FLOW AND GEOMETRICAL ALTERATIONS IN RETINAL MICROVASCULATURE CORRELATED WITH THE OCCURRENCE OF DIABETIC RETINOPATHY: Evidence from a Longitudinal Study.

PURPOSE: To assess the relationship between flow and geometric parameters in optical coherence tomography angiography images and the risk of incident diabetic retinopathy (DR). METHODS: This prospective, observational cohort study recruited patients with Type 2 diabetes without DR in Guangzhou, China, and followed up annually. A commercially available optical coherence tomography angiography device (DRI OCT Triton; Topcon Inc, Tokyo, Japan) was used to obtain a variety of flow (foveal avascular zone area, vessel density, and vessel length density) and geometric (fractal dimension and blood vessel tortuosity) parameters in superficial capillary plexus (SCP) and deep capillary plexus. The odds ratio (OR) and its 95% confidence interval (CI) were calculated per 1-SD increase in each optical coherence tomography angiography parameter. RESULTS: Over a follow-up of 1 year, 182 of 1,698 participants (10.7%) developed incident DR. After adjusting for conventional risk factors and image quality score, the higher risk of DR onset was significantly associated with the reduced parafoveal vessel density of SCP (OR = 0.81; 95% CI: 0.69, 0.96; P = 0.016), reduced parafoveal vessel length density of SCP (OR = 0.73; 95% CI: 0.59, 0.90; P = 0.003), reduced fractal dimension of SCP (OR = 0.73; 95% CI: 0.61, 0.87; P < 0.001), increased blood vessel tortuosity of SCP (OR = 1.39; 95% CI: 1.18, 1.64; P < 0.001), and increased blood vessel tortuosity of deep capillary plexus (OR = 1.19; 95% CI: 1.01, 1.40; P = 0.033). CONCLUSION: Reduced vessel density and impaired vessel geometry posed higher susceptibility for DR onset in patients with Type 2 diabetes, supporting the adoption of optical coherence tomography angiography parameters as early monitoring indicators of the newly incident DR.

Oxidation of dCTP contributes to antibiotic lethality in stationary-phase mycobacteria.

Growing evidence shows that generation of reactive oxygen species (ROS) derived from antibiotic-induced metabolic perturbation contribute to antibiotic lethality. However, our knowledge of the mechanisms by which antibiotic-induced oxidative stress actually kills cells remains elusive. Here, we show that oxidation of dCTP underlies ROS-mediated antibiotic lethality via induction of DNA double-strand breaks (DSBs). Deletion of mazG-encoded 5-OH-dCTP-specific pyrophosphohydrolase potentiates antibiotic killing of stationary-phase mycobacteria, but did not affect antibiotic efficacy in exponentially growing cultures. Critically, the effect of mazG deletion on potentiating antibiotic killing is associated with antibiotic-induced ROS and accumulation of 5-OH-dCTP. Independent lines of evidence presented here indicate that the increased level of DSBs observed in the ΔmazG mutant is a dead-end event accounting for enhanced antibiotic killing. Moreover, we provided genetic evidence that 5-OH-dCTP is incorporated into genomic DNA via error-prone DNA polymerase DnaE2 and repair of 5-OH-dC lesions via the endonuclease Nth leads to the generation of lethal DSBs. This work provides a mechanistic view of ROS-mediated antibiotic lethality in stationary phase and may have broad implications not only with respect to antibiotic lethality but also to the mechanism of stress-induced mutagenesis in bacteria.

Regulations of m6A and other RNA modifications and their roles in cancer.

RNA modification is an essential component of the epitranscriptome, regulating RNA metabolism and cellular functions. Several types of RNA modifications have been identified to date; they include N6-methyladenosine (m6A), N1-methyladenosine (m1A), 5-methylcytosine (m5C), N7-methylguanosine (m7G), N6,2'-O-dimethyladenosine (m6Am), N4-acetylcytidine (ac4C), etc. RNA modifications, mediated by regulators including writers, erasers, and readers, are associated with carcinogenesis, tumor microenvironment, metabolic reprogramming, immunosuppression, immunotherapy, chemotherapy, etc. A novel perspective indicates that regulatory subunits and post-translational modifications (PTMs) are involved in the regulation of writer, eraser, and reader functions in mediating RNA modifications, tumorigenesis, and anticancer therapy. In this review, we summarize the advances made in the knowledge of different RNA modifications (especially m6A) and focus on RNA modification regulators with functions modulated by a series of factors in cancer, including regulatory subunits (proteins, noncoding RNA or peptides encoded by long noncoding RNA) and PTMs (acetylation, SUMOylation, lactylation, phosphorylation, etc.). We also delineate the relationship between RNA modification regulator functions and carcinogenesis or cancer progression. Additionally, inhibitors that target RNA modification regulators for anticancer therapy and their synergistic effect combined with immunotherapy or chemotherapy are discussed.

