ObjectiveThe potential suitable area for ecological planting， key ecological factors， and suitable range of Polygonatum odoratum in China were analyzed to provide theoretical and scientific guidance for the artificial planting of P. odoratum. MethodA total of 454 geographical distribution records of P. odoratum in China and 118 ecological factors were used in this study. The maximum entropy model （MaxEnt） was adopted to predict the suitable areas of P. odoratum. The key ecological factors and their suitable ranges were analyzed by the jackknife method， contribution rates of ecological factors， and response curves. ResultThe suitable areas of P. odoratum were mainly located in the northwest， north， and northeast of China， the highly suitable areas of which were concentrated in Shaanxi， Shanxi， Gansu， etc. Solar radiation in November （Srad11）， precipitation in July （Prec7）， percentage of evergreen/deciduous needleleaf trees （Class1）， silt content （2-50 μm） mass fraction （SLTPPT）， and annual average temperature （Bio1） were found to be the key ecological factors affecting the suitable distribution of P. odoratum in China. The cumulative contribution rate of solar radiation factors （31.29%）>vegetation factors （25.61%）>soil factors （19.52%）>precipitation factors （11.38%）>temperature factors （8.57%）>topography factors （3.63%）. ConclusionIt is suggested to carry out ecological planting of P. odoratum mainly in Shaanxi （such as Baoji and Ankang Cities and Ningshan， Liuba， and Hua Counties）， Gansu （such as Tianshui City， Gannan Tibetan Autonomous Prefecture， and Liangdang and Huating Counties）， and Shanxi （such as Yangquan， Taiyuan， Fenyang， and Jinzhong Cities， as well as Xingxian County） of China. Solar radiation factors should be given priority in the planting process， followed by vegetation， soil， precipitation， temperature， and topography factors. The range of key ecological factors， namely Srad11， Prec7， Class1， SLTPPT， and Bio1 should be controlled within 8 095.21-10 334.98 （optimum 8 787.50） kJ·m^-2·d^-1， 109.99-223.60 （146.91） mm， 1.00%-9.45% （6.76%-10.68%）， 41.73%-50.35% （46.53%）， and 3.29-16.33 （13.57） °C， respectively.

High quality continuing medical education is important to ensure the clinical competence of doctors. However, the current continuing medical education of general practitioners has some problems, such as low motivation to participate in and poor training effect. We tried a new model of continuing medical education to deal with these problems. In this new model, position competence improvement is the aim, online group learning is the main method, individualized learning goals are developed and results are evaluated in verifiable ways.

Objective:To investigate the clinical characteristics and electroencephalogram (EEG) of epilepsy patients with breach rhythm, improve clinical understanding of breach rhythm and avoid over-interpretation.Methods:Twelve epilepsy patients with breach rhythm who visited the Department of Neurology, Xijing Hospital, the Air Force Military Medical University from January 2016 to January 2017 were collected retrospectively. The clinical data, including etiology, clinical manifestations, EEG features and prognosis were summarized, and outpatient and telephone follow-up was performed for at least three years.Results:The clinical data of 12 patients with epilepsy with breach rhythm were collected, including eight males and four females, aged 36-78 years. After analysis, it was found that brain trauma was the most common cause of breach rhythm. Among them, two cases of skull defect were not repaired, eight cases were repaired with skull titanium mesh, one case was repaired with skull polymethylmethacrylate, and one case was repaired with skull polyetheretherketone. The distribution of the breach rhythm in 12 patients was consistent with the abnormal area of the skull. The breach rhythm can be expressed as high amplitude and fast frequency, or low amplitude and slow frequency and appear individually (similar to sharp waves, spikes). On the basis of pleomorphic slow waves, 10 patients were mixed with sharp waves and spike waves, and imaging confirmed that they had brain damage in corresponding parts. All of the 12 patients had a history of seizures, with tonic-clonic seizures and (or) focal seizures being the most common. Three patients with breach rhythm had no clinical seizures for more than five years, and had been taking antiepileptic drugs for epileptic spikes on EEG, and they were given reduction and discontinuation of the drugs and were seizure-free for three years during follow up.Conclusions:Skull repair is a common cause of breach rhythm, and repair materials with different resistances cause different waveforms and frequencies. Breach rhythm, epileptiform discharge and other pathological slow-wave activities can exist at the same time. Breach rhythm is a benign variant phenomenon which needs no special treatment.

Chemotherapy has become an important therapy for breast cancer. The myelosuppression is an inevitable adverse reaction during the chemotherapy, as well as a sign of drug effectiveness to some degree. Some retrospective studies have found that the patients with myelosuppression show the better survival in the chemotherapy of early breast cancer. This paper discusses the significance of myelosuppression in the chemotherapy of early breast cancer.

