紫杉醇药物涂层球囊成形术治疗症状性椎动脉开口处狭窄的疗效

目的 探讨紫杉醇药物涂层球囊（P-DCB）成形术治疗症状性椎动脉开口狭窄的安全性和有效性。方法 回顾性分析2017 年12月至2019年6月经P-DCB成形术治疗的43例症状性椎动脉开口处狭窄的临床资料。结果 所有病人均完成介入治疗，成功率为100%。术后即刻狭窄率[（12.03±2.15）%]较术前[（86.32±10.26）%]明显降低（P<0.05）。围手术期发生动脉夹层1例，无其他并发症。随访12~16个月，平均13.5个月；症状改善43例，无变化例，症状改善率为95.3%（41/43）；全部病人接受DSA或CTA随访，随访狭窄率[（16.1±3.12）%]与术后即刻无统计学差异（P>0.05）；5例发生再狭窄，再狭窄率为11.6%。结论 P-DCB成形术治疗椎动脉开口狭窄具有较好的临床疗效。     

Cardioprotective effects of sinomenine in myocardial ischemia/reperfusion injury in a rat model

BackgroundIschemia reperfusion (I/R) play an imperative role in the expansion of cardiovascular disease. Sinomenine (SM) has been exhibited to possess antioxidant, anticancer, anti-inflammatory, antiviral and anticarcinogenic properties. The aim of the study was scrutinized the cardioprotective effect of SM against I/R injury in rat.MethodsRat were randomly divided into normal control (NC), I/R control and I/R + SM (5, 10 and 20 mg/kg), respectively. Ventricular arrhythmias, body weight and heart weight were estimated. Antioxidant, inflammatory cytokines, inflammatory mediators and plasmin system indicator were accessed.ResultsPre-treated SM group rats exhibited the reduction in the duration and incidence of ventricular fibrillation, ventricular ectopic beat (VEB) and ventricular tachycardia along with suppression of arrhythmia score during the ischemia (30 and 120 min). SM treated rats significantly (P < 0.001) altered the level of antioxidant parameters. SM treatment significantly (P < 0.001) repressed the level of creatine kinase MB (CK-MB), creatine kinase (CK) and troponin I (Tnl). SM treated rats significantly (P < 0.001) repressed the tissue factor (TF), thromboxane B2 (TXB2), plasminogen activator inhibitor 1 (PAI-1) and plasma fibrinogen (Fbg) and inflammatory cytokines and inflammatory mediators.ConclusionOur result clearly indicated that SM plays anti-arrhythmia effect in I/R injury in the rats via alteration of oxidative stress and inflammatory reaction.     

原发灶不明骨髓转移癌25例临床分析北大核心

目的:探讨原发灶不明骨髓转移癌的病例特点、治疗情况及预后。方法:对纳入的25例患者进行回顾性分析其各自的临床特点、治疗过程以及生存情况。结果:25例患者中位总生存期为6个月。初诊时是否伴有血液学症状、病理类型、治疗方式以及接受治疗时间对患者生存有显著差异。治疗方式、家庭支持强度是影响预后的独立因素。结论:原发灶不明骨髓转移癌是临床少见的疾病,给予积极的综合治疗,加强社会家庭的支持强度可能会改善其预后。     

我国中药材产地市场整合研究——以金银花、枸杞子、板蓝根和太子参为例

中药材专业市场交易量逐渐下降,产地市场交易成为趋势。研究产地市场整合程度有利于了解中药材市场的运行情况,对于合理规划中药材生产和提高市场效率具有重要意义。选取大宗中药材金银花、枸杞子、板蓝根和太子参研究中药材市场整合程度,利用2013—2019年价格指数,运用协整检验、误差修正模型和格兰杰因果检验进行实证分析。结果表明,我国中药材产地市场长期整合程度较高;中药材产地市场的短期整合程度远不及长期整合程度。为此提出4点政策建议:完善中药材价格信息平台、打造非道地产区中药材优质品牌、加快建成中药材质量追溯体系和建设中药材现代物流体系。     

Spatial and temporal expansion of intrahepatic metastasis by molecularly‐defined clonality in multiple liver cancers

