Objective To analyze the clinical characteristics,treatment and prognosis of primary esophageal small cell carcinoma (PESC).Methods Fifty-five patients with PESC were analyzed retrospectively.The survival rate was calculated by the Kaplan-Meier method and the Log-rank test using SPSS 17.0 software.Results The median survival time of 55 patients was 12 months.The 6,12,24.36months survival rates of these patients were 87.3 ％ (48/55),50.9 ％ (32/55),12.7 ％ (7/55),7.3 ％ (4/55),respectively.In multivariate analysis,stage and type of treatment were shown to be independent predictive.Conclusion PESC is a malignant tumor with early metastasis and poor prognosis.Combined therapy may improve the survival time of PESC patients.

Objective To investigate the effect of simple vertebral canal decompression for treating degree 1 senile degenerative lumbar spondylolisthesis .Methods 62 cases of degree 1 senile degenerative lumbar spondylolisthesis from January 1998 to January 2012 were retrospectively analyzed .The patients were surgically treated by simple vertebral canal decompression and included 20 males and 42 females ,aged from 65-82 years(mean 68 years) ,with the disease history of 2-7 years(average 3 .3 years) .The clini-cal effects in average postoperative 2 years and 8 .2 years were evaluated by Japanese Orthopaedic Association Scores (JOA ) and Visual Analogue Scale/Score(VAS) .Results The preoperative JOA score was 9 .7 in average and the JOA scores in average post-operative 2 years and 8 .2 years were 11 .7 and 12 .8 respectively(P<0 .05);the preoperative VAS score averaged 7 .8 ,which after operation were 2 .3 and 2 .6 respectively(P<0 .05) .Complications were observed in 16 cases .4 cases accepted reoperation .Conclu-sion In the basis of the actively controlling other organ systems diseases in perioperative period ,simple vertebral canal decompression is an effective method for treating degenerative vertebral canal spondylolisthesis and can obtain the satisfactory therapeutic effect .

Objective:To explore influence of risk factors of ischemic cerebral stroke (ICS)on its onset.Methods:A total of 350 patients diagnosed as ICS were selected as stroke group among 12241 >40 years people from Dongli dis- trict of Harbin city,another 350 >40 years non-ICS people,who were randomly selected from the same district, were enrolled as control group.ICS risk factors were compared between two groups,multi-factor Logistic regres- sion analysis was used to analyze independent risk factors for ICS.Results:(1)There were no significant difference in age,nationality,education,marriage and professions between two groups except food taste (P<0.01); (2) Multifactor Logistic regression analysis indicated that hypertension (OR=5.853,95%CI:3.188~10.673),hyper- lipidemia (OR=5.601,95%CI:2.378~ 9.635),carotid artery plaque (OR=4.963,95%CI:2.350~9.843), heart disease (OR=4.568,95%CI:2.535~7.745),hyperhomocysteinemia (OR=4.076,95%CI:3.001~8.270), apparent overweight (OR=3.421,95%CI:1.598~6.476)and family history of cerebrovascular diseases (OR=3.065,95%CI:2.543~4.236)were independent risk factors for ICS in both groups (P<0.01 all).According to OR value from big to small,risk factors for ICS were hypertension,hyperlipidemia,carotid artery plaque,heart disease,hyperhomocysteinemia,apparent weight and family history of cerebrovascular diseases respectively.Conclu-sion:Besides traditional risk factors like hypertension,dyslipidemia and family history of cerebrovascular diseases, other risk factors such as carotid artery plaque,heart disease,family history of cerebrovascular disease and apparent overweight are also important risk factors for stroke.

Objective:To explore advantage of intravascular ultrasound (IVUS) guiding coronary intervention .Meth‐ods:A total of 100 patients with left main (LM) lesion were selected and equally divided into IVUS group (n=50 , received stent implantation under IVUS guidance ) and control group [n=50 ,received stent implantation after coro‐nary angiography (CAG) evaluation without IVUS examination ) .Instant condition after stent implantation and fol‐low-up results after 12 months were compared between two groups .Results:There were no significant difference in general data ,percentages of LM opening ,body part and tail lesions ,different types of plaques between two groups , P>0.05 all .During hospitalization ,there were no significant difference in percentage of emergency coro‐nary artery bypass grafting (0% vs .4% ) and mortality (0% vs .4% ) between IVUS group and control group (P>0.05) .However ,after 12 months ,compared with control group ,there were significant reductions in incidence rates of in-stent restenosis (16% vs .4% ) and late stent malapposition (34% vs .6% ) in IVUS group , P< 0.05 ,<0.01. Conclusion:IVUS guiding left main lesion intervention is helps to select more appropriate therapeutic plan , reduce tissue injury and improve long -term therapeutic effect .

