.05). Other factors were not statistically significant. Conclusion Cholecystolithiasis frequently occurs in patients with liver cirrhosis, which has no correlation with the gender of patient, but it correlates with liver function, ascites, the levels of ALB and CCK. Among of them, the level of ALB is the main influencing factor.

Extraction and identification of exosomes from drug-resistant breast cancer cells and their potential role in cell-to-cell drug-resistance transfer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore whether docetaxel-resistant cells (MCF-7/Doc) and doxorubicin-resistant cells (MCF-7/ADM) can secrete Exosomes and their potential role in cell-cell drug-resistance transfer.</p><p><b>METHODS</b>Exosomes were extracted from the cell culture supernatants of MCF-7/Doc and MCF-7/ADM cells by fractionation ultracentrifugation, and were identified by transmission electron microscopy and Western blot analysis. GFP-MCF-7/S, a breast cancer parental sensitive cell line stably expressing green fluorescent protein (GFP), was constructed by recombinant lentiviral vector with GFP. Then the resistance experiment of cells and the experiment of resistance transfer by exosomes were designed to observe the phenomenon of cell-to-cell drug-resistance transfer.</p><p><b>RESULTS</b>Similar to the breast cancer parental sensitive cells (MCF-7/S), the breast cancer resistant sublines could secrete exosomes, which exhibited round or elliptic shape ranging from 30 to 100 nm in diameter with intact membrane, and only expressed the protein marker of exosomes, Tsg101, did not express the endoplasmic reticulum marker calnexin. After MCF-7/S, MCF-7/DOC and MCF-7/ADM cells we cocultured with GFP-MCF-7/S cells for 72 h, there were no significant differences in the expression of fluorescence-labeled cells among the four groups. When treated by the drug ADM or DOC for 24 hours, the MCF-7/DOC+GFP-MCF-7/S group was in favor of a significant higher survival rate of fluorescence-labeled cells compared with the MCF-7/S+GFP-MCF-7/S group (65.5% vs. 25.5%, P < 0.001), and so did the MCF-7/ADM+GFP-MCF-7/S group (53.6% vs. 25.4%, P < 0.001). The exosomes extracted from MCF-7/S, MCF-7/DOC and MCF-7/ADM cells were cultured with the GFP-MCF-7/S cells for 48 h. Among these groups, no significant differences in the expression of fluorescence-labeled cells were found. After treated by the drug ADM or DOC for 24 hours, the exosomes extracted from MCF-7/DOC+GFP-MCF-7/S group was associated with a significant higher survival rate of fluorescence-labeled cells compared with the exosomes extracted from MCF-7/S+GFP-MCF-7/S group (59.9% vs. 32.4%, P < 0.001), and so did the exosomes extracted from the MCF-7/ADM)+GFP-MCF-7/S group (58.3% vs. 27.2%, P < 0.001).</p><p><b>CONCLUSION</b>Our results suggest that drug-resistance can be transferred between breast cancer cells, and exosomes are probably the transporter of the drug resistance.</p>

Exploration on the application of standardized patients and implementation of agency resident system in digestion medical clinical practice / 中华医学教育探索杂志

Objective To study the application of standardized patients practice and agent physician system in digestion medical clinical practice. Methods One hundred and fifty five-year-clinical medical students who began digestion medical clinical practice from 2008 to 2009 were selected and randomly divided into teaching reform group and control group, each group containing 75 people. According to teaching reform group students' willingness and through the selection, 69 were identified as agent physician. Standardized patients and agent physician simulation clinical training were applied in the teaching reform group while conventional teaching methods were used in the control group. Sta-tistical analysis of the experimental data was conducted using SPSS 11.0 statistical package. Measure-ment data use independent-samples t test and rank sum test was used for heterogeneity of variance. Results Teaching reform group students' inquiry contents and skills scores for each project were higher than those of control group and the score difference was statistically significant (P<0.05) in chronological order, the transition language, interrogation schedule, repeated questions, summary records, citing verification, instrumentation courtesy, friendly behavior, praise and encouragement, eliciting the patient's views, concerns about the effects of disease, care and support and assistance aspects. After the end of the third internship, two groups were compared in operation results, reform history collection, physical examination skills group score and the excellent and good rate being higher (P=0.002, 0.001). After three times' practice, teaching group students' scoring pass rate in medical ethics demeanor, interrogation techniques and physical examination skills, case analysis is higher than that of the control group students, and the difference was statistically significant(P<0.05). Conclusion Application of standardized patients and implementing agency resident simulation clinical training in the guide teaching of digestion department of internal medicine has achieved good effect.

