Objective To contrast the accuracy rate of nuclear magnetic resonance imaging (MRI)-staging and the International Federation of Gynecology and Obstetrics (FIGO, 2009) clinical-staging, and evaluate the value of MRI in diagnosis of lymph node metastasis in cervical cancer. Methods The surgical pathology was used as golden standard, the accuracy rates of MRI-staging and FIGO-staging were compared in 86 patients of cervical cancer (surgical pathological staging≥Ⅰb). The lymph nodes with slightly hyperintense signal in diffusion-weighted magnetic resonance imaging (DWI) and with minor axis≥1 cm in T2WI-TRA (T2 weighted imaging-transverse section) were considered as metastatic lymph nodes, the characteristics of lymphatic metastasis diagnosed by MRI were analyzed, and the accuracy rate, the sensitivity, the specificity, the positive predictive value and the negative predictive value of MRI were evaluated. Results The accuracy rate of FIGO-staging was 80.2%(69/86), and the accuracy rate of MRI-staging was 83.7%(72/86), there was no significant difference between them (P > 0.05). The accuracy rate of lymphatic metastasis diagnosed by MRI was 94.2%(81/86), the sensitivity was 73.3%(11/15), the specificity was 98.6%(70/71), the positive predictive value was 91.7%(11/12), and the negative predictive value was 94.6%(70/74). The true positive metastatic lymph nodes in 11 cases were located in the external iliac nodes or common iliac lymph nodes, the average short/long diameter was 0.76. The forms of lymph nodes were as follows:quasi-circular (n=3), border irregularity (n=3), huge fusion form (n=4), and 1 with central necrosis area. One case of false positive metastatic lymph node was located in the right external iliac node, with the sharp of huge fusion form in T2WI/TRA, comminution in T2WI-axial thin slices, and long strip in T2WI/SAG. Conclusion The accuracy rates of MRI-staging and FIGO-staging were both higher, which can diagnose lymphatic metastasis relatively accurately when they are combined together.

Trans-cinnamaldehyde, the main component of volatile oil from cassia twig or Cinnamomum cassia, which is a traditional Chinese herbal medicine. Trans-cinnamaldehyde is a kind olefine aldehyde of organic compounds and has many pharmacological properties, such as anti-inflammatory, anti-tumor, anti-bacterial, antidiabetic, anti-obesity, and neuroprotection etc. The compound has preventive and therapeutic effects on the nervous system, cardiovascular, cancer, diabetes and other diseases. Trans-cinnamaldehyde, as a preventive care of nature medicine, has great clinical and market potential. This paper gives a review about the pharmacological effects and mechanism of trans-cinnamaldehyde researched in the latest five years. We hope to provide some basic information for further research on trans-cinnamaldehyde.
Acrolein ; analogs & derivatives ; chemistry ; pharmacology ; Animals ; Cinnamomum aromaticum ; chemistry ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans

Objective To investigate the clinical manifestations and MR imaging features of olivopontocerebellar atrophy(OPCA).Methods The clinical data and MR findings of 8 patients with OPCA (OPCA group) were retrospectively analyzed,and 75 cases of healthy physical examination people were chosen as control group (they were divided into 21-30 years group,31-40 years group,41-50 years group,51-60 years group,61-70 years group,and 15 cases in each group),all subjects under went pons measurement.Results All 8 patients with OPCA were sporadic cases.The cerebellar symptom,autonomic symptoms and extrapyramidal symptoms were common manifestations.The head MR imaging of OPCA presented with cerebellum and brain stem atrophy,cross sign was the characteristic appearance.Vertical diameter and anteroposterior diameter of the pons in OPCA group patients was (20.63 ± 2.16) and (16.74 ±4.37) mm,compared with control group [(27.14 ±1.73) and (22.28 ± 1.49) mm],there was significant difference (P ＜ 0.01).In control group,vertical diameter and anteroposterior diameter of the pons maximum in 21-30 years group and 31-40 years group,increased with age,the value had been reduced,but there was no significant difference (P ＞ 0.05).Conclusion MR is the first choice for the diagnosis of OPCA,combine with clinical manifestations may improve the diagnostic accuracy.

