Objective:To investigate the volatile constituents in Folium isatidis. Methods:The volatile constituents from Folium isatidis were analyzed by head-space solid micro-extraction coupled with GC-MS for the first time. Results: Thirty-five compounds (89. 95%) were identified from the volatile constituents in Folium isatidis. The main volatile constituents of Folium isatidis were 6, 10, 14-trimethyl-2-pentadecanone (6. 32%), nonanal (5. 99%), phenethyl isothiocyanate (5. 79%) and palmitic acid (5. 62%). Conclusion:Palmitic acid and benzyl alcohol may be the main effective constituents in Folium isatidis.

ObjectiveTo evaluate the app li cation value of the Dipstick Dye Immuno assay (DDIA) for screening chemotherapy targets of schistosomiasis in a lower endemic area. Methods[ WT5”BZ]In a lower endemic area of schistosomiasis a random sample of 463 individuals from a natural village were examined using miracidium hatching metho d, Kato Katz's method, DDIA, DGS COPT and ELISA. The positive rates of these a ss ays were compared. ResultsThe positive rate of stool examination was 3.9% in 463 individuals. The positive rate of DDIA was 15 8%. The positive rate in 18 stool positive subjects was 94 4% with Youden In dex 0 81. The positive rate of DGS COPT was 8 9% . The positive rate in 18 stool po sitive subjects was 72 2% with Youden Index 0 66. The positive rate of ELISA w as 18 4%. The positive rate in 18 stool positive subjects was 83 3% with Youden In dex 0 68. ConclusionDDIA was more suitable for application in screening target population in lower endemic areas than other im munoassys.

Objective:This study aimed to establish a mouse model of breast cancer by inoculating human breast cancer cells into mice with normal immune function. Methods:Forty female BALB/C mice were randomized into four groups, with 10 mice in each group. The four groups were established according to the dosage of cyclophosphamide and prednisone, namely, the control group, low dose group, medium dose group, and high dose group. The mouse models of breast cancer were established by injecting human breast cancer cells into the fat pad of the right second breast of mice in the groups. Mice in the four groups were observed based on the time of tumorigenesis, rate of tumor formation, tumor imaging and pathological features, and metastasis of vital internal organs. Results:In the high dose group, the time of tumor formation was lower than that of the other groups, but the rate of tumor formation was high. Some visceral metastases occurred in the mice. By contrast, the medium dose group revealed completely opposite results. No death and tumor formation in both the control and low dose groups were reported. Conclusion:A human breast carcinoma model in mice was successfully established. Using this model, the onset and development of breast cancer could be much better imitated in the normal immune system of mice.

Objective: To explore the impact of echocardiographic parameter of diastolic dysfunction (E/A) on the recurrence of atrial ifbrillation (AF) in patients after catheter ablation.
Methods: We retrospectively studied 277 consecutive AF patients with circumferential pulmonary vein ablation (CPVA) in our hospital. According to E/A ratio, the patients were divided into 3 groups: Normal group, the patients with 0.75< E/A<2, n=203, Mild abnormal group, E/A≤0.75, n=53 and Severe abnormal group, E/A>2, n=21. The late AF recurrent rates were compared among different groups. The patients were divided into another 2 groups upon AF recurrence after CPVA: Recurrent group, n=57 patients with atrial arrhythmia lasted more than 30 seconds at 3 months after CPVA and Non-recurrent group, n=220. The clinical conditions were compared between 2 groups.
Results: The patients were followed-up for (374 ± 276) days. The AF recurrent rate in Severe abnormal group was 33.3%, in Mild abnormal group was 23.5% and in Normal group was 18.5%, P>0.05. The E/A ratio in Recurrent group was 1.22 ± 0.54, in Non-recurrent group was 1.19 ± 0.49, P=0.653. Univariate analysis indicated that the risk factors for AF recurrence included LVEDD and gender, not E/A ratio (P=0.236). Cox multivariate analysis indicated that with adjusted gender, hypertension, diabetes, LVEDD and LVESD, abnormal E/A ratio was the predictor for late AF recurrence (HR 2.29, 95%CI 1.01-5.19, P=0.046). With further adjusted LVEDD and E/A, the severe abnormal E/A ratio was still the predictor for AF recurrence (HR 2.27, 95%CI 1.01-5.12, P=0.047).
Conclusion: E/A ratio was the important predictor for AF recurrence in patients after CPVA.

