Objective To explore the feasibility of 256-slice whole-brain CT perfusion (CTP) in evaluate graft reperfusion after surgical revascularization and hemodynamic alterations before and after surgery in Moyamoya disease. Methods Twenty-five cases with Moyamoya disease were scanned on a 256-slice CT.CTP was performed pre- and post- surgical revascularization. The wolumetric CT angiographic ( CTA ) images were generated from volumetric data acquired at the arterial phase of CTP. CBF, CBV, TTP and MTT were measured in functional maps at the operated side within middle cerebral artery perfusion areas and contralateral mirroring areas. Relative CBF( rCBF), relative CBV (rCBV), relative TTP (rTTP), relative MTT (rMTT) were also obtained. Differences in perfusion CT values pre- and post operation were assessed with the paired t test or matched-pairs signed-ranks test. Data with normal distribution was present as : (x-)± s,while those with the non-normal distribution were present as M ( P25-P75 ). Results All the direct graft patencies were displayed on volumetric CTA. No significant differences were found between volumetric CTA and conventional CTA. Postoperative CBF, rCBF and rCBV values of the operated side [ 72. 86 (55.54-112. 19) ml · 100 g-1 · min-1 , 1. 31 ( 1.05-1.73), 1.45 ±0. 62] were significantly higher than those before operation [46.72(28.57-57.67) ml · 100 g-1 · min-1, 0.53(0.33-0.82), 1.01 ±0.36](Z=- 2.72, - 2. 98, t = - 2. 85, P ＜ 0. 05 ). Postoperative MTT, TTP and rTTP values of the operated side [ (3.98 ± 2. 36 ) s, ( 17.56 ± 4. 38 ) s, 1.01 ± 0. 09 ] were significantly lower than those before operation [(5.43±2.07) s,(19.40±3.87) s,1.14±0.28] (t=2.41,2.17,2.17, respectively, P＜0.05).However, no significant differences were detected for changes of CBV and rMTT after revascularization ( P ＞0. 05). Conclusion 256-slice CT has the potential value for the non-invasive assessment of both the graft patency and cerebral hemodynamics changes in moyamoya disease after surgery with administration of one contrast medium bolus in a single examination.

The Chinese Pharmacopoeia is the legal technical standard which should be followed during the research, production, use, and administration of drugs. At present, the new edition of the Chinese Pharmacopoeia is planned to be promulgated and implemented. This article summarizes and analyzes the main characteristics and the content of updates and amendments of the Chinese Pharmacopoeia 2025 Edition(Volume Ⅰ), to provide a reference for the correct understanding and accurate implementation the new edition of the pharmacopoeia.

OBJECTIVEA multi-center randomized phase III clinical trial was designed to evaluate the efficacy, clinical benefit response (CBR) and toxicity profile of germcitabine (GEM) or GEM plus cisplatin (CDDP) for locally advanced (LAPC) or metastatic pancreatic cancer (MPC).

METHODSFrom July 2000 to May 2001, 42 untreated patients with LAPC or MPC were collected and randomized into two groups: Arm A-GEM 20 patients and Arm B-GEM + CDDP 22 patients. Eligibility criteria were: cytologically and pathologically proven pancreatic carcinoma, Karnosky performance status (KPS) 60 - 80, age 18 - 75 yrs, adequate hematological, renal and liver function, measurable disease, and controllable pain. For Arm A patients, weekly dose of GEM 1 000 mg/m(2)/w for 7 times followed by a week rest. Then weekly GEM at the same dose for 3 times every 4 weeks. Arm B patients were given weekly dose of GEM 1 000 mg/m(2)/w for 3 times every 4 weeks combined with CDDP 60 mg/m(2) on D15 for 3 cycles.

