Objective To observe the clinical efficacy of acupuncture at the nine acupoints on nape in treating vertebrobasilar ischemia (VBI). Methods Totally 100 VBI patients were randomized into a treatment group and a control group, 50 in each group. The treatment group was intervened by acupuncture at Fengfu (GV 16), Fengchi (GB 20), Wangu (GB 12), Tianzhu (BL 10), and Jiaji (EX-B 2, C3);while the control group was by oral administration of Nimodipine tablets. The parameters in Transcranial Doppler (TCD) and Dizziness Assessment Rating Scale (ADRS) were observed before and after intervention, and the clinical efficacies were compared. Results The TCD parameters were significantly changed in the treatment group after intervention (P<0.05). The TCD parameters [Vs (RVA), Vd (BA, LVA), Vm (BA, RVA), PI (BA)] were significantly changed in the control group after intervention (P<0.05). After intervention, there were significant differences in comparing the TCD parameters [Vs (BA, LVA, RVA), Vd (BA, RVA), Vm (BA, LVA), PI (BA)] between the two groups (P<0.05). The DARS average scores were significantly changed in both groups after 7-day treatment (P<0.01). The DARS average scores after the whole intervention were significantly different from that after 7-day treatment in both groups (P<0.01). There were significant differences in comparing the DARS average scores between the two groups after 7-day intervention and after the whole intervention (P<0.01). The recovery-markedly effective rate and total effective rate were respectively 76.0%and 98.0%in the treatment group versus 44.0%and 96.0%in the control group, and there was a significant difference in comparing the recovery-markedly effective rate (P<0.05). Conclusions Acupuncture at the nine nape acupoints is an effective method in treating VBI.

Objective To explore the value of contrast-enhanced ultrasound(CEUS)in the differential diagnosis of endometrial carcinoma and endometrial hyperplasia.Methods Forty-five patients with endometrial carcinoma and 21 patients with hyperplasia were studied by CEUS.Twenty-four normal women were enrolled as contrast group.Results In normal uterus, myometrium exhibited earlier enhancement later washout than the endometrium.Similar phenomenon was observed in patients with hyperplasia.In patients with endometrial carcinoma,the lesion showed wash-in and washout earlier, at least not later than the myometrium.Conclusions Endometrial carcinoma and hyperplasia showed different enhancement patterns,which may be helpful for the diagnosis of the two diseases.

Objective To investigate the contrast enhanced ultrasound(CEUS)features of ovarian tumor torsion(OTT).Methods Seventeen cases with OTT were evaluated using CEUS.CEUS was performed with low mechanical index and the contrast agent of Sono Vue.Results Thirteen cases with total torsion of ovarian tumor appeared as no enhancement.Four cases with partial torsion showecl hyperechoic enhancement in the early phase and hypoechogenicity in the late phase.Conclusions The enhancement of OTT has characteristic,which would be helpful for the diagnosis and differential diagnosis of OTT.

Posttranslational modifications of antibody products affect their stability,charge distribution,and drug activity and are thus a critical quality attribute.The comprehensive mapping of antibody modifications and different charge isomers(CIs)is of utmost importance,but is challenging.We intended to quanti-tatively characterize the posttranslational modification status of CIs of antibody drugs and explore the impact of posttranslational modifications on charge heterogeneity.The CIs of antibodies were fraction-ated by strong cation exchange chromatography and verified by capillary isoelectric focusing-whole column imaging detection,followed by stepwise structural characterization at three levels.First,the differences between CIs were explored at the intact protein level using a top-down mass spectrometry approach;this showed differences in glycoforms and deamidation status.Second,at the peptide level,common modifications of oxidation,deamidation,and glycosylation were identified.Peptide mapping showed nonuniform deamidation and glycoform distribution among CIs.In total,10 N-glycoforms were detected by peptide mapping.Finally,an in-depth analysis of glycan variants of CIs was performed through the detection of enriched glycopeptides.Qualitative and quantitative analyses demonstrated the dynamics of 24 N-glycoforms.The results revealed that sialic acid modification is a critical factor ac-counting for charge heterogeneity,which is otherwise missed in peptide mapping and intact molecular weight analyses.This study demonstrated the importance of the comprehensive analyses of antibody CIs and provides a reference method for the quality control of biopharmaceutical analysis.

