Clinical application of individualized coil embolization in interventional therapy of renal artery aneurysm / 实用放射学杂志

Objective To explore the clinical application of individualized coil embolization in the interventional treatment of renal artery aneurysm(RAA).Methods Data of 23 patients with RAA treated by individualized coil embolization were analyzed.There were 27 RAAs,in which narrow-necked RAAs were treated with coil embolization and wide-necked RAAs were treated with stent-assisted coil embolization.The efficacy of the two embolization methods were analyzed and the changes of renal function and symptoms were observed.Results A total of 27 RAAs in 23 patients were successfully embolized at one time,including 23 narrow-necked RAAs in 19 cases treated with coil embolization and 4 wide-necked RAAs in 4 patients treated with stent-assisted coil embolization.The embolization effect of 20 cases(86.96%)reached Raymond grade Ⅰ,and 3 cases(13.04%)reached gradeⅡ.Postoperative computed tomography angiography(CTA)showed that all parent arteries were patent,the RAA was not visualized,and there was no renal infarction.There was no statistical difference in creatinine values before operation,1 month,6 months and 1 year after operation(P>0.05).In the 12 patients with hypertension,there were statistically significant differences in blood pressure at 1 year after operation compared with preoperative,1 month,and 6 months after operation(P<0.05).The symptoms of low back pain and hematuria disappeared after operation.Conclusion Individualized coil embolization for RAA is safe,effective and worthy of clinical promotion.

Correlation analysis of preoperative red blood cell distribution width and prognosis of patients undergoing TACE for hepatocellular carcinoma / 中华肝胆外科杂志

Objective:To evaluate the relationship between red blood cell distribution width (RDW) and prognosis of patients with hepatocellular carcinoma (HCC) andergoing transcatheter arterial chemoembolization (TACE).Methods:Clinical data of 212 patients with HCC andergoing TACE for the first time in Department of Interventional Radiology, the Affiliated Hospital of Xuzhou Medical University from January 2011 to May 2018 were retrospectively analyzed, including 184 males and 28 females, aged (56.8±11.2) years. Follow-up for survival. X-tile software was used to determine 13.1% as the optimal threshold for preoperative RDW prediction of prognosis, and enrolled patients were divided into a low level group (RDW<13.1%, n=70) and a high level group (RDW≥13.1%, n=142). Aspartate aminotransferase, total bilirubin, albumin, hemoglobin and lipoprotein a, Barcelona clinical liver cancer (BCLC) stage and other indexes were compared between the two groups. Survival analysis was performed by Kaplan-Meier method, survival rate was compared by log-rank test, and the effect of RDW on prognosis was analyzed by Cox regression. Results:The 1-year, 2-year and 3-year cumulative survival rates in RDW high level group were 34.5%, 14.1% and 6.3%, respectively, while those in RDW low level group were 64.3%, 38.6% and 21.4%, respectively, with significant difference ( χ2=23.09, P<0.001). Compared with the low level group, the levels of aspartate aminotransferase and total bilirubin were higher, the levels of albumin, hemoglobin and lipoprotein a were lower, the proportion of portal vein cancer thrombin was higher, and the stage of BCLC was later, with statistical significance (all P<0.05). Cox regression analysis showed that HCC patients with RDW≥13.1%( HR=1.732, 95% CI: 1.223-2.452, P=0.002) had poor survival prognosis after TACE. Conclusion:Preoperative RDW≥13.1% is an independent risk factor for survival after TACE in patients with HCC. RDW has potential predictive value for prognosis of patients with HCC.

Comparative analysis of domestic Octoparms and imported Celect inferior vena cava filter in interventional treatment of venous thromboembolism / 实用放射学杂志

