[Present situation, challenge and strategy of acupuncture standardization in China]

On the base of the overall summarization of the development situation of acupuncture standardization, four kinds of relationships are proposed, which needs to be harmonized in the current acupuncture standardization, i.e. standardization and individualization, China acupuncture and world acupuncture, quantity and quality, as well as internal motivation and the government overall instruction. Through in-depth analysis of the problems and their causes, the solutions and measures are put forward, e.g. paying attention to the study on relevant knowledge on standardization and standard publicity, increasing the inputs on theoretic study, strategy study, methodological study as well as the applicability of standards, accelerating the construction of talent team, cultivating and attracting first-class professionals to participate in the standardization work, integrating institutions, straightening out relations as well as improving management system and operation mechanism of acupuncture standardization.

[Bioavailability of Dissolved Organic Carbon in Rivers for Typical Vegetation Types in the Permafrost Regions on the Qinghai-Tibet Plateau]

Samples collected from 12 rivers with typical vegetation types in the permafrost regions on the Qinghai-Tibetan Plateau were incubated in the laboratory, and the relationships among the vegetation types, river discharges, the compositions of dissolved organic carbon (DOC), permafrost areas, riverine DOC concentration, biodegradability of dissolved organic carbon (BDOC), and the biodegradation kinetics were examined. The results showed that the DOC concentrations of typical vegetation types in the basin, such as alpine meadow (AM), alpine swamp meadow-alpine meadow (ASM-AM), alpine meadow-alpine steppe (AM-AS), and alpine meadow-alpine steppe-bare soil (AM-AS-BL), were (5.17±0.21), (5.02±0.50), (3.55±0.25), and (2.79±0.41) mg ·L^-1, respectively. The values for the bioavailability of river DOC of different vegetation types were (23.54±2.62)%, (23.66±3.31)%, (18.17±5.26)%, and (11.72±15.56)%, respectively. Correspondingly, the riverine DOC aromaticity increased along with the vegetation cover, while the biodegradation and degradation rates decreased gradually. During the incubation, the reaction of BDOC was in accordance with the first-order kinetics equation. Furthermore, the BDOC in continuous permafrost regions of the rivers was greater than that in the non-continuous permafrost regions. The BDOC in higher discharges were lower than those with lower discharges. Taken together, the results suggested that the vegetation types were the main controlling factors for the BDOC, and BDOC was also related to the discharge and permafrost.

Effectiveness of Bi-Needle Technique (Hybrid Yeung Endoscopic Spine System/Transforaminal Endoscopic Spine System) for Percutaneous Endoscopic Lumbar Discectomy

OBJECTIVE

The bi-needle technique is a new technique for percutaneous endoscopic lumbar discectomy. This technique combines the advantages of Yeung endoscopic spine system (YESS) and transforaminal endoscopic spine system (TESSYS) techniques. The aim of this study was to evaluate effectiveness of the bi-needle technique for percutaneous endoscopic lumbar discectomy and compare it with the TESSYS technique.

METHODS

We reviewed 86 patients with single-level lumbar disc herniation treated by percutaneous endoscopic lumbar discectomy in our hospital from June 2013 to December 2015. Bi-needle technique was used in 49 patients (30 men, 19 women; average age 40.4 ± 5.2 years). TESSYS technique was used in 37 patients (19 men, 18 women; average age 42.8 ± 6.4 years). Clinical results were evaluated and compared between the 2 groups.

RESULTS

Symptoms in both groups were significantly improved at the last follow-up (P < 0.01). There was no statistical difference in visual analog scale and lumbar Japanese Orthopaedic Association scores between bi-needle and TESSYS groups at last follow-up (P = 0.69 and P = 0.33, respectively). Operative time was shorter in the bi-needle group (P < 0.01). Recurrence rate and reoperation rate were lower in the bi-needle group (P = 0.04 and P = 0.03, respectively). Discitis was diagnosed in 2 patients in the TESSYS group. There were no patients with postoperative discitis in the bi-needle group.

