Hyperglycemia is common in patients with aneurysmal subarachnoid hemorrhage (aSAH),and it has important association with dehyed cerebral ischemia (DCI) and may result in poor prognosis.This article summarizes the mechanism of the elevated blood glucose after aSAH,the reasons of causing DCI,and the corresponding treatment measures.

Objective To study the application of hepatamethine cyanine near-infrared fluorescence (NIRF) dye IR-783 in the mouse models of human liver cancer exenografts, and to analyze the molecular mechanisms of the NIRF dye targeting tumor cells.Methods Luciferase-tagged HepG2 cells were inoculated subcutaneously into the nude mice.We detected the correlation of NIRF intensity and bioluminescence intensity (BIL) in the tumor region.Patient-derived xenograft (PDX) model was established in mouse by subrenal capsular implantation of clinic liver cancer specimen.After injecting the IR-783 dye, the interface between mouse kidney and the xenograft tumors was confirmed by NIRF analysis, and the tumor tissue in kidney was observed by pathology using H&E staining.The expression of CEA, AFP, HIF1α and OATP3A1 in the liver cancer tissue was detected by immunohistochemical staining.The intracellular retention of NIRF dyes was observed under fluorescence microscope after adding Mito Tracker or Lyso Tracker into cultured HepG2 cells.We added IR-783 in a co-culture system of HCCs and normal liver cells to test the specifical identification ability of IR-783 of the liver cancer cells.Results There was a good correlation between NIRF intensity and BIL intensity of the subcutaneous liver cancer xenograft region in nude mice.The margin between the mouse kidney tissue and xenograft tumors was clearly identified by IR-783.Compared with normal kidney tissue, CEA, HIF1α, OATP3A1 and AFP were highly expressed in the tumor region detected by IHC staining.The NIRF dye IR-783 was mainly accumulated in the mitochondria and lysosomes of cancer cells.GFP-tagged HepG2 cells could be recognized directly, whereas red fluorescence was not detected in normal liver cells.Conclusions IR-783 is a novel near-infrared fluorescent dye with tumor targeting and imaging properties.Its targeting ability may be related to the high expression of HIF1α and OATP3A1 in the liver cancer tissue.

Objective To evaluate the effect of intravenous Gd-DTPA on 3.0T proton MR spectroscopy (MRS) water suppression and shimming. Methods Prospective study of proton MRS was performed with GE Signa Excite HD 3.0T system and eight-channel phased-array coils with PRESS sequence (head, liver and kidney, respectively). Routine auto prescan program was operated to record full width half maximum (FWHM) and water suppression (WS%). Routine scan was performed after injection of Gd-DTPA, then prescan program was reoperated to record FWHM and WS%. The data of FWHM and WS% in head, liver and kidney were compared between before and after injection of Gd-DTPA with the Wilcoxon matched pairs signed test. Results WS% of spectroscopy of head and liver after administration of Gd-DTPA decreased significantly (T_+=12, T_-=66, P=0.02; T_+=0, T_-=45, P=0.007). The effect of shimming of kidney after administration of Gd-DTPA was poor (T_+=0, T_-=435, P<0.001) and WS% of spectroscopy of kidney after administration of Gd-DTPA decreased significantly (T_+=0, T_-=435, P<0.001). Conclusion WS% of spectroscopy in head, liver and kidney can be impacted negatively by Gd-DTPA. Gd-DTPA has great influence on shimming of spectroscopy of kidney, but has little influence on shimming of spectroscopy of head and liver. It is better to acquire MRS data before administration of contrast medium in kidney.

Objective To observe the effect of full width half max (FWHM) on spectra signal-to-noise ratio (SNR), NAA/Cr, Cho/Cr and water suppression at 3.0T MR. Methods GE Signa Excite HD 3.0T MR scanner with 8 channel phrased-array head and neck coil was used. The respective study of liver 1H-MRS was performed using PRESS sequence. A total of 49 spectrums were obtained with parameters of TR 1500 ms, TE 30 ms, NSA 128. FWHM and water suppression were recorded automatically and the subjects were divided into better shimming group (FWHM<10 Hz) and worse shimming group (FWHM≥10 Hz). Independent t test was used to analyze the Cr_SNR, NAA/Cr, Cho/Cr, water suppression and volume of interest (VOI). Results Compared with worse shimming group, better shimming group could provide better Cr_SNR (t=5.976, P<0.001), higher NAA/Cr (t=2.469, P=0.017), lower Cho/Cr (t=-4.460, P<0.001) and smaller VOI (t=3.862, P<0.001). Conclusion When single voxel proton spectroscopy of head is adopted with 3.0T MR, small VOI is easy to achieve effective shimming, and better shimming is helpful to improve SNR, the ratio of main metabolites as well as water suppression.

