[Clinical characteristics and prognosis analysis of pulmonary sarcomatoid carcinoma]

Objective: To summarize the clinical characteristics, treatment, and outcomes of patients with pulmonary sarcomatoid carcinoma (PSC) in order to improve clinicians' understanding of this disease. Methods: The clinical data of patients diagnosed with PSC in our hospital from January 1, 2015 to November 30, 2023 were retrospectively analyzed. According to whether radical resection was performed, the patients were divided into resectable group and unresectable group. The characteristics and treatments of PSC in different groups were compared. The survival curves were drawn by Kaplan-Meier method to compare the prognosis of different groups of patients. Results: A total of 43 PSC patients were included, including 32 males, with an average age of (62.79±9.59) years, and 31 smokers. Peripheral-type tumors were more common, with imaging showing predominantly solid soft tissue masses, and the maximum diameter of the tumor was more than 5 cm in 14 patients. Among the 23 patients who underwent NGS gene testing, the KRAS mutation rate was 43.5%, the TP53 mutation rate was 30.4%, and the MET mutation rate was 8.7%, all of which were MET-14 exon skipping mutations. PD-L1 expression was detected in 13 patients, 10 of whom showed high expression. The median overall survival (mOS) of the 43 patients with PSC was 24.6 months (13.0-52.7 months). Among them, 22 patients underwent radical lobectomy plus mediastinal lymph node dissection, 13 patients had postoperative recurrence, and 7 patients died during follow-up. The median disease-free survival (mDFS) was 12.3 months, the mOS was not achieved and the 1-year OS rate was 77.3 %. Twenty-one patients had unresectable locally advanced or advanced stage, and 15 patients died. The mDFS was 2.5 months, the mOS was 6.2 months, and the 1-year OS rate was 42.9 %. Seventeen patients received immunotherapy, and 1 patient received targeted therapy with the MET inhibitor glumetinib. Conclusions: PSC has a higher incidence in the elderly, smokers, and males, is highly malignant and has a poor prognosis. Based on its molecular biological characteristics, PD-L1 expression and tumor molecular detection can be performed to guide treatment options.

[The prevalence of insufficient physical activity and the influencing factors among Chinese adults in 2018]

Objective: To understand the prevalence of insufficient physical activity among adults aged ≥18 years in China and to explore the influencing factors. Methods: The China Chronic Disease and Risk Factor Surveillance was conducted in 298 counties/districts in China in 2018, covering 31 provinces (autonomous regions, municipalities). A multi-stage stratified cluster random sampling method was used to select permanent residents aged ≥18 years. A questionnaire including Global Physical Activity Questionnaire was used to collect information about the participants' demographic characteristics and physical activity through face-to-face interview. A total of 183 769 participants completed the survey. After complex data weighting, the prevalence of insufficient physical activity, occupation, transportation, and leisure-time physical activity time was analyzed. Multivariate logistic regression models were used to analyze the influencing factors related to insufficient physical activity. Results: The prevalence of insufficient physical activity among adults aged ≥18 years was 22.3% (95%CI: 20.9%-23.7%) in China in 2018, with males [24.4% (95%CI: 23.0%-25.8%)] significantly higher than females [20.2% (95%CI: 18.6%-21.8%)]. Adults aged 70 years and above [28.4% (95%CI: 26.9%-29.9%)] were significantly higher than adults in other age groups, followed by adults aged 18-29 years [26.4% (95%CI: 24.4%- 28.3%)] and 30-39 years [23.4% (95%CI: 21.5%-25.3%)], and tended to increase with increasing education and total sedentary behavior time (P<0.001). The weekly occupation, transportation, and leisure-time physical activity time appeared 958.6 (95%CI: 911.4-1 005.8) minutes, 234.5 (95%CI: 224.7- 244.2) minutes, and 88.6 (95%CI: 83.5-93.7) minutes, respectively. Multivariate logistic regression analysis showed that males, adults living in rural areas or northern China, ≥70 years, with junior high school education, an annual household income per capita <6 000 yuan and institutional/clerical/ technical occupation and longer total sedentary behavior time were related to a higher prevalence of insufficient physical activity. Conclusions: In China, over one-fifth of the adults had lower physical activity levels. Adults who are male, young adults, more educated, institutional/clerical/technical occupation, and with more extended total sedentary behavior are the populations that need to be focused on to promote physical activity-related health.

[Cardiovascular health status of Chinese adults based on "Life's Essential 8" score]

Objective: To assess the cardiovascular health status of adults in China by using the "Life's Essential 8" score, and provide reference for the development and improvement of cardiovascular disease prevention and control policies and measures. Methods: Chronic Disease and Nutrition Surveillance was conducted in 298 counties/districts in 2015 in 31 provinces (autonomous regions, municipalities) across China, multi-stage stratified cluster random sampling was used to select 45 households in each village or neighborhood, and 20 households were further selected to conduct dietary surveys. In this study, a total of 70 093 adults aged ≥20 years who completed the dietary survey and had complete information were included, their cardiovascular health status were assessed by using the "Life's Essential 8" score, a cardiovascular health scoring standard released by the American Heart Association in 2022. All results were adjusted using complex design-based sampling weights to achieve a better estimate of the population. Results: In 2015, the overall cardiovascular health score of Chinese adults aged ≥20 years was 73.3±12.6, the score was significantly higher in women (77.9±11.6) than in men (68.7±11.8), and higher in urban area (74.5±12.8) than in rural area (71.9±12.2), the differences were significant (P<0.001). It was estimated that about 0.25% (95%CI: 0.16%-0.33%) of adults in China had cardiovascular health score of 100, and 33.0% (95%CI: 31.6%-34.3%), 63.2% (95%CI: 62.1%-64.3%), and 3.9% (95%CI: 3.5%-4.2%) of adults had high, moderate and low cardiovascular health scores, respectively. The proportion of those with high cardiovascular health scores was relatively low in men, those with low education level, those with low income, those living in rural areas, and those living in southwest China (P<0.001). Of the eight factors, diet had the lowest mean score (46.0, 95%CI: 44.7-47.3), followed by blood pressure (59.4, 95%CI: 58.2-60.6) and tobacco exposure (61.4, 95%CI: 60.6-62.2). Conclusions: The cardiovascular health status of two-thirds of adult population in China needs to be improved. Diet, tobacco exposure, and blood pressure are the factors affecting the cardiovascular health of Chinese population, to which close attention needs to be paid, and men, rural residents, and those with lower socioeconomic status are key groups in cardiovascular health promotion.

