[Application of modified brain protection double-lumen drainage tube in external drainage of chronic subdural hematoma]

Objective: To compare the clinical effects of modified double-lumen drainage tube and traditional silicone tube in external drainage of chronic subdural hematoma. Methods: Selected 49 patients suffering from chronic subdural hematoma hospitalized in the Department of Neurosurgery, the First Affiliated Hospital of Bengbu Medical College between July 2016 and June 2018 who underwent external drainage, and divided them randomly into experimental groups (using modified brain protection double lumen drainage tube in 23 cases) and control group (using traditional silicone drainage tube in 26 cases). Comparison of postoperative hematoma residual volume, the tube indwelling time, the numbers of drainage tube contact with brain tissue and arachnoid membrane, the numbers of infections, the numbers of postoperative epilepsy cases, and changes in Modified Rankin Scale scores between the two groups. Results: At the time of extubation, the residual amount of hematoma in the experimental group was (13±7) ml, and that in the control group was (17±8) ml. There was no significantly statistical difference in the residual amount of hematoma between the experimental group and the control group (P>0.05). The tube indwelling time of the experimental group was (2.0±0.9) days, and that of the control group was (2.7±0.8) days. The difference between the experimental group and the control group in the drainage tube indwelling time was statistically significant (P<0.05). No cases of drainage tube contact with brain tissue and/or arachnoid membrane appeared in the experimental group, and 7 cases of drainage tube contact with brain tissue or arachnoid membrane appeared in the control group. No infection occurred in both groups. No cases of epilepsy occurred in preoperative, and there were 0 cases of epilepsy in the experimental group and 1 case in the control group in postoperative. There were significantly statistical differences in each of the two groups in the modified Rankin scale before and after surgery (P<0.001), there was no significant difference in postoperative Modified Rankin Scale scores between the two groups. Conclusion: The modified brain protection double-lumen drainage tube has good drainage effect in the external drainage of chronic subdural hematoma, and the short tube retention time, causing fewer complications. It is a safe and effective tool for treating chronic subdural hematoma, and it is worthy of clinical promotion.

[The clinical significance of PRL-3,VEGF expression in sinonasalsquamous cell carcinoma]

Objective:To analyze the clinical significance of phosphatase of regenerating liver-3(PRL-3) and vascular endothelial growth factor(VEGF)expression in sinonasal squamous cell carcinomas.Method:We use immunohistochemical analysis and RT-PCR to detecte the expression of PRL-3 and VEGF protein in 62 cases of sinonasal squamous carcinoma tissues(SNSCC),30 cases of nasal polyps(NP),and 25 cases of normal nasal mucosa(NM).Result:①The expression of PRL-3 and VEGF in sinonasal squamous cell carcinoma tissues were statistically higher than in nasal polyps and normal nasal mucosa tissues (P<0.05).②The expression of PRL-3 and VEGF were not correlated with patient's age or gender(P>0.05).But the High expression of PRL-3 and VEGF in SNSCC was significantly related with advanced,lower tumor differentiation and lymph node metastasis(P<0.05).③The expression of PRL-3 and VEGF was positively correlated in sinonasal squamous cell carcinomas.Conclusion:The expression of PRL-3 and VEGF in SNSCC may involve in the regulation of tumor growth and differentiation.The expressing intensity may reflect the proliferation activity of sinonasal squamous cell carcinoma cell.PRL-3 and VEGF may promote the tumor metastasis in a synergistic manner.

[Application of reflux symptom index in diagnosis of allergic patients with laryngopharyngeal reflux]

Objective:To explore the diagnostic value and optimal diagnostic threshold of reflux symptom index(RSI) in allergic patients with laryngopharyngeal reflux. Method: All the adult allergic patients with respiratory tract symptoms completed the RSI with the consent of the patients. A total of 150 patients with RSI＞13 were screened out. The LPR patients were confirmed by 24 h pH-metry of pharyngo-laryngoesophageal (allergic group). The same number of non allergic laryngeal reflux patients were selected as control group (non allergic group). The ratio of RSI＞13 to LPR was calculated. The total score of RSI and each score were compared between the allergic group and the non allergic group. ROC curve was used to analyze the highly suspicious RSI score thresholds for patients with reflux laryngitis. Result:Only 53(35.33%) of 150 patients with RSI＞13 were diagnosed as LPR after 24 h pH-metry test in allergic patients. Among the 9 symptoms of RSI, the scores of 6 symptoms in allergic group were significantly higher than those in non allergic group(P<0.05). The average RSI score of allergic group was 23.57±3.17. The average RSI score of non allergic group was 17.57±2.64. The total score of allergic group was higher than that of non allergic group(P<0.05). According to the RSI score ROC curve of allergic group, the area under 95% confidence interval curve was 0.815. RSI had certain diagnostic accuracy for allergic patients with LPR. The best critical value of RSI score for allergic patients with LPR was 18, the sensitivity was 94.3%, and the specificity was 56.7%. Conclusion:RSI can be used to screen allergic patients with LPR, diagnostic score threshold RSI＞18 points, has a certain diagnostic accuracy.