Objective To investigate the effectiveness of target-controlled infusion (TCI) of etomidate and remifentanil for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods Sixtynine ASA Ⅰ or Ⅱ patients of both sexes,aged 35-71 yr,weighing 41-83 kg,scheduled for elective EBUS-TBNA,were randomly divided into 3 groups ( n =23 each).In group Ⅰ,anesthesia was induced with TCI of propofol and iv injection of fentanyl 4 μg/ml,and the target plasma concentration (Cp) of propofol was set at 3-4 μg/ml.In group Ⅱ ,anesthesia was induced with TCI of propofol ( Cp 3-4 μg/ml) and remifentanil ( Cp 5 ng/ml).In group Ⅲ ,anesthesia was induced with TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml).After the patients lost consciousness,laryngeal mask airway was inserted to perform mechanical ventilation.PETCO2 was maintained at 30-40 mm Hg.BIS value was maintained at 40-60.The use of vasoactive agents (perdipine,ephedrine,atropine and esmolol) and occurrence of bucking during operation,emergence time,and the occurrence of nausea and vomiting within 24 h after operation were recorded.Blood samples were collected from the femoral vein at 30 min before induction,at the end of operation and at 24 h after operation for determination of the plasma cortisol concentration.Results The incidence of bucking and nausea and vomiting was significantly lower,the emergence time was significantly shorter,and the number of patients who needed vasoactive agents during operation was significantly smaller in groups Ⅱ and Ⅲ than in group Ⅰ ( P ＜ 0.05).The number of patients who needed vasoactive agents during operation was significantly smaller in group Ⅲ than in group Ⅱ (P ＜0.05).Compared with groups Ⅰ and Ⅱ,the plasma cortisol concentration was significantly decreased at the end of operation in group Ⅲ (P ＜ 0.05).There was no significant difference in the plasma cortisol concentration at each time point between groups Ⅰ and Ⅱ (P＞0.05).Conclusion TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml) can provide satisfactory anesthesia for EBUS-TBNA with few adverse effects.

Objective To characterize the effect of the ~1H-MRS scan parametem, including the type of coil, TE,NSA and VOI, on shimming, water suppression, spectral signal to noise ratio(SNR)and the stability of the baseline of liver in vivo. Methods ~1H-MRS of liver in vivo was performed prospectively on GE Signa Excite HD 3.0 T system in 46 volunteers. Point-resolred spectroscopy(PRESS)sequence with built-in body coil and eight-channel torso phased-array coils was applied. After the localized scan,the first PRESS sequence with a TR of 1500 ms,TE of 30 ms. VOI of 2 cm×2 cm×2 cm and NSA of 64 times was acquired using eight-channel torso phased-array coils.(The first PRESS sequence parametem was deemed as A).Then,the sequence was repeated with alteration of the three parameters including the type of coil,TE and size of VOI.(Changed parameters deem as B).The data were analyzed with the Wilcoxon matched pairs signed test.0 mark:A is similar to B,1 mark:A better than B,-1 mark:A worse than B.Results SNR(-1 mark 0 pair,0 mark 1 pair,1 mark 10 pair,Z=-3.162,P=0.002)was better in data(n=11)with eight-channel torso phased-array coils(A)than that with the built-in body coil(B),but the autoshimming line width with eight-channel torso phased-array coils were inferior to those with built-in body coil (-1 mark 8 pair,0 mark 2 pair,1 mark 1 pair,Z=-2.511,P=0.012).SNR was better in data(n=13)with TE of 30 ms(A)than that at the sequence with TE of 90 ms(B)(-1 mark 2 pair,0 mark 0 pair,1 mark 11 pair,Z=-2.496,P=0.013).whereas baseline stability was,poorer in the former(-1 mark 10 pair,0 mark 2 pair,1 mark 1 pair,Z=-2.333,P=0.020).SNR at the sequence(n=10)with VOI of 2 cm×2 cm×3 cm(B)was better(-1 mark 6 pair,0 mark 4 pair,1 mark 0 pair,Z=-2.449,P=0.014)than that at the sequence(n=29)with VOI of 2 cm ×2 cm × 2 cm(A),but poorer(-1 mark 0 pair,0 mark 5 pair,1 mark 5 pair,Z=-2.041,P=0.041)auto-shimming line width was shown. By comparison the sequences with NSA of 128 times(B)and NSA of 64 times(A),the former could provide better spectrum SNR(-1 mark 21 pair,0 mark 7 pair,1 mark 1 pair,Z=-4.264,P=0.000).Conclusion It is more easy to achieve a homogeneous bo magnetic field using a small size of VOI and builtin body coli.The sequence with VOI of 2 cm ×2 cm ×3 cm.NSA of 128 times is recommended for clinical use. Increase VOI and NSA are helpful to improve SNR. Longer TE is helpful to improve baseline stability.