Objective To investigate the electroclinical,treatment response and prognosis of juvenile absence epilepsy (JAE).Methods Thirty-two patients diagnosed as JAE from Epilepsy Center of Xijing Hospital between January 2014 and August 2017 were investigated.All of them underwent 24-hour video-electroencephalography (EEG) recording.Clinical aspects,electroencephalographic features,and antiepileptic drugs (AEPs) received were reviewed.The follow-up time was 6-44 months,with an average of (18.6 ± 11.6) months.Results Five patients (15.6％) had family history of epilepsy.Four patients (12.5％) had history of febrile seizures.Twenty-six patients (81.3％) showed absence seizures,11 patients (34.4％) were hyperventilation test positive,five patients (15.6％) were intermittent flash stimulation test positive.All the 32 patients received AEDs treatments,21 cases (65.5％) with monotherapy,nine patients (28.1％) with two AEDs,two patients (6.3％) with three AEDs.The most commonly used AED was valproic acid,and the second was levetiracetam.At the end of follow-up,five patients (15.6％) had complete seizure free and 27 patients (84.4％) had poor seizure control.Conclusions It is necessary to give electroclinical study on more samples of JAE and establish detailed practical diagnostic criteria about JAE as early as possible.More than half of JAE patients seizure control were not ideal.The monotherapy of JAE was less effective than combined treatment.

PURPOSE: Prolactinoma (prolactin-secreting pituitary adenoma) is one of the most common estrogen-related functional pituitary tumors. As an agonist of the dopamine D2 receptor, bromocriptine is used widely to inhibit prolactinoma progression. On the other hand, it is not always effective in clinical application. Although a dopamine D2 receptor deficiency contributes to the impaired efficiency of bromocriptine therapy to some extent, it is unknown whether there some other underlying mechanisms leading to bromocriptine resistance in prolactinoma treatment. That is the main point addressed in this project. MATERIALS AND METHODS: Human prolactinoma samples were used to analyze the S-phase kinase associated protein 2 (SKP2) expression level. Nutlin-3/adriamycin/cisplatin-treated GH3 and MMQ cells were used to analyze apoptosis in SKP2 overexpression or knockdown cells. SKP2 expression and the interaction partners of SKP2 were also detected after a bromocriptine treatment in 293T. Apoptosis was analyzed in C25 and bromocriptine-treated GH3 cells. RESULTS: Compared to normal pituitary samples, most prolactinoma samples exhibit higher levels of SKP2 expression, which could inhibit apoptosis in a p53-dependent manner. In addition, the bromocriptine treatment prolonged the half-life of SKP2 and resulted in SKP2 overexpression to a greater extent, which in turn compromised its pro-apoptotic effect. As a result, the bromocriptine treatment combined with C25 (a SKP2 inhibitor) led to the maximal apoptosis of human prolactinoma cells. CONCLUSION: These findings indicated that SKP2 inhibition sensitized the prolactinoma cells to bromocriptine and helped promote apoptosis. Moreover, a combined treatment of bromocriptine and C25 may contribute to the maximal apoptosis of human prolactinoma cells.
Apoptosis* ; Bromocriptine ; Half-Life ; Hand ; Humans* ; Pituitary Neoplasms ; Prolactinoma* ; Receptors, Dopamine D2 ; S-Phase Kinase-Associated Proteins

Objective The study is aimed to research into the effect of CD4+ T cells on patients with severe advanced breast cancer under radiotherapy that cannot be treated with surgery ,by observing the variation of CEA ,AFP ,CA125 and CA15‐3 before and after the radiotherapy applied .Methods We identified the CEA ,AFP ,CA125 and CA15‐3 densities in blood serum for a group of 38 patients with advanced breast cancer and a group of 30 normal people with chemiluminescence immune assay ,and we deter‐mined the CD3+ ,CD4+ ,CD8+ T percentage in peripheral blood and the ratio of CD4+ /CD8+ with flow cytometry .Results The group with normal CD4+ T percentage went through a decreased in CEA ,AFP ,CA125 ,CA15‐3 densities after the radiotherapy ,and the variation was significant(P<0 .05) .The group of people with abnormal CD4+ T percentage go through CEA ,CA15‐3 densities decrease after the radiotherapy ,and the variation was statistically significant(P< 0 .05) .Conclusion For those with advanced breast cancer and cannot be treated with surgery ,the influence of radiotherapy on CEA ,AFP ,CA125 ,CA15‐3 densities is significant in the group of patients with CD4+ T percentage ,adn has better therapeutic effect .

OBJECTIVETo evaluate the efficacy and safety of anagrelide in essential thrombocythemia (ET).

METHODSPatients who diagnosed as ET according to the World Health Organization classification were enrolled. Each patient was assigned to take anagrelide hydrochloride capsule or hydroxyurea tablet by random 1∶1 ratio. Dose of anagrelide started at 2 mg/d, then increased gradually and the maximum dose was 10 mg/d until the platelet counts dropped to (100-400) × 10⁹/L, one month later gradually reduced to maintain dose. The dose of hydroxyurea was 1000 mg/d at beginning, then increased gradually, when platelet counts dropped to (100-400)×10⁹/L and kept for one month, reduced to maintain dose as 10 mg·kg⁻¹·d⁻¹. The observation period was 12 weeks.

