[Analysis of the difference in MGMT promoter status in gliomas and its significance in prognosis assessment].

The data of 1 268 newly diagnosed gliomas from the Fourth Ward of Neurosurgery Department of Beijing Tiantan Hospital between April 2013 and March 2022 were retrospectively analyzed. Based on postoperative pathology, the gliomas were divided into groups: oligodendrogliomas (n=308), astrocytomas (n=337) and glioblastomas (n=623). According to the O6-methylguanine-DNA methyl transferase (MGMT) promoter status defined by the 12% of best cut-off value in previous research results, patients were divided into methylation group (n=763) and non-methylation group (n=505). Methylation level [M (Q1, Q3)] in patients with glioblastoma, astrocytoma and oligodendroglioma was 6% (2%, 24%), 17% (10%, 28%) and 29% (19%, 40%), respectively (P<0.001). Compared with non-methylation patients, the progression-free survival (PFS) and overall survival (OS) of glioblastomas patients with methylation of MGMT promoter demonstrated more favorable prognosis [M (Q1, Q3)]) of PFS: 14.0 (6.0, 36.0) months vs 8.0 (4.0, 15.0) months, P<0.001; M (Q1, Q3) of OS: 29.0 (17.0, 60.5) months vs 16.0 (11.0, 26.5) months, P<0.001]. In astrocytomas patients, the PFS was much longer for those with methylation [the median PFS of patients with methylation was not observed at the end of follow-up, but those without methylation showed a median PFS of 46.0 (29.0, 52.0) months] (P=0.001). However, no statistically significant difference was observed in OS [the median OS of patients with methylation was not observed at the end of follow-up, but those without methylation had a median OS of 62.0 (46.0, 98.0) months] (P=0.085). In oligodendrogliomas patients, no statistically significant differences of PFS and OS were observed between patients with methylation and those without methylation. MGMT promoter status was a related factor affecting PFS and OS in glioblastomas (PFS: HR=0.534,95%CI: 0.426-0.668, P<0.001; OS: HR=0.451, 95%CI: 0.353-0.576, P<0.001). Moreover, MGMT promoter status was also a related factor affecting PFS in astrocytomas (HR=0.462, 95%CI: 0.221-0.966, P=0.040), but not for OS (HR=0.664, 95%CI: 0.259-1.690, P=0.389). The methylation level of MGMT promoter differed substantially in different types of gliomas, and the status of MGMT promoter profoundly affected the prognosis of glioblastomas.

[Clinical characteristics of 13 cases with entrapped temporal horn syndrome and efficacy of refined temporal-to-frontal horn shunt].

Thirteen consecutive patients with entrapped temporal horn syndrome in the Department of Neurosurgery of Beijing Tiantan Hospital from February 2018 to September 2022 were retrospectively analyzed, and there were 5 males and 8 females, with a mean age of (43±21) years. Increased intracranial pressure caused by hydrocephalus was the main clinical symptom. All the patients underwent refined temporal-to-frontal horn shunt, and all the symptoms were improved after surgery. Postoperative Karnofsky performance score (KPS) [90 (90, 100)] was higher than preoperative KPS [57 (40, 70)] (P=0.001). However, postoperative entrapped temporal horn volume [13.85 (8.90, 15.25) cm3] decreased, compared with preoperative volume [66.52 (38.65, 88.65) cm3] (P=0.001). Likewise, postoperative midline shift [0.77 (0, 1.50) mm] was longer than preoperative midline shift [6.69 (2.50, 10.00) mm] (P=0.002). No surgery-related complications were observed after the operation. Therefore, the refined temporal-to-frontal horn shunt is safe and effective treatment for entrapped temporal horn syndrome, with favorable outcomes.

[A three-year follow-up observation of a pedigree of maturity onset diabetes of the young caused by a novel mutation of glucokinase and literature review].

