Objective To investigate the effect of hydrogen sulfide (H2S) on brain injury and inflammatory response after cerebral ischemia/reperfusion in rats.Methods Forty-eight malc SD rats were randomly divided into four groups:sham operation group,ischemia/reperfusion (I/R) group,H2S-30 ppm group,and H2S-60 ppm group (n=12 in each group;1 ppm=1 mg/L).The middle cerebral artery occlusion method was used to induce a model of focal cerebral ischemia for 2 h and reperfusion for 24 h.After reperfusion for 24 h,the tape remove experiment was used to perform the nerve function evaluation.2,3,5-triphenyl-tetrazolium chloride staining method was used to measure the percentage of cerebral infarction volume.Enzyme-linked immunosorbent assay was used to measure the levels of interleukin (IL)-1 β and IL-6.Western blotting was used to detect the expression levels of inducible nitric oxide synthase (iNOS) and intercellular cell adhesion molecule-1 (ICAM-1),as well as the transposition activation of nuclear factor-κB (NF-κB).Results Inhalation of H2S could shorten the time required to remove the tape in a dose-dependent manner compared with the I/R group (I/R group vs.H2S 30 ppm group and H2S 60 ppm group:180 s vs.130 [113-157]s vs.110 [87-138] s;P＜ 0.05),reduced the cerebral infarct volume (48.8％ ± 9.1％ vs.23.3 ％ ± 5.1％ vs.17.3 ％ ± 3.5 ％;P ＜ 0.05),downregulated the expression levels of IL-1β (39.53± 6.02 pg/mg protein vs.30.17± 3.46 pg/mg protein vs.22.69± 6.09 pg/mg protein;P ＜0.05) and IL-6 (54.65 ± 10.68 pg/mg protein vs.37.89 ±4.54 pg/mg protein vs.27.00 ±3.08 pg/mg protein;P ＜ 0.05) in ischemic brain tissue,significantly decreased NF-κB nucleus/ cytoplasm ratio (4.40 ± 1.05 vs.3.07 ± 0.82 vs.2.30 ± 0.60;P ＜ 0.05),inhibited expressions of iNOS (4.22 ±0.67 vs.3.14 ±0.90 vs.2.08 ±0.35;P ＜0.05),and ICAM-1 (5.45 ± 1.08 vs.3.45 ±0.67 vs.2.21 ±0.39;P ＜0.05).Conclusions Inhalation of exogenous H2S can reduce cerebral infarct volume after cerebral ischemia/reperfusion in a dose-dependent manner and improve neurological function.Its mechanism may be associated with the inhibition of NF-κB activation,down-regulation of its downstream iNOS and ICAM-1 expression levels,and decrease of IL-1β and IL-6 levels.

OBJECTIVETo observe the effects of "menstrual cycle-based acupuncture therapy" on ovarian function and pregnancy results of in vitro fertilization-embryo transfer (IVF-ET) in patients with decline in ovarian reserve (DOR).

METHODSA total of 63 patients of DOR who received treatment of IVF/intracytoplasmic sperm injection (ICSI) were randomly divided into an observation group (30 cases) and a control group (33 cases). The patients in the observation group were treated with "menstrual cycle-based acupuncture therapy". The syndrome differentiation and treatment were given based on different phases of menstruation. Shiqizhui (EX-B 8) and Mingmen (GV 4) were selected during menstrual phase, Shenshu (BL 23), Geshu (BL 17), Sanyinjiao (SP 6) and Taixi (KI 3) were selected after menstruation, Qihai (CV 6), Guanyuan (CV 4), Zigong (EX-CA 1), Zusanli (ST 36) were selected during ovulatory period, Qihai (CV 6), Guanyuan (CV 4), Yanglingquan (GB 34), Taichong (LR 3) were selected before menstruation. The acupuncture was given twice a week until second menstrual cycle of oocyte retrieval. The total times of acupuncture was (15 ± 2). After acupuncture, patients were treated with IVF-ET. The patients in the control group were treated with IVF-ET but no acupuncture. The indices of ovarian reserve function, including basic follicle-stimulating hormone (FSH), estradiol (E2), antral follicle count (AFC), number of retrieved oocytes, number of fertilization and number of high quality embryo, were compared and analyzed before and after acupuncture in the observation group. The differences of outcomes of IVF-ET, including the cycle cancellation rate, implantation rate, the clinical pregnancy rate, were compared between the two groups.

