The active components of Astragali Radix, its patent drugs and preparations can play a protective role on brain tissue through a variety of pharmacological effects such as anti-oxidative stress, inhibition of cell apoptosis, protection of blood-brain barrier, alleviation of inflammatory response, inhibition of ferroptosis, promotion of nerve cell regeneration and new angiogenesis. In the basic research of Astragali Radix in the treatment of ischemic stroke, the repetition rate of experimental indexes is high. The research on upstream levels such as signal pathway and cell type should be strengthened, and the basic research should be effectively connected with clinical research.

Objective:To explore the feasibility of predicting axillary lymph node metastasis of breast cancer using radiomics analysis based on dynamic contrast-enhanced (DCE) MRI.Methods:The retrospective study enrolled 163 patients (163 lesions) with breast cancer diagnosed by core needle biopsy from January 2013 to December 2013 in Peking University First Hospital. The status of axillary lymph nodes in all patients was pathologically confirmed, and they had complete preoperative breast MRI images. Among the 163 patients, 94 patients were confirmed with axillary lymph node metastasis, and 69 patients without axillary lymph node metastasis. They were randomly divided into the training dataset ( n=115) and testing dataset ( n=48) in a 7∶3 ratio. The radiomics analysis was performed in the training dataset, including image preprocessing and labeling, radiomics feature extraction, radiomics model establishment and model predictive performance inspection. Model performance was tested in the testing dataset. Receiver operating characteristic curve and area under curve (AUC) was used to analyze the model prediction performance. Results:Of the 1 075 features extracted from the training dataset, principal component analyses (PCA) features 8, 41 and 67 were selected by random forest classifier. The radiomics model including 3 PCA features reached an AUC of 0.956 (95%CI 0.907-0.988), with sensitivity of 91.2%, specificity of 100% and accuracy of 94.8%. In the testing dataset, the radiomics model including 3 PCA features reached an AUC of 0.767 (95%CI 0.652-0.890), with sensitivity of 80.8%, specificity of 72.7% and accuracy of 77.1%.Conclusion:It is feasible to predict axillary lymph node metastasis using radiomics features based on DCE-MRI of breast cancer.

OBJECTIVE: To analyze the clinical features of chronic myeloid leukemia (CML) with T315 I mutation (CML-T315I) and compare the effectiveness of different treatments. METHODS: We retrospectively analyzed the clinical data and outcomes of 19 patients with CML-T315I receiving different treatments. The T315 I mutations in these patients were detected by examination of BCR-ABL kinase domain (KD) mutation by RTQ-PCR and Sanger sequencing. The relapse following the treatments, defined as hematological, cytogenetic and molecular biological recurrences, were analyzed in these patients. RESULTS: Of the 19 patients with CML-T315I, 14 (73.7%) were in CML-CP stage at the initial diagnosis, and 13 (81.2%) were high-risk patients based on the Sokal scores. All the 19 patients were treated with TKI after the initial diagnosis, and during the treatment, 15 (78.9%) patients were found to have additional chromosomal aberrations, and 10 (52.6%) had multiple mutations; 13 (68.4%) of the patients experienced disease progression (accelerated phase/blast crisis) before the detection of T315I mutation, with a median time of 40 months (5-120 months) from the initial diagnosis to the mutation detection. After detection of the mutation, 12 patients were treated with ponatinib and 7 were managed with the conventional chemotherapy regimen, and their overall survival rates at 3 years were 83.3% and 14.2%, respectively ( < 0.001). CONCLUSIONS CML patients resistant to TKI are more likely to have T315I mutations, whose detection rate is significantly higher in the progressive phase than in the chronic phase. These patients often have additional chromosomal aberrations and multiple gene mutations with poor prognoses and a high recurrence rate even after hematopoietic stem cell transplantation. Long-term maintenance therapy with ponatinib may improve the prognosis and prolong the survival time of the patients.
Drug Resistance, Neoplasm ; Fusion Proteins, bcr-abl ; Humans ; Imidazoles ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Mutation ; Pyridazines ; Retrospective Studies

In order to form the expert consensus which researched on the comprehensive individualized protocol of Tuina therapy for Knee osteoarthritis, the preliminary protocol was summarized and formed by analyzing the interviews and published paper. And then the expert consensus method was applied for the protocols of Tuina therapy for KOA. After discussions, the consensus of three protocols according to the classification of KOA main symptomes was researched. In the protocols, 75％～80％ of the entries were considered as strong recommendation, and the others were weak recommended. Thus, it is believed that the comprehensive protocols for the treatment of KOA with different Tuina manipulations is feasible and reproducible after standardization.

