Effects of abnormal vertebral arteries and the circle of Willis on vertebrobasilar dolichoectasia: A multi-scale simulation study.

BACKGROUND: Vertebrobasilar dolichoectasia is a rare cerebrovascular disease characterized by obvious extension, dilation and tortuosity of vertebrobasilar artery, and its pathophysiological mechanism is not clear. This study focused on local hemodynamic changes in basilar arteries with typical vertebrobasilar dolichoectasia, together with unbalanced vertebral arteries and abnormal structures of the circle of Willis, through multi-scale modeling. METHODS: Three-dimensional models of 3 types of vertebrobasilar arteries were constructed from magnetic resonance images. The first type has no vertebrobasilar dolichoectasia, the second type has vertebrobasilar dolichoectasia and balanced vertebral arteries, and the third type has vertebrobasilar dolichoectasia and unbalanced vertebral arteries. A lumped parameter model of the circle of Willis was established and coupled to these three-dimensional models. FINDINGS: The results showed that unbalanced bilateral vertebral arteries, especially single vertebral artery deletion mutation, might associate with higher wall shear stress on anterior wall of basilar artery in patients with vertebrobasilar dolichoectasia. And unbalanced bilateral vertebral arteries would increase the blood pressure in basilar artery. Meanwhile, missing communicating arteries in the circle of Willis, especially bilateral posterior communicating arteries absences, would significantly increase blood pressure in basilar artery. The unilateral absence of posterior communicating arteries would increase differences in blood flow between the left and right posterior cerebral arteries. INTERPRETATION: This study provided a multi-scale modeling method and some preliminary results for helping understand the role of hemodynamics in occurrence and development of vertebrobasilar dolichoectasia.

Effects of External Counterpulsation on Typical Coronary Artery Diseases:A Lumped Parameter Model Study / 医用生物力学

Objective To study the hemodynamic effects of enhanced external counter pulsation(EECP)on typical coronary artery disease and microcirculation angina.Methods A physiological model of the right dominant coronary artery,including the coronary conduit arteries and coronary microcirculation,was established using lumped parameter models.Pathological conditions,such as one-vessel lesions,three-vessel lesions,and microcirculation angina,were simulated.EECP intervention models were established,and the hemodynamic effects of EECP on pathological models was simulated.Results The simulation results of the coronary physiological model,pathological models,and EECP intervention model established in this study were consistent with experimental data in related literature.EECP improved coronary blood flow in all three pathological conditions.For one-vessel lesions,EECP could not recover the blood flow of left main coronary artery to a normal level after the stenosis rate reached 80%-85%.For three-vessel lesions,EECP treatment could not be used if the stenosis rate in one of the three vessels exceeded 90%.For microcirculation angina,EECP was effective when critical condition myocardial blood flow was>1.03 mL/min·g and coronary flow reserve was>1.64.Conclusions The model of coronary disease under EECP interference established in this study meets expectations,and the obtained simulation data have certain reference values for the clinical application of EECP.

Overview of the main biological mechanisms linked to changes in periodontal ligament stem cells and the inflammatory microenvironment / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Periodontitis is a complex chronic inflammatory disease. The invasion of pathogens induces the inflammatory microenvironment in periodontitis. Cell behavior changes in response to changes in the microenvironment, which in turn alters the local inflammatory microenvironment of the periodontium through factors secreted by cells. It has been confirmed that periodontal ligament stem cells (PDLSCs) are vital in the development of periodontal disease. Moreover, PDLSCs are the most effective cell type to be used for periodontium regeneration. This review focuses on changes in PDLSCs, their basic biological behavior, osteogenic differentiation, and drug effects caused by the inflammatory microenvironment, to provide a better understanding of the influence of these factors on periodontal tissue homeostasis. In addition, we discuss the underlying mechanism in detail behind the reciprocal responses of PDLSCs that affect the microenvironment.