A method was developed for the simultaneous determination of 17 characteristic ingredients of plant extracts, including paeoniflorin, hydroxysafflor yellow A, calycosin_7_glucoside ferulic acid, etc. , in hair growth cosmetics using ultra high performance liquid chromatography ( UPLC ) . Different cosmetic samples were extracted by ultrasonic_assisted extraction with the solvent of methanol/water (4∶1, V/V) solution. After demulsified by the addition of appropriate amount of NaCl and high speed centrifugation, the supernatant was transferred and analyzed with UPLC. The separation was conducted on a Waters reversed phase column of ACQUITY UPLC CSH C18(50 mm×2. 1 mm, 1. 7μm), and the mobile phases were methanol and the solution of 0. 05% phosphate in water. The detection was performed with a photodiode_array ( PDA) detector. The linear range was 0 . 2-25 mg/L with correlation coefficients higher than 0 . 999 . The limits of detection were within 0. 3-1. 5 mg/kg, and the limits of quantification were from 1. 0 to 4. 0 mg/kg. The average recoveries of 17 characteristic ingredients were within 93 . 5%-105 . 0%, with the intra_and inter_day precision ( n=6 ) less than 4. 6%. This method was simple, rapid, with good_repeatability, and had been applied to the analysis of real samples.

Objective To establish and evaluate a patient-derived orthotopic xenograft ( PDOX ) model of pancreatic cancer. Methods Tissues of patient-derived pancreatic tumor were transplanted into nude mouse pancreas by surgery. The PDOX models were evaluated by the small animal near infrared fluorescence ( NIRF) optical imaging and PET/CT. The traceability of PDOX models was detected by STR technology, and the pathological changes were observed by H&E staining, immunohistochemistry, and serum level of CA19-9 was detected by ELISA. Results Apparent NIRF were observed to be accumulated in pancreatic site by optical imaging system. The location and size of the xenografts tumor were revealed by fluorescence intensity. The PET/CT images with 18F-FDG molecular probe confirmed the tumor's location and size. Ex vivo NIRF imaging of isolated organ further showed the tumor formation. The traceability of PDOX models was 99. 99% with human origin. H&E staining pathology and immunohistochemistry indicated the pancreatic cancer characteristics. The high serum level of ca19-9 confirmed the mice bearing tumor. Conclusions Pancreatic PDOX models are successfully established in this study, and it can be evaluated comprehensively by NIRF optical imaging and PET/CT, providing an appropriate platform for further research of pancreatic cancer.

Objective To evaluate the therapeutic effect of chemotherapeutic drugs on pancreatic carcinoma based on patient-derived xenograft(PDX)models,and to screen an individualized treatment strategy. Methods Fresh human pancreatic carcinoma tissues were subcutaneously transplanted into nude mice to establish PDX models which could be stab-ly passaged. The traceability of PDX models was determined by STR analysis. The PDX models were treated with three dif-ferent clinical chemotherapeutic drugs oxaliplatin, gemcitabine and irinotecan, respectively, and the tumor volumes were measured at different times. The therapeutic effect of those drugs was assessed by TGD mathematical model and plasma CA19-9 test. Results The traceability of patient-derived xenograft samples was up to 99.99%. Compared with the con-trol group,the treatment with irinotecan and gemcitabine inhibited tumor growth significantly(P=0.001), and gemcit-abine had even better result. The minimum toxic effect in the mice was induced by irinotecan treatment,followed by gem-citabine treatment. Conclusions Pancreatic carcinoma PDX models are successfully established and can be stably pas-saged. Gemcitabine shows the most inhibitory effect on tumor growth based on TGD mathematical model assessment, and deserves to be recommended as the preferred drug for individual treatment of pancreatic carcinoma.

Objective To systematically study the efficacy and safety of KRAS^G12C inhibitors in advanced solid tumors with KRAS^G12C-mutated. Methods Computer searches from PubMed, The Cochrane Library, Web of Science, Embase, CNKI, and CBM databases were conducted to collect clinical studies on KRAS^G12C inhibitors in advanced solid tumors with KRAS^G12C-mutated, with a search time from inception to October 12, 2022. Then, two investigators independently screened the literature, extracted information, assessed the risk of bias in included studies, and performed meta-analyses using RevMan 5.4 software. Results There were four publications included, all of which were single-arm clinical studies. The KRAS^G12C inhibitors that completed clinical phase Ⅰ and Ⅱ trials were sotorasib and adagrasib, with two publications each. A total of 388 and 394 patients were included in the efficacy evaluation and safety evaluation, respectively. Resultsof the Meta-analysis showed that the patients had objective response rate, overall disease control, and disease stabilization rates of 35%, 82%, and 45%, respectively. In addition, the rate of serious adverse events, general adverse events, and all adverse events in patients was 2%, 28%, and 79%, respectively. Moreover, the rate of partial remission of disease in NSCLC patients was 38%. Conclusion The KRAS^G12C inhibitors sotorasib and adagrasib exhibited good efficacy and high safety in advanced solid tumors.