Acute hepatic failure was induced in rats with intraperitoneal administration of D-galactosamine.Serum and tissue amino acid profiles of the animals were studied. Except for arginine, serum levels of all amino acids were elevated. This is in variance with the findings of Fischer and other investigators. In their studies, the decreased levels of BCAA could be related to the administration of dextrose. In our study, the serum BCAA/AAA ratio was decreased and it was correlated negatively with the dosage of D-galactosamine (r =-0.789). Amino acid profiles in the liver,kidney and muscles were significantly altered. The chracteristics of the changes indicated that enhanced proteolysis of tissue proteins was the major factor accounting for the elevation of serum amino acid levels. Hepatic coma might be related to the increase of aromatic amino acids in the brain. It is usually difficult for glycine, cystine, asparagine and threonine to penetrate the blood-brain-barrier. Elevation of their levels in the brain might be a consequence of increased permeability of the blood-brain-barrier. Further studies are needed to clarify the role of GABA in hepatic coma.

Objective To investigate the quality of concentrated platelet with less WBC by improved white membrane method,so as to provide the basis for preparation of the concentrated platelet in the future.Methods Testing the quality indicators of 56 cases of concentrated platelet with less white blood cells by improved white membrane method,and comparing the quality indicators of 56 cases of collected platelet at random by machine.Testing the expression rate of platelet membrane surface glycoprotein molecules CD62P and PAC-1 before and after filtering in different storage time,and comparing the expression rate of 37 cases of collected platelets at random by machine.Results The differences of quality indicators between concentrated platelet with less white blood cells by improved white membrane methods and collected platelet at random by machine were not statistically significant (P＞0.05),such as volume,platelet content,Ph,amount of RBC mixed within.But The differences of amount of WBC mixed with were statistically significant (P＜ 0.01),both of sterility tests were negative.The differences of the expression rate of platelet membrane surface glycoprotein molecules CD62P and PAC-1 during storage period within 3 days were not statistically significant (P＞0.05).Conclusion The various quality indicators of concentrated platelet with less white blood cells by improved white membrane methods attain mixed concentrated platelet and platelet national standards,and in vitro platelet activity kept well.Platelet special leucocyte filter does not cause obvious platelet activation and damage within three days of storage period of concentrated platelet in filter processing.Collected platelet by machine is being activated and damaged continuously when kept in platelet oscillation device 22±2℃ for 3 days,but activation and damage does not significantly change the platelet activity in vitro.

ObjectiveTo study the dose distribution of the intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) inverse plans with different energy X-ray, to provide a reference of energy options for radiation therapy. MethodsEight cases with different disease were chosen, the plan for each case were finished with 1Arc (360°) VMAT, 9 fields IMRT and 5 fields IMRT.For each plan project, the energy selections were 4 MV, 6 MV, 8 MV and 15 MV. In the evaluation,homogeneity index ( HI), conformity index ( CI ) and external volume index ( EVI ) of target, the average dose ( Dmean) and 2％ volume in dose volume histogram ( D2 ) of serial organs at risk ( OARs), the average dose ( Dmean ) and a dose level volume ( Vx ) of parallel OARs were chosen and compared . Results Statistical analysis showed that: For the target, the result of HI were F=0. 13,0. 51,0. 09, P=0. 939,0.679,0.965,CI were F=0. 13,0.51,0.09,P=0.939,0.679,0.965, EVI were F=0. 15,0.31,0. 15,P =0. 930,0. 818,0. 931, respectively ; For the OARs of each patient, F ＜ 0. 20, P ＞ 0. 05. All results indicated there was little difference in option of energy for the same field p8roject. ConclusionsThe results indicate that the middle and low energy X-ray (6 MV or 8 MV) can satisfy the needs of IMRT and VMAT radiotherapy. Compared with middle and low energy, the high energy X-ray (15 MV ) showed little advantage in dose distribution.