On the basis of relevant literature, according to the clinical experience of Tuina specialists, a preliminary plan of Tuina for nonspecific low back pain has been formed. An expert consensus meeting was used to form a non-specific low back pain assessment program and 3 modern Gongting Lijinshu (Tuina massage) for the treatment of nonspecific low back pain. The treatment has showed to be clinically repeatable and suitable for the RCT study.

OBJECTIVETo investigate the effects of microRNA(miRNA)-29b on the proliferation and migration of breast cancer cells and its molecular mechanism.

METHODSThe recombinant lentiviral expression vector (lenti-miRNA-29b) was constructed and transfected into 293T cells to obtain lentivirus particles that were used to infect breast cancer MCF-7 cells. Transfection efficiency of lenti-miRNA-29b in MCF-7 cells was identified by the expression of green fluorescent protein (GFP). The expression of miRNA-29b was detected by real-time PCR. The cell proliferation and migration were detected by CCK8 assay and Transwell assay, respectively. The bioinformatics softwares were used to predict and screen the downstream target genes regulated by miRNA-29b, which were verified by double luciferase reporter gene assay, RT-PCR and Western blot. The effects of screened target gene RTKN on the growth and migration of MCF-7 cells were verified by RTKN siRNA.

RESULTSRecombinant lentiviral expression vector of miRNA-29b were successfully constructed. About 90% and 60% of the breast cancer cells showed green fluorescence in lenti-miRNA-29b and lenti-miRNA-NC groups, respectively. The expression of miRNA-29b in lenti-miRNA-29b group increased significantly compared with the lenti-miRNA-NC group and blank control group (all<0.05); the proliferation and migration ability of MCF-7 cells significantly reduced compared with the control group (all<0.05). The screening with bioinformatics softwares found that the 3'UTR coding region RTKN had the binding site to miRNA-29b; the dual luciferase reporter gene assay showed that the luciferase activity decreased significantly after the MCF-7 cells were co-transfected with wild type RTKN-WT-3'UTR and miRNA-29b mimics report gene vector (<0.05). The RTKN proteins in MCF-7 cells were significantly decreased after transfection with siRNA-RTKN, and the proliferation and migration ability of MCF-7 cells were significantly reduced (all<0.05).

CONCLUSIONSMiRNA-29b can inhibit the proliferation, invasion and metastasis of breast cancer cells by inhibiting the expression of RTKN.

Objective: To explore the method of extracting chaperone antigen peptide complexes from gastric cancer stem cells and its immune function. Methods: Gastric cancer stem cells and gastric cancer cells were screened by low temperature ultrasonic lysis. After salting out and dialysis, the lysate supernatant was processed with SDS-PAGE to analyze the expression of chaperone antigen peptide complexes, and then was separated and purified with CNBr-activated SepharoseTM 4B. Reverse high pressure liquid chromatography (HPLC), SDS-PAGE and Western blotting were used to analyze the purity and nature of the acquired albumen. Lymphocyte proliferation assay and lymphocytotoxicity assay were used to ditermine the immunological activity of the chaperone-antigen peptide complexes. Results: The chaperone antigen peptide complexes of gastric cancer stem cells were prepared and identified successfully, of which the main components were the antigen peptides of HSP60, HSP70, HSP90 and HSP110. 0.75 μg and 1.00 μg HSP70-antigen peptide and 1.00 μg HSP90-antigen peptide activated lymphocytes significantly. Their A₄₉₀ values were 0.26±0.03, 0.45±0.05 and 0.32±0.04, respectively, while the corresponding doses of HSP60-antigen peptide and HSP110-antigen peptide did not activate lymphocytes. The killing rates of 1.00 μg HSP70-antigen peptide and 1.00 μg HSP70 were (45.0±2.0)% and (16.0±2.0)%, respectively, showing a significant difference (P=0.012). Similarly, the killing rates of 1.00 μg HSP90-antigen peptide and 1.00 μg HSP90 were (36.0±5.0)% and (13.0±4.0)%, respectively, also showing a significant difference (P=0.048). Conclusions The amount of chaperone antigen peptide complexes in gastric cancer cells is extremely low, but it is obviously increased in gastric cancer stem cells. After purification, the chaperone antigen peptide complexes with high purity can be prepared. The extracted chaperone antigen peptide complexes have stronger immunogenicity, and can be used to make tumor vaccine in vitro, which may have a good application value in the targeted therapy of gastric cancer.

