Objective To explore the effect of pulmonary arterial hypertension on the children with functional single ventricle in the early period after Fontan operation. Methods Forty-three children with pulmonary arterial hypertension after Fontan operation were enrolled in our department between January 2015 and December 2016. There were 24 males and 19 females at a median age of 4.3 years ranging from 2.5 to 4.8 years. The pulmonary arterial pressure was evaluated by cardiac catheterization. There were 23 children diagnosed without pulmonary hypertension (a non-PAH group) including 16 males and 7 females, while 20 patients were diagnosed with pulmonary hypertension (a PAH group) including 8 males and 12 females. Postoperative parameters related to outcomes were compared between the two groups. Results There was no death in the non-PAH group, but the mortality of children in the PAH group was 20.0% (4/20, χ2=5.34, P=0.02). The central venous pressure (t=–2.50, P=0.02), N-terminal prohormone of brain natriuretic peptide (NT-proBNP, Z=–3.50, P<0.01), peritoneal dialysis rate (χ2=5.40, P=0.02), incidence of arrhythmia (χ2=4.40, P=0.03) in the PAH group were significantly higher than those of the non-PAH group. The early postoperative utilization rate of pulmonary vascular targeting agents in the PAH group was significantly higher than that in the non-PAH group (χ2=6.30, P=0.04). Conclusion Pulmonary arterial hypertension is one of the most important factors which influence the early postoperative prognosis of children with functional single ventricle after Fontan operation.
Objective Hepatitis B virus X (HBx) protein is involved in the initiation and progression of hepatocellular carcinoma (HCC) by regulating the host protein-coding genes. Herein, we want to explore whether HBx protein can alter the expression of microRNAs (miRNAs) to promote proliferation and transformation in malignant hepatocytesin vitro. Methods MiRNA microarray and quantitative reverse-transcription polymerase chain reactions (qRT-PCRs) were performed to identify miRNAs that were differentially regulated by HBx protein in HCC cells. Protein and mRNA expression analyses, cell cycle and apoptosis analyses, and luciferase reporter assays were performed to delineate the consequences of miR-16 family repression in HepG2 cells. Results HBx protein induced widespread deregulation of miRNAs in HepG2 cells, and the downregulation of the miR-16 family was reproducible in HepG2, SK-HEP-1, and Huh7 cells. CCND1, a target gene of the miR-16 family, was derepressed by HBx protein in HepG2 cells. C-myc mediated the HBx-induced repression of miR-15a/16 in HepG2 cells. Ectopically expressed miR-15a/16 suppressed the proliferation, clonogenicity, and anchorage-independent growth of HBx-expressing HepG2 cells by arresting them in the G1 phase and inducing apoptosis, whereas reduced expression of miR-16 accelerated the growth and cell-cycle progression of HepG2 cells. Conclusions HBx protein altered thein vitro expression of miRNAs in host malignant hepatocytes, particularly downregulating the miR-16 family. Repression of miR-15a/16 is c-myc mediated and is required for the HBx-induced transformation of HepG2 cellsin vitro. Therefore, miR-16 family may serve as a therapeutic target for hepatitis B virus (HBV)-associated HCC.
Objective To evaluate the effect of remote controlled injection manipulator system (RCIM) assisted percutaneous kyphoplasty (PKP) for the treatment of rupture of posterior vertebral osteoporotic vertebral fracture by comparing with intermittent hand bolus injection of bone cement during operation. Methods Between September 2010 and January 2016, a retrospective analysis was made on the clinical data of 48 senile patients with single segment rupture of the posterior vertebral osteoporotic thoracolumbar fracture undergoing PKP who accorded with the inclusion criteria. Of 48 patients, 22 received intermittent hand bolus injection of bone cement in the control group, and 26 received RCIM assisted bone cement perfusion in the trial group. There was no significant difference in age, gender, duration of disease, causes of injury, implicated vertebral bodies, bone mineral density T value, pain duration, preoperative visual analogue scale (VAS), relative vertebral body height in the anterior part, and posterior convex Cobb angle between groups (P>0.05). The bone cement perfusion time, the radiation dose of both doctors and patients, and the amount of bone cement injection were recorded; treatment effects were evaluated based on VAS score, posterior convex Cobb angle, relative ver-tebral body height in the anterior part, ratios of bone cement diffusion area and bone cement leakage rate. Results The patients were followed up for 6 months; no complications of toxic effect of bone cement, spinal cord or nerve root injuries, infection and vascular embolization occurred during follow-up period. There was no significant difference in bone cement injection amount and radiation dose of doctors between groups (P>0.05), but bone cement perfusion time, ratios of bone cement diffusion area, and radiation dose of patients were significantly lower in the trial group than the control group (P<0.05). Bone cement leakage was observed in 6 cases of the control group (27.27%) and 2 cases of the trial group (7.69%), showing significant difference between groups (χ2=4.850,P=0.029); no cement leakage into the spinal canal was found in both groups. VAS score, relative vertebral body height in the anterior part, and posterior convex Cobb angle were significantly improved at 3 days and 6 months after operation when compared with preoperative ones (P<0.05), but no significant difference was observed in the above indexes between groups at 3 days and 6 months after operation (P>0.05). Conclusion Satisfactory effectiveness can be achieved by applying RCIM assisted PKP for the treatment of rupture of posterior vertebral osteoporotic vertebral fracture. RCIM can shorten perfusion time, reduce radiation dose, and decrease incidence of bone cement leakage.