RESULTSCompared before acupuncture, the E2, AFC, number of retrieved oocytes, number of high quality embrgo and number of fertilization were all increased after acupuncture in the observation group (all P< 0. 05). Compared with the control group, levels of the E2, the number of retrieved oocytes, number of fertilization and number of high quality embryo were all increased in the observation group (all P < 0.05). Also, the implantation rate, the clinical pregnancy rate were improved (both P < 0.01) and cycle cancellation rate was reduced (P< 0.01).

CONCLUSIONThe "menstrual cycle-based acupuncture therapy" can effectively improve the ovarian reserve function in DOR patients, leading to an improved clinical pregnancy rate of IVF-ET.

Acupuncture Therapy ; Adult ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Infertility, Female ; physiopathology ; therapy ; Menstrual Cycle ; Middle Aged ; Ovarian Reserve ; Ovary ; physiopathology ; Pregnancy ; Young Adult

Objective Acute massive pulmonary embolism(PE)is a clinical emergency requiring rapid and supportive measures.With the development of interventional technology and devices,percutaneous mechanical thrombectomy(PMT)is considered to be an alternative for the treatment of PE,though there is still relative lack of clinical experience.The purpose of this study is to evaluate the clinical efficacy and safety of PMT in the management of acute massive PE.Methods The clinical data of massive PE patients treated with interventional methods were collected and analyzed in a retrospective way.From Jan.2003 to Jan.2008,6 patients(5 males and one female,with a mean age of 62 years)with acute massive PE,which was initially diagnosed by computed tomography and finally confirmed by pulmonary angiography,were treated with percutaneous catheter fragmentation and/or Straub Rotarex thrombectomy device.Results The improvement of clinical status and restoration of blood flow in the main branches of pulmonary artery were obtained in all patients.Oxygen saturation(SaO2)increased from preoperative(79.5±5.3)%to postoporative (92.8±3.4)%,with P＜0.01.Partial arterial oxygen pressure(PaO2)increased from preoperative(58.0±9.8)mmHg to postoperative(88.7±4.1)mmHg(P＜0.01).After PMT treatment,the mean pulmonary artery pressure(PAP)decreased from preoperative(40.8±7.8)mmHg to postoperative(29.8±8.0)mmHg (P＜0.01).Miller index decreased from preoperative 0.54±0.03 to postoperative 0.18±0.07(P＜0.01).During a clinical follow-up period ranged from 1 to 5 years,four patients showed no recurrence of PE,the other two patients lost touch with the authors.Conclusion The preliminary experience in onr series suggests that PMT is an easy,effective and safe therapy in the clinical management of acute massive PE,especially when thrombolysis is contraindicated.