CONCLUSIONS

The bi-needle technique is safe and effective for treatment of lumbar disc herniation. Compared with TESSYS technique, operative time is shorter, and recurrence and reoperation rates are lower.

[Study on the dynamic variations and influencing factors of serum lipid levels during pregnancy and postpartum]

Objective: To study the variations and influencing factors of serum triglycerides and cholesterol levels during pregnancy and postpartum. Methods: A retrospective study was performed among 5 020 healthy singleton (95.10%, 4 774/5 020) and twin (4.90%, 246/5 020) women who had delivery in Women's Hospital, Zhejiang University School of Medicine from January 2011 to December 2016. Serum triglycerides and cholesterol levels during pregnancy and postpartum of all the cases were collected. Both singleton and twin pregnant women were divided into advanced age and appropriate age groups, and then data of serum sample were assigned to 3 groups according to the gestation weeks, which were second trimester pregnancy (24-28 gestation weeks) , third trimester pregnancy (32-41 gestation weeks) and postpartum (within 72 hours after delivery) . The serum triglycerides and cholesterol levels in each groups were compared. Results: (1) Serum triglycerides and cholesterol levels during the second trimester pregnancy, third trimester pregnancy and postpartum were higher than levels of non-pregnancy in both singleton and twin groups (all P<0.05) . (2) Serum triglycerides and cholesterol levels in the third trimester pregnancy group were higher than those of second trimester pregnancy group in both advanced age and appropriate aged women regardless singleton or twin pregnancy (all P<0.05) . The 95%CI of serum lipid levels in each group during second and third trimester pregnancy were as follows: in appropriate aged singleton group, the triglycerides levels were 1.07-4.13 and 1.52-7.21 mmol/L, and the cholesterol levels were 2.77-12.11 and 4.44-9.36 mmol/L. In advanced aged singleton group, the triglycerides levels were 1.28-4.61 and 1.70-7.80 mmol/L, and the cholesterol levels were 4.35-8.40 and 4.46-9.35 mmol/L; in appropriate aged twin group, the triglycerides levels were 1.39-7.16 and 1.90-9.29 mmol/L, and the cholesterol levels were 4.99-12.16 and 4.52-10.07 mmol/L; in advanced aged twin group, the triglycerides levels were 1.61-5.32 and 1.94-9.29 mmol/L, and the cholesterol levels were 5.24-8.10 and 4.53-8.86 mmol/L. (3) Serum lipids levels rapidly decreased during postpartum compared to the third trimester pregnancy. The 95%CI of blood lipid levels in each group were as follows: in appropriate aged singleton group, the triglycerides level was 0.90-5.64 mmol/L and the cholesterol level was 4.70-8.52 mmol/L; in advanced aged singleton group, the triglycerides level was 0.87-5.43 mmol/L and the cholesterol level was 4.68-9.04 mmol/L; in appropriate aged twin group, the triglycerides level was 1.20-8.21 mmol/L and the cholesterol level was 4.66-8.45 mmol/L; in advanced aged twin group, the triglycerides level was 1.32-6.61 mmol/L, and the cholesterol level was 5.01-7.94 mmol/L. (4) Serum triglycerides and cholesterol levels in twin pregnant women were significantly higher than in singleton during the second trimester and third trimester pregnancy both in advanced age and appropriate age groups (all P<0.05) . During postpartum, there was no difference in serum lipid levels between the singleton and twin pregnant women in appropriate age group (triglycerides: P=0.982; cholesterol: P=0.759, respectively) . While the serum lipid levels in twin pregnant women were significantly higher than those of singleton women in advanced age group (triglycerides: P=0.000; cholesterol: P=0.000, respectively) . Conclusions: The standard of serum lipid levels of non-pregnant adults is not suitable for assessing that in pregnant women. Regardless of singleton or twin pregnancy, serum triglyceride and cholesterol levels during pregnancy elevate with the increasing gestational week and then rapidly decrease during postpartum. Age and twins are the influencing factors of the elevated physiological lipid levels during pregnancy.

