Doxorubicin is an effective anthracycline chemotherapeutic drug, which is widely used in single or combined chemotherapy for various malignant tumors. However, the cardiotoxicity caused by doxorubicin has limited its clinical application. Despite a large amount of research investment, no suitable target has been found to reduce cardiotoxicity caused by doxorubicin while guaranteeing the effect of chemotherapy. Recent studies have found that non-coding RNA is related to doxorubicin-induced cardiomyopathy. Further explaining the relationship between the two may provide new strategies for the diagnosis, prevention and treatment of doxorubicin-induced cardiotoxicity.

BACKGROUND: The incidence of the adjacent vertebral fracture after kyphoplasty is about 2.4%-23.0%, and 2/3 of new fractures occurred in adjacent vertebrae in 6 months. There is controversy addressing the reason which is the development of osteoporosis or the result of bone cement augment at present.OBJECTIVE: To determine the correlations between percutaneous kyphoplasty on adjacent vertebral endoplates stresses pressure under physiologianl load and a new fracture of adjacent vertebral body in physiological load.METHODS: Computed tomography (CT) data of an old female osteoporotic patient was selected, and a three-dimensional finite element model of the osteoporetic thoracolumbar spine T_(12)-L_1-L_2 was created by using kinds of computer aided design software.The height of vertebral L_1 was compressed by 60% to simulated the compressed fracture, and the height of L_1 became the 90% of normal to simulate the replacement, two columns-like PAMA mass (4 mL) was placed in vertebral L_1 to simulate pemutaneous kyphoplasty. The stress on inferior endplate of L_(12) and superior endplate of L_2 was compared with three models. RESULTS AND CONCLUSION: Compared to the normal vertebral body, the maximum stress in the adiacent vertebral bodies endplates increased by 76% for L_1 compress fracture model and increased by 27% for kyphoplasty model, respectively. The stress on the posterior part of vertebral body after percutaneous kyphoplasty have an average increase of 13.2%, of which 4.5% increase in the pedicle, isthmus, and 6.15% increased in the key points 25.6%, but with the wedge-shaped fracture of L_1 vertebral body compared to the model, percutaneous kyphoplasty after pedicle, isthmus and the articular process had reduced stress. The results indicate that the stress on inferior endplate of L-(12) and superior endplate of L_1 increased after percutaneous kyphoplasty under all loading conditions. Increased stress may lead endplate fracture, and increase the risk of adjacent vertebral body fracture. Further researches are needed to support the conclusion.

Objective·To compare the efficacy of video-assisted thoracic surgery (VATS) and conventional lung volume reduction surgery for the treatment of patients with severe chronic obstructive pulmonary disease with a meta-analysis.Methods·Randomized controlled trials (RCT) and non-randomized control studies of VATS (the VATS group) and conventional lung volume reduction surgery (the thoracotomy group) for treating patients with severe chronic obstructive pulmonary disease were collected from databases,including Web of Science,EMbase,PubMed,the Cochrane Library,CNKI,CBM disc,WanFang Data,and VIP.The latest literature was published in November 2016.The assessment included the quality of literature and RevMan5.3 software was used to perform the meta-analysis.Results·Of 779 retrieved articles,12 studies involving 966 patients were included according to the inclusion criteria.The results of meta-analysis showed that the operation time of bilateral LVRS was longer in the VATS group than in the thoracotomy group,but the difference in the operation time of single LVRS between the two groups was not statistically significant.The difference in the duration of chest tube drainage for bilateral LVRS between the two groups was not statistically significant,while the duration of chest tube drainage for single LVRS was significantly shorter in the VATS group than in the thoracotomy group.The amount of intraoperative blood loss postoperative drainage was significantly smaller in the VATS group than in the thoraeotomy group.Postoperative pulmonary function and blood gas analysis showed that the 6 min walking distance was longer in the VATS group than in the thoracotomy group.The differences in FEV1 and PaO2 between the two groups were not statistically significant,as well as the difference in postoperative complications between the two groups.Conclusion·Comparing to conventional lung volume reduction surgery,Video-Assisted thoracic lung volume reduction surgery is a better choice.However,randomized control trials with higher quality and larger scale are required for verification this conclusion due to limitations of the quality and samples of these studies.

BACKGROUND:Conflicting data have been reported regarding the expression of retinol-binding protein 4 in non-alcoholic fatty liver disease. OBJECTIVE:To evaluate the impact of dietary interventionversus metformin treatment on expression of retinol-binding protein 4 in rats with non-alcoholic fatty liver disease. METHODS: Fifty male Sprague-Dawley rats were randomized to six groups, including two normal control groups (rats were kiled after 8 and 16 weeks of normal diet), two HFD groups (rats were kiled after 8 and 16 weeks of high-fat diet), one dietary intervention group (rats were kiled after 8 weeks of high-fat diet and 8 weeks of normal diet) and one metformin treatment group (rats were kiled after 8 weeks of high-fat diet and 8 weeks of high-fat diet and metformin treatment). The levels of retinol-binding protein 4 in serum and biochemical indexes were detected through enzyme-linked immunosorbent assay. The expression of retinol-binding protein 4 mRNA in liver tissues was measuredvia western blot analysis, immunohistochemistry and RT-PCR. RESULTS AND CONCLUSION:Non-alcoholic fatty liver disease models were successfuly established by high-fat diet. Liver tissues of high-fat diet fed rats showed progressing non-alcoholic fatty liver disease histology, from non-alcoholic fatty liver to non-alcoholic steatohepatitis. Dietary intervention increased retinol-binding protein 4 expression in liver tissue as wel as improving liver enzyme, dyslipidemia and insulin resistance, and aleviated impaired liver histology. Metformin treatment only aleviated hepatic steatosis caused by high-fat diet. The results indicated that retinol-binding protein 4 expression might play a role in the pathogenesis of non-alcoholic fatty liver disease. Metformin treatment can aleviate non-alcoholic fatty liver disease histology,dietary intervention should be the fundamental treatment.