[Research on the association between physical activity and type 2 diabetes]

Type 2 diabetes mellitus (T2DM) has become a significant public health problem affecting the health of our population. Physical inactivity is a significant risk factor for the occurrence and development of major chronic diseases, including T2DM, and appropriate physical activity patterns and levels have positive implications for the prevention and treatment of T2DM. This paper reviews the progress and results of domestic and international studies on the relationship between physical activity and the occurrence, development, and mortality of T2DM in recent years to support the improvement of strategies and measures for the prevention and management of diabetes in general and high-risk populations in China.

[Awareness and influencing factors on weight and waist circumference among adult Chinese residents in 2018]

Objective: To understand the awareness of weight and waist circumference and their influencing factors among residents aged ≥18 years in China and provide a reference for the development of relevant prevention and treatment policies and evaluation of intervention effects. Methods: We selected 298 counties (districts) from the 31 provinces (autonomous regions and municipalities) which participated in the 2018 China Chronic Disease and Risk Factor Surveillance program and included 194 779 permanent residents aged ≥18 years. To obtain the demographic characteristics of the study population, we used a multi-stage stratified whole-group random sampling method, questionnaires, and physical measurements. In this study, 179 045 people who completed the survey and had complete information on weight and waist circumference awareness were used as the study subjects. The weight awareness rate and waist circumference awareness rate were calculated by gender stratification, age, urban-rural, and education level groups. A multi-factor logistic regression model was used to analyze the influencing factors related to weight and waist circumference awareness of residents aged ≥18 years. Results: The weight awareness rate of adult residents in China in 2018 was 45.4% (95%CI: 41.9%-48.9%), higher among men [46.2% (95%CI: 42.5%-49.8%)] than women [44.6% (95%CI: 41.1%-48.2%)], and in urban areas [54.3% (95%CI: 49.3%-59.3%)]. The highest weight awareness rate appeared in residents with low BMI grouping [49.9% (95%CI: 44.3%-55.6%)], and the weight awareness rate in residents with undiagnosed central obesity, hypertension, and diabetes was higher than that of residents with diagnosed diabetes, with statistically significant differences (P<0.05). The waist circumference awareness rate of adult residents was 11.6% (95%CI: 9.7%-13.4%), higher in women [12.8% (95%CI: 10.8%-14.8%)] than in men [10.3% (95%CI: 8.6%-12.0%)], higher in urban [14.6% (95%CI: 11.7%-17.4%)] than in rural [8.3% (95%CI: 6.5%-10.2%)], and the waist circumference awareness rate was higher among residents with confirmed diabetes than those with undiagnosed diabetes, with statistically significant differences (P=0.020). The difference was statistically significant (P<0.001). The weight and waist circumference awareness rate increased with education level and annual per capita household income. Multi-factor logistic regression analysis suggested that urban, highly educated, high per capita annual household income and health check-up residents may have higher weight and waist circumference awareness rates among adult residents in China. Conclusion: Less than half of the adult residents in China know their weight status, and only about one-tenth know their waist circumference. Rural residents, those with low education levels and low annual per capita household income, and those who are obese need to be given prioritized attention. The relevant government departments should strengthen the popularization of the importance of weight and waist circumference on health and improve the awareness of our residents about their waist circumference and weight.

[Analysis of blood pressure measurement among Chinese adults in 2018]

Objective: To analyze the blood pressure measurement of Chinese adult residents in 2018 and provide a scientific basis for early detection and intervention of hypertension. Methods: In 2018, China Chronic Disease and Risk Factor Surveillance were conducted in 298 counties (districts) of 31 provinces (autonomous regions, municipalities) across the country, using a multi-stage stratified cluster random sampling method to survey permanent residents aged 18 years and above. We selected 184 509 people and carried out a face-to-face questionnaire survey and body measurement method to collect demographic data, major chronic diseases, and blood pressure measurement information of the survey subjects. Blood glucose and blood lipid-related indicators were obtained by laboratory testing. There were 170 551 adult residents included in the study after excluding abnormal and missing data for key variables. After complex weighting, blood pressure detection rates and detection times in people with different blood pressure levels and other diseases were analyzed. SAS 9.4 software was used to perform the χ²-test and trend test. Results: Among adult residents in China, the proportions of those with normal blood pressure, commonly recognized 'high' blood pressure, and newly detected hypertension who had their blood pressure tested within three months were 44.4%, 50.4%, and 52.6%, respectively. The proportions all appeared higher in women than in men (all P<0.05), in urban than in rural areas (all P<0.05), and showed an increasing trend with age (all P<0.001); The proportion of these three populations who had never had their blood pressure measured was 27.6%, 24.2%, and 23.5% respectively. The proportion of people with diagnosed hypertension who had their blood pressure tested within seven days was 44.0%, 51.4% in urban areas, higher than 37.7% in rural areas (P<0.001), and the proportion of people who had their blood pressure tested increased with education, per capita annual income and BMI (all P<0.001). Conclusions: The behavior of regular self-monitoring of blood pressure among adult residents in China still needs to be improved, especially among men and rural areas. Relevant health promotion and education should be strengthened. More targeted policies and measures should be developed to improve blood pressure measurement behavior in people with normal high blood pressure and other high-risk groups to control elevated blood pressure effectively.