γ-secretase binding sites in aged and Alzheimer's disease human cerebrum: the choroid plexus as a putative origin of CSF Aß.

Deposition of ß -amyloid (Aß) peptides, cleavage products of ß-amyloid precursor protein (APP) by ß-secretase-1 (BACE1) and γ-secretase, is a neuropathological hallmark of Alzheimer's disease (AD). γ-Secretase inhibition is a therapeutical anti-Aß approach, although changes in the enzyme's activity in AD brain are unclear. Cerebrospinal fluid (CSF) Aß peptides are thought to derive from brain parenchyma and thus may serve as biomarkers for assessing cerebral amyloidosis and anti-Aß efficacy. The present study compared active γ-secretase binding sites with Aß deposition in aged and AD human cerebrum, and explored the possibility of Aß production and secretion by the choroid plexus (CP). The specific binding density of [(3) H]-L-685,458, a radiolabeled high-affinity γ-secretase inhibitor, in the temporal neocortex and hippocampal formation was similar for AD and control cases with similar ages and post-mortem delays. The CP in post-mortem samples exhibited exceptionally high [(3) H]-L-685,458 binding density, with the estimated maximal binding sites (Bmax) reduced in the AD relative to control groups. Surgically resected human CP exhibited APP, BACE1 and presenilin-1 immunoreactivity, and ß-site APP cleavage enzymatic activity. In primary culture, human CP cells also expressed these amyloidogenic proteins and released Aß40 and Aß42 into the medium. Overall, our results suggest that γ-secretase activity appears unaltered in the cerebrum in AD and is not correlated with regional amyloid plaque pathology. The CP appears to be a previously unrecognised non-neuronal contributor to CSF Aß, probably at reduced levels in AD.

[Adenovirus vector mediated human 14-3-3 γ gene transfer protects dopaminergic cells against rotenone-induced injury].

OBJECTIVE: To explore the protective effect of human 14-3-3 γ gene transfer on dopaminergic cells against rotenone-induced injury. METHODS: Adenovirus vector carrying the gene of 14-3-3 γ (Ad/14-3-3 γ) was employed to transfect PC12 cells. Then the cells were exposed to rotenone as a model of Parkinson's disease. Methyl thiazolyl tetrazolium (MTT) was used to assay the viability of PC12 cells. The 4',6-diamidino-2-phenylindole (DAPI) staining was used to analyze the apoptotic ratio of PC12 cells among the groups of control, Ad/14-3-3 γ, Ad-null and Rotenone. And high performance liquid chromatography (HPLC) was performed to detect the secreting functions of PC12 cells. The aggregates of α-Synuclein protein were detected under confocal microscopy. RESULTS: MTT showed that the cell absorbance A(570) of Ad/14-3-3 γ group (0.46 ± 0.09) was higher than that of Ad-null group (0.19 ± 0.08) and rotenone group (0.16 ± 0.07), but lower than that of normal control (0.63 ± 0.11), (all P < 0.01); HPLC-ECD showed that the levels of dopamine (189 ± 11) ng/ml and noradrenalin (55 ± 8) ng/ml in the culture fluid of Ad/14-3-3 γ group were higher than those of Ad-null group (79 ± 12, 38 ± 7) ng/ml and rotenone group (81 ± 13, 39 ± 7) ng/ml (all P < 0.01). DAPI staining showed that cell apoptosis ratio of group Ad/14-3-3 γ (27% ± 64%) was lower than that of group Ad-null (53% ± 10%) and rotenone group (56% ± 12%, P < 0.01), but higher than that of control group (10% ± 5%, P < 0.01). Under confocal microscopy, the aggregates of α-synuclein protein in PC12 cells were detected more in Ad-null group and rotenone group than that in Ad/14-3-3 γ group. CONCLUSION: Gene transfer of Ad/14-3-3 γ has a protective effect on dopaminergic cells against rotenone-induced injury.