[Objective]This study was aimed to evaluate treatment outcomes and toxicity of continuous-infusion EPOCH regimen for NK/T-cell lymphoma(NK/TCL).[Methods]From June 2003 to June 2008,34 patients including 30 nasal NK/TCL (88.2%)and 4 nasal type NK/TCL(11.8%)received doxorubicin,vincfistine,etoposide over 96 hours infusion with bolus eyelophosphamide and oral predinisone(EPOCH)chemotherapy as first-line treatment.Median cycles of EPOCH administered were 2.5(1-6 cycles).Additional involved field radiation therapy(IFRT)was administered to patients with localized nasal focus after chemotherapy.[Results]Among 34 patients,33 were eligible for response evaluation.The response rate(RR)was 60.6% (20/33)with complete remission(CR)rate of 45.5%(15/33).The RR of patients with nasal NK/TCL was 66.7%(20/30)with CR rate of 50%(15/30).Only one of the 3 nasal type NK/TCL patients achieved stable disease(SD),the other 2 had progressive disease(PD)during chemotherapy.After a median follow-up of 22(2-68)months,the estimated 3-year overall survival rate(OS)was 52.2%.For patients with nasal NK/TCL,the estimated median survival time was not reached,the 3-year OS was 59.4%.For patients with nasal type NK/TCL,the estimated median survival time was only 7 months.The CR rate was 75.0% for localized nasal NK/TCL who received initial EPOCH chemotherapy followed IFRT with the 3-year OS of 75.0%.Major adverse effect was myelosuppression.The incidence of grade Ⅲ～Ⅳ neutropenia was 30.9%.No treatment-related mortality occurred.[Conclusions]EPOCH regiment was effective and well tolerant for nasal NK/TCL.Combined EPOCH chemotherapy followed by IFRT produced promising outcome for patients with localized disease.However,patients with nasal type NK/TCL responded poorly and more efficacious treatment strategies are urgently needed.

Objective To explore the empathy deficits of adolescents with different types of conduct disorder. Methods The participants included 65 adolescents ( who met the DSM-Ⅳ criteria for conduct disorder)ranging from 13 ～ 18 in age,and 195 normal adolescents ranging from 13 ～ 18 in age. All participants were assessed by revised Basic Empathy Scale. 65 patients were divided into 4 subgroups according to symptoms: destructive-nondestructive subgroups and overt-covert subgroups. Results (1) Scores of cognitive empathy were lower in patients than normal controls ( (29.86 ± 4.72) vs ( 32.09 ± 4.94), P ＜ 0. 01 ). (2) There were significant differences in the levels of cognitive empathy between patients and controls (P＜0. 01 ). Scores of cognitive empathy were lower in destructive subgroup than controls ( (29.76 ± 4.46) vs ( 32.09 ± 4.94) , P ＜ 0.01 ). (3) There were significant differences in the levels of two dimensions and total scores of empathy between patients and controls (F=3.10 ～5.36, P ＜ 0.05 ). Scores of cognitive empathy were lower in overt subgroup ( 29.22 ± 3.77 ) and covert subgroup (30.21 ± 5.17 ) than controls (32.09 ± 4.94) (P＜ 0.05, P＜0.01 );and scores of affective empathy were lower in overt subgroup than covert subgroup ( (26.13 ±5.05) vs (29.50 ±4.16), P＜0.05 ). Total scores of empathy were lower in overt subgroup (55.35 ±7.09) than covert subgroup (59.71 ±7.58) and controls (60.04 ±8.50 ) (P＜0.05). (4) Logistic regression analysis showed that cognitive empathy was a protective factor for conduct disorders( OR = 0.43 ). Conclusion The cognitive empathy level of patients is significantly lower than normal students;and boys with different types of conduct disorder possess different empathic abilities when compared with healthy controls;and cognitive empathy is a protective factor for conduct disorder.

Objective To investigate the application value of Photoshop in grading invasive risk of gastric stromal tumors (GSTs). Methods EUS image of 97 cases of GSTs confirmed by pathological and immunohistochemical examination were collected. GSTs were divided into four groups (very low risk, low risk, intermediate risk, high risk) by tumor size, mitotic count and rupture of tumor. Mean gray value (intensity of echo) and gray value standard deviation (uniformity of echo) of EUS images of the lesions were determined by Photoshop and then the differences of each group were found by statistical analysis. Results It is difficult to differentiate EUS images of GSTs from each group by visual observation. The mean gray value of EUS image of very low risk group,low risk group, intermediate risk group and high risk group of GSTs respectively were (56.54 ± 6.10), (59.20 ± 7.51), (77.77 ± 10.90) and (83.43 ± 12.47). There was no significant difference between very low risk group and low risk group (P > 0.05). There was no significant difference between intermediate risk group and high risk group (P > 0.05). In addition, the others all had significantly different from that of each group (P < 0.05). The mean gray value standard deviation of EUS image of very low risk group, low risk group, intermediate risk group and high risk group of GSTs respectively were (8.46 ± 2.59), (12.57 ± 5.89), (12.84 ± 4.15) and (16.69 ± 4.69). There was no significant difference between low risk group and intermediate risk group (P > 0.05). In addition, the others all had significantly different from that of each group (P < 0.05). Conclusions The higher risk of GSTs, the higher of echo intensity and the worse of echo uniformity under EUS. Photoshop combined with EUS is helpful for differentiating different risk of GSTs by analyzing mean gray value and gray value standard deviation of the lesions.