[Research advances of music therapy and its application in the field of burn treatment]

Different from other trauma, the scar and pigmentation formed after healing of burn wound not only hinder beauty but also easily lead to a series of sequential psychological problems, such as depression and anxiety. Music therapy, as a supplementary treatment, is widely used in many fields including medical and health care and psychological regulation. However, affected by factors such as medical resources, the awareness and acceptance of music therapy among burn treatment workers in China are still low. Based on the clinical characteristics of burns, this paper matches the applicability of music therapy with it, summarizes the supplementary application of music therapy in the field of burn treatment, expounds this natural science with both science and aesthetics, and puts forward feasible suggestions for its future development.

[Effect analysis of sequential laser application in treating the hypertrophic scars of burn children at early stage]

Objective: To explore the effects of sequential application of intensive pulsed light and carbon dioxide laser in treating the hypertrophic scars of burn children at early stage. Methods: A retrospective cohort before-after control study in the same patients was conducted. From January 2016 to December 2018, 145 burn children with hypertrophic scar at the early stage who met the inclusion criteria were admitted to the First Hospital of Jilin University, including 82 males and 63 females, aged 1 to 12 (3 (2, 6)) years. All the children were firstly treated with intense pulsed light therapy (no anesthesia or intravenous-inhalation combined anesthesia) at an interval of once per month, and then changed to carbon dioxide laser therapy (topical anesthesia or intravenous-inhalation combined anesthesia) when the degree of scar hyperemia was reduced, at an interval of once every 3 months, for a total of 3 times. Before the first intense pulsed light treatment (hereinafter referred to as before the first treatment) and 3 months after the last carbon dioxide laser treatment (hereinafter referred to as after the last treatment), scar scoring was evaluated by Vancouver Scar Scale (VSS), and scar hyperemia (denoted as hemoglobin level) was measured with Antera 3D^® camera. The times of intense pulsed light, the time of single treatment, the anesthesia method, and the time of intravenous-inhalation combined anesthesia of intense pulsed light and carbon dioxide laser treatment were analyzed. After the last treatment, Likert Scale was used to evaluate the efficacy satisfaction of both doctors and patients. Adverse reactions were recorded during the treatment. Data were statistically analyzed with Wilcoxon signed rank sum test, and paired sample t test. Results: The color, vascular distribution, thickness, and softness scores, and total score in VSS scoring of scars of children after the last treatment were significantly lower than those before the first treatment (Z=-6.05, -10.34, -9.84, -9.28, -10.43, P<0.01). The hemoglobin level of scar of children after the last treatment was 1.86±0.24, significantly lower than 2.27±0.32 before the first treatment (t=17.65, P<0.01). A total of 411 times of intense pulsed light therapy were performed, (2.8±0.6) times per person, and the single treatment time was 35 (20, 45) s. There were 392 times (95.38%) without anesthesia, and 19 times (4.62%) with intravenous-inhalation combined anesthesia with time of 6 (5, 8) min. The single treatment time of carbon dioxide laser therapy was 5 (3, 10) min. There were 364 times (83.68%) of topical anesthesia and 71 times (16.32%) of intravenous-inhalation combined anesthesia with time of 10 (8, 15) min. After the last treatment, the efficacy satisfaction scores of doctors and patients were (4.3±0.7) and (3.8±1.0) points, respectively. Blisters occurred in 5 cases after intense pulsed light treatment, which were healed naturally after drainage. One child developed local skin infection, skin redness and swelling accompanied by purulent exudate after carbon dioxide laser treatment, which was improved after skin disinfection and external use of mupirocin ointment. No inflammatory pigmentation, worsening of hyperplasia of scar, erythema, or other skin adverse reactions or anesthetics-related adverse reactions occurred in any child. Conclusions: Sequential application of intense pulsed light and carbon dioxide laser to treat the hypertrophic scars of burn children at early stage can obviously improve the appearance and texture of scar, with higher satisfaction of doctors and patients and fewer adverse reactions.

Silence of MiR-9 protects depression mice through Notch signaling pathway

OBJECTIVE

To investigate the potential influence of micro ribonucleic acid (miR)-9 on depressive behaviors of depression mice.

MATERIALS AND METHODS

Depression model in mice was established via chronic unpredictable mild stress. A total of 36 C57BL/6 mice were randomly divided into control group (control mice, n=12), model group (depression mice administrated with control lentivirus, n=12) and miR-9 low-expression group (depression mice administrated with LV-miR-9-shRNA lentivirus, n=12). After 6 weeks, the depressive behaviors of mice were evaluated by behavioral experiments. Mice were then sacrificed for harvesting the hippocampus. Relative level of miR-9 in mouse hippocampus was determined via quantitative polymerase chain reaction (qPCR). Moreover, the number of newborn neurons in the hippocampus in each group was detected via immunofluorescence assay. Expression levels of doublecortin (DCX), post-synaptic density protein 95 (PSD95) and Notch signaling pathway in the hippocampus in each group were detected via Western blotting.

RESULTS

In the open field test, there were no significant differences in the crossing score and rearing score among control group, model group and miR-9 low-expression group (p>0.05). The immobility time of mice in tail suspension test and forced swimming test increased significantly in model group compared with that in control group (p<0.01), while it was significantly shorter in miR-9 low-expression group than that in model group (p<0.01). The expression of miR-9 in mouse hippocampus in model group was significantly higher than that in control group and miR-9 low-expression group (p<0.01). In miR-9 low-expression group, the number of newborn neurons in the hippocampus was significantly larger than that in control group and model group (p<0.01). Protein levels of both DCX and PSD95 were significantly higher in control group than those in model group (p<0.01). Besides, protein levels of Notch intracellular domain (NICD), Hes1 and Jag1 in the hippocampus in model group were remarkably declined compared with those in control group (p<0.01), which were higher in miR-9 low-expression group.

CONCLUSIONS

MiR-9 is upregulated in the hippocampus of depression mice. Silence of miR-9 in the hippocampus can effectively activate the Notch signaling pathway, promote the neuronal regeneration in the hippocampus and improve the depressive symptoms of mice.