Objective: To explore the clinical characteristics and follow-up outcomes of a pedigree of maturity onset diabetes of the young (MODY) induced by a novel mutation of glucokinase (GCK). Methods: The clinical features and laboratory data of a pedigree diagnosed with GCK-MODY in Peking Union Medical College Hospital was analyzed. Genomic DNA was extracted, and Sanger sequencing was performed to detect the gene mutation of the family members. The proband and her father were followed up for 3 years. Wanfang and PubMed were used to search literatures on follow-up studies for treatment of GCK-MOYD. Results: Both the proband and her father were found to have a novel mutation on the GCK gene located in exo10 c.1348G.T (p. Ala450Thr). The proband was treated with diet and exercise control only. At the end of the follow-up, her fasting plasma glucose (FPG, 6.8 mmol/L), 2 h postprandial plasma glucose (2hPG, 7.4 mmol/L), and glycated hemoglobin (HbA1c, 6.3%) were all within the control targets. Additionally, the levels homeostasis model assessment of insulin resistance (HOMA-IR) tended to improved comparing to that at baseline (4.09 to 2.32), and glucose disposition index (DI) was improved compared with baseline (16.22 to 20.05). As to the proband's father, the treatment with insulin plus acarbose was converted to sulfonylureas monotherapy. His FPG and 2hPG mostly were within the target range, and the levels of HbA1c were significantly reduced by 0.5%-0.7% when compared to that at baseline. The HOMA-IR or islet beta cell function was comparable to those at baseline. Conclusions: Screening patients whose clinical performance meets GCK-MODY and their family members with proper genetic testing is of great importance to reduce misdiagnosis of GCK-MODY, so as to obtain a better glucose control without unnecessary over-treatment and protect islet beta cell function.

[Factor analysis of cerebrospinal fluid spread in glioblastoma].

Objective: To analyze the prognosis factors of cerebrospinal fluid (CSF) spread after surgery in glioblastoma (GBM) patients when tumors progressed and the effect factors on prognosis. Methods: A retrospective study was conducted on 124 patients who were pathologically diagnosed as glioblastoma after surgery, and found tumor progressed during regularly follow-up at Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University between January 2009 and August 2017.There were 82 males and 42 females, aged 47.9 years(range: 19 to 75 years) .Patients were divided into local recurrence group(96 cases) and CSF spread group (28 cases) .Clinical data were recorded in detail and compared by independent sample t test or χ(2) test.Kaplan-Meier survival curves was used to demonstrated the distribution of progression free survival (PFS) overall survival (OS) and post progression survival (PPS), and differences between local recurrence and CSF spread groups were assessed by Log-rank test.Cox proportion hazard regression analysis was used to identify independent prognostic factors. Results: Logistics regression analysis showed ventricle entry was the only prognosis factor of CSF spread (OR=2.667, 95% CI: 1.128 to 6.304, P=0.025).No significant distinction was observed in PFS between CSF spread group and local recurrence group(7.0 months vs.9.3 months, P=0.066).However, OS and PPS were substantially shortened in CSF spread group (13.0 months vs.23.0 months, P=0.011; 6.0 months vs.11.0 months, P=0.022, respectively).Mutations of isocitrate dehydrogenase gene, distant spread, gross-total resection, Ki-67 index>30% were independent prognostic factors of GBM patients. Conclusions: Ventricle entry is a prognosis factor for CSF spread, after which the median OS and PPS are markedly diminished.However, ventricle entry is not independent prognosis factor shortening survival.

Measurement of gain characteristics of semiconductor lasers by amplified spontaneous emissions from dual facets.

In this letter, we describe a novel gain measurement approach for semiconductor edge-emitting lasers, with which TE and TM gain spectra can be easily obtained by collecting the amplified spontaneous emissions at dual facets of the device. An unstrained and continuously-operated GaAs/AlGaAs single quantum well laser strip is used to illustrate this method. The measured gain spectra are compared with theoretical gain curves to analyze the gain polarization characteristics and the relevant subband structure in the valence band of the well using the measured gain spectra.

A sero-epidemiological survey of Chinese Babesia motasi for small ruminants in China.

Babesia motasi BQ1 (Lintan) was first isolated from Haemaphysalis qinghaiensis collected in Gannan Tibet Autonomous Region, Gansu province in April 2000. In this study, a total of 3,204 serum samples from small ruminants in 22 provinces located in different districts of China were tested for antibodies against merozoite antigens from cultured B. motasi BQ1 (Lintan) by enzyme-linked immunosorbent assay. This method can survey the prevalence of low-pathogenic Chinese B. motasi. The results of this survey indicated that the average positive rate was 43.5 %, and the positive rates of investigated provinces were significantly different from 6.1 to 91.0 %, and the infections had been found in all provinces investigated. Our data provide large important information regarding the current sero-prevalence of B. motasi in China.

