Objective To investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) of right hemisphere on the rehabilitation of aphasia in patients with acute cerebral infarction. Methods Forty right-handed patients with acute cerebral infarction on the left hemisphere complicated with aphasia were randomly allocated into either a treatment group (n=20) or a control group (n=20). There was no significant difference in the ages between the patients in both groups. They all received routine drug treatment and appropriate language training. The patients in the treatment group also received a course of low frequency rTMS at language area of right hemisphere 7 days after the symptom onset, once a day for 10 days. Their language function was evaluated by the Aphasia Battery in Chinese (ABC) before and after the treatment, and at day 90 after the onset. The National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI) were used to evaluate their overall neurological function and activities of daily living. Results There were no significant differences in the ABC, NIHSS and BI scores between the control group and the treatment group before and after rTMS; at day 90 after the onset, the ABC scores were improved significantly in the treatment group (P＜ 0.05), however, there was still no significant difference between the NIHSS and BI scores.There were significant differences between the ABC scores before and after the rTMS in the treatment group (P＜0.01), and there was no significant difference between the NIHSS and ABC scores, however, the 3 scores were improved more significantly than those before and after the treatment at day 90 after the onset (P ＜0.01). There were no significant difference in the 3 scores before and after the treatment in the control group, and at day 90 after the onset the 3 scores were improved more significantly than those before and after rTMS (P＜0.01).Conclusions The early low-frequency rTMS of the right hemisphere contributes to the rehabilitation of language function in patients with acute cerebral infarction complicated with aphasia.

OBJECTIVETo study the clinicopathologic features of acquired immunodeficiency syndrome (AIDS)-related lymphadenopathy and to elucidate the salient features helpful in achieving a correct pathologic differentiated diagnosis.

METHODSEighteen cases of AIDS-related lymphadenopathy were retrieved from the files of the First Affiliated Hospital of Guangxi Medical University from 2001 to 2004. Histochemical stains, including periodic acid-Schiff, acid-fast, Giemsa, Grocott stains and immunohistochemistry (EnVision method), were used to detect the presence of pathogens in tissue sections and classify them.

RESULTSFifteen of the 18 cases (83%) were stage 4 (i.e. follicular and lymphocytic depletion). Twelve cases were co-infected with Penicillium marneffei and 4 other cases with Mycobacterium, and no pathogen was found in 1. The remaining patient was complicated with diffuse large B-cell lymphoma.

CONCLUSIONSWhen presented in early stages, AIDS-related lymphadenopathy may be overlooked, especially in routine pathology practice. Awareness of the entity in patients with persistent fever and generalized lymphadenopathy is thus crucial. Florid infection with Penicillium marneffei is also considered as an important predictor for underlying AIDS. Thorough understanding of morphologic features of AIDS-related lymphadenopathy, including possible co-infection, is essential in arriving at the correct diagnosis.

AIDS-Related Complex ; microbiology ; pathology ; AIDS-Related Opportunistic Infections ; microbiology ; pathology ; Adult ; Diagnosis, Differential ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphoma, AIDS-Related ; pathology ; Lymphoma, Large B-Cell, Diffuse ; pathology ; Male ; Middle Aged ; Mycobacterium ; isolation & purification ; Mycobacterium Infections ; microbiology ; pathology ; Mycoses ; microbiology ; pathology ; Penicillium ; isolation & purification ; Retrospective Studies

Prostate cancer (PCa) has become one of the common malignant diseases in elderly men, and its incidence is increasing year by year. Apart from surgery, radiotherapy and chemotherapy, immunotherapy, as with the programmed death receptor-1 (PD-1) or the programmed death ligand-1 (PD-L1) inhibitor, is a most promising new strategy for the treatment of PCa. PD-1 and PD-L1 inhibitors restore the activity of T cells by blocking the PD-1/PD-L1 signaling pathway in tumor cells, reverse the mechanism of tumor immune escape, recover the immune system and directly kill tumor cells. This review focuses on the current progress in the studies of PD-1 and PD-L1 inhibitors in the treatment of PCa.
B7-H1 Antigen/antagonists & inhibitors* ; Humans ; Immune Checkpoint Inhibitors/therapeutic use* ; Immunotherapy ; Male ; Programmed Cell Death 1 Receptor/antagonists & inhibitors* ; Prostatic Neoplasms/drug therapy* ; Signal Transduction