Traditional Chinese medicine Qiliqiangxin attenuates phenylephrine-induced cardiac hypertrophy via upregulating PPARγ and PGC-1α

Background

Clinical study has demonstrated that the traditional Chinese medicine Qiliqiangxin (QLQX) has protective effects on heart failure. Phenylephrine (PE) is an important inducing factor for cardiac hypertrophy and our previous studies have showed that QLQX attenuates PE-induced cardiac hypertrophy. Besides, QLQX protects against cardiac remodeling after myocardial infarction via activating PPARγ. However, whether QLQX prevents PE-induced cardiac hypertrophy through PPARγ and its coactivator PGC-1α is still unknown.

Methods

The effects of QLQX were investigated based on PE induced cardiac hypertrophy mouse models. Echocardiography and hematoxylin-eosin (HE) staining were used to determine cardiac function and cross-sectional area, respectively. Quantitative real time PCR (qRT-PCR) was used to determine ANP and BNP expressions. Based on primary neonatal rat ventricular cardiomyocytes (NRVMs) treated with PE, the cell size and expressions of ANP and BNP were determined by immunofluorescent staining and qRT-PCR, respectively. In addition, western blot was used to determine PPARγ and PGC-1α expressions.

Results

In present study, we confirmed that QLQX could significantly attenuate cardiac hypertrophy in mice treated with PE. Then we showed that PPARγ and PGC-1α were downregulated in PE-induced cardiac hypertrophy, and QLQX could block the decrease of PPARγ and PGC-1α both in vitro and in vivo. Importantly, we found that PPARγ inhibitors or PGC-1α siRNAs eliminated the protective effects of QLQX on PE-induced cardiac hypertrophy.

Conclusions

Our study suggested that QLQX prevents from PE-induced cardiac hypertrophy by activating PPARγ and its coactivator PGC-1α.

MiR-23a targets RUNX2 and suppresses ginsenoside Rg1-induced angiogenesis in endothelial cells

Rg1 is a predominant protopanaxatriol-type of ginsenoside found in Panax ginseng, and it has been shown to have anti-cancer effects in multiple types of cancer cells. However, Rg1 also induces the expression of proangiogenic factors, such as vascular endothelial growth factor (VEGF-A), in endothelial cells. Unfortunately, angiogenesis positively correlates with cancer development. In this study, we identified RUNX2 as a regulator of ginsenoside Rg1-induced angiogenesis for the first time. We found that RUNX2 was directly targeted and regulated by miR-23a. Additionally, miR-23a was shown to inhibit angiogenesis in both human umbilical vein endothelial cells (HUVECs) and in zebrafish. Furthermore, a decrease in RUNX2 expression resulted in translational repression of VEGF-A in HUVECs. Taken together, this study identified a MiR-23a/RUNX2/VEGF-A pathway in angiogenesis and shed light on the molecular mechanism of Rg1-induced angiogenesis. Thus, RUNX2 might be a potential therapeutic target in Rg1-mediated angiogenesis in cancer.

[Curative effects and influenced factors of primary chemotherapy with single-agent methotrexate on low-risk gestational trophoblastic neoplasia]

Objective: To evaluate the efficacy of primary chemotherapy with single-agent methotrexate (MTX) for low-risk gestational trophoblastic neoplasia and to analysis the influenced factors. Methods: We retrospectively reviewed 259 cases with low-risk gestational trophoblastic neoplasia whose primary chemotherapies were MTX 0.4 mg·kg(-1) (maximum 25 mg) daily for 5 days every other week. Patients' data between January 2001 and June 2015 was collected and the relationships of different factors to outcomes of chemotherapy were also evaluated. Results: 183 of the 259 patients (70.66%, 183/259) achieved complete primary remission and all patients achieved complete remission after salvage chemotherapy. Univariate analysis showed that FIGO score, serum level of HCG before treatment and interval months from previous pregnancy were significantly associated with outcome of chemotherapy (P=0.001, 0.018, 0.014 respectively). Logistic regression analysis showed that the FIGO score (OR=4.094) and antecedent pregnancy (OR=0.268) were two independent factors predictive for the outcome of chemotherapy. Conclusions: Primary chemotherapy with single-agent MTX may still be one of the options for patients with low risk GTN. The FIGO score and antecedent pregnancy are two independent risk factors of outcome of single-agent MTX chemotherapy.