Effect of ischemic postconditioning on the expression of heme oxygenase-1 in acute lung ischemia-reperfusion injury in rats / 中华急诊医学杂志

Objective To investigate the effect of ischemic post-conditioning (IPO) on the level of Heme oxygenase-1 (HO-1) in acute ischemia - reperfusion (I/R) injury of lung in order to illuminate its protective mechanism.Methods Forty-eight adult SD rats were randomly divided (random number) into 6groups ( n =8 each):sham operation group ( S group) ; I/R group in which the hilum of left lung was clamped for 45 min followed by 105 min reperfusion; IPO group in which left lung hilum was clamped for 45min and post - conditioned by alternation of 30 s reperfusion with 30 s re-occlusion for three times before perfect perfusion for 102 min; Hemin (HM) + I/R group; ZnPPⅨ (zinc protoporphyrin Ⅸ) + IPO group and HM + S group.Arterial partial pressure of oxygen ( PaO2 ) and malondialdehyde (MDA) content in blood serum were assayed.The left lung was removed for determination of wet/dry (W/D) lung weight ratio and level of HO-1 protein was detected by immunohistochemical technique and pathohistological changes were observed under light microscopic examination. Comparisons among multiple groups were studied by using one-way analysis of variance (ANOVA). Statistical comparisons within groups were analyzed by using paired t -test.Results The level of HO-1 in lung tissue was significantly increased in the I/R group compared with the S group and the HM + S group (P ＜0.01,P ＜0.05).Compared to the I/R group,the IPO and the HM + I/R groups had significant higher level of HO-1 ( P ＜ 0.05,P ＜ 0.01 ).The PaO2 was significantly lower in all experimental groups than that in the S group (90 ± 11 ) mmHg.However,the values of PaO2 in the IPO and the HM + I/R groups were higher than that in the I/R group (P ＜ 0.01 ).In addition to severe lung tissue damage evidenced by pathohistological changes,the lung wet/dry (W/D) weight ratio and MDA level in blood serum were significantly higher in the I/R group than those in the S group (P ＜0.01 ),whereas the lung damage was attenuated either by IPO or by HM pretreatment (P ＜ 0.05,IPO or HM + I/R vs.I/R).Conclusions IPO can attenuate the lung ischemia - reperfusion injury through upregulating the level of HO-1 protein and inhibiting lipid peroxidation injury.

Benzylphenethylamine Alkaloids from the Bulbs and Flowers of Lycoris radiata / 中草药·英文版

Objective To study the benzylphenethylamine alkaloids from the bulbs and flowers of Lycoris radiata.Methods Alkaloids were isolated by various column chromatographic methods and their structures were identified by spectral data.Results Fifteen known benzylphenethylamine alkaloids were isolated and identified as lycoramine(1),O-demethyllycoramine(2),N-demethyllycoramine(3),galanthamine(4),lycorine(5),caranine(6),ungminorine(7),narciclasine(8),5-hydroxy-10-O-demethyl-homolycorine(9),hippeastrine(10),ungerine(11),hippeastrine N-oxide(12),O-demethylhaemanthamine(13),haemanthidine(14),and 8-demethoxybostasine(15).Conclusion Compound 15 is first isolated from the plants in Amaryllidaceae,compounds 3,6,9,and 11 are first reported from the plants in Lycoris Herb.,and compounds 2,7,and 14 are isolated from L.radiata for the fast time.The 13C-NMR data of compouds 3,7,and 12 are first reported in the present study.Furthermore,the galasine-type alkaloid is isolated from the plants of Lycoris Herb.for the first time.