【摘要】 目的 研究不同亞型多系統萎縮（multiple system atrophy，MSA）患者的臨床特點。 方法 回顧分析2009年1月—2011年1月收治的105例“很可能的”MSA患者的臨床資料，包括發病年齡、首發癥狀、臨床表現、治療反應性等。 結果 105例MSA患者中，男57例，女48例，發病年齡58歲。以小腦性共濟失調為主要特點的MSA（MSA with predominant cerebellar ataxia，MSA-C）患者76例，以帕金森綜合征為主要特點的多系統萎縮（MSA with predominant parkinsonism，MSA-P）患者29例。39例患者僅以小腦功能障礙為首發癥狀；29例患者僅以帕金森綜合征為首發癥狀，23例患者僅以自主神經功能障礙為首發癥狀，其余14例患者的首發表現至少包括2種癥狀組合。至最后一次隨訪時，54例患者同時存在小腦功能障礙、帕金森綜合征、自主神經功能障礙和錐體束征，51例患者表現為自主神經功能障礙與小腦功能障礙和（或）帕金森綜合征的不同形式的組合。 結論 MSA患者以MSA-C為主。由于在病程早期，MSA與其他帕金森綜合征或小腦性共濟失調疾病的鑒別較為困難，因此，仔細動態觀察患者臨床特點的演變情況，對MSA的診斷至關重要。【Abstract】 Objective To investigate subtypes and clinical features of multiple system atrophy (MSA). Methods The clinical data of 105 probable MSA patients treated in our hospital from January 2009 to January 2011 were analyzed, including the age at onset, initial symptoms, clinical manifestations and responsivity to levodopa. Results The 105 probable MSA patients consisted of 57 males and 48 females, including 76 patients (72.4%) of MSA with predominant cerebellar ataxia (MSA-C) and 29 patients (27.6%) of MSA with predominant parkinsonism (MSA-P). The mean age at onset was 58 years. The initial symptom of 39 patients was pure cerebellar dysfunction. Twenty-nine patients presented pure parkinsonism as the initial symptom. The initial symptom of 23 patients was pure dysautonomia. By the last clinical visit, 54 patients had cerebellar dysfunction, parkinsonism, autonomic failure and pyramidal signs. Conclusion The study revealed a predominance of MSA-C patients. The differentiation of MSA and other forms of parkinsonism or cerebellar ataxia may be difficult at the early stage. For more accurate diagnosis, it is important to carefully observe the clinical progression.
