Lynch syndrome.(LS) is an autosomal dominant condition caused by a mutation in the mismatch repair genes (MMR).Endometrial cancer (EC) is the most common extra-colonic cancers of LS Ⅱ type.Among the female members of LS family with the MMR gene mutation,EC has an overall lifetime risk more than 35％.LS-associated EC is more likely present as the clinical pathological characteristics of early age of onset,endometrioid adenocarcinoma,lower grade,lower uterine segment involvement,and better prognosis.LS patients with family history and early age of onset should be performed with a combined screening and genetic testing,while high-risk patients should be taken clinical monitoring methods as endometrial biopsy.Oral contraceptives mav be reasonable chemopreventive agents in the patients with LS.Although prophylactic hysterectomy with bilateral salpingo-oophorectomy is an effective strategy to prevent EC in women with LS,preoperative counseling should address the trade-offs between the reduction in the risk of cancer,and the risks and side effects of surgery.The patients need hormone replacement therapy after surgery.

Aconitum, as a kind of common traditional Chinese medicine, contains multiple biological active substances, with a very high medicinal value but high toxicity. Its major toxic ingredients are aconitine, mesaconitine and hypaconitine, which are also efficient ingredients. Therefore, the safety of its clinical application has aroused wide attention. With the constant deepening of drug development studies, people want to learn about its toxic mechanism and the regularity of its emergence and development of its toxicology, so as to make a scientific and rational assessment for its safety. Therefore, toxicokinetics and metabonomics have gradually become important content in the new drug assessment. During the development of drug performance, it is crucial to establish a scientific, objective and standardized Aconitum safety evaluation system and correctly assess and utilize its toxicity. Having summarized studies on metabonomics and toxicokinetics of Aconitum drugs in recent years, authors proposed to strengthen the studies on Aconitum drug safety assessment and establish a scientific and standardized safety evaluation system as soon as possible, in order to make the national treasure more useful.
Aconitum ; chemistry ; toxicity ; Animals ; Drugs, Chinese Herbal ; pharmacokinetics ; toxicity ; Humans ; Metabolomics

Objective To investigate the influence of folic acid and vitamin B12 levels on the curative effect in Uygur and Han patients with non-small cell lung cancer(NSCLC) treated by first-line chemotherapy of pemetrexed combine with platinum.Methods Sixty-one Uygur and Han cases of NSCLC treated by the first-line chemotherapy of pemetrexed combine with platinum and at least two cycles of this regimen were selected.The folic acid and vitamin B12 levels before chemotherapy were detected by using the electrochemiluminescence method.The chemotherapeutic effect evaluation was performed once at least per 2 weeks.The follow up lasted until the disease progress or first line chemotherapy finish,furthermore the data collected from the two nationalities were performed the comparative analysis.Results The gender,smoking history,age,differentiation degree,staging and vitamin B12 level had no statistical differences between Uygur and Han NSCLC patients(P＞0.05);but the serum folic acid level in Han NSCLC patients was higher than that in Uygur NSCLC patients(P＜0.05).The gender,smoking history,age,tumor differentiation degree,neoplasm staging and serum vitamin B12 level had no influence on the prognosis in NSCLC patients using the pemetrexed combine with platinum chemotherapy(P＞0.05),while the prognosis in Han patients was better than that in Uygur patients(P＜0.05),and the patients with higher folic acid level had good prognosis.The progress free survival(PFS) in Han NSCLC patients was obviously superior to that in Uygur patients.Conclusion The serum folic acid level in Han NSCLC patients is higher than that in Uygur patients,and the curative effect in Han patients receiving the pemetrexed combine with platinum chemotherapy is obviously superior to that in Uygur patients,and serum folic acid level may be related with the prognosis in NSCLC patients.

Taking Doctor HUANG Shi-ping as the representative, the school of Huang's golden needle is based on Chinese martial art. Golden needles are adopted as main tool. Attaching great importance on the combination of acupuncture and moxibustioin, it is also characterized with penetrating needling with long needles. Through the development of three generations, it once outshone other schools in the field of acupuncture, and became famous all over the world. It made great contribution to the development of the course of acupuncture. However, with the development of the history, the form of acupuncture education as well as apparatus were all undergone an unified reform. Therefore, Doctor HUANG Shi-ping's acupuncture school be lost gradually.
Acupuncture ; education ; history ; Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, 19th Century ; History, 20th Century ; Humans ; Schools