Hot spot analysis of outpatient complaints on medical quality and safety in a hospital / 中华医院管理杂志

Objective:To analyze the hot spots complained by outpatients in a tertiary hospital, so as to provide a basis for improving patients′ medical experience and the quality of medical service and medical safety.Methods:The data were selected from the outpatient complaint information severity of a tertiary hospital from November 1, 2020 to April 30, 2021. Complaints were classified and graded with severity. The hot spots of erious plaints and high-risk hidden events were analyzed. The database was established by double entry method. The data were analyzed with descriptive statistic, and the correlation among variants was tested by chi-square.Results:A total of 4 160 valid complaints involving 6 340 questions were included. In terms of the complaint departments and problems, clinical departments(3 682, 88.51%) and environment problems(2 451, 38.66%) accounted for the highest proportions respectively. There was a correlation between the severity of complaint and medical treatment( P<0.001). The distributions of severe complaints in each type of problems were significantly different( P<0.001). In terms of severe complaints, listening and communication(62, 26.38%)accounted for the highest proportions. A total of 161 complaints were in line with definitions of " high-risk hidden incidents" , of which environment-related problems topped the rest, accounting for 45.24%. Conclusions:Outpatient complaints of the tertiary hospital mainly focused on the admission and diagnosis sectors of clinical departments, mostly on environment, listening and communication. In the future, the hospital should focus on optimizing the outpatient environment and establish an effective doctor-patient communication mechanism for better doctor-patient relationship, to avoid occurrence of high-risk hidden events, and improve both medical service quality and safety.

Chemometrics methods for the investigation of methylmercury and total mercury contamination in mollusks samples collected from coastal sites along the Chinese Bohai Sea.

The development and application of chemometrics methods, principal component analysis (PCA), cluster analysis and correlation analysis for the determination of methylmercury (MeHg) and total mecury (HgT) in gastropod and bivalve species collected from eight coastal sites along the Chinese Bohai Sea are described. HgT is directly determined by atomic fluorescence spectrometry (AFS), while MeHg is measured by a laboratory established high performance liquid chromatography-atomic fluorescence spectrometry system (HPLC-AFS). One-way ANOVA and cluster analysis indicated that the bioaccumulation of Rap to accumulate Hg was significantly (P<0.05) different from other mollusks. Correlation analysis shows that there is linear relationship between MeHg and HgT in mollusks samples collected from coastal sites along the Chinese Bohai Sea, while in mollusks samples collected from Hongqiao market in Beijing City, there is not any linear relationship.

Applications of Compression Therapy in Vascular Diseases and its Research Progress / 医用生物力学

Vascular diseases including cardiovascular and cerebrovascular diseases and peripheral vascular diseases of the lower extremities are serious threats to human health. The emergence of compression therapy is of great significance for the effective prevention and treatment of these vascular diseases and the therapeutic value of compression therapy has been confirmed by many research results at present. Compression therapy is a non-invasive physical therapy implemented through a series of compression therapy devices, including external counterpulsation for the treatment of various ischemic diseases, intermittent pneumatic compression for the treatment of some peripheral vascular diseases in the lower extremities, graduated compression stockings for the treatment of deep vein thrombosis, and so on. This review summarizes clinical applications of these typical compression therapies in cardiovascular and cerebrovascular diseases and peripheral vascular diseases of the lower extremities, analyzes their advantages and limitations, and discusses the necessity and significance of biomechanical research on compression therapies.

Expression of ATAD2 in hilar cholangiocarcinoma and the clinical significance / 中华普通外科杂志

Objective To investigate the expression and clinical significance of ATAD2 in patients with hilar cholangiocarcinoma (HC) Methods The qRT-PCR,Western blottig and immunohistochemistry were used to detect the expression of ATAD2 in HC and normal bile duct tissues,and the relationship between ATAD2 and the clinicopathological factors,prognosis was analyzed.Results The positive expression rate of ATAD2 in HC tissues was 70％ (57/81),significantly higher than that of normal bile duct tissues 7％ (2/30) (x2 =35.678,P ＜0.01),and ATAD2 expression was associated with lymph node metastasis and TNM staging (respectively x2 =28.619,31.612,all P ＜ 0.01).The 1'-,3'-,and 5-year survival rates of ATAD2 negative HC patients were 87.5％,54.1％,and 33.3％,respectively.The 1'-,3'-,and 5-year survival rates of ATAD2 positive HC patients were 40.3％,14.0％ and 1.7％,respectively (x2 =14.162,P ＜ 0.01).Univariate analysis and multivariate COX regression model analysis showed that microvascular invasion,lymph node metastasis and ATAD2 expression were independent factors influencing the prognosis of patients with HC (respectively F =4.703,4.961,5.013,all P ＜ 0.05).Conclusion The expression of ATAD2 in HC increased,and the overexpression of ATAD2 was closely related to the occurrence,development,invasion,metastasis and poor prognosis of HC.