Macular Choroidal Thickness and the Risk of Referable Diabetic Retinopathy in Type 2 Diabetes: A 2-Year Longitudinal Study.

Purpose: The purpose of this study was to evaluate the associations between choroidal thickness (CT) and the 2-year incidence of referable diabetic retinopathy (RDR). Methods: This was a prospective cohort study. Patients with type 2 diabetes in Guangzhou, China, aged 30 to 80 years underwent comprehensive examinations, including standard 7-field fundus photography. Macular CT was measured using a commercial swept-source optical coherence tomography (SS-OCT) device (DRI OCT Triton; Topcon, Tokyo, Japan). The relative risk (RR) with 95% confidence intervals (CIs) was used to quantify the association between CT and new-onset RDR. The prognostic value of CT was assessed using the area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Results: A total of 1345 patients with diabetes were included in the study, and 120 (8.92%) of them had newly developed RDR at the 2-year follow-up. After adjusting for other factors, the increased RDR risk was associated with greater HbA1c (RR = 1.35, 95% CI = 1.17-1.55, P < 0.001), higher systolic blood pressure (SBP; RR = 1.02, 95% CI = 1.01-1.03, P = 0.005), lower triglyceride (TG) level (RR = 0.81, 95% CI = 0.69-0.96, P = 0.015), presence of diabetic retinopathy (DR; RR = 8.16, 95% CI = 4.47-14.89, P < 0.001), and thinner average CT (RR = 0.903, 95% CI = 0.871-0.935, P < 0.001). The addition of average CT improved NRI (0.464 ± 0.096, P < 0.001) and IDI (0.0321 ± 0.0068, P < 0.001) for risk of RDR, and it also improved the AUC from 0.708 (95% CI = 0.659-0.757) to 0.761 (95% CI = 0.719-0.804). Conclusions: CT thinning measured by SS-OCT is an early imaging biomarker for the development of RDR, suggesting that alterations in CT play an essential role in DR occurrence.

Decreasing hyaluronic acid combined with drug-loaded nanoprobes improve the delivery and efficacy of chemotherapeutic drugs for pancreatic cancer.

Pancreatic cancer is one of the common malignant tumors of the digestive system, and its clinical treatment is still very challenging. Most of the pancreatic cancer chemotherapeutic drugs have poor plasma stability, low cell uptake efficiency, and are prone to developing drug resistance and toxic side effects. Besides, pancreatic cancer often has a dense extracellular matrix, which consists of collagens, hyaluronic acid, and other proteoglycans. Among them, hyaluronic acid is a key component of the dense matrix, which results in vascular compression and insufficient perfusion, and hinders the delivery of chemotherapeutic drugs. In this study, we explore using hyaluronidase in tumor-bearing mice to eliminate the hyaluronic acid barrier, to reduce blood vessel compression and reshape the tumor microenvironment. In addition, we evaluate using doxorubicin-loaded nanoprobes to improve the stability and local tumor-killing effect of the drug. The nanoprobes have the characteristics of near-infrared optical imaging, which are used to monitor the tumor size in real-time during the treatment process, and dynamically observe the tumor inhibitory effect. The results show that elimination of the hyaluronic acid barrier combined with the doxorubicin-loaded nanoprobes can greatly increase drug penetration into tumor tissue and improve the effectiveness of chemotherapy drugs. This study provides a novel strategy for the treatment of pancreatic cancer.

Housecleaning of pyrimidine nucleotide pool coordinates metabolic adaptation of nongrowing Mycobacterium tuberculosis.