OBJECTIVETo detect the expression of cytokines by acute promyelocytic leukemia (APL) cells before and after exposure to arsenic trioxide.

METHODSDiagnoses were performed according to the FAB cytological classification criteria and cytogenetic criteria. Bone marrow or blood samples from APL patients were collected in heparinized tubes, then primary APL cells were separated by traditional Ficoll-Hypaque density centrifugation and purified after adherence to plastic surfaces. IL-1(beta), IL-6, IL-8, TNF alpha and G-CSF levels in the leukemia cell culture supernatants were detected by ELISA. At the same time, nitro blue tetrazolium (NBT) reduction test was used to detect the differentiation of APL cells.

RESULTSAfter 96 hours exposure to arsenic trioxide, 10 - 6 mol/L in vitro or 10 mg/d in vivo, APL cells showed a significant increase of IL-1(beta) (P < 0.05) and G-CSF (P < 0.05) production, and a significant decrease of IL-6 (P < 0.05) and IL-8 (P < 0.05). However, there was no obvious variation of TNF alpha when compared with APL cells without exposure to arsenic trioxide. On the other hand, the proliferation ratio of APL cells in vitro was statistically correlated to the IL-1(beta) secretion ratio or G-CSF secretion ratio. The cell number ratio in patients with detectable IL-1(beta) or G-CSF was higher than that without detectable IL-1(beta) or G-CSF.

CONCLUSIONIL-1(beta) and G-CSF secretion may play an important role in the proliferation of APL cells after exposure to arsenic trioxide.

Arsenicals ; pharmacology ; Cells, Cultured ; Cytokines ; secretion ; Granulocyte Colony-Stimulating Factor ; secretion ; Humans ; Interleukin-1 ; secretion ; Interleukin-6 ; secretion ; Interleukin-8 ; secretion ; Leukemia, Promyelocytic, Acute ; metabolism ; Oxides ; pharmacology ; Tumor Necrosis Factor-alpha ; secretion

Objective:To compare the detection success rates (DSRs) of different kinds of near-infrared spectrum non-invasive hemoglobin monitors in high-altitude environments.Methods:One hundred and forty-four healthy volunteers of either sex, aged 18-50 yr, were assigned to one of 3 groups using a random number table method: simulated high-altitude 3 500 meter group ( n=35), 4 000 meter group ( n=55) and 4 500 meter group ( n=54). Hemoglobin was detected by Radical-7, NW-9002SHM, A5 and TensorTip MTX type hemoglobin monitors in plain environment and simulated environment at different altitudes, and the DSRs were compared.Logistic regression analysis was conducted to identify the risk factors affecting the success rate of instrument detection, and the cut-off value was determined by ROC curve and the Youden index. Results:In the simulated high-altitude environment of 3500, 4000 and 4500 m, the DSR of TensorTip MTX was significantly higher than that of Radical-7, NW-9002SHM and A5 ( P<0.001), and there was no significant difference in the DSR among Radical-7, NW-9002SHM and A5 ( P>0.05). Low SpO 2 was the main factor affecting the DSRs of the Radical-7, NW-9002SHM and A5 type hemoglobin monitor in high-altitude environment ( P<0.001), and the cut-off value of SpO 2 in determining the success of detection was 88.5%, 87.5% and 89.5%, respectively.The DSR of TensorTip MTX was not affected by low SpO 2. Conclusions:The DSR of TensorTip MTX hemoglobin monitor is minimally affected by the high-altitude environment and can be preferred in the absence of oxygen supply; when Radical-7, NW-9002SHM or A5 hemoglobin monitor applied in high-altitude environments, oxygen saturation needs to be increased to ensure a high DSR.

