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Objective: To investigate the safety and efficacy of mitoxantrone liposome in the treatment of children with high-risk acute myeloid leukemia (AML)., Methods: The children with high-risk AML who received the mitoxantrone liposome regimen at Wuhan Children's Hospital from January 2022 to February 2023 were collected as the observation group, and the children with high-risk AML who received idarubicin regimen were enrolled as controls, and their clinical data were analyzed. Time to bone marrow recovery, the complete remission rate of bone marrow cytology, the clearance rate of minimal residual disease, and treatment-related adverse reactions were compared between the two groups., Results: The patients treated with mitoxantrone liposome showed shorter time to recovery of leukocytes(17 vs 21 day), granulocytes(18 vs 24 day), platelets(17 vs 24 day), and hemoglobin(20 vs 26 day) compared with those treated with idarubicin, there were statistical differences ( P <0.05). The effective rate and MRD turning negative rate in the observation group were 90.9% and 72.7%, respectively, while those in the control group were 94.1% and 76.4%, with no statistical difference ( P >0.05). The overall response rate of the two groups of patients was similar., Conclusion: The efficacy of mitoxantrone liposome is not inferior to that of idarubicin in children with high-risk AML, but mitoxantrone liposome allows a significantly shorter duration of bone marrow suppression and the safety is better.

Objective: To investigate the relationship between genetic polymorphisms of cytochrome P450 2C19 (CYP2C19) and the efficacy of Helicobacter pylori (Hp) eradication therapy in children. Methods: The retrospective cohort study was conducted on 125 children with gastroscopy and positive rapid urease test (RUT) from September 2016 to December 2018 who presented to the Children's Hospital of Zhejiang University School of Medicine due to gastrointestinal symptoms including nausea, vomiting, abdominal pain, bloating, acid reflux, heartburn, chest pain, vomiting blood and melena. Hp culture and drug susceptibility test were carried out with gastric antrum mucosa before treatment. All the patients completed 2 weeks of standardized Hp eradication therapy and had 13 C urea breath test 1 month after that, which was used to evaluate the curative effect. The DNA of gastric mucosa after RUT was analyzed and CYP2C19 gene polymorphism was detected. Children were grouped according to metabolic type. Combined with the results of Hp culture and drug susceptibility, the relationship between CYP2C19 gene polymorphism and the efficacy of Hp eradicative treatment was analyzed in children. Chi square test was used for row and column variables, and Fisher exact test was used for comparison between groups. Results: One hundred and twenty five children were enrolled in the study, of whom 76 were males and 49 females. The genetic polymorphism of CYP2C19 in these children found poor metabolizer (PM) of 30.4% (38/125), intermediate metabolizer (IM) of 20.8% (26/125), normal metabolizer (NM) of 47.2% (59/125), rapid metabolizer (RM) of 1.6% (2/125), and ultrarapid metabolizer (UM) of 0. There were statistically significant in positive rate of Hp culture among these groups ( χ 2 =124.00, P <0.001). In addition, the successful rates of Hp eradication in PM, IM, NM and RM genotypes were 84.2% (32/38), 53.8% (14/26), 67.8% (40/59), and 0, respectively, with significant differences ( χ 2 =11.35, P= 0.010); those in IM genotype was significantly lower than that in PM genotype ( P =0.011). With the same standard triple Hp eradicative regimen, the successful rate of Hp eradication for IM type was 8/19, which was lower than that of PM (80.0%, 24/30) and NM type (77.3%, 34/44) ( P =0.007 and 0.007, respectively). There was a significant difference in the efficacy of Hp eradication treatment among different genotypes ( χ 2 =9.72, P =0.008). According to the clarithromycin susceptibility result, the successful rate of Hp eradication treatment for IM genotype was 4/15 in the sensitive group and 4/4 in the drug-resistant group ( χ 2 =6.97, P= 0.018). Conclusions: The genetic polymorphism of CYP2C19 in children is closely related to the efficacy of Hp eradication treatment. PM has a higher successful rate of eradication treatment than the other genotypes.

