Dual elastography to discriminate adjacent stages of fibrosis and inflammation in chronic hepatitis B: A prospective multicenter study.

BACKGROUND AND AIMS: To evaluate the diagnostic performance of dual elastography (dual-elasto) in continuous differentiation of liver fibrosis and inflammation in a large prospective cohort of patients with chronic HBV. APPROACH AND RESULTS: Adults with positive HBsAg for at least 6 months were recruited from 12 medical centers. Participants underwent dual-elasto evaluations. Biopsy was performed 3 days after dual-elasto examination. Four logistic regression models were trained and strung together into series models. Decision trees based on the series models were performed to achieve continuous differentiation of liver fibrosis and inflammation. The influence of inflammation on the fibrosis stage was also evaluated. A total of 560 patients were included in the training set and 240 in the validation set. Areas under the receiver operating characteristic curve of the series model were 0.82, 0.86, 0.93, and 0.96 to predict ≥F1, ≥F2, ≥F3, and F4 in the validation set, which were significantly higher than those of serum markers and shear wave elastography (all p < 0.05), except for the ≥ F1 levels ( p = 0.09). The AUCs of the series model were 0.93, 0.86, 0.95, and 0.84 to predict inflammation stages ≥G1, ≥G2, ≥G3, and G4, respectively. Decision trees realized 5 continuous classifications of fibrosis and inflammation. Inflammation could enhance the mild fibrosis stage classification while showing limited influences on severe fibrosis or cirrhosis diagnosis. CONCLUSIONS: Dual-elasto demonstrated high performance in the continuous discrimination of fibrosis and inflammation in patients with HBV and could be used to diagnose mild fibrosis without the influence of inflammation.

CRISPR/Cas9 gene correction of HbH-CS thalassemia-induced pluripotent stem cells.

Haemoglobin (Hb) H-constant spring (CS) alpha thalassaemia (- -/-αCS) is the most common type of nondeletional Hb H disease in southern China. The CRISPR/Cas9-based gene correction of patient-specific induced pluripotent stem cells (iPSCs) and cell transplantation now represent a therapeutic solution for this genetic disease. We designed primers for the target sites using CRISPR/Cas9 to specifically edit the HBA2 gene with an Hb-CS mutation. After applying a correction-specific PCR assay to purify the corrected clones followed by sequencing to confirm the mutation correction, we verified that the purified clones retained full pluripotency and exhibited a normal karyotype. This strategy may be promising in the future, although it is far from representing a solution for the treatment of HbH-CS thalassemia now.

Study on the correlation between the enhance patterns of carotid plaque and cerebral infarction by contrast-enhance ultrasound / 中国医师杂志

Objective To investigate the characteristics and the enhanced patterns of carotid plaque using contrast-enhanced ultrasound (CEUS) and patients with cerebral infarction.Methods The patients with carotid plaque were divided into two groups according to whether they had cerebral infarction:54 patients (62 plaques with CEUS) with cerebral infarction were included in group A,and 48 patients (54 plaques with CEUS) without cerebral infarction were included in group B.The plaques were divided into four grades according to the degree of plaque enhancement.According to the source of intraplaque contrast agents,plaque enhancement patterns were divided into adventitia enhancement,lumen enhancement and mixed enhancement.To analyze the degree and pattern of carotid plaque enhancement in the two groups.Results Carotid plaque enhancement in cerebral infarction group was mainly grade 3 (26/62) and grade 4 (22/62),while that in non-cerebral infarction group was mainly grade 2 (20/54) and grade 3 (20/54).There was significant difference between the two groups in the proportion of carotid plaque enhancement of grade 2 (P =0.019) and grade 4 (P =0.041).The proportion of plaque adventitia enhancement model in group A(27/59) was lower than that in group B (37/50),with statistically significant difference (P =0.003).While the proportion of mixed enhancement mode in group A was significantly higher than that in group B (P =0.003).Conclusions The enhancement of carotid plaque was obvious in cerebral infarction patients,and the mixed enhancement pattern was more common.It suggested that the communication between vascular cavity and plaque might be an important factor leading to cerebral infarction.

Generation of GZKHQi001-A and GZWWTi001-A, two induced pluripotent stem cell lines derived from peripheral blood mononuclear cells of Duchenne muscular dystrophy patients.

