Objective To explore esomeprazole(EMZ)on acetaminophen(APAP)pharmacokinetics and intestinal microbial balance.Methods A total of 14 rats were randomly allocated into two groups,with 7 rats in each group:acetaminophen group(APAP group),and acetaminophen+esomeprazole combination group(APAP+EMZ group),respectively.Rats in the combination group were fed in the metabolic cage.Equivalent 3.6 mg·kg-1·d-1 esomeprazole was administered intragastrically to the combination group for 14 days;Similarly,an equal volume of 0.9％sodium chloride soution(NaCl)was fed to the APAP group for 14 days.During this period,fecal samples were collected from the rats before and after 14 days of EMZ administration for microbial 16S rRNA sequencing.On the 15th day,both the APAP group and APAP+EMZ groups were administratered an equivalent of 44.82 mg·kg-1 APAP by the same method after the regular EMZ administration.The concentrations of APAP in rat plasma were determined by the UPLC-MS/MS method.Main pharmacokinetic parameters were processed and compared using the software DAS 3.0.1 and SPSS 24.0.Results The pharmacokinetic parameter Cmax of APAP was significantly different between APAP group and APAP+EMZ group(P＜0.05).Compared with APAP group,Cmax increased by 120.38％in the APAP+EMZ group.The pharmacokinetic parameters(AUC(0-∞)、CL、t 1/2、tmax)of APAP showed no statistical differences between APAP group and APAP+EMZ group(P＞0.05).The results of 16SrRNA of intestinal flora showed that the abundance of Lactobacillus,Bacteroides,Clostridium,and Escherichia decreased compared with that before drug administration,while the abundance of Bifidobacterium increased.However,the relative abundance of the above flora showed no prominent differences before and after the EMZ intervention(P＞0.05).Conclusions This study showed that when combining EMZ with APAP,the relative abundance of those related flora,which may influence the β-Glucuronidase,all changed to some extent,but made no difference in statistics.The effect of EMZ on the Cmax of APAP was statistically significant.However,the use of EMZ for two weeks did not alter the other pharmacokinetics of APAP by affecting the gut microbiota.

Glioma is the most common primary intracranial central nervous system tumor, and postoperative radiotherapy is an important treatment for glioma. At present, computed tomography (CT) and magnetic resonance imaging (MRI) are widely applied in the delineation of radiotherapy targets for glioma. However, there are still some deficiencies in evaluating tumor scope, recurrence, radiation necrosis and prognosis, etc. Positron emission tomography (PET) / computed tomography (PET-CT) combines the molecular images of PET with the anatomical images of CT, which plays an important role in the diagnosis and differential diagnosis of glioma. With the popularization and application of multimodal imaging technology in radiotherapy, PET-CT molecular imaging, as an important supplement, contributes to the delineation of glioma target volume and the development of accurate radiotherapy, and brings benefits to the prognosis and follow-up of glioma patients. In this article, the application and research progress on PET-CT in the diagnosis, treatment and follow-up for glioma were reviewed.

