Objective To explore the effects of cyclophosphamide administered by different routes or in different doses on the embryo-fetal development in pregnant rabbits, and to determine the optimal mode of cyclophosphamide administration to induce fetal malformation.Methods Pregnant rabbits were divided into control group C (saline), group Y1 (intravenous injection of 15 mg/kg cyclophosphamide,), group Y2 (subcutaneous injection of low dose cyclophosphamide, 20 mg/kg), and group Y3 (subcutaneous injection of high dose cyclophosphamide, 30 mg/kg).Each rat was administrated according to the corresponding mode once daily on GD10~13.The day of conception was designated as GD0.The pregnant rabbits were sacrificed and dissected on GD28.Then, the number of corpora lutea and implantation, the weight of uterus with contained fetus, and fetal resorption rate were detected, the fetuses were removed and the fetal sex, body length, tail length, the number of live births and stillbirths were recorded, and the appearance of deformities, visceral deformities and skeletal malformations were detected.Results Pregnant rabbit fetuses in the cyclophosphamide intravenous injection group and subcutaneous injection of low dose cyclophosphamide group showed deformities.The appearance malformation rates in the two groups were 30.77% and 95.65%, the skeletal deformity rates were 7.69% and 73.91%, and the visceral abnormality rates were 20.51% and 47.83%, respectively.The fetal resorption rate in the high dose cyclophosphamide subcutaneous injection group was 100%.Conclusions Subcutaneous injection of 20 mg/kg cyclophosphamide to pregnant rabbits at GD10~13 can be used as a positive administrationmethod for rabbit embryo-fetal developmental toxicity test.Thismethod has the advantages of short administration period, easy operation, few fetus resorption, and high rate of fetal malformation, thus, providing the evidence for selection of appropriate model of rabbit embryo-fetal developmental toxicity.

Objective To investigate the clinical application of pedicle screw placement technique for pelvic external fixation.Methods A retrospective review was made on 63 patients (37 males and 26 females;23-67 years of age) managed with anterior or combined anterior and posterior external fixation of pelvic fracture between February 2011 and May 2014.According the ways of screw insertion,the study was divided into two groups:observation group (screw was inserted using the pedicle screw placement technique,n =36) and control group (screw was inserted directly,n =27).Tile fracture classification was 11 patients with type B1,7 type B2,7 type B3,5 type C1,3 type C2 and 3 type C3 in observation group,and 9 patients with type B1,7 type B2,4 type B3,4 type C1,2 type C2 and 1 type C3 in control group.Operation time,rate of the penetration,X-ray fluoroscopy times,screw loosening rate,and postoperative complication rate were documented.Radiologic evaluation of the pelvis was detected with the Matta' s criteria.At the final follow-up,functional evaluation of the pelvis was evaluated with the score proposed by Cole et al.Results Period of follow-up was (14.7 ± 3.2)months in observation group and was (13.8 ± 3.1) months in control group.A total of 190 screws were placed in observation group and 138 screws in control group.Better results were found in observation group than in control group with respect to operation time [(18.8 ± 4.1) min vs.(22.6 ± 5.4) min],rate of the penetration (1.6％ vs.8.7％),X-ray fluoroscopy times (1.6 ± 0.8 vs.2.2 ± 0.9),and screw loosening rate (1.6％ vs.6.5％).There were no significant difference between observation and control groups in percentage of good to excellent reduction(89％ vs.85％) and function score [(35.6 ±3.0) points vs.(34.8 ± 3.9) points] (P ＞ 0.05).After operation,3 patients with lateral femoral cutaneous nerve paralysis and none with wouud infection were found in observation group;3 patients with lateral femoral cutaneous nerve paralysis and one patient with wound infection were found in control group.Conclusion Either the pedicle screw placement technique or conventional technique achieves satisfactory clinical effect,but the former owns better results in operation time,screw insertion accuracy,fluoroscopy frequency and rate of screw loosening,suggesting a fast,safe,and effective screw placement method in pelvic external fixation that should be widely applied.

Objective To explore the efficacy of group cognitive behavioral therapy for improving depressive symptoms and social functional in patients with major depressive disorder.Methods A total of 160 patients with major depressive disorder were randomly divided into intervention group (n=80) and control group (n=80).Intervention group was treated with conventional antidepressants combined with group cognitive behavioral therapy.Control group was treated with one conventional antidepressants.All participants were assessed with Hamilton Depression Scale (HAMD)and Scale of Social function of Psychosis Inpatients (SSFPI) before and 8 weeks after the treatment.Results After 8 weeks treatment,the scores of HAMD (14.76±9.48) was significantly reduced and the scores of SSFPI(30.09±4.34) were significantly increased in intervention group compared with the baseline ((37.91± 10.58),(12.40±2.56),all P＜0.01).The scores of HAMD were significantly lower and the scores of SSFPI were significantly higher in intervention group than that in control group((20.71±7.85),(22.63±3.63),all P＜0.01).Conclusion Group cognitive behavioral therapy is effective for major depressive disorder patients by reducing depressive symptom and improving social function.