The ability of Mycobacterium tuberculosis (Mtb) to adopt a slowly growing or nongrowing state within the host plays a critical role for the bacilli to persist in the face of a prolonged multidrug therapy, establish latency and sustain chronic infection. In our previous study, we revealed that genome maintenance via MazG-mediated elimination of oxidized dCTP contributes to the antibiotic tolerance of nongrowing Mtb. Here, we provide evidence that housecleaning of pyrimidine nucleotide pool via MazG coordinates metabolic adaptation of Mtb to nongrowing state. We found that the ΔmazG mutant fails to maintain a nongrowing and metabolic quiescence state under dormancy models in vitro. To investigate bacterial metabolic changes during infection, we employed RNA-seq to compare the global transcriptional response of wild-type Mtb and the ΔmazG mutant after infection of macrophages. Pathway enrichment analyses of the differentially regulated genes indicate that the deletion of mazG in Mtb not only results in DNA instability, but also perturbs pyrimidine metabolism, iron and carbon source uptake, catabolism of propionate and TCA cycle. Moreover, these transcriptional signatures reflect anticipatory metabolism and regulatory activities observed during cell cycle re-entry in the ΔmazG mutant. Taken together, these results provide evidence that pyrimidine metabolism is a metabolic checkpoint during mycobacterial adaptation to nongrowing state.

Preparation and quality evaluation of total flavonoids microemulsion of "Pueraria lobata-Hovenia dulcis" / 中国中药杂志

The effective components of flavonoids in the "Pueraria lobata-Hovenia dulcis" drug pair have low bioavailability in vivo due to their unstable characteristics. This study used microemulsions with amphoteric carrier properties to solve this problem. The study drew pseudo-ternary phase diagrams through titration compatibility experiments of the oil phase with emulsifiers and co-emulsifiers and screened the prescription composition of blank microemulsions. The study used average particle size and PDI as evaluation indicators, and the central composite design-response surface method(CCD-RSM) was used to optimize the prescription; high-dosage drug-loaded microemulsions were obtained, and their physicochemical properties, appearance, and stability were evaluated. The results showed that when ethyl butyrate was used as the oil phase, polysorbate 80(tween 80) as the surfactant, and anhydrous ethanol as the cosurfactant, the maximum microemulsion area was obtained. When the difference in results was small, K_(m )of 1∶4 was chosen to ensure the safety of the prescription. The prescription composition optimized by the CCD-RSM was ethyl butyrate(16.28%), tween 80(9.59%), and anhydrous ethanol(38.34%). When the dosage reached 3% of the system mass, the total flavonoid microemulsion prepared had a clear and transparent appearance, with average particle size, PDI, and potential of(74.25±1.58)nm, 0.277±0.043, and(-0.08±0.07) mV, respectively. The microemulsion was spherical and evenly distributed under transmission electron microscopy. The centrifugal stability and temperature stability were good, and there was no layering or demulsification phenomenon, which significantly improved the in vitro dissolution of total flavonoids.

Electroencephalogram signal analysis and its research progress in the field of epilepsy treatment / 中华神经科杂志

Epilepsy is a serious chronic neurological disorder that can be detected by analysing the brain signals generated by brain neurons, with electroencephalography (EEG) becoming a key tool in the diagnosis of epilepsy. The application of specific methods for processing and analysing EEG signals is important in exploring the working mechanisms of the brain and in the diagnosis of neurological disorders of the brain. The article describes the application of EEG signals in epilepsy treatment through feature extraction, feature classification and other related analysis methods. The article presents an overview of recent research advances through the use of principal component analysis, independent component analysis, wavelet transform, linear discriminant analysis, support vector machine, artificial neural network and decision tree. It provides some reference for the detection and classification of seizures and future research directions.

Kinetics and variation of volatile components of Atractylodis Macrocephalae Rhizoma during hot-air drying / 中国中药杂志

