映山红花总黄酮对盐酸异丙肾上腺素诱导大鼠心肌缺血的保护作用

目的观察映山红花总黄酮(TFR)对盐酸异丙肾上腺素诱导的实验性心肌缺血的保护作用。方法采用皮下(sc)注射盐酸异丙肾上腺素(Iso)(8 mg.kg-1×2 d)诱导大鼠实验性心肌缺血模型,测定血清中MDA含量、GSH-PX活力、SOD及心肌组织中ATPase活性。同时行心肌组织病理组织学检查。结果TFR 30 mg.kg-1显著降低血清中MDA的生成,30,15 mg.kg-1及60,30 mg.kg-1升高SOD,GSH-PX的活力,60,30 mg.kg-1TFR可抑制心肌组织中Na -K -ATPase,Ca2 -Mg2 -AT-Pase,总ATPase活力的降低,TFR 60,30 mg.kg-1能显著改善sc Iso后心肌病理损伤程度,降低其病理损伤评分。结论TFR对盐酸异丙肾上腺素诱导的实验性心肌缺血有保护作用,其机制可能与减少体内自由基生成、改善心肌能量代谢有关。     

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??Objective??To investigate the efficacy and safety of propofol used as anesthesia and deep sedation during flexible bronchoscopy in children. Methods??The clinical data of 206 children with atelectasis who underwent flexible bronchoscopic alveolar lavage in the Endoscopy Room of the Respiratory Department of Hebei Children’s Hospital from January 2016 to January 2017 were retrospectively analyzed. Children for ASA??/?? level were divided into two groups according to the sedation method :there were 106 cases in the propofol group??2 mg/kg?? and 100 cases in the midazolam group??0.1 mg/kg??. To compare the onset time of anesthetict??heart rate??HR????respiratory rate??RR????mean arterial pressure??MAP????percutaneous oxygen saturation??SPO2?? before and after anesthesia induction??T0??T1????during endoscopy placement??T2??and after awakening??T3?? at 4 time points??operative duration??the waked duration of postoperation??the rate of adverse reactions??hiccups??respiratory depression??in the operation and Ramsay score between two groups. All data were analyzed by SPSS 20.0 statistical software. Results????1??There were statistically significant differences at the onset time of anestheticts??operative duration and the rate of side-effects between the two groups??P??0.05??. There was no statistical differences in awake time??P??0.05??.??2??There was no significant difference in MAP or SPO2 at time points of T0??T1??T2??T3??P??0.05????whereas the difference in HR and RR at time points of T1??T2??T3 between the two groups was statistically significant??P??0.05??. ??3??The sedative effect of propofol group was significantly better than that of midazolam group in Ramsay sedative scoring. Conclusion??Propofol used for anesthesia and deep sedation works fast??safely and effectively in flexible bronchoscopy for children??the time to gain consciousness is short??the operation time is short and there is fewer side effects??which is worth promoting.     

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??Objective    To evaluate the cytotoxicity?? biocompatibility and biological safety of PGMA pre-impregnated quartz fiber in vitro?? providing scientific basis for clinical application. Methods    According to standard of GBT16886.5-2003 and YYT0268-2008 documents?? the cellular cultivation and cytotoxicity test in vitro were conducted to evaluate the target materials on the morphology?? growth and proliferation of cultured cells ??L929 and GE1??. Results        The range of cell relative growth rate ??RGR?? of 50% and 100% extraction of non-polymerized composite were 44.59%-65.66% ??L929?? and 52.06%-62.86% ??GE1???? and the cytotoxicity was grade 2-3. The range of cell relative growth rate ??RGR?? of 50% and 100% extraction of polymerized composite were 90.56%-100.89% ??L929?? and 89.99%-101.21% ??GE1???? and the cytotoxicity was grade 0-1. Conclusion    Polymerized PGMA pre-impregnated quartz fiber is safe and fit for the clinical application.     