Objective To compare and analyze the application value of domestic Octoparms and imported Celect inferior vena cava filter(IVCF)in the interventional treatment of venous thromboembolism(VTE).Methods Forty patients with VTE were randomly divided into Octoparms group(experimental group)and Celect group(control group)according to the double-blinded method of the central random system.All the patients underwent filter placement,catheter-directed thrombolysis and filter retrieval.The primary end point was the success of filter placement and retrieval,and the secondary end point included indwelling complications such as the occurrence of pulmonary embolism(PE)and filter tilt and migration.Results Forty patients were enrolled in this study,22 patients and 18 patients were divided into the experimental group and the control group,respectively.Among them,11 cases were identified with right lower extremity deep vein thrombosis,29 cases with left lower extremity deep vein thrombosis,17 cases with PE,and 6 cases with inferior vena cava thrombosis.The success rate of IVCF placement was 100%in all participants.Immediately after filter place-ment,the angle of filter tilt was(3.8±2.3)° in the experimental group and(4.9±2.8)° in the control group(t=1.44,P=0.16).Filter retrieval was successful in 21 cases(21/22,95.5%)of the experimental group and 17 cases(17/18,95.5%)of the control group.There was no significant difference between the two groups(t=0.14,P=0.89).The mean indwelling time of filter was(8.0±2.1)days in the experimental group and(9.7±3.1)days in the control group(t=0.73,P=0.47).The angle of filter tilt was(5.3±3.4)° in the experimental group and(5.7±7.7)° in the control group(t=0.19,P=0.85).There was no significant difference for filter placement and retrieval between the two groups(t=0.48 and 2.00,P=0.06 and 0.64,respectively).There were no complications of filter migration,strut penetration or new PE in both groups.Conclusion The application value of domestic Octoparms and impor-ted Celect IVCF is similar in interventional treatment of VTE.

Advances in the effect of body temperature on perioperative neurocognitive disorders in elderly patients / 中华老年医学杂志

Perioperative neurocognitive disorders(PND)is a common complication after surgery or anesthesia, especially in elderly patients.The effects and mechanism of body temperature on PND are still controversial.In this paper, the relationship between body temperature and PND and its possible mechanism of action were discussed based on some research results of perioperative body temperature management in elderly patients, aiming at suggesting the significance of body temperature management in preventing PND.

Regulation of Xuanbai Chengqi Decoction on lung-gut injury and intestinal microflora in sepsis mice / 中华急诊医学杂志

Objective:To investigate the effect of Xuanbai Chengqi Decoction (XBCQT) on lung-gut injury and intestinal function, and analyze its effect on intestinal flora in sepsis mice.Methods:C57 male mice were randomly divided into three groups with 12 mice in each group: control group, model group and treatment group. The sepsis model was prepared by intra-peritoneal injection of lipopolysaccharide (LPS) 5 mg/kg. XBCQT was administered by gavage 24 h before, 0.5 h after and 12 h after modeling. The lung, colon and blood samples were collected at 24 h after modeling. The pulmonary and intestinal inflammatory cytokine content of interleukin-1β (IL-1β), IL-6, tumor necrosis factor α (TNF-α) and monocyte chemoattractant protein (MCP-1) was measured by real-time fluorescence quantitative PCR. HE staining was used to evaluate the structural damage and changes of lung and gut, and Western blot and Immunohistochemistry methods were used to analyze the expression of occludin and claudin-1 in intestinal epithelium. Finally, the plasma endotoxin content of each group was tested by Limulus test kit. Fecal DNA of mice was extracted and the changes of intestinal flora in sepsis mice were detected by 16S rDNA quantitative PCR. The measurement data among the three groups were compared by one-way analysis of variance.Results:(1) XBCQT significantly reduced the pulmonary inflammatory cytokine IL-1β, IL-6, TNF-α and MCP-1 expression (all P<0.05), and attenuated lung injury. (2) Compared to the model group, the treatment group exhibited a reduction in intestinal damage and a decrease in the intestinal inflammatory cytokines (all P<0.05). XBCQT increased the expression of epithelial tight junction and mucin of colon, and improved the intestinal epithelium barrier function. (3) XBCQT treatment decreased the content of endotoxin in plasma of sepsis mice ( P<0.05), promoted the growth of beneficial bacteria Akkermansia muciniphila and reduced the expression of Enterococcus in the intestine of sepsis mice (all P<0.05). Conclusions:XBCQT can significantly improve the intestinal inflammatory injury, regulate the intestine epithelium barrier and improve the intestinal function in sepsis mice.

