Objective To compare the efficacy and side effects of paliperidone-ER and risperidone in treating schizophrenia.Methods 60 patients of schizophrenia were treated with paliperidone-ER( n = 30) or risperidone (n =30) randomly,for 8 weeks. The efficacy was assessed with the positive and negative symptoms scale( PANSS), and the safety was assessed with treatment emergent symptoms scale before treatment and at the ends of week 1,2,4and 8 treatments,respectively. Results The PANSS scores of two groups were significantly decreased after the patients received the drug treatment. Paliperidone-ER group showed lower negative symptom score at week 4 and 8 than risperidone group. The efficacy of study group was significantly higher than that of control group. Conclusion Paliperidone-ER was effective and safe antipsychotic drug with significant improvement compared with risperidone in negative symptoms.

Objective To prepare a lipoic acid (LA) modified intrinsically disordered protein-cytosol-localizing internalization peptide 6 (CL) nanocomplex (LA-CL) entering cells by non-endocytosis mechanism for co-delivery of gene and chemotherapeutic drugs, and to investigate its transfection efficiency and cellular uptake on human embryonic kidney cell line HEK293 cells and its release behavior in vitro. Methods We synthesized four disulfide cross-linked lipoic acid modified LA-CLss(1-4) at different cross-linked degrees using different mass fractions (2.5%, 5%, 10% and 20%) of cysteine as cross-linking agent. The construction of LA-CLss was characterized by1H nuclear magnetic resonance (1HNMR) and gel permeation chromatography. The LA-CLss/plasmid enhanced green fluorescent protein (pEGFP) nanocomplexes were self-assembled with LA-CLss and pEGFP at different nitrogen/phosphorus (N/P) ratios (2.5, 5, 10, 20, 40 and 80). The size and zeta potential of LA-CLss/pEGFP nanocomplexes were determined by particle size analyzer, and the pEGFP enrichment capacity of LA-CLss was determined by agarose gel electrophoresis. The docetaxel (DTX)-loaded micelles were prepared by ultrasonic emulsification, and the critical micelle concentration of LA-CLss3 was determined by pyrene fluorescence probe spectroscopy. The LA-CLss/pEGFP nanocomplexes were co-cultured with HEK293 cells, and the transfection efficiencies of LA-CLss/pEGFP nanocomplexes at different cross-linked degrees were investigated. Results1 HNMR results showed the LA-CLss was successfully synthesized. When N/P ratio was 40, the transfection efficiency of LA-CLss3/pEGFP nanocomplex by HEK293 cells was significantly higher than that of LA-CL/pEGFP, LA-CLss1/pEGFP, LA-CLss2/pEGFP and LA-CLss4 nanocomplexes. The encapsulation efficiency and drug loading of docetaxel-loaded micelles prepared by ultrasonic emulsification were (85.25±0.04)% and (8.81±0.02)%, respectively. Cellular uptake test showed that the gene could be effectively delivered into the HEK293 cells by the LA-CLss micelles. In vitro release experiments showed that the LA-CLss micelles had redox-responsive drug release behavior. Conclusion The prepared LA-CLss/DTX/pEGFP nanocomplex is expected to become an efficient vector for co-delivery of gene and chemotherapeutic drugs.

Advances in biotechnology give much importance to the therapeutic biomacromolecules in the therapy of diseases, such as proteins, oligonucleotides, and peptides. But their effects are limited in practical application because of cell membrane barrier. Cell-penetrating peptides (CPPs) are promising oligopeptides with a remarkable capacity for membrane translocation, which can carry various macromolecules into cells. In this paper, we reviewed the classification and transmembrane mechanism of CPPs as nanoparticles, with particular focus on their recent progress in tumor-targeted therapy.

Objective: To establish a method for isolation, culture and identification of primary human pericardial interstitial cells (PICs). Methods: Human pericardial tissues were cut into 1 mm×1 mm×1 mm sized pieces, digested with type II collagenase, hyaluronic acid enzyme and trypsin to isolate the interstitial cells. The cells were cultured and cell morphology was observed. The cell doubling time, flow cytometry and immunohistochemical staining were applied for cell identilication. Results: Adherent cells were observed 24 h after culturing. The cells reached 80% confluences and could be subcultured after about 10 days. The cells isolated and cultured were fibroblast-like or spindle-like, with obvious nuclti, clear nucleolus, and a greater proportion of nucleus and cytoplasm. Flow cytometry results showed no cell surface markers CD34 and CD45. Immunocytochemistry showed negative CK staining, and positive vimentin and a{script}SMA staining. Cells isolated from 8 of the 10 pericardial tissues were successfully cultured. Conclusion: The present method can effectively isolate and culture primary human PICs, which lays a foundation for further in vitro study of constrictive pericarditis.