[Emission Characteristics of Residential Coal Combustion Flue Gas in Beijing]

Honeycomb briquet,biomass briquettes and bituminous coal from suburb of Beijing were chosen as testing samples to carry out combustion experiments. The characteristics of inorganic pollutant emission factors and VOCs emission factors released from the flue gas were studied. The results showed that under the condition of sufficient combustion, the average emission factors of SO₂ from these three types of coal respectively were 1.50,1.91,1.62 kg·t^-1;NO_x 0.420,0.901,2.20 kg·t^-1;CO 22.4,37.3,87.3 kg·t^-1. Combustion emission factors of gaseous pollutants for NO_x and CO were in the order of bituminous coal > biomass briquettes > honeycomb briquet. SO₂ emission factors were in the order of biomass briquettes > bituminous coal > honeycomb briquet. The 2014 emissions inventory of the three civil coal combustion pollutants in Beijing was obtained. Bituminous coal emissions of SO₂ was more than 5.5×10³ tons,NO_x was more than 7.5×10³ tons,CO was more than 290×10³ tons. All these coal types released more kinds and higher concentrations of volatile organic compounds in ignition phase and damp down stage. VOCs emission factor was the highest during ignition phase, followed by damp down phase.

New arbutin derivatives from the leaves of Heliciopsis lobata with cytotoxicity

Heliciopsis lobata is a medicinal plant, which is exclusively used to treat tumor in Li folk region. Two new arbutin derivatives, 6'-((E)2-methoxy-5-hydroxycinnamoyl) arbutin (1) and 2'-((E)2, 5-dihydroxycinnamoyl) arbutin (2) along with five known compounds (3-7), were isolated from the leaves of Heliciopsis lobata. Their structures were elucidated on the basis of extensive spectroscopic interpretations. They were evaluated for their potential anticancer activity. Compounds 6 and 7 exhibited cytotoxicity against MGC-803 cells with IC₅₀ values being 44.1 and 11.3 μg·mL^-1, respectively. Additionally, compounds 1, 2 and 5-7 exhibited a moderate inhibition of MGC-803 cells invasion; compound 2 at 20 μg·mL^-1 inhibited the invasion of MGC-803 cells by 43.0%, compared with the controls.

Is There a Correlation between the Presence of a Spiculated Mass on Mammogram and Luminal A Subtype Breast Cancer?

Objective

To determine whether the appearance of a spiculated mass on a mammogram is associated with luminal A subtype breast cancer and the factors that may influence the presence or absence of the spiculated mass.

Materials and Methods

Three hundred seventeen (317) patients who underwent image-guided or surgical biopsy between December 2014 and April 2015 were included in the study. Radiologists conducted retrospective assessments of the presence of spiculated masses according to the criteria of Breast Imaging Reporting and Data System. We used combinations of estrogen receptor (ER), progesterone receptor (PR), human epithelial growth factor receptor 2 (HER2), and Ki67 as surrogate markers to identify molecular subtypes of breast cancer. Pearson chi-square test was employed to measure statistical significance of correlations. Furthermore, we built a bi-variate logistic regression model to quantify the relative contribution of the factors that may influence the presence or absence of the spiculated mass.

Results

Seventy-one percent (71%) of the spiculated masses were classified as luminal A. Masses classified as luminal A were 10.3 times more likely to be presented as spiculated mass on a mammogram than all other subtypes. Patients with low Ki67 index (< 14%) and HER2 negative were most likely to present with a spiculated mass on their mammograms (p <0.001) than others. The hormone receptor status (ER and PR), pathology grade, overall breast composition, were all associated with the presence of a spiculated mass, but with less weight in contribution than Ki67 and HER2.