Influence of sleep disturbance,depression and anxiety on cognitive function of medical staff / 中华行为医学与脑科学杂志

Objective To explore the relationship between cognitive function and sleep disturb-ance,depression and anxiety. Methods Totally 333 medical staff were investigated using the repetitive neu-ropsychological status questionnaire (RBANS),the Pittsburgh sleep quality index ( PSQI),the depression self-rating scale (SDS) and the anxiety self-rating scale ( SAS). Results ①The difference of visual span in gender(male:(81. 87±13. 48) vs female:(77. 12± 13. 09)) was statistically significant ( t=2. 928,P<0. 05).②Differences in immediate memory,language function,attention function and total score of RBANS among patients of different ages were statistically significant ( F=9. 654,8. 370,11. 465,11. 112, all P<0. 01).③There were significant differences in the RBANS,immediate memory,visual span,attention function and delayed memory between doctor and nurse(t=5. 374,4. 730,3. 389,4. 359,5. 675,all P<0. 01).④There were significant differences in the RBANS,immediate memory,and delayed memory between different PSQI levels ( F=3. 475,4. 892,4. 087, all P<0. 05). ⑤There were significant differences in RBANS ((88. 87±12. 47) vs (83. 69±13. 03)),immediate memory ((86. 18±16. 09) vs (80. 56±15. 38)),visual span ((79. 39±13. 32) vs (73. 47±12. 46)),and delayed memory ((89. 03±10. 26) vs (85. 49±11. 41)) between the depressive symptoms and not depressive symptoms groups( t=2. 794,2. 380,3. 042,2. 295,all P<0. 05) .⑥The total score of medical staff's RBANS was significantly negatively correlated with their PSQI,SDS and SAS scores (r=-0. 158,-0. 233,-0. 117,all P<0. 05).⑦SDS,age,occupation,education, time of sleep and PSQI entered multiple stepwise regression equations,which explain 39. 9% variation in cog-nitive function of medical staff. Conclusion The cognitive function of medical staff is affected by gender, age,occupation,education,depression,and sleep disturbance. The worse the sleep quality,the higher the de-gree of depression and anxiety,and the poorer the cognitive function.

A Review on Mock Circulatory Systems for in vitro Hemodynamic Performance Evaluation of Ventricular Assist Devices / 医用生物力学

Mock circulatory system (MCS) is an experimental platform for simulating hemodynamic performance of human circulatory system, and has been widely used in in-vitro hemodynamic performance evaluation of passive devices such as ventricular assist devices (VADs), artificial valves, as well as hemodynamic responses of mock circulation loop. MCSs are capable of simulating various physiological conditions, including health, exercise, and heart failure, by adjusting drive element of heart simulator and lumped-parameter element of vasculature components. Since 1 960 s, the research and development target of MSCs has evolved from meeting the basic performance evaluation requirement of VADs and mechanical valve to mimicking local hemodynamic characteristics in vital organs. This review summarizes the design principles, system construction of MCSs as well as its research progress and future prospects.