[A preliminary study on the relationship between laryngopharyngeal reflux and chronic rhinosinusitis]

Objective:To study the relationship between laryngopharyngeal reflux and chronic rhinosinusitis. Method:A total of 46 patients were enrolled in this study including 25 cases with chronic rhinosinusitis with nasal polyps, 10 cases with chronic rhinosinusitis without nasal polyps and 11 cases underwent surgery due to abnormal nasal anatomy such as nasal septum deviation, bubble in the turbinate, etc. as control group. The expression of pepsin was detected using immunohistochemistry in three groups. The intensity of pepsin expression and CT score of sinus, blood eosinophils percentage, blood neutrophils percentage, blood basohils percentage, blood mononuclear percentage, blood lymphocytes percentage were analyzed. Result:There were 8 strong positive cases (32%, 8/25), positive in 8 cases (32%, 8/25), 2 weakly positive cases (8%,2/25), 7 negative cases (28%, 7/25) in chronic rhinosinusitis with nasal polyps group. In the chronic rhinosinusitis without nasal polyps group, the expression of pepsin was strong positive in 4 cases (40%, 4/10), positive in 3 cases (30%, 3/10), weakly positive in 1 cases (10%, 1/10), negative in 2 cases (20%, 2/10). There were no strong positive expression in the control group, positive in 2 cases (18.2%, 2/11), weakly positive in 3 cases (27.3%, 3/11), negative in 6 cases (54.5%, 6/11), chronic rhinosinusitis with nasal polyps group and chronic rhinosinusitis without nasal polyps group higher than the control group (P<0.05). There was no significant difference in pepsin expression between chronic rhinosinusitis with nasal polyps group and without group (P=0.617). Spearman correlation analysis indicated that the intensity of pepsin was positively correlated with the score of Lund-Markay (r=0.349,P=0.017), there was no correlation with the percentage of various inflammatory cells. Conclusion:The positive expression intensity of pepsin in chronic rhinosinusitis without nasal polyps and chronic rhinosinusitis with nasal polyps is significantly higher than that in normal control group, suggested that there is a correlation between laryngopharyngeal reflux and chronic rhinosinusitis. Laryngopharyngeal reflux is positively correlated with the severity of nasal polyps. Chronic nasal inflammation caused by laryngopharyngeal reflux is not mediated by a certain kind of inflammatory cells.

[Minimal fat renalangiomyolipoma with multiple lymph nodes enlargement and postoperative refractory lymphatic fistula: a case report and literature review]

Renal angiomyolipoma (AML) is a common benign tumor in the urinary system, mainly composed of adipose tissue, blood vessels and muscle tissue. Renal AML is sporadic in most of patients, while a few are associated with tuberous sclerosis. Classical renal AML occurs predominantly in middle-aged females. Most cases are found incidentally during imaging examinations. The fat content makes AML have unique imaging characteristics and is easy to be identified with other renal tumors. However, the amount of fat varies in each tumor. AML that contains only microscopically detectable fat and whose amount of intratumoral fat may be too small to be identified on unenhanced computed tomography (CT) images is termed minimal fat or fat-poor renal AML, which appears as a high density shadow in the renal parenchyma on unenhanced CT images. Thus, it can be difficult to distinguish it from renal cell carcinoma (RCC) on imaging. Since the imaging findings are atypical, the diagnosis depends on pathological results. In addition, a few of AML can mimic malignant neoplasms. Recent studies suggested that AML might involve to peri-renal or renal sinus fat, regional lymphatics and other visceral organs, as well as inferior vena cava, which further makes the diagnosis more difficult. However, there is currently no reports about involvement of regional limphatics in minimal fat renal AML. In this article, we report a 27-year-old female patient without family history of tuberous sclerosis, who came to visit the hematologist because a high density shadow near the left kidney was found during CT scan which was accompanied by neck, armpits, groin, abdominal cavity and retroperitoneal lymph nodes enlargement. She was suspected of lymphoma in the beginning and transferred to Department of Urology to perform laparoscopic left renal mass and retroperitoneal lymph node excision and pathological examination for a definitive diagnosis. Finally, pathologic results revealed AML. Postoperative continuous lymphatic fistula developed and the retroperitoneal drainage of chylous fluid was 100-200 mL per day, lasting for 12 weeks. The fistula was successfully closed after conservative treatment including fasting and rehydration. This article summaries and discusses the diagnosis and treatment of renal AML with lymph nodes enlargement and the management of postoperative refractory lymphatic fistula by reviewing the related cases and literature.