Protective effects of ligustrazine, kakonein and Panax notoginsenosides on multiple organs in rats with severe acute pancreatitis.

The aim of this study was to compare the protective effects of three traditional Chinese herbal medicines (ligustrazine, kakonein and Panax notoginsenosides) on multiple organs in a rat model of severe acute pancreatitis (SAP) and to explore the underlying mechanisms. The mortality rates in all three treated groups were significantly lower than the control group (P < 0.05). All three herbal medicines significantly alleviated the pathological changes in the pancreas, liver and kidney in SAP rats, induced pancreatic acinar cell apoptosis and effectively prevented the apoptosis of cells in the liver and kidney; however, no obvious lung protection was observed. Panax notoginsenosides showed better pancreatic protection than ligustrazine and kakonein, while kakonein displayed a better role in improving liver and kidney function. The protective effects of ligustrazine were somewhat more comprehensive.

The potential biological functions of circular RNAs during the initiation of atresia in pig follicles.

The specific expression profile and function of circular RNAs (circRNAs) in mammalian ovarian follicles, especially during the atresia process, are unclear. In this study, genome-wide deep circRNA sequencing was applied to screen circRNAs in healthy and early atretic antral follicles in pig ovaries. A total of 40,567 distinct circRNAs were identified in follicles, among which 197 circRNAs (108 upregulated and 89 downregulated) were significantly shifted during the early atresia process. Most differentially expressed circRNAs (DECs) lacked protein-coding potential. Annotation analysis of the DECs revealed 162 known host genes, or noncoding RNAs, and 10 intergenic regions. The key pathways in which these host genes are involved include the focal adhesion-PI3K-Akt-mTOR signaling pathway, vascular endothelial growth factor A (VEGFA)-vascular endothelial growth factor receptor 2 signaling pathway and transforming growth factor-beta signaling pathway. Further comparison analysis between host genes of DECs and the differentially expressed linear messenger RNA transcripts revealed the cotranscription of circRNAs and their linear mRNAs in inhibin beta units (INHBA and INHBB), glutathione S-transferase (GSTA1), and VEGFA. In addition, we predicted 196 pairs of potential circRNA-micro RNA (miRNA) interactions among 77 DECs and 101 porcine miRNAs. We have identified 16 functional miRNAs by comparing the 101 miRNAs to the functional miRNAs reported in mammal ovarian follicle atresia and granulosa cell apoptosis studies. Our study adds new knowledge to circRNA distribution profiles in pig ovarian follicles, offers a valuable reference for transcriptomic profiles in the initiation of follicular atresia, highlights warranted circRNAs for further functional investigation, and provides possible biomarkers for ovarian dysfunctions.

At least two genetically distinct large Babesia species infective to sheep and goats in China.

A fatal disease of sheep and goats in the northern part of China has been reported to be due to Babesia ovis. However, some characteristics of the causative agent in recent reports are not in accordance with the original attributes ascribed to this parasite. Therefore, the 18S small subunit ribosomal RNA (18S rRNA) genes of a number of Babesia isolates in China were sequenced and compared with that of other Babesia and Theileria species in an attempt to clarify their taxonomic position. In the present study, seven Babesia isolates were collected from distinct areas of northern China, and the 18S rRNA genes were amplified and sequenced. The phylogenetic trees were inferred based on 18S rRNA gene sequences of the Chinese ovine Babesia isolates and some of ovine Babesia and Theileria species available in GenBank. In the phylogenetic tree, Babesia sp. isolates from Madang, Tianzhu, Lintan, Ningxian, Hebei and Liaoning all grouped with B. motasi with 88.2-99.9% identity, while Babesia sp. Xinjiang grouped in a separate clade between B. ovis and B. crassa with 79.7-81.2% identity. The results indicated that there are at least two distinct Babesia species groups-B. motasi and Babesia sp. Xinjiang, the latter was distinctly different from other ovine Babesia isolates from China with less than 86.6% identity.

Pharmacokinetics of ivermectin in the yak (Bos grunniens).