Role of protein kinase C in induction of vascular endothelial growth factor secretion by isoflurane in primary cultured rat cardiomyocytes / 中华麻醉学杂志

Objective To investigate the role of protein kinase C (PKC) in induction of vascular endothelial growth factor (VEGF) secretion by isoflurane in primary cultured rat cardiomyocytes. Methods Primary cultured neonatal rat cardiomyocytes were randomly divided into 6 groups ( n = 6 each): control group (group C), 3 different concentration isoflurane groups (group Ⅰ1-3 ), PKC inhibitor calphostin C group (group P), and PKC inhibitor + isoflurane group (group PI). The cells were exposed to 0.7%, 1.4% and 2.1% isoflurane for6 h in group Ⅰ1-3 respectivly. Calphostin C was added to the culture medium with a final concentration of 50 nmol/L in group P. Calphostin C was added to the culture medium with a final concentration of 50 nmol/L, then the cells were exposed to 1.4% isoflurane for 6 h in group PI. VEGF concentrations and expression of PKC isoforms were determined by ELISA and Western blot respectively. Results Compared with group C, the VEGF concentration was significantly increased in group Ⅰ2 and Ⅰ3, and PKCε expression was down-regulated in the cytoplasm while upregulated in the cytomembrane in group Ⅰ2 ( P ＜ 0.01 ), but no significant change was found in the parameters mentioned above in group Ⅰ2 ( P ＞ 0.05). PKCα, PKCδ and PKCζ expression was significantly higher in the cytoplasm than in the cytomembrane in group C and Ⅰ2. VEGF concentrations were gradually increased with the increase in isoflurane concentrations ( P ＜ 0.05). VEGF concentrations were significantly lower in group PI than in Ⅰ2 ( P ＜0.05) .Conclusion Isoflurane induces VEGF secretion in primary cultured rat cardiomyocytes through translocation of PKCε from the cytoplasm to the cytomembrane, suggesting that it is a mechanism of the cardioprotective effects of isoflurane.

Effects of Propofol on the Heme Oxygenase-1 Expression in Rats with H_2O_2-mediated Damage to Cultured Cardiac Myocytes / 华中科技大学学报(医学版)

Objective To investigate the effect of propofol on the heme oxygenase-1(HO-1)expression in rats with H_2O_2-mediated damage to cultured cardiac myocytes.Methods Primary cultured new-born rat cardiac myocytes were divided into 8 groups:control,H_2O_2 group,low dose propofol (LP) group,middle dose propofol(MP)group,high dose propofol(HP)group,LP +ZnPP Ⅸ group.MP+ZnPP Ⅸ group and HP+ZnPP Ⅸ group.The cells in all groups were incubated for 6 h.The concentration of malondialdehyde(MDA),activity of superoxid dismuase(SOD),mitochondria and Caspase-3,and the expression of HO-1 were determined.Results As compared with H_2O_2 group,the HO-1 expression,and the activity of SOD and mitochondria were significantly increased(P<0.05,P<0.01),and activity of Caspase-3 and concentration of MDA was decreased(P<0.05)in MP and HP groups.As compared with LP,MP and HP groups respectively.the HO-1 expression and SOD activity were significantly decreased and the concentration of MDA increased in LP+ZnPP IX,MP+ZnPP Ⅸ and HP+ZnPP Ⅸ groups(P<0.05,P<0.01),while Caspase-3 activity was significantly increased in MP+ZnPP IX and HP+ZnPP IX(P<0.05,P<0.01).Conclusion Propofol can protect cardiac myocytes against H_2O_2-mediated cytotoxicity in a dose-dependent manner,and increase the HO-1 expression,which may partly mediate cytoprotective effects of propofol.