Expressions and mechanisms of ATPase family AAA domain-containing protein 2 and β-catenin in hepatocellular carcinoma / 中华肝胆外科杂志

Objective To investigate the expressions of ATPase family AAA domain-containing protein 2 (ATAD2) and β-catenin,and to analyze their correlations with clinicopathological features and prognostic significance in patients with hepatocellular carcinoma (HCC).Methods The HCC tissues of 40 patients were tested by real-time PCR to study the expressions of ATAD2 and β-catenin.Real-time PCR and Western blot were performed to detect the proteins and mRNA levels of ATAD2,APC,β-catenin and wnt signaling pathway downstream.The HCC tissues of 80 patients and 20 peritumoral tissues were tested by immunohistochemistry (IHC).The cumulative survival-rate was analyzed by the Kaplan-Meier method,and univariate and multivariate were analyzed by the Cox proportional hazards model.Results ISH:The positive rates of ATAD2 and β-catenin were 65.0％ and 55.0％,respectively.These rates were significantly higher than those in the peritumoral tissues (30.0％ and 25.0％,respectively).The ATAD2 expression was related to tumor size (P ＜ 0.05),metastasis (P ＜ 0.05),serum AFP level (P ＜ 0.05) and TNM stag ing (P ＜ 0.05).The β-catenin expression was only significantly related to metastasis (P ＜ 0.05).Correlation analysis showed that the ATAD2 expression was positively related to the β-catenin expression (Pearson =0.578,P ＜ 0.01,R2 =0.3607,Spearman =0.495).This positive relationship was also found in the remaining 4 cell lines except the SK-hep1.Depleting ATAD2 up-regulated APC and down-regulated β-catenin protein and mRNA expression.Univariate and multivariate analyses showed that ATAD2 and β-catenin expressions,tumor size,metastasis,serum AFP,and TNM staging were poor prognostic factors for HCC,and ATAD2 and β-catenin expressions,metastasis,serum.AFP were independent prognostic factors.Patients whose ATAD2 and β-catenin were both positive had worse survival than those with only one positive expression or both negative expressions (P ＜ 0.05).Depleting ATAD2 down-regulated survivin,cyclinD1,c-myc,MMP7,Vimentin in wnt signaling pathway and EMT related proteins.Conclusions ATAD2 and β-catenin expressions were positively related in patients with HCC.Abnormal expressions between ATAD2 and β-catenin might participate in the wnt signaling pathway.

Comparison of Signal Peptides for Two Hemicellulase Secretory Expression / 中国生物工程杂志

Xylanase and mannanase are two hemicellulases,which are widely used in many fields.To improve the expression of thermostable xylanase DSB and thermostable mannanase ManA in Pichia pastoris,three endogenous signal peptides of Pichia pastoris(Scw1 1,Dse4 and Exg1) were chosed.Their capability to mediate the secretion of DSB and ManA with that of the Saccharomyces cerevisiae α-factor were compared.In shake-flask cultivation,three endogenous signal peptides and α-factor efficiently mediated the secretion of DSB and ManA,but the secretion efficiency has obvious difference.As for DSB,the expression efficiency of α-factor was much higher than three endogenous signal peptides.But as for ManA,the expression efficiency of Dse4 was equal to α-factor and much higher than Scw11 and Exg1.Therefore,α-factoris the most efficient signal peptide for DSB expression and Dse4 or α-factor are the most efficient signal peptide for ManA expression in Pichia pastoris X33.Moreover,the intracellular activities of DSB and ManA by α-factor are higher than Scw1 1,Dse4 and Exg1,and the intracellular activity of ManA was higher than DSB (the molecular weight of ManA was larger than DSB).Thus,when ManA were expressed in Pichia pastoris,different signal peptide,such as Dse4,could be used for improving the secretion efficiency.A basis for identifying more available signal peptides and screening for the optimal signal peptide for the target protein was provided.

