Clinical data of 61 cases of imported malaria were analyzed retrospectively.Patients with malaria were divided into three groups,asymptomatic tertian (vivax) malaria,symptomatic tertian malaria and pernicious (falciparum) malaria.Only mild hepatic damage occurred in some patients with asymptomatic tertian malaria,compared with other groups Symptomatic tertian malaria and pernicious malaria were misdiagnosed in 6 of 20 and three of six,respectively before hospitalization,and 16 of 20 and four of six patients complicated with thrombocytopenia,respectively,and both of them had increased serum level of C-reactive protein (CRP).Platelet count negatively correlated with their serum level of CRP significantly in patients with symptomatic tertian malaria (r =-0.555,P ＜ 0.05).Routine anti-malaria therapy was used in imported malaria,blackwater fever occurred in two patients and acute renal failure occurred in one with falciparum malaria.It is suggested plasmodium exam ination in peripheral blood should be performed in all persons returned from countries prevalent with malaria,thrombocytopenia is an indicator of acute malaria,and more severe complications usually tend to occur in falciparum malaria.

Objective To investigate the apoptotic effect of microRNA-1 (miR-1) on hypoxemic cardiomyocytes. Methods The cultured H9C2 cells were divided into 5 groups:normal control group, negative control group, H2O2 group, miR-1 group and H2O2+miR-1 group. After verified the success of transfection by real time PCR, MTT and flow cytometry methods were used to test the cell vitality and apoptotic rate, while the mRNA and protein expression level of Bcl-2 were de-tected by real time PCR and Western blot methods. Results Compared with normal control group, there were no significant differences in all indexes in negative control group. The application of H2O2 and miR-1 respectively or together significantly increased the miR-1 level and apoptotic rate, and reduced the cell vitality and Bcl-2 expression level. Conclusion mi-croRNA-1 can induce cardiomyocyte apoptosis by downregulating anti-apoptosis factor Bcl-2.

Objective To report surgical outcomes of managing comminuted fractures of the inferior patellar pole with separate vertical wiring plus anchor suture fixation.Methods From January 2010 to January 2015,37 patients with comminuted fractures of the inferior patellar pole were treated with separate vertical wiring and anchor suture fixation.They were 15 men and 22 women,from 32 to 76 years of age (average,55.1 years).The intervals from fracture to surgery ranged from 2 to 3 days (average,2.1 days).According to the AO classification,all the fractures were type 34-A1.The visual analogue scale (VAS) scores,ranges of motion (ROM) of the knee,Bostman scores and postoperative complications were recorded at 6 weeks,3,6 and 12 months and the final follow-up postoperatively.Results The follow-up time for the 37 patients averaged 16 months (range,from 12 to 23 months).The fracture union time averaged 10 weeks after surgery (range,from 8 to 13 weeks).At postoperative 6 weeks,3,6 and 12 months and the final follow-up,respectively,the average VAS scores were 2.5,1.1,0.3,0.2 and 0.2 points,the average ranges of motion 109.5°,123.7°,128.6°,129.1° and 132.5°,and the average Bostman scores 23.7,26.9,29.1,29.4 and 29.6 points.No patient reported delayed union,nonunion,loss of reduction,wire breakage,wound problem or irritation from the implant.Conclusion Separate vertical wiring combined with anchor suture fixation is a useful technique for comminuted fractures of the inferior patellar pole,for it is easy to perform,allows early functional exercise and leads to fine curative outcomes.

Objective To explore the effects of electroacupuncture at Baihui (DU20) acupoint on learning and memory and its possible mechanism through the expression of brain-derived neurotrophic factor (BDNF) in APP/PS1 double-transgenic mice. Methods 30 female APP/PS1 double transgenic mice were randomly divided into model group, DU20 group and non-acupoint group, and 10 wild type mice con-sisted of wild group. DU20 group received electroacupuncture at Baihui and the non-acupoint group received electroacupuncture at non-acu-point for 28 days. Learning and memory was tested by Morris water maze. Deposition ofβ-amyloid (Aβ) peptide was determined by immu-nohistochemical staining. The expression of BDNF in cortex was examined by RT-PCR and Western blotting. Results Compared with the model group, DU20 group ameliorated the learning and memory ability of APP/PS1 double-transgenic mice (P<0.05), decreased the deposi-tion of Aβpeptide (P<0.05) and upregulated the gene and protein levels of BDNF (P<0.01). There was no significant difference between the model group and non-acupoint group (P>0.05). Conclusion Electroacupuncture at DU20 acupoint could ameliorate learning and memory in APP/PS1 double-transgenic mice. The mechanism may be related to increase the expression of BDNF and decrease the deposition of Aβ.