Objective To investigate the predictive value of plasma lipoprotein phospholipase A2 (Lp -PLA2 )and D -dimer in patients with hypertension complicated with stroke.Methods 70 hypertensive patients with stroke were selected as A group,72 patients with simple hypertension were selected as B group,and 71 healthy sub-jects were selected as C group.The light transmitting method was used to detect serum Lp -PLA2 ,and immunoturbi-dimetry was used to detect plasma D -dimer.The clinical value of the two joint detection and single detection in prediction of hypertension complicated with stroke was analyzed.Results The plasma Lp -PLA2 and D -dimer levels of A group were (471.88 ±181.49)ng/mL,(982.54 ±373.28)μg/mL,which were higher than those of B group[(195.17 ±34.74)ng/mL,(263.57 ±29.70)μg/mL]and C group[(122.94 ±46.25)ng/mL,(96.44 ± 8.49)μg/mL](F =189.7,171.1,all P =0.000).The plasma Lp -PLA2 level of A group was positively correlated with D -dimer(r =0.692,P <0.01).The plasma D -dimer >252g/mL forecast hypertension stroke risk sensitivity was 83.3% and specificity was 98.6%,the plasma Lp -PLA2 >176.36ng/mL forecast hypertension stroke risk sen-sitivity was 92.9% and specificity was 83.1%,and the combined prediction of hypertension stroke risk sensitivity was 87.6%,specificity was 93.5%.Conclusion The plasma levels of Lp -PLA2 and D -dimer are significantly increased in hypertensive patients with stroke,and the combined detection of the two indicators can improve the prediction of stroke risk in patients with hypertension.

Objective To investigate the clinical value of serum carbohydrate antigen (CA125,CA199)and vascular endothelial growth factor C (VEGF-C)in early diagnosis of ovarian carcinoma.Methods 51 cases of ovarian cancer patients with retroperitoneal lymph node dissection were performed in the observation group,including 23 cases of ovarian cancer retroperitoneal lymph node metastasis,32 cases of ovarian benign tumor were selected as the control group.The serum levels of CA199 and CA125 were detected by the method of chemiluminescence detection,and the serum VEGF-C level was detected by enzyme-linked immunosorbent assay (ELISA).Results The serum level of CA125 in patients with ovarian cancer (1 682.5 ±261.5)u/mL was significantly higher than that in the control group (30.5 ±6.3)u/mL(P <0.01),serum VEGF-C level in ovarian cancer patients (2 125.6 ±96.7)pg/mL was signif-icantly higher than that in the control group (1 738.0 ±79.8)pg/mL (P <0.01 ).The serum CA199 level of 51 patients with newly diagnosed epithelial ovarian cancer was (72.5 ±30.6)u/mL,serum CA199 level of the control group was (17.4 ±8.5)u/mL,CA199 level of retroperitoneal lymph node metastasis was (134.9 ±72.5)u/mL, ovarian cancer retroperitoneal lymph node metastasis CAl99 serum level were significantly higher than those without lymph node metastasis and the control group (t =7.39,18.34,all P <0.01).The diagnostic sensitivity,specificity and accuracy of serum VEGF-C +CA199 +CA125 in detection of ovarian cancer retroperitoneal lymph node metasta-sis were 95.5%,96.5%,99.5%.Conclusion Combined detection of CA125,VEFG-C and CA199 in serum has important clinical value in predicting lymph node metastasis of ovarian cancer.