[Minor similarities and major differences between cold injury and burn injury]

Cold injury is very damaging. This article summarizes the mechanism, types, and rehabilitation of cold injury, focusing on the degree and clinical treatment of frostbite. Frostbite can mainly cause damage of microcirculation and capillary structure, while burn injury can mainly cause damage of cutaneous tissues. Based on this, the key point of management of frostbite is to improve microcirculation and appropriate rewarming, while that of burn injury is wound repair. Up to date, the rate of amputation caused by frostbite is still high, and the rehabilitation for sequela caused by frostbite remains a big challenge in modern medicine. It is worth paying more attention to.

[Bacterial biofilm and chronic wound infection]

Bacteria usually colonize, reproduce, and grow aggressively on chronic wounds in the form of biofilm. Different from free bacteria, bacteria in biofilm exhibit unique mechanism in epigenetics and biological behavior, especially in resistance to antibiotics and host immunity. In this article, we introduce the composition and structural function of bacterial biofilm, expound the drug-resistance mechanism of bacterial biofilm, discuss the clinical characteristics of bacterial biofilm infection wound and the diagnosis method of biofilm, and analyze the treatment strategy for bacterial biofilm. It is suggested that clinicians should pay more attention to bacterial biofilm infection and advocate in-depth study of bacterial biofilm in order to improve the quality of managing chronic wounds.

Preliminary results indicate resveratrol affects proliferation and apoptosis of leukemia cells by regulating PTEN/PI3K/AKT pathway

OBJECTIVE

PTEN-PI3K/AKT signaling pathway is widely involved in the regulation of cell proliferation, cell cycle, apoptosis, and invasion. Resveratrol (Resv) is a natural botanical ingredient involved in several biological activities. It is still unclear in terms of whether Resv may exert anti-leukemia effects by regulating the PTEN-PI3K/AKT pathway. This study investigated the effect of Resv on leukemia cell proliferation and apoptosis by regulating PTEN-PI3K/AKT pathway.

PATIENTS AND METHODS

Human normal peripheral blood PBMC cells, and human acute promyelocytic leukemia (APL) cell line NB-4 and HL-60 cells were cultured in vitro. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect Phosphatase and tensin homolog (PTEN) mRNA expression. Western blot was adopted to test PTEN protein expression. HL-60 and NB-4 cells were treated with 0, 5, 10, and 20 μM Resv, respectively. Cell proliferation was analyzed by cell counting kit8 (CCK-8) assay. The level of caspase-3 was measured by Western blot. HL-60 cells were divided into control group, 20 μM Resv treatment group, and Resv+PTEN inhibitor SF1670 group. Cell apoptosis was determined by flow cytometry. Cell proliferation was assessed by EdU staining.

RESULTS

Compared with peripheral blood mononuclear cell (PBMC), PTEN mRNA and protein levels were significantly decreased in NB-4 and HL-60 cells. Resv significantly inhibited the proliferation activity in HL-60 and NB-4 cells, and increased the activity of caspase-3. Resv treatment up-regulated the expression of PTEN and reduced the expression of p-AKT protein in HL-60 cells. However, Resv treatment markedly suppressed the proliferation of HL-60 and induced apoptosis. SF1670 treatment in the presence of Resv significantly antagonized the down-regulation of p-AKT protein expression induced by Resv, resulting in decreased apoptosis and enhanced cell proliferation.

CONCLUSIONS

Resv can up-regulate PTEN expression and inhibit the activity of PI3K/AKT pathway to play an anti-leukemia effect through suppressing cell proliferation and inducing apoptosis.

[Clinical strategy on repair of pressure injury on ischial tuberosity based on the histopathological type]

Objective: To investigate effects of clinical strategy on repair of pressure injury on ischial tuberosity based on the histopathological type. Methods: From January 2014 to January 2018, 33 patients with 33 pressure injuries on ischial tuberosity were admitted to our department. There were 25 males and 8 females aged 35 to 87 years. Pressure injuries on ischial tuberosity were repaired with different methods according to pathological types of denatured tissue on basal parts of wounds and tissue defect volumes. Areas of wounds after thorough debridement ranged from 2.0 cm×1.0 cm to 14.0 cm×12.0 cm. Pressure injuries of necrosis type with tissue defect volumes of 6.5-9.5 cm(3) were sutured directly after debridement at the first stage. Tissue defect volumes of 3 patients with pressure injuries of granulation type ranged from 56.0 to 102.5 cm(3). According to situation around wounds, the above mentioned 3 patients were respectively repaired with posterior femoral Z-shaped reconstruction, posterior femoral advanced V-Y flap, and posterior femoral propeller flap. Tissue defect volumes of 5 patients with pressure injuries of infection type ranged from 67.5 to 111.0 cm(3). Among the patients, 2 patients were repaired with posterior femoral propeller flaps, 2 patients were repaired with posterior femoral advanced V-Y flaps, and 1 patient was repaired with posterior femoral Z-shaped reconstruction. Among patients with pressure injuries of synovium type, wounds of 14 patients with tissue defect volumes 6.4-9.5 cm(3) were sutured directly after debridement, and tissue defect volumes of another 8 patients were 97.0-862.5 cm(3). Among the 8 patients, 7 patients were repaired with gluteus maximus myocutaneous flaps and continued vacuum sealing drainage was performed for 7 to 14 days according to volume of drainage, and 1 patient was repaired with posterior femoral propeller flap. Areas of flaps or myocutaneous flaps ranged from 3.5 cm× 2.5 cm to 14.0 cm×12.0 cm. The donor sites of flaps were sutured directly. Operative areas after operation and healing of wounds during follow-up were observed. Results: The sutured sites of 33 patients connected tightly, with normal skin temperature, color, and reflux. During follow-up of 12 months, wounds of 25 patients healed well with no local ulceration, and 8 patients were admitted to our department again due to recurrence of pressure injuries on or near the primary sites. Pathological types of pressure injuries of the 8 patients were synovium types. After complete debridement, the tissue defect volumes were 336.8-969.5 cm(3,) wounds with areas ranged from 8.0 cm×7.0 cm to 14.0 cm×12.0 cm were repaired with gluteus maximus myocutaneous flaps or posterior femoral propeller flaps which ranged from 8.0 cm×7.0 cm to 14.0 cm×12.0 cm. Eight patients were discharged after wound healing completely. During follow-up of 12 months, operative sites of the patients healed well, with no recurrence. Conclusions: Appropriate and targeted methods should be chosen to repair pressure injuries on ischial tuberosity based on the pathological types. Direct suture after debridement is the first choice to repair pressure injury of necrosis type. Pressure injuries of granulation type and infection type can be repaired with posterior femoral propeller flap, Z-shaped reconstruction, or advanced V-Y flap according to situation around wounds. Gluteus maximus myocutaneous flap is the first choice to repair pressure injury of synovium type. In addition, recurrence-prone characteristics of pressure injury of synovium type should be taken into consideration, plan should be made previously, and resources should be reserved.

