Objective To establish a mouse model of circulating tumor cells (CTCs) by applying mouse hepatoma Hapa 1-6 cells.Methods 108 healthy male C57BL/6 mice were randomly divided into 3 groups according to their body weights.Hepa 1-6 cell suspension was intravenously injected to each mouse in the three groups at a concentration of 1×106,5×106 and 1×107/mL,0.2 mL per mouse,respectively.Blood samples were collected from the mice on the 1st,5th,9th,13th,17th and 21st days after tumor cell injection.The number,ratio and relative inhibition rate of CTCs were calculated in 20,000 nucleated cells.The mortality of mice was recorded.②80 male C57BL/6 mice were averaged into 2 groups according to their body weight: control and sorafenib tosylate groups.0.2 mL of Hepa 1-6 single cell suspension was injected to each mouse through the caudal vein at a concentration of 5×106/mL.The mice were gavaged with sorafenib tosylate (50 mg/kg) for 21 days and blood samples were collected at the 3rd,8th,15th,and 21st days for CTC assessment.Results For the 1×106/mL group,the CTC inhibition rate was 25.1%,18.1%,8.9%,4.4%,2.9% and 0.3% on the 1st,5th,9th,13th,17th and 21st days,respectively,and all the mice were alive.For the 5×106/mL group,the CTC inhibition rate was 40.4%,35.4%,15.4%,9.0%,6.6% and 4.1% on the 1st,5th,9th,13th,17th and 21st days,respectively,and all the mice were alive.For the 1×107/mL group,the CTC inhibition rate was 39.1% and 33.5% on the 1st and 5th days,respectively.Some mice died immediately after intravenous injection and all mice died within 7 days.②The relative clearance of CTCs was-7.5%,4.6%,55.3% and-94.5% on the 3rd,8th,15th and 21st days of sorafenib tosylate administration.Compared with the control group,there were significant differences among the three groups (P<0.05 or P<0.01).Conclusions A mouse model of circulating hepatoma cells has been established by intravenous injection of 0.2 mL of 5×106/mL mouse Hepa 1-6 cell suspension.This mouse model can be used for screening and evaluation of drugs for circulating tumor cell inhibition.

Objective:To evaluate the clinical efficacy and safety of compound acid combined with Chinese medicinal liniment pourmask in the treatment of pigmentation after acne.Methods:From October 2020 to October 2021, the Department of Dermatology, the First Affiliated Hospital of Anhui College of Traditional Chinese Medicine divided 96 patients with pigmentation after acne inflammation, 34 males, 62 females, aged 18-53 (27.4±7.3) years, into a joint group (compound acid combined with Chinese medicinal liniment pourmask, n=32), compound acid group ( n=32) and Chinese medicinal liniment pourmask group ( n=32). Compound acid was used once every 2 weeks, Chinese medicinal liniment pourmask twice a week, a total of 8 weeks. The clinical efficacy of 2 weeks and 4 weeks after treatment was different from that before treatment ( P<0.05). The pigmentation degree score and the total efficacy of each group were assessed at 2 weeks and 4 weeks after the end of treatment. The occurrence of adverse reactions in each group during the treatment cycle was also recorded. Results:After 2 weeks and 4 weeks of follow-up after the course of treatment, the pigmentation score of the three groups of patients decreased, and the difference was statistically significant ( P<0.05). The total effective rates of the combined group were 68.75% (22/32) and 96.88% (31/32) at 2 and 4 weeks after treatment respectively, both were higher than that of the compound acid group and Chinese medicinal liniment pourmask group ( P<0.05). There was no significant difference in total effective rate between compound acid group and Chinese medicinal liniment pourmask group ( P>0.05). Conclusions:The efficacy of compound acid combined with Chinese medicinal liniment pourmask group in the treatment of pigmentation after acne is remarkable and the safety is good, and therefore it is worth promoting.

