Objective:To investigate the clinical characteristics and prognosis of cryptococcal meningitis patients with anti-granulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies.Methods:A total of 216 non-acquired immunodeficiency syndrome (AIDS) related cryptococcal meningitis cases with positive cultures of Cryptococcus, hospitalized at Huashan Hospital, Fudan University during January 2014 and December 2021, were retrospectively included. The serum anti-GM-CSF autoantibodies were detected by enzyme linked immunosorbent assay, and the clinical characteristics and prognosis were compared between patients with and without anti-GM-CSF autoantibodies. Statistical comparisons were mainly performed using the chi-square test or Fisher′s exact test. Cox proportional-hazards model was used to analyze the risk factors associated with prognosis. Results:Among 216 enrolled patients, 23 patients were positive of anti-GM-CSF autoantibodies, with a positive rate of 10.6%. Among 23 patients, seven cases were infected with Cryptococcus gattii, and 16 cases were infected with Cryptococcus neoformans. In the group with positive anti-GM-CSF autoantibodies, 30.4%(7/23) of the patients were infected with Cryptococcus gattii, which was higher than that of 1.6%(3/193) in the group with negative anti-GM-CSF autoantibodies, and the difference was statistically significant ( χ2=38.82, P<0.001). In the group with positive anti-GM-CSF autoantibodies, 30.0% (6/20) had mass lesions with a diameter greater than three centimeters in the lungs, and the one-year all-cause mortality rate was 50.0% (10/20), which were both higher than those of 3.4%(5/145) and 16.1% (29/180) in the negative group, respectively. The differences were both statistically significant (both Fisher′s exact test, P<0.01). Age≥60 years (hazard ratio ( HR)=4.146, P=0.002), predisposing factors ( HR=3.160, P=0.021), epilepsy ( HR=6.129, P=0.002), positive anti-GM-CSF autoantibodies ( HR=2.675, P=0.034), white blood cell count of cerebrospinal fluid (CSF)<100 ×10 6/L ( HR=2.736, P=0.039), the titers of cryptococcal capsular polysaccharide antigen of CSF≥1∶1 280 ( HR=4.361, P=0.009) were independent risk factors for one-year all-cause mortality in patients with cryptococcal meningitis. Conclusions:In non-AIDS related cryptococcal meningitis patients, the positive rate of serum anti-GM-CSF autoantibodies is as high as 10.6%. Patients with anti-GM-CSF autoantibodies could be infected with both Cryptococcus neoformans and Cryptococcus gattii, and they have higher proportion of lung mass lesions than patients with negative anti-GM-CSF autoantibodies. The one-year survival rate decreases significantly in patients with anti-GM-CSF autoantibodies, which is an independent risk factor for the prognosis of cryptococcal meningitis.

Breast cancer is the most common cancer for Chinese women. Early screening is the best way to improve the rates of early diagnosis and early treatment of breast cancer. The peak ages of breast cancer in Chinese women are obviously different from those in the European and American countries. It is imperative to develop a guideline for breast cancer screening that is suitable for Chinese women. Based on the analysis and summary of breast cancer screening data in China, and the latest guidelines and consensus on breast cancer screening in Europe, the United States and East Asia, China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) has developed a population-based guideline for breast cancer screening in Chinese women. This guideline has provided detailed recommendations on the screening starting age, screening modalities, and screening interval in Chinese women with average risk and high risk of breast cancer, respectively. This article aims to interpret the above guideline, providing references for professionals in breast cancer screening.