Duchenne muscular dystrophy (DMD) is an X-linked disease caused by mutations in the DMD gene, which spans ~2.4Mb of genomic sequence at locus Xp21. This mutation results in the loss of the protein dystrophin. DMD patients die in their second or third decade due to either respiratory failure or cardiomyopathy, as the absence of dystrophin leads to myofiber membrane fragility and necrosis, eventually resulting in muscle atrophy and contractures. Currently, there is no effective treatment for DMD, therefore induced pluripotent stem cells from DMD patients would be a powerful tool for studying disease mechanisms.

The correlation between carotid plaque stability and the serum level of Hs-CRP, MMP-9 and TIMP-1 / 中国医师杂志

Objective To study on the relationship between the serum level of highsensitivity c-reaction protein (hs-CR),matrix metalloproteinase 9 (MMT-9),tissue inhibitor of metalloproteinase 1 (TIMP-1) and carotid plaque stability in elderly people.Methods According to the carotid ultrasonography examination,120 old people were divided into vulnerable plaque group (group A,n =45),stable plaque group (group B,n =41) and no plaque group (group C,n =34),and serum levels of hs-CRP,MMP-9,TIMP-1 in each group were also detected.Results The serum levels of hs-CRP and MMP-9 of unstable plaque group and stable plaque group were higher than those of non-plaque group (P ＜ 0.05).hsCRP and MMP-9 were positively correlated with carotid plaque unstability,while TIMP-1 was negatively correlated with carotid plaque unstability,hs-CRP,MMP-9 and TIMP-1 were independent risk factors for carotid plaque stability.Conclusions Serum levels of hs-CRP,MMP-9 and TIMP-1 are closely related to the stability of carotid plaque.Elevated levels of hs-CRP and MMP-9 increase the risk of carotid plaque,and elevated levels of TIMP-1 decrease the risk of carotid plaque.

Risk factors for breast cancer-related upper extremity lymphedema:a meta-analysis / 中华放射肿瘤学杂志

Objective To systematically evaluate the risk factors for upper extremity lymphedema after breast cancer treatment and the strength of their associations.Methods PubMed,Ovid,EMbase,and the Cochrane Library were searched to identify clinical trials published up to December 2012.The quality of included studies was assessed by the Newcastle-Ottawa Scale;data analysis was performed by Stata 10.0 and RevMan 5.2;the strength of associations between risk factors and breast cancer-related upper extremity lymphedema was described as odds ratio (OR) and 95％ confidence intervals (CI).Results Twenty-two studies involving 10106 patients were included in the meta-analysis.The risk factors for upper extremity lymphedema after breast cancer treatment mainly included axillary lymph node dissection (OR =2.72,95％ CI=1.06-6.99,P=0.038),hypertension (OR=1.84,95％ CI=1.38-2.44,P=0.000),body mass index (OR =1.68,95％ CI=1.22-2.32,P =0.001),and radiotherapy (OR =1.65,95％ CI =1.20-2.25,P =0.002),while no significant associations were found for such factors as chemotherapy,age,number of positive lymph nodes,and number of dissected lymph nodes.Conclusions The incidence of upper extremity lymphedema is high among patients with breast cancer after treatment,and axillary lymph node dissection,hypertension,body mass index,and radiotherapy are the main risk factors for lymphedema after breast cancer treatment.

Left ventricle partial and global diastolic function evaluated in patients with silent myocardial ischemia by Doppler combined with dobutamine stress echocardiography / 中国基层医药

ObjectiveTo evaluate left ventricle partial and global diastolic function in patients with silentmyocardial ischemia (SMI) by Doppler tissue imaging (DTI) combined with dobutamine stress echocardiography(DSE).Methods30 cases of silent myocardial ischemia(SMI) and 30 cases of normal control underwent dobu-tamine stressechocardiography(DSE). DTI was acquired at baseline and stress, and waveforms in mitral valve clos- ing, and the base and mid segments of left ventricle were used to measure diastolic early velocity(Ve), diastolic latelyvelocity(Va) ,and E deceleration time(Te). ResultsⅤ in control group increased accompanied with the increasingdose of dobutamine, Ve/Va decreased a little but not significantly. Ⅴ in the group with silent myocardial ischemia(SMI) increased at 10μg·kg-1·min-1 ,but decreased at 40μg·kg-1·min-1 compared with 10μg·kg-1·min-1 ,T inboth control and DSE group decreased at 40μg/kg accompanied with 10μg·kg-1·min-1, T in both control and DSEgroup decreased accompanied with the increasing dose of dobutamine, and there were significant differences betweenthe groups(P < 0.05). ConclusionDTI-DSE could quantificadvely detect the partial and global diastolic function ofleft ventricle.