Objective To explore the relationship between ATP content in CD4+ T lymphocytes and acute rejection after liver transplantation(LT). Methods This study contained 77 patients who received LT from February to October 2009, They were divided into AR (acute rejection) and NAR (non-acute rejection) groups while 56 healthy people were enrolled to serve as the control group.Blood specimens were collected preoperatively and at 1, 2 and 4 weeks postoperatively. For the AR group, specimens were also collected on the day when AR occurred and 1 week after steroid bump together with that of the healthy people. ImmuKnowTM test kits for immune cell function were used to assay the ATP value. Results ATP values within CD4+T lymphocytes were elevated significantly in each group compared with those preoperatively. Peak level was reached in the AR group and was significantly higher than that of the contemporary NAR group (P＜0.05). ROC curve analysis showed that the obvious elevation of the ATP value within CD4+ T lymphocytes 1 week postoperatively had better sensitivity and specificity in diagnosing AR. The ATP sensitivity rate for early AR was 84.6 %and specificity rate 81 %. The ATP value within CD4+ T lymphocytes on the day of AR occurrence had a positive relationship with the rejection acting index(RAI), while relative index (r) was 0. 876(P＜0.05). After the steroid dump treatment, AR in all the patients was reversed and the ATP value declined significantly as compared with the control group and the day when AR occurred(P＜0. 05).Conclusion During the postoperative period, the dynamic change of ATP value within CD4 + T lymphocyte had a close relationship with acute rejection after liver transplantation. Thus, it might be used as a feasible and noninvasive monitoring index for diagnosing AR and the effectiveness of the anti-rejection treatment.

Objective To compare the antiarrhythmic effects and safety of landiolol and esmolol .Methods The sequential method was used to detect the median lethal dose ( LD50 ) and 50%effective dose ( ED50 ) of the two drugs.Treatment index were calculated by LD 50/ED50 .Several of arrhythmia models were used to study the antiarrhythmic effects of landio-lol and esmolol in the equivalent dose .Results ED50 and LD50 of landio-lol and esmolol were 14.4 , 17.3 mg? kg -1 and 347 , 100 mg? kg -1 re-spectively , TI were 24.1 and 5.8.The ratio of equivalent dose between landiolol and esmolol on anti -chloroform induced arrhythmia was 0.83∶1.Landiolol and esmolol have similar anti -arrythmia effect on va-rious arrhythmia models.Esmolol has a stronger inhibition function on the heart rate than that of landiolol .Conclusion Compared with esmolol , landiolol has similar antiarrhythmic effect , gentle and slow effect on heart rate, higher treatment index and safety in equivalent dose .

[Abstact] Objective To investigate the characteristics of heart rate variability (HRV) of ambulatory electrocardiogram in patients with acute stroke, and evaluate the predictive value of HRV in stroke prognosis. Methods Eighty-three patients acute stroke (study group) and 83 cases of healthy subjects (control group) from October 2016 to October 2017 in Dalian Municipal Central Hospital Affiliated of Dalian Medical University were selected. The 24 h ambulatory electrocardiogram was performed to determine HRV in 2 groups, including standard deviation of NN intervals (SDNN), standard deviation of the 5 min mean cycle lengths (SDANN), root-mean-square successive difference (RMSSD) and percentage value of NN50 count (PNN50). Results The SDNN, SDANN, RMSSD and PNN50 in study group were significantly lower than those in control group: (80.83 ± 10.52) ms vs. (148.11 ± 22.59) ms, (79.98 ± 8.89) ms vs. (129.35 ± 5.34) ms, (19.28 ± 4.25) ms vs. (39.57 ± 2.38) ms and (5.91 ± 2.12) % vs. (19.35 ± 12.15) %, and there were statistical differences (P＜0.05). Among the 83 patients with acute stroke, there were no statistical differences in SDNN, SDANN, RMSSD and PNN50 between ischemic stroke (54 cases) and hemorrhagic stroke (29 cases) (P＞0.05). The SDNN, SDANN, RMSSD and PNN50 in right stroke (43 cases) were significantly lower than those in left stroke (40 cases): (75.18 ± 2.32) ms vs. (88.12 ± 3.58) ms, (73.36 ± 2.18) ms vs. (85.69 ± 7.29) ms, (17.57 ± 1.67) ms vs. (20.58 ± 4.23) ms and (4.39 ± 1.57) % vs. (8.61 ± 1.12) %, and there were statistical differences (P＜0.05). Patients were followed up for 1 year, 24 died and 59 survived. The SDNN, SDANN, RMSSD and PNN50 in dead patients were significantly lower than those in survived patients: (92.35 ± 4.58) ms vs. (154.37 ± 4.65) ms, (76.23 ± 4.03) ms vs. (143.95 ± 4.34) ms, (7.43 ± 2.12) ms vs. (31.65 ± 1.52) ms and (2.35 ± 0.46) % vs. (11.65 ± 0.48) % , and there were statistical differences (P＜0.05). Conclusions The autonomic nervous function of patients with acute stroke is seriously unbalanced, with increased sympathetic excitability and decreased vagus excitability. The decrease of HRV can easily induce cardiac events and seriously affect the prognosis.