To establish a neonatal rat model of thoracic aortic dissection by treating pregnant rats with semicarbazide. Methods Implantable capsule osmotic pump with different concentrations of semicarbazide (5, 10, 15, 20, 25, 30, 35, 40 mg/[kg • d])or normal saline were implanted into the abdomen of rats on day 14 of pregnancy. The thoracic aortas of 21 day fetus and neonatal rats were collected. H-E staining was applied to examine the pathological changes under microscope, and the formation of thoracic aortic dissection was analyzed. Results Various degrees of thoracic aortic dissections were observed in neonatal rats after the mother rats were given different concentrations of semicarbazide. At a lowest semicarbazide release rate of 25 mg/kg per day, all the neonatal rats survived and had a high incidence of thoracic aortic dissection. Conclusion A neonatal rat model of thoracic aortic dissection has been successfully established, paving a way for further researches.

Objective: To improve the current understanding on the imaging features of pancreatic schwannoma. Methods: Clinical data of pancreatic schwannoma patients admitted in Changhai Hospital affiliated with Navy Medical University from January 1989 to January 2019 were retrospectively analyzed, related literature on pancreatic schwannomas was retrieved through the Chinese and English database, and clinical and imaging features of pancreatic schwannoma were analyzed. Results: A total of 84 cases were analyzed, including 3 cases of pancreatic schwannomas in Changhai hospital, and 81 cases reported in the literature. The age of onset was 17-78 years old, with an average of 55 years. There were 30 males and 54 females. The main symptoms were abdominal pain or the detection of pancreatic mass via body check. Pancreatic schwannoma was mainly in pancreatic head, and the lesion has a long diameter of 1-18 cm with an average of 4.6 cm, which can be solid, cystic (most frequent) and cystic-solid. The border of the lesion from the normal tissue was clear, and semi-transparent capsule composed of neural external membrane and fiber were often found. 15 patients underwent endoscopic ultrasonography guided fine needle aspiration, and diagnostic accuracy was 73.3%(11/15). No typical findings for pancreatic schwannoma was detected on CT. MRI was performed in 35 cases, and 12 cases had complete data. The characteristics of target sign were tumor tissue in completely low signal at T₁WI, and in partially low signal and partially high signal at T₂WI, and completely opposite signal characteristics of T₂WI area after T₁ enhancement, referring to the finding that low T₂WI signal part was gradually enhanced to be high signal, but high signal part was not enhanced and in low signal. Conclusions Pancreatic schwannoma is rare, and its target signs by MRI have imaging features which can help to improve the preoperative diagnosis.

OBJECTIVETo report an acute promyelocytic leukaemia (APL) case with translocation of rob (13;21) t(15;17) (q22;q21) and review its clinical and laboratory characteristics.

METHODSBased on routine karyotype analysis and bone marrow morphology, we further used double color double fluorescent in situ hybridization (DCDF-FISH) and reverse transcriptase PCR (RT-PCR) to examine the patient's abnormities on cytogenetic and molecular biology, and reveal the clinical characteristics of this rare translocation also from the related literatures.

RESULTSThe clinical manifestation and bone marrow morphology examination of this patient were in accordance with pathologic feature of APL. On first visit, immunophenotyping analysis showed positive myeloid markers. Through R-banding, the patient's karyotype was confirmed as 45, XX, rob(13;21) t(15;17) (q22;q21) [6]/45, XX, rob(13;21) [14]. FISH results showed that 68.9% cells were typical t(15;17) pattern. The positive rates of fusion gene of PML-RARα detected by RT-PCR was 25.8%. Patient was treated by induction and consolidation therapy, the karyotype was 45, XX, rob(13;21 )[20] after complete remission. The positive rate of fusion gene of PML-RARα by FISH and its level were 2.5% and 0.003% respectively.

CONCLUSIONAPL with rob (13;21) t(15;17) (q22;q21) was very rare, which was accorded with clinical and laboratory characteristics of APL. The value of chromosome abnormality as a prognostic marker in APL needs to be further observed..

Chromosome Aberrations ; Chromosome Banding ; Chromosomes, Human, Pair 15 ; Chromosomes, Human, Pair 17 ; Chromosomes, Human, X ; Humans ; In Situ Hybridization, Fluorescence ; Karyotype ; Leukemia, Promyelocytic, Acute ; Oncogene Proteins, Fusion ; Remission Induction ; Translocation, Genetic

OBJECTIVETo investigate the patients' characteristics and efficacy of prognosis evaluation by International Prognosis Scoring System (IPSS) and Revised International Prognosis Scoring System (IPSS-R) in patients with myelodysplastic syndrome (MDS).

METHODSPrognostic value of IPSS and IPSS-R was evaluated on clinical data from 159 MDS patients, according to WHO classification.

RESULTSWith a median age of 44 years (range:15-80 years), MDS patients had the frequency of 38.56% with abnormal karyotype, including the most common abnormality +8 (20/153, 12.6%). 34 of 142 patients transformed into leukemia. Age and the level of β2 micro-globulin were the prognostic factors by multivariate analysis and IPSS-R had a better prognostic significance. The differences in cumulative survival between IPSS subgroups were significant (P<0.05) except that between low- and intermediate I-risk group (P>0.05). There were statistical differences for IPSS-R low risk group vs high or very high risk group, and intermediate risk group vs high or very high risk group (P<0.05). IPSS-R enables IPSS subgroups re-stratification and split IPSS intermediate I-risk group into two subgroups with different prognosis.