Objective: To study the cerebrospinal fluid (CSF) status and prognosis value in patients with newly diagnosed acute lymphoblastic leukemia (ALL) by flow cytometry (FCM)., Methods: The clinical features of the 75 newly diagnosed ALL patients from September 2020 to December 2021 in our centre were retrospective analyzed, as well as the bone marrow (BM) and CSF minimal residual disease (MRD) data, and the CSF conventional cytology data. Central nervous system infiltration(CNSI) positive was as CSF MRD positive by FCM or leukemia cells detected by conventional cytology. The status of CSF were compared and analyzed by FCM and conventional cytology, the clinical features and the prognosis value of different CNSI status in these patients were analyzed., Results: Among 75 newly diagnosed ALL, 16 cases (21%) with CNSI positive (CNSI + ) were detected by FCM, while only 2 positive cases (3%) were detected by conventional cytology. The CNSI + rate detected by FCM was significantly higher than conventional cytology( P <0.05). Compared with CNSI - ALL patients, the median age of CNSI + ALL patients was significantly younger, and the median platelet count was significantly lower, the difference was statistically significant ( P <0.05). Up to follow-up time (August 31, 2022), four ALL patients were died, including 3 patients were CNSI - and 1 patient was CNSI + . Furthermore, three cases were primary disease relapse, including 1 case was CNSI + . There was no significant difference in overall survival (OS) rate and relapse-free survival (RFS) rate of the patients with different CNSI status., Conclusion: Compared with conventional cytology, FCM is a more sensitive assay to evaluate the central nervous system status in ALL patients. After active treatment, there was no significant difference in OS and RFS between patients with different CNSI status at diagnosis.

This study aimed to investigate the effects of Erxian Decoction(EXD)-containing serum on the proliferation and osteogenic differentiation of MC3T3-E1 cells under oxidative stress through BK channels. The oxidative stress model was induced in MC3T3-E1 cells by H&#95;2O&#95;2, and 3 mmol·L~(-1) tetraethylammonium(TEA) chloride was used to block the BK channels in MC3T3-E1 cells. MC3T3-E1 cells were divided into a control group, a model group, an EXD group, a TEA group, and a TEA+EXD group. After MC3T3-E1 cells were treated with corresponding drugs for 2 days, 700 μmol·L~(-1) H&#95;2O&#95;2 was added for treatment for another 2 hours. CCK-8 assay was used to detect cell proliferation activity. The alkaline phosphatase(ALP) assay kit was used to detect the ALP activity of cells. Western blot and real-time fluorescence-based quantitative PCR(RT-qPCR) were used to detect protein and mRNA expression, respectively. Alizarin red staining was used to detect the mineralization area of osteoblasts. The results showed that compared with the control group, the model group showed significantly blunted cell proliferation activity and ALP activity, reduced expression of BK channel α subunit(BKα), collagen Ⅰ(COL1), bone morphogenetic protein 2(BMP2), osteoprotegerin(OPG), and phosphorylated Akt, decreased mRNA expression levels of Runt-related transcription factor 2(RUNX2), BMP2, and OPG, and declining area of calcium nodules. EXD-containing serum could significantly potentiate the cell proliferation activity and ALP activity, up-regulate the protein expression of BKα, COL1, BMP2, OPG, and phosphorylated Akt, and forkhead box protein O1(FoxO1), promote the mRNA expression of RUNX2, BMP2, and OPG, and enlarge the area of calcium nodules. However, BK channel blockage by TEA reversed the effects of EXD-containing serum in promoting the protein expression of BKα, COL1, BMP2, OPG, and phosphorylated Akt and FoxO1, increasing the mRNA expression of RUNX2, BMP2, and OPG, and enlarging the area of calcium nodules. EXD-containing serum could improve the proliferation activity, osteogenic differentiation, and mineralization ability of MC3T3-E1 cells under oxidative stress, which might be related to the regulation of BK channels and downstream Akt/FoxO1 signaling pathway.

Objective: To investigate the efficacy and safety of VDZ (Vedolizumab) in the salvage treatment of glucocorticoid resistance to gastrointestinal graft-versus-host disease (GR-GI GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children., Methods: The clinical data of 5 patients with refractory GI GVHD who received allo-HSCT in Wuhan Children's Hospital from December 2020 to December 2021 were retrospectively analyzed with VDZ salvage therapy., Results: Among the 5 children with refractory GI GVHD, there were 1 male and 4 female, including 2 cases of extremely severe aplastic anemia, 1 case of acute myeloid leukemia (M2, high-risk), 1 case of fanconi anemia and 1 case of myelodysplastic syndrome. The median age of transplant recipients was 54.4 (12-164) months. The median treatment time from transplantation to VDZ was 1.4 (0.6-6.8) months. On average, 3.5 (2-5) doses of VDZ were received. After receiving treatment, 2 patients achieved a complete response (CR), 2 patients achieved a very good partial response (VGPR), 1 patient was non-responsive (NR) after a short-term partial response (PR). Compared with that before VDZ treatment, the amount of diarrhea, stool color, blood and traits of the children after medication were effectively improved. The median follow-up time was 9.3 (7.23-12.83) months. No disseminated or severe bacterial/fungal infections occurred during VDZ treatment and follow-up, and 2 children died of leukemia recurrence and pulmonary bronchiolitis obliterans., Conclusion: VDZ salvage treatment of refractory GI GVHD in children has obvious short-term efficacy and good safety.