Objective To study liver transplantation in the treatment of alcoholic liver disease (ALD).Methods A retrospective study was conducted on 40 patients with ALD who underwent liver transplantation in the Changzheng Hospital of the Second Military Medical University from April 2005 to June 2017.The data were expressed as mean ± standard deviation ((-x) ±s) in populations with a normal distribution,and as median (min～max) in populations with an abnormal distribution.The survival rate was analyzed by life tables,and the Cox regression analysis was used for multivariate analysis.Results All patients were followed up until August 31,2017.The follow-up time was 2 ～ 4518 days,with a median of 997 days.Among the 40 patients,8 had already died (3 died of multiple organ failure,2 of biliary complications,1 of liver failure,1 of sepsis and 1 of recurrence of hepatocellular carcinoma (HCC).The 1-year survival rate was 81.0％,and the 5-year survival rate was 77.0％.Four of 40 patients developed tumor recurrence.The initial recurrence time was 189 ～ 337 days (median 236.5).The recurrence sites included the liver,colon combined with lungs,lungs,and lumbar vertebrae.Six of 40 (15.0％) patients had relapse in alcoholism.Multivariate analysis showed that age was a prognostic factor (RR =1.109,P ＜0.05).Years of drinking,daily amount of alcohol intake,abstinence,a previous history of upper gastrointestinal bleeding,a previous history of splenectomy,co-existing hepatocellular carcinoma,preoperative MELD score,preoperative Child-Pugh score,total operation time,anhepatic period,cold ischemia time,amount of intraoperative bleeding,postoperative alcoholism relapse,tumor recurrence or new onset of tumor were not significantly correlated with the postoperative survival rate (P＞0.05).Conclusions ALD patients were mostly 40 ～ 60 years old.Age was an independent factor affecting survival.The younger the patient,the better the prognosis.Other factors were of no prognostic significance.

The application of prostate-specific antigen (PSA) in the screening and diagnosis of prostate cancer (PCa) has improved the clinical management of PCa patients.However,the PSA assay has been faced with criticism due to its potential association with over-diagnosis and subsequent overtreatment of indolent patients.Matrix metalloproteinase-26 (MMP26) is a member of matrix metalloproteinases (MMPs) and has been reported to be highly expressed in many cancers.This investigation evaluated the potential of serum MMP26 as a biomarker for PCa.The level of serum MMP26 was measured by enzyme-linked immunosorbent assay (ELISA) in 160 subjects including PCa group (n=80),benign prostatic hyperplasia (BPH) group (n=40) and control group (n=40).Furthermore,we evaluated the expression of MMP26 in tissues by immunohistochemistry.The results showed the serum MMP26 levels were significantly higher in PCa group than in BPH group and control group.Similarly,the MMP26 protein was positive in PCa tissues and negative in BPH tissues and control tissues.In conclusion,these results suggested MMP26 could be used as a potential serum biomarker in the diagnosis of PCa.

BACKGROUNDMicroRNAs (miRNAs) are small noncoding regulatory RNAs whose aberrant expression may be observed in many malignancies. However, few data are yet available on human primary medulloblastomas. This work aimed to identify that whether miRNAs would be aberrantly expressed in tumor tissues compared with non-tumorous cerebellum tissues from same patients, and to explore a possible role during carcinogenesis.

METHODSA high throughput microRNA microarray was performed in human primary medulloblastoma specimens to investigate differentially expressed miRNAs, and some miRNAs were validated using real-time quantitative RT-PCR method. In addition, the predicted target genes for the most significantly down- or up-regulated miRNAs were analyzed by using a newly modified ensemble algorithm.

RESULTSNine miRNA species were differentially expressed in medulloblastoma specimens versus normal non-tumorous cerebellum tissues. Of these, 4 were over expressed and 5 were under expressed. The changes ranged from 0.02-fold to 6.61-fold. These findings were confirmed using real-time quantitative RT-PCR for most significant deregulated miRNAs (miR-17, miR-100, miR-106b, and miR-218) which are novel and have not been previously published. Interestingly, most of the predicted target genes for these miRNAs were involved in medulloblastoma carcinogenesis.

CONCLUSIONSMiRNAs are differentially expressed between human medulloblastoma and non-tumorous cerebellum tissue. MiRNAs may play a role in the tumorigenesis of medulloblastoma and maybe serve as potential targets for novel therapeutic strategies in future.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Medulloblastoma ; genetics ; MicroRNAs ; genetics ; metabolism ; Oligonucleotide Array Sequence Analysis ; Reverse Transcriptase Polymerase Chain Reaction