Ultrasound-guided and CT-guided selective cervical nerve root injection for the treatment of cervical radicular pain: A retrospective clinical study.

OBJECTIVE: To compare the clinical effects and safety of ultrasound (US)-guided selective cervical nerve root injection (SCNI) and computed tomography (CT)-guided SCNI for patients with cervical radicular pain (CRP). METHODS: Forty-two CT-guided SCNI procedures (26 eligible patients) and forty-two US-guided SCNI procedures (25 eligible patients) performed to treat CRP were identified from the medical record system between October 2017 and July 2021 and enrolled in the study. The numeric rating scale was used to assess pre- and postprocedural pain levels, and the neck disability index was used to assess the level of function. All immediate and delayed clinical complications were also recorded. The cost of each procedure and the radiation dose of the CT procedure were documented. The follow-up data were obtained by telephone calls or outpatient visits. RESULTS: Five patients in the CT group and one patient in the US group were lost to follow-up at 1 year. No procedure-related complications were observed in either group. Significant pain relief and cervical function improvement were achieved after treatment in both the CT-guided SCNI and US-guided SCNI groups; however, there were no significant differences between the two groups. The average cost per CT-guided SCNI procedure was 133.2 USD, which was higher than the cost per US-guided SCNI procedure (42.2 USD). Meanwhile, the necessary radiation dose per patient in the CT group was 0.36 ± 0.08 mGy. CONCLUSIONS: US-guided SCNI and CT-guided SCNI have similar efficacy in treating CRP, but US-guided SCNI is radiation free and less costly than the CT-guided procedure.

Effects of Exogenous Glucoamylase Enzymes Alone or in Combination with a Neutral Protease on Apparent Total Tract Digestibility and Feces D-Lactate in Crossbred Angus Bulls Fed a Ration Rich in Rolled Corn.

The aim of this study was to evaluate the effect of two glucoamylases (GA) and the combination of one GA with a neutral protease on apparent total tract digestibility in beef bulls fed a total mixed ration (TMR) rich in rolled corn. Sixteen Angus beef bulls (266 ± 4.9 kg of initial BW, and 182 ± 1.7 d of age) were distributed in 4 blocks, each block consisted of 4 animals balanced by BW. The experimental design was a 4 × 4 Latin square (4 blocks and 4 periods, 2 w per period). Four treatments were tested; (1) control, (2) GA preparation from Trichoderma reesei (TrGA); (3) GA from Aspergillus fumigatus (AfuGA); (4) AfuGA in combination with a neutral protease from Bacillus amyloliquefaciens (BamPro). Apparent total tract digestibility and fecal D-lactate concentration were analyzed. Enzyme supplementation, regardless of enzyme type, increased apparent total tract digestibility of dry matter (from 66.7% to 73.1% ± 2.01), and starch (from 74.7% to 81.8% ± 2.25), without affecting feces D-lactate concentration. Irrespective of glucoamylase type, glucoamylase supplementation improved apparent digestibility of dry matter and starch, and the addition of a protease did not have additional benefits on nutrient digestibility.

Factors Associated with Site-specific Distribution of Glioblastoma / 肿瘤防治研究

The treatment of glioblastoma, the most prevalent malignant tumor in the central nervous system, poses considerable challenges. Glioblastoma multiforme, classified as a grade Ⅳ highly malignant brain glioma by the World Health Organization, is typically managed through a combination of surgery, postoperative chemotherapy, and radiotherapy. The treatment of glioblastoma is complicated by its infiltrative nature, genetic heterogeneity, and presence of the blood-brain barrier. Almost all cases of glioblastoma experience recurrence despite aggressive therapy, exploring the development of updated molecular treatment strategies that can improve overall efficacy. A crucial aspect in modern neurosurgery is the precise delineation of brain regions in terms of their anatomy and function. It serves as the fundamental basis for investigating variations in the distribution of brain gliomas. Hence, this review will elucidate the origin of glioblastomas and analyze the potential factors contributing to the spatially specific distribution of gliomas on the basis of a theoretical framework of brain connectomics research. Molecular characteristics, information pathways, tumor microenvironment landscape, and immunology will inform the analysis. We aim to identify novel biomolecular targets and therapeutic pathways to gain scientific insights for effective glioblastoma treatment.