CONCLUSIONThere were significant differences in age of onset, distribution of prognosis scoring system subgroups and abnormal karyotype compared with those in Europe and America. The proportion of higher risk (worse than good karyotype) in IPSS-R was higher than that in Europe and America. Age and the level of β2 micro-globulin were prognostic factors. Both IPSS and IPSS-R were applicable in Chinese MDS patients and the latter performed better. Applying IPSS-R to re-stratify IPSS subgroups helps evaluate prognosis more accurately and improve treatment outcomes.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Humans ; Karyotype ; Karyotyping ; Leukemia ; Middle Aged ; Multivariate Analysis ; Myelodysplastic Syndromes ; Prognosis ; Risk ; Young Adult

Objective: To investigate the safety and efficacy of pelvic peritoneal reconstruction and its effect on anal function in laparoscopy-assisted anterior resection of low and middle rectal cancer. Methods: A prospective cohort study was conducted. Consecutive patients with low and middle rectal cancer who underwent laparoscopy-assisted transabdominal anterior resection at Naval Military Medical University Changhai Hospital from February 2020 to February 2021 were enrolled. Inclusion criteria: (1) the distance from tumor to the anal verge ≤10 cm; (2) laparoscopy-assisted transabdominal anterior resection of rectal cancer; (3) complete clinical data; (4) rectal adenocarcinoma diagnosed by postoperative pathology. Exclusion criteria: (1) emergency surgery; (2) patients with a history of anal dysfunction or anal surgery; (3) preoperative diagnosis of distant (liver, lung) metastasis; (4) intestinal obstruction; (5) conversion to open surgery for various reasons. The pelvic floor was reconstructed using SXMD1B405 (Stratafix helical PGA-PCL, Ethicon). The first needle was sutured from the left anterior wall of the neorectum to the right. Insertion of the needle was continued to suture the root of the sigmoid mesentery while the Hemo-lok was used to fix the suture. The second needle was started from the beginning of the first needle, after 3-4 needles, a drainage tube was inserted through the left lower abdominal trocar to the presacral space. Then, the left peritoneal incision of the descending colon was sutured, after which Hemo-lok fixation was performed. The operative time, perioperative complications, postoperative Wexner anal function score and low anterior resection syndrome (LARS) score were compared between the study group and the control group. Three to six months after the operation, pelvic MRI was performed to observe and compare the pelvic floor anatomical structure of the two groups. Results: A total of 230 patients were enrolled, including 58 who underwent pelvic floor peritoneum reconstruction as the study group and 172 who did not undergo pelvic floor peritoneum reconstruction as the control group. There were no significant differences in general data between the two groups (all P>0.05). The operation time of the study group was longer than that of control group [(177.5±33.0) minutes vs. (148.7±45.5) minutes, P<0.001]. There was no significant difference in the incidence of perioperative complications (including anastomotic leakage, anastomotic bleeding, postoperative pneumonia, urinary tract infection, deep vein thrombosis, and intestinal obstruction) between the two groups (all P>0.05). Eight cases had anastomotic leakage, of whom 2 cases (3.4%) in the study group were discharged after conservative treatment, 5 cases (2.9%) of other 6 cases (3.5%) in the control group were discharged after the secondary surgical treatment. The Wexner score and LARS score were 3.1±2.8 and 23.0 (16.0-28.0) in the study group, which were lower than those in the control group [4.7±3.4 and 27.0 (18.0-32.0)], and the differences were statistically significant (t=-3.018, P=0.003 and Z=-2.257, P=0.024). Severe LARS was 16.5% (7/45) in study group and 35.5% (50/141) in control group, and the difference was no significant differences (Z=4.373, P=0.373). Pelvic MRI examination 3 to 6 months after surgery showed that the incidence of intestinal accumulation in the pelvic floor was 9.1% (3/33) in study group and 46.4% (64/138) in control group (χ(2)=15.537, P<0.001). Conclusion: Pelvic peritoneal reconstruction using stratafix in laparoscopic anterior resection of middle and low rectal cancer is safe and feasible, which may reduce the probability of the secondary operation in patients with anastomotic leakage and significantly improve postoperative anal function.
Anastomotic Leak/surgery* ; Humans ; Intestinal Obstruction/surgery* ; Laparoscopy ; Postoperative Complications/surgery* ; Prospective Studies ; Rectal Diseases/surgery* ; Rectal Neoplasms/surgery* ; Retrospective Studies ; Syndrome ; Treatment Outcome

Adolescent ; Bone Transplantation ; methods ; Humans ; Scoliosis ; surgery ; Spinal Fusion ; methods