The present study explored the kinetics and variation of volatile components of Atractylodis Macrocephalae Rhizoma during the hot-air drying process to obtain the optimal process parameters under multiple goals such as drying efficiency and drying quality. The dry basis moisture content and drying rate curves along with the change of drying time of Atractylodis Macrocephalae Rhizoma were investigated at five levels of drying air temperatures(30, 40, 50, 60, and 70 ℃). The relationship between moisture ratio and time in the drying process of Atractylodis Macrocephalae Rhizoma was fitted and verified by Midilli model, Page model, Overhults model, Modified Page model, Logaritmic model, Two terms Exponential model, and Newton model. Meanwhile, the effective diffusion coefficient of moisture(D_(eff)) and activation energy(E_a) in Atractylodis Macrocephalae Rhizoma were calculated under different drying air temperatures. GC-MS was used to determine the volatile components and content changes of the fresh Atractylodis Macrocephalae Rhizoma and dried products at different temperatures. The dry basis moisture content and drying rate of Atractylodis Macrocephalae Rhizoma were closely related to the temperature of the drying medium, and the moisture of the Atractylodis Macrocephalae Rhizoma decreased with the prolonged drying time. As revealed by the drying rate curve, the drying rate increased with the increase in hot air temperature, and the migration of moisture was accelerated. The comparison of the correlation coefficient(R~2), chi-square(χ~2), and root mean standard error(RMSE) of each model indicated that the parameter average of the Midilli model had the highest degree of fit, with R~2=0.999 2, χ~2=8.78×10~(-5), and RMSE=8.20×10~(-3). Besides, the D_(eff) at 30-70 ℃ was in the range of 1.04×10~(-9)-6.28×10~(-9) m~2·s~(-1), and E_a was 37.47 kJ·mol~(-1). The volatile components of fresh Atractylodis Macrocephalae Rhizoma and dried products at different temperatures were determined by GC-MS, and 18, 18, 18, 17, 17, and 18 compounds were identified respectively, which accounted for more than 84.76% of the volatile components. In conclusion, the hot-air drying of Atractylodis Macrocephalae Rhizoma can be model-fitted and verified and the variation law of the moisture and volatile components of Atractylodis Macrocephalae Rhizoma with temperature is obtained. This study is expected to provide new ideas for exploring the drying characteristics and quality of aromatic Chinese medicine.

Long noncoding RNAs are involved in osteoblast differentiation and osteoclast production / 中国组织工程研究

BACKGROUND: Long noncoding RNAs play a role In transcription and post-transcrlptlonal levels, participate in the regulation of bone regeneration, and are closely related to osteoarthritis as well.  OBJECTIVE: To review the research progress of long noncoding RNAs in bone regeneration and osteoarthritis. METHODS: A computer-based search of CNKI, PubMed, and Elsevier was performed for relevant articles regarding long noncoding RNAs in bone regeneration and osteoarthritis published from January 2000 to June 2019, including review, basic research and clinical research. The search terms were “LncRNA; bone; bone regeneration; osteoarthritis” in Chinese and English. After preliminarily reading titles and abstracts, irrelevant articles were excluded. According to the inclusion and exclusion criteria, 64 articles were finally included in result analysis. RESULTS AND CONCLUSION: Bone regeneration is a complex process involving the interaction of osteoblasts and osteoclasts. Long noncoding RNAs are involved in the differentiation of osteoblasts and the production of osteoclasts, which play an important role in the balance of osteoblasts and osteoclasts. Therefore, it is a key molecule of bone regeneration. Long noncoding RNAs are involved in the occurrence and development of osteoarthritis and differentially expressed in osteoarthritis patients and healthy people, some of which are elevated and some are decreased in osteoarthritis patients. Thus, defining their respective expression differences and functions is of great significance for the prevention and treatment of osteoarthritis.

Research advances in drug resistance mechanisms of bacterial biofilm and natural drug intervention / 中国中药杂志

Drug resistance resulting from bacterial biofilms can invalidate antibacterial agents. Therefore,eradicating bacterial biofilms to reverse drug resistance is a hotspot in the pharmaceutical research. In recent years,numerous studies have revealed the complicated mechanism of bacterial biofilm formation and strong drug resistance with multiple influential factors involved. This paper gives a comprehensive review on the process of biofilm formation and intervention by natural drugs,which can provide some reference and evidence for the following studies.

Preparation of progressive gradient-aperture osteochondral scaffold and its cytocompatibility evaluation / 中华老年医学杂志

