Carcinoma ; diagnosis ; surgery ; Chylothorax ; diagnosis ; Humans ; Lymph Node Excision ; Thyroid Neoplasms ; diagnosis ; surgery

OBJECTIVE: To observe the effect and explore the mechanism of Huannao Yicong capsule in treating senile patients with mild cognitive impairment (MCI). METHODS: The investigational drugs were packed by blind method. A randomized, double-blind and controlled trial was conducted on ninety senile patients with MCI. Other forty-five senile healthy persons were recruited to the healthy control group. The ninety senile patients were randomly divided into the Huannao Yicong capsule-treated group (45 patients administered with three Huannao Yicong capsules and two aniracetam capsule analogues) and aniracetam-treated group (45 patients treated with two aniracetam capsules and three Huannao Yicong capsule analogues). Patients in the two groups were treated three times daily for 16 weeks. Memory, traditional Chinese medicine syndrome, cerebral blood flow, free radicals and inflammatory mediators, such as superoxide dismutase (SOD), malondialdehyde (MDA), acetylcholinesterase (AchE), interleukin-1alpha (IL-1alpha) and interleukin-6 (IL-6) were determined before and after the treatment. Blood lipids, including triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein A-1 (ApoA-1) and apolipoprotein B-100 (ApoB-100), were detected before and after the treatment. The safety indexes, such as routine tests of blood and urine, hepatic and renal function tests and electrocardiogram (ECG) were taken before and after the treatment. RESULTS: Index score of clinical memory scale in senile healthy people was significantly higher than that in MCI patients before treatment (P<0.01), and the content of AchE, IL-1alpha and IL-6 was obviously lower (P<0.01, P<0.05), the activity of SOD was higher (P<0.05). No significant difference was found in direction memory of clinical memory scale between the two treatment groups. Other index scores of clinical memory scale and traditional Chinese medicine syndrome in patients of Huannao Yicong capsule-treated group were significantly improved as compared with those of the aniracetam-treated group (P<0.05, P<0.01). The blood flow parameters of anterior cerebral artery, posterior cerebral artery and resistant index in patients of Huannao Yicong capsule-treated group were increased significantly (P<0.01, P<0.05). Huannao Yicong capsule could significantly increase the activity of serum SOD and decrease the content of AchE, IL-1alpha and IL-6 (P<0.01, P<0.05), better than aniracetam. Furthermore, Huannao Yicong capsule could significantly improve the blood lipid, such as the level of TG, LDL-C, HDL-C, ApoA-1 and ApoB-100 (P<0.01, P<0.05), and better than aniracetam (P<0.01, P<0.05). No significant changes were found after treatment in safety indexes, such as routine tests of blood and urine, hepatic and renal function tests and ECG. CONCLUSION: Huannao Yicong capsule has better therapeutic effect than aniracetam capsule in treating senile mild cognitive impairment.

Objective To evaluate the curative effects of carbon nanoparticles on central lymphnode dis -section in papillary thyroid carcinoma ( PTC) .Methods 72 PTC patients were randomly divided into two groups:carbon nanoparticle group(n=32)and the control group(n=32).Patients in the carbon nanoparticle group were injected with carbon nanoparticles during surgery .Patients in the control group had conventional surgery .The number of lymph nodes being dissected ,lymph node metastasis , and the rate of hypoparathyroidism were compared between the two groups .Results The number of lymph nodes dissected in nanoparticle group ( n =312 ) was much bigger than that in the control group (n=189)(P<0.01;t=8.476).The incidence of hypoparathyroidism in nanoparticle group(n=1)was much lower than that in the control group (n=8)(P<0.05;χ2 =4.571).The metastasis of lymph nodes has no significant difference between the two groups (P>0.01;χ2 =1.048).Conclu-sions The lymphatic tracer technique may improve the number of lymph nodes dissected in central region of PTC and reduce parathyroid gland damage .