Objective:To explore the early clinical efficacy of ultrasound visualized platelet-rich plasma (PRP) in the treatment of lower back myofascial pain syndrome (MPS) after sports injury.Methods:A prospective cohort study was conducted to analyze the clinical data of 32 patients with lower back MPS after sports injury, who were admitted to West China Hospital of Sichuan University from January 2023 to March 2023. Ultrasound-guided PRP injection into the erector spinalis or quadratus psoas muscles was used for treatment. Before treatment, at 24 hours, 2 weeks, and 4 weeks after treatment, pain and function were evaluated using visual analogue scale (VAS), McGill pain questionnaire (McGill), Roland Morris dysfunction questionnaire (RMDQ), and Oswestry dysfunction index (ODI). Before treatment and 4 weeks after treatment, the quality of life was evaluated using the short-form 36 item health survey questionnaire (SF-36). The adverse reactions were observed during treatment and follow-up.Results:A total of 32 patients with lower back MPS after sports injury were enrolled, including 10 males and 22 females; aged 12-68 years [(47.3±16.3)years]. All the patients were followed up for 4 weeks. Before and at 24 hours, 2 weeks, and 4 weeks after treatment, the VAS was 5.0(4.0, 6.0)points, 3.5(3.0, 4.8)points, 2.0(2.0, 3.0)points, and 2.0(1.3, 3.0)points, respectively; the McGill score was 9.0(7.0, 11.0)points, 7.0(5.0, 9.0)points, 4.0(3.0, 5.0)points, and 3.0(3.0, 5.0)points, respectively; the RMDQ score was 8.0(5.3, 10.8)points, 5.5(3.0, 8.0)points, 4.0(3.0, 5.8)points, and 3.0(2.0, 4.8)points, respectively; the ODI was 22.0(14.5, 30.0), 20.0(14.5, 25.5), 9.0(6.0, 16.0), and 8.0(4.5, 14.0), respectively. Compared with the values before treatment, the VAS, McGill score, and RMDQ score were significantly decreased at 24 hours, 2 weeks, and 4 weeks after treatment (all P<0.05); the ODI had no significant difference at 24 hours after treatment ( P>0.05), but it was significantly decreased at 2 and 4 weeks after treatment (all P<0.05). Compared with the values at 24 hours after treatment, the VAS, McGill score, RMDQ score and ODI further decreased at 2 weeks after treatment (all P<0.05). Compared with the values at 2 weeks after treatment, there was no significant difference in the VAS, McGill score, RMDQ score, or ODI at 4 weeks after treatment (all P>0.05). In the SF-36, the scores of physiological function [77.5(60.0, 93.8)points], physiological role [50.0(0.0, 100.0)points], body pain [64.0(44.5, 74.0)points], vitality [75.0(65.0, 78.8)points], social function [87.5(75.0, 100.0)points], emotional role [66.7(33.3, 100.0)points] and mental health [72.0(68.0, 83.0)points] before treatment were increased to 90.0(80.0, 98.8)points, 100.0(56.3, 100.0)points, 84.0(74.0, 84.0)points, 75.0(70.0, 80.0)points, 100.0(87.5, 112.5)points, 100.0(66.7, 100.0)points, and 76.0(68.0, 84.0)points after 4 weeks of treatment, respectively ( P<0.05 or 0.01). However, there was no significant difference in the general health status or health changes before and after treatment (all P>0.05). During treatment and follow-up, no adverse reactions such as redness, swelling, pain, or subcutaneous bleeding were observed. Conclusion:Ultrasound-guided PRP treatment can improve the early pain, lumbar mobility and quality of life of patients with lower back MPS after sports injury, with no presence of adverse reactions.

Mandibular defects caused by injuries, tumors, and infections are common and can severely affect mandibular function and the patient's appearance. However, mandible reconstruction with a mandibular bionic structure remains challenging. Inspired by the process of intramembranous ossification in mandibular development, a hierarchical vascularized engineered bone consisting of angiogenesis and osteogenesis modules has been produced. Moreover, the hierarchical vascular network and bone structure generated by these hierarchical vascularized engineered bone modules match the particular anatomical structure of the mandible. The ultra-tough polyion complex has been used as the basic scaffold for hierarchical vascularized engineered bone for ensuring better reconstruction of mandible function. According to the results of in vivo experiments, the bone regenerated using hierarchical vascularized engineered bone is similar to the natural mandibular bone in terms of morphology and genomics. The sonic hedgehog signaling pathway is specifically activated in hierarchical vascularized engineered bone, indicating that the new bone in hierarchical vascularized engineered bone underwent a process of intramembranous ossification identical to that of mandible development. Thus, hierarchical vascularized engineered bone has a high potential for clinical application in mandibular defect reconstruction. Moreover, the concept based on developmental processes and bionic structures provides an effective strategy for tissue regeneration.
Bone Regeneration ; Bone Transplantation/methods* ; Hedgehog Proteins ; Humans ; Mandible/surgery* ; Osteogenesis

Objective: To analyze the prevalence of and risk factors for infections in patients with pemphigus, and to evaluate their effect on prognosis. Methods: Clinical data were collected from 182 inpatients with pemphigus in Department of Dermatology, Xijing Hospital, Fourth Military Medical University from May 2011 to May 2017, and retrospectively analyzed. Associations of infection rates with age, disease severity, comorbidities, maximum dose of glucocorticoids, hospitalization duration and costs were analyzed. Statistical analysis was carried out with SPSS 22.0 software by using Logistic regression analysis for analyzing risk factors for concurrent infections in pemphigus patients who were hospitalized for the first time. Results: Among the 182 patients, 82 (45.05%) experienced infections. Additionally, 107 pathogenic strains were cultured from secretions from skin lesions of 77 patients, including 60 strains of Staphylococcus aureus (56.07%) , and 58 Staphylococcus aureus strains were resistant to penicillin (96.67%) . Among the 182 patients, infections were observed in 11 of 14 patients with hypoproteinemia, 69 (41.07%) of 168 patients without hypoproteinemia, 4 (4.81%) of 27 patients with mild pemphigus, 34 (37.7%) of 90 patients with moderate pemphigus and 44 (67.69%) of 65 patients with severe pemphigus. Logistic regression analysis showed that the prevalence rate of infections was significantly higher in the patients with hypoproteinemia than in those without hypoproteinemia (OR = 5.559, 95% CI 1.053-29.347, P = 0.043) . Compared with the patients with mild pemphigus, the prevalence rate of infections significantly increased in the patients with moderate (OR = 4.676, 95% CI 1.276-17.123, P < 0.05) or severe pemphigus (OR = 16.529, 95% CI 4.183-65.314, P < 0.001) . The prevalence of infections in patients with pemphigus was unaffected by gender, types of pemphigus, or the presence of hypertension or diabetes (all P > 0.05) . Among the 145 patients who were followed up, 33 were completely cured, 67 were cured clinically, 23 received improvement, 10 experienced relapse or exacerbation, and 12 died. Of the 12 dead patients, 3 died of pneumonia, 2 died of exacerbated pemphigus and skin infections, and 1 died of sepsis. Conclusions High disease severity and hypoproteinemia are risk factors for infections in patients with pemphigus. Bacterial infection is a common complication in patients with pemphigus, and severe infections are one of the causes of death in patients with pemphigus.

