[Clinical and laboratory characteristics and genetic diagnosis of Kabuki syndrome]

Objective: To investigate the clinical features, laboratory characteristics and genetic diagnosis of Kabuki syndrome (KS). Methods: Between September 2014 and September 2016, seven children with clinically diagnosed KS from the neurology department, Beijing Children Hospital, Capital Medical University were included in this study. Three of them were male and 4 were female aged from 19 days to 6 years and 4 months with a median age of 3 years and 1 month. The clinical features, laboratory and imaging materials, gene tests were analyzed prospectively. Results: Clinical manifestation: cephalofacial anomaly: all seven cases had unusual facies presented as long palpebral fissures, eversion of the lateral third of lower eyelids, arched eyebrow with brow sparse, epicanthus, orbital hypertelorism, short columella with broad and depressed nasal tip; six cases presented with palatal arch deformity; four cases presented with ptosis; three cases presented with dental abnormalities and hearing impairment respectively; two cases presented with strabismus and earlap malformation respectively; one case presented with amblyopia. Six cases presented with skeletal anomalies. Six cases presented with dermatoglyphic anomalies. All cases presented with mild to moderate mental retardation. Three cases presented with short stature. Four cases presented with cardiac abnormalities. Three cases presented with epileptic seizures. Others: three cases presented with dystonia and neonatal hyperbilirubinemia respectively; two cases presented with feeding problem and hypoglycemia respectively; one case presented with micropenis and fetal finger pads respectively. All seven patients received magnetic resonance imaging (MRI) tests, and none demonstrated an abnormal finding. Five patients received electroencephalogram (EEG) tests, and three of them presented with seizures and EEG abnormalities. Five patients received genetic testing and all presented with KMT2D heterozygous mutations which were new mutations proved by parents validation (three cases were nonsense mutations, one was frameshift mutation, one was missense mutation). All patients received rehabilitation training and symptomatic treatments. Three patients presented with epileptic seizures received antiepileptic therapy. At a median follow-up of 11 months (from 4 months to 2 years), one patient died, one lost to follow-up and five had improved intellectual and physical development. Epileptic seizures were controlled or reduced significantly in three patients presented with epileptic seizures. Conclusions: KS is a multisystem disease with complicated manifestations, which needs a combination of various diagnosis and treatments. Genetic testing can help determine the diagnosis. Unusual facies and mental retardation are the main clinical features and diagnostic clue. It is important to improve prognosis through increasing the knowledge of KS, early diagnosis, and treatment.

Antiplatelet vs. R-tPA for acute mild ischemic stroke: A prospective, random, and open label multi-center study

Rationale

The evidence of intravenous thrombolysis in patients with not clearly disabling minor stroke (low National Institutes of Health Stroke Scale of 0–5) is still insufficient. Recent early terminated PRISMS trial could not provide definitive conclusion, although suggesting the similar functional outcome between alteplase and aspirin groups. Recent two clinical trials provide a definitive evidence for the superiority of dual antiplatelet to mono-antiplatelet in minor stroke. However, the efficacy and safety of dual antiplatelet vs. alteplase in the treatment of acute minor stroke are not known.

Aim

To explore the efficacy and safety of dual antiplatelet with aspirin and clopidogrel vs. alteplase in the treatment of acute minor stroke.

Sample size estimates

A maximum of 760 subjects are required to test the non-inferiority hypothesis with 80% power according to a one-sided 0.025 level of significance, stratified by age, diabetes, time from onset to treatment, stroke etiology, degree of vascular stenosis, location of index vessel.

Methods and design

ARAMIS is a prospective, randomized, open label, blinded assessment of endpoints (PROBE) and multicenter clinical trial in China. The subjects are randomized to the control arm (intravenous alteplase with standard dose of 0.9 mg/kg, followed by guideline-based treatment 24 h after thrombolysis) or the experiment arm (clopidogrel: loading dose of 300 mg on the first day, followed by 75 mg daily for 10–14 days; aspirin: 100 mg on the first day, followed by 100 mg daily for 10–14 days; after the combination, antiplatelet will be given based on guideline till 90 days).

Study outcome

The primary efficacy endpoint is favorable functional outcome, defined as a mRS 0–1 assessed at 90-day post-randomization.

