Objective To explore the ideal treatment mode of brain metastases by Meta-analysis.Methods Articles were searched for from the databases at home and abroad using English and Chinese keywords.Searching time limited from the databases setting up to December 30,2012.Jadad score was applied to evaluate the qualities of literatures.RevMan5.0 software was applied to perform the Meta-analysis.A totle of 25 articles including 2 750 patients were eligible for the Meta-analysis,which divided into groups with different treatment.Results Compared with monotherapy,combined therapy improved 1-year survival (OR =0.58,95％ CI:0.46 ～0.71,P ＜0.000 01).In combined therapy groups,compared with two methods,three kinds of therapies improved 1-year survival (OR =0.63,95 ％ CI:0.50 ～ 0.80,P =0.000 1).Compared with local therapy only or systemic therapy only,systemic combined local therapy improved 1-year survival (OR =0.68,95％ CI:0.53 ～ 0.86,P =0.001 ; OR =0.59,95％ CI:0.41 ～ 0.86,P =0.006).In systemic combined local therapy groups,three kinds of treatments improved 1-year survival compared with two methods (OR =0.52,95％ CI:0.35 ～ 0.78,P =0.002).Compared with non-molecular targeted therapy,molecular targeted therapy improved 1-year survival (OR =0.76,95％ CI:0.67 ～ 0.87,P ＜ 0.000 1).Conclusion The reasonable treatment for patients with brain metastases is combined treatment with operation,radiotherapy and chemotherapy.There is better curative effect added molecular targeted therapy based on original scheme,if patients have targeted therapy indications.

Objective To investigate the risk factors of proximal junctional kyphosis (PJK) after posterior long segmental lumbar fusion for degenerative lumbar disease. Methods From October, 2012 to July, 2014, 118 degenerative lumbar disease patients who accepted posteri-or long segmental fusion and followed up at least 1.5 years were reviewed. All the PJK were evaluated with X-ray. Results Sixty-six pa-tients completed the follow-up (mean of 3.2 years), in which 12 patients with PJK (PJK group), and the others without (non-PJK group, n=54). There was significant difference in body mass index, bone density and the last Oswestry Disability Index scores (t>2.194, P<0.05) be-tween both groups, as well as the rate of the upper instrumented vertebra (UIV) located in the thoracolumbar segment (T11-L1) (χ2=4.63, P<0.05). The PJK angle was more in PJK group than non-PJK group pre-surgery, post-surgery and finally (t>3.862, P<0.001). Binary Logistic regression showed that osteoporosis (OR=5.328, 95% CI: 1.110~25.581), UIV located in the thoracolumbar segment (T11-L1) (OR=6.239, 95%CI:1.157~33.648) and the pre-surgery PJK angle>10° (OR=5.789, 95%CI:1.075~31.183) were the independent risk factors of PJK. Conclusion Osteoporosis, UIV located in the thoracolumbar segment (T11-L1) and the pre-surgery PJK angle>10° are risk factors of PJK af-ter posterior long segmental lumbar fusion.

Objective To explore the image quality and diagnostic efficiency of coronary CTA (CCTA) in patients without heart rate (HR) control by optimizing acquisition phase with auto-ECG-gating technology using 256-row wide-volume detector.Methods Totally 200 patients with suspected coronary artery disease (CAD) were selected and underwent CCTA with auto-ECG-gating on a 256 row wide detector CT (Revolution CT).Patients were divided into 4 groups according to the real-time HR,group A (n=50):HR≤69 bpm;group B (n=50):HR 70-80 bpm;group C (n=50):HR 81-90 bpm;group D:HR≥91 bpm (n=50).CCTA images quality and diagnostic rate were assessed by two experienced radiologists blindly,and effective radiation dose were compared among 4 groups.Results There were no significant differences of age,sex,and body mass index among 4 groups (all P＞0.05),and there was significant difference of image quality score among 4 groups (P＜0.05).Totally,800 coronary arteries and 2 575 segments in 200 patients were assessed.There had no significant difference of diagnostic rate among four groups derived from the segment,coronary artery and patients (all P＞0.05).The effective radiation dose in A D groups were (1.05t0.48)mSv,(2.41± 1.20)mSv,(1.27±0.55) mSv,(2.66±1.12)mSv,and the difference was significant (F=29.22,P＜0.001).Conclusion It is feasible to perform CCTA in single cardiac cycle in patients with arbitrary heart rate by auto-ECG-gating using Revolution CT equipped widevolume detector.And it can improve image quality and success ratio in patients with moderate and high heart rate.