Objective:To prepare a progressive gradient-aperture scaffold composed of silk fibroin(SF)-chitosan(CS)-nano-hydroxyapatite(nHAp)for osteochondral repair.Method:The SF solution, CS solution and nHA suspension were mixed in vitro at equal proportions.The progressive gradient osteochondral(OC)scaffold-1(2%), scaffold-2(3%)and scaffold-3(4%)was respectively prepared by using centrifugation, vacuum freeze-drying, chemical cross-linking and three shaping steps.General conditions, porosity, hot water dissolution rate, water swelling rate, compression water swelling rate, water swelling rate after dissolution, mechanical properties, internal structure observation and pore size were measured.Rat bone marrow mesenchymal stem cells(BMSCs)were cultured and the scaffold extract was prepared.The effect of scaffold extract on the proliferation of BMSCs was detected by the cell counting kit-8(CCK-8)method.BMSCs were co-cultured with the scaffold, and the distribution and morphology of the cells around the scaffold were observed.Results:The structure of scaffold was regular in each group and the porosity was more than 80%.Along with the increase of the material concentration, the water swelling rate of the scaffold was decreased gradually( P<0.05). Compared with before compression, the water swelling rate of scaffold-1 was decreased after compression( P<0.05). There was no significant difference in the hot water dissolution rate among all groups( all P>0.05), and the complete dissolution of the scaffold-1, scaffold-2 and scaffold-3 in vitro required 65.9, 60.9, and 73.9weeks, respectively.The elastic modulus of scaffolds in above three groups were 0.0955, 0.1762 and 0.3468 MPa, respectively.The examination results of scanning electron microscope(SEM)showed that the internal structure of scaffold was honeycomb in each group, the pore shape was regular, which showed an inter-connected pore network.The pore distribution was gradually dense and the pore diameter gradually decreased from the cartilage side to the osteogenic side( P<0.05), and the nHAp content increased gradually.The scaffold extract had no obvious toxicity to the growth and proliferation of BMSCs in each group.After BMSCs were seeded on scaffolds and co-cultured for 5 days, the cells grew well without obvious cell death or morphological abnormalities. Conclusions:In this study, a progressive gradient pore size OC scaffold is successfully prepared with good physical properties and biocompatibility, which is expected to be a new bio-mimetic composite scaffold material for repairing OC defects.

The clinical significance of the changes of Th17 cells and cytokines IL-17 and IL-6 in hepatocellular carcinoma patients / 中华肝胆外科杂志

Objective To investigate the change of the percentage of Th17 cells and cytokine among hepatocellular carcinoma (HCC) tissues and para-carcinoma tissue and the liver tissue of hepatic hemangio-ma, and to explore its clinical significance. Methods To choose 26 of hepatocellular carcinoma patients between November 2014 and December 2016 and also include 11 cases of hepatic hemangioma as control group. The percentage of Th17cells in HCC tissue and para-carcinoma tissue and the liver tissue of hepatic hemangioma was evaluated by flow cytometric; The levels of IL-6 and IL-17 in HCC tissues, para-carcinoma tissue and the liver tissue of hepatic hemangioma were detected by RT-PCR. Results The ratio of Th17 cells to CD4 cells in peripheral blood of HCC was significantly higher than that in control group (4. 07% ± 0. 68% vs. 1. 39% ± 0. 41% ), P＜0. 05. The ratio of Th17 cells to CD4 cells in patients with hepatocellular carcinoma was significantly higher than that in paracancerous tissues and liver tissues of hepatic hemangioma (4. 76% ± 0. 75% vs. 2. 30% ± 0. 26% vs. 0. 77% ± 0. 31% , P＜0. 05). Multivariate linear stepwise regression analysis of the changes of Th17 cells in patients with HCC and their correlation with clinical parameters showed that Th17 lymphocytes in peripheral blood of patients with HCC were closely related to TNM staging(YTh17 =2. 647 +0. 687TNM. It’s indicated that the level of IL-6 and IL-17 in liver cancer tissues was significantly higher than that of the liver hemangioma in the control group through ELISA ( P＜0. 05). The proportion of peripheral blood Th17 cells to CD4 cells is different in different TNM stages(stage I＜stage II ＜stage III ～IV, the difference was statistically significant. RT-PCR analysis showed that the expression of IL-17, IL-6mRNA in hepatocellular carcinoma was significantly higher than that in adjacent tissues and hepatic hemangioma liver tissue (all P＜0. 05). Conclusion The increased proportion of Th17 cells and the increased levels of cytokines IL-6 and IL-17 may be closely correlated with occurrence and development of hepatocellular carcinoma. It can be an important target of anti-tumor therapy.