[Clinicopathologic features of primary renal neuroendocrine carcinoma]

Objective: To investigate the clinicopathologic characteristics, diagnostic features and prognosis of primary renal neuroendocrine carcinoma (NEC). Methods: The clinicopathologic data of eight cases of renal NEC was collected from January 2008 to December 2017 from Affiliated Hospital of Qingdao University. Immunohistochemical staining was performed, and follow-up information was analyzed, and the relevant literature reviewed. Results: The patients' mean age at diagnosis was 45 years (range, 27-66 years); five were women, and three were men. The tumors located on the left side in five patients, and on the right side in three. Five cases were detected incidentally, and three patients presented with loin pain. Microscopically, these cases included five well-differentiated NECs (three carcinoids, two atypical carcinoids), two small cell NECs, and one large cell NEC according to the World Health Organization classification of 2016. The tumors infiltrated the renal capsule in six cases. Necrosis was found in five cases. Vascular invasion with tumor emboli was seen in three cases. Lymph node metastasis was identified in one case. Immunohistochemically, the expression rates of neuroendocrine markers CD56, chromogranin A (CgA) and synaptophysin (Syn) were 6/8, 4/8, and 8/8 respectively. Some of the NECs were positive for epithelial markers CKpan (6/8, with three cases showing focal positivity) and CAM5.2 (4/8) of variable degrees. The Ki-67 proliferation index was≤3% in the carcinoids; ≥50% in the small cell carcinoma and large cell carcinoma; and 5% and 8% for the two cases of atypical carcinoid, respectively. All cases were negative for EMA, CK7, CA9, CD10, CD117, PAX2, PAX8, WT1, p63, S-100 and TTF1. Three patients (two with small cell carcinoma and one with large cell carcinoma) died of extensive metastases at 3 months, 4 months and 9 months after operation, while five patients were well, without recurrence or distant metastasis for follow-up period of one to nine years. Conclusions: Primary renal NEC is rare. Carcinoid is the most common histological type. The pathomorphological features and neuroendocrine markers (CD56, CgA, Syn), epithelial markers (CKpan, CAM5.2) and nephrogenic markers (PAX2, PAX8) are important for the diagnosis. Renal carcinoid tumors are indolent and prone to early metastasis, but are associated with prolonged survival. The small cell renal cell carcinoma and large cell carcinoma are highly malignant renal tumors with poor prognosis and short survival.

[Network correlation of circRNA-miRNA and the possible regulatory mechanism in acute myocardial infarction]

Objective: Using microarray technology, to research characteristic circRNA and miRNA expression profile of acute myocardial infarction (AMI), and then explore the role of these circRNA and miRNA in gene regulation. The aim is to explore the mechanism of development of AMI. Methods: The patients hospitalized in the Cardiovascular Research Center of the First Affiliated Hospital of Xinxiang Medical University between November 2016 and January 2017 were included and divided into control group and AMI group according to diagnostic criteria. We collected their whole blood and extracted the total RNA, and the expression profiles of circRNA and microRNA genes in peripheral blood of AMI were analyzed by gene chip. We predicted circRNA which was possible to combine with miRNA, and drew a network diagram, and the differentially expressed circRNA was analyzed by GO and Pathway. Results: There was difference in circRNA expression profile between the control group and the AMI group. The results showed: (1) a total of 1 670 circRNA had differential expressions, and in the analysis of miRNA expression, 13 miRNA had differential expressions (P<0.05, fc≥2); (2) multiple circRNAs-miRNAs were involved in the occurrence of AMI; (3) the analysis of GO and Pathway for differentially expressed circRNAs showed that many pathways, disease and function participated in it. Conclusion: CircRNA, as an important post transcriptional regulator, is closely related to the development of AMI with miRNA.

[Efficacy of endoscopic approach to reconstruct the medial orbital fracture with perpendicular plate of ethmoid]

Objective:To study the efficacy of endoscopic sinus approach in the repair of medial orbital fracture with perpendicular plate of ethmoid.Method:Retrospective chart was reviewed in 10 cases receiving endoscopic approach to reconstruct the medial orbital fracture with perpendicular plate of ethmoid.We observed the improvement of the symptom such as diplopia, eye movement,and enophthalmos of the preoperative and postoperative.Result:After postoperative follow-up of 4 months to 23 months, all the patients had no graft loss or displacement, infection and other complications, and except for 1 patient with mild diplopia, other patients recovered completely, including eye movement disorder, diplopia,and enophthalmos.Conclusion:Endoscopic approach is a safe and effective treatment in the repair of medial orbital fracture with perpendicular plate of ethmoid.

[Current status of reproductive health and its occupational influencing factors among female medical staff in a provincial maternal and child health hospital]