Studies show that serum alkaline phosphatase (ALP) can be used not only to evaluate cholestasis, but also as a surrogate marker to assess the severity of primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), and several cholestatic liver diseases. This article introduces the mechanisms of action of liver ALP in the healthy population and patients with cholestatic liver disease. In case of cholestasis caused by inflammation, acidic environment and relocation of the bile capillaries cause liver ALP deactivation and an increased accumulation of lipopolysaccharide and thus lead to aggravation and delayed healing. In the treatment of PBC and PSC, promoting the restoration of hepatocyte polarity and the elimination of bile acid through the bile capillaries and using drugs capable of adjusting the pH of bile can achieve a good anti-inflammatory effect. The effect of oral intestinal ALP in the treatment of cholestatic diseases awaits further investigations in laboratories and in clinical practice.

This paper studies the vein extraction technique based on the susceptibility weighted imaging (SWI) and introduced an improved self-adaptive threshold method based on the vessel enhancing diffusion. The approach employs the combination indicator of the local gray character, the global gray character and the tubular information of the vein. It first applies the vessel enhancing diffusion filter to enhance the continuity of the vein, increases the detection rate of tiny vein and suppresses the nucleus areas. And then it uses the improved self-adaptive threshold method to extract the vein. The results demonstrate that this approach can solve the problem above and extract the vein from the SWI image accurately.
Cerebral Veins ; anatomy & histology ; pathology ; Diffusion Magnetic Resonance Imaging ; methods ; Humans ; Image Enhancement ; methods ; Imaging, Three-Dimensional

Objectives To observe the clinical curative effect of Wuzhuyu acupoint on the treatment of gastrointestinal dysfunction in severe patients. Methods A total of 60 patients with gastrointestinal dysfunction were randomly divided into treatment group and control group, 30 patients in each group. The control group was treated with routine western medicine, and the treatment group was given the acupoint application of Wuzhuyu on the basis of routine treatment. The treatment last 7 days. The clinical efficacy was evaluated by observing bowel sounds recovery time, exhaust time and defecating time, enteral nutrition tolerability, gastrointestinal dysfunction score and acute physiology and chronic health evaluation (APACHE Ⅱ). Results The treatment group showd significantly shorter bowel sound recovery time and anal exhaust time than the control group (t value were 8.811, 5.538, 8.908, all P value <0.01). The enteral tolerance rate was 80.0％ (24/30), and the control group tolerance rate was 53.3％ (16/30). The tolerance rate of treatment group was significantly higher than that of control group (χ2=4.720, P=0.030). The Gastrointestinal dysfunction score and APACHE Ⅱ score in treatment group were significantly lower than control group (t value were 3.873,2.805,all P value <0.01). Conclusions The acupoint application of Wuzhuyu can promote the recovery of gastrointestinal function, increase the tolerance of enteral nutrition, and reduce the severity of the patient's condition and improve the prognosis of patients.

Objective To establish an early prediction model for the diagnosis of severe acute pancreatitis based on the improved machine learning models,and to analyze its clinical value.Methods A case-control study was conducted on 352 patients with acute pancreatitis admitted to the Gastroenterology and Hepatobiliary Surgery Departments of the Army Medical Center of PLA and Emergency and Critical Care Medicine Department of No.945 Hospital of Joint Logistics Support Force of PLA from January 2014 to August 2023.According to the severity of the disease,the patients were divided into the severe group(n=88)and the non-severe group(n=264).The RUSBoost model and improved Archimead optimization algorithm was used to analyze 39 routine laboratory biochemical indicators within 48 h after admission to construct an early diagnosis and prediction model for severe acute pancreatitis.The task of feature screening and hyperparameter optimization was completed simultaneously.The ReliefF algorithm feature importance rank and multivariate logistic analysis were used to analyze the value of the selected features.Results In the training set,the area under curve(AUC)of the improved machine learning model was 0.922.In the testing set,the AUC of the improved machine learning model reached 0.888.The 4 key features of predicting severe acute pancreatitis based on the improved Archimedes optimization algorithm were C-reactive protein,blood chlorine,blood magnesium and fibrinogen level,which were consistent with the results of ReliefF algorithm feature importance ranking and multivariate logistic analysis.Conclusion The application of improved machine learning model analyzing the laboratory examination results can help to early predict the occurrence of severe acute pancreatitis.