[Curative effect analysis of two surgical methods for removal of pituitary adenoma via endonasal transsphenoidal approach]

Objective: To compare the efficacy of endoscopic endonasal transsphenoidal surgery and microsurgery for pituitary adenomas. Methods: One hundred and ten patients with pituitary adenoma who were treated by single nostril transsphenoidal surgery in the department of neurosurgery of the First Affiliated Hospital of Bengbu Medical College from June 2014 to December 2016 were enrolled.These cases were randomly divided into endoscopic group 53 cases (including 36 cases of functional pituitary adenoma and 17 cases of non-functional pituitary adenoma) and microscope group 57 cases (including 34 cases of pituitary adenoma and 23 cases of non-functional pituitary adenomas), with no significant difference in preoperative clinical data about gender, age, tumor size and endocrine function (P>0.05). The total tumor resection rate, postoperative complication rate and the rate of functional tumor hormone levels were compared between the two groups. Results: The total resection rate of tumor in patients with endoscope and microscope group were 75.5% (40/53) and 70.2% (40/57) without statistically significant difference (P>0.05). The total resection rate and hormone level decline effective rate of functional pituitary adenomas in neuroendoscope group (91.7%, 33/36; 83.3%, 30/36) were higher than those in microscope group (70.6%, 24/34; 61.8%, 21/34) with statistically significant difference (P<0.05). Another side, there was no statistically significant difference in total resection of non-functional pituitary adenomas between endoscope group (41.2%, 7/17) and microscope group (69.6%, 16/23) (P>0.05). The total incidence of postoperative complications in endoscopic group (9.4%, 5/53) was lower than that in the microscope group (24.6%, 14/57), with statistically significant difference (P<0.05), in which the rate of postoperative complications of functional pituitary adenomas and nonfunctional pituitary adenoma in endoscopy group (8.3%, 3/36; 11.8%, 2/17) and in microscope (20.6%, 7/34; 30.4%, 7/23) had no statistical significance (P>0.05). Conclusion: Pituitary adenoma resection rate in two ways had no obvious difference, but the advantages of endoscopic surgery for functional pituitary adenomas were obvious.The incidence of postoperative complications of endoscopic surgery was lower than that of microscopic surgery, but there was no difference between functional and non-functional tumors.

[Effect of different course of omeprazole in the treatment of laryngopharyngeal reflux]

Objective:To compare the efficacy and safety of omeprazole in the treatment of laryngopharyngeal reflux. Method:One hundred and sixty patients with laryngopharyngeal reflux in our hospital from March 2015 to January 2017 (diagnosis treatment for 8 weeks) were selected and randomly divided into group A, B, C, D, with 40 cases in each group. Each group of patients were treated with omeprazole enteric-coated capsules (20mg, Bid) for 1, 2, 3 and 4 months, respectively. The reflux symptom index(RSI), reflux finding score(RFS) score, and 24h intraesophageal pH-metry , pepsin detection were compared between the four groups before treatment, at the end of treatment, at 1 month and 2 months after treatment. The efficacy and side effects were evaluated.Result:With the increase of treatment course, patient's RSI and RFS score, 24h pH-metry <4.0 percentage, pepsin positive rate decreased gradually, and there was a significant difference between before and after treatment. After treatment, there was a statistical significance in group B and group A, group C and group B. There was no significant difference between group D and group C. After the end of treatment and up to 2 months of follow-up, the RSI and RFS scores gradually increased and 24h Ph-metry <4.0 percentage, pepsin positive rate increased in group A and B,and those were not significantly different in group C and group D. With the increase of treatment duration, the effective rate of treatment increased, which was 67.5%, 80.0%, 90.0% and 95.0%, respectively. The difference was statistically significant, but the adverse effects did not increase (P>0.05).Conclusion:Omeprazole is safe and effective in the treatment of laryngopharyngeal reflux. The symptoms and signs of the patients are obviously improved during the 5 months of the course, and the condition is relatively stable and the recurrence rate is low.

[Analysis of Arsenic Compounds in Blood and Urine by HPLC-ICP-MS]

OBJECTIVES

To establish an analysis method for the detection of 6 arsenic compounds [AsC, AsB, As（Ⅲ）, DMA, MMA and As（V）] in blood and urine by high-performance liquid chromatography-inductively coupled plasma-mass spectrometry （HPLC-ICP-MS）, and apply it to real cases.

METHODS

Triton was used to damage cells, and then EDTA·2Na·2H2O was used to complex arsenic compounds in cells, and sonication and protein deposition by acetonitrile were performed for sample pretreatment. With the mobile phase consisted of ammonium carbonate and ultrapure water, gradient elution was performed for obtaining the arsenic compounds in samples, which were analysed by ICP-MS with Hamilton PRP-X100 column.

RESULTS

The limits of detection in blood were 1.66-10 ng/mL, while the lower limits of quantitation in blood ranged from 5 to 30 ng/mL. The limits of detection in urine were 0.5-10 ng/mL, while the lower limits of quantitation in urine were 5-30 ng/mL. The relative standard deviation of inter-day and intra-day precisions was less than 10%. This method had been successfully applied to 3 cases.

CONCLUSIONS

This study has established an analysis method for detecting 6 common arsenic compounds in blood and urine, which can be used to detect the arsenic compounds in the blood and urine from arsenic poisoning cases as well as the patients under arsenic treatment.