BACKGROUND:Cauda equina syndrome often induces skin hypoesthesia in the perineal area, poor urine-stool control, and impairs male function. After peripheral nerve fiber injury, apoptosis of neurons appeared. This is associated with the nature of the injury, the types of neurons, the species of animals, the age, and the distance between neurons. OBJECTIVE:To explore the motor neuron apoptosis and expression of apoptosis-associated protein in the anterior horn of the spinal cord after acute cauda equina compression. METHODS:A total of 27 canines were randomly divided into three groups. In the compression and control groups, models of cauda equina compression were established. In the normal group, no models were established. Compression group received water sac compression for 4, 8, 12, 24, 48, 72 and 168 hours, with three models in each group. In the control group, only water sac was implanted, but water was not injected. Terminal deoxynucleotidyl transferase TdT-mediated biotin dUTP nick end-labeling assay was used to detect the apoptosis of neurons in the anterior horn of the spinal cord. Bcl-2, Bax and Caspase-3 protein expressions were measured by immunohistochemical staining (strept avidin-biotin complex). Gray values of positive cels of Bax, Bcl-2 and Caspase-3 protein expressions were detected using Qwin550Cw image colection and analysis system. RESULTS AND CONCLUSION:The apoptosis of motor neuron occurred in the compression groups. At 12 hours of compression, positive cels were detected, and the number of positive cels reached a peak at 72 hours. Bax and Bcl-2 protein expression was smal in the normal group. Caspase-3 protein expression was not detected in the normal and control groups. Bax and Bcl-2 protein expression was significantly increased at 8 hours, peaked at 72 hours and reduced to a normal level at 168 hours. The increased range of Bax protein expression was bigger than that of Bcl-2. Caspase-3 protein began to express at 12 hours, peaked at 72 hours and reduced to a low level at 168 hours. Bax and Caspase-3 protein expression peaked at 72 hours, and Bcl-2 protein expression was not obviously increased. These findings verified that after acute cauda equina compression, the apoptosis of neurons occurred in the anterior horn of the spinal cord. Bax and Bcl-2 protein expression showed an antagonistic action. In the Bax/Bcl-2 complex, Bax protein in a high expression promoted apoptosis, induced Caspase-3 protein expression, and neuronal apoptosis.

OBJECTIVE To evaluate the long-term toxicity of fully human anti-human tumor necrosis factor-α monoclonal antibody(anti-hTNF-α FHMA)for injection in cynomolgus monkeys. METHODS Forty cynomolgus monkeys were randomly divided into 5 groups (4 males and 4 females in each group):negative control group,adalimumab 10 mg·kg-1 group,anti-hTNF-αFHMA 2,10 and 50 mg·kg-1 groups. Cynomolgus monkeys in each group were injected sc once a week for 5 consecutive times, followed by 4 weeks of recovery. During the test,general clinical observation,body mass,body temperature,electrocardiogram(ECG),hematology,coagulation function,blood biochemistry,urine, ophthalmology,immune index,and pathological changes in organs and tissues were observed. At the same time,plasma drug concentrations were detected and the toxicokinetics parameters were analyzed. RESULTS No significant toxicological changes related to drugs were observed in general clinical observation,body mass,body temperature,ECG,ophthalmic examination,blood cell counts,coagu?lation function,blood biochemistry,urine analysis,lymphocyte subsets,cytokines,serum immuno?globulin,serum complement. Neutralizing anti-drug antibody(ADA)could be detected in adalimumab group and anti-hTNF-αFHMA groups. Anti-hTNF-αFHMA showed linear dynamic characteristics in cyno?molgus monkeys. At the same dose(10 mg·kg-1),anti-hTNF-αFHMA had similar immunogenicity and kinetics characteristics to adalimumab. CONCLUSION The level of anti-hTNF-α FHMA at which no adverse effect was observed was 50 mg · kg-1,which is equivalent to 75 times clinical dosage of quasi (0.67 mg·kg-1),which suggests that anti-hTNF-αFHMA be safe in clinical use.