目的 比較5種新一代抗癲癇藥物對成人全面強直陣攣發作單藥治療的保留率。 方法 選擇2010年7月－2011年6月354例確診為癲癇全面強直陣攣發作患者，分別采用拉莫三嗪、左乙拉西坦、奧卡西平、托吡酯、加巴噴丁5種藥物進行單藥治療，對其5種藥物的6、12個月保留率進行比較。 結果 5種藥物的6、12個月保留率分別為：拉莫三嗪90.8%、79.8%，左乙拉西坦88.0%、66.7%，奧卡西平82.1%、58.2%，托吡酯81.2%、58.0%，加巴噴丁26.5%、20.6%。6個月保留率加巴噴丁與其他4種藥物比較差異有統計學意義（P＜0.001），其他藥物之間差異無統計學意義。12個月保留率拉莫三嗪與其他4種藥物比較差異有統計學意義（P＜0.005），其他藥物之間差異無統計學意義。 結論 拉莫三嗪對成人全面強直陣攣發作單藥治療12個月保留率最高。通過對5種新一代抗癲癇藥物12個月保留率比較研究，可以對臨床單藥治療癲癇藥物選擇提供一定參考。
目的 研究長期持續性心房顫動患者靜息心率控制與脈搏波傳導速度（PWV）的關系。 方法 序貫收集于2011年12月－2012年3月在四川大學華西醫院心臟內科門診就診的長期持續性心房顫動患者84例，將人群按靜息心率是否低于80次/min，分為標準組（心率＜80次/min）和對照組（心率≥80次/min），采用Pearson相關及多元線性回歸分析方法，研究靜息心率控制與PWV的關系。 結果 ①標準組人群的PWV顯著低于對照組，而飲酒率顯著高于對照組，差異皆有統計學意義（P＜0.05）。②Pearson相關分析顯示靜息心率與PWV存在線性相關關系（r=0.355，P=0.001）；多元線性回歸分析顯示，在調整了年齡、性別、BMI、收縮壓、舒張壓、吸煙、飲酒、空腹血糖、總膽固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白等混雜因素影響后，心率與PWV仍獨立相關。 結論 長期持續性心房顫動患者的靜息心率控制不良與PWV升高關系密切。
【摘要】 目的 探討佛波酯激活的蛋白激酶C與扭轉蛋白A在亞細胞成分中的表達之間的關系。 方法 采用免疫熒光法觀察扭轉蛋白A在原代培養的神經元和小鼠胚胎成纖維細胞（NIH 3T3細胞）中的分布。運用蛋白質印跡法分析蛋白激酶C和扭轉蛋白A在細亞細胞成分中的表達。 結果 扭轉蛋白A在NIH 3T3細胞中的表達類似于神經元。扭轉蛋白A在細胞質溶質、膜成分中均有分布。佛波酯活化蛋白激酶C后并不引起扭轉蛋白A在細胞質成分和膜成分中表達含量的變化。 結論 扭轉蛋白A可能是膜相關蛋白，細胞氧化應激中扭轉蛋白A表達上調和重分布變化不是由佛波酯誘導的蛋白激酶C活化途徑來實現的。鑒于扭轉蛋白A表達上調具有潛在的治療原發性早發扭轉性肌張力障礙的前景，影響其分布和表達的分子機制需要進一步研究。【Abstract】 Objective To investigate the relationship between the phorbol 12-myristate 13-acetate (PMA) activated protein kinase C (PKC) and the subcellular expression of TorsinA protein. Methods The expression of TorsinA in the primary cultured neurons and the NIH 3T3 cells was detected by immunofluorescence. The expression of PKC and TorsinA in subcellular fraction was analyzed by the western blotting. Results The expression pattern of TorsinA in NIH 3T3 cells was similar to neuron. PMA, an activator of PKC, did not promote the up-expression of TorsinA or redistribution in the subcellular fraction of NIH 3T3 cells. Conclusions TorsinA may be a membrane-associated protein. The up-regulation and redistribution of TorsinA is not caused by the pathway of the PMA activating PKC after cells insulted by oxidative stress. We should pay more attention on the mechanisms of the expression of TorsinA protein for the potential therapies to early-onset primary torsion dystonia (DYT1).
Objective To learn the current situation of traditional Chinese medicine (TCM) systematic reviews/meta-analyses published in Chinese journals. Methods All TCM systematic reviews/meta-analyses published from 1978 to July 31, 2009 were searched in the Chinese Biomedical Database (CBM). According to the inclusion and exclusion criteria, relevant information was extracted on the basis of research purpose. Meanwhile, publication year, journal name, author’s district, number of authors and their articles, types of diseases and interventions were took as the indexes, and then descriptive analysis was performed using SPSS 15.0 software. Results A total of 245 articles including 238 in Chinese and 7 in English were included. All of them were published in 117 different journals from 1998 to 2008, showing an accelerating growth trend of article number. In addition to only one article with first author from Germany, the first author of other 244 were from 24 domestic provinces (autonomous regions and municipalities); the number of authors ranged from 1 to 11; a total of 186 people had published articles as first author, and the number of their published articles ranged from 1 to 29. There were 16 types of diseases according to the International Classification of Diseases 10th Edition (ICD-10). Totally, 218 articles took drugs as interventions (including 106 listed drugs, 25 self-made prescriptions, 70 related to both listed drugs and self-made prescriptions, and 17 without reporting detailed interventions), accounting for 89%; and 27 articles were about non-drug interventions (including 26 about acupuncture and 1 about massage), accounting for 11%. Most (95.8%) of the articles about self-made prescriptions and listed drugs/self-made prescriptions adopted inappropriate pooled analyses. Conclusion Evidence-based medicine has been spread into the field of TCM, the number of TCM systematic reviews/meta-analyses shows an accelerated growth trend. The types of diseases discussed in the literature were almost the same as the diseases those could be effectively treated by TCM, but there existed imbalance in districts. In the future, systematic review/meta-analysis on drug intervention should aim at Chinese patent medicines and single medicines rather than self-made prescriptions, and should pay more attention to advantageous drugs and advantageous treatments of diseases. Moreover, importance should be also attached to clinical heterogeneity controlling when using acupuncture as a non-drug intervention.