Objective To explore the correlation study of cerebral vascular hemo -dynamic index(CVHI) with blood pressure,body mass index (BMI)etc.in outpatients.Methods Participants were outpatients with non -invasive CVHI test,who were selected as study subjects.Height,weight,blood pressure and other general information were investigated and the distribution characteristics of blood pressure,BMI and CVHI were compared in different age and gender groups.Results A total of 28 616 subjects were included in the study.The age range was 11 -99 years. Means of CVHI integral score in males and females were (77.78 ±28.44)points and (79.18 ±27.8)points(t =4.275,P <0.01),and abnormality rates of the score(<75 points)were 30.1% and 28.1%(χ2 =13.444,P <0.01),the differences were statistically significant.CVHI score was decreased and the abnormal rate was increased with aging.Systolic blood pressure was elevated with aging and diastolic blood pressure was higher in middle age subjects (40 -65 years).The proportions of over weighted and obesity in male were 37.5% and 15.4%,which in female were 33.2% and 14.9%(χ2 =70.661,P <0.01).It was especially higher in middle age subjects.Conclusion Degree of injury of cerebrovascular function and level of systolic blood pressure are along with aging.Means of BMI and diastolic blood pressure is higher in middle age population.The rate of high risk individuals in outpatients is about 30%.

PURPOSE: Breast cancer is the most frequently diagnosed malignancy in women worldwide. MicroRNAs (miRNAs) are thought to serve as potential biomarkers in various cancers, including breast cancer. METHODS: We evaluated the miRNA expression profiles in 1,083 breast cancer samples and 104 normal breast tissues from The Cancer Genome Atlas database. We used the edgeR package of R software to analyze the differentially expressed miRNAs in normal and cancer tissues, and screened survival-related miRNAs by Kaplan-Meier analysis. A receiver operating characteristic curve was generated to evaluate the accuracy of these miRNAs as molecular markers for breast cancer diagnosis. Furthermore, the functional role of these miRNAs was verified using cell experiments. Targets of candidate miRNAs were predicted using 9 online databases, and Gene Ontology (GO) functional annotation and pathway analyses were conducted using Database for Annotation, Visualization and Integrated Discovery online tool. RESULTS: A total of 68 miRNAs showed significantly different expression patterns between the groups (p < 0.001), and 13 of these miRNAs were significantly associated with poor survival (p < 0.05). Three miRNAs with high specificity and sensitivity, namely, miR-148b-3p, miR-190b, and miR-429, were selected. In vitro experiments showed that the overexpression of these 3 miRNAs significantly promoted the proliferation and migration of MDA-MB-468 and T47D cells and reduced the apoptosis of T47D cells. GO and pathway enrichment analyses revealed that the targets of these dysregulated miRNAs were involved in many critical cancer-related biological processes and pathways. CONCLUSION: The miR-148b-3p, miR-190b, and miR-429 may serve as potential diagnostic and prognostic markers for breast cancer. This study demonstrated the roles of these 3 miRNAs in the initiation and progression of breast cancer.
Apoptosis ; Biological Phenomena ; Biological Processes ; Biomarkers ; Breast Neoplasms ; Breast ; Diagnosis ; Female ; Gene Ontology ; Genome ; Humans ; In Vitro Techniques ; Kaplan-Meier Estimate ; MicroRNAs ; ROC Curve ; Sensitivity and Specificity