The application of liver shear wave velocity and its correlation with portal vein pressure in evaluating the efficacy of interventional treatment for Budd-Chiari syndrome / 介入放射学杂志

Objective To discuss the application value of liver shear wave velocity(SWV)and its correlation with portal vein pressure in evaluating the efficacy of interventional therapy for Budd-Chiari syndrome(BCS).Methods The clinical data of 40 BCS patients,who were admitted to the Affiliated Hospital of Xuzhou Medical University of China to receive treatment between April 2020 and April 2022,were collected.During interventional procedure,the hepatic venous pressure gradient(HVPG)was determined separately before and after recanalization of the treated vessels,the liver SWV was determined at one day before,2 days,1 month and 3 months after the treatment,and the above indexes were statistically analyzed.Results Successful initial interventional therapy was accomplished in all patients.The preoperative one-day,postoperative 2-day,one-month and 3-month mean liver SWV values were(2.34±0.36)m/s,(1.74±0.36)m/s,(1.62±0.30)m/s,and(1.56±0.28)m/s respectively.The differences in the mean liver SWV between its preoperative value and its postoperative 2-day,one-month and 3-month value were statistically significant(all P＜0.05),and statistically significant difference in the mean liver SWV also existed between postoperative 2-day value and postoperative 3-month value(P＜0.05).The mean HVPG decreased from preoperative(15.19±2.35)mmHg(1 mmHg=0.133 kPa)to postoperative(6.44±1.34)mmHg(P＜0.05).The preoperative one-day liver SWV was positively correlated with preoperative HVPG(r=0.803,P＜0.01).The postoperative 2-day liver SWV also carried a positive correlation with the postoperative HVPG(r=0.844,P＜0.01).The difference value(D-value)between preoperative liver SWV value and postoperative 2-day liver SWV value was(0.59±0.27)m/s,and the D-value between preoperative HVPG value and postoperative HVPG value was(8.75±1.92)mmHg,and a positive correlation existed between the above two D-values(r=0.676,P＜0.01).Conclusion There is a good correlation between liver SWV and HVPG,which can be used to evaluate the postoperative efficacy of BCS patients after receiving interventional therapy.(J Intervent Radiol,2023,32:1178-1183)

Tripterygium hypoglaucum extract ameliorates adjuvant-induced arthritis in mice through the gut microbiota / 中国天然药物

Traditionally, Tripterygium hypoglaucum (Levl.) Hutch (THH) are widely used in Chinese folk to treat rheumatoid arthritis (RA). This study aimed to investigate whether the anti-RA effect of THH is related with the gut microbiota. The main components of prepared THH extract were identified by HPLC-MS. C57BL/6 mice with adjuvant-induced arthritis (AIA) were treated with THH extract by gavage for one month. THH extract significantly alleviated swollen ankle, joint cavity exudation, and articular cartilage destruction in AIA mice. The mRNA and protein levels of inflammatory mediators in muscles and plasma indicated that THH extract attenuated inflammatory responses in the joint by blocking TLR4/MyD88/MAPK signaling pathways. THH extract remarkably restored the dysbiosis of the gut microbiota in AIA mice, featuring the increases of Bifidobacterium, Akkermansia, and Lactobacillus and the decreases of Butyricimonas, Parabacteroides, and Anaeroplasma. Furthermore, the altered bacteria were closely correlated with physiological indices and drove metabolic changes of the intestinal microbiota. In addition, antibiotic-induced pseudo germ-free mice were employed to verify the role of the intestinal flora. Strikingly, THH treatment failed to ameliorate the arthritis symptoms and signaling pathways in pseudo germ-free mice, which validates the indispensable role of the intestinal flora. For the first time, we demonstrated that THH extract protects joint inflammation by manipulating the intestinal flora and regulating the TLR4/MyD88/MAPK signaling pathway. Therefore, THH extract may serve as a microbial modulator to recover RA in clincial practice.ver RA in clincial practice.

Application of plasma with same blood group as kidney donor to preconditioning of ABO incompatible kidney transplantation / 中华器官移植杂志