Objective To investigate the related factors of postoperative hypocalcemia after thyroid carc-er surgery.Methods 346 cases of thyroid carcer patients undergoing surgery from Jan .2013 to Dec.2013 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed .Results 129 cases developed hepocalcemia after thyroid surgery .Among the related factors that may cause postoperative hypocalcemia , the scope of surgery , parathyroid injury and secondary surgery might play important roles .Conclusions The inci-dence of postoperative hypocalcaemia is high after total thyroidectomy .Patients with reoperation and lymph node dissection have an increased rate of postoperative hypocalcaemia .In order to reduce hypocalcaemia incidence ,sur-gons need to protect parathyroid blood supply in thyroid surgery and give calcium after surgery .

Objective:To evaluate the performance of RapidArc technique on cervical cancer patients with various filling status of the bladder. Methods: Conventional fixed field intensity modulation radiated therapy (IMRT) is used as the benchmark. In 10 fe-males suffering from cervical cancer, two CT scans were performed for treatment planning:one with an empty bladder and the other with filled bladder. The prescribed dose was 50 Gy. The images of that with an evacuated bladder and that with filled bladder were planned in the dual-arc RapidArc and the 7-field IMRT, respectively. The implementor of the plan was the Varian TrueBeam linear ac-celerator. Dose-volume histogram was used to evaluate the data from each plan. Results:When the bladder was filled, IMRT and Rapi-dArc homogeneity were 1.05 and 1.04 (P>0.05), respectively. When the bladder was emptied, the homogeneity was 1.04 for both plans (P>0.05). With or without bladder filling, the conformity index was 0.71 and 0.73 for IMRT and RapidArc (P>0.05), respectively. The effect of V30 and V40 (volume for receiving doses of 30 and 40 Gy) on the intestine and the bladder was more favorable in a full than in an empty bladder. No significant difference between the two plans was observed. IMRT exhibited improved V30 on the rectum and on the bladder. RapidArc was much better in terms of monitor unit (MU) and deliver time. Conclusion:No significant differences in the homogeneity and conformity index between dual-arc RapidArc and 7-field IMRT were observed. Filled bladder is better than empty bladder in intestine and bladder protection in both RapidArc and IMRT. IMRT is better on V30 of the rectum and the bladder, whereas RapidArc improved MU and deliver time.

OBJECTIVETo observe the intervention effects of Huannao Yicong decoction on cognitive function and apoptosis and expression of relative regulative gene of Hippocampus in cognitive impairment rats induced by complex factors.

METHOD60 SD rats were divided randomly into Huannao Yicong decoction high-dose group (HHG), Huannao Yicong decoction low-dose group (HLG), positive control group (PCG), model control group (MCG) and blank control group (BCG). Rats in the BCG were received daily hypodermic injection of tales doses of normal sodium for 10 weeks with normal feeder. Rats in other groups were received daily hypodermic injection of D-galactose with the concentration of 50 mg kg(-1) for 10 weeks, from the 5th week on, half fat feeder were fed until the end of the 10th week. From the 7th on, rats in HHG were administered with 0.01 mL g(-1) Huannao Yicong decoction suspension by gavage (crude drug 14 g kg(-1)). Rats in LHG were administered with 0.01 mL g(-1) Huannao Yicong decoction suspension by gavage (crude drug 7 g kg(-1)). Rats in PCG were administered with 0.01 mL g(-1) hydrochloricdonepezil suspension by gavage (0.4 mg kg(-1)). Rats in MCG and BCG were administered with 0.01 mL g(-1) distilled water by gavage, intragastric administration was given daily until the end of the 10th week. The behaviors of the rats were observed by morris water maze, the apoptosis and expression of relative regulative gene of hippocampus were measured.

RESULTThe morris water maze indicated that compared with the BCG, the platform locating latency of rats in the MCG was longer and the frequency of swimming through the platform was fewer(P <0.05, P < 0.01), compared with the MCG, there was significant difference on the frequency of swimming through the platform in the HHG and PCG (P <0.05, P <0.01). The number of apoptosis cells in the MCG was more than that in the BCG, the difference was significant (P <0.01), the number of apoptosis cells in the HHG, HLG and PCG was reduced and the ratio of Bcl-2 and Bax was increased (P < 0.01).