RESULTSThirty-four patients were available for objective response (Arm A 16 and Arm B 18) and 36 (Arm A 16 and Arm B 20) for CBR evaluation. In Arm A and Arm B, PR 1 (6.3%) and 2 (11%), MR 4 (25%) and 3 (16.7%), SD 7 (43.8%) and 8 (44.4%), PD 4 (25%) and 5 (27.8%), PR + MR 31.3% and 27.8%, PR + MR + SD 75% and 72.2% were observed. Positive CBR was 14/16 (87.5%) in Arm A and 14/20 (70.0%) in Arm B. The negative results was 2/16 (12.5%) in Arm A and 6/20 (30.0%) in Arm B. The median time of disease progression was not yet available at present. The 3-month survival rate of both Arm A and B was 100%, the 6-month survival rates of Arm A and B were 81.3% and 61.6% and the 12-month survival rates of Arm A and B was 31.3% and 11.1%, with median survivals of 273 and 217 days. The incidence of hematological and non-hematological toxicity of Arm A was lower than that of Arm B without statistical significance. The toxicity ranging from being mild to moderate was manageable.

CONCLUSIONGEM or GEM plus CDDP is able to lead to a moderate objective response rate, also significantly improve the quality of life in patients with locally advanced or metastatic pancreatic cancer patients, prolonging the survival time with tolerable toxicity.

Adult ; Aged ; Antimetabolites, Antineoplastic ; adverse effects ; therapeutic use ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; CA-19-9 Antigen ; analysis ; Cisplatin ; adverse effects ; therapeutic use ; Deoxycytidine ; adverse effects ; analogs & derivatives ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms ; drug therapy ; mortality ; Survival Rate ; Treatment Outcome

OBJECTIVETo evaluate the result of surgical treatment of the middle and upper-middle esophageal carcinoma with a new operation, performing the anastomosis posterior to the aortic arch at the apex of the thoracic cavity.

METHODSFrom April 1996 to May. 2000, 179 patients with esophageal carcinoma were treated. Sixty-eight of these patients (49 in the middle and 19 in the upper-middle segment) were treated by esophogogastrostomy at the top of the chest, posterior to the aortic arch. There were squamous cell carcinoma 50, adenocarcinoma 16, undifferentiated carcinoma 2, including 8 double-primaries. The lesions were stage I 9 and stage II-III 59.

RESULTSAll patients have been alive after follow-up of 2 months to 3 years. Without any positive margins, anastomotic leak or perioperative death, this new method has merits: 1. Length of esophagus resected was maximal through one single incision. It would be especially useful for some of the upper-middle lesions. 2. This new method requires a shorter transposed stomach than that required by the combined triple cervico-thoraco-abdominal approach. 3. As the site of thoracic stomach was on the bed of esophagus, there was less chance of post-operative embarrassment in respiration due to the dilatation of the transpositioned stomach and pylorostenosis, etc. 4. There would be less chance of reflux esophagitis because of the "blocking" by the aortic arch, thereby, the patients life is improved.

CONCLUSIONThis radical operation for esophageal carcinoma with anastomosis at top of the thoracic cavity posterior to the aortic arch, being a newly designed surgical method, is especially useful for carcinoma in the middle and upper-middle esophageal segment.

Anastomosis, Surgical ; methods ; Aorta, Thoracic ; surgery ; Esophageal Neoplasms ; surgery ; Follow-Up Studies ; Humans ; Thoracic Surgical Procedures ; methods ; Treatment Outcome