Objective:To explore the feasibility of applying plasma with same blood group as kidney donor to ABO incompatible kidney transplantation(ABOi-KT)preconditioning of blood group O recipients with high-titer anti-A/B preformed antibody(IgM/IgG titer ≥1∶256).Methods:A total of 15 cases of blood group O ABOi-KT recipients with high-titer anti-A/B were recruited and divided into two groups of AB( n=8)and kidney donor's blood(KD, n=7)according to plasma type for plasma exchange during preconditioning phase. Clinical data of preconditioning and post-KT were recorded. Results:They received plasmapheresis(PP)(8.1±2.5)sessions in preconditioning phase, including double plasma filtration(DFPP)(4.0±1.4)sessions and plasma exchange(PE)(4.1±2.0)sessions, PP frequency was(0.8±0.1)sessions per day. No hemolysis reaction occurred during preconditioning phase. Anti-A/B titers declined as expected and fulfilled the ABOi-KT criteria(IgM/IgG titers ≤1∶8). KT was performed successfully without antibody-mediated rejection. All of them survived with normal renal function within 90 days post-KT. Levels of serum creatinine at Day 7/30/90 post-KT were(92.9±30.4), (96.2±25.9)and(103.1±28.4)μmol/L; anti-A/B IgM titers at Day 7/30/90 post-KT 1∶1-1∶32, 1∶1-1∶64 and 1∶1-1∶32; anti-A/B IgG titers at Day 7/30/90 post-KT 1∶1-1∶64, 1∶1-1∶64 and 1∶1-1∶32 respectively. No significant differences existed in count/frequency of PP sessions, levels of serum creatinine or anti-A/B titers at each observation point between AB and KD groups( P>0.05). Conclusions:Plasma with the same blood group as kidney donor is feasible for maximizing the intensity of ABOi-KT preconditioning. Favorable outcomes may be achieved through an intensified desensitization strategy on blood group O recipients with high-titer anti-A/B preformed antibody. The potential risks and long-term outcomes should be further explored.

Efficacy of TIPS in treatment of recurrent portal hypertension after splenectomy and devascularization in patients presenting with upper gastrointestinal bleeding / 中华肝胆外科杂志

Objective:To study the efficacy, feasibility and safety of transjugular intrahepatic portosystemic shunt (TIPS) in treatment of recurrent portal hypertension after splenectomy and devascularization in patients presenting with upper gastrointestinal bleeding.Methods:Cirrhotic patients with recurrent portal hypertension after splenectomy and devascularization and presenting with upper gastrointestinal bleeding from August 2015 to December 2020 were studied. Thirty-nine patients were included in this study. There were 24 males and 15 females, with age of (51.56±9.08) years old. These patients were treated with TIPS by using the Viabahn stent. Intraoperative portal vein pressure, success operative rate, hemostasis rate after surgery, changes in hematological indicators and postoperative efficacy and complication rate were studied.Results:Thirty-eight of 39 patients successfully underwent TIPS shunt and 1 patient failed because of portal vein spongiosis. The success rate was 97.44%(38/39). Thirty-three patients underwent TIPS and variceal vein embolization, while 5 patients were treated with TIPS alone. Thirty-nine Viabahn stents with a diameter of 8 mm were implanted in 38 patients, of which 5 patients had the stent expanded to its nominal diameter of 8 mm. The remaining 33 patients (86.84%) had a shunt with a diameter of 6 mm. The hemostasis rate of postoperative gastrointestinal bleeding was 97.37% (37/38). The portal vein pressure and portal venous pressure gradient decreased from (31.28±6.24), (20.61±5.14) mmHg (1 mmHg=0.133 kPa) to (19.58±4.69), (9.24±3.07) mmHg respectively, the differences were significant (all P<0.001). All patients were followed-up for 3 to 36 months, with a median follow-up of 12 months. The postoperative rebleeding rate was 6.90% (2/29). The incidence of hepatic encephalopathy was 13.79% (4/29), and the incidence of shunt disorder was 13.79% (4/29). Conclusion:TIPS was safe, effective and feasible in treating patients with recurrent portal hypertension after splenectomy and devascularization presenting with upper gastrointestinal bleeding. Most patients obtained good clinical outcomes with a 6 mm diameter shunt.

Clinical efficacy of kidney transplantation from senile living-related donors aged over 70 years: a report of 18 cases / 中华器官移植杂志

Objective:To explore the clinical efficacy of kidney transplantation(KT)from senile living-related donors aged over 70 years.Methods:Between 2017 and 2019, perioperative and follow-up data from 18 pairs of donors and recipients were retrospectively reviewed.Results:Operations of all 18 pairs of recipients and donors were conducted successfully without serious perioperative complications.No delayed graft function occurred.There was 1 episode(5.6%)of acute rejection.The mean level of serum creatinine(SCr)at Day 3 post-KT and at discharge was(155.7±63.5)and(97.6±28.7)μmol/L.The median follow-up period was 37.5 months.All 18 donors survived with normal renal function.And no proteinuria or kidney donation related hospitalization events occurred.SCr was(84.4±15.0)μmol/L at the last follow-up and there was no statistical significance as compared with SCr level at discharge( P=0.610). No recipient mortality or graft loss occurred.Levels of SCr were(92.1±18.3), (95.5±21.9)and(100.1±21.2)μmol/L at Month 12/24 and the last follow-up.No statistical difference existed in posttransplant SCr level at these follow-up timepoints( P=0.507). Posttransplant proteinuria occurred in 3 recipients(16.7%). In 8 donors, donated kidney glomerular filtration rate(GFR)was lower than 40 ml/(min·1.73m 2). No statistical difference existed in posttransplant SCr level between this group and higher GFR group( P>0.05). Conclusions:After thorough preoperative assessments, satisfactory short-term outcomes may be achieved for KT from living-related donors aged over 70 years.The long-term outcome should be further explored.