Objective: To discuss the effect of high-density fat-binding SVF-GEL in female facial lipofilling. Methods: This is a retrospective study including 32 female patients, received facial fat transplantation during June 2017 to June 2018 in Yichun College. Each patient underwent high-density fat-binding SVF-GEL transplantation for facial surgery. Patients′satisfaction with the surgery and the rate of secondary surgery was evaluated. Fat was harvested from the inner thigh, centrifuged at 1200 g for 3 min, and the liquid was removed. The upper 2/3 part is prepared for SVF-GEL, for further used in delicate lipofilling in eyelid, tear groove and nasolabial groove. The lower 1/3 high density fat was used for volume restoration, such as forehead, temporal area and cheek. Results: All patients had significant improvements in facial contours with mild swelling and short recovery time. The satisfaction rate was 68.8%(22/32), and the second operation rate was 15.6%(5/32). Conclusions High-density fat-binding SVF-GEL transplantation can achieve good results in correcting facial volume loss.

Objective To investigate the expression of miR-124 in glioblastoma (GBM) cell lines LN229 and LN229R,as well as the regulatory mechanism of miR-124 on radiosensitivity of LN229R cells.Methods miR-124 mimic (miR-124) and negative control (miR-NC),STAT3 overexpression plasmid (STAT3) and pcDNA3.1 vector (pcDNA) were transfected or co-transfected into radioresistant glioma cells LN229R.qRT-PCR was employed to analyze the expression of miR-124 in LN229 and LN229R cells.The survival rate and sensitivity-related parameters of LN229R cells at different doses were analyzed by cloning formation assay.Cell apoptosis of LN229R was evaluated by flow cytometry.Targeting gene of miR-124 was predicted using Targetscan software and verified by the double-luciferase reporter assay.Western blot assay was performed to detect STAT3 protein expression.Results The expression of miR-124 in LN229R cells (0.32 ± 0.03) was significantly lower than that in LN229 cells (1.02 ± 0.09) (t =12.780,P＜0.05).Transfection of miR-124 mimics promoted the expression of miR-124 in LN229R cells (4.02±0.39) compared with miR-NC group (0.95±0.06) (t=13.476,P＜0.05).After 8 Gy irradiation,the survival rate of LN229R cells transfected with miR-124 mimics (0.003 ± 0.000 4) was significantly lower than that in miR-NC group (0.033±0.005 0) (t=5.655,P＜0.05),and the apoptosis rate (22.34±2.42) ％ was significantly higher than that in miR-NC group (4.69 ± 0.51) ％ (t =12.361,P＜0.05).STAT3 was identified to be a target gene of miR-124.Exogenous restoration of STAT3 reversed the inhibitory effect of miR-124 on LN229R cell survival.Conclusion miR-124 increases the radiosensitivity of LN229R cells by targeting STAT3.