Objective To explore the scan technique and image quality of coronary artery imaging with dual-source CT without oral Betaloc preparation.Methods Plain and enhanced dual-source CT coronary artery imaging without oral Betaloc preparation was performed in 215 patients with clinically suspected coronary heart disease or early-stage coronary lesions.Calcium scoring with plain scan images and multi-planar reconstruction(MPR),maximum intensity projection(MIP)and volume rendering technique (VRT)reconstruction with enhanced scan images were made in all cases.The scan technique and post reconstruction experience was summarized.The image quality was classified as three grades,and coronary segments classified according to AHA standards were evaluated.Results The median of calcium score of the 215 cases was 82.2(2.3—1827.9).The average heart rate of the enhanced scan was(80.6?15.3) (57—139)bpm.The post reconstruction methods with which coronary segments could be shown as best as possible consisted of(1)multiphases screening methods,(2)bi-phase or multiple-phase complement method,and(3)premature beat removing or arrhythmia shifting method.Altogether 3026 coronary segments were evaluated,among them 97.5% were evaluated as grade 1 image quality,2.0% were evaluated as grade 2 and 0.5% were evaluated as grade 3.The coronary segments in 91 cases were completely normal, while 112 segments with

Objective To compare measurements of dual-energy CT iodine map parameters and liver perfusion CT parameters in patients with focal liver lesions using a third-generation dual-source CT scanner. Methods Between November 2015 and August 2016,33 patients with non-cystic focal lesions of liver were enrolled in this study. CT examinations were performed with a third-generation dual-source CT. The study CT protocol included a perfusion CT and dual-energy arterial and portal venous scans,with a time interval of 15 minutes. Iodine attenuation was measured at five region of interests including areas of high,medium,and low density within the lesion,as well as right and left liver parenchyma from the iodine map,while arterial liver perfusion (ALP),portal venous liver perfusion (PVP),and hepatic perfusion index (HPI) at the same location were measured from perfusion CT. The Pearson product-moment correlation coefficient was used to evaluate the relationship between iodine attenuation and perfusion parameters. Results The iodine attenuation at arterial phase showed significant intra-individual correlation with ALP (r=0.812,95% CI=0.728-0.885,P<0.001)and PVP (r=-0.209,95% CI=-0.323--0.073,P=0.007),but not significantly correlated with HPI (r=0.058,95% CI=0.046-0.498,P=0.461). The iodine attenuation at portal venous phase showed significant correlation with PVP (r=0.214,95% CI=0.072-0.361,P=0.005) but not with HPI(r=0.036,95% CI=-0.002-0.242,P=0.649). The mean effective dose of arterial phase and portal venous phase of dual-energy CT together [(3.53±1.17)mSv] was significantly lower than that of the perfusion CT [(14.53±0.45)mSv](t=25.212,P<0.001). Conclusion Iodine attenuation from arterial phase of dual energy CT demonstrates significant correlation with ALP and PVP,and iodine attenuation from portal venous phase demonstrates significant correlation with PVP.
Contrast Media ; Humans ; Iodine ; Liver ; diagnostic imaging ; pathology ; Perfusion ; Portal Vein ; Tomography, X-Ray Computed ; methods