Objective To determine the relationship between the serum level of β2-microglobin (β2-MG)and international prognostic index (IPI) and investigate the role of IPI in predicting the prognosis and making individualized therapy for peripheral T-cell lymphoma (PTCL).Methods Eighty-one patients with PTCL were treated by standard CHOP regimen.The clinical characteristics,response,long-term surival rates and the relationship between serum level of β2-MG and IPI scores were analyzed retrospectively.Results Eighty-one patients were eligible.All of them were treated by CHOP regimen.The overall response rate (RR) was 82.7 ％ with 53.1％ complete remission (CR) rate.The RR of IPI low risk,low-intermediate risk,high-intermediate risk,and high risk were 95.7 ％,87.5 ％,53.8 ％ and 20.0 ％,with CR rate 74.5 ％,37.5 ％,15.4 ％ and 0,respectively (P ＜0.05).The median survival times (MST) were 31.2 months at a median follow-up of 30 months (2-98 months).The acturial 1-,3-,and 5-year overall survival (OS) rates were 83.5 ％,41.8 ％ and 34.7 ％,respectively.The 5-year OS rates of low risk,low-intermediate risk,high-intermediate risk,high risk were 57.3 ％,55.9 ％,0 and 0,respectively (P ＜0.05).The OS rates of low risk group (IPI 0-2 scores) and high risk group (IPI 3-5 scores) were 54.8 ％ and 0,respectively (P ＜0.05).Serum levels of β2-MG were significantly elevated in the high risk group than those in the low risk group.The proportion of abnormal serum level of [β2-MG were also significantly elevated in the high risk group than those in the low risk group.The results of multivariante analysis showed that serum level of β2-MG and IPI scores were independent prognostic factors for PTCL (P＜0.05).Conclusion The serum level of β2-MG with IPI scores system can be uscd for evaluating the prognosis of PTCL patients.