Objective To evaluate the effect of EMS through ureteroscope per urethra for the treatment of infant bladder and urethral stone with acute urinary retention. Methods Ten cases (9 boys, 1 girl)of infant bladder and urethral stone with acute urinary retention were treated by EMS through ureteroscope per urethra. Mean age of the patients was 9 months. Two cases suffered from bladder stones while the other 8 cases suffered from urethral stones. The size of stones varied from 0.5-1.1 cm with the average of 0.8 cm. All 10 cases underwent EMS through ureteroseope per ure-thra after general anaesthesia by using ketamine in vein. Wolf F8/9. 8 ureteroscope was used and mo-nitored by television. The EMS probe of ultrasound lithotripsy was sticked through operating passway of ureteroscope to shatter and eliminate bladder and urethral stone. During operation, 50-- 100 ml li-quid pressure was retained in the urinary bladder. The pressure of perfusion pump varied between 160 and 210 kPa(average, 180 kPa). The energy of ultrasound lithotripsy was 40%--60% with a ratio of 30%--70%. F8 type of 2 cavity aerocyst urethral catheter was indwelled after operation. Results The average operation time was 25 min. Urethral stones were rinsed into bladder. Stones were elimi-nated at one time by ureteroscope. Urethral catheters were removed after the patients revived from anesthesia and smooth urination was seen immediately after operation. No retained calculus in the bladder and urethra was found by B ultrasound 3 days later. Conclusions Low urinary obstruction could be relieved immediately after EMS through ureteroscope per urethra in patients of infant bladder and urethral stone with acute urinary retention. This operation is safe, high-efficient with less lesion, and would be the first option for the patients of infant bladder and urethral stone with acute urinary re-tention.

Objective To investigate the clinical application of ureteroseope in the treatment of infant renal calculus with acute post-renal failure. Methods Thirteen cases of infant renal calculus with acute post-renal failure included 11 males and 2 females aging from 5 months to 1 years with a mean age of 9 months. Five cases showed bilateral renal calculi with hydronephrosis, 3 cases showed one side renal calculus with eontralateral uretal calculus incarceration, 3 cases showed bilateral uretal calculus incarceration, 2 cases showed bilateral renal calculi and hydronephrosis with urinary calculi. Anuria appeared in 11 cases for 1-3 d while oliguria appeared in 2 cases for 5-10 d. BUN and SCr were higher than normal level in all cases. Hyperuricemia was found in 8 cases, hyperkaliemia was found in 9 cases, pH values in urine of all infants were less than 6. 5(mean, 5. 5). Radiopague stone was not found in all cases by KUB. Hydronephrosis was found in 13 cases, and the diameter of hydro-nephrosis in 9 cases was more than 2.5 cm by B ultrasound. All cases were diagnosed as urinary stones with the diameter from 0.5 to 1.5 cm by CT. All cases were inserted with double J stents un-der ureteroscope for internal drainage, crushing, rinsing and eliminating stones. Results Hyperdi-uresis emerged within 24 h after operation in 13 patients. The duration of hyperdiuresis was from 24 h to 72 h. Urine volume revived gradually 48-96 h after operation while BUN and SCr revived 1-5 dafter operation. Serum uric acid revived 1-7 d after operation in 8 cases of hyperuricacidemia. Serum potassium revived 1-3 d after operation in 9 cases of hyperpotassaemia. Double J tubes were detained for 2-4 weeks. Renal calculus in 10 cases were found by B ultrasound to be discharged and conse-quently double J tubes were pulled out. Renal calculi in 2 cases became smaller and lighter. Conclu-sions For infant renal calculus with acute post-renal failure, upper urinary obstruction could be re-lieved immediately with revived urination and improved renal function by dissolution and crushing of calculus, and the placement of double J tube for internal drainage under ureteroscope. This operation is safe, high-efficient with less lesion, and would be the first option to relieve obstruction for infant re-nal calculus with acute post-renal failure.

A patient with severe hypoglycemia due to insulin-like growth factor ( IGF)-IIsecreted by a giant solitary fibrous tumor of the pleura ( SFTP) was investigated through comprehensively reviewing his medical history and clinical records. The patient had severe hypoglycemia accompanied with significantly decreased serum insulin level. A solitary fibrous tumor of the pleura was found, and right pneumonectomy removed this giant tumor. Two years after the operation, the patient was fit and well with no further hypoglycemia episodes. Non-islet-cell tumor hypoglycemia should be considered in patients who have hypoglycemia episodes accompanied with significantly decreased serum insulin level.