Multiple hepatocellular carcinoma (HCC) is divided into two categories: intrahepatic metastasis (IM), which is a true relapse of HCC, and multicentric origin (MO), which is a second primary tumor. Clinical diagnosis of multiple HCC is usually made based on tumor location and/or time to recurrence; however, it is often difficult to distinguish the two types of multiple HCC. Using 41 matched pairs of multiple HCC specimens, we confirmed the accuracy of clinical diagnoses using exome sequence data and investigated the importance of discriminating the type of multiple HCC. Genomic analysis revealed that 18 (43.9%) patients diagnosed as having genomic IM had common mutations in a pair of HCC tumors with the main tumor of these patients being more progressive compared to those with genomic MO. The accuracy of clinical diagnosis based on lobe (Definition 1) and segment (Definition 2) were 68.3% and 78.0%, respectively. Intriguingly, recurrence ≥2 years after initial surgery for 3 patients was IM. The survival of patients with clinical IM was significantly shorter than for those with clinical MO based on both Definition 1 (P = 0.045) and Definition 2 (P = 0.043). However, mean survival was not different between the patients with genomic IM and those with MO (P = 0.364). Taken together, genomic analysis elucidated that liver cancer may spread more extensively and more slowly than previously thought. In addition, distinguishing multiple HCC as IM or MC may have provided biological information but was not of clinical importance with respect to patient prognosis.     

Geographical Origin and Level Identification of Frankincense Based on Hyperspectral Image

Background: As the demand for traditional Chinese medicinal materials increases in China and even the world, there is an urgent need for an effective and simple identification technology to identify the origin and quality of the latter and ensure the safety of clinical medication. Mineral element analysis and isotope finger-printing are the two commonly used techniques in traditional origin identification. Both of these techniques require the use of stoichiometric methods in the identification process. Although they have high accuracy and sensitivity, they are expensive and inefficient. In addition, near-infrared spectroscopy is a fast, nondestructive, and widely used identification technique developed in recent years, but its identification results are susceptible to samples’ states and environmental conditions, and its sensitivity is low. Hyperspectral imaging combines the advantages of imaging technology and optical technology, which can simultaneously access the image information and spectral information which reflect the external characteristics, internal physical structure, and chemical composition of the samples. Hyperspectral imaging is widely applied to agricultural product inspection, but research into its application in origin and quality identification of TCM materials is rare. Methods: In this study, the algorithm framework discriminative marginalized least squares regression (DMLSR) was used for feature extraction of frankincense hyperspectral data. The DMLSR with intraclass compactness graph and manifold regularization can efficiently learn the projective samples with higher separability and less redundant information than the original samples. Then, the discriminative collaborative representation with Tikhonov regularization (DCRT) was applied for classifying the geographical origin and level of frankincense. DCRT introducesthe discriminant regularization term and incorporates SID, which is more sensitive to the spectrum as the measurement method and is more suitable for the frankincense spectral data compared with SVM. Results: For the origin classification task, samples of all levels from each origin were, respectively, selected for three?way classification. We used 10-fold cross-validation to select a model parameter in the experiment. When obtaining the optimal parameters, we randomly selected the training set and testing set, where the training set accounts for 70% and the training set for 30%. After repeating this random process 10 times, we obtained the final average classification accuracy, which is higher than 90%, and the standard deviation fluctuation is usually small. For the level classification task, samples of each level from three origins were separately selected for multiclassification. We randomly selected the training set and testing set from each origin. The level classification results of the three origins are good on D4350 data, and the classification accuracy of each level is basically above 80%. Conclusion: Experiments and analysis show that our algorithm framework has excellent classification performance, which is stable in origin classification and has potential for generalization. In addition, the experiments show that in our algorithm framework, different classification tasks need to combine different data sources to achieve better classification and recognition, as the origin classification task uses frankincense’s D3000 data, and level classification task uses frankincense’s D4350 data.     

异位葡萄胎妊娠早期临床特点及诊疗：附二例报道

异位葡萄胎在临床上可以引起严重的并发症，其发病率极低，且易被漏诊、误诊。本文报道了2例异位葡萄胎患者的临床表现及病理诊断结果。患者1为部分性葡萄胎，患者2为完全性葡萄胎合并宫颈恶性肿瘤，两例患者临床上均表现为异位妊娠，并首先按照异位妊娠治疗，造成了误诊、误治；均采取手术治疗，术后病理检查确诊为异位葡萄胎。后续又补充治疗，得以痊愈。以上两例患者的诊断和治疗上均有欠缺，本文结合相关文献对病例资料进行分析总结，阐述异位葡萄胎典型临床表现和最新治疗研究进展，以期引起临床医师的重视，为早期诊断及治疗提供支持。