OBJECTIVETo investigate the expression level of SET gene in patients with acute myeloid leukemia (AML) and evaluate its significance.

METHODSThe expression level of SET gene in 141 de novo AML patients was determined by real time quantitative PCR (RQ-PCR), and its relationship with the clinical features and outcomes of these patients were analyzed.

RESULTSSET gene transcript level was detected in 141 AML patients with the median expression level of 0.86(range 0.02-15.69). AML patients with higher SET gene expression had a higher level of white blood cell (WBC ≥ 100 × 10⁹/L) count than of lower SET gene expression ones (31.0% vs 11.4%, P=0.005). In the 136 patients who received treatment after diagnosis, higher SET gene expression group had lower complete remission rate (50.0%) than of lower expression cohort (73.5%) after two cycles of chemotherapy (P=0.005). Survival analysis showed that patients with higher SET gene expression had significantly shorter overall survival(OS) (10 months vs 22 months, P=0.001) and event-free survival (EFS) (2 months vs 14 months, P=0.005) than of lower SET gene expression ones. Multivariate COX regression analysis showed SET overexpression was an independent prognostic factor for OS. In the patients with the normal karyotype, higher SET expression group also had significantly shorter OS (12 months vs 35 months, P=0.010) and EFS (4 months vs 14 months, P=0.026) than of lower SET expression ones.

CONCLUSIONHigh expression of SET gene was associated with poor prognosis and might be a prognostic molecular marker of AML.

Disease-Free Survival ; Gene Expression Regulation, Neoplastic ; Histone Chaperones ; genetics ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Prognosis ; Remission Induction ; Transcription Factors ; genetics

OBJECTIVETo explore the clinical significance of ten-eleven-translocation methylcytosine dioxygenase 2 (TET2) mRNA expression levels in adult acute myeloid leukemia patients with normal cytogenetics (CN-AML).

METHODSExpression levels of TET2 mRNA were measured by real-time PCR in 157 adult CN-AML, and its clinical impact in CN-AML was evaluated as well.

RESULTSTET2 gene expression levels from bone marrow mononuclear cells (BMMNCs) [7.29(3.41-9.99)] and CD34+ cells [6.02(5.64-6.54)] in CN-AML were significantly lower than those [BMMNCs: 8.13(6.68-9.04), P=0.026; CD34+ cells: 6.48(5.97-7.12), P=0.034] in healthy control. And TET2 mRNA level at diagnosis [7.32(6.11-8.41)] was obviously lower than that at complete remission [8.39(7.76-8.79), P<0.01]. CN-AML patients with lower levels of TET2 mRNA showed worse survival rate [(32.7±5.9)%] at 18-month than those with higher levels [(48.6±6.9)%, P=0.041]. In multivariate analysis, lower level of TET2 mRNA was an independent prognostic factor for OS [hazard ratio(HR)2.032, 95% confidence interval (CI)1.272-3.247, P=0.003] and event-free survival [HR 1.532, 95% CI 1.014-2.314, P=0.043].

CONCLUSIONThe level of TET2 mRNA is significantly lower in patients with CN-AML and it is an independent negative prognostic factor. TET2 could be an important factor for the molecular-based risk stratification in CN-AML.

Adult ; Cytogenetic Analysis ; Cytogenetics ; DNA-Binding Proteins ; genetics ; Disease-Free Survival ; Gene Expression ; Gene Expression Profiling ; Gene Expression Regulation, Neoplastic ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Proto-Oncogene Proteins ; genetics ; Real-Time Polymerase Chain Reaction

At present， there is a lack of unified and standardized management for the rational use of national key monitoring drugs. According to the relevant requirements of the state， based on the relevant literature published at home and abroad in recent years and combined with the management practice of many medical institutions across the country on the national key monitoring drugs， in order to make the national key monitoring drugs more reasonable use and standardized management in medical institutions at all levels， the Clinical Pharmacy Branch of the Chinese Medical Association， the Pharmaceutical Epidemiology Special Committee of the Chinese Pharmaceutical Association and the Pharmaceutical Epidemiology Special Committee of the Sichuan Pharmaceutical Association organized experts to fully discuss， and to form this management standard. This standard mainly provides relevant opinions and suggestions on the basic principles of rational use of key monitoring drugs and the regulatory measures for key monitoring drugs， especially on how to strengthen the pharmaceutical management and use management of key monitoring drugs， further promoting the standardized use of key monitoring drugs.