Standardization of preparation and implementation of radiological emergency exercises / 中国辐射卫生

Based on the relevant guidelines published by the International Atomic Energy Agency and the Ministry of Ecology and Environment of the People's Republic China, this article summarizes the process of conducting a comprehensive radiological emergency exercise by reviewing the achievements and experience of radiological emergency exercises in various provinces of China since 2014. In addition, based on the actual combat requirements of the exercises, this article details the technical requirements and standard methods of exercise planning, preparation, implementation, and evaluation, so as to provide a reference for conducting radiological emergency exercises.

Effects of Baduanjin combined with limb function exercise on trunk control and living ability of stroke patients with hemiplegia / 中华健康管理学杂志

Objective:To explore the effect of Baduanjin combined with limb function exercise on trunk control and living ability of stroke patients with hemiplegia.Methods:From September 2019 to March 2021, a total of 86 stroke patients with hemiplegia admitted into the First Affiliated Hospital of Zhengzhou University who met the inclusion criteria were selected and divided into the control group and the experimental group with 43 cases in each group according to the random number table method. The control group was given limb function exercise, while the experimental group was given Baduanjin combined with limb function exercise, and the intervention time was 6 weeks. The Trunk impairment scale (TIS), Berg balance scale (BBS), Fugl-Meyer assessment of motor function (FMA), Barthel index (BI) scores and the thicknesses of transverse abdominis and multifidus muscle were compared between the two groups before and after the intervention.Results:After the intervention, the TIS, BBS, FMA and BI scores of the experimental group were significantly higher than that of the control group [(19.52±2.68) vs (16.78±2.51) points, (43.19±5.03) vs (35.62±4.89) points, (71.24±7.39) vs (59.26±6.35) points, (69.52±6.81) vs (62.31±6.46) points], the thickness of transversus abdominis and multifidus were significantly greater than that in the control group [(2.76±0.39) vs (2.39±0.35) mm, (24.37±1.69) vs (23.67±1.45) mm] (all P<0.05). Conclusion:Baduanjin combined with limb function exercise can improve the trunk control ability, balance function, motor function and daily life ability of stroke patients with hemiplegia.

Clinical value of high frequency ultrasound in the early screening subclinical psoriatic arthritis / 中华超声影像学杂志

Objective:To explore the significance of enthesitis in psoriasis(PsO) and the value of high-frequency Doppler ultrasound (HDUS) in screening potential subclinical psoriatic arthritis(PsA) patients through enthesitis; Designing the semi-quantitative score of enthesitis explore the value of semi-quantitative score in evaluating the degree of joint structure damage and improving the curative effect in patients with subclinical PsA.Methods:Clinical and sonographic data were collected in 125 PsO patients and 50 osteoarthritis (OA) patients who attended hospital from January 2019 to March 2021, and healthy controls (HC) recruited during the same period. The prevalence of enthesitis of distal interphalangeal joint (DIP) of psoriasis patients, osteoarthritis patients and HC was compared. Meanwhile the semi-quantitative scoring system for ultrasound-guided enthesitis was designed, and the correlation between the severity of enthesitis and clinical score was analyzed. The correlation between psoriasis nail and enthesitis of extensor tendon of DIP finger was also analyzed.Results:The significant difference was found in the prevalence of enthesitis of DIP among PsO group, OA group and HC group (all P<0.001); There was a significant difference in the severity of enthesitis of DIP in PsO group before and after treatment ( P<0.001); In PsO group, the correlation between the severity of enthesitis of DIP and Psoriasis Area and Severity Index(PASI)score was moderate ( rs=0.538, P<0.001), and highly correlated with Nail Psoriasis Severity Index (NAPSI) scores( rs=0.877, P<0.001). There was a significant difference in the incidence of enthesitis between the patients with psoriasis nail and the patients without that ( P<0.001). The prevalance of enthesitis of nail disease free fingers was also found significantly different between PsO group and HC group( P<0.001). Conclusions:Enthesitis is a prominent characteristic of PsO.And the semi-quantitative scores designed in this research are in satisfied consistence with the clinical scores, and could be used to evaluate subclinical PsA structural damage.Furthermore, it is possible that the enthesitis of DIP is a relatively independent process from the nail disease.