Objective:To analyze the prevalence of parturiophobia and its association with preferred mode of delivery in pregnant women in Changning District, Shanghai.Methods:A cross- sectional study was conducted among 1 560 pregnant women in the third trimester who had their antenatal examination in Changning Maternity and Infant Health Hospital from September 2020 to March 2021. Fear of childbirth was measured with a validated Chinese version of Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A). Based on the W-DEQ-A scores, the participants were divided into two groups: non-clinical parturiophobia group [<85 scores, including mild (≤37 scores), moderate (38-65 scores) and severe (66-84 scores) parturiophobia] and clinical parturiophobia group (≥85 scores). Rank-sum test, Chi-square test and t-test were used for univariate analysis. Multivariate binary logistic regression was used to analyze the factors associated with fear of childbirth and its relationship with preferred mode of delivery. Results:The detection rates of mild, moderate, severe and clinical parturiophobia were 18.8% (294/1 560), 44.9% (700/1 560), 31.1% (485/1 560) and 5.2% (81/1 560), respectively. Multivariate binary logistic regression showed that the participants who were supported by relatives and friends to have cesarean section ( OR=3.45, 95% CI: 1.29-9.22) or had antenatal anxiety ( OR=4.73, 95% CI: 2.49-8.97) were more likely to have clinical parturiophobia, while those with planned pregnancy ( OR=0.49, 95% CI: 0.29-0.82), high intensity physical activity ( OR=0.36, 95% CI: 0.18-0.72) or better/well understanding of the delivery process ( OR=0.42, 95% CI: 0.19-0.97) were less likely to develop clinical parturiophobia (all P<0.05). Compared with the non-clinical parturiophobia women, those with clinical parturiophobia were more likely to choose cesarean section ( OR=2.15, 95% CI: 1.22-3.78, P=0.008). Conclusions:The detection rates of severe and clinical parturiophobia are 31.1% and 5.2% in Changning District, Shanghai. The associated factors mainly include the attitudes of relatives and friends towards the mode of delivery, antenatal anxiety, planned pregnancy or not, physical activity level and the understanding of delivery process. Clinical parturiophobia might be an important factor for cesarean section on maternal request.

Background: and Purpose Previous studies suggested increased visit-to-visit variability of total cholesterol (TC) is associated with stroke. This study aimed to investigate the associations of various lipids measurements variability and the risk of stroke and stroke type (ischemic and hemorrhagic stroke). Methods: Fifty-one thousand six hundred twenty participants in the Kailuan Study without history of myocardial infarction, stroke, and cancer who underwent three health examinations during 2006 to 2010 were followed for incident stroke. Variability in TC, triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) measurements were measured using the coefficient of variation (CV), standard deviation (SD), variability independent of the mean (VIM), and average real variability (ARV). Results: During a median of 6.04 years of follow-up, 1,189 incident stroke (1,036 ischemic and 160 hemorrhagic stroke) occurred. In the multivariable-adjusted model, the hazard ratio (HR) comparing participants in the highest versus lowest quartile of CV of HDL-C were 1.21 (95% confidence interval [CI], 1.02 to 1.45; P for trend=0.013) for ischemic stroke. The highest quartile of CV of LDL-C was associated with 2.17-fold risk of hemorrhagic stroke (HR, 2.17; 95% CI, 1.25 to 3.75; P for trend=0.002) compared with the lowest quartile. We did not observe any significant association between TC and triglycerides variability with any of stroke. Consistent results were obtained when calculating variability index using SD, VIM, or ARV. Conclusions These findings suggest the high visit-to-visit HDL-C and LDL-C variability were associated with an increased incidence of ischemic and hemorrhagic stroke, respectively.

Objective To establish a specialized division of labor system for cerebrovascular disease clinical research and verify the effectiveness of specialized division of labor system in the management of cerebrovascular disease clinical research.Methods Using Delphi method to establish the specialized division of labor system of clinical research,identify personnel responsibilities,access mechanism and access standards.Compare two clinical studies that using and not using this system in terms of clinical research management efficiency,effectiveness of the clinical research progress and quality control.Results Specialized division of labor system can reduce the time spent for research design and preparation,improve the research progress and data integrity,reduce the protocol deviation and the loss of subject follow up.Conclusions Specialized division of labor system can improve the efficiency of clinical research management and improve the research progress and quality.