Objective:To investigate the effect of a 2-year resistance and aerobic training on reducing the risk of cardiovascular disease in patients with prediabetes.Methods:A total of 248 patients with prediabetes were enrolled from Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from January to April 2014, and Danyang People′s Hospital and The First Affiliated Hospital of Guangxi Medical University from May to December 2014.Based on random number table method, the patients were divided into 3 groups: the resistance training group (RT group, 82 cases), the aerobic training group (AT group, 83 cases) and control group (83 cases). Participants in the RT group and the AT group underwent a total of 24 months of exercise training. Changes in indicators (blood glucose,blood lipid, etc.) at baseline and the end of 12 and 24 months among the groups were compared.Results:After intervention, glycosylated hemoglobin (HbA1c), low density lipoprotein cholesterol (LDL-C), blood pressure and homeostasis model 2 insulin resistance index (HOMA2-IR) in the RT and AT groups tended to decrease, and the steady state model 2 β cell function index (HOMA2-β) tended to increase. At the end of 24 months, HbA1c [5.80 (5.43, 6.20) %, 5.70 (5.50, 6.00)% vs. 6.20 (5.70, 6.60) %, all P≤ 0.01], LDL-C [3.07 (2.69, 3.58) mmol/L, 2.97 (2.62, 3.95) mmol/L vs. 3.21(2.54, 3.78) mmol/L, all P<0.05] and HOMA2-IR [0.96 (0.82, 1.47), 1.20 (0.99, 1.43) vs. 1.34 (1.09, 1.51), all P<0.05] were significantly decreased in the RT and AT groups than in the control group. In addition, HOMA2-β [84.50 (60.55, 107.33), 93.00 (78.60, 119.75) vs. 53.40 (37.70, 80.40), all P = 0.001] was significantly increased in the AT and RT groups compared with that in the control group. There were no significant differences in triglyceride (TG) and high-density lipoproteincholesterol (HDL-C) levels between the training groups and the control group (all P>0.05). After adjusting for age, sex and blood pressure, the cardiovascular risk of prediabetes was significantly reduced in RT ( P =0.017) and AT groups ( P =0.018). The Cox regression analyses showed that both the resistance training (HR=0.419, 95 %CI =0.415-0.942, P=0.037) and the aerobic training ( HR=0.310, 95 %CI=0.447-0.866, P=0.026) were protective factors for cardiovascular disease in prediabetic patients after adjustment of age, sex, statins, body mass index and waist-to-hip ratio, which reduced the risks of cardiovascular disease in prediabetic patients by 58.1% and 69.0%, respectively. Conclusions:Two years of aerobic and resistance training interventions have obvious advantages on glycemic and insulin resistance control in prediabetes patients. The resistance training can reduce the risk of cardiovascular disease, and it is, thus, recommended for prediabetic patients without obvious exercise contraindications.

ObjectiveTo investigate the changes of serum concentration of parathyroid hormone (PTH) and calcium after thyroid surgery and compare the changes among different modes of operation. MethodsFrom Aug. 2006 to Dec. 2009, 470 patients accepted thyroid surgery. The serum concentration of PTH and calcium in different groups was measured and compared before and 1 day after surgery. According to the extent and similarity of the surgery, patients were classified into 7 groups and they were compared in terms of postoperative changes of PTH and serum calcium. Statistical analysis was performed. ResultsThe serum concentration of PTH and calciurn decreased significantly after surgery in all patients except for those receiving unilateral and bilateral partial thyroidectomy. Compared with unilateral lobectomy, surgeries such as bilateral subtotal thyroidectomy, unilateral thyroidectomy with contralateral subtotal thyroidectomy, bilateral near-total thyroidectomy and total thyroidectomy resulted in more dramatic decreases of serum concentration of PTH and calcium and higher incidence of hypocalcemia ( P ＜ 0.05 ). The comparison between patients receiving CLND or not had the same result. Conclusions Almost all kinds of thyroid surgery affect the parathyroid function. The wider the surgery, the higher the possibility of postoperative hypoparathyroidism. The indications and criteria of different types of thyroid surgery are essential for hypoparathyroidism prevention. In some cases, vitamin D and calcium are recommended for preventive purpose.

Objective To establish an adverse event monitoring system in the course of encoding medical record homepages, using the internationally accepted Clavien-Dindo surgical complications grading standard, for the purpose of hospital′s medical safety management. Methods The surgical complications record system was established based on encoded medical record homepages. Data of three types of medical therapies of the discharge cases of a tertiary hospital in 2017 were studied and the incidence, type and grading of the surgical complications were analyzed, to identify doctors′missed diagnoses. Results A total of 588 surgical complications were detected from the discharge cases throughout the year. The incidence of surgical complications was 1.1% (588/52 319). The highest proportions of all surgical complications were infection and surgical incision problems. Grade Ⅱ complications accounted for the highest incidence rate (41.5% , 244/588); the proportion of missed surgical complications at the initial homepage was 62.2% (366/588), most of which being as grade Ⅱ complications ( 42.1% , 154/366). Conclusions The hospital adverse event monitoring system established based on the encoded medical record homepages features unified standard, making it feasible and universal, which serves an important role of the medical adverse event reporting system.