Objective: To investigate the efficacy of different bleaching methods on white-spot lesions of the enamel using optical coherence tomography and to evaluate its feasibility for monitoring the therapeutic effects on white-spot lesions. Methods: Forty-eight sound premolars extracted for orthodontic reasons were selected and cut for 4 mm×4 mm×2 mm enamel blocks in buccal surfaces of the crowns. The samples were covered with acid-resistant varnish (except for the buccal surfaces) and immersed in demineralization solution for 18 days to establish the white-spot lesion models of the enamels. Samples were randomly divided into four groups (n=12). Group A was given demineralization only. Specimens in Group B, C and D were treated with 40% hydrogen peroxide, resin infiltration and 40% hydrogen peroxide combined with resin infiltration, respectively. Eight samples in each group were randomly selected. OCT was applied to observe the optical changes of the enamel surface and according to the OCT scanning results, the demineralization depth of enamel samples in each group was calculated. Then, the enamel blocks were embedded in epoxy resins, except the buccal surfaces, and measured for the microhardness values of the enamel surface by a microindentation hardness tester. Four samples in each group were cut longitudinally, and the ultrastructural changes of enamel samples in each group were observed by scanning electron microscope. Results: OCT showed that the light scattering characteristics of enamel surface changed in all groups, and the bright layer was formed, but the thickness of bright layer in Group C and D was significantly lower than that in Group A and B (P<0.05). The microhardness values (kg/mm2) of the samples in Group A-D were (214.99±31.70), (250.66±33.64), (312.42±18.01) and(286.53±26.65), respectively. The microhardness of enamel surfaces in Group C and D was significantly higher than that in Group A and B (P<0.05), and the ultrastructure of enamel surfaces in Group C and D were more flat and dense in SEM observation (P<0.05). Conclusion The methods of resin infiltration therapy or 40% hydrogen peroxide combined with resin infiltration could effectively improve white-spot lesions of the enamel and the non-invasive OCT can be used as a better evaluation method for the diagnosis and treatment of white-spot lesions of the enamel.

BACKGROUND:Autophagy has become a rapidly developing research hotspot in the biomedical fields.Many researchers are actively exploring the molecular regulatory mechanism of autophagy in a variety of diseases.However,the role of autophagy in hair growth is still unknown. OBJECTIVE:To review the current research progress and application value of autophagy in hair growth and regeneration,to understand the role of autophagy in hair growth,to explore the pathogenesis of autophagy in pathological hair loss,and to provide new ideas for the study of drugs for hair loss. METHODS:Using"hair follicle growth,hair growth,hair regeneration,autophagy associated proteins,autophagy activity,autophagy associated genes,autophagy"as Chinese search terms and"hair growth,hair follicle,hair regeneration,autophagy"as English search terms,PubMed and CNKI databases were searched.The research progress on autophagy,hair growth and the role of autophagy in hair growth in and outside China in recent years was reviewed and summarized.Articles incompatible with the subject content of the paper were excluded.Finally,78 articles were included for the result analysis. RESULTS AND CONCLUSION:(1)Autophagy is a normal metabolic process in eukaryotes with complex molecular mechanisms and functional properties,which is beneficial to cell survival and cell death.(2)Alopecia-related diseases are associated with changes in autophagy activity,which can regulate hair growth cycle.Knockout or overexpression of autophagy-related genes can change the state of hair growth.Multiple autophagy related signaling pathways have been found to be related to hair follicle growth.Activators or inhibitors of autophagy can be used to treat or prevent hair loss.

Objective:To explore the effect of homemade aromatic masks on nausea, vomiting and pain in non-small cell lung cancer patients with chemotherapy.Methods:From October 2018 to August 2019, convenience sampling was used to select 82 patients with non-small cell lung cancer admitted to the 900th Joint Logistic Support Unit of the People's Liberation Army of China. All patients were randomly divided into control group and experimental group, each with 41 cases. Control group carried out the routine care, and experimental group was treated with the homemade aromatic mask on this basis. The Chinese version of Index of Nausea and Vomiting and Retching (INVR) and the Brief Pain Index (BPI) were used to compare nausea, vomiting and pain indicators of patients between two groups during chemotherapy.Results:On the third day of chemotherapy, the total score of nausea and vomiting, and the average pain score of experimental group were (11.00±5.46) and (1.63±1.14) respectively, lower than those of control group, and the differences were statistically significant ( t=-6.635, -4.781; P<0.01) . Conclusions:The homemade aromatic mask can relieve chemotherapy-induced nausea and vomiting in non-small cell lung cancer patients with chemotherapy, and reduce the pain of patients.

With the development of social economy and the full opening of the three-child policy, more and more elderly people will become the main force in raising grandchildren in the future, and the mental health of the elderly in intergenerational raising has become the focus of the whole society. This article summarizes the causes of the intergenerational raising, the mental health status of the elderly in intergenerational raising, and reviews the influencing factors of the mental health of the elderly in intergenerational raising, in order to provide a reference for the construction of the social security system for the elderly and young people in China.