Objective To compare the effectiveness of stereotactic hematoma aspiration and conservative treatment for supratentorial hypertensive intracerebral hemorrhage (HICH) with hematoma volume 25-40 ml. Methods Patients with supratentorial HICH admitted to the Department of Neurosurgery, the Fifth Affiliated Hospital of Zhengzhou University from January 2014 to January 2017 were retrospectively enrolled. The incidence of rebleeding, good outcome (defined as the modified Rankin Scale score 0-2 at 3 months after onset) rate, and mortality were compared between the stereotactic hematoma aspiration group and the conservative treatment group. Results A total of 204 patients were enrolled. Their mean age was 61. 3 ±9. 2 years, 114 were males, and their median hematoma volume was 32 ml (interquartile range 25- 39 ml), median baseline Glasgow Coma Scale score was 11 (interquartile range 9-14), and there was no patient with brain herniation. One hundred and twenty patients (58. 8％) underwent stereotactic hematoma aspiration and 84 (41. 2％) received conservative treatment. Compared with the conservative treatment group, the incidence of rebleeding in the stereotactic hematoma aspiration group was significantly lower (2. 5％ vs. 22. 6％, χ2 =20. 788, P < 0. 001), and the rate of good outcome was significantly higher at 3 months after onset (85. 0％ vs. 70. 2％; χ2 = 8. 305, P = 0. 004 ), but there was no significant difference in mortality (5. 0％ vs. 11. 9％, χ2 =3. 259, P =0. 071). Multivariable logistic regression analysis showed that advanced age (odds ratio [OR] 1. 77, 95％ confidence interval [CI] 1. 25-2. 46; P = 0. 006), previous stroke history (OR 1. 36, 95％ CI 1. 12-1. 64; P =0. 032), and conservative treatment (OR 1. 42, 95％ CI 1. 25-1. 78; P = 0. 021) were the independent risk factors for poor outcomes. Conclusions Stereotactic hematoma aspiration can significantly reduce the incidences of rebleeding and risk of the poor outcome in the supratentorial HICH patients with hematoma volume 25-40 ml. Therefore, early active surgical treatment should be considered.

Objective: To compare the clinical efficacy and safety of bortezomib, cyclophosphamide, dexamethasone (VCD) regimen and bortezomib dexamethasone (VD) regimen in the treatment of the patients with newly diagnosed multiple myeloma (NDMM). Methods: The clinical data of 73 patients with NDMM in Shanxi Dayi Hospital from January 2013 to January 2016 were retrospectively analyzed. According to the chemotherapy regimen, the patients were divided into VCD group (41 cases) and VD group (32 cases). The efficacy and adverse reactions of the two groups were evaluated. Results: The overall response rate of VCD group and VD group was 80.5% (33/41) and 78.1% (25/32) respectively, and the difference was not statistically significant (χ ²= 0.061, P= 0.804); and complete remission (CR) rate was 36.6% (15/41) and 15.6% (5/32) respectively, and the difference was statistically significant (χ ²= 3.970, P= 0.046); the median progression-free survival (PFS) was 27 months and 24 months respectively, and the median overall survival (OS) was 35 months and 33 months respectively, and the differences were not statistically significant (all P > 0.05). Most adverse reactions occurred in grade 1-2, in which peripheral polyneuropathy and thrombocytopenia were the most common. Peripheral neuritis was the most common finding among the adverse reactions of grade 3. The incidence of adverse reactions in both groups was not statistically significant (P > 0.05). Conclusions VCD and VD regimen could be recommended as a better induction therapy for NDMM patients. Compared with VD scheme, VCD scheme has a higher CR rate.

Objective To observe the clinical effects and safety of sodium valproate combined with decitabine for treatment of myelodysplastic syndrome (MDS). Methods Forty-two patients with MDS were enrolled in department of hematology in Shanxi Dayi Hospital from February 2012 to February 2017. According to random number table, the patients were divided into the control group (21 cases) and the experimental group (21 cases). The patients in the control group received decitabine at the dose of 20 mg·m-2·d-1, and intravenous infusion was completed in 2 hours, continuous therapy up to 5 days, 4 weeks as a course; the patients in the experimental group received combined medication, orally given sodium valproate 0.2 g once, 3 times per day. One week later, the dosage was added to 0.4 g once, 3 times per day. Both groups received at least 4 courses of treatment. The treatment was stopped when serious adverse reactions or obvious disease progression occurred. The bone marrow smear was rechecked every 4 weeks after treatment to evaluate the efficacy. The expressions of ASXL1, DNMT3A and TET2 in bone marrow cells were detected by fluorescence quantitative PCR before and after treatment. Results The total treatment response rate of the experimental group and the control group were 76.2 % (16/21) and 57.1 % (12/21) respectively, and there was statistically significant difference (P< 0.05); the total remission rate of the two groups was 47.6 % (10/21) and 38.1 %(8/21) respectively, and there was no significant difference (P> 0.05). All patients had slight adverse reactions, and the adverse reaction rate was 42.9 % (9/21) and 38.1 % (8/21), and there was no significant difference (P>0.05). The content of TET2 mRNA and DNMT3A mRNA after treatment in both groups were decreased compared with the expressions before treatment, and there were significant differences (P<0.05). However, there was no significant difference between the two groups after treatment (P> 0.05); the content of ASXL1 mRNA had no obvious change in the control group and a dramatic decrease in the experimental group compared with that before treatment (P<0.05). Conclusion Sodium valproate combined with decitabine has favorable effects and mild adverse reactions for treatment of MDS, besides, it can influence the expressions of TET2, DNMT3A and ASXL1.