Signaling pathways involved in inhibition of macrophage phagocytosis by TcpC of uropathogenic Escherichia coli / 中华微生物学和免疫学杂志

Objective:To investigate the signaling pathway of inhibiting macrophage phagocytosis of TIR domain-containing protein encoded by Escherichia coli (TcpC) N-terminal ubiquitin ligase active fragments of uropathogenic Escherichia coli. Methods:Bioinformatics software was used to analyze the amino acid sequences and the function of TcpC N-terminal ubiquitin ligase active fragments as well as the functional sites. PCR was performed to amplify tcpc-330, tcpc-450 and tcpc-510 genes and a prokaryotic expression system was constructed to express the target proteins. The recombinant proteins rTcpC-N110, rTcpC-N150 and rTcpC-N170 were purified by Ni-NTA affinity chromatography. LPS in the recombinant proteins was removed by Detoxi-gel chromatography. The expression of MyD88 at protein and mRNA levels in macrophages incubated with rTcpC-N110, rTcpC-N150, rTcpC-N170 or rTcpC-TIR was detected by Western blot and qRT-PCR. The activation of NF-κB signal pathway and the levels of proinflammatory factors in macrophages incubated with the above TcpC protein fragments were measured by Western blot and ELISA, respectively. Results:Cys12, Trp104 and Trp106 in the N-terminal fragment of TcpC were crucial amino acids in maintaining its ubiquitin ligase activity. The target recombinant proteins rTcpC-N110, rTcpC-N150 and rTcpC-N170 were successfully expressed and purified. After Detoxi-gel chromatography, rTcpC-N110, rTcpC-N150 and rTcpC-N170 extracts were undetectable for LPS. TcpC ubiquitin ligase fragments inhibited the expression of MyD88 at protein level, but not affect its expression at mRNA level in macrophages. LPS-induced phosphorylation of NF-κB signaling pathway-related proteins p50 and p65 was significantly inhibited in macrophages treated with TcpC ubiquitin ligase fragments. Moreover, LPS-induced production of pro-inflammatory factors was also significantly inhibited.Conclusions:The recombinant proteins rTcpC-N110, rTcpC-N150 and rTcpC-N170 could inhibit the expression of MyD88 at protein level and suppress the activation of NF-κB signaling pathway, suggesting that they were closely related to the inhibition of innate immune activity of macrophages.

Hypervirulent Klebsiella pneumoniae serotype K1 induces liver abscess through activating NLRP3 inflammasome / 中华微生物学和免疫学杂志

Objective:To investigate whether the hypervirulent Klebsiella pneumoniae (hvKP) induces liver abscess through activating NLRP3 inflammasome. Methods:K1-hvKP and K35-non-hvKP bacterial suspensions were intraperitoneally injected into C57BL/6 mice to establish the models of liver abscess. Human peripheral blood neutrophils were sorted by immunomagnetic beads with CD45 + and Gr-1 + , and the purity was detected by flow cytometry. The concentrations of capsular polysaccharide of K1-hvKP and K35-non-hvKP were detected by total carbohydrate assay kit. The expression of IL-18 and IL-33 by neutrophils at mRNA and protein levels was detected by real-time fluorescence quantitative PCR and ELISA, respectively. The activation of NLRP3 inflammasome in neutrophils was detected by Western blot. Neutrophil extracellular trap formation (NETosis) was observed under confocal laser scanning microscope. Results:The C57BL/6 mice with K1-hvKP infection had significantly serious liver abscess as compared with the K35-non-hvKP-infected mice. The purity of human neutrophils was more than 95%. The concentration of capsular polysaccharide in K1-hvKP was significantly higher than that in K35-non-hvKP. Compared with K35-non-hvKP, K1-hvKP significantly promoted the neutrophils to express IL-18 and IL-33 at both mRNA and protein levels, enhanced the activation of NLRP3 and induced NETosis.Conclusions:This study suggested that hvKP could promote NETosis by activating NLRP3 inflammasome to cause liver abscess.

Role and pathogenic mechanism of TcpC in uropathogenic Escherichia coli-induced mouse model of cystitis / 中华微生物学和免疫学杂志