单中心近10年腹主动脉瘤1246例流行病学研究

目的 回顾性分析近10年中国医科大学附属第一医院收治的腹主动脉瘤（AAA）病人的流行病学特点，为研究近10年AAA流行病学变化趋势，以及为AAA的进一步预防和诊治提供依据。方法 纳入自2011年1月至2020年12月中国医科大学附属第一医院诊治的1246例AAA病人的病案资料，回顾性分析包括病人年龄、性别、就诊时间、就诊科室、首发症状、住院时间、住院费用、术式选择等信息，分析近10年AAA流行病学变化特点。结果 入院病人平均年龄为（66.9±10.5）岁，男女占比约为4∶1。男性AAA病人以同型半胱氨酸升高为主，女性以血脂升高为主。AAA病人的主要合并症为3级高血压（41.9%）、冠心病（31.1%）和合并髂动脉瘤（25.8%）。男性AAA合并髂动脉瘤比率明显高于女性（27.8% vs.17.8%，P＜0.01）。72.7%的AAA病人首诊原因为体检发现，其次是AAA破裂（18.7%）。AAA病人急诊与门诊就诊例数呈逐年升高态势，急诊与门诊就诊占比约为2∶3。65~69岁为现阶段住院病人主要年龄段。各年份男性占比约为80%，年龄段65~69岁为男性占比可达近90%。各年份腔内修复术（EVAR）是AAA的主要治疗方式，行EVAR治疗病人的例数和比例总体趋势逐年增加，行EVAR治疗的占比随病人年龄增加而逐渐增大。近10年AAA病人的病死率呈降低趋势，2015年后病死率总体维持在2%～3%，以男性为主，年龄段70~74岁的病死率最高为5.8%。AAA病人平均住院（17.0±16.4）d，平均住院费用为（11.3±10.7）万元。结论 近10年AAA住院病人有逐年增高趋势，主要患病人群为年龄＞60岁男性，男女临床特点有较大差异。采用EVAR治疗的占比逐年增加。对于老年AAA人群，尤其是年龄段65~69岁男性AAA病人，在AAA的防治过程中应给予更多关注。     

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??Analysis on clinicopathological characteristics and prognostic factors of breast cancer in young women GAO Guo-xuan, YU Da-peng, ZHANG Hong, et al. Breast Disease Center, Peking University First Hospital, Beijing 100034, China
Corresponding author: YE Jing-ming, E-mail: md_ye@sina.com
GAO Guo-xuan and YU Da-peng contributed qually to this work
Abstract Objective To explore the clinical and pathological characteristics of breast cancer in young women????35 years old?? and to analyze their association with treatment and prognosis. Methods The records of 110 breast cancer in young women treated from January 2008 to December 2014 were reviewed. Statistical methods were used for analyzing the correlation between clinical and pathological characteristics such as T-stage, N-stage, IHC (Immunohistochemistry) and the morbidity as well as prognosis. The clinical and pathological characteristics of breast cancer in young women were compared with patients ≥35years using the χ2 test. Kaplan-Meier curves were reported for OS (overall survival) and PFS (progression-free survival), and the log-rank test was used to compare the difference in groups. Cox proportional models were fitted for multivariate analysis. Results All of the patients were women and the median age was 32 (21 to 34)-year old, accounted for 5.71% (110/2189) of the breast cancer treated at the same period. The morbidity of Luminal A-like and Luminal B-like(HER2 negative) in ??35-year group were higher than ≥35-year group(P??0.001). Patients??35 years chose breast-conserving or mastectomy combined reconstruction surgery were much more than older group(P??0.001). The median follow-up duration of breast cancer in young women was 31.5 months, the 5-year OS rate was 93.3% and the 5-year PFS rate was 89.3%. It is concluded that the N-stage??P??0.001??and M-stage??P??0.001??were the influencing factors of the PFS by multivariate Cox regression analysis. The N-stage??P??0.001??was the influencing factor of OS. Conclusion Breast cancer in young women had special clinical and pathological characteristics. The endocrine therapy should be strengthened as well as protecting fertility. Patients??35 years demanded high quality of life and appearance, and the option of surgical treatment should be personalized.     

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??Multi-disciplinary team and conversion therapy for colorectal cancer with unresectable liver metastases??A report of 86 patients WEI-Ye*??YE Qing-hai??YU Yi-yi??et al. *Department of General Surgery, Zhongshan Hospital??Fudan University??Shanghai200032??China
Corresponding author??QIN Xin-yu??E-mail??qin.xinyu@zs-hospital.sh.cn
Abstract Objective To analyze safety and effect of the conversion therapy for initially unresectable colorectal liver metastases (CLMs) under the guidance of multi-disciplinary team (MDT). Methods The retrospective analysis was conducted for 86 patients with unresectable CLMs received MDT management and arrived conversion therapy successfully from January 2008 to December 2011 in Zhongshan Hospital of Fudan University. The perioperative and survival outcomes??prognostic factors were evaluated. Results During the mean follow-up of 41 months (24-68 months), according to the finding time of liver metastases of 86 patients??recurrence events were 73 patients??and 39 patients died. The 1 year??2 year and 3 year overall survival rate (OS) was 90.6%??75.6% and 65.1% respectively. The median OS time was ??47.5±3.1?? months. The 1 year??2 year and 3 year disease free survival rate (DFS) was 72.1%??48.8% and 31.4% respectively. The median DFS time was ??22.0±2.9?? months. The OS and DFS were no significant difference when compared 86 patients with initially unresectable CLMs successfully arrived conversion therapy with 99 patients with initial resectable CLMs??P >0.05??. The perioperative mortality rate was 1.5%??and operative complication rate was 24.4%. Tumor regression grade and early tumor shrink could predict the prognosis of CLM patients received conversion therapy. Conclusion The conversion therapy under the guidance of MDT mode is safe and effective for unresectable CLMs. The mid-term survival rate is similar with initially resectable CLMs??and long-term survival is expected.     