Objective: To investigate the current status of reproductive health among the female medical staff in a provincial maternal and child health hospital and analyze the occupational influencing factors for reproductive health, particularly the effects of high-intensity work, work shift, chemical poisons, and physical and biological factors on reproductive health, and to provide a scientific basis for developing related intervention measures and promoting the reproductive health of professional females. Methods: A reproductive health questionnaire was designed in terms of age, type of work, professional title, education level, working hours, working strength, and the reproductive health of female staff to analyze the current status of reproductive health, working strength, and occupational hazardous factors. The female medical staff in the provincial maternal and child health hospital completed the questionnaire on the internal network of the hospital voluntarily. Results: Of all respondents, 19.46% had a history of miscarriage, 5.90% visited the hospital due to infertility, 21.31% had irregular menstruation within the last 3 months, and 30.57% had reproductive system disease; 72.28% of the investigated medical staff often worked at night, 47.25% often worked overtime (more than 3 days a week) , and 22.27% worked over 8 hours daily. The respondents who often worked overtime had a significantly higher prevalence of reproductive system disease than those who did not often work overtime (χ(2)= 58.65, P<0.01) . The respondents who often worked at night had a significantly higher rate of miscarriage than those who did not work at night (χ(2)=41.57, P<0.01) . In all respondents, 87.08% were often exposed to chemical injuries such as disinfectants, and 78.15% had contact with noise, radiation, and other physical injuries; the medical staff exposed to chemical and physical injuries had a significantly higher proportion of individuals with a history of miscarriage than the unexposed staff (χ(2)=10.04, P<0.01; χ(2)=13.30, P<0.01) . Conclusion: Much attention should be paid to the reproductive health of female medical staff in the provincial maternal and child health hospital, who have high working strength. The occupational hazard factors can be avoided by reasonably arranging the work schedule and creating a supportive environment to improve the reproductive health of female medical staff.

[Effects of metformin and adiponectin on endometrial cancer cells growth]

OBJECTIVE

To determine the effect of metformin and adiponectin on the proliferation of EC cells and the relationship between metformin and adiponectin.

METHODS

The proliferation impact of different concentrations of metformin and adiponectin on two types of EC cells ishikawa (IK) and HEC-1B was confirmed by CCK-8 method. qRT-PCR and Western blot were used to detect the effect of different concentrations of metformin on the changes of adiponectin receptors (AdipoR1 and AdipoR2) of the EC cells both in mRNA and protein level and the role of compound C, an adenosine monophosphate-activated protein kinase (AMPK) inhibitor, on the above effects.

RESULTS

(1) Both metformin and adiponectin could significantly promote the proliferation of endometrial cancer (EC) cells in a time and concentration dependent manner (P<0.05).(2)Metformin and adiponectin had synergy anti-proliferative effect on EC cells and the combination index (CI) value of IK cells was 0.906 34 and of HEC-1B cells was 0.827 65. (3)qRT-PCR was used to detect the mRNA levels of AdipoR1 and AdipoR2 after 5 mmol/L and 10 mmol/L metformin, respectively, stimulating IK and HEC-1B cells for 48 hours and the mRNA expressions of AdipoR1 and AdipoR2 were significantly increased when compared with the control group (0 mmol/L)(IK: AdipoR1 of 5 mmol/L and 10 mmol/L group: P<0.001,AdipoR2 of 5 mmol/L group: P<0.001; HEC-1B: AdipoR1 of 5 mmol/L group: P<0.001, 10 mmol/L group: P=0.023, AdipoR2 of 5 mmol/L group: P<0.001, 10 mmol/L group: P=0.024). When combined with compound C, the RNA levels of AdipoR1 and AdipoR2 were not different compared with the control group (0 mmol/L, P>0.05). (4) Western blot was used to detect the protein levels of AdipoR1 and AdipoR2 after 5 mmol/L and 10 mmol/L metformin, stimulating IK and HEC-1B cells for 48 hours and the protein level was significantly increased when compared with the control group (0 mmol/L)(IK: AdipoR1 of 5 mmol/L group: P=0.04, 10 mmol/L group: P=0.033, AdipoR2 of 5 mmol/L group: P=0.044, 10 mmol/L group: P=0.046; HEC-1B: AdipoR1 of 5 mmol/L group: P=0.04, 10 mmol/L group: P=0.049, AdipoR2 of 5 mmol/L group: P=0.043, 10 mmol/L group: P=0.035). When combined with compound C,the protein levels of AdipoR1 and AdipoR2 were not different compared with the control group (0 mmol/L, P>0.05).

CONCLUSION

We find that metformin and adiponectin have synergy anti-proliferative effect on EC cells. Besides, metformin can increase adiponectin receptors expressions of EC cells both in mRNA and protein levels and this effect is accomplished by the activation of AMPK signaling pathway.

Preparation of CeO₂-Quantum Dots/Cu₂O Nanocomposites with Enhanced Photocatalytic Properties

To improve the efficiency of photocatalysts, a composite of CeO2-quantum dots/Cu2O (CeO2-QDs/Cu2O) was prepared through a one-step hydrothermal procedure in alkaline carbonate solution with Cu2(OH)2CO3 and Ce(NO3)3. 6H2O as precursors and glucose as reducing agent. The morphologies and structures of the prepared photocatalysts were well characterized utilizing Transmission Electron Microscopy (TEM), X-ray Diffractometry (XRD), X-ray Photoelectron Spectroscopy (XPS) and UV-Vis Diffuse Reflectance Spectrophotometer (DRS). The results indicated that the CeO2-QDs with 5 to 10 nm diameters were well dispersed and had a good contact with Cu2O. As observed in the photocatalytic experiments, Rhodamine B could be degraded more effectively under simulated sunlight using CeO2-QDs/Cu2O as the photocatalysts. Also, the obtained photocatalytic kinetics constant was higher than that in the experiments using CeO2 or Cu2O nano particles as photocatalysts. The enhanced photocatalytic activities might be attributed to the efficient separation of photo-generated charge carriers with the help of the p-n heterojunction and the morphology of quantum dots.