Objective: To preliminarily investigate the difference of position fixation accuracy between polyurethane styrofoam and vacuum negative pressure pad in intensity-modulated radiation therapy (IMRT) after radical mastectomy for breast cancer. Methods: Forty breast cancer patients, who received breast-conserving surgery followed by hyper-fractionated IMRT of the whole breast (42.56 Gy for 16 times) in our hospital between 2017 and 2018 were recruited and randomly divided into the polyurethane styrofoam group and vacuum negative pressure pad group. Before IMRT treatment, the anterior and lateral films of patients were taken with kilovoltage digital radiographs (KVDRs) by Varian Trilogy machine-borne OBI KV image verification system. The KVDRs images were matched with the DRR images reconstructed by the planned system to obtain the setup errors in the left and right, head and foot, and ventral and back directions between two groups. Each patient was verified for 10 times to obtain 400 sets of data. The independent sample t-test was adopted to analyze the setup errors between two groups. The external expansion value of graded setup errors from clinical target volume (CTV) and planned target volume (PTV) was calculated. Results: The setup errors in the left and right, head and foot, ventral and back directions between the styrofoam fixation and vacuum pad groups were (1.63±1.29) mm and (1.83 ±1.61) mm (P=0.18), (1.46±1.51) mm and (2.26±2.03) mm (P=0.00), and (1.30±1.35) mm and (1.91±1.67) mm (P=0.00), respectively. The external expansion values of setup errors from CTV to PTV were 2.19 mm, 2.51 mm, 1.57 mm and 2.40 mm, 3.97 mm and 2.63 mm, respectively. Conclusion Both two fixation methods meet the clinical requirements. However, the setup accuracy and reproducibility in the polyurethane styrofoam group are better than those in the vacuum negative pressure pad group.

Objective To investigate the difference of styrofoam and breast carrier in postposition fixation of intensity-modulated radiotherapy after breast conservative surgery for breast cancer patients.Methods From February 2018 to August 2018,tweenty-four patients with breast cancer in Sun Yet-Sen Memorial Hospital of Sun Yet-sen University were selected for this study,who underwent hypofactionationed radiotherapy after breast conservative surgery with total dose 42.56 Gy/16Fractions.They were randomized into styrofoam test group and breastcarrier control group.Cone beam CT as used to record the positioning error under the directions of left and right (x),head and foot (y),abdomen and back (y) within two groups at the first,third,fifth,seventh,eleventh time before irradiation.Furthermore,the PTV extension margin was calculated and the positioning time of two groups was recorded.Two sets of pendulum errors were analyzed by independent sample T-test,and the outspread value of inter-fractional set up error of the PTV was calculated.Results The errors of the test group and the control group in the direction of x,y,z were as follows:(2.36±1.89) and (2.56±2.05) mm (P=0.49),(1.76± 1.78) and (3.28±2.79) mm (P＜0.05),(1.47± 1.49) and (1.73± 1.81) mm (P=0.28).The extension values of inter-fractional set up error of CTV to PTV were 2.97,2.92,2.21 mm and 3.41,4.09,2.59 mm respectively.The time of single positioning was (3.4± 1.1) and (5.5 ± 3.1) min respectively (P=0.01).Conclusion Styrofoam has better positioning accuracy and efficiency compared with breast carrier.

ObjectiveTo investigate the intervention effects of moxibustion and moxa smoke on blood lipids,hepatic pathological changes and intrahepatocytic molecules related to cholesterol metabolism and analyze the regulating effects of moxibustion and moxa smoke on cholesterol metabolism and explore the mechanisms of actions of moxibustion and moxa smoke. MethodFifty-one 8-week-old ApoE-/-mice were randomized into model, moxa smoke and moxibustion groups, 17 mice each. Twenty C57BL/6 mice comprised a blank control group. The normal and model groups of mice were routinely grabbed and fastened. The moxa smoke group of mice was exposed to 10-15 mg/m3moxa smoke circumstances. The moxibustion group of mice was given moxibustion on point Guanyuan(CV4). All interventions were made 20 min daily, 6 times a week, for 12 consecutive weeks. Total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C) were measured using an automatic biochemical analyzer. Hepatic pathologic morphology was observed by HE staining. Hepatic CD36 and ABCA1 expressions were determined by immunohistochemical method.ResultIn the model group of mice, serum TG and LDL-C contents were significantly higher than in the normal group (P=0.003;P=0.001);HDL-C content was significantly lower than in the normal group (P=0.007); TC content had no significant difference compared with the normal group (P>0.05). In the moxibustion group of mice, serum TG and LDL-C contents were significantly lower than in the model group (P=0.03;P=0.001) and HDL-C content had no significant difference compared with the model group (P=0.11). In the moxa smoke group of mice, serum TG and LDL contents were significantly lower than in the model group (P=0.01;P=0.008) and HDL content had no significant difference compared with the model group (P=0.11). There were no significant differences in various blood lipid indicators between the moxibustion and moxa smoke groups (P>0.05). There were hepatic cell cord and sinusoid derangement and obvious hepatocytic swelling in the model group of mice. In the moxa smoke and moxibustion groups, hepatocytic swelling subsided significantly, and inflammatory cell infiltration reduced compared with the model group. In the model group,CD36 expression was significantly higher than in the normal group (P=0.004) and ABCA1 expression was significantly lower than in the normal group (P=0.001). In the moxibustion group, CD36 expression had no significant difference compared with the model group (P=0.09) and ABCA1 expression was significantly higher than in the model group (P=0.03). In the moxa smoke group, CD36 expression was significantly lower than in the normal group (P=0.02) and ABCA1 expression was significantly higher than in the model group (P=0.002). There were no significant differences in CD36 and ABCA1 expressions between the moxibustion and moxa smoke groups (P>0.05).ConclusionEarly moxibustion on point Guanyuan can regulate disorders of blood lipid metabolism, delay the occurrence of hepatic lesions and reduce intrahepatic accumulation of cholesterol to a certain extent in an ApoE-/-mouse model of atherosclerosis. That may be one of the mechanisms by which moxibustion therapy prevents atherosclerosis. Moxa smoke as the product of moxibustion is an effective factor in moxibustion producing a therapeutic effect.