Network Meta-analysis on the efficacy and safety of surgical resection and thermal ablations for hepatocellular carcinoma in China / 中华肝胆外科杂志

Objective@#To compare the efficacy and safety of surgical resection and thermal ablations in patients with hepatocellular carcinoma in China using a network Meta-analysis.@*Methods@#References related to eligible randomized controlled studies (RCTs) were searched from China Biology Medicine, China National Knowledge Infrastructure(CNKI), PubMed, Embase and Cochrane Library from 1st January 2010 to 1st December 2017, and were selected according to the criteria. The 1-year, 3-year, and 5-year survival rates and incidence of serious complications were compared among surgical resection (SR), radiofrequency ablation (RFA), and microwave ablation(MWA) by network Meta-analysis based frequency and Bayesian methods.@*Results@#A total of 24 RCTs were included in this study. The results of surface under the cumulative ranking probabilities (SUCRA) showed that when all RCTs were included, the frequency model supported MWA had the highest 5-year overall survival rate (66.1%), while the Bayesian model supported SR had the highest 5-year overall survival rate (64.7%). When the tumor diameter of hepatocellular carcinoma was less than 5 cm and the liver function was Child-Pugh A/B, the frequency and Bayesian model both supported SR had the highest 5-year overall survival rate (89.1% and 88.3%, respectively). When all RCTs or RCTs were included with the tumor diameter less than 5 cm and liver function was Child-Pugh A/B, both the frequency and the Bayesian model supported RFA had the best safety (serious complications rate) (16.4%, 18.7%, 12.6 and 12.8%, respectively).@*Conclusion@#SR should be the first choice for early and small hepatocellular carcinoma, while RFA and MWA have their own indications.

Analyses on allocation and utilization of class-B large medical equipments at public hospitals under Pudong New Area / 中华医院管理杂志

Objective To analyze the allocation and utilization of class-B large medical equipments at public hospitals under Pudong New Area,Shanghai.Methods Data on the allocation and utilization of class-B large medical equipments were collected by a questionnaire survey of 17 public hospitals under Pudong New Area from June to July 2017 and were analyzed in descriptive statistics.Results There were 55 units of class-B large medical equipments at the public hospitals under by Pudong New Area.The average utilization rates of MRI,CT and DSA were 52.62％,61.49％ and 24.43％ respectively.Conclusions The number of class-B large medical equipments has increased at such hospitals,but the services using DSA need to be extended.

Classification of Chinese Medicines Containing Volatile Oil and Analysis of Quality Influencing Factors Based on Fist Part in Chinese Pharmacopoeia 2015 Edition / 中国实验方剂学杂志

Volatile oil is widely distributed in Chinese medicinal materials,which contains rich chemical compositions and has a variety of pharmacological activities such as anti-bacterial,anti-inflammatory,anti-oxidant,anti-tumor,transdermal absorption and antalgic activities,etc.In recent years,the research on the Chinese medicines containing volatile oil is increasing,showing a wide prospect of application in clinical medicine,health care,daily products development,etc.Volatile oil of traditional Chinese medicine has poor solubility,volatility and unstable properties.Factors such as species,harvesting seasons,extraction methods,processing technologies and storage conditions would affect the compositions and contents of volatile oil,thus directly affecting its efficacy,safety and quality stability.Hence,it is especially necessary to control the volatile oil content.The current 2015 edition of the Chinese Pharmacopoeia has made a lot of regulations on the quality control of Chinese medicines containing volatile oil,but generally does not provide the lowest and highest concentrations of volatile oil.As the volatile oil of traditional Chinese medicines has good biological activity and the quality standards are not yet perfect,this study would take the Fist Part of Chinese Pharmacopoeia 2015 Edition as the data source to determine the species of Chinese medicines containing volatile oils through literature research and pharmacopoeia description;the functions,indications,and sources of 196 kinds of traditional Chinese medicines containing volatile oil would be classified and the confusable species would be discriminated by using the Chinese pharmacy knowledge.In this study,the quality-influencing factors would be comprehensively analyzed and the content determination methods of volatile oil would be summarized to offer a reference for the development and application of Chinese medicinal materials containing volatile oil,as well as to lay the foundation for further reinforcing and improving their quality standards.