[Comparative study on deep venous thrombosis onset in hospitalized patients with different underlying diseases]

Objective: To improve the understanding of deep venous thrombosis (DVT), the present study was conducted to investigate the difference of DVT onset in hospitalized patients with different underlying diseases. Methods: This is a single-center retrospective study from Beijing Shijitan Hospital. Clinical data from hospital onset DVT patients from 2007 to 2016 were collected. DVT was confirmed with compression ultrasonography (CUS), color Doppler flow imaging (CDFI), CT venography (CTV), magnetic resonance venography (MRV), lower extremities radionuclide venography(RDV) or conventional venography (CV). The risk factors of DVT in hospital were analyzed with a Chi-square analysis. Results: A total of 5 063 patients (1.65%) with DVT involving 5 024 veins were identified from 305 922 inpatients admitted without DVT during ten years. Among DVT patients, 2 752 were males (54.36%) and 2 311 were females (45.64%) with age of (74.1±15.9) years (range from 1 to 103 years). Patients with DVT were elder and longer inhospital than those without DVT (P< 0.001). Patients with respiratory diseases had higher incidence of DVT (6.83%, OR= 5.498, 95%CI 5.151-5.868) than those with other system diseases, in which patients with respiratory failure had the highest incidence of DVT (9.53%, 95%CI 6.912-8.018) among all patients. The risks of having DVT were higher in patients with serious internal medicine diseases than those in patients with trauma, or cataclasis/operations, or invasive manipulations. Among all DVT patients, 71.54% of them were with inflammation diseases, 55.56% were with hypertension and 54.93% were with structural heart disease. DVT often occurred in inferior extremities (83.78%, 4 360/5 063) in patients irrespective of underlying diseases. Conclusions: There is an association between underlying diseases of hospitalized patients and the development of DVT. Patients with internal medicine diseases had higher risk to develop DVT than those with trauma or cataclasis/operations or invasive manipulations. To prevent the development of DVT, its screening should be emphasized in patients with serious internal diseases.

Extraction of ferulic acid and vanilla acid by hydrophobic ionic liquid 1-hexyl-3-methylimidazolium hexafluorophosphate

The study was carried out to evaluate the extraction efficiency of ferulic acid (FA) and vanilla acid (VA) from aqueous phase into IL phase. To achieve the highest extraction efficiency, the influence of varying key parameters was evaluated and optimized by response surface methodology based on Box-Behnken design, including phase volume ratio, extraction temperature and extraction time. FA (or VA) extraction under the optimal conditions were: phase volume ratio of 1.38 (1.28), extraction temperature of 66.34 °C (49.28 °C) and extraction time of 33.83 min (36.64 min) under optimum conditions an average extraction efficiency of 97.11 ± 1.05% for FA was achieved, while VA was 85.43 ± 1.62%. This was very close to the predicted value from the model, 98.05% (86.16%). Additionally, recycling and utilization of ILs were performed well with the recovery ratio for 81.0%. Based on thermodynamic analysis, FTIR and ¹H NMR analysis, the combination of hydrophobic interaction and hydrogen-bond interaction resulted in the real extraction result above. It is desirable to provide a useful reference for the separation and purification of FA, VA, and extend the potential application of ionic liquid in the separation of natural active compounds with great prospects.

[Evidence-based evaluation of recent clinical practice guidelines for the diagnosis and treatment of benign prostatic hyperplasia]

Objective: To systematically evaluate the quality of clinical practice guidelines for the diagnosis and treatment of benign prostatic hyperplasia (BPH), and to compare the context of recommendations in order to provide references for clinical application. Methods: We searched databases such as the National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN) and World Health Organization (WHO), PubMed, Embase, CNKI, VIP, WanFang Data, CBM, and Medlive from their establishment until August 13, 2016, to collect evidence-based guidelines and/or consensus on BPH. Method: Methodological quality of included guidelines was assessed according to the AGREE Ⅱ instrument, and differences and similarities among recommendations were compared. Results: A total of 15 guidelines were included. According to the AGREE Ⅱ instrument, the score of scope and purpose, stakeholder involvement, rigour of formulate, clarity of presentation, applicability, and editorial independence was 72%, 38%, 30%, 58%, 16%, and 40%, respectively. The recommendations of different guidelines were basically similar, only with conflicts in some areas. Conclusions: The quality of included guidelines remains to be unified, the context of them can provide valuable implications for development or improvement.