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??Abstract??Objective To make doctor perform operation accurately on patients with dentomaxillofacial deformity by preoperative simulation based on digital data which was collected by digital software. Methods Fifteen patients had previously undergone 3-dimensional computed tomography and the data from CT scan were input into digital software. We used the software to simulate operations preoperatively including fixing point??osteotomies and movements of jaw bones. The collected information from software was applied to actual operations. Results All the operations had been completed successfully without serious complication. The patients were satisfied with the effect of operation 6 months after operation??with a satisfaction rate of 93.3%. Conclusion The digital simulation technique is a precise method which provides practical and effective basis for establishing the preoperative planning of individual optimal surgical procedure for patients with dentomaxillofacial deformities in orthognathic surgery.     

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??Objective    To study the role of the CCR5 antagonists Maraviroc in the migration??chemotaxis??invasion and proliferation of human salivary adenoid cystic carcinoma. Methods    Scratches??migration??invasion and MTT assays were performed to detect the migration??chemotaxis??invasion and proliferation of SACC-83 and SACC-LM in vitro. Results    Compared with control group, the experimental group which was pretreated by CCR5 inhibitor Maraviroc had lower recuperability in cell scratch model. The number of cells which were blocked by inhibitor decreased significantly on the lower surface of the filters which were fixed in methanol in migration and invasion assays. And proliferation experiment results show that the multiplication capacity of SACC-83 and SACC-LM were obviously inhibited by Maraviroc. Conclusion    Maraviroc may be a kind of new targeted anti-tumor drugs and small-molecule antagonists of CCR5 could inhibit the development of salivary gland adenoid cystic carcinoma.     

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??Present status of immunotherapy for hepatocellular carcinoma YANG Yang*??CHEN Wen-jie??ZHANG Qi. *Department of Hepatic Surgery??Institute of Organ Transplantation??the Third Affiliated Hospital of Sun Yat-sen University??Guangzhou 510630??China
Corresponding author??YANG Yang??E-mail??yysysu@163.com
Abstract The development of biotherapy??especially immunotherapy which is the most important form of biotherapy??could meet the pressing need of better treatment modalities for Hepatocellular carcinoma (HCC) and has captured the increasing imagination of scientists and doctors. The immunotherapy??including adoptive cell transfer??tumor vaccines and checkpoint inhibi¬tors??focuses on the whole immune system besides cancer cells. And the strategies of immunotherapy to harnesses the power of the immune system improve the ability against liver cancer and then recover the immune system. Now that some clinical trails have shown that immunotherapy can effectively treat some forms of cancer and contribute to disease stabilization??live quality??and long-term survival. Therefore??cancer immunotherapy could be used more widely and be integrated them with other cancer therapies to get more therapeutic benefit.     

灌饲牙龈卟啉单胞菌对小鼠肠道炎症影响的研究

目的　研究灌饲牙龈卟啉单胞菌（Porphyromonas gingivalis，P. gingivalis）对C57bl/6小鼠结肠炎症的诱导作用。方法　将P. gingivalis ATCC33277液体增菌后备用。将15只C57bl/6小鼠适应1周后随机均分为3组，高浓度组灌饲1 × 109 CFU P. gingivalis，低浓度组灌饲1 × 108 CFU P. gingivalis，而对照组则灌饲等量无菌BHI培养液。每只小鼠每天灌饲1次，3周后处死小鼠，采集结肠及脾脏组织，行HE染色观察组织学变化，并采用实时荧光定量PCR（qRT-PCR）检测结肠组织中CD3抗原（CD3 antigen，epsilon polypeptide，CD3）、受体型蛋白酪氨酸磷酸酶C（protein tyrosine phosphatase，receptor type C，B220）、黏附G蛋白偶联受体E1（adhesion G protein-coupled receptor E1，F4/80）、转化生长因子-β（transforming growth factor-β，TGF-β）及干扰素-γ（interferon-gamma，IFN-γ）的表达水平。结果　HE染色显示高浓度组小鼠结肠黏膜下结缔组织中淋巴滤泡增多，且高浓度组小鼠脾指数出现增高的趋势，但差异无统计学意义（P > 0.05）。qRT-PCR结果显示，与对照组及低浓度组相比，高浓度组小鼠的结肠组织中B220及TGF-β的表达水平显著增高（P < 0.05），其余指标表达水平差异无统计学意义（P > 0.05）。结论　P. gingivalis可诱导结肠炎症，从而增加牙周病患者对消化系统疾病的易感性，且其可能与牙周病病情的严重程度相关。