Objective: To investigate the risk factors of anastomotic leakage (AL) after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy and construct a nomogram prediction model. Methods: This study was a retrospective case-control study that collected and reviewed the clinicopathological data of 359 patients who underwent laparoscopic surgery from January 2012 to January 2018, including 202 patients from the Department of General Surgery, Nanfang Hospital of Southern Medical University and 157 patients from the Department of Gastrointestinal Surgery of Fujian Provincial Cancer Hospital. Inclusion criteria: (1) age ≥ 18 years old; (2) diagnosis as rectal cancer by biopsy before treatment; (3) distance from tumor to anus within 12 cm; (4) locally advanced stage (T3-T4 or N+) diagnosed by imaging (CT, MRI, PET or ultrasound); (5) standardized neoadjuvant therapy followed by laparoscopic radical operation. Exclusion criteria: (1) previous history of colorectal cancer surgery; (2) short-term or incomplete standardized neoadjuvant therapy; (3) Miles, Hartmann, emergency surgery, palliative resection; (4) conversion to open surgery. Clinicopathological data, including age, gender, body mass index (BMI), preoperative albumin, distance from tumor to anus, operation hospital, American Society of Anesthesiologists score (ASA score), operation time, T stage, N stage, M stage, TNM stage, pathological complete response (pCR) were analyzed with univariate analysis to identify predictors for AL after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy. Then, incorporated predictors of AL, which were screened by multivariate logistic regression, were plotted by the "rms" package in R software to establish a nomogram model. According to the scale of the nomogram of each risk factor, the total score could be obtained by adding each single score, then the corresponding probability of postoperative AL could be acquired. The area under ROC curve (AUC) was used to evaluate the predictive ability of each risk factor and nomogram on model. AUC > 0.75 indicated that the model had good predictive ability. The Bootstrap method (1000 bootstrapping resamples) was applied as internal verification to show the robustness of the model. The discrimination of the nomogram was determined by calculating the average consistency index (C-index) whose rage was 0.5 to 1.0. Higher C-index indicated better consistency with actual risk. The calibration curve was used to assess the calibration of prediction model. The Hosmer-Lemeshow test yielding a non-significant statistic (P>0.05) suggested no departure from the perfect fit. Results: Of 359 cases, 224 were male, 135 were female, 189 were ≥ 55 years old, 98 had a BMI > 24 kg/m², 176 had preoperative albumin ≤ 40 g/L, 128 had distance from tumor to anus ≤ 5 cm, 257 were TNM 0-II stage, 102 were TNM III-IV stage, and 84 achieved pCR after neoadjuvant therapy. The incidence of postoperative AL was 9.5% (34/359). Univariate analysis showed that gender, preoperative albumin and distance from tumor to the anus were associated with postoperative AL (All P<0.05). Multivariate logistic regression analysis revealed that male (OR=2.480, 95% CI: 1.012-6.077, P=0.047), preoperative albumin ≤40 g/L (OR=5.319, 95% CI: 2.106-13.433, P<0.001) and distance from tumor to anus ≤ 5 cm (OR=4.339, 95% CI: 1.990-9.458, P<0.001) were significant independent risk factors for postoperative AL. According to these results, a nomogram prediction model was constructed. The male was for 55 points, the preoperative albumin ≤ 40 g/L was for 100 points, and the distance from tumor to the anus ≤ 5 cm was for 88 points. Adding all the points of each risk factor, the corresponding probability of total score would indicated the morbidity of postoperative AL predicted by this nomogram modal. The AUC of the nomogram was 0.792 (95% CI: 0.729-0.856), and the C-index was 0.792 after internal verification. The calibration curve showed that the predictive results were well correlated with the actual results (P=0.562). Conclusions Male, preoperative albumin ≤ 40 g/L and distance from tumor to the anus ≤ 5 cm are independent risk factors for AL after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy. The nomogram prediction model is helpful to predict the probability of AL after surgery.

Despite exciting achievements with some malignancies, immunotherapy for hypoimmunogenic cancers, especially glioblastoma (GBM), remains a formidable clinical challenge. Poor immunogenicity and deficient immune infiltrates are two major limitations to an effective cancer-specific immune response. Herein, we propose that an injectable signal-amplifying nanocomposite/hydrogel system consisting of granulocyte-macrophage colony-stimulating factor and imiquimod-loaded antigen-capturing nanoparticles can simultaneously amplify the chemotactic signal of antigen-presenting cells and the "danger" signal of GBM. We demonstrated the feasibility of this strategy in two scenarios of GBM. In the first scenario, we showed that this simultaneous amplification system, in conjunction with local chemotherapy, enhanced both the immunogenicity and immune infiltrates in a recurrent GBM model; thus, ultimately making a cold GBM hot and suppressing postoperative relapse. Encouraged by excellent efficacy, we further exploited this signal-amplifying system to improve the efficiency of vaccine lysate in the treatment of refractory multiple GBM, a disease with limited clinical treatment options. In general, this biomaterial-based immune signal amplification system represents a unique approach to restore GBM-specific immunity and may provide a beneficial preliminary treatment for other clinically refractory malignancies.