[Clinical study of no necrotic cavity lavage after debridement and drainage in patients with infected pancreatic necrosis]

Objective: To observe the outcomes of no necrotic cavity lavage after debridement and drainage in patients with infected pancreatic necrosis(IPN). Methods: From February 2014 to August 2017, there were 89 patients who were diagnosed as IPN undergoing minimally invasive surgery with no necrotic cavity lavage and large caliber-wide channel drainage in Department of General Surgery, Xuanwu Hospital, Capital Medical University. There were 57 male and 32 female patients aging of (49.5±14.4)years (ranging from 23 to 84 years). The body mass index of 89 patients was (25.4±3.8)kg/m(2) (ranging from 17.6 to 36.7 kg/m(2)). Among the 89 patients, 37 cases(41.6%) of biliary pancreatitis, 10 cases (11.2%) of alcoholic pancreatitis, 16 cases(18.0%) of hyperlipidemic pancreatitis, and 26 cases(29.2%) of other reasons. Results: Of 89 patients, IPN in 6 patients(6.7%) resolved using only percutaneous catheter drainage; another 83 patients underwent laparoscopic debridement(n=3, 3.4%) or video-assisted debridement(n=80, 89.9%). No patient was conversed to laparotomy. The average operation frequency and surgery time was (2.3±1.7) times and (56.5±31.7) minutes.The median bleeding volume and total length of stay was 10(0-600) ml and 34(6-172) days separately. The complication rate(Clavien-Dindo grade≥Ⅲ) was 9.0%(8/89) which involved mainly abdominal hemorrhage (5/8) and digestive tract fistula formation (3/8). The overall mortality rate was 6.7%(6/89). Among them, 3 cases died of abdominal infection, bacteremia and multiple organ failure, 2 cases died of pulmonary infection and bacteremia and 1 case died of fungal infection. Conclusion: No necrotic cavity lavage after debridement and drainage operation is considered effective and safe for IPN patients.

[Expression of BRD4 in squamous cell carcinoma and its effects on cell proliferation and invasion ability]

Objective: To investigate the expression of BRD4 in squamous cell carcinoma (SCC) tissues and cells, and the effects of its expression on cell proliferation and invasion ability. Methods: Immunohistochemistry was used to detect BRD4 protein expression in SCC tissues and paired normal esophageal squamous epithelial tissues. The expression of BRD4 protein was detected in different SCC cell lines and normal esophageal squamous epithelial cells by Western blot. BRD4 siRNA and control siRNA were used to transfect SCC Eca109 cells, and experiments were divided into three groups: untreated group, control siRNA group and BRD4 siRNA group. Western blot was employed to investigate the expression of BRD4 protein in the three groups of SCC Eca109 cells. CCK-8 kit was utilized to detect cell proliferation ability, and Transwell chamber was used to examine cell invasion ability. Finally, Western blot was used to detect the expression of MMP2 and MMP9 proteins. Results: The positive rate of BRD4 protein expression in SCC tissues was significantly higher than that of normal squamous epithelial tissues. The expression of BRD4 protein in 4 SCC cell lines was higher than that in normal esophageal cell Het-1A. BRD4 siRNA obviously downregulated the expression of BRD4 protein in Eca109 cells, and its downregulation contributed to the suppression of cell proliferation and invasion ability in Eca109 cells (all P<0.05), coupled with the decreases of MMP2 and MMP9 proteins. Conclusion: BRD4 may be closely associated with the proliferation and invasion of SCC, and it thus may be a potential therapeutic target for SCC.

Laser-induced plasma imaging for low-pressure detection

A novel technique based on laser induced plasma imaging is proposed to measure residual pressure in sealed containers with transparent walls, e.g. high voltage vacuum interrupter in this paper. The images of plasma plumes induced on a copper target at pressure of ambient air between 10^-2Pa and 10⁵Pa were acquired at delay times of 200ns, 400ns, 600ns and 800ns. All the plasma images at specific pressures and delay times showed a good repeatability. It was found that ambient gas pressure significantly affects plasma shape, plasma integral intensities and expansion dynamics. A subsection characteristic method was proposed to extract pressure values from plasma images. The method employed three metrics for identification of high, intermediate and low pressures: the distance between the target and plume center, the integral intensity of the plume, and the lateral size of the plume, correspondingly. The accuracy of the method was estimated to be within 15% of nominal values in the entire pressure range between 10^-2Pa and 10⁵Pa. The pressure values can be easily extracted from plasma images in the whole pressure range, thus making laser induced plasma imaging a promising technique for gauge-free pressure detection.