Conclusion

We observed an association between the luminal A subtype of invasive breast cancer and the presence of a spiculated mass on a mammogram. It is hypothesized that lower Ki67 index and HER2 negativity may be the most significant factors in the presence of a spiculated mass.

[Evolution of Classification Methods and Nomenclature of Clinical Disorders Treated by Acupuncture and Moxibustion in the 20th Century]

Through systematic review of the literature on the treatment of different clinical conditions or illnesses with acupuncture and moxibustion therapies in the 20^th century, the authors of the present paper analyzed the evolution process of classification of related clinical disorders. It was found that the classification and nomenclature of clinical disorders or illnesses are defined in terms of traditional Chinese medicine or western medicine, which undergoes an evolutionary process from western medicine to Chinese medicine and back to western medicine. This evolution process is due to the intrinsic requirement' of clinical practice such as thinking ways of diagnosis and treatment or to be influenced by extrinsic factors including introduction of western medicine at the Republic period, policies of"advanced studies of traditional Chinese physcians" and "western medicine doctors" lear-ning from traditional Chinese medicine, and the leading role of western medicine,etc. The former issue about the diagnosis and treatment of clinical problems needs being researched further.

Ectopic expression of Arabidopsis thaliana Na+(K+)/H+ antiporter gene, AtNHX5, enhances soybean salt tolerance

Drought and salt stresses are the two major factors influencing the yield and quality of crops worldwide. Na(+)(K(+))/H(+) antiporters (NHXs) are ubiquitous membrane proteins that play important roles in maintaining the cellular pH and Na(+)(K(+)) homeostasis. The model plant Arabidopsis potentially encodes six NHX genes, namely AtNHX1 to 6. In the present study, AtNHX5, a comparatively less well-studied NHX, was cloned and transferred into a soybean variety, Dongnong-50, via Agrobacterium-mediated cotyledonary node transformation to assess its role in improving salt tolerance of the transgenic plants. The transgenic soybean plants were tolerant to the presence of 300 mM NaCl whereas the non-transgenic plants were not. Furthermore, after NaCl treatment, the transgenic plants had a higher content of free proline but lower content of malondialdehyde compared to the non-transgenic plants. Our results revealed that that AtNHX5 possibly functioned by efficiently transporting Na(+) and K(+) ions from the roots to the leaves. Overall, the results obtained in this study suggest that soybean salt tolerance could be improved through the over expression of Arabidopsis AtNHX5.

Twenty-nine-Year Follow-up of Nonoperatively Treated Three-Level Lumbar Spondylolysis: A Case Report and Review of the Literature

This article was updated on May 25, 2016, because of a previous error. On page 4, in the address block, one of the e-mail addresses was incorrectly identified. The line had previously read "E-mail address for Y.-Y. Chen: yugangg@163.com." The sentence now reads "E-mail address for Y. Chen: yugangg@163.com."

CASE

Multilevel spondylolysis, especially involving more than two levels, is rarely encountered in clinical practice. We present a case of three-level spondylolysis with two-level spondylolisthesis followed for twenty-nine years after nonoperative treatment. The patient was a forty-six-year-old man who presented with stabbing pain in the lower left portion of his back without radiating symptoms or neurological deficit. Lumbar radiographs showed bilateral pars defects at L3, L4, and L5 and grade-I spondylolisthesis at L4/L5 and L5/S1, but flexion and extension views showed no obvious translation. Review of medical records showed that the patient had already had three-level bilateral spondylolysis at L3, L4, and L5 almost thirty years ago. The patient had no history of lumbar surgery during the intervening years. Nonsteroidal anti-inflammatory drugs were initially prescribed. Physical therapy was prescribed for eight weeks, and the low back pain improved.

CONCLUSION

For patients with multilevel lumbar spondylolysis without neurological symptoms and with slippage of <25%, we recommend conservative treatment with regular follow-up.