Research on the quality standard of Kangjing pill / 国际中医中药杂志

Objective To improve the quality standard ofKangjing pills.Methods The qualities of Angelica sinensis, Taxillus sutchuenensis, Radix paeoniae Alba, Eucommia ulmoides and Ligusticum chuanxiong Hort in the pills were identified by microscopic examination; the natures of Radix rehmanniae Praeparata, Radix paeoniae Rubra, Radix paeoniae Alba,Angelica sinensis and Ligusticum chuanxiong Hort were detected by thin layer chromatography (TLC); the content of Paeoniflorin were measured by high performance liquid chromatography (HPLC). The operating conditions by HPLC were InertSustain C18 (4.6 mm×250 mm, 5μm ), the mixture of acetonitrile-0.2% Phosphoric acid water (15:85) as mobile phase, 1.0 ml/min as flow speed and wavelength 316 nm.Results The results observed by microscopy were obvious; The results showed that the TLC spots of Radix rehmanniae Praeparata, Radix paeoniae Rubra, Radix paeoniae Alba, Angelica sinensis and Ligusticum chuanxiong Hort were fairly clear, and the according blank test showed no interference. Ferulic Acid showed a good linear relationship within the range of 0.067-0.168μg (r=0.9997) with an average recovery of 99.84% (RSD=1.22%). Conclusions Microscopy, TLC and HPLC are handy, safe and accurate forKangjing pills to determine the quality.

The correlation between communication skills attitude and general self-efficacy among medical in-terns / 中华医学教育探索杂志

Objective This study is to explore the correlation between communication skills attitude and general self-efficacy among medical interns. Methods Medical intern students of three medical colleges in Shanghai were participated in this study, and questionnaire survey was conducted by cluster sampling of class. SPSS 19.0 was used to process descriptive analysis, t-test, F-test, correlation analysis and hierarchical regression analysis for data analysis. Result 600 questionnaires were handed out and 575 valid samples were collected. The effective rate was 95.83％. The mean score of positive and negative attitude dimension in CSAS were (51.880 ±7.003) and (31.550 ±5.839). The mean score of GSES was (26.230 ±4.820). A positive correlation was found between positive attitude of communication skills and general self-efficacy (r=0.165, P<0.01). Hierarchical regression analysis indicated that school, cognition about importance of com-munication skills and general self-efficacy significantly predicted positive attitude of communication skill.These three variables could explain 21.8％ of total variance and general self-efficacy can explained 2.1％after control other variables. Conclusion Communication skills attitudes of medical interns is positive on the whole. Enhancing their general self-efficacy is beneficial to improving their positive attitude towards communication skills.

Research on the quality standard of Baoyun pill / 国际中医中药杂志

Objective To improve the quality standard of Baoyun pill. Methods The natures of Psoralea corylifolia, Radix Dipsaci and Loranthus parasiticus were detected by thin layer chromatography (TLC); the content of Hesperidine were measured by high performance liquid chromatography (HPLC). The operating conditions by HPLC were InertSustain C18 (4.6 mm×250 mm, 5 μm ), the mixture of methanol-acetic acid-water (35:4:61) as mobile phase, 1.0 ml/min as flow speed and wavelength 283 nm. Results The results showed that the TLC spots of Psoralea corylifolia, Radix Dipsaci and Loranthus parasiticus were fairly clear, and the according blank test showed no interference. Hesperidine showed a good linear relationship within the range of 0.820-4.920 μg(r=1.000 0)with an average recovery of 99.85%(RSD=0.21%).Conclusions The TLC and HPLC are handy,safe and accurate for Baoyun pills to determine the quality.

Research on the quality standard of Kangjing pill / 国际中医中药杂志

Objective To improve the quality standard ofKangjing pills.Methods The qualities of Angelica sinensis, Taxillus sutchuenensis, Radix paeoniae Alba, Eucommia ulmoides and Ligusticum chuanxiong Hort in the pills were identified by microscopic examination; the natures of Radix rehmanniae Praeparata, Radix paeoniae Rubra, Radix paeoniae Alba,Angelica sinensis and Ligusticum chuanxiong Hort were detected by thin layer chromatography (TLC); the content of Paeoniflorin were measured by high performance liquid chromatography (HPLC). The operating conditions by HPLC were InertSustain C18 (4.6 mm×250 mm, 5μm ), the mixture of acetonitrile-0.2% Phosphoric acid water (15:85) as mobile phase, 1.0 ml/min as flow speed and wavelength 316 nm.Results The results observed by microscopy were obvious; The results showed that the TLC spots of Radix rehmanniae Praeparata, Radix paeoniae Rubra, Radix paeoniae Alba, Angelica sinensis and Ligusticum chuanxiong Hort were fairly clear, and the according blank test showed no interference. Ferulic Acid showed a good linear relationship within the range of 0.067-0.168μg (r=0.9997) with an average recovery of 99.84% (RSD=1.22%). Conclusions Microscopy, TLC and HPLC are handy, safe and accurate forKangjing pills to determine the quality.