Analysis of risk factors of Budd-Chiari syndrome associated with hepatocellular carcinoma in patients who underwent endovascular recanalization / 中华肝胆外科杂志

Objective:To study the risk factors of Budd-Chiari syndrome (BCS) associated with hepatocellular carcinoma in patients who underwent endovascular recanalization.Methods:The data of 340 patients with BCS who underwent endovascular recanalization at the Affiliated Hospital of Xuzhou Medical University between January 2015 and June 2021 were retrospectively collected. Using propensity score matching, a total of 57 patients (40 males and 17 females) were enrolled into this study, with the age of (50.4±8.7) years. Patients were divided into the hepatocellular carcinoma group ( n=19) and the control group ( n=38) according to whether occurrence of hepatocellular carcinoma after cardovascular recanalization. Preoperative indicators including gender, age, BCS type, and model for end-stage liver disease (MELD) score, and postoperative indicators including alpha fetoprotein, intrahepatic nodule formation, vascular restenosis, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were compared between the two groups after propensity score matching. Multivariate logistic regression analysis was used to analyze the risk factors of BCS associated with after endovascular recanalization in these patients. Results:There were no significant differences in gender, age, BCS type, MELD score and other preoperative data between the two groups (all P>0.05). The proportions of patients with postoperative alpha fetoprotein>9.0 μg/L, AST>40 U/L, ALT>50 U/L, intrahepatic nodules and vascular restenosis after endovascular treatment in the hepatocellular carcinoma group were significantly higher than those in the control group (all P<0.05). Multivariate analysis showed postoperative alpha fetoprotein >9.0 μg/L ( OR=46.778, 95% CI: 3.310-661.140), AST>40 U/L ( OR=36.307, 95% CI: 1.317-1 001.009), intrahepatic nodule formation ( OR=66.254, 95% CI: 4.225-1 038.974) and vascular restenosis ( OR=16.276, 95% CI: 1.712-154.773) to have an increased risk of being associated with hepatocellular carcinoma in these BCS patients (all P<0.05). Conclusion:Postoperative alpha fetoprotein>9.0 μg/L, AST>40 U/L, intrahepatic nodule formation and vascular restenosis were independent risk factors of BCS associated with hepatocellular carcinoma in patients who underwent endovascular recanalization.

The study of the risk factors and pathogenesis of idiopathic epimacular membrane / 中华眼底病杂志

Idiopathic macular membrane (iERM) is a fibrocellular membrane that forms on the inner surface of the retina. In its early stages, symptoms of iERM are usually not apparent. However, advanced iERM can cause different degrees of visual impairment and effect the quality of life of patients. Current studies suggest that iERM may be associated with posterior vitreous detachment (PVD), age, sex, race and/or ethnicity, poor lifestyle, refractive error, diabetes, hypercholesterolemia, and cardiovascular disease. The most well-established risk factors for iERM are age and PVD. The pathogenesis of iERM is extremely complex. Various cell types, such as Müller cells, Hyalocytes and myofibroblasts, nerve growth factor, interleukin-6, transforming growth factor β, vascular endothelial growth factor and other cytokines and growth factors, as well as a variety of genes and proteins are directly or indirectly involved in the formation of iERM, however, their exact role remains a mystery. In the future, further studies at the molecular level and gene level are needed to provide greater help for the clinical diagnosis and treatment of iERM.