[Multimodal analgesic analgesia in patients with obstructive sleep apnea hypopnea syndrome with multiple planar surgery]

Objective:To observe the value of multimodal analgesia in patients with OSAHS undergoing multiplanar surgery.Method: A total number of 90 patients with obstructive sleep apnea hypopnea syndrome with tongue hypertrophy or hyperplasia of the root lymphoid tissue were collected. All patients underwent improved uvulatopharyngeal angioplasty (H-UPPP) and tongue root partial resection, or simultaneous tongue ablation at the same time, and they were randomly divided into two groups,45 patients in each group.In multi-modal analgesic group, the parrixibub sodium 40 mg were given intravenously 0.5 h before surgery, and oxygen budesonide aerosol inhalation therapy was given after surgery.Besides,sodium aescinate 10 mg was given intravenously 24, 48, 72 h after surgery,respectively.The control group did not do the above treatment. Both groups received 40 mg paradoxes sodium hydrostatic Bid for 4 days.To perform VAS on two groups of patients, uvula swelling time and first time to eat were recorded，and the symptoms of postoperative nausea and vomiting were observed.Result: The general conditions of the two groups of patients, including age, sex, body mass index, intraoperative blood loss, and operative time, were not statistically significant(all of the P>0.05). The scores of 24, 48, 72, 96 h VAS in multi-mode analgesic group were lower than those in control group after the operation of multi-mode analgesia, and the difference was statistically significant（P<0.05）.The duration of the swelling time of the uvula in the multi-mode analgesic group was significantly shorter than that in the control group, and the difference was statistically significant (5.44±0.88) d compared with (7.68±0.89) d (t=12.01, P<0.01);(30.1±7.3)h compared with (36.5±7.0) h,(t=4.25, P<0.01). Conclusion: Multi-mode analgesia is effective for OSAHS patients after multi-planar surgery. It effectively reduces postoperative pain, shortened postoperative swelling time, and improves the surgical compliance and safety.

[Reliability and validity of the simplified Chinese version of the fecal incontinence quality of life questionnaire in the patients with fecal incontinence]

Objective: To develop the Chinese version of the fecal incontinence quality of life (FIQL) questionnaire, and to validate them in Chinese population. Methods: Our study included 52 cases recruiting from outpatients diagnosed with fecal incontinence in Peking Union Medical College Hospital, fecal incontinence in Beijing City nursing homes for the elderly, and patients received perineal repair surgeries who suffered from perineal laceration and laceration in in Peking Union Medical College Hospital from October 2013 to 2016 December.The Original English Fecal Incontinence Quality of Life scale questionnaires were translated into Chinese and they were linguistically validated following the Cross-cultural adaptation of health-related quality of life measures.The reliability and validity of the Chinese version of FIQL questionnaires in Chinese population were evaluated. Results: Fifty-two patients completed the FIQL and the SF-12 questionnaires, as well as Cleveland Clinic Incontinence Score.The Cronbach's alpha of FIQL was 0.949, test-retest reliability ICC was 0.437-0.866. FIQL scores were positively correlated with SF-12 (Spearman correlation coefficient was 0.588, P<0.01) and negatively correlated with Cleveland Clinic Incontinence Score (Spearman correlation coefficient was -0.617, P<0.01). Factor analysis showed that there were 6 common factors in FIQL. Conclusions: Chinese version of FIQL have high reliability and validity in Chinese population, there fore it is suitable for clinic and research.

Bevacizumab and gefitinib enhanced whole-brain radiation therapy for brain metastases due to non-small-cell lung cancer

Non-small-cell lung cancer (NSCLC) patients who experience brain metastases are usually associated with poor prognostic outcomes. This retrospective study proposed to assess whether bevacizumab or gefitinib can be used to improve the effectiveness of whole brain radiotherapy (WBRT) in managing patients with brain metastases. A total of 218 NSCLC patients with multiple brain metastases were retrospectively included in this study and were randomly allocated to bevacizumab-gefitinib-WBRT group (n=76), gefitinib-WBRT group (n=77) and WBRT group (n=75). Then, tumor responses were evaluated every 2 months based on Response Evaluation Criteria in Solid Tumors version 1.0. Karnofsky performance status and neurologic examination were documented every 6 months after the treatment. Compared to the standard WBRT, bevacizumab and gefitinib could significantly enhance response rate (RR) and disease control rate (DCR) of WBRT (P<0.001). At the same time, RR and DCR of patients who received bevacizumab-gefitinib-WBRT were higher than those who received gefitinib-WBRT. The overall survival (OS) rates and progression-free survival (PFS) rates also differed significantly among the bevacizumab-gefitinib-WBRT (48.6 and 29.8%), gefitinib-WBRT (36.7 and 29.6%) and WBRT (9.8 and 14.6%) groups (P<0.05). Although bevacizumab-gefitinib-WBRT was slightly more toxic than gefitinib-WBRT, the toxicity was tolerable. As suggested by prolonged PFS and OS status, bevacizumab substantially improved the overall efficacy of WBRT in the management of patients with NSCLC.