Development of liquid bandage used for emergency care of war wound / 医疗卫生装备

Objective To develop a liquid bandage for self aid of war wound.Methods Solution A and B were prepared containing functional polymers derived from the biocompatible poly (ethylene glycol) and hyaluronic acid,which had ability of fast crosslinking reaction when they were mixed.Among them,A solution mainly comprised of mercapto group-containing hyaluronic acid derivative (HA-SH),water-solubility starch,propylene glycol,benzoic acid and etc.B solution contained pentaerythritol tetraacrylate derivative (4arm-PEG-Acrylate) and benzoic acid.The structure of mercapto group-containing hyaluronic acid derivative was confirmed by IR,1H-NMR and etc.HA-SH and 4arm-PEG-Acrylate were formulated to different concentrations (W/V) in different buffers.The two kinds of solution were mixed in different ratios,and in situ crosslinking hyaluronic acid hydrogel was obtained;the crosslinking time was recorded.The adhesive force and waterholding capacity of the hydrogel after crosslinking were measured by adding excipients such as water-solubility starch.Results In case the concentration of HA-SH and 4arm-PEG-Acrylate was 2％ and pH value was 11,the hydrogel film on wound skin would be quickly formed in 20 seconds for wound dressing after spraying A and B solution onto the wound skin.Conclusion The liquid bandage has strong adhesive force,high water-holding capacity and controllable crosslinking time,so it could be used as a novel wound dressing for war wound.

Application of QCC activities in the efficiency improvements of the inventory management of oral tablets in ward pharmacy / 药学实践杂志

Objective To enhance oral tablets ward pharmacy inventory efficiency and improve the comprehensive quality of the pharmacist by QCC activities .Method Main factors to extend the ward pharmacy tablet counting time were analyzed through collecting the previous ward pharmacy tablet count time and account matching rate .According to the main problems , the strategies were found out to be implemented ,identify and evaluate the implementation result .Result In view of the oral medicine ward pharmacy inventory of the reasons for the low efficiency ,following measures should be taken :reducing oral drug dispensing station varieties ,finishing cargo ,strengthening personnel training ,changing inventory counting method and optimi-zation of inventory materials and re-enacted drugs location code and so on .Ward pharmacy tablet counting time reduce from 6 .5 hours to 3 hours (reducing by 53 .85% ) .Conclusion The QCC activities could significantly improve the oral medicine ward pharmacy inventory efficiency and comprehensive quality of pharmacists .

Expression and correlation of ATAD2 and E-cadherin in hepatocellular carcinoma / 中华肝胆外科杂志

Objective To investigate the correlation and clinicopathological features of ATAD2 and E-cadherin expression in human hepatocellular carcinoma (HCC),and role of ATAD2 in HCC cells invasion and metastases.Methods The expressions of ATAD2 and E-cadherin in 90 HCC specimens and 16 specimens collected from peritumoral tissue were detected by immunohistochemistry (IHC) test.The correlations between ATAD2 and E-cadherin expression and clinicopathological features were analyzed.The lentiviral vector of sh-ATAD2 RNA was used to interfere with ATAD2 expression.Western blot was performed to evaluate the changes of E-cadherin and Vimentin expression in HCC cells after ATAD2 expression interference.The role of ATAD2 in HCC cells invasion and metastasis was assessed by Transwell analysis.Results ATAD2 protein expression was obviously upregulated in HCC tissue compared to peritumoral tissue (56.7％ vs.31.3％,P ＜ 0.05).Meanwhile,E-cadherin expression was significantly downregulated in HCC tissue (43.3％ vs.68.7％,P ＜0.05).ATAD2 and E-cadherin expressions were both correlated with HCC metastasis (P ＜ 0.05).Correlation analysis demonstrated that the ATAD2 expression was negatively correlated with E-cadherin (r =-0.263,P ＜ 0.05).After interfering ATAD2 expression,cell migration and invasion of HCCLM3 cells were suppressed (migration,42.5 ± 2.6 vs.78.1 ± 3.8,P ＜ 0.05;invasion,33.0 ± 4.7 vs.72.7 ± 5.6,P ＜ 0.05).Meanwhile,the E-cadherin expression was remarkably upregulated (P ＜ 0.05).However,the Vimentin expression downregulated (P ＜ 0.05).Conclusions ATAD2 expression was upregulated in HCC,and silencing ATAD2 could upregulate E-cadherin expression and downregulate Vimentin expression,and inhibit the invasion and metastasis of HCC cells.Modulating E-cadherin expression may be the potential mechanism of ATAD2 in HCC invasion and metastasis.