Ginsenoside Rg1 (Rg1), the major effective component of ginseng, has been shown to have multiple bioactivities, but low oral bioavailability. The aim of this study was to develop a simple, sensitive and rapid high performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) method, which could be used to validate and quantify the concentrations of Rg1 and its metabolites in Sprague-Dawley rat bile, urine, and feces after oral administration (25 mg/kg). Calibration curves offered satisfactory linearity (>0.995) within the determined ranges. Both intra-day and inter-day variances were less than 15%, and the accuracy was within 80-120%. The excretion recoveries of Rg1, ginsenoside Rh1 (Rh1), and protopanaxatriol (Ppt) in bile, urine, and feces combined were all greater than 70%. The fecal excretion recoveries of Rg1, Rh1, and Ppt were 40.11%, 22.19%, and 22.88%, respectively, whereas 6.88% of Rg1 and 0.09% of Rh1 were excreted in bile. Urinary excretion accounted for only 0.04% of Rg1. In conclusion, the observed excretion profiles for Rg1 and its metabolites after oral administration are helpful for understanding the poor oral bioavailability of Rg1 and will aid further investigations of Rg1 as a pharmacologically active component.

OBJECTIVETo investigate whether inhalable particulate matters can cause the damage of chromosome or mitotic apparatus to produce micronucleus, and to evaluate genetic toxicology of moxa smoke on chromosome.

METHODSBy MTT method, the 24 h half maximal inhibitory concentration (IC50) of moxa smoke condensation (MSC) on Chinese hamster ovary (CHO) cells was 0.087 mg/mL. CHO cells, which were cultured in vitro, were divided into a solvent control group, a positive control group (cyclophosphamide as solvent), a low concentration group, a moderate concentration group and a high concentration group. The low concentration group, moderate concentration group and high concentration group were set approximately 1/8, 1/4, 1/2 of IC50, respectively. Whether micronucleus had dose-effect response induced by the damage of chromosome or mitotic apparatus was observed after CHO cells were contaminated by MSC in the low concentration group, moderate concentration group and high concentration group.

RESULTSThe rate of micronucleus induced by MSC in the low concentration group, moderate concentration group and high concentration group was higher than that in the solvent control group (all P < 0.05), which presented dosage-effect response. The experiment was repeated 3 times, indicating it was repeatable with statistical significance.

CONCLUSIONHigh concentration of MSC shows toxicity to induce chromosome damage, which disappears at low concentration. The genetic toxicology is also dependent on concentration, and the concentration of moxa smoke is essential. In clinical treatment, it is noted to control the level of moxa smoke, while the clinical safety standard of moxa smoke concentration is in need of further study.

Air Pollutants ; adverse effects ; Animals ; CHO Cells ; Cell Nucleus ; drug effects ; genetics ; Cricetinae ; Cricetulus ; Inhalation Exposure ; adverse effects ; analysis ; Micronucleus Tests ; Moxibustion ; adverse effects ; Particulate Matter ; adverse effects ; Smoke ; adverse effects ; analysis