Plastic responses in the metabolome and functional traits of maize plants to temperature variations

Environmentally inducible phenotypic plasticity is a major player in plant responses to climate change. However, metabolic responses and their role in determining the phenotypic plasticity of plants that are subjected to temperature variations remain poorly understood. The metabolomic profiles and metabolite levels in the leaves of three maize inbred lines grown in different temperature conditions were examined with a nuclear magnetic resonance metabolomic technique. The relationship of functional traits to metabolome profiles and the metabolic mechanism underlying temperature variations were then explored. A comparative analysis showed that during heat and cold stress, maize plants shared common plastic responses in biomass accumulation, carbon, nitrogen, sugars, some amino acids and compatible solutes. We also found that the plastic response of maize plants to heat stress was different from that under cold stress, mainly involving biomass allocation, shikimate and its aromatic amino acid derivatives, and other non-polar metabolites. The plastic responsiveness of functional traits of maize lines to temperature variations was low, while the metabolic responsiveness in plasticity was high, indicating that functional and metabolic plasticity may play different roles in maize plant adaptation to temperature variations. A linear regression analysis revealed that the maize lines could adapt to growth temperature variations through the interrelation of plastic responses in the metabolomes and functional traits, such as biomass allocation and the status of carbon and nitrogen. We provide valuable insight into the plastic response strategy of maize plants to temperature variations that will permit the optimisation of crop cultivation in an increasingly variable environment.

Metabolic response of maize plants to multi-factorial abiotic stresses

Clarification of the metabolic mechanisms underlying multi-stress responses in plants will allow further optimisation of crop breeding and cultivation to obtain high yields in an increasingly variable environment. Using NMR metabolomic techniques, we examined the metabolic responses of maize plants grown under different conditions: soil drought, soil salinity, heat and multiple concurrent stresses. A detailed time-course metabolic profile was also performed on maize plants sampled 1, 3 and 7 days after initiation of soil drought and heat stress. The metabolic profile of maize plants subjected to soil drought was more similar to plants exposed to salt stress than to heat-stressed plants. Drought-stressed maize plants subjected to salt or heat stress showed distinct integrated metabolic profiles compared with those exposed to either stressor individually. These differences show the considerable metabolic plasticity of maize in response to different growth conditions. Moreover, glucose, fructose, malate, citrate, proline, alanine, aspartate, asparagine, threonine and one unknown compound fluctuated obviously between maize plants grown in controlled growth cabinet and a natural regime. These changes were associated with the TCA cycle and core nitrogen metabolism, and could be related to their multiple functions during plant growth. The evident stress-induced trajectory of metabolic changes in maize indicated that the primary metabolic responses to soil drought, heat and combined drought and heat stresses occurred in a time-dependent manner. Plasticity at the metabolic level may allow maize plants to acclimatise their metabolic ranges in response to changing environmental conditions.

A simple and rapid high performance liquid chromatography method to determine levofloxacin in human plasma and its use in a bioequivalence study

A simple and rapid HPLC-UV method has been developed for determination of levofloxacin in human plasma. Chromatographic separation was performed on a Kromasil C18 column with the mobile phase consisting of acetonitrile, water, phosphoric acid and triethylamine (14:86:0.6:0.3, v/v/v/v) and flow rate was 1.0 mL/min. The method used ultraviolet detection set at a wavelength of 294 nm. The standard curves were linear over concentration range of 0.05-5.0 μg/mL (r > 0.99). The method was simple, rapid, precise, accurate and suitable for routine bioequivalence study. The method was successfully applied to the bioequivalence study of two different levofloxacin hydrochloride capsules in Chinese healthy volunteers.

Effects of polysaccharides (FI0-b) from mycelium of Ganoderma tsugae on proinflammatory cytokine production by THP-1 cells and human PBMC (I)

AIM

To compare the effects of water-soluble polysaccharides, FI0-b, and its formic acid-modified derivative, FI0-b-H, on production of human proinflammatory cytokines.

METHODS

The polysaccharides were modified by formic acid. Cytokine production was quantitated by radioimmunoassay. mRNA for cytokines was measured by semi-quantitative RT-PCR.

RESULTS

FI0-b and FI0-b-H 4, 40, and 400 mg/L significantly downregulated interleukin-1 alpha (IL-1 alpha) production by THP-1 cells induced by lypopolysaccharide (LPS) 1 or 10 mg/L and phorbol myristate acetate (PMA) 200 nmol/L. At lower stimulation with LPS 10 mg/L and PMA 200 nmol/L, both polysaccharides significantly upregulated tumor necrosis factor alpha (TNF alpha) production by THP-1 cells. However, at higher stimulation with LPS 100 mg/L and PMA 200 nmol/L, they downregulated TNF alpha production. FI0-b-H downregulated interleukin-8 (IL-8) production by THP-1 cells at a lower-dose of LPS 1 mg/L and PMA 200 nmol/L, but upregulated IL-8 production at a higher-dose of LPS 10 mg/L and PMA 200 nmol/L. Production of cytokines (IL-1 alpha and TNF alpha) was transcriptionally or post-transcriptionally regulated by FI0-b and FI0-b-H.

CONCLUSION

The water-soluble polysaccharides of Ganoderma tsugae mycelium have bidirectional immunomodulatory effects on cytokine production in different stimulatory conditions in a dose-dependent manner. Compared with FI0-b, FI0-b-H has more marked effects on human proinflammatory cytokine production.

Effects of polysaccharides (FI0-c) from mycelium of Ganoderma tsugae on proinflammatory cytokine production by THP-1 cells and human PBMC (II)

AIM

To study the effects of water-soluble polysaccharides. FI0-c, and its sulfated derivative, FI0-c-S, on production of human proinflammatory cytokines, interleukin-1 alpha (IL-1 alpha) and tumor necrosis factor alpha (TNF alpha).

METHODS

The herbal polysaccharides were modified by chlorosulfornic acid in dimethyl sulfoxide (Me2SO). Cytokine production was measured by radioimmunoassay, mRNA for the cytokines was measured by semi-quantitative RT-PCR.