[Professor B. Jigmed's conception on the division of stages of history of Mongolian medicine]

The division of stages on the formation and development of Mongolian medicine is a major issue on the history of Mongolian medicine. Based on Mongolian social, economic and cultural development and the characteristics of Mongolian medicine itself, Professor B. Jigmed creatively puts forward the three stages of development of ancient and modern times of Mongolian medicine. He also reasonably sorts out historical materials to comprehensively and systematically display the general picture of its development. This approach exerts great effect on restructuring the body of Mongolian medicine itself, unveils its rule of development, and promotes its disciplinary construction.

[The establishment of the immortalized mouse brain microvascular pericytes model and its preliminary application in screening of cerebrovascular toxicants]

Objective: To establish the immortalized mouse brain microvascular pericytes model and to apply to the cerebrovascular toxicants screening study. Methods: Brain pericytes were isolated from 3 weeks of mice by tissue digestion. Immortalized pericyte cell line was constructed by infecting with LT retrovirus. Monoclone was selected to purify the immortalized pericyte cell line. The pericyte characteristics and purity were explored by immunocytochemistry. Cell proliferation was measured by using the Pomega MTS cell Proliferation Colorimetric Assay Kit. Pericytes were treated with 0, 160, 320, 640, 1 280, 2 560 μmol/L lead acetate, 0, 5, 10, 20, 40, 80 μmol/L cadmium chloride and 0, 5, 10, 20, 40, 80 μmol/L sodium arsenite in 24 hours. Cell toxicity of each group was determined by MTS assay, median lethal dose (LD(50)) was calculated in linear regression. Results: Mouse brain pericytes were successfully isolated by tissue separation and enzyme digestion method. After immortalized by LT retroviruses, monoclone was selected and expanded to establish pericyte cell line. The brain pericytes exhibited typical long spindle morphology and positive staining for α-SMA and Vimentin. The proliferation of brain pericytes cell lines was very slowly, and the doubling time was about 48 hours. The proliferation of immortalized brain pericytes cell lines was very quickly, and the doubling time was about 24 hours. After lead acetate, cadmium chloride and sodium arsenite treatment for 24 hours respectively, gradual declines in cell viability were observed. The LD(50) of lead acetate was 2 025.0 μmol/L, the LD(50) of cadmium chloride was 36.6 μmol/L, and the LD(50) of sodium arsenite was 33.2 μmol/L. Conclusion: The immortalized mouse brain microvascular pericyte model is established successfully by infecting with LT retrovirus, and can be applied to screen cerebrovascular toxicants. The toxicity of these toxicants to immortalized mouse brain microvascular pericyte is in sequence: sodium arsenite,cadmium chloride, lead acetate.

Study of interaction between ionic liquids and orange G in aqueous solution with UV-vis spectroscopy and conductivity meter

The interactions between Orange G (OG) with three kinds of ionic liquid surfactants (C₁₀mimBF₄, C₁₂mimBF₄, C₁₆mimBF₄) and CTAB were studied with UV-Vis spectra and conductivity measurements. The systematic changes in UV-Vis spectra with an increase of carbon-chain length may be observed in presence of OG. They correspond to CMC of every system, respectively, and the CMCs of four systems have exhibit the decrease of CMCs compared to pure surfactant. The binding constants are calculated from the results of conductivity measurements in the order of C₁₆mimBF₄>CTAB>C₁₂mimBF₄>C₁₀mimBF₄. Furthermore, system behaviors presented significant association of complex formation and micelles formation, i.e. the change in UV-Vis spectra before and after the formation of micelles in mixed systems. In addition, Fourier-transform infrared (FT-IR) spectroscopy and ¹H NMR analysis further confirmed that the complexes are formed by hydrogen bond and van der Waal force. These findings could provide scientific guidance for extraction and separation of dyes.

[Feasibility study of QAMS for quantitative analysis of multiple structural types of ingredients in Atractylodis Rhizome by GC]

In this study， quantitative analysis of multi-components with single marker(QAMS) was established and validated to simultaneously determine four sesquiterpenoids(β-eudesmol， atractylon， atractylolideⅠ， atractylolide Ⅱ) in Atractylodis Rhizome based on the gas chromatographic method(GC). Using β-eudesmol as the contrast， the relative correctionfactors(RCF) of the other three sesquiterpenoids were determined by GC. Within the line arranges，the values of RCF of β-eudesmol to atractylon， atractylolideⅠand atractylolide Ⅱ were 0.823， 0.690 and 0.766， respectively. The RCF had a good reproducibility in various instruments， chromatographic columns. According to their RCF， we simultaneously determined four sesquiterpenoids in Atractylodis Rhizome only using one marker. The results of QAMS method were validated by comparing with that of internal standard method， and no obvious significant difference was found.