Objective: To prospectively compare single-shot (SS) echo-planar imaging (EPI) and field-of-view optimized and constrained undistorted single-shot multiplexed sensitivity-encoding (FOCUS MUSE) for diffusion-weighted imaging (DWI) in evaluating thyroid-associated ophthalmopathy (TAO). Materials and Methods: SS EPI and FOCUS MUSE DWIs were obtained from 39 patients with TAO (18 male; mean ± standard deviation: 48.3 ± 13.3 years) and 26 healthy controls (9 male; mean ± standard deviation: 43.0 ± 18.5 years). Two radiologists scored the visual image quality using a 4-point Likert scale. The image quality score, signal-to-noise ratio (SNR), contrast-tonoise ratio (CNR), and apparent diffusion coefficient (ADC) of extraocular muscles (EOMs) were compared between the two DWIs. Differences in the ADC of EOMs were also evaluated. The performance of discriminating active from inactive TAO was assessed using receiver operating characteristic curves. The correlation between ADC and clinical activity score (CAS) was analyzed using Spearman correlation. Results: Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated significantly higher image quality scores (P < 0.001), a higher SNR and CNR on the lateral rectus muscle (LRM) and medial rectus muscle (MRM) (P < 0.05), and a non-significant difference in the ADC of the LRM and MRM. Active TAO showed higher ADC than inactive TAO and healthy controls with both SS EPI and FOCUS MUSE DWIs (P < 0.001). Inactive TAO and healthy controls did not show a significant ADC difference with both DWIs. Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated better discrimination of active from inactive TAO (AUC:0.925 vs. 0.779; P = 0.007). The ADC was significantly correlated with CAS in SS EPI DWI (r = 0.391, P < 0.001) and FOCUS MUSE DWI (r = 0.645, P < 0.001). Conclusion FOCUS MUSE DWI provides better images for evaluating EOMs and better performance in diagnosing active TAO than SS EPI DWI. The application of FOCUS MUSE will facilitate the DWI evaluation of TAO.

Objective: To prospectively compare single-shot (SS) echo-planar imaging (EPI) and field-of-view optimized and constrained undistorted single-shot multiplexed sensitivity-encoding (FOCUS MUSE) for diffusion-weighted imaging (DWI) in evaluating thyroid-associated ophthalmopathy (TAO). Materials and Methods: SS EPI and FOCUS MUSE DWIs were obtained from 39 patients with TAO (18 male; mean ± standard deviation: 48.3 ± 13.3 years) and 26 healthy controls (9 male; mean ± standard deviation: 43.0 ± 18.5 years). Two radiologists scored the visual image quality using a 4-point Likert scale. The image quality score, signal-to-noise ratio (SNR), contrast-tonoise ratio (CNR), and apparent diffusion coefficient (ADC) of extraocular muscles (EOMs) were compared between the two DWIs. Differences in the ADC of EOMs were also evaluated. The performance of discriminating active from inactive TAO was assessed using receiver operating characteristic curves. The correlation between ADC and clinical activity score (CAS) was analyzed using Spearman correlation. Results: Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated significantly higher image quality scores (P < 0.001), a higher SNR and CNR on the lateral rectus muscle (LRM) and medial rectus muscle (MRM) (P < 0.05), and a non-significant difference in the ADC of the LRM and MRM. Active TAO showed higher ADC than inactive TAO and healthy controls with both SS EPI and FOCUS MUSE DWIs (P < 0.001). Inactive TAO and healthy controls did not show a significant ADC difference with both DWIs. Compared with SS EPI DWI, FOCUS MUSE DWI demonstrated better discrimination of active from inactive TAO (AUC:0.925 vs. 0.779; P = 0.007). The ADC was significantly correlated with CAS in SS EPI DWI (r = 0.391, P < 0.001) and FOCUS MUSE DWI (r = 0.645, P < 0.001). Conclusion FOCUS MUSE DWI provides better images for evaluating EOMs and better performance in diagnosing active TAO than SS EPI DWI. The application of FOCUS MUSE will facilitate the DWI evaluation of TAO.