Lack of association between the aryl hydrocarbon receptor rs2066853 polymorphism and breast cancer: A meta-analysis on Ahr polymorphism and breast cancer

Published data regarding the association between aryl hydrocarbon receptor (Ahr) rs2066853 polymorphism and the risk of breast cancer shows conflicting results. We performed a meta-analysis on 2999 patients and 3050 controls from three related case-control studies to estimate the association between Ahr rs2066853 polymorphism and the risk of breast cancer. The protocol was approved by the Institutional Animal Care and Use Committee (IACUC) at the University of Florida (America NIH Publication No. 86-231985 Revision). According to the three eligible populations, the odds ratios (ORs), 95% confidence intervals (CIs) on the risk of breast cancer for the genotypes GA vs GG, AA vs GG, and A vs G were 1.06 (0.81-1.40), 0.96 (0.81-1.13), and 1.02 (0.85-1.22), respectively. The OR (95%CI) for GA + AA vs GG was 1.05 (0.80-1.37). Furthermore, after multi-variates adjustment, the ORs (95%CIs) were 1.05 (0.80-1.38) for GA vs GG, and 0.92 (0.76-1.10) for AA vs GG. This meta-analysis suggests that Ahr (rs2066853) polymorphism would not modify the risk of breast cancer. However, further research should be conducted to provide more evidence.

Covalently immobilised type I collagen facilitates osteoconduction and osseointegration of titanium coated implants

Background/Objective

Plasma-sprayed titanium coating (TC) with rough surfaces has been successfully applied in hip or knee prostheses. This study aimed to investigate the osteoconduction and osseointegration of Type I collagen covalently immobilised on TC (TC-AAC) compared with those of TC.

Methods

In vitro, the migration of human mesenchymal stem cells (hMSCs) on TC and TC-AAC was observed by scanning electron microscopy and visualised fluorescent live/dead assay. In vivo, a rabbit model with femur condyle defect was employed, and implants of TC and TC-AAC were embedded into the femur condyles.

Results

Collagen immobilised on TC could promote hMSCs' migration into the porous structure of the TC. Micro computed tomography images showed that bone trabeculae were significantly more abundant around TC-AAC implants than around TC implants. Fluorescence micrographs indicated more active new-bone formation around implants in the TC-AAC group than in the TC group. The measurement of bone–implant contact on histological sections indicated significantly greater osteointegration around TC-AAC implants than around TC ones.

Conclusion

Immobilised Type I collagen could improve the osteoconduction and osseointegration of TC implants.

Expression and clinical significance of microRNA-376a in colorectal cancer

The incidence of colorectal cancer (CRC) is increasing in many Asian countries and microRNAs have already been proven to be associated with tumorigenesis. Currently, microRNA-376a (miR-376a) expression and association with clinical factors in CRC remains unclear. In this study, real-time quantitative reverse transcriptase- polymerase chain reaction (qRT-PCR) was carried out on 53 matched pairs of CRC and adjacent normal mucosa to investigate the expression levels of miR-376a. According to the high or low expression of miR-376a, patients were divided into two groups. The relationship between miR-376a expression and clinicopathological factors of 53 patients was evaluated. Survival analysis of 53 CRC patients was performed with clinical follow- up information and survival curves were assessed by the Kaplan-Meier method. Immunohistochemistry (IHC) staining was performed on sections of paraffin-embedded tissue to investigate the vascular endothelial growth factor (VEGF) expression. MiR-376a showed low expression in cancer tissues compared to the adjacent normal tissues and altered high miR-376a expression tended to be positively correlated with advanced lymph node metastasis and shorter patient survival. VEGF IHC positivity was significantly more common in patients with high expression levels of miR-376a.Those results demonstrated that miR-376a may be a meaningful prognostic biomarker and potential therapeutic target in colorectal cancer.

Positive expression of programmed death ligand-1 correlates with superior outcomes and might be a therapeutic target in primary pulmonary lymphoepithelioma-like carcinoma

Background

Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subtype of non-small cell lung cancer (NSCLC), and no effective treatments have been defined for advanced disease. Programmed cell death-ligand 1 (PD-L1) is expressed in a group of cancers that may be suitable targets for specific immunotherapy.