[The molecular-cytogenetic characterization and tyrosine kinase inhibitors efficacy in newly diagnosed chronic phase CML patients with variant Philadelphia chromosomes]

Objective: To investigate the molecular-cytogenetic characterization and impact on tyrosine kinase inhibitors (TKIs) therapy in chronic phase of chronic myeloid leukemia (CML-CP) patients with variant Ph chromosome (vPh). Methods: The clinical data of 32 patients with vPh chromosomes were collected and compared with 703 patients with typical Ph chromosome in newly diagnosed CML-CP who were on first-line imatinib (IM) and with BCR-ABL transcript of P210. Results: There was no significant difference in demographic and hematological characteristics between vPh and classic Ph patients. 3(9.4%) of the 32 vPh cases were simple variant translocations. Among the remaining 29 cases with complex variant translocations, 28 cases (87.5%) involved 3 chromosomes, and only 1 (3.1%) involved 4 chromosomes. Except for 8, 15, 18, X, and Y chromosomes, the other chromosomes were involved. The frequency of chromosome 12q(15.5%) and 1p (12.1%) were higher involved. The most common FISH signal pattern was 2G2R1Y (74.1%), followed by 1G1R2F (14.8%), 2G1R1Y (3.7%), 1G2R1Y (3.7%), 1G1R1Y (3.7%). The comparison of complete cytogenetic response (CCyR) (P=0.269), major molecular response (MMR) (P=0.391) were carried out between simple and complex mechanisms, without difference. Compared with the classic Ph, the patients with vPh had higher IM primary resistance rate (χ2=3.978, P=0.046), especially primary hematological resistance (χ2=7.870, P=0.005), but the difference of CCyR (χ2=0.192, P=0.661), MMR (χ2=0.822, P=0.365), EFS (χ2=0.509, P=0.476), OS (χ2=3.485, P=0.062) were not statistically significant, and multivariate analysis showed that the presence of vPh did not affect OS (RR=0.692, 95%CI 0.393-1.765, P=0.658)、EFS (RR=0.893, 95%CI 0.347-2.132, P=0.126) and PFS (RR=1.176, 95%CI 0.643-2.682, P=0.703). Conclusion: CML-CP patients with vPh and classic Ph had similar demographic and hematological characteristics. Except for 22q11, 9q34, the frequency of chromosome 12q and 1p were higher involved. The most common FISH signal pattern was 2G2R1Y, and different mechanisms had no impact on TKIs therapy. Compared with cases with classic Ph chromosomes, the patients with vPh chromosomes had higher risk of IM primary resistance, especially primary hematological resistance, which can obtain deeper molecular response quickly after changing to second-generation TKIs and didn't affect long-term outcomes and OS.

[Effects of different concentrations of MgSiF(6) as electrolyte for micro-arc oxidation on the bond strength between titanium and porcelain]

Objective: To investigate the effects of different concentrations of MgSiF(6) as electrolyte on the bond strength between titanium and porcelain after micro-arc oxidation (MAO) treatment and screen the suitable concentration of MgSiF(6) that can improve the bond strength between titanium and porcelain. Methods: Four different concentrations of MgSiF(6) (10, 20, 30, 40 g/L) were chosen as MAO reaction solutions. Sandblasting treatment was selected as a control group. After porcelain was fused to each specimen, titanium-porcelain bond strengths were evaluated by the three-point bending test according to ISO 9693. Scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) were adopted to evaluate the morphologies and elemental compositions of both the MAO coatings and the interfaces of the titanium-porcelain restoration. Results: The surface of titanium specimen in the control group was sharp and rough, while specimens in both 10 g/L group and 20 g/L group were porous and homogeneous. However, the pores found on the specimens in the latter group were larger in diameter (approximately 1.0-2.0 μm) than those on the former one (0.2-0.5 μm). The bond strengths of the control group and the experimental groups (10, 20, 30, 40 g/L MgSiF(6)) were (27.08±3.16), (38.18±2.65), (44.75±2.21), (36.44±2.04), (31.04±2.59) MPa, respectively. All the experimental groups showed higher bond strengths than the control group did (P<0.05), and the bond strength of 20 g/L MgSiF(6) group was significantly higher than those of the other groups (P<0.05). Besides, the interfaces between titanium and porcelain were tight and compact in the 20 g/L group, while different amounts of pores and cracks were visible in the other groups. Additionally, after the three-point bending test, few residual porcelains could be observed on the surfaces of specimens in the control group. Conclusions: MAO treatment with 20 g/L MgSiF(6) on titanium can improve bonding strength between titanium and porcelain.

Cardiac μ-opioid receptor contributes to opioid-induced cardioprotection in chronic heart failure

BACKGROUND

The therapeutic potential of cardiac μ-opioid receptors in ischaemia-reperfusion (I/R) injury during opioid-modulating diseases, such as heart failure, is unknown. We aimed to explore the changes of cardiac μ-opioid receptor expression during heart failure, and its role in opioid-induced cardioprotection.