Background and purpose:Microsatellite instability (MSI) status is commonly applied to predict the prognosis and chemosensitivity in stage Ⅱ and stage Ⅲ colorectal cancer patients. However, researches of its function on metastasis colorectal cancer are limited. This study investigated its value on prognosis and chemosensitivity in metastatic colorectal cancer (CRC) patients.Methods:We retrospectively investigated tumor tissues from metastasis CRC patients who were treated with oxaliplatin and 5-FU-based therapy regimens (FOLFOX and XELOX). Immunostaining of proteins of the mismatch repair genehMLH1,hMSH2,hMSH6 andhPMS2 was performed. Prognostic value and chemosensitivity in patients with MSI status were also determined.Results:Clinical features from 113 patients were analyzed. No cor-relation of overall survival (OS) and chemosensitivity with MSI status was found. We further investigated 79 patients with synchronous metastasis and palliatively tumor resection. Median progression free survival (PFS) from 22 MSI patients was significant longer than that in 57 MSS patients (19.9 monthsvs 7 months,P=0.005). No significant difference was seen in OS comparison (P=0.07). MSI status was also an independent prognostic factors of PFS by Cox multivariate analysis (MSS/MSI,HR=2.079,P=0.043). Moreover, in this group, MSI patients had improved disease control rate (59.1%vs 31.6%, P=0.025) in chemosensitivity analysis than MSS patients.Conclusion:A better PFS in MSI patients with synchronous metastasis and palliative tumor resection was found after treated with oxaliplatin and 5-FU-based therapy and a better chemosensitivity in MSI patients was also found.

OBJECTIVE To investigate whether stromal cell-derived factor-1α (SDF-1α) might be able to prevent senescence of endothelial stem cell (ESC) and also study its effects on the telomerase activity. METHODS Total mononuclear cells (MNCs) were isolated from peripheral blood by density gradient centrifugation, and then the cells were plated on fibronectin-coated culture dishes. After cultured for 4 d, attached cells were divided into control and SDF-1α 1, 10, 50 and 100 μg·L~(-1) groups. ESC became senescent as determined by acidic β-galactosidase staining. The proliferation of ESC was assessed by MTT assay and colony-forming capacity. Telomerase activity was measured by telomerase-PCR ELISA and the phosphorylation of Akt was determined by using Western blotting. RESULTS Ex vivo prolonged cultivation of ESC led to rapid onset of ESC senescence. Compared with control group, SDF-1α concentration-dependently inhibited the onset of ESC senescence, maximum at 100 μg·L~(-1) (40.8±7.1 vs 17.5±3.0; P<0.01). Moreover, SDF-1α 100 μg·L~(-1) increased ESC proliferation (0.22±0.02 vs 0.39±0.04; P<0.01) and ESC colony-forming activity (7.8±2.2 vs 22.4±3.4). Compared with control group, SDF-1α 100 μg·L~(-1) also increased telomerase activity (0.34±0.05 vs 0.57±0.09; P<0.01). In addition, SDF-1α treatment of ESC stimulated a concentration- and time-dependent Akt phosphorylation. CONCLUSION SDF-1α-induced prevention of ESC senescence leads to the potentiation of proliferative activity, and clonal expansion, which may be related to the activation of telomerase and Akt phosphorylation.

Objective To investigate the feasibility and accuracy of dual energy CT myocardial iodine maps in detecting acute myocardial infarction in canine model. Methods Myocardial ischemia model was made by ligaturing left anterior descending coronary arteries (LAD) after thoracotomy in six dogs, while another 3 dogs undergoing thoracotomy not ligaturing LAD as control group. Before and three hours after operation, dual-source CT (DSCT) was performed, followed by resting 99Tcm-MIBI single photon emission computed tomography myocardial perfusion imaging. Then, dogs were sacrificed, and the hearts were removed, triphenyltetrazolium chloride staining and conventional HE staining were performed. CT number of non-ischemic and ischemic regions were measured and analyzed. The wall of the left ventricle in the short axis was divided into 17 segments, the segments of myocardial perfusion defect in DSCT myocardial iodine maps, SPECT, and pathology were determined. Student t test was used to analyze the difference of CT number between infarcted and non-infarcted myocardium. Kappa test was used for the accuracy of DSCT myocardial iodine maps and SPECT in detecting myocardial ischemia according to the pathological results. Results No abnormal regions were detected using DSCT myocardial iodine maps in preoperative control and infarction group. After thoracotomy, partial sparse or defective perfusion was consistently noted in six dogs' apical anterior and partition wall in both DSCT myocardial iodine maps and SPECT. In the infarcted group, the attenuation of infarction region (34.75 ± 16.66) HU was significantly decreased compared with preoperative measurements ( 123. 18 ± 15.38 ) HU ( t = 10. 526, P ＜ 0. 01 ); decreased perfusion in the infarcted region was also noted in the DSCT myocardial iodine maps and SPECT. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of DSCT myocardial iodine maps and SPECT were 85.0% (34/40) , 84. 1% (95/113) ,65.4% (34/52) ,94. 0%(95/101) ,and 82. 5% (33/40), 90. 3% ( 102/113 ) ,75.0% (33/44) ,93.6% ( 102/109 ), respectively.Kappa values were 0. 63 and 0. 71 for the agreement of DSCT myocardial iodine maps and SPECT.Conclusion DSCT myocardial iodine maps is comparable diagnostic accuracy with rest SPECT myocardial perfusion imaging in detection of acute myocardial infarction in a canine model.