Diagnosis and treatment of autoimmune pancreatitis / 中华消化外科杂志

Objective To summarize the clinical characteristics,diagnosis and treatment of autoimmune pancreatitis(AIP).Methods The retrospective descriptive study was adopted.The clinical data of 43 patients with AIP who were admitted to the First Affiliated Hospital of China Medical University between January 2010 and December 2014 were collected.All patients underwent laboratory tests and imaging examinations.For the patients who had the definite diagnosis of AIP,corticosteroid therapy was adopted,and for the patients who had the suspicion of pancreatic cancer,surgical operation was carried out.Observed indexes included clinical manifestations,laboratory findings,imaging findings,treatment,pathological findings and follow-up status.The follow-up of imaging examinations and laboratory tests via outpatient and inpatient examinations was performed on the patients until January 2016.Measurement data with skewed distribution were presented as average (range).Results (1) Clinical manifestations:of the 43 patients,33 demonstrated obstructive jaundice,19 had loss of weight,18 had upper abdominal pain and 5 had acute mild pancreatitis (the same patient with a variety of symptoms).Extrapancreatic organ involvement was detected in 23 of the 43 patients,including focal nephritis in 15 patients,sicca syndrome in 7 patients,pulmonary involvement in 5 patients,autoimmune thyroiditis in 5patients,hilar IgG4-associated cholangitis in 3 patients,retroperitoneal fibrosis in 3 patients and ulcerative colitis in 1 patient (the same patient with a variety of diseases).(2) Results of laboratory tests:17 patients underwent serum IgG4 detection and increased expression of IgG4 was found in 15 patients.(3) Imaging findings:all the 43patients underwent enhanced computed tomography (CT) scan of pancreas.Diffused enlargement of pancreas with appearance of sausage was observed in 34 patients and localized pancreatic head enlargement was observed in 9patients.Twenty patients had peripancreatic vascular involvement including stenosis or occlusion of splenic vein,stricture at the confluence of superior mesenteric vein,portal vein and splenic vein resulting in regional portal hypertension which led to gastric venous varices and splenomegaly.Three patients showed that superior mesenteric artery was surrounded by tissue masses with massive ascites.Five patients had pancreatic pseudocyst with splenic vein involvement and peripancreatic effusion.The abdominal CT examination of 15 patients with renal involvement showed renal cortical wedge or nodular lesions.Pulmonary inflammatory pseudotumor and interstitial pneumonia appeared in 5 patients,CT of whom showed solid pulmonary nodules or diffuse ground-glass opacities and patchy shadows in pulmonary interstitium.Thirty-two patients underwent magnetic resonance cholangiopancreatography and 28 patients underwent endoscopic retrograde cholangiopancreatography.The results showed the focal and diffuse or segmental stenosis of the main pancreatic duct were detected in 28 patients (diffuse stenosis in 23patients,local stenosis in 5 patients),stenosis of the intrapancreatic common bile duct in 32 patients,stenosis of hilar bile duct in 3 patients.Nine patients underwent endoscopic ultrasonography examination.The results showed 3 patients had hypoechoic mass in the head of pancreas and 6 patients had diffuse or heterogeneous hypoechoic of the pancreatic parenchyma.(4) Treatment status:of 43 patients,30 patients received initial steroid treatment.After steroid treatment,the clinical symptoms of 27 patients gradually improved and laboratory and imaging findings were both improved.Eleven patients didn 't receive initial steroid treatment,of whom 2 patients with obstructive jaundice underwent endoscopic biliary stent implantation,7 patients underwent surgical biliary drainage and 2 received neither endoscopic treatment nor surgical treatment.Two patients underwent pancreatoduodenectomy due to suspicion of pancreatic adenocarcinoma and were diagnosed as AIP based on postoperative pathological results and treated with steroid after operation.(5) Pathological examination:of the 43 patients,22 underwent pathological examination.Results of pathological examination of superficial lymph nodes showed lymph follicles hyperplasia,and immunohistochemistry staining showed massive IgG4 positive plasmocytes in 5 patients,supporting the diagnosis.Results of fine needle aspiration cytology in 15 patients showed no cytological evidence were detected in 14 patients and epithelial cells of malignant tumors in 1 patient.Results of pathological examination of surgical specimens showed dense infiltration of lymphocyte and immunohistochemistry staining showed massive IgG4 positive plasmocytes.(6) Follow-up status:of 43 patients,41 were followed up for an average time of 28 months (range,12-71 months).Of the 30 patients who received steroid treatment,27 had complete response and 3 had partial response.Of the 27 with complete response,4 patients relapsed during followup and were cured by continuous steroid treatment and extending treatment course,3 patients did not relapse,1 patient relapsed again,and long-term low dose steroid maintenance therapy was needed.The 3 patients with partial response were treated with mycophenolate mofetil for 6,4,4 months and imaging abmormalities disappeaved absolutely.Eleven patients received no steroid for the initial treatment,in whom 2 patients were lost to follow-up,1 patient with common bile duct jejunum anastomosis died in 1 year after surgery.In the other 8 patients,the imaging abnormalities were spontaneous remission or clinical and imaging manifestations were improved after steroid treatment and no recurrence was found.Two patients who underwent pancreatoduodenectomy due to suspicion of pancreatic adenocarcinoma received steroid treatment after operation and no recurrence was observed.Conclusion Clinicians should combine clinical manifestations,serological examination,imaging findings and pathological examination to make definite diagnosis of AIP and make differential diagnosis of pancreatic cancer to avoid unnecessary surgical treatment by misdiagnosis.