Objective To explore the pharmacokinetic changes of single dose of fentanyl in rats in a simulated high-altitude and contributing factors.Methods Thirty-six healthy female SD rats(6～8 weeks old,250±20 g)were randomly divided into high-altitude-acute-exposure group(group A),high-altitude-chronic-exposure group(group S)and control group(group C)through random number table,with 12 rats in each group.The group A and S were housed in a low-pressure chamber simulating the high altitude of 5000 m above sea level for 3 and 30 d respectively,and the group C was housed out of the chamber(at an altitude of 300 m).A single dose of fentanyl was administered through the femoral vein to 6 rats randomly selected from each group.Liquid chromatography tandem mass spectrometry(LC-MS/MS)was used to detect blood concentrations of fentanyl and WinNonlin 8.2 software was used to calculate the pharmacokinetic parameters,while blood samples were taken through the femoral artery before and in 1,2,4,8,15,30,60,120 and 180 min after administration.The remaining 6 rats were ultrasonographically assessed for portal vein internal diameter(PVD),peak flow velocity(PVV)and blood flow(PVF),and liver tissues were collected for CYP3A1 protein content assay.Results The blood drug concentrations of fentanyl in the group A and group S were significantly lower than those in the group C at 60,120,and 180 min(P=0.002,P＜0.001,P= 0.001).Compared with the group C,the clearance rate(CL)of the group A was increased by 54.06%(P=0.021),and the mean residence time(MRTlast)was shortened by 24.21%(P=0.033);CL of the group S was increased by 50.10%(P=0.041),the area under the concentration-time curve(AUC0-t,AUC0-∞)and MRTlast were reduced by 18.92%(P=0.039),27.54%(P=0.018)and 33.61%(P= 0.004),respectively.PVD and PVF in the group S increased by 10.87%(P=0.006)and 42.50%(P= 0.006)when compared with the group C.The CYP3A1 protein content in the group A was 28.74%,which was higher than that in the group C(P=0.048).Conclusion Fentanyl is cleared significantly faster after a single dose in rats in simulated high-altitude,which may be related to the increased liver blood flow and increased CYP3A1 protein expression in liver.

BACKGROUND:Steroid-induced osteonecrosis of the femoral head is a refractory disease in the field of orthopedics.There is no definitive idea to fully explain its pathogenesis.With the increased research on the active ingredients of Panax notoginseng interfering with the signaling pathways related to various diseases,the active ingredients of Panax notoginseng that treat steroid-induced necrosis of the femoral head via the regulation of relevant signaling pathways have gradually become a hot research topic. OBJECTIVE:To systematically summarize the literature on the pathological mechanism of steroid-induced osteonecrosis of the femoral head and the regulation of signaling pathways by the active ingredients of Panax notoginseng in recent years,thereby providing a reference for the follow-up study on the active ingredients of Panax notoginseng in the treatment of this disease. METHODS:CNKI,WanFang,and PubMed were searched for relevant literature with the key words of"glucocorticoid,steroid-induced osteonecrosis of the femoral head,pathological mechanism,signaling pathway,Panax notoginseng,active ingredient"in Chinese and English.Documents related to the pathological mechanism of steroid-induced osteonecrosis of the femoral head as well as related to the intervention of active ingredients of Panax notoginseng on the signaling pathway of steroid-induced osteonecrosis of the femoral head were retrieved.A total of 63 documents were finally included according to the inclusion and exclusion criteria. RESULTS AND CONCLUSION:The main ingredients of Panax notoginseng include Panax notoginseng saponins,ginsenoside,Panax notoginseng saponins,quercetin,kaempferol,etc.Panax notoginseng saponins,ginsenoside Rb1 and quercetin can promote bone repair and angiogenesis by acting on the transforming growth factor-β/bone morphogenetic protein pathway.Panax notoginseng saponins,ginsenoside CK and kaempferol can promote osteogenic differentiation and lipid metabolism by acting on the Wnt/β-catenin pathway.Panax notoginseng saponins and Panax notoginseng saponins R1/R2 act on the MAPK pathway to inhibit osteoclastogenesis and promote bone repair.Panax notoginseng saponins,ginsenoside Rb2 and quercetin can inhibit osteoclast proliferation and promote osteoblastic differentiation by acting on the RANKL/RANK/OPG pathway.Panax notoginseng saponins,quercetin and kaempferol can repair vascular injury and promote osteogenesis by acting on the hypoxia-inducible factor-1α pathway.Panax notoginseng saponins R1,quercetin combined with hydroxyapatite nanoparticles,Panax notoginseng saponins combined with polyethylene-L-lactic acid and other biomaterials have good research prospects in the treatment of steroid-induced osteonecrosis of the femoral head.The active ingredients of Panax notoginseng can regulate the signaling pathways related to steroid-induced osteonecrosis of the femoral head through various mechanisms,and play an active intervention role in the disease.However,the depth and breadth of relevant research are insufficient at present,and the future research should be based on the existing mechanism to explore the specific mechanism of Panax notoginseng regulating different pathways and the interaction between pathways,which will be beneficial to the multi-development of the active ingredients of Panax notoginseng in the treatment of steroid-induced osteonecrosis of the femoral head.