The incidence of placenta accreta (PA) is globally increasing. Accurate prenatal diagnosis of placental implantation and depth can significantly improve maternal outcomes. At present, ultrasound is the first choice for screening and diagnosis of PA, but contains some limits. As the promptly technologic advancing, MRI has become an important approach for diagnosing PA. The research progresses of MRI in diagnosis of PA were reviewed in this article.

Background Exposure to heavy metals has potential adverse impacts on human health, and the concentration of heavy metals in abandoned mining areas may still be higher than that in general areas, so the health risk assessment in such areas cannot be ignored. Objective To explore the health risk of heavy metal exposure and the spatial distribution characteristics of associated main metals in a typical abandoned mining area. Methods Environmental samples of irrigated soil, rice, and drinking water were collected from 13 natural villages under the jurisdiction of a township in Liuzhou, Guangxi from November to December 2019, where a typical abandoned mining was located. Finally, 13 irrigation soil samples, 11 rice samples, and 13 drinking water samples were collected. The concentrations of six metals and metalloid elements in each environmental sample were detected by inductively coupled-plasma mass spectrometry (ICP-MS), including cadmium (Cd), arsenic (As), lead (Pb), chromium (Cr), copper (Cu), and zinc (Zn). At the same time, 251 local residents were recruited for health risk assessment. Model parameters such as body weight, rice intake, and drinking water intake of local residents were obtained through field survey, and the median metal concentration of each environmental sample was taken as the risk assessment parameter of the region. The health risk of heavy metal exposure of local residents was assessed by using oral health risk assessment model of U.S. Environmental Protection Agency. The spatial distribution characteristics of health risks associated with heavy metals were evaluated by empirical Bayes interpolation method using Geographic Information System (GIS) technology. Results The positive rates of Cd, As, Pb, Cr, Cu, and Zn in the irrigated soil samples were 100.00%. The positive rate of Pb was 63.64% in the rice samples, while the rates of other metals were 100.00%. The positive rates of Cd, As, Pb, Cr, Cu, and Zn in the drinking water samples were 53.85%, 76.92%, 92.31%, 15.38%, 84.62%, and 100.00%, respectively. The results of non-carcinogenic risk assessment of oral exposure to heavy metals suggested that the contribution of heavy metals causing non-carcinogenic risk from high to low was As (70.52%) > Cd (18.03%) > Zn (6.63%) > Cu (4.12%) > Pb (0.64%) > Cr (0.06%), and the corresponding estimated non-carcinogenic risk values were 3.54 × 10⁰, 9.05 × 10⁻¹, 3.33 × 10⁻¹, 2.07 × 10⁻¹, 3.23 × 10⁻², and 5.42 × 10⁻⁴, respectively. The results of carcinogenic risk assessment of oral exposure to heavy metals suggested that the contribution of studied metals from high to low was Cd (87.00%) > As (10.24%) > Cr (2.60%) > Pb (0.16%), and the estimated carcinogenic risks were 4.35× 10⁻³, 5.12 × 10⁻⁴, 1.30 × 10⁻⁴, and 3.08 × 10⁻⁷, respectively. Rice was the leading media associated with non-carcinogenic risk and carcinogenic risk (99.4% and 99.8% respectively). The spatial distribution characteristics of GIS showed no obvious regularity in the distribution of As in irrigated soil, rice, and drinking water. In rice and irrigated soil, the content of Cd in the villages adjacent to the mining area was obviously higher than that in the other villages, while in drinking water, the content in the villages far away from the mining area was higher. Conclusion As and Cd are the main heavy metals that increase the health risk of local residents in a typical abandoned mining area, and the distribution characteristics of the two heavy metals in different environmental media are not completely consistent.