Effect of transcutaneous electrical acupoint stimulation on perioperative anxiety and postoperative pain in living kidney donors / 中华麻醉学杂志

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on perioperative anxiety and postoperative pain in living kidney donors (LKDs).Methods:Seventy-two American Society of Anesthesiologists physical status Ⅰ or Ⅱ LKDs, aged 18-64 yr, with body mass index of 18-28 kg/m 2, undergoing living kidney transplantation, were selected, and divided into 2 groups ( n=36 each) using a random number table method: TEAS group (group T) and sham stimulation group (group S). In group T, TEAS was performed on the forenoon at 1 day before surgery (T 0), at 30 min before anesthesia induction on the morning of the operation day (T 1) and on the forenoon at 1 day after surgery (T 2) at bilateral Neiguan, Taichong and Yintang with a frequency 2-100 Hz, disperse-dense waves and current intensity 6-15 mA, and each TEAS lasted for 30 min.Only electrode patches were applied at the same acupoint and at the same time point, but no stimulation was applied in group S. In T and S groups, brachial venous blood samples were collected before each stimulation for measurement of the plasma 5-hydroxytryptamine (5-HT) concentration.The Hospital Anxiety Depression Scale-Anxiety subscale (HADS-A) scores at T 0, T 1, T 2, on day 3 after surgery (T 3) and before discharge (T 4) in the 2 groups were recorded.The consumption of anesthetics during operation, laryngeal mask airway removal time, requirement for rescue analgesia within 72 h after surgery and the development of postoperative complications were recorded.The LKDs were followed up by telephone at 3 months after surgery (T 5) to record the scores of HADS-A and Leeds Assessment of Neuropathic Symptoms and Sign (LANSS) scale. Results:Compared to group S, the incidence of anxiety was significantly decreased T 1, T 2 and T 3, the incidence of rescue analgesia within 72 h after surgery was decreased, plasma concentration of 5-HT was increased at T 1 and T 2, the incidence of postoperative nausea and vomiting was decreased, and the time to first flatus was shortened in group T ( P<0.05). There was no significant difference in the consumption of anesthetics during operation, laryngeal mask airway removal time, and the incidence of anxiety and neuropathic pain within 3 months after surgery between the 2 groups ( P>0.05). Conclusion:TEAS can relieve early preoperative and postoperative anxiety and alleviate postoperative pain in LKDs.

Bile acid detection by biosensors-a review / 生物工程学报

Bile acids facilitate the absorption of lipids, and affect the development of various diseases by regulating intestinal flora structure and modulating immunity and metabolism. It is therefore important to quantitatively detect bile acids. Current analytical methods are still immature due to constituent complexity, structural heterogeneity and bioactive variability of bile acids. Detection of individual bile acids is of significance for pharmacological research, clinical diagnosis and disease prevention. Advances have been made in bile acid analysis from multiple sources including serum, bile, urine and feces, although several limitations still exist for bile acid quantification. Here we review research progress in conventional bile acid assays, including spectrophotometry, thin-layer chromatography, liquid/gas chromatography and liquid/gas chromatography-mass spectrometry. Moreover, we emphasize the development of bile acid biosensors that may have promising prospects.

Preliminary results of multicenter studies on ABO-incompatible kidney transplantation / 中华器官移植杂志

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Over-expression of WNT5B inhibits migration and invasion of human breast cancer MDA-MB-231 cells / 肿瘤

Objective: To investigate the effects of WNT5B over-expression on the invasion and migration of human breast cancer MDA-MB-231 cells, and to explore its possible mechanisms. Methods: After the recombinant vector pcDNA3.1-WNT5B+EGFP containing enhanced green fluorescent protein (EGFP) and WNT 5B genes was transfected into human breast cancer MDA-MB-231 cells, the expression levels of WNT5B mRNA and protein were examined by real-time fluorescent quantitative PCR and Western blotting, respectively. The abilities of cell migration and invasion were analyzed by wound-healing test and Transwell chamber assay, respectively. Furthermore, the expression levels of epithelial-mesenchymal transition (EMT)-related molecules N-cadherin, E-cadherin and Vimentin were detected by Western blotting. Results: Compared with the untransfection and the empty vector-transfection groups, the expression levels of WNT5B mRNA (P < 0.01) and protein (P < 0.05) in MDA-MB-231 cells transfected with the recombinant vector pcDNA3.1-WNT5B+EGFP were up-regulated. The abilities of migration (P < 0.05) and invasion (P < 0.01) of MDA-MB-231 cells after WNT5B over-expression were significantly decreased. The expression level of E-cadherin in MDAMB- 231 cells with WNT5B over-expression was up-regulated (P < 0.05), whereas the expression levels of N-cadherin and Vimentin were down-regulated (both P < 0.05). Conclusion: WNT5B over-expression can inhibit the migration and invasion of breast cancer MDA-MB-231 cells, which may be related to the regulation of EMT process.