METHODS

Rats received doxorubicin (DOX) or were subjected to coronary artery ligation to induce heart failure, or received normal saline (NS) as control. Hearts from NS or DOX rats were isolated and subjected to myocardial ischaemia and reperfusion in an in vitro perfusion system. The opioid [D-Ala,²N-MePhe,⁴ Gly-ol]-enkephalin (DAMGO), with a high μ-opioid receptor specificity, morphine, and remifentanil were administrated before I/R with or without opioid receptor antagonists, or an extracellular signal-regulated kinase (ERK) inhibitor.

RESULTS

Cardiac μ-opioid receptor mRNA concentrations were 3.2 times elevated in DOX-treated rats compared with NS rats, while cardiac μ-opioid receptor protein concentrations showed 6.1- and 3.5-fold increases in DOX-treated and post-infarcted rats, respectively. DAMGO reduced I/R-caused infarct size, expressed as the ratio of area at risk, from 0.50 (0.04) to 0.25 (0.03) in failing rat hearts, but had no effect on infarct size in control hearts. DAMGO promoted phosphorylation of ERK and glycogen synthase kinase (GSK)-3β only in failing hearts. DAMGO-mediated cardioprotection was blocked by an ERK inhibitor. The μ-opioid receptor antagonist D-Pen-Cys-Tyr-D-Trp-Orn-Thr-Pen-Thr-NH2 (CTOP) prevented morphine- and remifentanil-induced cardioprotection and phosphorylation of ERK and GSK-3β in failing hearts. In contrast, δ- and κ-opioid receptor selective antagonists were less potent than CTOP in the failing hearts.

CONCLUSIONS

Cardiac μ-opioid receptors were substantially up-regulated during heart failure, which increased DAMGO-induced cardioprotection against I/R injury.

[Photoelastic analysis of the influence of prosthetic material on the stress distribution in bone around implant]

Objective: To provide a reference for a suitable alternative treatment choice for implant-supported prostheses, and to explore the influence of 3 types of prosthetic material on the stress distribution around implant. Methods: The implant-abutment analogs were embedded individually into photoelastic resin blocks, which were medical pure titanium castings reproducing the surface and outline of implant (diameter 4.3 mm, length 11.5 mm) and esthetic abutment (regular profile, 1 mm). The prostheses were divided into 3 groups according to the type of prosthetic material. Each group consisted of 5 samples. The samples of composite resin ceramic and zirconia group were milled by chair-side computer aided design and computer aided manufacture (CAD/CAM) system. The samples of porcelain-fused-to-metal crown group were made manually and a pre-arranged silicone rubber impression of CAD/CAM crown would guide to shape the veneer porcelain. Each set was submitted to a 300 N compressive load axially or obliquely (75°). The stress value in the peri-implant bone at the level of the neck, neck1/3, middle1/3 and root1/3 of the sections (0.5, 1.5, 2.5, 3.5 mm) from implant was analyzed by digital photoelasticity, and the stress cushioning effect of 3 types of prosthetic material was comprehensively evaluated. Results: The time spent reaching the stress peak of composite resin ceramic group [(1.58±0.08) s, axially; (2.75±0.21) s, obliquely] was larger than that of the zirconia group [(1.40±0.12) s, axially; (2.30±0.25) s, obliquely] (P<0.05) under the same download mode. Although there were no significant differences in equivalent stress values of the measurement points among the three groups (P>0.05), a downward trend of equivalent stress values of composite resin ceramic group was observed compared to zirconia group, regardless of load type. When loaded obliquely, the highest degree of stress concentration at the level of the neck of implant were found in the porcelain-fused-to-metal crown group. Conclusions: Within the limitations of this study, composite resin ceramic was more beneficial to the biomechanical behavior of implant in stress buffer compared to zirconia.

[Transnasal endoscopic surgery of communicating neoplasm outside cerebral dura mater and orbital fasciae]

Objective:This paper is intend to observe the feasibility of surgical approach with which communicating neoplasm outside cerebral dura mater and orbital fasciae was removed by transnasal endoscopic surgery.Method:Nine patients suffered from communicating neoplasm in the area of naso-orbital-cranio complex were treated with transnasal endoscopic surgery. The size of skull base bone defect was from 1.25 cm×1.13 cm to 3.25 cm×2.69 cm. No eye enucleation was done. No reconstructions of skull base and medial wall of orbital cavity were done. Iodoform gauze was packed in paranasal sinuses fourteen days. Patients with malignant tumor were treated radiation therapy and chemical therapy after surgical treatment. The degree of resection, complications of intracranial and orbital cavities, survival condition were the focus of this study.Result:The tumor were completely removed and all operations were successfully completed by trasnasal endoscopic surgery. Only one patient was required blood transfusion due to seriously bleeding from tumor during the operation. There was no orbital, intracranial, and vascular complications. The defect of bone at skull base and lamina papyracea were automatic reconstructed. Three patients have showed recurrence of neoplasm, and two of them died during two years of following up time.Conclusion:Transnasal endoscopic surgery is a safe, reliable and effective approach to treat communicating neoplasm in the area of naso-orbital-cranio complex, of which main part of tumor exists in the sinunasal cavity.