DSF-Cu induces apoptosis of human nasopharyngeal carcinoma CNE-2 Z cells by affecting function of mitochondria and cytoskeleton / 中国药理学通报

Aim To study the mechanism of DSF-Cu induced apoptosis of human nasopharyngeal carcinoma CNE-2 Z cells by affecting the function of mitochondria and cytoskeleton. Methods The cell cycle,the rate of apotosis,the levels of intracellular ROS and MMP in CNE-2 Z cells were tested by flow cytometry after trea-ted with different concentration of DSF-Cu. The chan-ges of the cell surface morphology, ultrastructure, cell height, width and roughness were detected by AFM. The distribution and reorganization of cytoskeleton F-actin were observed by Laser scanning confocal micro-scope. Results Cells were incubated with different concentration of DSF-Cu ( 0 ~200 nmol · L-1 ) for 24 h, the apoptotic ratio increased significantly and the treatment of DSF-Cu resulted in a concentration-de-pendent accumulation of CNE-2Z cells in G2/M phase. Furthermore,the treatment of DSF-Cu was able to in-crease the production of intracellular ROS and decrease the MMP in CNE-2Z cells. In addition,AFM imaging showed that compared to the control group,with the in-crease of DSF-Cu concentration,the CNE-2Z cells be-came smaller, cytoplasm condensed, the height in-creased,and the surface roughness reduced. Moreover, the filopodia became shorter, shrinked and even com-pletely destroyed after treated with different concentra-tion of DSF-Cu. At last,the LSCM image showed that the fluorescence intensity of F-actin networks was de-creased, then the structure was rearranged and de-stroyed obviously by treated with DSF-Cu. Conclusion DSF-Cu can induce apoptosis and arrest cell cycle at G2/M phase in CNE-2Z cell through a mitochondria-dependent pathway. Above findings highlight the appli-cations of AFM at the single cell level for the investiga-tion of antineoplastic drug in nasopharyngeal carcinoma therapy.