[Intestinal barrier dysfunction and its related factors in patients with sepsis]

Objective: To investigate the relationship between related factors of intestinal barrier dysfunction in patients with sepsis or septic shock and severity of the condition. Methods: A prospective observational study was conducted in 31 sepsis patients, 28 septic shock patients, and 21 postoperative patients without sepsis (control group) who were admitted to intensive care unit (ICU) of General Hospital of Ningxia Medical University between November 2015 and June 2016. Blood samples were collected from the patients within 24 hours following admission to ICU. D-lactic acid and endotoxin levels were measured by enzymatic method, serum high-sensitivity C-reactive protein (hsCRP) level by immune scatter turbidimetry. An arterial blood gas (ABG) measurement was carried out every 8 hours within the first 24 hours after admission to ICU, and average arterial blood lactate levels were calculated. Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, Sequential Organ Failure Assessment (SOFA) score of the patients within 24 hours following ICU admission were recorded. The patients with sepsis or septic shock were followed up for 28 days after admission to ICU, and divided into survival group (n=44) and death group (n=15). The patients with sepsis or septic shock were divided into two groups according to the site of infection, i. e. intra-abdominal infection group (n=37) and extra-abdominal infection group (n=22). Results: (1) In the control, sepsis, and septic shock groups, D-lactic acid [mg/L, M(P₂₅, P₇₅) ] were 11.68(7.49, 14.92), 19.78 (12.25, 34.85), and 32.45 (16.03, 46.95), respectively; endotoxin levels [U/L, M(P₂₅, P₇₅)] were 10.60(7.59, 13.39), 16.12(10.09, 20.23), and 17.31(14.09, 23.77), respectively. The levels of serum D-lactic acid and endotoxin in the patients with sepsis or septic shock were significantly higher than those in the control group (all P<0.01); while no statistically significant differences existed in these two indices between the sepsis and septic shock groups (both P>0.05). There were no statistically significant differences in serum D-lactic acid and endotoxin levels between the intra-abdominal infection group and the extra-abdominal infection group [20.07(14.70, 38.97)vs 21.65 (14.53, 56.56)mg/L; 17.23(13.38, 20.85)vs 17.17(9.93, 20.81)U/L; both P>0.05]. There were no statistically significant differences in levels of serum D-lactic acid and endotoxin between the survival group and the death group [21.65(15.11, 39.00) vs 19.78(14.41, 80.93)mg/L; 17.09(12.62, 20.42) vs 19.26(13.22, 26.27)U/L, both P>0.05]. (2) In the sepsis and septic shock patients, serum D-lactate level was significantly related to mean arterial blood lactate concentration, APACHE Ⅱ score, and SOFA score in the first 24 hours after admission to ICU (r=0.499, 0.447, 0.469, all P<0.01); serum endotoxin level was correlated with hsCRP, APACHE Ⅱ score, and SOFA score (r=0.224, 0.388, 0.393, all P<0.05). (3) Multivariate linear regression analysis showed that D-lactic acid level was independently associated with average arterial blood lactate concentration as well as with SOFA score(R²=0.34, F=19.91, P<0.01), and endotoxin was independently associated with only SOFA score(R²=0.14, F=12.68, P<0.01). Conclusions: Regardless of the site of infection, patients with sepsis or septic shock often have intestinal barrier injury, which is correlated with the severity of disease, but does not independently affect patient outcome. Tissue hypoperfusion in the early stage of sepsis may be one of the causes of intestinal barrier injury.

[Small vessel-childhood primary angiitis of the central nervous system: a case report and literature review]

Objective: To summarize the clinical and pathological features of small vessel-childhood primary angiitis of the central nervous system (SV-cPACNS), discuss the immune therapy and increase the attention to brain biopsy in SV-cPACNS. Methods: The clinical data, pathology of brain biopsy, treatment and outcome of an SV-cPACNS patient hospitalized in Beijing Children's Hospital in February 2016 were analyzed retrospectively. The cases reported at Pubmed, CNKI and Wanfang databases from 2007 to 2017 were searched, the clinical and pathological features, immunotherapy and prognosis of the disease were summarized according to the literature review. Results: A 70 months old girl had 6 times relapses during 5 months' disease course. Symptoms included convulsions, limb paralysis, blurred vision and speech difficulty. Multiple cortical lesions were found successively in brain MRI but CT angiography was negative. The pathology of brain biopsy revealed thickening of small vessel walls together with lymphocytic infiltration. After the treatment with rituximab, remission was achieved and remained stable without recurrence in 1 year follow up. A total of 44 pathologically confirmed cases reported in nearly 10 years were retrieved. Male to female ratio was 1∶3.5. The average onset age was 9.8 years. Clinical manifestations included seizures (37/45, 82%), headache (35/45, 78%), cognitive decline (28/45, 62%), speech regression(20/45, 44%), paralysis (15/45, 33%), and so on; 70% (19/27) patients experienced relapses. Erythrocyte sedimentation rate and C-reactive protein slightly elevated, antinuclear antibody and other autoimmune antibodies were mostly negative. Mild lymphocytosis in cerebrospinal fluid was found in 67%(29/43) patients. 53%(23/43) patients had elevated CSF protein level, several had elevated IgG and positive oligoclonal band. Bilateral multifocal lesions were revealed in 80% (36/45) brain MRIs, meanwhile all angiographies were unremarkable. The pathology showed small angiitis and immunohistochemistry positive for CD3 and CD20. Twenty-seven patients had detailed therapeutic information; 25 of them received immunosuppressive agents, including cyclophosphamide, mycophenolate mofetil and rituximab. One patient died, 26 patients achieved remission with 54% (22/44) had neurological sequelae. Conclusions: SV-cPACNS had varied clinical manifestations, there was no specificity in laboratory and imaging examination and angiography was often negative. The definite diagnosis relied on brain biopsy, which showed lymphocytic inflammation of small vessels. SV-cPACNS tended to relapse and induce neurologic deterioration. Treatment required long-term use of steroids and immunosuppressive agents. Rituximab could be an effective agent.