Recent advance in biological functions of neuroglobin and mechanism of mitochondrial protection / 中华神经医学杂志

Neuroglobin (Ngb), a novel oxygen-carrying globin, has been shown to have neuroprotective effect on a variety of central nervous system disorders, and this protection is associated with maintenance of mitochondrial function. Therefore, this paper will focus on the recent biological functions of Ngb and Ngb-induced mitochondrial protection mechanisms.

Meta-analysis of the Effects of Sh enqi Fuzheng Injection Combined with Conventional Chemotherapy on the Immune Function of Patients with Advanced NSCLC / 中国药房

OBJECTIVE： To systematically evaluate the effects of Shenqi fuzheng injection combined with conventional chemotherapy on the immune function of patients with advanced non-small cell lung cancer （NSCLC）， and provide evidence-based reference for clinical medication. METHODS： Retrieved from Cochrane Library， PubMed， Medline， Embase， CNKI， Wanfang database， VIP and CBM， Shenqi fuzheng injection combined with conventional chemotherapy （trial group） versus conventional therapy （control group） for advanced NSCLC were collected. After literature screening， data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0 risk evaluation tool， Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS： A total of 16 literatures were included， involving 1 324 cases. Results of Meta-analysis showed that there were no statistical significance in the difference of objective remission rate （ORR） [RR＝1.14， 95％CI（0.91，1.43）， P＝0.25] and the level of  CD8+ [MD＝－1.26，95％CI（－4.10， 1.59），P＝0.39] between 2 groups. The levels of CD3+ [MD＝17.48， 95％CI（13.40， 21.56）， P＜0.000 01 ]， CD4+[MD＝12.26， 95％CI（8.39 16.13）， P＜0.000 01]， CD4+/CD8+ [MD＝0.33，95％CI（0.27， 0.39），P＜0.000 01] and the percentage of NK cells [MD＝9.33， 95％CI（5.72， 12.94）， P＜0.000 01] in trial group were significantly higher than control group. Results of subgroup analysis for medication duration of Shenqi fuzheng injection showed that after 1-14 d treatment of Shenqi fuzheng injection， the levels of CD3+ [MD＝17.11， 95％CI（12.37 ，23.17），P＜0.000 01]， CD4+[MD＝13.28，95％CI（8.33， 18.23），P＜0.000 01]， CD4+/CD8+[MD＝0.36，95％CI（0.28，0.43），P＜0.000 01] and the percentage of NK cells [MD＝12.06，95％CI（7.52，16.61），P＜0.000 1] in trial group were significantly higher than control group. After 21 d treatment of Shenqi fuzheng injection， the levels of CD3+[MD＝14.88， 95％CI（7.51，22.26），P＜0.000 01]， CD4+[MD＝10.56，95％CI（5.57，15.56），P＜0.000 01]， CD8+[MD＝3.02， 95％CI（1.80， 4.23），P＜0.000 01]， CD4+/CD8+[MD＝0.29，95％CI（0.23， 0.35），P＜0.000 01] and the percentage of NK cells [MD＝5.58，95％CI（2.49， 8.67），P＝0.000 4] in trial group were significantly higher than control group. There was no statistical significance in the level of CD8+ between 2 groups after 7-14 d treatment of Shenqi fuzheng injection [MD＝－4.26，95％CI（－12.60， 4.09），P＝0.32]. The incidence of leukopenia， nausea and vomiting， and renal dysfunction in trial group were significantly lower than control group. There was no statistical significance in the incidence of hemoglobin decreased and thrombocytopenia between 2 groups. The results of publication bias showed that there was a greater possibility of publication bias in this study. CONCLUSIONS： Shenqi fuzheng injection combined with conventional chemotherapy may improve the immune function of patients with advanced NSCLC and improve the safety after chemotherapy. But more large-scale， milltiple-center and high-quality RCT are needed to validate this conclusion.