PURPOSE: Hepatocellular carcinoma (HCC) is a common cancer worldwide. Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), a long noncoding RNA (lncRNA), has been reported to be aberrantly expressed in hypoxic cancer cells. MALAT1 plays a significant role in many malignancies, including HCC. The aim of this study was to explore the role of MALAT1 in hypoxic HCC cells and its underlying regulatory mechanism. MATERIALS AND METHODS: Quantitative reverse transcription PCR (qRT-PCR) assay was performed to detect the mRNA levels of MALAT1 and microRNA-200a (miR-200a) in HCC cells. Cell invasion and migration ability were evaluated by Transwell assay. Starbase v2.0 and luciferase reporter assay were employed to identify the association between MALAT1 and miR-200a. Cell proliferation and apoptosis were measured by MTT assay and flow cytometry, respectively. RESULTS: MALAT1 levels were significantly upregulated in HCC cells under hypoxia. Hypoxia promoted proliferation, migration, and invasion, and blocked apoptosis in Hep3B cells, which were weakened by knockdown of MALAT1. Starbase v2.0 showed that MALAT1 and miR-200a have a complementarity region, and luciferase reporter assay verified that MALAT1 interacted with miR-200a in Hep3B cells. Moreover, MALAT1 negatively regulated the expression of miR-200a. miR-200a levels were dramatically downregulated in HCC cells under hypoxia. Upregulation of miR-200a inhibited proliferation, migration, and invasion, and induced apoptosis in Hep3B cells under hypoxia. Interestingly, downregulation of miR-200a partially reversed the tumor-suppressive effect of knockdown of MALAT1 on Hep3B cells in hypoxic condition. CONCLUSION: LncRNA MALAT1 was involved in proliferation, migration, invasion, and apoptosis by interacting with miR-200a in hypoxic Hep3B cells, revealing a new mechanism of MALAT1 involved in hypoxic HCC progression.
Adenocarcinoma ; Anoxia ; Apoptosis ; Carcinoma, Hepatocellular ; Cell Proliferation ; Down-Regulation ; Flow Cytometry ; Luciferases ; Lung ; Polymerase Chain Reaction ; Reverse Transcription ; RNA, Long Noncoding ; RNA, Messenger ; Up-Regulation

The active ingredients in traditional Chinese medicine have been reported to possess significant pharmacological activity and played an important role in clinical treatments. However, lots of the active ingredients in traditional Chinese medicine suffer from disadvantages such as low solubility, high melting point and low stability that results in low bioavailability and limit its clinical application. Crystal structure plays an important role in improving physicochemical properties and efficacy of the active ingredients in traditional Chinese medicine. This review concludes the research advances of several crystal forms used in the active ingredients in traditional Chinese medicine in terms of polymorph, cocrystal, amorphous/coamorphous and nanocrystal. And the effects of crystal forms on the physicochemical properties and efficacy of the active ingredients in traditional Chinese medicine were reviewed. This research may be useful for the formulation preparation and development of the active ingredients in traditional Chinese medicine.

Objective To investigate the effect of health education for discharged patients, and to explore the reasons and effective countermeasures on the health education. Methods Through the question-naire survey, convenient sampling method was used to evaluate the effect of the hospital health education. The existing problems and corresponding countermeasures taken for continuous improvement were analyzed. SPSS 17.0 statistical software was applied for data processing, the count data was expressed by rate and Statistical methods using chi-square test. Results The hospital health education satisfaction rate rose to 95.21%from 54.17%after intervention, and differences between the two groups was statistically significant (P<0.05). The satisfaction rate of the department of internal medicine, surgery department, and the department of gynaecology and pediatrics was significantly improved than before. Conclusion By improving health education importance, strengthening learning and training of specialized subject knowledge, rationally allo-cating human resources and establishing health education quality control system, the health education for discharged patients was effectively improved with satisfaction.

The flavonoids were investigated from the whole plants of Lagopsis supina. The compounds were isolated and purified by various column chromatography, and their structures were identified by physiochemical properties and spectroscopic data. Two flavones were isolated from the CH2Cl2 layer of Lagopsis supina extract and identified as genkwanin (1) and 5-hydroxy-7,4'-dimethoxyflavone (2), respectively. Ten flavonoid glycosides were isolated from the water layer of Lagopsis supina and elucidated as kaempferol-3-O-6" (3-hydroxy-3-methylglutaryl) -β-D-glucoside (3), quercetin-3-O-6"-(3-hydroxy-3-methylglutaryl) -β-D-glucoside (4), quercetin-3-O-β-D-glucoside(5), kaempferol-3-Of3-D-glucoside ( 6), isorhamnetin-3-O-/-D-glycopyranoside (7), apigenin-7-O-6-D-glucoside (8), luteolin-7-O-β-D-glucoside (9), chrysoeriol-7-O-β-D-glucoside (10), rutin (11 ), and kaempferol-3-β-(6"-p-coumaroyl) -β-D-glucoside (tiliroside, 12). Compounds 3 and 4 were firstly isolated from Lamiaceae family, and compounds 1-12 were isolated from the plants of Lagopsis genus for the first time.
Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Flavonoids ; chemistry ; isolation & purification ; Lamiaceae ; chemistry ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization

Objective To assess the clinical efficacy and adverse reac-tions of olanzapine combined with escitalopram oxalate on depressive disorder in elderly patients.Methods Sixty two elderly patients with depressive disorder were recruited from February 2012 to April 2014 in our hospital and were randomized divided into the control group ( n=33 ) and experiment group ( n=29 ).Patients in the control group were given escitalopram oxalate 10 mg · d-1 orally for 8 weeks and patients in the experiment group were given escitalopram oxalate 10 mg · d-1 combined olanzapine 2.5 mg· d-1 ( initially) ,ranging from 5 to 10 mg· d-1 within the first week.The data of hamilton depression scale ( HAMD) and treat-ment emergent symptom scale ( TESS ) score were recorded between the two groups to evaluate the clinical efficacy and adverse reactions before treatment and 1, 2, 4, 6 and 8 weeks after treatment.Results From the end of the second week to the eighth week , the HAMD scale were significantly decreased in both groups ( P <0.05 ).At the end of the fourth week to the eighth week , the HAMD score in the experiment group were significantly lower than those in control group ( P <0.05 ).After 8 weeks, more than 10%patients in the experiment group showed weight gain , higher than those in the control group (P<0.05).The other adverse reactions such as dizziness , dry mouth, constipation and nausea showed no statistical differences( P>0.05 ).Conclusion Olanzapine combined with escitalopram oxalate in the treatment of depressive disorder in elderly patients can rapidly improve the symptom and have better clinical efficacy , but the weight gain was a common adverse reaction.

BACKGROUNDThe relationship between monosymptomatic resting tremor (mRT) and Parkinson's disease (PD) remains controversial. In this study, we aimed to assess the function of presynaptic dopaminergic neurons in patients with mRT by dopamine transporter positron emission tomography (DAT-PET) and to evaluate the utility of clinical features or electrophysiological studies in differential diagnosis.

METHODSThirty-three consecutive patients with mRT were enrolled prospectively. The Unified Parkinson's Disease Rating Scale and electromyography were tested before DAT-PET. Striatal asymmetry index (SAI) was calculated, and a normal DAT-PET was defined as a SAI of <15%. Scans without evidence of dopaminergic deficits (SWEDDs) were diagnosed in patients with a subsequent normal DAT-PET and structural magnetic resonance imaging.

RESULTSTwenty-eight mRT patients with a significant reduction in uptake of DAT binding in the striatum were diagnosed with PD, while the remained 5 with a normal DAT-PET scan were SWEDDs. As for UPRDS, the dressing and hygiene score, walking in motor experiences of daily living (Part II) and motor examination (Part III) were significant different between two groups (P < 0.05 and P < 0.01, respectively). Bilateral tremor was more frequent in the SWEDDs group (P < 0.05). The frequency of resting tremor and the amplitude of postural tremor tend to be higher in the SWEDDs group (P = 0.08 and P = 0.05, respectively).

CONCLUSIONSmRT is heterogeneous in presynaptic nigrostriatal dopaminergic degeneration, which can be determined by DAT-PET brain imaging. Clinical and electrophysiological features may provide clues to distinguish PD from SWEDDs.

Adult ; Aged ; Dopamine Plasma Membrane Transport Proteins ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease ; diagnosis ; Positron-Emission Tomography ; methods ; Prospective Studies ; Tremor ; diagnosis

OBJECTIVETo investigate potential mutations and clinical features of 9 unrelated patients with inherited coagulation factor VII (FVII) deficiency.

METHODSClinical diagnosis was validated by assaying of coagulation parameters including prothrombin time, activated partial thromboplastin time, FVII activity and specific antigens. All exons, exon-intron boundaries, and 5' and 3' untranslated regions of F7 genes were amplified with PCR. Potential mutations were detected by direct sequencing of purified PCR products. Suspected mutations were confirmed by sequencing of the opposite strand.

RESULTSAll probands have featured prolonged prothrombin time, with FVII activity ranging between 2.0% to 6.0%. The titers of FVII antigen were significantly reduced in 7 probands. Eight mutations, including 6 missense mutations, 1 deletion and 1 insertion, were identified, among which 3 (Gln100Leu, Ser269Pro and g.11520_11521insT) were not described previously. Six mutations have located in the protease domain. All mutations were inherited, and consanguineous marriages were reported in 5 families. Mutations g.27_28delCT, Cys329Gly, Arg304Trp and His348Gln have been identified in unrelated families. There was a lack of correlation between the mutations and their clinical features. Two individuals with homozygous His348Gln mutations and 1 individual with homozygous Arg304Trp mutation were only mildly affected or asymptomatic. Two patients, who have respectively carried homozygous and heterozygous deletions of g.27_28delCT, were moderately affected and asymptomatic. In 4 patients carrying double heterozygous mutations, 1 (Ser269Pro and Cys329Gly) was asymptomatic, 2 (Arg304Trp and Cys329Gly, Arg277Cys and g.11520_11521insT, respectively) had a mild bleeding tendency, whilst 1 (Gln100Leu and His348Gln) has a moderate bleeding diathesis.

CONCLUSIONThere seem to be hotspots of F7 gene mutations in ethnic Han Chinese populations. And there is a lack of correlation between particular types of mutations and clinical phenotypes.

Adolescent ; Adult ; Aged ; Base Sequence ; Blood Coagulation Disorders, Inherited ; genetics ; Child ; Factor VII ; genetics ; Factor VII Deficiency ; genetics ; Female ; Heterozygote ; Homozygote ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Mutation ; Young Adult