Autophagy represents one of the essential cellular mechanism to maintain homeostasis within cells, performing multiple biological functions during tumorigenesis. Base on the unique physicochemical properties of inorganic nanomaterials, supplemented by easy modification and targeting and so on, they could be used to regulate autophagy, controlling the occurrence and development of tumor and finally achieve treatment. This article primarily reviews the application of several representative inorganic nanomaterials, such as Gold nanoparticles, Silver nanoparticles, Iron oxide nanoparticles, Fullerene C60 nanomaterials, Graphene oxide nanomaterials in regulating autophagy of tumor cells and achieving treatment in recent years.

OBJECTIVE: To investigate the role of P53 and high mobility group protein 1 (HMGB1) protein expression in liver fibrosis stages in chronic hepatitis B patients.
 METHODS: According to the pathological grades, 103 patients were divided into 3 groups: no fibrosis group (n=18), low fibrosis group (n=49) or high fibrosis group (n=36). Serum HMGB1 levels were determined and receiver operating characteristic (ROC) curve was made based on the HMGB1 level and liver fibrosis score. Liver fibrosis model was developed by CCl4 in 60 male SD rats, which were sacrificed 6 or 12 weeks later. The degree of fibrosis was examined by Masson staining; HMGB1 and P53 protein expression were analyzed by Western blot; histone deacetylase (HDAC) activity, TNF-α, IL-1β and IL-6 levels in serum were measured.
 RESULTS: The serum levels of HMGB1 level in low and high fibrosis groups were significantly higher than that in no fibrosis group (P<0.01, respectively). ROC curve showed that serum HMGB1 in the diagnosis of hepatic fibrosis with cut off at 74 pg/mL, specificity at 65% and sensitivity at 87%. Compared with the control group, HMGB1 expression in both low and high fibrosis group was decreased in nucleus but was increased in cytoplasm, accompanied by the elevated P53 expression, increased HDAC activity and inflammatory cytokine levels (all P<0.01, respectively).
 CONCLUSION P53 and HMGB1 expression was significantly increased in chronic hepatitis B patients with liver fibrosis; serum HMGB1 level was positively correlated with the degree of liver cirrhosis and HMGB1 could be used as a sensitive and specific index for liver fibrosis prognosis.
Animals ; HMGB1 Protein ; metabolism ; Hepatitis B, Chronic ; metabolism ; pathology ; Humans ; Interleukin-1beta ; blood ; Interleukin-6 ; blood ; Liver Cirrhosis ; metabolism ; pathology ; Male ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; blood ; Tumor Suppressor Protein p53 ; metabolism

OBJECTIVETo study the efficacy and safety of Chinese drugs for expelling evil-wind, removing dampness, promoting blood circulation and invigorating yin in treating active rheumatoid arthritis (RA).

METHODSSixty-seven patients with active RA were randomized into 3 groups, the Group A, B and C. They were made coequal in terms of age, sex and condition of disease and treated respectively with basic treatment (non-steroid anti-inflammation drug combined with immune inhibitor) only, basic treatment + small dose prednisone, and basic treatment + Chinese herbal medicine, all for 8 weeks. The efficacy and adverse effects of treatment were analyzed by scoring.

RESULTSThe total effective rate was 20.0% (4/20) in Group A, 810% (17/21) in Group B and 85.7% (18/21) in Group C, the latter two were superior to the former one (P <0.01). Before treatment, comparison of disease activity score (DAS) among the three groups showed no significant difference (P > 0.05). After treatment, improvements of Ritchie arthritis index (RAI), number of swollen joint, erythrocyte sedimentation rate (ESR), general health (GH), and DAS were shown in Group B and C (P <0.05), while in Group A, improvement was only shown in GH (P <0.05). The difference of DAS between pre- and post-treatment was 0.25 +/- 0.77 in Group A, 0.87 +/- 0.60 in Group B and 0.92 +/- 0.59 in Group C, showing statistical significance between Group A vs B and A vs C (P = 0.0000). The total accumulative score of adverse reaction was 3.76 +/- 2.72 in Group C, 9.10 +/- 6.01 in Group A and 14.38 +/- 9.36 in Group B, also showing statistical significance among groups (P < 0.05).

CONCLUSIONThe combination of Chinese and Western medicine for active RA is effective and safe.