The yak (Bos grunniens) belongs to the cattle family Bovidae and lives in the mountains of China and adjacent areas. Due to the physiological adaptations of yak to its environment and the lack of data, the ivermectin pharmacokinetic was studied following a single subcutaneous dose at the recommended dose for cattle (0.2 mg kg(-1)). The observed peak plasma concentration (Cmax) was 48.93 ng ml(-1) and the time to reach Cmax (Tmax) was 0.73 day. These results show a faster rate of absorption than in cattle. The values for the absorption half-life (t(1/2a)), the distribution half-life (t(1/2alpha)) and the terminal half-life (t(1/2beta)) were 0.31, 0.74 and 4.82 days, respectively. The calculated area under the concentration-time curve (AUC) was 146.2 ng day ml(-1) and the mean residence time (MRT) was 3.57 days. The availability of ivermectin appears low in yaks in comparison to cattle but equivalent to that reported in horses and is likely to be due to physiological characteristics of this species.

[Cardiac-hemodynamic effects of M3 receptor agonist on rat and rabbit hearts].

AIM: To study the activation of choline on M3-R in heart and observe the hemodynamic changes of rat and rabbit. METHODS: A cardiac catheter was inserted into the left ventricular cavity via the right carotid artery, then the HR, LVSP, LVEDP, and +/- dp/dt were measured using a polygraph system. RESULTS: Choline was shown to decrease the hemodynamic assessments, such as HR, + dp/dt, LVSP and LVEDP. while the M3-R antagonist 4-DAMP (4-diphenylacetoxy-N-methylpiperidine-methiodide) showed little effect on these assessments. It was found to reverse the hemodynamic effects of choline. CONCLUSION: M3 receptor agonist can produce negative inotropic and chronotropic effects on the heart of rat and rabbit.

[Catheter ablation for therapy of patients with arrhythmia].

Catheter ablation using radiofrequency currents has been established as the safe and effective therapeutic modality of tachyarrhythmias. Most stable results were obtained in the ablation of accessory pathway of any location in WPW syndrome, and in the ablation of slow pathway in atrioventricular nodal reentry. However, in ventricular tachycardia, the efficacy is strongly affected by underlying heart diseases as well as the site of VT origin. Idiopathic VT either from the right ventricular outflow tract or left ventricular septum can be highly ablated. Common type atrial flutter is another candidate for catheter ablation. Using catheter, Maze procedure is mimicked in atrial fibrillation.

Patient-controlled epidural analgesia after caesarean section using a disposable device.

We have evaluated the use of a disposable device, the Patient Controlled Epidural Infusor, for patient-controlled epidural analgesia (PCEA) using pethidine, for pain relief in the first 24 hours after elective Caesarean section. Patients using the Patient Controlled Epidural Infusor (n = 20) were compared with a control group (n = 20) who received PCEA using a standard electronic device. Efficacy, as assessed by visual analogue scores, was comparable to that achieved in the control group. Patient and nursing satisfaction was high and similar to that in the control group. There was a low incidence of side-effects with both devices. Patients using the disposable device used less pethidine than patients using the electronic device (median (interquartile range) 181 (100-275) mg versus 238 (213-375) mg; p = 0.035). Use of this disposable device is an acceptable alternative to more expensive and bulkier electronic devices for PCEA after Caesarean section.

[Analysis of sedative effect of chloral hydrate and diazepam on children during CT examination].

Before CT examination, make those non-cooperation children take chloral hydrate or diazepam according to their ages can go beyond the limit to reduce the repeation and dose of taking medicine and shorten the waiting time. The author collected 204 samples and divided them into three groups of baby, infant and preschool children. Among them, there were 94 samples of taking orally chloral hydrate and 110 ones having intravenous injection with diazepam according to doctor's order. The author also compared the effect of sedation and the chi 2 test showed that chloral hydrate and diazepam had similar effect on babies (P > 0.05), while the sedative effect of diazepam on infants and preschool children was superior to that of chloral hydrate on them (P < 0.05, P < 0.01).

Patient-controlled epidural analgesia after caesarean section using meperidine.