ObjectiveTo investigate the correlationship between clinical and histopathological results of adrenocortical hyperplasia,adenoma and adenocarcinoma in the adrenocortical glomerular,fascicular and reticular zones. MethodsA total number of 167 702 surgical specimens were collected by the Department of pathology at the General Hospital of Tianjin Medical University from 1993 -2008.Of these,there were 631 adrenocortical specimens.Statistic analysis was done with Run test,t or t'test and x2 test on data in the aspects of proportion rate,mean age,sex proportion and relationship between clinical and pathological results of adrenocortical diseases.ResultsThe total number of adrenal diseases and adrenocortical diseases were 910 cases (0.54％) and 631 cases (0.38％),respectively.The number of adrenocortical glomerular,fascicular,reticular diseases were 310 cases (49.13％),319 cases (50.55％) and 2 cases (0.32％),respectively.The rate of adrenal diseases and adrenocortical diseases specimens did not change during the 16 year study period.The trend in proportion of hyperplasia,adenoma,adenocarcinoma in adrenocortical glomerular,fascicular and reticular zones did not change as well.The proportion pattern showed that there were more cases of adenoma than of hyperplasia and adenocarcinoma.The functional diseases of adrenocortical glomerular,fascicular and reticular zone (90.97％,79.00％,100.00％ ) were higher than nonfunctional diseases in the corresponding zones (9.03％,21.00％,0％ ) and both were higher in female patients.The mean age of nonfunctional patients with adenoma,glomerular zone adenocarcinoma and hyperplasia,adenoma of fascicular zone was higher than that in functional diseases.Interestingly,the mean age of glomerular zone adenocarcinoma patients (62.7 yrs) was higher than that in hyperplasia patients (47.8 yrs) and in adenoma patients (44.8 yrs).The mean and male diagnostic ages of adenocarcinoma of fascicular (44.3 yrs,50.0 yra) were higher than that in adenoma (44.0 yrs,49.1 yrs) and hyperplasia (41.5 yrs,40.9 yrs) respectively.But the female mean diagnostic age of fascicular adenocarcinoma (38.7 yrs) was lower than that in adenoma (42.4 yrs) and hyperplasia (41.9 yrs) respectively and the lowest average age was for nonfunctional adenocarcinoma (34.4 yrs).The diameters of the functional and nonfunctional adenocarcinoma were large (4.3 cm and 4.0 cm in glomerular zone,7.1 cm and 8.0 cm in fascicular zone).The carcinoma cells were in serious atyrpia,haemorrhage,necrosis and capsular or vascular infiltration.The rates of functional hyperplasia,adenoma with hypertension in Conn,Cushing or adrenogenital syndrome of adrenocortical glomerular,fascicular,reticular zone were higher than that without hypertension,but their tumor diameters were similar.The diameters of functional adenoma in glomerular or fascicularer ( 1.7 cm,2.3 cm ) were lower than that of nonfunctional adenoma (2.3 cm,2.4 cm ) and the diameters of glomerular tumors were smaller than that of fascicular tumors.Nonfunctional adenoma ( 2.5 cm,2.0 cm ) of glomerular or fascicular by check up finding were bigger than that of non-endocrine adenoma ( 2.5 cm,2.3cm).There were seven cases with adrenogenital syndrome (2 male cases,5 female cases ),among these,there were 4 fascicularer adenoma cases,1 adenocarcinoma case,1 network hyperplasia case and 1 adenoma case.ConclusionsGenetic abnormality plays an important role in pathogenesis of adrenocortical disease and environment had less influence.Radiological examinations (CT and MRI) of adrenocortical diseases are the first choice and have important roles in evaluating tumor characteristics.There is close relationship between clinical manifestation and pathology.However,the exact diagnosis of definite type of disease and nature of tumor needs to be made by pathologic examination.