[Establishment of a model of hydrogen peroxide-induced injury in pulmonary artery endothelium cells and relevant mechanisms of oxidative stress]

Objective: To establish a hydrogen peroxide (H(2)O(2)) induced injury model of pulmonary artery endothelial cells (PAECs) and explore the molecular mechanisms of oxidative stress on the structure and function of PAECs in this model. Methods: Human PAECs were treated with H(2)O(2) at different concentrations (25, 50, 100, 200, 400, 800, 1 600, 3 200, 6 400 μmol/L) for 4 and 24 h, respectively. The PAECs survival curve was obtained according to the cell viability measured by CCK-8 assay. The cell apoptosis of PAECs was detected by flow cytometry. The reactive oxygen species (ROS) generation and mitochondrial activity were measured using small molecule fluorescent probes. Proteins were extracted and the phosphorylation levels of signal molecules in PAECs were detected by Western blot assays. Results: (1) The effect of H(2)O(2) at various concentrations on cell viability of PAECs: cell viability of PAECs decreased in proportion to increasing concentration of H(2)O(2) after incubation for 4 h. The half maximal inhibitory concentration (IC(50)) of PAECs exposed to H(2)O(2) for 4 and 24 h were 397.00 and 488.77 μmol/L, respectively. (2) The effect of H(2)O(2) on cell apoptosis of PAECs: After H(2)O(2) incubation for 4 h, proportions of PAECs at late-apoptosis ((22.58±3.69) %) and necrotic stage( (11.86±4.27)%) were significantly higher than those of control PAECs at late-apoptosis stage( (3.41±1.44)%, P<0.01) and at necrotic stage ((1.94±1.15) % , P<0.05). The survival rate of PAECs post H(2)O(2) was dramatically lower than that of control PAECs ((7.98±3.21)% vs. (48.89±8.08)%, P<0.01). However, there is no statistical difference between both groups regarding to the early apoptosis. (3) The effect of H(2)O(2) on mitochondrial activity and ROS production of PAECs: the mitochondrial activity and ROS generation of PAECs treated by H(2)O(2) were significantly increased compared to those in control PAECs (P<0.01). (4) The effect of H(2)O(2) on signaling molecules in PAECs: there was a significant increase in phosphorylation level of Akt in PAECs incubated with H(2)O(2) for 30 minutes compared to that in control PAECs (P<0.01), while there was no significant difference in levels of Akt between H(2)O(2) treated PAECs and control PAECs. Phosphorylation level of JNK as well as p38 were also significantly upregulated in H(2)O(2) treated PAECs (P<0.01). Conclusion: H(2)O(2) at the concentration of 400 μmol/L could induce human PAECs injuries via the regulation of Akt and MAPK signaling pathways.

Sibelium in combination with dibazole in the treatment of angioneurotic headache

Angioneurotic headache is a common nerve headache featured by intermittence, repetition, paroxysm and aggravation, which can severely affect the sufferer’s quality of life. Currently, there are multiple drugs which can be used for relieving this type of headache, and the effectiveness and safety of drugs have been a subject of interest in clinical practice. To observe the effects of sibelium in combination with dibazole and offer a basis for the clinical treatment, 136 patients with angioneurotic headache who were admitted to hospital between February and September 2015 were selected and randomly divided into a test group and a control group, 68 in each. Patients in the test group were treated with sibelium in combination with dibazole, while patients in the control group were given sibelium only. The effects, adverse reactions, complications and toxic and side effects of the treatment in the two groups were observed. Furthermore, the blood flow speed and hemodynamic changes before and after treatment were compared. The results demonstrated that the hemodynamic indexes and cerebral blood flow speed of the patients in the test group showed obvious changes after treatment, and the difference was statistically significant (P<0.05); the improvement of the above indexes of the test group was superior to that of the control group, and the difference had statistical significance (P<0.05); the overall effective rate of the test group was higher than that of the control group (94.12% vs 76.47%) (P<0.05); the medication safety of the test group was higher than that of the control group (all P<0.05). It can be concluded that sibelium in combination with dibazole has a remarkable effect in treating angioneurotic headache as it can significantly improve hemodynamic indexes and cerebral blood flow speed. Moreover, the therapy seldom induces toxic and side effects, adverse reactions or complications.

[Brief survey of some foreign currents of classical acupuncture]

This paper reviews the history of acupuncture's dissemination to Japan, France, and England in the modern period. In particular, it examines how Chinese acupuncture methods were modified in each of these countries and how these modifications were theoretically justified based on new readings of classical texts. In each country, these currents of acupuncture practice all claimed to be transmitting true traditional acupuncture, even as they developed along different trajectories and created new and different theories and practices of acupuncture. Some of these foreign methods were re-exported back to China, where they, in turn, have influenced the development of Chinese acupuncture.