Methods

This study investigated the expression and clinical value of PD-L1 in pulmonary LELC. Seventy-nine patients with pulmonary LELC were investigated. Paraffin-embedded tumor sections were stained with PD-L1 antibody. Correlations of PD-L1 expression with clinicopathologic parameters and outcomes were analyzed.

Results

Fifty patients (63.3%) were PD-L1 positive. The 3-year and 5-year progression-free survival (PFS) rate was 76.0% and 68.0%, respectively, and the 3-year and 5-year overall survival (OS) rate was 88.0% and 79.0%, respectively. Kaplan–Meier analysis revealed that patients with positive PD-L1 expression had longer PFS and OS than those with negative PD-L1 expression (P=0.019 and P=0.042, respectively). In a multivariate Cox regression model including age, tumor size, stage, and PD-L1 expression status, the latter three factors were found to be independent predictors of PFS (P=0.023, P=0.000, and P=0.009, respectively), but only stage was found to be an independent factor for OS (P=0.007), and PD-L1 expression status showed a trend to be independently correlated with OS (P=0.080).

Conclusion

Our results showed that a large proportion of patients with pulmonary LELC had positive expression of PD-L1, supporting the potential use of anti-PD-1/PD-L1-targeted therapies in this distinct type of NSCLC.

[Sources of dissolved organic carbon and the bioavailability of dissolved carbohydrates in the tributaries of Lake Taihu]

Surface water samples of Yincungang and Chendonggang Rivers were collected from September 2012 to August 2013 in Lake Taihu. Water temperature, Chlorophyll a and bacterial abundance were analyzed, as well as dissolved organic carbon (DOC) concentrations, stable carbon isotope of DOC (Δ13C(DOC)), specific UV absorbance (SUVA254 ) and dissolved carbohydrates concentrations. Δ13C(DOC) ranged from -27.03% per thousand ± 0.30% per thousand to -23.38%per thousand ± 0.20% per thousand, indicating a terrestrial source. Both the autochthonous and allochthonous sources contributed to the carbohydrates pool in the tributaries. Significant differences in PCHO (polysaccharides) and MCHO (monosaccharides) concentrations were observed between spring-summer and autumn-winter (P < 0.01, n = 12; P < 0.01, n = 12), which might be caused by the variation in the sources and bioavailability of carbohydrates. PCHO contributed a major fraction to TCHO (total dissolved carbohydrates) in autumn and winter, which could be explained by the accumulation of undegradable PCHO limited by the low water temperature; MCHO contributed a major fraction to TCHO in spring and summer, which might be caused by the transformation from PCHO by microbes at high water temperature.

Gamma knife combined with high-intensity focused ultrasound for treatment of locally advanced pancreatic carcinoma

AIM: To evaluate the safety and effectiveness of high-intensity focused ultrasound (HIFU) following gamma knife for treating locally advanced pancreatic cancer.

METHODS: Sixty-eight patients with locally advanced pancreatic cancer were randomly divided into two groups to receive either simple radiotherapy (group A; n = 33) or HIFU following gamma knife (group B; n = 35). The patients underwent contrast-enhanced computed tomography (CT) scans and CA199 tests 1, 2, 3 mo after treatment and every 3 mo thereafter during a total of 36 mo of follow-up. Short-term and long-term effects were observed after treatment, and survival curve analysis was performed.

RESULTS: The rate of clinical benefit response was significantly lower in group A than in group B (87.88% vs 94.29%, χ² = 4.001, (P = 0.045 < 0.05); the median survival time was significantly shorter in group A than in group B (12.00 mo vs 26.00 mo, P < 0.05); the average survival time was significantly shorter in group A than in group B (18.01 mo vs 22.99 mo, (P = 0.040 < 0.05). All the patients in the two groups completed the treatment smoothly as planned, and no serious complications such as pancreatic leakage, skin burns, viscera perforation and radioactive enteritis occurred.