Objective:To investigate the role of TcpC in uropathogenic Escherichia coli (UPEC)-induced cystitis in mice and to preliminarily analyze the pathogenic mechanism. Methods:C57BL/6 mice were injected with 10 9 CFU wild-type UPEC CFT073 (CFT073 wt) or tcpc gene-deleted mutant (CFT073 Δ tcpc) from urethra into bladder to construct the mouse model of cystitis. The mice were sacrificed 3 d after infection and the bladders were taken to observe the gross pathological changes. Histopathological changes in bladder tissues were observed after HE staining. Immunohistochemistry was used to detect TcpC in bladder tissues. Bacterial loads in urine samples of UPEC-infected mice were counted by tenfold dilution method, and the presence of tcpc gene in the genomic DNA of bacteria from the bladder and urine samples of CFT073 wt-infected mice was measured by PCR. Real-time quantitative RT-PCR (qRT-PCR) and Western blot were performed to detect the expression of TcpC at mRNA and protein levels in macrophages after CFT073 wt infection. The influence of UPEC strains on the activation of NF-κB signaling pathway in macrophages were determined by Western blot. The levels of proinflammatory factors and the bacterial and cell activity after infecting macrophages with UPEC strains were detected by ELISA, laser confocal microscope and fluorescence microscope, respectively. Results:Compared with the mice with CFT073 Δ tcpc infection, CFT073 wt-infected mice had significantly enlarged bladder and severe neutrophil infiltration and abundant TcpC in bladder tissues. The number of bacteria in the urine of CFT073 wt-infected mice was significantly greater than that of the CFT073 Δ tcpc group. PCR results showed that the bacteria in bladder or urine were CFT073 wt. The expression of TcpC at both mRNA and protein levels in macrophages increased significantly after CFT073 wt infection. Moreover, in CFT073 wt-infected macrophages, the expression of IκBα was promoted and the phosphorylation of p65 and the production of proinflammatory factors were suppressed. TcpC was instrumental in the survival and invasion of CFT073 wt in macrophages. Conclusions:TcpC expression increased significantly in mice with CFT073 wt-induced cystitis. TcpC inhibited the activation of NF-κB signaling pathway and the production of proinflammatory factors in macrophages to improve the survival rate of CFT073 wt, which was closely related to the pathogenesis and immune evasion of UPEC.

Genome mining combined metabolic shunting and OSMAC strategy of an endophytic fungus leads to the production of diverse natural products

Endophytic fungi are promising producers of bioactive small molecules. Bioinformatic analysis of the genome of an endophytic fungus

The design and effect of nursing workshop based on SKIN mode for prevention of pressure ulcer caused by ICU equipment / 中国实用护理杂志

Objective@#To investigate whether it can reduce the incidence of pressure ulcer caused by ICU equipment, when nurses in ICU use the SKIN model framework to carry out preventive and nursing measures.@*Methods@#To construct the teaching group of nursing workshop based on SKIN mode for preventing pressure ulcer caused by ICU equipment and train 36 ICU nurses. Before and after training course, to collect the behaviors of preventing pressure ulcer caused by ICU equipment during clinical work time and the incidence and severity of pressure ulcer.@*Results@#The nurses′ behaviors of controlling skin status of patients who use Bi-level positive airway pressure non-invasive mask and evaluating nutritional status of patients change a lot (χ2=34.420,10.123, P <0.01). The nurses′ behaviors of checking and evaluating skin status of patients who have stomach tube to reduce skin pressure, shear and friction and assessing nutritional status of patients were improved (χ2=7.547-49.451, P <0.05). The nurses′ behaviors mentioned above of nursing patients who have oral air tube were also changed significantly (χ2=5.225, 23.402, 12.444, P<0.05 or 0.01). The incidence of pressure ulcer caused by ICU equipment dropped from 2.86%(100/3 502) to 1.87%(67/3 580) (χ2=7.445, P<0.05). The decrease in incidence of Ⅱand Ⅲ grade pressure ulcer are from 48%(48/100) to 22.39%(15/67) and 34%(34/100) to 7.46%(5/67) respectively and had significant differences as well (χ2=11.202, 15.784, P<0.01).@*Conclusions@#This study explains the training approach based on SKIN mode of prevention of pressure ulcer caused by ICU equipment. The results show that the training approach can decrease the incidence and severity of pressure ulcer caused by ICU equipment, improve the nurses′ nursing behaviors and promote the transform of theory related to pressure ulcer from basement to clinical reality.