  Objective  To evaluate the effect of intraoperative multimodal analgesia on the early postoperative quality of recovery in end-stage head and neck cancer patients undergoing open gastrostomy surgery.  Methods  This was a prospective, parallel, randomized controlled study. The research subjects were end-stage head and neck cancer patients who underwent elective open gastrostomy at Beijing Tongren Hospital affiliated to Capital Medical University from November 2022 to May 2023. The patients were randomly divided into local anesthesia group and multimodal analgesia group at a 1∶1 ratio. For local anesthesia group, 0.25% ropivacaine 20-30 mL was administered for local infiltration anesthesia. For multimodal analgesia group, the anesthesia method was nerve block + intravenous analgesia: ultrasound-guided left transverse abdominis plane block (0.25% ropivacaine 0.3 mL/kg)+bilateral rectus abdominis sheath block (0.25% ropivacaine 0.3 mL/kg per side)+intravenous injection of oxycodone 0.1 mg/kg, flurbiprofen 1 mg/kg, and dexamethasone 0.2 mg/kg. The primary outcome measure was the quality of requirements-15 (QoR-15) score at postoperative 24 h, while the secondary outcome measures were the QoR-15 score at postoperative 48 h, the numerical rating scale (NRS) and Bruggemann comfort scale (BCS) scores at different time points after the surgery, the first time of rescue analgesia, the first time of off-bed activity and intestinal exhaust, as well as the incidences of adverse reactions within postoperative 48 h.  Results  A total of 46 patients with end-stage head and neck cancer who underwent open gastrostomy and met the inclusion and exclusion criteria were ultimately enrolled, with 23 patients in multimodal analgesia group and 23 patients in local anesthesia group. There was no statistically significant difference in preoperative QoR-15 scores between the two groups (P > 0.05). Multimodal analgesia group had higher QoR-15 scores at 24 h postoperatively[(81.77±8.91) vs. (71.46±7.61), P < 0.05] and 48 h postoperatively[(86.26±7.92) vs. (80.13±6.98), P < 0.05], and the difference in QoR-15 scores at 24 h postoperatively was clinically significant. Compared with local anesthesia group, at 6 h and 24 h after surgery, the multimodal analgesia group showed a decrease in NRS scores at rest and during exercise, while the comfort BCS score increased (all P < 0.05). Multimodal analgesia group also had a delayed time for the first rescue analgesia, a reduced incidence of rescue analgesia within 48 h after surgery, an earlier time for first postoperative off-bed activity and intestinal exhaust (all P < 0.05). The incidence of adverse reactions in multimodal analgesia group and local anesthesia group was 8.70% and 13.04%, respectively, but the difference was not statistically significant (P > 0.05).  Conclusion  Intraoperative multimodal analgesia can effectively alleviate postoperative pain, increase the comfortable degree, shorten the first time of postoperative off-bed activity and intestinal exhaust, and accordingly improve the quality of early postoperative recovery in patients undergoing open gastrostomy.

In the clinical settings, disseminated intravascular coagulation (DIC) and complications such as hemorrhage are commonly seen in acute promyelocytic leukemia patients, whereas thrombosis is rarely reported. We reported a case here that the patient presented with cerebral infarction as the first manifestation. During the admission, the patient encountered differentiation syndrome, pulmonary embolism, pulmonary hemorrhage, and myocardial ischemia, as well as bleeding and thrombosis complications. Hence the patient was diagnosed as DIC. After the treatment of blood transfusion instead of anticoagulation, his condition was stable and the remission was completely achieved. The treatment experience provides guides for other patients with similar complications of simultaneous bleeding and thrombosis.
Blood Coagulation ; Cerebral Infarction ; Disseminated Intravascular Coagulation ; etiology ; Humans ; Leukemia, Promyelocytic, Acute ; complications ; Thrombosis

To study the protective effect of Xingnaojing Injection on early global brain ischemia-induced deep coma in rats.
 Methods: The deep coma model was induced by global brain ischemia by using four-vessel occlusion method in male SD rats. According to the body weight, the rats were randomly divided into 8 groups: a model control group, three different dose of Xingnaojing Injection (1.8, 3.6 and 5.4 mL.kg-1) groups, a Xingnaojing Injection (3.6 mL.kg-1) plus PI3K inhibitor group, a naloxone injection (0.04 mL.kg-1) group and a naloxone injection (0.04 mL.kg-1) plus Xingnaojing Injection (3.6 mL.kg-1) group (n=8 per group). In addition, eight animals served as the sham group were performed same operation with the model group excepting no blockage of the blood vessels. After the operation, three different doses of Xingnaojing Injection and/or naloxone injection were given intravenously once a day for three days. Ten μL PI3K inhibitor (LY294002, 10 mmol/L) was injected via anterior cerebral ventricle at once after global brain ischemia. The awakening time after the first drug treatment, the grasping power and the autonomous activity within 10 min after the last drug treatment were recorded. The levels of both dopamine (DA) and glutamate (Glu) in cerebrospinal fluid were detected by ELISA. The pathological changes were observed in brain tissue slices with HE staining and the protein levels of Akt/p-Akt and cAMP-response element binding protein (CREB)/p-CREB in hippocampus were detected by Western blotting.
 Results: Comparing with the model group, single administration of Xingnaojing Injection could significantly shorten the waking time (P<0.05) and continuous administration of Xingnaojing Injection for 3 d could increase grasping power, distance, frequency and duration of autonomous activities (P<0.05 or P<0.01) in the deep coma rat. Also, Xingnaojing Injection could inhibit these increases in neurotransmitters DA and Glu contents (P<0.05 or P<0.01), and improve pathological changes of hippocampal tissue. Xingnaojing Injection significantly induced protein phosphorylation of both Akt and CREB (P<0.05 or P<0.01); this effect was inhibited by PI3K inhibitor (P<0.05 or P<0.01). Moreover, the protective effects of naloxone on awakening time, grasping power, the autonomous activity and hippocampus damage in global brain ischemia-induced deep coma could be enhanced by joint use of Xingnaojing Injection (P<0.05 or P<0.01).
 Conclusion: Xingnaojing Injection could significantly improve deep coma induced by global brain ischemia in rat, which is related to inducing PI3K/Akt-dependent protein phosphorylation of CREB, and reducing hippocampal damage. The protective effect of Xingnaojing Injection is synergistically enhanced by naloxone.
Animals ; Brain ; Brain Ischemia ; Coma ; Drugs, Chinese Herbal ; Male ; Phosphatidylinositol 3-Kinases ; Rats ; Rats, Sprague-Dawley