RESULTS

FI0-c 4 mg/L itself induced IL-1 alpha production by THP-1 cells without stimulants, such as lipopolysaccharides (LPS) and phorbol myristate acetate (PMA). On the other hand, FI0-c and FI0-c-S inhibited the IL-1 alpha production by THP-1 cells with these stimulants. FI0-c and FI0-c-S significantly upregulated TNF alpha production by THP-1 cells without stimulants or at a low dose of LPS 10 mg/L and PMA 200 nmol/L, whereas these polysaccharides markedly downregulated the TNF alpha production by a high dose of LPS 100 mg/L and PMA. Human peripheral blood mononuclear cells (PBMC) responded to FI0-c and FI0-c-S in IL-1 alpha and TNF alpha production in a fashion similar to THP-1 cell responses. FI0-c 4 mg/L downregulated high-dose LPS- and PMA-induced IL-1 alpha or TNF alpha mRNA and their protein production by THP-1 cells.

CONCLUSION

The water-soluble polysaccharides of Ganoderma tsugae mycelium have bidirectional immunomodulatory effects on cytokine production in different cell stimulatory conditions. Chemical modification of this polysaccharide changed the intensity of regulatory effect on cytokine production.

Electrochemical studies of the effect of lanthanide ions on the activity of glutamate dehydrogenase

Using the electrochemical method based on the "diffusion" layer concept of the convective system, the effect of lanthanide ions La3+ and Eu3+ on the activity of glutamate dehydrogenase (GLDH) has been determined. In suitable concentrations, the lanthanide ions La3+ and Eu3+ can activate the GLDH in the reductive amination of alpha-Ketoglutarate (alpha-KG). The activation mechanism would be that the lanthanide ions could interrupt the binding of NAD+ to GLDH by combining preferentially to NAD+. This mechanism was proposed by the voltammetric studies.

Electrochemical study of the effect of ADP and AMP on the kinetics of glutamate dehydrogenase

A chronoamperometric method based on the 'diffusion' layer concept of the convective system was used to assay the glutamate dehydrogenase (GLDH) activity. Once the reaction was initiated by adding the enzyme GLDH into a well-stirred nicotinamide adenine dinucleotide (NADH, coenzyme) solution, the steady-state oxidation limiting current of NADH would decrease linearly in a short time. The major advantage of this method is that it directly indicates the continuous in-situ change of the coenzyme concentration, thus, the real initial reaction rate of enzyme-catalyzed reaction, V0, can be determined. Using this method, the effect of adenosine-5'-monophosphate (AMP) and adenosine-5'-diphosphate (ADP) on the GLDH activity has been monitored. The results showed that ADP and AMP could increase the activity of GLDH. This activation mechanism was proposed by the voltammetric study.

Regional differences of dura osteoinduction: squamous dura induces osteogenesis, sutural dura induces chondrogenesis and osteogenesis

Dura plays an important role in calvarial morphogenesis. However, precisely what that role is remains unclear. We present here in vivo evidence that dura without other central nervous system components induces both chondrogenesis and osteogenesis. The mechanism is, at least in part, by proximate tissue interaction. The objectives of this experiment were to answer the following: (1) Can dura actually induce osteogenesis without the influence of the underlying brain? (2) What are the requirements of this dura-induced heterotopic osteogenesis? (3) What are the differences between dura underlying sutures and dura underlying the squamous portions of the cranial bones? Dura underlying the metopic, sagittal, and lambdoidal sutures and dura underlying the flat portions of frontal and parietal bones were obtained from neonatal Lewis rats and transplanted into the posterior thoraces of adult Lewis recipients. In group I, dura underlying the metopic, sagittal, and lambdoidal sutures (n = 20) and dura underlying the flat portions of frontal and parietal bones (n = 20) were transplanted individually into separate epitheliomesenchymal pockets. Group II animals had dura underlying the metopic, sagittal, and lambdoidal sutures (n = 10) and dura underlying the flat portions of frontal and parietal bones (n = 10) transplanted individually into surgically created mesenchymal pockets by placing the dura grafts between panniculus carnosus and latissimus dorsi muscles. The animals were sacrificed at 2-week intervals. Light microscopy, special histochemical analysis, immunohistochemistry, and electron microscopy were performed. Bone formation was seen in 15 of the 18 animals (83 percent) in group I. No bone or cartilage formation was seen in group II. Chondrogenesis was seen in 4 animals receiving dura underlying the metopic, sagittal, and lambdoidal sutures in group I. Cellular hyperproliferation was seen at 2 weeks when dura was transplanted close to the hair follicles. These cells had a high nucleus-to-cytoplasm ratio and were positive for transforming growth factor beta. This hyperproliferation was followed by production and accumulation of Alcian blue-positive extracellular matrix that resisted digestion by hyaluronidase. Cellularly active cartilage was seen at 6 weeks. There was no chondrogenesis in animals receiving dura underlying the flat portions of frontal and parietal bones in group I. Electron microscopy demonstrated the presence of proteoglycan-like ground substance and type II collagen in the inner layer of sutural dura and the predominance of dense type I collagen in the squamous dura and the external layer of the sutural dura. The important findings of this experiment are that (1) heterotopically transplanted neonatal dura can induce osteogenesis, (2) this heterotopic osteoinduction by dura requires epitheliomesenchymal interaction, and (3) separating dura into sutural dura and squamous dura, chondrogenesis occasionally occurred in addition to osteogenesis with the former, while only membranous ossification occurred with the latter, indicating intrinsic differences within the dura mater. This dural heterogeneity is supported by direct ultrastructural data.