Adult ; Aged ; Arthritis, Rheumatoid ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

AIM: To analyze the diagnostic value of macular ganglion cell complex(mGCC)in primary glaucoma and explore the correlation between mGCC and peripapillary retinal nerve fiber layer(pRNFL)and visual field, in order to provide scientific reference for the diagnosis and treatment of primary glaucoma.

METHODS: Eighty eyes in 67 primary glaucoma patients admitted to our hospital from January 2015 to December 2016 were included in the observation group. Another 80 eyes in 40 healthy subjects in our hospital were included in the control group during the same period. The mGCC and pRNFL thicknesses of two groups were measured with an optical coherence tomography(OCT). The thickness of mGCC and pRNFL and visual field were compared between the two groups. The diagnostic value of mGCC for primary glaucoma was analyzed. The correlation between mGCC and pRNFL and visual field mean defect was detected.

RESULTS: The superior, inferior and average mGCC thickness in the observation group was significantly lower than that in the control group(P<0.05). The superior, inferior and average pRNFL thickness in the observation group were significantly lower than those in the control group, the difference was statistically significant(P<0.05). The visual field mean defect in the observation group was significantly higher than that in the control group, the difference was statistically significant(P<0.05). Pearson correlation analysis showed that there was a significant positive correlation between mGCC and pRNFL(r=0.58, P<0.01)and there was a significant negative correlation between mGCC and the average visual field defect(r=-0.69, P<0.01)in the observation group. ROC curve analysis showed that the intercept point value of mGCC in the diagnosis of primary glaucoma was 86.39μm. The sensitivity was 82.5% and the specificity was 76.25%.

CONCLUSION: The mGCC has a certain diagnostic value for primary glaucoma. There is positive correlation between mGCC and pRNFL and negative correlation between that and visual field mean defect.

BACKGROUND: The catheter-tissue contact force (CF) is one of the significant determinants of lesion size and thus has a considerable impact on the effectiveness of ablation procedures. This study aimed to evaluate the impact of CF on the lesion size during right ventricular outflow tract (RVOT) ablation in a swine model. METHODS: Twelve Guangxi Bama miniature male pigs weighing 40 to 50 kg were studied. After general anesthesia, a ThermoCool SmartTouch contact-sensing ablation catheter was introduced to the RVOT via the femoral vein under the guidance of the CARTO 3 system. The local ventricular voltage amplitude and impedance were measured using different CF levels. We randomly divided the animals into the following four groups according to the different CF levels: group A (3-9 g); group B (10-19 g); group C (20-29 g); and group D (30-39 g). Radiofrequency ablations were performed at three points in the free wall and septum of the RVOT in power control mode at 30 W for 30 s while maintaining the saline irrigation rate at 17 mL/min. At the end of the procedures, the maximum depth, surface diameter, and lesion volume were measured and recorded. A linear regression analysis was performed to determine the relationship between continuous variables. RESULTS: A total of 72 ablation lesions were created in the RVOT of the 12 Bama pigs. The maximum depth, surface diameter, and volume of the lesions measured were well correlated with the CF (free wall: β = 0.105, β = 0.162, β = 3.355, respectively, P < 0.001; septum: β = 0.093, β = 0.150, β = 3.712, respectively, P < 0.001). The regional ventricular bipolar voltage amplitude, unipolar voltage amplitude, and impedance were weakly positively associated with the CF (β = 0.065, β = 0.125, and β = 1.054, respectively, P < 0.001). There was a significant difference in the incidence of steam pops among groups A, B, C, and D (free wall: F = 7.3, P = 0.032; septum: F = 10.5, P = 0.009); and steam pops occurred only when the CF exceeded 20 g. Trans-mural lesions were observed when the CF exceeded 10 g in the free wall, while the lesions in the septum were non-trans-mural even though the CF reached 30 g. CONCLUSIONS CF seems to be a leading predictive factor for the size of formed lesions in RVOT ablation. Maintaining the CF value between 3 and 10 g may be reasonable and effective for creating the necessary lesion size and reducing the risk of complications, such as steam pops and perforations.