CONCLUSIONHuannao Yicong decoction could improve the learning and memory functions of cognitive impairment rats, inhibit the apoptosis of cells in hippocampus, regulate the expression of relative gene, accelerate the repairing of cells, protect the impaired brain tissue, and these may be part of the channels of clinical effects.

Animals ; Apoptosis ; drug effects ; Cognition Disorders ; drug therapy ; genetics ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Gene Expression ; drug effects ; Hippocampus ; drug effects ; metabolism ; Humans ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; bcl-2-Associated X Protein ; genetics ; metabolism

Background: Isolated systolic hypertension (ISH) is a common disease in elderly people, threatening their health. Traditional Chinese medicine (TCM) treatment or integrative treatment had advantages in improving quality of life and protecting target organs, but need to be proved by large evidence-based researches. Objective: To observe the effects of TCM treatment (Jiangya Capsule) or integrative treatment (combination of Jiangya Capsule and nimodipine) on blood pressure and vasoactive agents, and their safety in elderly ISH patients. Design, setting, participants and interventions: A multicenter, randomized, double-blind controlled trial was adopted. A total of 270 elderly ISH patients recruited from Xiyuan Hospital, and TCM Hospital and Community Health Service Centers of Yanqing County of Beijing were randomly divided into 3 groups: TCM group (Jiangya Capsule plus nimodipine simulation, 90 cases), integrative group (Jiangya Capsule plus nimodipine, 90 cases) and Western medicine (WM) group (nimodipine plus Jiangya Capsule simulation, 90 cases). They were all treated for 4 weeks. Main outcome measures: Before and after 4-week treatment, office blood pressure, 24-hour ambulatory blood pressure, serum nitric oxide (NO), and plasma endothelin-1 (ET-1), thromboxane B2 (TXB2) and 6-keto-prostaglandin 1alpha (6-keto-PGF1alpha) were detected, and safety evaluation was conducted. Results: After 4-week treatment, 5 patients in TCM group were lost to follow-up and another 5 patients were excluded, and 80 patients finished the trial; 7 patients in integrative group were lost to follow-up and another 7 patients were excluded, and 76 patients finished the trial; 2 patients in WM group were lost to follow-up and another 3 patients were excluded, and 85 patients finished the trial. After treatment, systolic blood pressure (SBP) decreased in each group (P<0.05), and integrative treatment was superior to TCM or WM treatment in decreasing SBP (P<0.05). Twenty-four hour average SBP and day average SBP decreased significantly in each group, and night average SBP decreased in integrative group, and integrative treatment was superior to TCM or WM treatment in decreasing day average SBP. Serum NO and plasma 6-keto-PGF1alpha levels were elevated and plasma ET-1 and TXB(2) levels were reduced after treatment, and integrative treatment was superior to TCM or WM treatment in reducing plasma TXB(2) level. Conclusion: TCM treatment or integrative treatment has affirmative effects and safety in treating elderly ISH patients, and integrative treatment has superiority in improving some indexes, and deserves further study.

Background:Despite the recent development of new therapies, multiple myeloma (MM) remains an incurable disease. Thus, new, effective treatments are urgently needed, particularly for relapsed or refractory MM (RRMM). In an earlier phase I study, a novel form of recombinant human Apo2L/tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) that is currently in clinical development for the treatment of hematologic malignancies, i.e., circularly permuted TRAIL (CPT), was well tolerated at a dose of 2.5mg/kg per day and showed promising preliminary activity in patients with RRMM. This phase II, open-label, multicenter study further investigated the effcacy and safety of 2.5-mg/kg per day CPT as single-agent therapy for patients with RRMM. Methods:Patients with RRMM were treated once daily with CPT (2.5mg/kg, intravenously) for 14 consecutive days for each 21-day cycle. Clinical response and toxicity were assessed after each treatment cycle. Results:Twenty-seven patients received CPT. Using the European Group for Blood and Marrow Transplantation criteria, we calculated the overall response rate of 33.3% with 1 near-complete response (nCR) and 8 partial responses (PRs). The clinical beneift rate (48.1%) included 1 nCR, 8 PRs, and 4 minimal responses. The most common treatment-related adverse events (TRAEs) were fever, aspartate aminotransferase elevation, alanine aminotransferase elevation, leucopenia, rash, neutropenia, and thrombocytopenia. We graded toxicity using the Common Toxicity Criteria for Adverse Events, version 3.0, and determined that 37.0% of patients had at least 1 grade 3–4 TRAE. Conclusions:CPT as a single agent can elicit a response in patients with RRMM and is well tolerated. Further clinical investigation is warranted.