ObjectiveTo evaluate the usefulness of estimation of physiologic ability and surgical stress (E-PASS) for predicting postoperative complications in patients undergoing elective colorectal cancer surgery. MethodsPatients underwent colorectal cancer surgery between August 2009 and October 2010 were analyzed retrospectively. E-PASS equations were applied to those patients for estimation of operative risk. The preoperative risk score (PRS), surgical stress score (SSS), and comprehensive risk score (CRS) of the E-PASS were compared with actual postoperative complications. The relationship between E-PASS variables and morbidity after colorectal cancer surgery was identified. ResultsOf the 313 patients, 22 (7.0%) had postoperative complications. Of all the E-PASS variables between complicative group and noncomplicative group, the morbidity was significantly correlated to age (P=0.003), weight (P=0.019), tumor histologic types (P=0.033), Dukes stage (P=0.001), severe heart disease (P=0.019), severe pulmonary disease (P=0.000), performance status (P=0.000), loss of blood volume/body weight (P=0.007), loss of blood volume (P=0.001) and operation time (P=0.001). Differentiation degree of tumor (P=0.503), diabetes (P=0.745), ASA grade (P=0.085), and size of surgical incision (P=0.726) were not significantly associated with postoperative complications. The PRS and CRS were higher in complicative group than those in noncomplicative group (Plt;0.001). But the difference of SSS between the two groups was not statistically significant (P=0.059). ConclusionThe E-PASS scoring system is a relatively simple, fast, and operable tool that can be used to predict short-term postoperative morbidity accurately for clinical decision-making in colorectal cancer surgery.
ObjectiveTo compare the citations of Chinese literature in the 2015 and 2025 editions of the American Thyroid Association (ATA) guidelines, thereby evaluating the progress in the field of differentiated thyroid cancer (DTC) in China. MethodsChinese literature cited in the 2015 and 2025 ATA guidelines was collected and cataloged. Comparisons were made between the two editions regarding the number of citations, source journals, affiliated institutions, regional distribution, research types, and research foci. Results① Changes in the quantity and regional distribution of Chinese citations: The proportion of Chinese literature cited in the 2025 ATA guidelines increased nearly threefold compared to the 2015 edition (8.8% vs. 3.3%, P<0.001). The number of source journals increased nearly fourfold, the number of contributing cities more than doubled, and the number of involved hospital institutions quadrupled. Compared to the 2015 edition, where cited institutions were primarily located in Taiwan (11 publications), Hong Kong (11 publications), and coastal cities in Mainland China (12 publications), the 2025 edition showed a broader distribution encompassing medical centers in the Beijing-Tianjin-Hebei region, Yangtze River Delta, Pearl River Delta, Chengdu, Changchun, among others. West China Hospital of Sichuan University led the nation with the most citations (20 publications). The proportion of citations from Mainland Chinese institutions increased significantly compared to those from Taiwan and Hong Kong (accounting for 84.5%).② Changes in research types of cited literature: Clinical research constituted the majority (>95%) of cited Chinese literature in both editions. However, three basic research studies appeared in the 2025 edition. Single-center studies predominated in both guidelines.③ Changes in research foci of cited literature: The number of research foci covered increased nearly twofold in the 2025 edition (20 foci) compared to the 2015 edition (11 foci). Radioactive Iodine (RAI-131) therapy was the most frequently cited focus in both editions. Among research foci with ≥5 citations, traditional areas like tumor staging & prognosis and surgical methods & extent remained prominent, while the focus on recurrent laryngeal nerve protection rose in rank. Some traditional foci declined in ranking. Notable newly prominent or significantly changed foci included ablation therapy (12 publications, ranked 2nd), comprehensive treatment (11 publications), lymph node metastasis (10 publications), parathyroid protection (7 publications), thyroid cancer & pregnancy risks (5 publications), and active surveillance (5 publications). ConclusionCompared to the 2015 ATA guidelines, the 2025 edition cited a higher proportion of Chinese literature, demonstrated a wider geographical distribution of publications (expanding from Taiwan, Hong Kong, and coastal developed areas to major regional centers across China), and covered broader and more in-depth research foci. This indicates significant growth in China's DTC field in recent years, with a gradual shift from traditional concerns like cure and recurrence rates towards improving long-term quality of life and developing personalized, precise comprehensive management models. China is playing an increasingly important role in shaping global DTC standards. However, high-quality prospective, multicenter, randomized clinical trials remain an area for future enhancement.