[Tissue distribution of TPGS modified artesunate liposome and its metabolites in rats]

Artesunate, which is a widely used anti-malaria medicine, can be made into liposome to overcome its poor bioactivity. Its tissue distribution in rats may change with different dosage forms, which therefore shall be studied after ARS-TPGS-Lipo was injected. Based on this experiment, ARS-TPGS-Lipo and ARS-Lipo were prepared by thin-film hydration method. LC-MS/MS method was used to simultaneously determine ARS and DHA in rat tissues at different time points. The results showed that this method was suitable for the content analysis of ARS and DHA in biological samples. The distribution of ARS and DHA in ARS-TPGS-Lipo, ARS-Lipo and ARS groups were quite different. The content of ARS-TPGS-Lipo in liver was the highest, with significant differences.ARS and DHA contents in ARS group eliminated rapidly. ARS and DHA contents in ARS-Lipo group were higher in liver and spleen, while those in ARS-TPGS-Lipo group significantly increased only in liver (P<0.05).

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.

[Prevalence and clinical characteristics of blood eosinophilia in patients with acute exacerbation of chronic obstructive pulmonary disease]

Objective: To investigate the prevalence and clinical characteristics of peripheral blood eosinophilia (EOS) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: From July 2014 to June 2016, AECOPD patients in the Department of Respiratory Medicine of Affiliated Hospital of Chengdu University, were retrospectively stratified into two groups according to two standards of eosinophilic exacerbations (the peripheral blood eosinophil count ≥2% or ≥3% on admission). Demography, clinical symptoms, laboratory results, length of stay, total hospitalization expenses, and defined daily expenses were compared between groups. Results: A total of 559 cases with AECOPD were finally recorded, the prevalence of eosinophilia was 43.1% (241 cases by EOS≥2%) and 27.2% (152 cases by EOS≥3%), respectively. According to either standard, there were no significant differences in sexes, age, course of disease (P>0.05), and there were no significant differences in global initiative for chronic obstructive lung disease (GOLD) grades, parameters of pulmonary function, modified british medical research council (mMRC) scores, rate of antibiotic use, systemic glucocorticoids administration, and average daily expenses (P>0.05). According to 2% standard, leucocytes, neutrophils, monocytes, hs-CRP were lower than non-eosinophilic patients [(5.9±2.0)×10(9)/L vs (8.2±4.0)×10(9)/L, (3.9±1.6)×10(9)/L vs (6.5±3.8)×10(9)/L, (0.446±0.169)×10(9)/L vs (0.501±0.276)×10(9)/L, (25.8±35.9) vs (46.2±55.6) mg/L, all P<0.01]; basophils, lymphocytes were higher than non-eosinophilic patients [(0.043±0.025)×10(9)/L vs (0.029±0.021) ×10(9)/L, (1.3±0.6) ×10(9)/L vs (1.1±0.6) ×10(9)/L, both P<0.01]; length of stay, total hospital expense were shorter (or lower) than non-eosinophilic patients [(10.6±5.0) vs (11.6±5.8) d, (11 851±7 491) vs (14 254±10 751) RMB, both P<0.05]. According to 3% standard, leucocytes, neutrophils, monocytes, hs-CRP were lower than non-eosinophilic patients (all P<0.05), and basophil were higher than non-eosinophilic patients (P<0.01), but no significant differences were observed in lymphocytes, length of stay and total hospital expense (all P>0.05). Conclusion: Eosinophilia is of relative high prevalence in AECOPD patients, and basophil in eosinophilic patients is higher than non-eosinophilic patients.