Objective To raise the awareness of adrenal Castleman′s disease by analyzing the clinical features and management of a patient with adrenal Castleman′s disease. Methods A case of adrenal Castleman′s disease of our hospital was retrospectively analyzed, including clinical feature, laboratory findings, pathology, treatment, and follow-up. All the data and pertinent literatures were reviewed and analyzed. Results An incidentaloma measuring 4. 8 cm × 6. 3 cm in the right adrenal gland was observed in a 30-year-old men in a ultrasonography examination performed due to a medical check-up. Laboratory analysis showed that the lesion was not hyperfunctioning. The patient subsequently underwent an exploratory laparotomy. Pathological examination revealed retroperitoneally localized Castleman′s disease of the hyaline vascular type. Conclusion Adrenal Castleman′s disease is a rare cause of lymph node hypertrophy, and it is necessary to keep in mind the possibility of its occurrence and take it into consideration in the differential diagnosis of any solitary, heterogeneous, and hypervascular retroperitoneal mass. The proper cooperation between the clinician and pathologist allows early diagnosis and suitable therapy.

Objective By analyzing the changes in behavior and the myelin basic protein (MBP) of the offspring in adult that treated with Poly(I∶C) during pregnancy,and to understand the role of white matter abnormalities in the abnormal behavior of the offspring induced by infection in maternal hosts.Methods Two models maternal female rats were given Poly(I∶ C) with 5 mg/kg and 10mg/kg respectively during the early pregnancy,and control maternal female rats was administered 5 mg/kg saline.The prepulse inhibition test,passive avoidance test and active avoidance test were used to evaluate schizophrenia like behaviors for each groups offspring in 8 weeks,and the expression of MBP was detected by immunohistochemical staining methods.Results The results of prepulse inhibition test showed that significant differences of PP2,PP4 and PP8 results existed among control group,single-dose model group and double-dose model group (F=10.381,P=0.001,F=10.313,P=0.001,F=15.233,P=0.000).Compared with the control group,the two model groups showed significantly lower,the double-dose model group was lower than single-dose model group (P＜0.05).In passive avoidance test,there were significant differences of T1 and T2 results existed among control group,single-dose model group and double-dose model group (F=23.555,P=0.000,F=17.524,P=0.000).The T1 results of two model groups were significantly higher than control group,the double-dose model group was significantly higher than single-dose model group (P＜0.05) ; the T2 results of two model groups were lower than control group,the double-dose model group was lower than single-dose model group(P＜0.05).The results of passive avoidance test indicated that significant differences existed among control group,single-dose model group and double-dose model group in whole period of testing and total conditioned response rate(F=8.631,P=0.000,F=6.986,P=0.001),the two model groups were significantly lower than control group,double-dose model group was significantly lower than single-dose model group (P＜0.05).MBP results of two model groups were significantly lower than control group,two model groups had no significant difference (P＞ 0.05).Conclusion The adult offspring that were treated with Poly (I∶C) exit abnormal behavior and damaged white matter,and there is a correlation between the degree of abnormal behavior and drug dose.

Objective To explore the changes of pubescent immune response in the schizophrenia offspring induced by poly(I:C) during pregnancy and the effects on white matter.Methods The obtained pregnant rats were randomly divided into model group(n=6) and control group (n=5), receiving either poly (I:C) at a dose of 10 mg/kg diluted in 0.9％ NaC1 solution or vehicle solution alone (sterile pyrogen-free 0.9％ NaC1) on gestation day 9 (GD9).Immunohistochemical technique(IHC) was applied to detect the changes of microglias and astrocytes in the prefrontal cortex(PFC) and hippocampus(HC) of partly offsprings in the two groups at the sixth week,as well as Luxol fast blue(LFB) for the changes of white matter.The other offsprings of each group were selected for behavioral assessment at the eighth week.Results The results of prepulse inhibition test showed that PP2, PP4 and PP8 of model groups were significantly lower than that of the control group at young adult(P＜0.01).In passive avoidance test, and the T1 results of model group were significantly higher than those of the control group, the T results of model group were lower than those of control group (P＜ 0.01).Immunohistochemical results indicated that the number of microglias in the model group((264±33)/mm2, (271 ±38)/mm2) was significantly increased in PFC and HC than that in the control group((140±29)/mm2, (169±37)/mm2, P＜0.05) ,which was accompanied with significant morphological changes, while the OD value of astrocyte protein expression in the frontal lobe and hippocampus had no obvious difference between the model group and control group(P＞0.05).The OD value of LFB staining for myelin in the model group(0.29±0.02) was significantly decreased compared with that in the control group(0.33±0.03)(P＜0.01).Conclusion The young adult offsprings with prenatal infection present obvious schizophrenia-like behavior, meanwhile, the microglias activation and demyelination changes in white matter are observed,which provides more evidence for the relationship between immune response and white matter in the pathogenesis of schizophrenia.