Effects of Wuzhi Capsules on in vivo Pharmacokinetic Behavior of Apatinib Mesylate in Rats / 中国药房

OBJECTIVE： To establish a method for the concentration determination of apatinib mesylate in plasma of rats， and to investigate the effects of single and multiple administration of Wuzhi capsules on the pharmacokinetic behavior of apatinib mesylate in rats. METHODS：  LC-MS/MS method was used to detect the plasma concentration of apatinib mesylate in rats. Using carbamazepine as internal standard， the determination was performed on Waters XBridge BEH C18 column with mobile phase consisted acetonitrile-0.1％ formic acid solution （45 ∶ 55，V/V） at the flow rate of 0.3 mL/min. The column temperature was 40 ℃. The temperature of injector was 15 ℃， and the sample size was 2 μL. ESI was used for positive ion scanning in MRM mode. The ion pairs m/z used for quantitative analysis were 398.1→212.1 （apatinib mesylate） and  237.2→194.2 （internal standard）. The rats were randomly divided into control group Ⅰ， observation group Ⅰ， control group Ⅱ， observation group Ⅱ， with 6 rats in each group. Control group Ⅰ were given single administration of apatinib mesylate intragastrically （50 mg/kg， similarly hereinafter）. Observation group Ⅰ was given Wuzhi capsules intragastrically （450 mg/kg， similarly hereinafter）， and then 10 min later given apatinib mesylate intragastrically. Control group Ⅱ was given normal saline intragastrically， once a day， for consecutive 7 d， and then were given single administration of apatinib mesylate. Observation group Ⅱ was given Wuzhi capsules intragastrically， once a day， for consecutive 7 d， and then 10 min later were given single administration of apatinib mesylate. The blood samples were collected from intraocular canthus vein plexus and determined 0.25， 0.5， 1.0， 2.0， 2.5， 3.0， 4.0， 6.0， 8.0， 12.0， 24.0 h after intragastric administration， respectively. Pharmacokinetic parameters were apatinib mesylate were calculated and compared among those groups by using DAS 2.1 software and t-test. RESULTS： The linear range of apatinib mesylate were 2-2 000 ng/mL. The lower limit of quantitation was 2 ng/mL. RSDs of intra- day and inter-day were all lower than 10％， and the accuracy were 94.93％-104.68％. Matrix effect did not affect the quantitative analysis of the substance to be measured. Compared with control group Ⅰ， cmax， AUC0-24 h and AUC0-∞ of observation group Ⅰ were increased significantly， CLZ was decreased significantly （P＜0.05）. Compared with control group Ⅱ， AUC0-24 h and AUC0-∞ of observation group Ⅱ were increased significantly， and CLZ was decreased significantly （P＜0.05）. Compared with observation group Ⅰ， AUC0-24 h and AUC0-∞ of observation group Ⅱ were decreased significantly （P＜0.05）. CONCLUSIONS： Established LC-MS/MS method is sensitive and specific， and can be used for the concentration determination of apatinib mesylate in plasma of rats. Wuzhi capsules can influence in vivo pharmacokinetic behavior of apatinib mesylate in rats. The effect of multiple administration of Wuzhi capsules is weaker than that of single administration.

Analysis of the management and clinical effect of accessory renal artery in the living-related donor renal, transplantation / 器官移植

Objective To investigate the management and clinical effect of accessory renal artery in living-related donor renal transplantation. Methods Clinical data of 277 donors and recipients undergoing living-related donor renal transplantation were retrospectively analyzed. According to the results of preoperative CT angiography (CTA), the donor kidney was selected and the accessory renal artery of the renal graft was treated intraoperatively. Intraoperative status of the donors, and intraoperative management, postoperative complications, clinical prognosis of the recipients were summarized. Results Among 277 cases of renal transplantation, accessory renal arteries were detected in 83 donors by preoperative CTA examination with an accuracy rate of 95%. Fifty-eight donor kidneys with accessory renal arteries were obtained. Twenty-five donor kidneys with accessory renal arteries were reconstructed and anastomized by vascular repairing. Among them, 1 patient presented with anastomotic thrombosis during abdominal closure, whereas the other 24 cases were successfully anastomized with excellent blood flow. No complications, such as hemorrhage, renal graft embolism, ureteral necrosis and urinary fistula, occurred after renal transplantation. The 1-year survival rates of the recipients and renal grafts were 94% and 91%. The clinical efficacy did not significantly differ between the recipients with single renal artery and their counterparts with accessory renal artery (P > 0.05). Conclusions It can be obtained good clinical efficacy of renal transplantation by selecting a suitable donor kidney and reconstructing and anastomizing the accessory renal artery of the renal graft through vascular repair.