[Application of tipping-point analysis to address missing data in clinical studies]

To use a visualized method, tipping-point analysis to address missing data in clinical study and discuss related problems. All the possible outcomes caused by missing data were listed and the tipping points where P-values of hypothesis test changed at 0.05 significant level were found out, then the ratio of P<0.05 was calculated, reflecting the reliability of the study's result. Tipping-point analysis can be applied to both continuous and binary data to help find points where p-values are changed. The area of P<0.05 of continuous data is 93.6%, indicating that the reliability of success of the study is large; and the area of P<0.05 of binary data is 29.7%, reflecting that the reliability of success of the study is small. Tipping-point analysis, which provides a visualized evidence for decision making, is suitable for analyzing clinical studies with missing data.

[Drainage characteristic of the brain interstitial fluid detected by using fluorescence and magnetic tracer method]

OBJECTIVE

Compare the results of molecular diffusion and mass flow in the interstitial space(ISS) displayed by using optical and magnetic probes and study partitioned drainage of the brain interstitial fluid (ISF).

METHODS

In the study, 36 male SD rats were randomly divided into fluorescent inspection group (18), magnetic tracer group (18). Then they were divided equally into caudate nucleus (Cn), thalamus (T) and substantia nigra (Sn) subgroup, 6 rats in each subgroup. Referencing the brain stereotaxic atlas, the coronal globus pallidus as center level, Cn, T or Sn were acted as puncture positioning target. A 10 μL microsyringe was stereotaxically positioned and the lucifer yellow (LY) solution of 2 μL 10 mmol/L was infused into centric position. The coronary slices undergo cardiac perfusion and fix respectively in time point Cn 3 h, T 2 h and Sn 1 h. The rat brain was placed in rat stainless steel brain matrices and cut backward along visual intersection. The injection point of coronal slice as the center level, take 3 slices in front of the center level and 2 slices behind of it. 1 mm for each slice and 6 slices in total. Then slices were detected by laser scanning confocal microscope (LSCM). Simultaneous, in the same coordinate brain regions of another three groups, a gadolinium-diethylene triamine pentaacetic acidm (Gd-DTPA) solution of 2 μL 10 mmol/L was infused into different injection and detected by MRI tracer-based method. Then the Radiant can be used to measure distribution area of Gd-DTPA.

RESULTS

LY and Gd-DTPA have different distribution regions in Cn, T and Sn. After LY and Gd-DTPA were introduced into the Cn subgroup 3 h, compare the 1 to 6 levels distribution area of LY and Gd-DTPA as follows: (10.95±4.27) mm² vs. (8.33±2.25) mm², (18.16±4.74) mm² vs. (16.42±2.88) mm², (24.57±3.65) mm² vs. (20.75±2.29) mm², (34.81±3.32) mm² vs. (28.88±1.51) mm², (30.53±3.12) mm² vs. (20.92±2.75) mm², (12.15±4.92) mm² vs. (10.00±1.89) mm². The statistical analysis of every level was made by T test, and the difference of the distribution area between the two tracers were not statistically significant (t=0.940, P=0.400; t=0.546, P=0.614; t=1.534, P=0.200; t=2.809, P=0.480; t=2.693, P=0.055; t=0.707, P=0.518); After LY and Gd-DTPA were introduced into the T subgroup 2 h, compare the 1-6 levels distribution area of LY and Gd-DTPA as follows: (5.56±4.61) mm² vs. (3.33±2.25) mm², (16.21±3.36) mm² vs. (11.42±2.88) mm², (19.00±5.21) mm² vs. (15.75±2.29) mm², (25.32±5.49) mm² vs. (22.33±3.25) mm², (17.34±5.31) mm² vs. (15.92±2.75) mm², (7.67±6.19) mm² vs. (5.00±1.89) mm². The statistical analysis of every level was made by T test, and the difference of the distribution area between the two tracers were not statistically significant (t=0.753, P=0.493; t=1.875, P=0.134; t=0.990, P=0.378; t=0.810, P=0.464; t=0.413, P=0.701; t=0.716, P=0.514); After LY and Gd-DTPA were introduced into the Sn subgroup 1 h, compare the 1-6 levels distribution area of LY and Gd-DTPA as follows: (6.78±4.56) mm² vs. (4.75±2.00) mm², (12.65±5.04) mm² vs. (10.44±1.13) mm², (19.51±6.54) mm² vs. (17.55±0.30) mm², (28.72±5.45) mm² vs. (24.48±1.32) mm², (21.34±4.42) mm² vs. (17.72±0.25) mm², (13.00±5.46) mm² vs. (12.00±2.88) mm². The statistical analysis of every level was made by T test and the difference of the distribution area between the two tracers were not statistically significant (t=0.705, P=0.519; t=0.743, P=0.499; t=0.517, P=0.656; t=1.310, P=0.260; t=1.416, P=0.292; t=0.281, P=0.793), but the distribution area of LY is slightly more than Gd-DTPA.

CONCLUSION

LSCM imaging technology confirmed partitioned drainage of the brain ISF found by MRI tracer-based method and provided technology and method validation for MRI tracer-based method. LSCM imaging technology with higher contrast and resolution, therefore more sophisticated partitioned drainage of the brain interstitial fluid were got.