ObjectiveTo investigate the effects of moxa smoke versus tobaccosmoke on autonomous behaviors and hippocampal expression of glial fibrillary acidic protein (GFAP) in apolipoprotein E gene knockout (ApoE-/-) mice.Method Thirteen 8-week-old C57BL/6 mice constituted a blank control group. Twenty-seven ApoE-/-mice of the same age were randomized into ApoE-/-model, moxa smoke and tobacco smoke groups. The tobacco smoke and moxa smoke groups of mice were exposed to smoke 5-15 mg/m3circumstances. Every group of mice was intervened in 20 min. daily, six days a week, for atotal of 12 weeks. A behavioral test was conducted in week 13. The animals were then sacrificed to take the materials. Hippocampal GFAP in the brain was measured by an immunohistochemical method.ResultAutonomous activities were significantly more in theblank group than in the model group (P<0.05) and significantly fewer in the tobacco smoke group than in the blank group (P<0.05). There was no statistically significant difference in autonomous activities between the tobacco smoke group and the model or moxa smoke group (P>0.05). Moving distance was longer in the moxa smoke group than in the model group (P<0.05). Standing-up number was smaller in the moxa smoke group than in the blank group (P<0.05). Integral optical density of GFAP immune reaction products in the hippocampus was significantlyhigher in the model group of mice than in the blank and moxa smoke groups (P<0.05). Hippocampal GFAP expression was significantly higher in the group of mice than in the moxa smoke and blank groups (P<0.05).Conclusion Moxa smoke can increase the excitability of central nervous system in mice and reduce hippocampal GFAP expression in a mice model of Alzheimer disease.

OBJECTIVETo observe the effects of intervention of moxa smoke with different concentrations on superoxide dismutase (SOD) and malondialdehyde (MDA) in serum and lung of male rats, so as to explore the safety concentration of moxa smoke.

METHODSA total of 32 Wistar male rats were randomly divided into a control group, a low-concentration group, a moderate-concentration group and a high-concentration group, 8 rats in each one. All the rats were exposed in the full-automatic toxicant exposure cabinet, and the overshadow of moxa smoke was set at 0%, 10%, 40% and 70%, respectively. Each rat was exposed for 20 min per day. After 26 weeks, the activities of SOD and content of MDA in serum, lung organ and bronchoalveolar lavage fluid were tested.

RESULTSCompared with the control group, the activities of serum SOD in the high-concentration group were reduced (P< 0. 05), but those in the low-concentration group and moderate-concentration group were not significantly different (both P>0. 05). Compared with the control group, the content of serum MDA in the low-concentration group, moderate-concentration group and high-concentration group was increased insignificantly (all P>0. 05). There were no significant differences regarding activities of SOD and content of MDA in lung organ and bronchoalveolar lavage fluid among each moxa smoke group (all P>0. 05).

CONCLUSIONThere is no obvious toxic reaction in the low-concentration group and moderate-concentration group; in the high-concentration group the antioxidant ability is damaged due to long-term exposure.

Animals ; Artemisia ; chemistry ; Lung ; enzymology ; metabolism ; Male ; Malondialdehyde ; blood ; metabolism ; Moxibustion ; Rats ; Rats, Wistar ; Smoke ; analysis ; Superoxide Dismutase ; blood ; metabolism

Objective To observe the effect of PM10 (inhalable particles) in moxa smoke on apoptosis of human lung adenocarcinoma cell line-A549 cells, and explore the possible mechanisms of inducing apoptosisMethods The A549 cells were studied in vitro experiment method, which were stained by Hoechest33258 staining method. Their morphological changes of apoptosis were observed by the fluorescence microscopy. The levels of intracellular Ca2+ and reactive oxygen species (ROS), and expression of NF-κB p65 were also measured.Results Some apoptotic cells were observed after treated with moxa smoke PM10 in the concerntration of 400μg/mL. After 4 hours intervention by moxa smoke PM10 in A549 cells, the intracellular Ca2+ level increased significantly (P<0.01). Compared with the blank control group, the expression of NF-κB p65 decreased significantly (P<0.05) after intervention of moxa smoke PM10 with different concerntrations for 4 hours. When the A549 cells were cultured with moxa smoke PM10 for 20 hours, the expression of p65 decreased significantly (P<0.05) in the concerntrations of 70, 280μg/mL, while there was no significant change in the concerntration of 140μg/mL (P>0.05). Compared with the blank control group, ROS level was significantly lower (P<0.05) in A549 cells after intervention of moxa smoke PM10.Conclusion PM10 in moxa smoke could induce apoptosis of A549 cells, could increase cytosolic Ca2+ level.