PURPOSE: To determine the effects of the addition of a background infusion to patient-controlled epidural analgesia (PCEA) using meperidine for analgesia after Caesarean section. METHODS: In a randomized, double-blind study, we assigned 40 patients having elective Caesarean section to receive postoperative analgesia by patient-controlled epidural analgesia (PCEA) using meperidine 5 mg.ml-1 with (group Pi) or without (group Po) a background infusion of 10 mg.hr-l. The PCEA settings (20 mg bolus, 10 min lockout interval, four-hour maximum dose 150 mg) were otherwise identical. We compared pain at rest, pain on coughing, side effects, number of PCEA demands, drug consumption and patient satisfaction between groups in the first 24 hr after surgery. RESULTS: Total consumption of meperidine was greater in group Pi (median 390 mg) than in group Po (median 240 mg; P = 0.017) and the number of PCEA demands was greater in group Po (median 12) than in group Pi (median 7.5; P = 0.012). Analgesia, side effects and patient satisfaction was similar between groups. CONCLUSION: Addition of a background infusion to PCEA using meperidine after Caesarean section has no clinical benefit.

Addition of adrenaline to pethidine for epidural analgesia after caesarean section.

We have investigated the addition of adrenaline to epidural pethidine for postoperative analgesia in 40 patients after Caesarean section. In a randomised, double-blind study, patients received pethidine 25 mg with adrenaline 50 micrograms (adrenaline group, n = 20) or pethidine 25 mg without adrenaline (plain group, n = 18) epidurally at the first request for postoperative analgesia. The median duration of analgesia was longer in the adrenaline group (196 min; IQR 123-286) compared with the plain group (96 min; IQR 43-113; p = 0.002) and plasma concentrations of pethidine in the first 30 min after injection were lower in the adrenaline group (p = 0.003). Visual analogue scale pain scores in the first 30 min after injection and onset of analgesia, defined by the time for pain scores to decrease by 50%, were similar between groups. Addition of adrenaline to epidural pethidine has advantages for analgesia after Caesarean section.

The effect of the addition of adrenaline to pethidine for patient-controlled epidural analgesia after caesarean section.

We have investigated the addition of adrenaline to pethidine for patient-controlled epidural analgesia after elective Caesarean section. In a randomised, double-blind study, patients received patient-controlled epidural analgesia for 24 h using pethidine 5 mg.ml-1 with adrenaline 5 micrograms.ml-1 (adrenaline group, n = 40) or pethidine 5 mg.ml-1 without adrenaline (plain group, n = 38). Visual analogue scale pain scores at rest and on coughing measured 2 h, 6 h and 24 h after surgery were similar between the two groups. There was a trend towards lower mean total consumption of pethidine in the adrenaline group (231.5 mg; SD 140.5 mg) compared with the plain group (289.5 mg; SD 139.5 mg; p = 0.071). Patients in the adrenaline group had higher visual analogue scale scores for nausea at 2 h and 24 h and higher scores for pruritus at 2 h compared with the plain group. Addition of adrenaline to pethidine for patient-controlled epidural analgesia does not appear to have significant clinical advantages.

Postoperative analgesic requirement after cesarean section: a comparison of anesthetic induction with ketamine or thiopental.

UNLABELLED: In a randomized, double-blind study, we compared postoperative pain and analgesic requirement in patients who underwent elective cesarean section under general anesthesia induced with thiopental 4 mg/kg (n = 20) or ketamine 1 mg/kg (n = 20). Anesthesia was maintained with nitrous oxide and isoflurane. Postoperative analgesia was provided by patient-controlled analgesia (PCA) using morphine. Median (range) time to first PCA demand was greater in the ketamine group (28 [3-134] min) compared with the thiopental group (20.5 [3-60] min; P = 0.04). Median (range) morphine consumption over 24 h was less in the ketamine group (24.3 [3-41] mg) compared with the thiopental group (35 [4-67] mg; P = 0.017). Visual analog scale pain scores were similar between groups. No patients had recall of intraoperative events or unpleasant dreams. Two patients in the thiopental group and one patient in the ketamine group had pleasant intraoperative dreams. Apgar scores were similar between groups. Median umbilical venous pH was higher (7.33 vs 7.31; P = 0.04) and attributable to lower median umbilical venous Pco2 (5.72 vs 6.14 kPa; P = 0.02) in the ketamine group compared with the thiopental group. Induction of anesthesia for cesarean section using ketamine is associated with a lower postoperative analgesic requirement compared with thiopental. IMPLICATIONS: Patients who had anesthesia for cesarean section induced with ketamine required less analgesic drugs in the first 24 h compared with patients who received thiopental. Ketamine, unlike thiopental, has analgesic properties that may reduce sensitization of pain pathways and extend into the postoperative period.