Axillary interventions, represented by axillary lymph node dissection (ALND), has been a key component in radical surgeries for breast cancer since the proposal of radical mastectomy. ALND substantially affects the quality of life of the patients. In recent years, many studies suggested that axillary interventions may not be necessary for all breast cancer patients, and for early early-stage patients, it brings more harm than benefit. Sentinel lymph node biopsy (SLNB) has provided good guidance to indicate the necessity of ALND, but several studies revealed that not all patients with positive SLNB results benefited from ALND. In this review, the authors summarize the recent progress of researches of these two hot issues.
Axilla ; Breast Neoplasms ; surgery ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; Quality of Life ; Sentinel Lymph Node Biopsy

Objective:To evaluate the efficacy of esketamine combined with different doses of remimazolam for induction of general anesthesia in pediatric patients.Methods:One hundred and sixty pediatric patients of either sex, aged 3-6 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, with body mass index of 13-20 kg/m 2, undergoing elective general anesthesia under a laryngeal mask, were divided into 4 groups ( n=40 each) by the random number table method: esketamine combined with propofol group (KP group) and esketamine combined with different doses of remimazolam group (0.2, 0.3, 0.4 mg/kg) groups (KR1 group, KR2 group, KR3 group). Esketamine 0.8 mg/kg was intravenously injected in the preanesthesia room. After entering the operating room, propofol 2.5 mg/kg was intravenously injected in KP group, and remimazolam 0.2, 0.3 and 0.4 mg/kg were intravenously injected in KR1, KR2 and KR3 groups, respectively. When the child lost consciousness and the Modified Observer′s Assessment of Alertness/Sedation Scale score<1, sufentanil and mevacurium were intravenously injected. When the Modified Observer′s Assessment of Alertness/Sedation Scale score≥1, rescue sedation was performed, and 3 min later the laryngeal mask airway was inserted. The onset time of sedation, response to laryngeal mask airway placement, rescue sedation, hypotension, tachycardia, bradycardia, bucking, hiccup, injection pain and apnea were recorded, and the increase rate of perfusion index (PI) was calculated. Results:No response to laryngeal mask implantation occurred in the four groups. Compared with KP group, the onset time of sedation was significantly prolonged, the incidence of hypotension, bradycardia, injection pain and apnea was decreased, the incidence of tachycardia was increased, and the increase rate of PI was decreased in KR1, KR2 and KR3 groups, and the rate of rescue sedation and incidence of bucking were increased in KR1 and KR2 groups ( P<0.05). Compared with KR1 group, the onset time of sedation was significantly shortened in KR2 group and KR3 group, and the rate of rescue sedation and incidence of bucking were decreased in KR3 group ( P<0.05). Compared with KR2 group, the onset time of sedation was significantly shortened, and the rate of rescue sedation was decreased in KR3 group ( P<0.05). There was no significant difference in the increase rate of PI, hypotension, bradycardia, tachycardia, injection pain and apnea among KR1, KR2 and KR3 groups ( P>0.05). There was no significant difference in the incidence of hiccup among the four groups ( P>0.05). Conclusions:Esketamine 0.8 mg/kg combined with remimazolam 0.4 mg/kg can be safely and effectively used for anesthesia induction and has milder inhibition of respiration and circulation as compared with esketamine combined with propofol in pediatric patients.

Objective To evaluate the effects of locked plates with different screw layouts on stability of the internal fixation system for femoral shaft fracture, so as to provide guidance for clinical study on screw layout of the internal fixation system for femoral shaft fracture. Methods Orthogonal test design method was used with 4 groups of screws at 3 parametric levels. Biomechanical properties of the internal fixation system for femoral shaft fracture under 9 screw layouts were analyzed respectively by the finite element method, and 4 inspection indices, namely, the maximum equivalent stress of the plate, the screw and the femur, and the maximum axial displacement of the internal fixation system were obtained from each group of the experiment, and the orthogonal test weight matrix analysis method was conducted for data analysis. Results The influences of different screw parameters on stability of the internal fixation system varied, and the maximum weights of the 4 sets of screw parameters in stability of the internal fixation system were 13.86%, 7.57%, 7.53% and 5.91%, respectively. Conclusions The best scheme for screw layout in orthogonal test is the screw with none-fixed threaded holes in the first group, the single cortical screws with fixed threaded holes in the second group and the double cortical screws with fixed threaded holes in the third and fourth group.