Vagal Transient Receptor Potential Ankyrin 1 Mediates Stress-exacerbated Visceral Mechanonociception After Antral Cold Exposure

BACKGROUND/AIMS: Abdominal pain can be evoked or exacerbated after gastrointestinal cold stimulation in some patients with diarrhea-predominant irritable bowel syndrome (IBS-D), indicating a low temperature-induced sensitization of visceral perception. We investigated the role of vagal transient receptor potential ankyrin 1 (TRPA1, a cold-sensing ion channel) in cold-aggravated visceral mechanonociception in a stress-induced IBS animal model. METHODS: TRPA1 expression was examined in antral biopsies of healthy controls and IBS-D patients. Abdominal symptoms were assessed before and after warm or cold water intake. The visceromotor response (VMR) to colorectal distention (CRD) following intra-antral infusion of cold saline was measured in animals undergoing sham or chronic water avoidance stress. TRPA1 expression, extracellular signal-regulated protein kinase 1/2 (ERK1/2) phosphorylation, and neuronal calcium influx in vagal afferents were assessed. RESULTS: Compared to healthy controls, IBS-D patients displayed elevated antral TRPA1 expression, which was associated with symptom scores after cold (4°C) water intake. Intra-antral infusion of cold saline increased VMR to CRD in naive rats, an effect dependent on vagal afferents. In stressed rats, this effect was greatly enhanced. Functional blockade and gene deletion of TRPA1 abolished the cold effect on visceral nociception. TRPA1 expression in vagal (but not spinal) afferents increased after stress. Moreover, the cold-induced, TRPA1-dependent ERK1/2 activation and calcium influx in nodose neurons were more robust in stressed rats. CONCLUSIONS: Stress-exaggerated visceral mechanonociception after antral cold exposure may involve up-regulation of TRPA1 expression and function on vagal afferents. Our findings reveal a novel mechanism for abnormal gastrointestinal cold sensing in IBS.

Advances in Research on Etiology of Recurrent Acute Pancreatitis / 胃肠病学

Some patients with acute pancreatitis (AP)can relapse after initial cure. With the development and maturity of diagnosis and treatment technology,especially the rise of endoscopic technology,the detection rate of AP recurrence (such as bile duct stones,Oddi sphincter dysfunction,pancreas divisum,gene mutation,etc. )is increased. Recurrent acute pancreatitis (RAP)is characterized by various causes,and complex mechanisms. Understanding etiology and positive treatment play a pivotal role in reducing the incidence of RAP. This article reviewed the advances in study on etiology of RAP.

Design and evaluation of clinical scenario cases with simulation-based learning on medication errors for novice / 中国实用护理杂志

Objective To improve fresh nurses′ implementation rate of standard clinical administration checking by applying situational simulation method, and enhancetheir ability of identifying hidden perils in nursing. Methods Totally 75 fresh nurses who graduated in 2016 were enrolled and divided into two groups (36 in control group and 39 in experimental group) according to randomized digital table method. Situational simulation method was applied in the experimental group, while the control group applied traditional nursing safety check training method. Then both groups′ satisfaction rate of lessons and self-confidence after training were recorded. Besides, their clinical administration checking behaviors after 3 months, the errors, hidden perilsand examining situations related to administration checking after 6 months,were also evaluated. Results Significant statistical differences were shown in satisfaction score (23.62 ± 2.02 in experimental group vs. 21.39 ± 1.98 in control group, t=4.818, P<0.01) and self-confidential evaluating score (35.67±2.02 in experimental group vs. 21.39±1.98 in control group, t=2.768, P<0.01). Observation of clinical administration checking behaviors 3 months after training had indicated significant differences in the number of nurses who check drug concentration (33 vs. 8, χ2=29.406, P<0.05) and executing time (30vs. 12, χ2=14.436, P<0.05).Statistical differences (χ2= 5.080-29.545, P< 0.01 or < 0.05) were also observed in the number of nurses checking bed number, patient name, drug name, dose, drug concentration and methods in and after operation. The potential nursing perils identified, and the number of nurses who identify hidden nursing perils 3 months and 6 months after training were significantly larger (χ2=50.591, 23.658, 3.914, P<0.05) in experimental group (33, 2, 10) than in control group (18, 1, 3),and there were no significant differences in the rate of potential perils and nursing error between both groups. Conclusion Situational method of administration, which is applied for fresh nurses in their initial working phase, transforms the basic and core checking system into clinical real-situation cases. It also shows an advantage of boosting their self-confidence of learning, improving the implementation rate of standard clinical administration checking and the ability of avoiding potential nursing perils.