Objective:To investigate whether the bladder neck descent and the area of levator ani hiatus obtained on the maximum Valsalva were consistent at the lithotomy position and separating-legs-holding-knees position.Methods:Forty four subjects who underwent perineal pelvic floor four-dimensional ultrasound at 6-8 weeks postpartum in Third Hospital of Longgang Shenzhen from November 2019 to January 2020 were enrolled in this study. All subjects were able to effectively complete the maximum Valsalva maneuver both at the lithotomy position and the separating-legs-holding-knees position. The bladder neck descent and hiatus area of the levator Ani on the maximum Valsalva at these two positions were measured and compared.Results:The bladder neck descent at the separating-legs-holding-knees position was higher than that at the lithotomy position [(41.06±8.25)mm vs (39.96±8.10)mm; t=-2.965, P=0.005], and the hiatus area of levator Ani at the separating-legs-holding-knees position was larger than that at the lithotomy position[(27.55±4.90)cm 2 vs (26.32±4.76)cm 2; t=-3.820, P<0.001]. Conclusions:The bladder neck descent and the area of levator Ani hiatus on the maximum Valsalva at separating-legs- holding-knees position are larger than those on the maximum Valsalva at the lithotomy position.

Objective To evaluate the clinical outcome of kidney transplantation from donation after brain death (DBD) donors complicated with acute kidney injury (AKI). Methods Clinical data of 216 DBD donors were retrospectively analyzed, and they were divided into the AKI group (n=69) and control group (n=147) according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. Donors in the AKI group were further divided into the KDIGO stage 1 and stage 2-3 subgroups. One hundred and thirty-five recipients were assigned into the AKI group and 288 recipients in the control group. Postoperative recovery of renal function and clinical outcomes of the recipients were recorded. The risk factors of delayed graft function (DGF) were identified. Results The highest serum creatinine (Scr) level, Scr level before procurement, the highest blood sodium level and blood sodium level before procurement in the AKI group were higher than those in the control group. The application duration of vasopressors in the AKI group was longer than that in the control group. In the AKI group, the amount of fluid resuscitation within 48 h was higher, the HCO₃⁻ level at admission was lower, and the incidence of diabetes insipidus and hypotension was higher than those in the control group. The highest Scr level and the Scr level before procurement in KDIGO stage 2-3 donors were significantly higher than those in KDIGO stage 1 counterparts (all P<0.05). Compared with the control group, the incidence of DGF and acute rejection was higher, the proportion of continuous renal replacement therapy was higher, the Scr level within postoperative 90 d was higher, and the urine amount within postoperative 3 d was less than those of recipients in the AKI group. Compared with KDIGO stage 1 recipients, KDIGO stage 2-3 recipients had higher Scr levels at postoperative 3, 4, 5 and 15 d, and less urine amount at postoperative 2 d (all P<0.05). Univariate analysis showed that donor age, the highest Scr level, the highest blood sodium level and the amount of fluid resuscitation within 48 h were the risk factors for DGF in recipients after kidney transplantation. Multivariate analysis showed that donor age was the independent risk factor for DGF in recipients after kidney transplantation (all P<0.05). Conclusions For the application of DBD donors complicated with AKI, active organ maintenance should be performed to alleviate AKI. It exerts no effect upon graft function and survival rate at postoperative 6 months, which may achieve equivalent efficacy as non-AKI donors and may be used as a source of extended criteria donor kidneys.

Previous studies suggest that the reduction of SMAD3 (mothers against decapentaplegic homolog 3) has a great impact on tumor development, but its exact pathological function remains unclear. In this study, we found that the protein level of SMAD3 was greatly reduced in human-grade IV glioblastoma tissues, in which LAMP2A (lysosome-associated membrane protein type 2A) was significantly up-regulated. LAMP2A is a key rate-limiting protein of chaperone-mediated autophagy (CMA), a lysosome pathway of protein degradation that is activated in glioma. We carefully analyzed the amino-acid sequence of SMAD3 and found that it contained a pentapeptide motif biochemically related to KFERQ, which has been proposed to be a targeting sequence for CMA. In vitro, we confirmed that SMAD3 was degraded in either serum-free or KFERQ motif deleted condition, which was regulated by LAMP2A and interacted with HSC70 (heat shock cognate 71 kDa protein). Using isolated lysosomes, amino-acid residues 75 and 128 of SMAD3 were found to be of importance for this process, which affected the CMA pathway in which SMAD3 was involved. Similarly, down-regulating SMAD3 or up-regulating LAMP2A in cultured glioma cells enhanced their proliferation and invasion. Taken together, these results suggest that excessive activation of CMA regulates glioma cell growth by promoting the degradation of SMAD3. Therefore, targeting the SMAD3-LAMP2A-mediated CMA-lysosome pathway may be a promising approach in anti-cancer therapy.