Effects of hypertonic saline on CD14/CD16 expression by monocytes and the levels of anti-inflammatory cytokines in patients sustaining traumatic hemorrhagic shock / 中华急诊医学杂志

Objective To investigate the expression of CD14/CD16 by monocytes and the anti-inflammatory effects of hypertonic saline plus dextran (HSD) in adult blunt trauma patients in hemonhagic shock. Method A total of 30 adult patients were eligible for inclusion in the study if they sustained blunt trauma from March to October 2007 and had at least one recorded episode of hypotension (systolic blood pressure ≤ 90 mm Hg) with clear evidence of blood loss (external or internal including the thorax, abdomen or retroperitoneum). Patients were excluded if they refused to participate, were admitted ≥ 6 hours after injury, were pregnant, or had chronic disease. The enrolled patients were randomly divided in a double-blinded manner into an HSD group which was administered 7.5% Nad plus 6% dextran - 70, and a control group which was administered 0.9% NaCl. A single 250 ml dose of either HSD or NaO was immediately administered to the patients in each of the two groups while they were in the emergency room. The primary outcomes were to measure the changes in CD4/CD16 expression by monocytes and the levels of anti-inflammatory cytokines, including tumor necrosis factor-alpha (TNF-α), interleukin (IL)-lra and IL-10. Patient demographics, fluid requirements, organ dysfunction, infection and death were recorded. Results A total of 28 patients were enrolled with no significant differences in their clinical measurements. Hyperosmolarity was modest and transient. HSD altered the shock-induced monocyte redistribution pattern by reducing the drop in the "classic" CD14 ++ subset and remarkably affecting the expansion of the "pro-inflammatory" CD14+CD16+ subsets. In parallel, HSD significamly reduced pro-inflammatory TNF-α production while increasing anti-inflammatory IL-lra and IL-10 production. Conclusions This human trial demonstrates that HSD has anti-inflammatory and immunologic properties for trauma patients in hemorrhagic shock. HSD exerts profound immunomodulatory effects, promoting more balanced pro-/anti-inflammatory responses and reducing post-traumatic complications. Therefore, it could be useful in attenuating post-trauma multiorgan dysfunction (MOD).

Effects of hypertonic-hyperoncotic solution on cardiac function and extravascular lung water in children after open-heart surgery / 中国医师杂志

Objectives To evaluate the effects of hypertonic-hyperoncotic solution (HHS) on cardiac function and extravascular lung water in children after open-heart surgery for congenital cardiac disease. Methods 50 children with congenital cardiac disease were randomly assigned to 2 groups. The HHS group received HHS (7.5% sodium chloride with 6% hydroxyethyl-stareh 200 kDa). The ISS group received isotonic saline solution (ISS 0.9% sodium chloride). Cardiac index (CI), extravascular lung water index (ELWI), stroke volume index (SVI), mean arterial pressure (MAP), and systemic vascular resistance index (SVRI) were measured. Immediately after sur-gery, patients were loaded either with HHS or with ISS (4 ml/kg). Sodium concentration, osmolality, thrombocyte count(TC), fibrinogen, and arterial blood gases were detected before operation, immediately after loading, 15 minutes, 1,4, 12, and 24 hours after the end of vol-ume loading. Hemodynamic parameters were recorded at the same time. The total amount of dobutamine required was documented. Results In HHS group, MAP, SVI and CI increased, and SVRI decreased significantly after the administration of HHS, compared with ISS group and before administration(P<0.01 or 0.05). Both CVP and HR were unchanged in both groups. In HHS group, ELWI decreased signifi-cantly, compared with before volume administration. But ELWI increased directly and remained elevated for 60 minutes after the administra-tion of ISS. Sodium concentration increased immediately after infusion of HHS. The postoperative need for infused dobutamine in the patients in HHS group was decreased, compared with ISS group (P<0.05). All patients left the hospital in a clinically sufficient state. Condu-sions A single infusion of HHS after cardiac surgery is safe. After cardiopuimonary bypass surgery, the administration of HHS increased CI by elevating SVI in combination with a decreased SVRI. ELWI significantly decreased, which suggest that HHS effectively counteracts, the capillary leakage.