Objective:To investigate the mid-term clinical efficacy and imaging changes of Waveflex semi-rigid internal fixation system combined with posterior lumbar interbody fusion (PLIF) in the treatment of double segmental lumbar degenerative diseases.Methods:The data of 51 patients with lumbar degenerative diseases who underwent surgery from September 2014 to September 2015 were retrospectively analyzed, including 29 males and 22 females, aged 65.5±5.6 years (range 58-73 years). Preoperative intervertebral space degeneration grade by University of California at Los Angeles (UCLA) and Pfirrmann intervertebral disc degeneration grade were recorded. 23 cases of primary responsible segments were treated with decompression, fixation and fusion, and adjacent secondary responsible or degenerative segments were treated with Waveflex semi-rigid internal fixation (combined group); 28 cases of double segments were treated with decompression, fixation and fusion (fusion group). Disc height index (DHI) and intervertebral foramina height (IFH) of the semi-rigid fixation segments, DHI and IFH of the upper adjacent intervertebral space, and horizontal displacement of the upper adjacent vertebral body (HD) were measured on lateral X-ray films of lumbar spine; In the fusion group, DHI and IFH adjacent to the upper vertebral space and HD adjacent to the upper vertebral body were measured. The efficacy was evaluated by short-form McGill Pain Questionnaire (SF-MPQ) and Oswestry disability index (ODI).Results:51 cases were followed up for 5.4±0.3 years (range 5.2-6.3 years). The low back and leg pain and function in the combined group and fusion group were significantly improved compared with those before operation. SF-MPQ and ODI at 3 months, 1 year, 5 years after operation were significantly different from those before operation ( P<0.05). In the combined group, the DHI of semi-rigid internal fixation segments before operation and 3 months, 1 year, 5 years after operation were 37.8%±7.6%, 37.9%±7.4%, 36.5%±6.9% and 36.0%±7.1% respectively ( P>0.05); The IFH of semi-rigid internal fixation segments before operation and 3 months, 1 year, 5 years after operation were 21.5±2.8, 21.4±2.8, 20.4±2.7, 19.4±2.4 mm respectively ( P<0.05); The DHI of the upper segment adjacent to semi-rigid internal fixation before operation and 3 months, 1 year, 5 years after operation were 37.1%±9.3%, 36.8%±9.1%, 35.2%±9.1%, 33.9%±8.8% respectively ( P>0.05); The IFH of the upper segment adjacent to semi-rigid internal fixation before operation and 3 months, 1 year, 5 years after operation were 21.9±3.0, 21.4±3.0, 20.4±2.9, 19.5±2.7 mm, respectively ( P<0.05). The HD of upper vertebral body adjacent to semi-rigid internal fixation before operation and 3 months, 1 year, 5 years after operation were 2.2±0.7, 2.3±0.5, 2.5±0.5, 2.8±0.5 mm respectively ( P<0.05). At the last follow-up, one case of semi-rigid titanium rod fracture, one case of screw loosening at semi-rigid internal fixation segment, three cases with unsatisfied numbness relief, and 2 cases of facet joint spontaneous fusion at semi-rigid fixation segment occurred in the combined group. Conclusion:Waveflex semi-rigid internal fixation can protect the degenerative lumbar intervertebral disc, and delay the degeneration of semi-rigid internal fixation segment and adjacent upper segment after interbody fusion, but long-term follow-up and study are needed.

Animals ; Caenorhabditis elegans ; metabolism ; radiation effects ; Caenorhabditis elegans Proteins ; genetics ; metabolism ; Light ; Lysine ; analogs & derivatives ; genetics ; metabolism ; Promoter Regions, Genetic ; Protein Transport ; RNA, Transfer ; genetics ; metabolism ; Tumor Necrosis Factor Ligand Superfamily Member 14 ; metabolism