Evaluation of ultrasound on peripheral atheral atherosderosis after treatment by folicacid in combination with mecobalamin in uremia patient / 中国基层医药

Objective To evaluate the clinical significance of peripheral atheral atherosclerosis after treatment by folicacid in combination with mecobalarain in uremia patient using vascular ultrasound.Methods 99 cases of uremia patients with carotid atherosclerosis were treated with folie acid tablets and mecobalamin tablets for six months.The carotid intimia-media thiclmess(IMT),total plaque area,numbers and ultrasound types of carotid atherosclerotic before and after treatment were observed.Results After six months,carotid IMT became tinner significantly,and the totsl plaque area decreased(P＜0.05).The ultrasound types of carotid atherosclerotic plagues have changed after six montha.and the plaque numbers decreased significantly(P＜0.05).Conclusion Threatment by folie acid combination with mecobalamin in uremia patients maybe helpful to the progression of carotid athereaclerotie disease.

Quantitive analysis of regional left ventricular systolic function before and after PTCA by quantitative tissue velocity imaging / 中国基层医药

Objective To analyze regional left ventricular systolic function before and after percutaneous translumial coronary angioplasty(PTCA),quantitative tissue velocity imaging(QTVI)was used tO detect wall motion of left ventricule.Methods 20 patients with isolated left anterior descending coronary artery(LAD)stenosis(≥70%)and 16 normal control subjects were included in this study.QTVI was performed one day before PTCA+stent,a week and a month after successful PTCA+stent.Peak systolic myocardial velocity(Vs)were measured with QTVI at different wall segments(basal and medial segments).Results Before PTCA+stent,Vs of all segments assigned by LAD were significantly lower than those of corresponding segments in normal subjects(P＜0.01).After PTCA+stent,the above segments showed a significant improvement of Vs in a week and a month(P＜0.01).Conclusion QTVI can quantitively detect changes of myocardiac motion and real-time quantify regional left ventricular systolic function before and after PTCA.

Overexpression of type I growth factor receptors in pterygium / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the expression of the type I growth factor receptor family [epidermal growth factor receptor (EGFR), ErbB2 and ErbB3] by the epithelial cells in pterygium.</p><p><b>METHODS</b>Immunoflourescent staining and Western blotting were performed to detect the expression pattern and quantity of EGFR, ErbB2 and ErbB3 proteins in the epithelia of 15 patients with primary pterygium and 12 subjects with normal conjunctiva.</p><p><b>RESULTS</b>In immunofluorescent staining, the EGFR protein was present in the basal cells while the ErbB2 and ErbB3 were expressed by the superficial cells in normal conjunctival epithelium. Of the pterygium cases 15, 11 were stained by EGFR, ErbB2 and ErbB3 in the full thickness of the epithelium and showed stronger staining compared with the control group. Four of them showed a similar staining pattern to the normal conjunctiva group. The density of protein bands detected by Western blotting for all three growth factor receptors was consistent with the immunofluorescent staining. Compared with normal conjunctiva, stronger protein bands of these three receptors were found in all of the pterygium specimens, in which EGFR, ErbB2 and ErbB3 were expressed in the full thickness, as shown by immunofluorescent staining.</p><p><b>CONCLUSIONS</b>The increased expression of EGFR, ErbB2 and ErbB3 proteins was present in pterygium, which indicated that pterygium is a disorder with abnormal proliferation. The abnormal expression of EGFR, ErbB2 and ErbB3 by the epithelium and the communication with cytokines in the stroma in pterygium may be a key pathogenic factor in this disorder.</p>

Experimental Study on the Anti-inflammation Effect of Volatile Oil in Ramulus Cinnamomi / 中药新药与临床药理

objective To study the anti-inflammation effect of volatile oil from ramulus cinnamomi(VORC).Methods Anti-inflammation effect was studied with the methods of mice auricular swelling,mice celiac capillary permeability,rat hind paw edema and acute pneumonia model.Results VORC had an inhibitory effect on acute inflammation of mice induced by xylene,celiac capillary permeability of mice induced by acetic acid,edema of rat hind paw induced by carrageenan,acute pulmonary inflammation of rat induced by LPS.Conclusion VORC has a markedly anti-inflammation action.