Application value of enhanced recovery after surgery in the laparoscopic surgery for cholecystolithiasis comorbid with choledocholithiasis / 中华消化外科杂志

Objective To explore the clinical application value of enhanced recovery after surgery (ERAS) in the laparoscopic surgery for cholecystolithiasis comorbid with choledocholithiasis.Methods The prospective study was conducted.The clinicopathological data of 52 patients with cholecystolithiasis comorbid with choledocholithiasis who were admitted to the Third Affiliated Hospital of Zunyi Medical University from September 2016 to September 2018 were collected.Patients were divided into 2 groups by random number table:patients in observation group received laparoscopic cholecystectomy + choledocholithotomy + choledochoscopic exploration +T-tube drainage (or primary suture of common bile duct) and perioperative management guided by the concept of enhanced recovery after surgery (ERAS),and patients in control group received traditional perioperative management.Observation indicators:(1) surgical situations;(2) postoperative situations;(3) postoperative complications;(4) postoperative pain scores;(5) changes in hepatic function and blood routine during perioperative period.Follow-up using outpatient examination and telephone interview was performed to detect complications during the postoperative 6 months up to March 2019.Measurement data with normal distribution were represented as Mean ± SD,and comparison between groups was analyzed using the paired t test or repeated ANOVA.Count data were described as absolute numbers and percentages,and comparison between groups was analyzed using the chi-square test or Fisher exact probability.Results Fifty-two patients were screened for eligibility,including 20 males and 32 females,aged 25-68 years,with an average age of 53 years.There were 30 patients in the observation group and 22 in the control group.(1) Surgical situations:the operation time and volume of intraoperative blood loss were (133± 19) minutes and (47 ± 21) mL in the observation group,and (136±22) minutes and (49±23)mL in the control group,respectively,showing no significant difference between the two groups (t=-0.386,-0.211,P＞0.05).(2) Postoperative situations:time to out-of-bed activity,time to initial food intake,time to first anal flatus,duration of postoperative hospital stay,and hospital expenses were (18±4) hours,(19±5) hours,(28±2)hours,(4.0± 1.0)days,and (1.82±0.22) × 104 yuan in the observation group,and (29±7)hours,(46±9)hours,(37±4)hours,(6.6±1.6)days,and (2.25±0.29) ×104 yuan in the control group,respectively,showing significant differences between the two groups (t =-7.054,-14.169,-9.426,-6.582,-5.809,P＜0.05).(3) Postoperative complications:1 of 30 patients in the observation group had postoperative biliary leakage,with a postoperative complication rate of 3.3％,and was cured after symptomatic support treatment.Six of 22 patients in the control group had postoperative complication,with a postoperative complication rate of 27.3％,including 2 of biliary leakage,1 of hemorrhage,1 of abdominal infection,1 of pulmonary infection,1 of urinary infection,and they were cured after symptomatic support treatment.There was a significant difference between the two groups (x2 =4.358,P ＜ 0.05).(4) Postoperative pain scores:from postoperative 6 hours to 48 hours,the postoperative pain score changed from 2.4 ± 0.7 to 1.9± 0.9 in the observation group,and from 4.1 ± 0.7 to 2.9 ± 0.9 in the control group,respectively,showing a significant difference in the changing trend between the two groups (F=78.053,P＜0.05).(5) Changes in hepatic function and blood routine during perioperative period:from preoperation to postoperative 3 days,levels of alamine aminotransferase (ALT),aspartate transaminase (AST),gamma-glutamyltransferase (GGT),total bilirubin (TBil),and count of white blood cells in the observation group changed from (77±20)U/L to (53± 12)U/L,from (85±22)U/L to (61± 17) U/L,from (166±39) U/L to (55±24) U/L,from (40± 13) μmol/L to (29±12) μmol/L,from (7.0±2.0) × 109/L to (6.8± 1.9) × 109/L,and changed from (79±23) U/L to (62± 14) U/L,from (88±24)U/L to (64± 17) U/L,from (179±34) U/L to (74±29) U/L,from (45± 13) μmol/L to (35±12) μmol/L,from (7.9±2.4)× 109/L to (7.5± 1.9)× 109/L in the control group,respectively.The levels of ALT,AST,GGT,TBiL,and count of WBC showed increasing at postoperative 1 day,and decreasing at postoperative 3 days.There was no significant difference in the changing trend between the two groups (F=0.058,0.471,3.021,1.593,2.172,P＞0.05).Conclusion ERAS is safe and effective in the laparoscopic surgery for choledocholithiasis comorbid with cholecystolithiasis.