Compare the effect of combined therapy between telbivudine plus adefovir dipivoxil and lamivudine plus adefovir dipivoxil corresponding to renal function in patients with hepatitis B virus infection / 中华肝脏病杂志

Objective@#To compare the effect of combined therapy using lamivudine (LAM) plus adefovir (ADV) versus telbivudine (LdT) plus adefovir corresponding to the renal function of CHB patients.@*Methods@#A total of 120 patients with chronic hepatitis B were enrolled. According to single daily dosing, they were divided into 4 groups: LdT + ADV group (n = 32), ADV+LdT group (n = 28), LAM + ADV group (n = 38) and ADV + LAM group (n = 22). Hepatorenal function, HBV serological markers, HBV DNA quantification, creatine kinase (CK) and other parameters were examined every 3 months. Serum alanine aminotransferase (ALT) normalization rate, undetectable HBV DNA rate, hepatitis B e antigen (HBeAg) seroconversion rate, level of serum creatinine (CR) and estimated glomerular filtration rate (eGFR) were analyzed at baseline time, and at weeks 24 and 52.Stastical data were analyzed by t- test and analysis of variance, count data using χ 2 test.@*Results@#There was no statistically significant difference between the four groups in terms of ALT normalization rate, HBeAg seroconversion rate, undetectable HBV DNA rate at 24 and 52 weeks. Compared with baseline, at 24 weeks of treatment, there was no significant change in serum creatinine and eGFR in the 4 groups, but after 52 weeks of treatment, serum creatinine decreased in LdT + ADV and ADV + LdT groups and eGFR increased (P < 0.05); Serum creatinine in ADV and ADV + LAM increased, and eGFR was decreased than before (P < 0.05). After treatment, there was no significant difference in renal function between the four groups at 24 weeks, but at week 52, eGFR increased and serum creatinine decreased in LdT + ADV group compared with LAM + ADV group (P < 0.05); ADV + LdT Compared with ADV + LAM group, eGFR increased and serum creatinine decreased (P < 0.05). At 52 weeks of treatment, 5 patients with mildly impaired renal function in the ADV + LdT group [n = 10, eGFR 60-90 ml·min-1 ·(1.73 m2)-1] returned to normal, and none of the ADV + LAM group (n = 9) returned to normal.@*Conclusion@#For patients with mild impaired renal function, adding LdT combined with ADV can improve renal function compared to that of LAM plus ADV.

Gold nanorods together with HSP inhibitor-VER-155008 micelles for colon cancer mild-temperature photothermal therapy

Enhancing the heat-sensitivity of tumor cells provides an alternative solution to maintaining the therapeutic outcome of photothermal therapy (PTT). In this study, we constructed a therapeutic system, which was composed of methoxy-polyethylene-glycol-coated-gold-nanorods (MPEG-AuNR) and VER-155008-micelles, to evaluate the effect of VER-155008 on the sensitivity of tumor cells to heat, and further investigate the therapeutic outcome of MPEG-AuNR mediated PTT combined with VER-155008- micelles. VER-155008- micelles down-regulate the expression of heat shock proteins and attenuate the heat-resistance of tumor cell. The survival of HCT116 cells treated with VER-155008- micelles under 45 °C is equal to that treated with high temperature hyperthermia (55 °C) . Furthermore, we proved either the MPEG-AuNR or VER-155008- micelles can be accumulate in the tumor site by photoacoustic imaging and fluorescent imaging. anti-cancer evaluation showed that tumor size remarkably decreased (smaller than 100 mm or vanished) when treated with combing 45 °C mild PTT system, which contrasted to the tumor size when treated with individual 45 °C mild PTT (around 500 nm) or normal saline as control (larger than 2000 nm). These results proved that the VER-155008- micelles can attenuate the heat-resistance of tumor cells and enhance the therapeutic outcome of mild-temperature photothermal therapy.

Analysis of TCOF1 mutation in a Chinese patient with Treacher-Collins syndrome / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To detect potential mutation of TCOF1 gene in a Chinese family affected with Treacher-Collins syndrome.</p><p><b>METHODS</b>Clinical data of the patient was collected. The analysis included history taking, clinical examination and genetic testing. All coding regions of the TCOF1 gene were subjected to PCR amplification and Sanger sequencing.</p><p><b>RESULTS</b>A novel mutation c.2261ins G (p.E95X) of the TCOF1 gene was discovered in the patient. The same mutation was not found in his parents and 100 healthy controls.</p><p><b>CONCLUSION</b>The c.2261insG (p.E95X) mutation of the TCOF1 gene probably underlies the disease in the patient. Genetic testing can facilitate diagnosis and genetic counseling for families affected with TCS.</p>

Chinese Society of Allergy Guidelines for Diagnosis and Treatment of Allergic Rhinitis