Brain Abscess ; surgery ; Epilepsy ; etiology ; Humans ; Kidney Failure, Chronic ; complications ; Male ; Middle Aged ; Recurrence

ObjectiveTo investigate the efficacy and toxicity of postoperative radiochemotherapy compared with chemotherapy alone in the treatment of locally advanced gastric cancer.MethodsA total of 83 patients with resected adenocarcinoma of the stomach were randomly assigned to postoperative radiochemotherapy group (RCT) ( n =43 ) or chemotherapy alone group (CT) ( n =40 ).Patients in RCT group received radiotherapy concurrent with capecitabine chemotherapy then followed by 4 - 6 cycles of FOLFOX4 chemotherapy.The total dose of radiation was 45 Gy.The dose of capecitabine was 1600 mg/m2per day.In the CT group,patients received 6 - 8 cycles FOLFOX4 chemotherapy.Survival was analyzed using Kaplan-Meier method and Logrank test. Results The follow-up rate was 96％. The number of patients who had a minimum of 2-,3-year follow-up time were 37,12 in the RCT group and 31,10 in the CT group.The 1-,2-,3-year local control rates for RCT and CT groups were 100％,97％,94％ and 95％,87％,73％ (x2 =4.54,P =0.033),respectively.The 1-,2-,3-year survival rates were 98％,86％,81％ in the RCT group,with 93％,80％,64％ in the CT group ( x2 =3.96,P =0.047 ).The incidence of grade 3hematological toxicity in the RCT and CT group was 23％ vs 15％ ( x2 =0.93,P =0.630 ),and grade 3gastrointestinal toxicity was 16％ vs 10％ ( x2 =0.95,P =0.624 ). Conclusions Compared with chemotherapy alone,postoperative radiochemotherapy can improve survival of locally advanced gastric cancer patients with acceptable toxicities.

Acute Disease ; Adult ; CD56 Antigen ; immunology ; Female ; Humans ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; complications ; immunology ; surgery ; Recurrence ; Stem Cell Transplantation

OBJECTIVETo observe the effect of huperzine A on cerebral cholinergic system in elderly patients during recovery from general anesthesia.

METHODSThirty elderly patients undergoing elective surgery under general anesthesia were randomized in a double-blind manner into group I (n=15) to receive huperzine A (0.3 mg/2 ml) and group II (n=15) with normal saline (2 ml) given intravenously. Huperzine A or normal saline was administered 30 min before completion of the operation, and acetylcholine (Ach) concentration in the cerebral spinal fluid (CSF) of the patients was determined using high-performance liquid chromatography with electrochemical detector (HPLC-ECD) and the activity of cholinesterase inhibitors (ChE) evaluated with automatic biochemistry analyzer before general anesthesia induction (T1) and 5 h after operation completion (T2).

RESULTSIn both the groups, Ach concentration in the CSF were lower at T2 than that at T1 (P<0.01), and at T2, CSF Ach concentration was significantly higher in group I than in group II (P<0.01); in group I, the activity of CSF ChE at T2 was lower than that at T1 (P<0.01), and also lower than at T2 in group II (P<0.01).

CONCLUSIONHuperzine A can inhibit cholinesterase to increase Ach, which has a positive effect on cerebral cholinergic system in elderly patients during recovery from general anesthesia.

Acetylcholine ; cerebrospinal fluid ; Aged ; Alkaloids ; Anesthesia Recovery Period ; Anesthesia, General ; Brain ; drug effects ; metabolism ; Cholinesterase Inhibitors ; therapeutic use ; Cholinesterases ; cerebrospinal fluid ; Chromatography, High Pressure Liquid ; Double-Blind Method ; Electrochemistry ; Female ; Humans ; Intraoperative Period ; Male ; Sesquiterpenes ; therapeutic use

Objective:To meet the demand of medical system for talents, the training of medical students' competency has become a new direction of medical education. This study aims to evaluate the effectiveness of training quality in medical graduates through the competency scale.Methods:Taking "attitude", "skill" and "knowledge" as the evaluation dimensions, the competency development was divided into four levels of "state", "explain", "apply" and "transfer", and we proposed the competence concept of "A.S.K.-SEAT" and formulated an evaluation scale. Questionnaires and behavior event interviews (BEI) were conducted in medical graduates of Shantou University in 2018. Reliability and validity of the questionnaire were evaluated and current situation of different competency items were analyzed.Results:A total of 155 questionnaires were collected with good reliability and validity, and 15 graduates participated in BEI. A total of 21 A.S.K. competency items (including five basic competency items and two discriminating competency items) and SEAT textual descriptions were finally established.Conclusion:A.S.K.-SEAT scale can provide valid references for the competency evaluation of medical graduates.