Correlation of PICCO/CT on cardiac output index value and prognosis in patients with heart disease

The aim of this paper is to study the correlation between the cardiac output index value and the prognosis of patients with heart disease with the help of Pulse-induced Contour Cardiac Output (PICCO) and computed tomography (CT). Three hundred eighteen patients with pathologically confirmed heart disease were selected as study subjects. The Sime ns Av anto 1.6T type superconducting magnetic resonance meter and GE Light Speed Pro 48 slice spiral CT were used for the phased array coil scanning and enhanced scanning, respectively and to analyze the relationship between the cardiac output index value and prognosis in patients with heart disease with the help of PICCO and CT. The accuracy rates of PICCO and CT in determining the cardiac output index of heart disease were 93.2% and 76.1%, respectively, which were significantly different (P less than 0.05). The coincidence rate between the results of the cardiac output index and pathological results of heart disease from PICCO and CT were 57.6%and 54.7%, respectively. According to the χ2 test results, the diagnostic results of PICCO were consistent with the pathological results of the heart disease group (Kappa = 0.039, 0.496, P less than 0.05). The coincidence rate for the five-year survival rate of PICCO/CT with the total survival rate and the results of the patients were 56.7% and 43.8%, respectively. The coincidence rate of PICCO and CT diagnosis results with the cardiac output index values, as well as prognosis results, was high. In judging the value of the cardiac output index and the prognosis of patients with heart disease, PICCO was superior to CT. The diagnostic results of PICCO have a strong correlation with the pathological results, therefore, PICCO can be used to accurately determine the cardiac output index and the prognoses of patients with heart disease.

Superconductivity in HfTe5 across weak to strong topological insulator transition induced via pressures

Recently, theoretical studies show that layered HfTe₅ is at the boundary of weak & strong topological insulator (TI) and might crossover to a Dirac semimetal state by changing lattice parameters. The topological properties of 3D stacked HfTe₅ are expected hence to be sensitive to pressures tuning. Here, we report pressure induced phase evolution in both electronic & crystal structures for HfTe₅ with a culmination of pressure induced superconductivity. Our experiments indicated that the temperature for anomaly resistance peak (Tp) due to Lifshitz transition decreases first before climbs up to a maximum with pressure while the Tp minimum corresponds to the transition from a weak TI to strong TI. The HfTe₅ crystal becomes superconductive above ~5.5 GPa where the Tp reaches maximum. The highest superconducting transition temperature (Tc) around 5 K was achieved at 20 GPa. Crystal structure studies indicate that HfTe₅ transforms from a Cmcm phase across a monoclinic C2/m phase then to a P-1 phase with increasing pressure. Based on transport, structure studies a comprehensive phase diagram of HfTe₅ is constructed as function of pressure. The work provides valuable experimental insights into the evolution on how to proceed from a weak TI precursor across a strong TI to superconductors.

Revealing Extremely Low Energy Amplitude Modes in the Charge-Density-Wave Compound LaAgSb_{2}

Using infrared spectroscopy and ultrafast pump probe measurement, we have studied the two charge-density-wave (CDW) instabilities in the layered compound LaAgSb_{2}. The development of CDW energy gaps was clearly observed by optical spectroscopy, which removed most of the free carrier spectral weight. More interestingly, our time-resolved measurements revealed two coherent oscillations that softened by approaching the two phase transition temperatures, respectively. We addressed that these two oscillations come from the amplitude modes of CDW collective excitations, the surprisingly low energies (0.12 THz and 0.34 THz for the higher and lower temperature ones, respectively) of which are associated with the extremely small nesting wave vectors. Additionally, the amplitude and relaxation time of photoinduced reflectivity of LaAgSb_{2} single crystals stayed unchanged across the CDW phase transitions, which is quite rare and deserves further investigation.

[Application strategies of the third-generation EGFR-TKI in the context of precision medicine]

With the advances in molecular detection technology and the emergence of various targeted agents, we have entered the era of precision medicine across the whole process of cancer diagnosis and treatment. Tyrosine kinase inhibitors targeting epidermal growth factor receptor gene mutation, the most common driver, have been developed from the first generation to the third generation, improving the survival and life quality of patients with advanced non-small cell lung cancer. It is critically important how to rank these targeted agents and arrange combination therapies, and this review will focus on the strategies of the third-generation EGFR-TKI in the context of precision medicine.

Terahertz generation from laser-driven ultrafast current propagation along a wire target

Generation of intense coherent THz radiation by obliquely incidenting an intense laser pulse on a wire target is studied using particle-in-cell simulation. The laser-accelerated fast electrons are confined and guided along the surface of the wire, which then acts like a current-carrying line antenna and under appropriate conditions can emit electromagnetic radiation in the THz regime. For a driving laser intensity ∼3×10^{18}W/cm^{2} and pulse duration ∼10 fs, a transient current above 10 KA is produced on the wire surface. The emission-cone angle of the resulting ∼0.15 mJ (∼58 GV/m peak electric field) THz radiation is ∼30^{∘}. The conversion efficiency of laser-to-THz energy is ∼0.75%. A simple analytical model that well reproduces the simulated result is presented.