Allergic rhinitis (AR) is a global health problem that causes major illnesses and disabilities worldwide. Epidemiologic studies have demonstrated that the prevalence of AR has increased progressively over the last few decades in more developed countries and currently affects up to 40% of the population worldwide. Likewise, a rising trend of AR has also been observed over the last 2–3 decades in developing countries including China, with the prevalence of AR varying widely in these countries. A survey of self-reported AR over a 6-year period in the general Chinese adult population reported that the standardized prevalence of adult AR increased from 11.1% in 2005 to 17.6% in 2011. An increasing number of original articles and imporclinical trials on the epidemiology, pathophysiologic mechanisms, diagnosis, management and comorbidities of AR in Chinese subjects have been published in international peer-reviewed journals over the past 2 decades, and substantially added to our understanding of this disease as a global problem. Although guidelines for the diagnosis and treatment of AR in Chinese subjects have also been published, they have not been translated into English and therefore not generally accessible for reference to non-Chinese speaking international medical communities. Moreover, methods for the diagnosis and treatment of AR in China have not been standardized entirely and some patients are still treated according to regional preferences. Thus, the present guidelines have been developed by the Chinese Society of Allergy to be accessible to both national and international medical communities involved in the management of AR patients. These guidelines have been prepared in line with existing international guidelines to provide evidence-based recommendations for the diagnosis and management of AR in China.

Analysis of CT enhanced scanning drugs / 中国生化药物杂志

Objective To investigate the factors causing exudation of drugs by intravenous contrast medium in CT enhanced scan, and to analyze the corresponding measures. Methods From January 2016 to June 2017 in the First People's Hospital of Jiande City 61 cases of drug extravasation enhanced CT scanning in patients as the research object, through the observation of the drug leakage factors to agents in this group of patients with intravenous contrast and record, in order to find out measures. Results The statistics show, this group of patients with drug extravasation factors: 12 years of age, the incidence rate was 63.93％ (39/61) injection velocity; the incidence rate of 3.0～4.0ml/s was 70.49％ (42/61);small vein injection of vascular forearm 80.33％ (49/61); osmotic pressure, the incidence rate of 300mOsm/kgH2O was 83.61％ (51/61). Conclusion CT scan causes intravenous contrast agent oozing drugs are various, according to the specific selection of patients with drug exudation measures, can effectively improve the patients clinicalcharacteristics of blood stasis, swelling, pain, and has important practical value.

Expression of PD-1 and PD-L1 in patients with stage Ⅳa nasopharyngeal carcinoma and its clinical significance / 中华放射肿瘤学杂志

Objective To measure the expression levels of PD-1 and PD-L1 in the tumor tissues of patients with nasopharyngeal carcinoma ( NPC) and to explore the association of their expression with the clinical characteristics and prognosis of NPC patients. Methods The expression levels of PD-1 and PD-L1 in 65 NPC patients were determined by immunohistochemistry, and an analysis was performed on the association of their expression with clinical characteristics and long-term survival in NPC patients. Comparisons between groups were made by the chi-square test or Fisher′s exact test, and the Pearson' s test was used for correlation analysis. Survival rates were calculated using the Kaplan-Meier method, and the log-rank test was used for survival comparison and univariate prognostic analysis. The Cox model was used for multivariate prognostic analysis. Results Expression of PD-1 and PD-L1 was observed in 88%(57/65) and 89%( 58/65) of tumor cell surfaces using a cut-off value of 5%, and 38%( 25/65) and 58%( 38/65) using a cut-off value of 10%. PD-1 expression was significantly correlated with PD-L1 expression using the cut-off value of 5%( P=0003) , and a non-significant correlation was found between the expression levels of PD-1 and PD-L1 using the cut-off value of 10%(P=0080). There was no significant association between the positive expression rates of PD-1 and PD-L1 and clinicopathological characteristics ( P>005 ) . The univariate and multivariate survival analyses showed that using the cut-off value of 10%, the patients with positive PD-L1 expression had significantly reduced progression-free survival ( hazard ratio [ HR]=273, 95% confidence interval [ CI]:107-697, P=0035 ) and overall survival ( HR=395, 95%CI:109-1427, P=0036) compared with those with negative PD-L1 expression. Conclusions PD-1 and PD-L1 are highly expressed in NPC tissues. The expression of PD-L1 is associated with the poor prognosis in patients with stage IVa NPC, and PD-L1 can better predict the poor prognosis using the cut-off value of 10%.