RESULTSA total of 222 patients were enrolled in seventeen centers (including 113 patients treated with anagrelide and 109 with hydroxyurea). Therapy efficacy can be evaluated in 198 patients (including 97 patients administered with anagrelide and 101 with hydroxyurea). At 12th weeks of therapy, the hematologic remission rate was 87.63% (85/97) in anagrelide group and 88.12% (89/107) in hydroxyurea group, the differences between the two groups were not significant (P=0.173). Treatment with anagrelide lowered the platelet counts by a median of 393 (362-1 339) × 10⁹/L from a median of 827 (562-1657) × 109/L at the beginning of the observation to 400(127-1130)×10⁹/L after 12 weeks (P<0.001), which were similar to the treatment result of hydroxyurea by a median drop of 398 (597-1846)× 10⁹/L (P=0.982). The median time to achieving response of anagrelide group was 7 (3-14) days, superior to that of hydroxyurea for 21 (14-28) significantly (P=0.003). Frequency of anagrelide related adverse events was 65.49 % (74/113), including cardiopalmus (36.28% ), headache (21.24% ), fatigue (14.16% ) and dizzy (11.50% ).

CONCLUSIONAnagrelide was effective in patients with ET which had similar hematologic remission rate to hydroxyurea and could take effect more quickly than hydroxyurea. Incidence of adverse events was undifferentiated between anagrelide and hydroxyurea, but anagrelide treatment had tolerable adverse effects and no hematologic toxicity.

Humans ; Hydroxyurea ; administration & dosage ; therapeutic use ; Platelet Aggregation Inhibitors ; administration & dosage ; therapeutic use ; Platelet Count ; Quinazolines ; administration & dosage ; therapeutic use ; Thrombocythemia, Essential ; drug therapy ; Treatment Outcome

Objective To explore the effects of serum 25-hydroxyl vitamin D3 on insulin resistance and bone metabolism in late pregnancy. Methods A total of 84 women in late pregnancy who received prenatal examination in our hospital from February 2012 to January 2013 were selected as research subjects. They were assigned to diabetes group in late pregnancy and healthy group in late pregnancy according to their physical conditions. TG, LDL-c, HDL-c and FBG levels in the two groups of patients were examined via automatic biochemical analyzer. FINS, serum 25-hy-droxyl vitamin D3, PTH and BALP levels were tested via automated luminescent immunoassay. Correlation analysis was also carried out between serum 25-hydroxyl vitamin and HOMA-IR, PTH and BALP. Results TG, LDL-c and HDL-c were compared between the two groups, and the differences were not statistically significant (P>0.05). FBG and FINS in the diabetes group were (5.83±0.68) mmol/L and (24.93±2.07) U/L respectively; FBG and FINS in the healthy group were (4.96±0.57) mmol/L and (17.67±1.83) U/L respectively. Based on the results above, FBG and FINS in the diabetes group were significantly higher than those in the healthy group, and the differences were statistically significant (P<0.05). 25-hydroxyl vitamin D3, HOMA-IR, PTH and BALP were (24.93±3.23) nmol/L, (0.80±0.08), (183.69±12.34) ng/Land (30.04±10.23) μg/L in diabetes group respectively, while 25-hydroxyl vitamin D3, HOMA-IR, PTH and BALP were (39.74±5.86) nmol/L, (0.43±0.04), (165.24±13.07) ng/L and (24.75±9.68) μg/L in the healthy group respectively. 25-hydroxyl vitamin D3, HOMA-IR, PTH and BALP between the two groups were compared, and the differences were statistically significant (P<0.05). 25-hydroxyl vitamin D3 was negatively correlated with HOMA-IR, PTH and BALP (r=-0.479, P<0.01; r=-0.283, P<0.05; r=-0.354, P<0.05). Conclusion Insufficient serum 25-hydroxyl vitamin D3 in late pregnancy is negatively correlated with insulin resistance and has negative effects on bone metabolism.

Objective To explore the role conversion, emotion regulation and maternal lactation effect of obstetrics in-tegrated nursing model on maternal. Methods A total of 160 cases maternal delivery in our hospital from May 2011 to May 2013 were randamly divided into observation group 80 cases and control group of 80 cases, the control group was treated with routine nursing, the observation group based on the control group underwent integrated nursing model. The maternal role conversion and emotion regulation effect was compared between two groups, and lactation maternal initial time, lactation and serum PRL levels were observed. Results The role conversion and neonatal care ability score in ob-servation group were significantly higher than the control group, and the difference between two groups with statistically significant(P<0.05). Two groups of maternal SAS, SDS score was significantly lower, and the observation group SDS, SAS score was significantly lower than the control group(P<0.05). The observation group in the initial time of lactation signifi-cantly earlier than the control group, postpartum 24 h, 48 h, 72 h lactation quantity and the level of serum PRL was significantly higher than that of the control group, and each index of two group with statistical significance(P<0.05). Conclusion Integration nursing mode can be accelerate maternal role conversion, improve maternal negative emotion, promote milk secretion,the method is easy to learn, and worthy of clinical application.