ObjectiveTo further assess the safety of clinical application of Shujin Jianyao pills after marketing and find its potential risk factors as early as possible， to obtain the real world medication situation of Shujin Jianyao pills and its incidence of adverse reactions and clinical characteristics， and to explore the factors affecting the occurrence of adverse drug reactions （ADR）. MethodIn this study， prospective， large-sample， multi-center and intensive whole-hospital monitoring with continuous registration was carried out， combined with telephone follow-up visits 2-4 weeks after the end of medication， for whole treatment course monitoring among patients. In addition， the three-level quality control was strictly implemented in the monitoring process. The study used a proprietary electronic data management system for data management， and SAS 9.4 and R software were used for statistical analysis. ResultFrom May 2018 to July 2020， the study completed the safety monitoring of 3 033 patients taking Shujin Jianyao pills in 30 clinical departments of 25 hospitals in China. A total of 36 ADR cases （49 times） were confirmed by expert assessment on data and supervision quality and expert interpretation of ADR. ConclusionAccording to the World Health Organization （WHO）， the symptoms of adverse reactions were mainly classified into occasional adverse reactions （0.1%≤ADR<1%： abdominal distension， oral ulcer， dry mouth， constipation） and rare adverse reactions （0.01%≤ADR<0.1%： loss of appetite， rash， fatigue， increased ALT， increased creatinine， dizziness， stomachache， stomach distension， liver discomfort， pruritus， dysphoria， acid regurgitation， numbness in mouth， abdominal pain， sore throat， earache， tinnitus）. Moreover， through the synthetic minority oversampling technique （SOMTE） combined with logistic regression， the following factors might affect ADR： taking Shujin Jianyao pills for 1-14 days， aged 46-65， 66-80 and 81 and above as well as combined use of atorvastatin， cobamamide， calcitriol capsules， Gushukang capsules， glucosamine， nifedipine， methylcobalamin， metformin， Tenghuang Jiangu pills， Bugu tablets， and diclofenac sodium sustained-release tablets. This study provided a real world basis for the safety and standardized use of Shujin Jianyao pills in clinical practice.

INTRODUCTIONHead and neck squamous cell carcinoma (HNSCC) is a common cancer worldwide and has a poor prognosis. A biomarker predicting the clinical outcome of HNSCC patients could be useful in guiding treatment planning. Overexpression of the T lymphoma invasion and metastasis 1 (Tiam1) protein has been implicated in the migration and invasion of neoplasms. However, its role in HNSCC progression needs to be further validated. We detected the expression of Tiam1 in normal and tumor tissues and determined its association with clinical outcomes in patients with HNSCC.

METHODSWe measured the expression of Tiam1 in normal and cancerous tissue samples from the patients with HNSCC treated at Sun Yat-sen University Cancer Center between 2001 and 2008. The Tiam1 expression was scored from 0 to 12 based on the percentage of positively stained cells and the staining intensity. We then determined the diagnostic performance of this score in predicting overall survival (OS) and disease-free survival (DFS).

RESULTSOf the 194 evaluable patients, those with advanced disease, lymph node metastasis at diagnosis, and recurrence or metastasis during follow-up had a higher tendency of having high Tiam1 expression as compared with their counterparts (P < 0.05). The proportion of samples with high Tiam1 expression was also higher in cancerous tissues than in non-cancerous tissues (57.7% vs. 13.9%, P < 0.001). Cox proportional hazards regression analysis revealed that Tiam1 expression scores of 5 and greater independently predicted short OS and DFS.

CONCLUSIONThe Tiam1 expression is shown as a promising biomarker of clinical outcomes in patients with HNSCC and should be evaluated in prospective trials.

Adult ; Aged ; Biomarkers, Tumor ; metabolism ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; secondary ; Disease Progression ; Female ; Follow-Up Studies ; Guanine Nucleotide Exchange Factors ; metabolism ; Head and Neck Neoplasms ; diagnosis ; pathology ; secondary ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Predictive Value of Tests ; Prognosis ; ROC Curve ; Retrospective Studies ; Survival Analysis ; T-Lymphoma Invasion and Metastasis-inducing Protein 1