The Spt-Ada-Gcn5-acetyltransferase (SAGA) is an ancillary transcription initiation complex which is highly conserved. The ADA1 (alteration/deficiency in activation 1, also called histone H2A functional interactor 1, HFI1) is a subunit in the core module of the SAGA protein complex. ADA1 plays an important role in plant growth and development as well as stress resistance. In this paper, we performed genome-wide identification of banana ADA1 gene family members based on banana genomic data, and analyzed the basic physicochemical properties, evolutionary relationships, selection pressure, promoter cis-acting elements, and its expression profiles under biotic and abiotic stresses. The results showed that there were 10, 6, and 7 family members in Musa acuminata, Musa balbisiana and Musa itinerans. The members were all unstable and hydrophilic proteins, and only contained the conservative SAGA-Tad1 domain. Both MaADA1 and MbADA1 have interactive relationship with Sgf11 (SAGA-associated factor 11) of core module in SAGA. Phylogenetic analysis revealed that banana ADA1 gene family members could be divided into 3 classes. The evolution of ADA1 gene family members was mostly influenced by purifying selection. There were large differences among the gene structure of banana ADA1 gene family members. ADA1 gene family members contained plenty of hormonal elements. MaADA1-1 may play a prominent role in the resistance of banana to cold stress, while MaADA1 may respond to the Panama disease of banana. In conclusion, this study suggested ADA1 gene family members are highly conserved in banana, and may respond to biotic and abiotic stress.
Musa/genetics* ; Phylogeny ; Fungal Proteins ; Cell Nucleus ; Histones ; Stress, Physiological/genetics*

ObjectiveTo evaluate the effect of antihypertensive and lipid-regulating Chinese patent medicine combined with conventional Western medicine in the treatment of hypertension with dyslipidemia. To carry out the evidence synthesis of clinical research and provide evidence-based evidence support for clinical decision-making. MethodThe databases including China National Knowledge Infrastructure （CNKI），Wanfang Data Knowledge Service Platform （WF），VIP，SinoMed，Embase，PubMed，Web of Science （WOS），and the Cochrane Library were searched for randomized controlled trials （RCT） of all listed Chinese patent medicines in the treatment of hypertension with dyslipidemia from the establishment of the databases to April 15，2023. The literature was screened and extracted，and the risk of bias tool 2.0 （RoB2） was used to assess the quality and risk of bias of the methodology. Revman 5.4.1 software was used to analyze the outcome indicators. Grading of Recommendations Assessment，Development and Evaluation （GRADE） was applied to assess the quality of evidence formed by clinical research data. The inclusion and recommendation of Chinese patent medicines in the National Drug Catalogue for Basic Medical Insurance，Work-related Injury Insurance and Maternity Insurance （2022） and domestic guidelines and consensus were searched to form a bubble chart. ResultA total of 15 studies were included. The evaluation of the methodological quality of each study showed that the risk of bias stemmed from the lack of blinding and allocation concealment，and low sample size. The comprehensive analysis of clinical studies showed that Dengzhan Shengmai capsules combined with rosuvastatin and amlodipine besylate，Yindan Xinnaotong capsules combined with simvastatin and levamlodipine tablets，Xiaoshuan Tongluo capsules combined with nifedipine controlled release tablets and pravastatin sodium tablets，Xinshubao capsules combined with atorvastatin calcium tablets and irbesartan，Wenyading capsules combined with enalapril，and Jiangzhining tablets combined with conventional Western medicines were all superior to conventional Western medicines used in the control group in improving systolic blood pressure （SBP），diastolic blood pressure （DBP），cholesterol （TC），triglyceride （TG），low density lipoprotein cholesterol （LDL-C），and high density lipoprotein cholesterol （HDL-C）. There was no significant difference in the incidence of adverse reactions between the two groups. The GRADE evaluation of the main outcome indicators showed that the evidence quality of SBP and incidence of adverse reactions was graded as B，that of DBP as C，and that of total TC，TG，LDL-C，and HDL-C as D. The evaluation of Chinese patent medicines covered by medical insurance and recommended by guidelines and consensus showed that Yindan Xinnaotong soft capsules，Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules belonged to class B drugs of medical insurance，and were recommended for 7，6 and 3 times in the guidelines and consensus，respectively. ConclusionCompared with simple medicine treatment，Chinese patent medicine combined with conventional Western medicine has more advantages in improving blood pressure and blood lipid，and shows higher safety. Among them，Yindan Xinnaotong soft capsules，Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules have stronger clinical applicability and economy. All the trials included in this article adhered to the principle of randomization and reported the outcome measures. However，the quality of evidence in related clinical studies was low. In terms of trial design，large-sample，multi-center，blinded randomized controlled trials based on the consolidated standards of reporting trials （CONSORT） statement are still needed for comprehensive trial designs and reporting，to further improve the GRADE quality evaluation and guideline formulation under the guidance of evidence-based medicine，so as to provide higher quality evidence-based research evidence for clinical decision-making.