Daily spinal cord stimulation suppresses autotomy behavior in rats following peripheral deafferentation

Autotomy in experimental animals following peripheral nerve section has been interpreted as a sign of pain corresponding to the chronic pain observed in patients with extensive nerve lesions. Such pain may be alleviated by spinal cord stimulation. In the present study, the effect of such stimulation, via chronically implanted electrodes, on autotomy behavior following sciatic nerve section was assessed in the rat. The stimulation was applied for 30 min daily during a 10-day period. There were four groups of animals, 16 in each, half of them females. Stimulating electrodes were implanted in all and one group served as control, receiving sham stimulation. In one group, the stimulation was started when autotomy was observed, one received stimulation from the day of nerve section, and in one it was begun three days before section. The onset of autotomy was significantly delayed in the latter two groups. When stimulation was applied as "treatment", autotomy ceased but reappeared after the 10-day stimulation period. The incidence and severity of autotomy was markedly delayed and reduced when the stimulation had been applied just after the nerve section or before. In the latter groups, the diminished degree of autotomy persisted for the entire observation period, lasting 60 days after the stimulation was stopped. It seems that spinal cord stimulation, albeit applied only once daily and during a limited time period, can protect the spinal cord from developing the state of hyperexcitability believed to be the major cause of autotomy behavior. Peripheral mechanisms may also play a role by the antidromic activity evoked by the stimulation in the sectioned peripheral nerve. This study shows that spinal cord stimulation, which is a commonly employed method for treating chronic neurogenic pain, may have long-lasting effects on plasticity changes in the spinal cord following peripheral nerve injury, even when the stimulation is applied for short periods of time.

The effects of octreotide on healing of small bowel anastomosis

Octreotide (OCT) is a somatostatin analog used for its inhibitory action on multiple GI functions. Although octreotide has numerous clinical benefits, it has also been shown to inhibit postresectional hyperplasia of small bowel and hepatic regeneration. Because octreotide inhibits both trophic and anabolic hormones, we hypothesize that the use of octreotide may be detrimental in patients with a recent bowel anastomosis. To test this hypothesis, 60 male rats were randomized to four equal groups following small bowel anastomosis. Group I = control; Group II = 10 mg/day of hydrocortisone succinate; Group III = 2.5 micrograms/kg/day octreotide (equivalent of a clinical dose); Group IV = 25 micrograms/kg/day octreotide. Hydrocortisone was used as a negative control because it is known to have inhibitory effects on small bowel anastomotic healing. On postoperative Day 7, bursting pressures were measured. Serum T-kininogen levels, as a marker for systemic inflammation, and hydroxyproline content from the anastomotic segments were obtained. These results indicate that in the rat small bowel model, octreotide did not have any deleterious effect on anastomotic strength, systemic inflammation, and collagen content, even at high doses. Hydrocortisone, as expected, showed significant detrimental effects on bursting strength, as well as decreasing systemic inflammation. These findings have significant clinical implications, as octreotide could be used without jeopardizing the intestinal anastomosis.

T-kininogen, processing and functions

Studies are presented which indicate that T-kininogen, the acute phase kininogen of the rat, could be a healing protein because of its properties as a cysteine protease inhibitor. Evidence is also presented that mRNA of T-kininogen synthesis may be a function of interleukin 6 production. A regulatory mechanism is postulated by which SH cofactors could determine if T-kinin is released or whether the T-kininogen molecule would remain intact. Evidence is also presented that T-kinin acts through kinin B2 receptors. No specific binding of bradykinin or T-kinin could be detected in rat heart preparations.

[Amyotrophic lateral sclerosis: an analysis of 167 cases]

167 cases of amyotrophic lateral sclerosis treated in Peking Union Medical College Hospital were analyzed. There was a significant difference between some of the clinical features of amyotrophic lateral sclerosis in China and western countries. The age of onset in China was 10 to 20 years earlier than and the male to female ratio (4.6:1) was 2 times higher than those in the west. Average age of death was 47 years, being earlier than that in the west. Some specific clinical features for early clinical diagnosis were also discussed.

[Relation between the clinical manifestations and electromyographic findings in motor neurone disease]

343 cases of motor neurone disease (MND) were examined with electromyography. The result showed EMG examination was of much vale in helping to ascertain an accurate diagnosis which clinically could be made in only about 1/4 of the series of cases. The ages of onset ranged from 4 months to 10 years with an average of 36.8 years. 56.8% under 40 years. There was a higher male preponderance, the male/female ratio being 3.2:1. It was 1.6:1 in a report from a western country. 123 cases showed only one limb involvement clinically while the EMG findings were also abnormal in the other three limbs. Fibrillation potentials were found to be at more than two sites in one muscle in 84.5% in this series, where as they occurred in 95-100% of the infantile and juvenile cases. Abundant fibrillation potentials were found in 37.1% of the cases within 3 years after the onset and in 13.6% in those with a longer duration. The increment of the mean duration of motor unit potential was 94.5% and that of the mean amplitude 91%. It seemed not necessary to emphasize giant potentials. The motor nerve conduction velocities (NCV) were normal in 95% while the sensory NCV were almost always normal (98%). All of the 3 cases tested with single fiber EMG showed an increment of jitter of 95-100% and a muscle fiber density of 2.95-3.65.

Isolation of a thiol-activated T-kininogenase from the rat submandibular gland

T-kininogenase (T-kgnase) activity has been investigated in tissues of the rat and submandibular glands of the rat, mouse and guinea pig. Both rat and mouse submandibular homogenates showed high T-kgnase activity. The enzyme has been purified 360-fold from rat submandibular gland homogenate supernatant fluid. The enzyme has an apparent molecular mass of 28 kDa and a pH optimum of 8.0 toward T-kininogen. It cleaved T-kininogen in catalytic quantities to release T-kinin (Ile-Ser-bradykinin) and small quantities of bradykinin and an unknown kinin. The activity of the enzyme was increased 10-fold in the presence of thiol groups (dithiothreitol) and inhibited by leupeptin (90%) and to a lesser extent by aprotinin (49%), TLCK (46%) and soybean trypsin inhibitor (27%). Pepstatin and PMSF did not inhibit the enzyme. Studies on substrate specificity, pH optimum and agents which inhibit T-kgnase activity demonstrate that this enzyme is different from plasma and tissue kallikreins, cathepsin D, esterase A and esterase B (other known kininogenases). It is the first thiol-activated kininogenase to be reported.