CONCLUSION: Gamma knife combined with HIFU therapy may be a safe and effective method for the treatment of locally advanced pancreatic cancer.

[On the necessity of intellectual property rights involving standardization of acupuncture and moxibustion therapies]

In the process of working out and implementing standardization of acupuncture-moxibustion (acu-moxi) therapy, the issue of intellectual property rights has been frequently involved. Whether is the standardization inevitably involved in intellectual property rights? A reasonable answer to this question is definitely of important realistic guiding value and significance for acu-moxi standardization work. For this reason, authors of the present paper sum up historical development of correlation between acu-moxi standardization and intellectual property rights, and fully analyze the related causes under the conditions of knowledge economy from 1) increasing protection of acu-moxi intellectual property rights, 2) intrinsic requirements for raising the standardization level of acu-moxi, 3) profits drive of the intellectual property rights owners, and 4) increasing impetuous international economic trade competition.

Correlation between the NPPB gene promoter c.-1298 G/T polymorphism site and pulse pressure in the Chinese Han population

The aim of this study was to investigate the correlation between the natriuretic peptide precursor B (NPPB) gene single nucleotide polymorphism (SNP) c.-1298 G/T and pulse pressure (PP) of the Chinese Han population and the association between genotype and clinical indicators of hypertension. Peripheral blood was collected from 180 unrelated patients with hypertension and 540 healthy volunteers (control group), and DNA was extracted to amplify the 5'-flanking region and 2 exons of the NPPB gene by polymerase chain reaction; the fragment was sequenced after purification. The clinical data of all subjects were recorded, the distribution of the NPPB gene c.-1298 G/T polymorphism was determined, and differences in clinical indicators between the two groups were evaluated. The mean arterial pressure PP, and creatinine levels were significantly higher in the hypertension group than in the control group (P<0.05), but no other clinical indicators differed between the groups. There were no significant differences in genotype frequency and distribution of the NPPB gene c.-1298 G/T polymorphism between the hypertension group and the control group (P>0.05); in the control group, the mean PP of individuals with the SNP c.-1298 GG genotype was greater than that of individuals with the GT+TT genotype (P<0.05). In conclusion, there was no significant correlation between the NPPB gene c.-1298 G/T polymorphism and the incidence of essential hypertension in the Han population; however, the PP of the SNP c.-1298 GG genotype was greater than that of the GT+TT genotype in the control group.

CT-guided 125I seed interstitial implantation combined with gemcitabine/cisplatin chemotherapy for treatment of locally advanced pancreatic carcinoma

AIM: To explore the clinical efficacy of computed tomography (CT)-guided ¹²⁵I seed interstitial implantation combined with the gemcitabine and cisplatin (GP) chemotherapy regimen for the treatment of locally advanced pancreatic carcinoma.

METHODS: Eighty-eight patients with unresectable locally advanced pancreatic carcinoma (LAPC) were randomly divided into two groups: A (n = 54; 125I seed implantation + chemotherapy) and B (chemotherapy alone). CT-guided ¹²⁵I seed interstitial implantation was performed under local anaesthesia. Chemotherapy was given 10-14 d after surgery. The chemotherapy protocol was gemcitabine 1000 mg/m², d1, 8, + cisplatin 75 mg/m² d1-4 every 21 d. After four cycles of chemotherapy, the curative effect was assessed. Contrast-enhanced CT scanning and CA199 test were performed 1, 2, and 3 mo after treatment, and thereafter every 3 mo during a follow-up period of 30 mo.

RESULTS: The rate of clinical benefit and mean survival time were significantly higher in group A than in group B (P < 0.05 for both). No serious complications such as pancreatic leakage, bleeding, visceral perforation and grade Ⅳ bone marrow suppression were observed in either group.

CONCLUSION: CT-guided ¹²⁵I seed interstitial implantation combined with GP chemotherapy is safe and effective in the treatment of locally advanced pancreatic cancinoma.