Objective: To analyze the gender differences of genetic etiology in the incidence of major depression disorder among Han freshmen. Methods: A 1-year follow-up survey was carried out among 8 079 Han freshmen from Jining, Rizhao and Weifang without lifetime major depressive disorder (MDD) at baseline (April to October 2018) and 4 828 venous blood samples were also collected. After extracting DNA, Sequenom Mass Array time-of-flight mass spectrometry biochip technology was used to detect the genotypes of 17 single nucleotide polymorphisms (SNPs) MDD-related loci. Logistic regression was used for univariate analysis. Generalized multifactor dimension reduction was used to analyze gene-gene interactions. Composite International Diagnostic Interview (CIDI) 3.0 was used for MDD diagnosis. Results: The 1-year incidence of MDD among Han freshmen was 2.23% (95% CI : 1.91%-2.60%) and the gender difference of incidence between males (1.97%, 95% CI : 1.52%-2.56%) and females (2.39%, 95% CI : 1.98%-2.90%) was not statistically significant ( P >0.05). AG genotype of rs768705 (nearby gene: TMEM161B) was a risk factor for MDD ( OR =1.98, 95% CI : 1.24-2.83). The TC genotype of rs17727765 (nearby gene: CRYBA1) was only a risk factor for MDD in males ( OR =9.61, 95% CI : 2.04-45.30). An 8-loci interaction model (PMFBP1, OLFM4, LHPP, ENOX1, TMEM161B, SPPL3, FBXL4 and L3MBTL2) could predict MDD in women with an accuracy rate of 60.05%. No effective prediction model was found for MDD in men. Conclusions: There might be gender differences in the genetic etiology of MDD. Further researches on the genetic causes of MDD in men should be explored.

Objective: To analyze the clinical effects of CCLG-AML-2015 protocol on newly diagnosed children with acute myeloid leukemia (AML)., Methods: The clinical data of 60 newly diagnosed AML children in the Department of Hematology and Oncology, Wuhan Children's Hospital from August 2015 to September 2019 were summarized, the effect of chemotherapy using the CCLG-AML-2015 regimen (hereinafter referred to as the 2015 regimen) were retrospectively analyzed. 42 children with AML treated by the AML-2006 regimen (hereinafter referred to as the 2006 regimen) from February 2010 to July 2015 were used as control group., Results: There were no statistical differences between the 2015 regimen group and the 2006 regimen group in sex, age at first diagnosis, and risk stratification (P>0.05). The complete remission rate of bone marrow cytology after induction of 1 course of chemotherapy (84.7% vs 73.1%, P=0.155), and minimal residual disease detection (MRD) negative (42.3% vs 41.4%, P=0.928) in the 2015 regimen group were not statistically different than those in the 2006 regimen group. The bone marrow cytology CR (98.1% vs 80.6%, P=0.004) and MRD negative (83.3% vs 52.8%, P=0.002) in the 2015 regimen group after 2 courses of induction were higher than those in the 2006 regimen group. The 5-year overall survival (OS) rate in the 2015 regimen group (62.3%±6.4% vs 20.6%±6.4%, P=0.001), the 5-year disease-free survival (EFS) rate (61.0%±6.4% vs 21.0% ±6.4% , P=0.001) were better than those in the 2006 regimen group. The 5-year OS and EFS of high-risk transplant patients in the 2015 regimen group were significantly better than those of high-risk non-transplant patients (OS: 86.6%±9.0% vs 26.7%±11.4%, P=0.000; EFS: 86.6%±9% vs 26.7%±11.4%, P=0.000)., Conclusion: The 2015 regimen can increase the CR rate after 2 courses of induction compared with the 2006 regimen. High-risk children receiving hematopoietic stem cell transplantation can significantly improve the prognosis.

Objective: To explore the treatment outcome of the strategy of early extubation and then switching to non-invasive mechanical ventilation in children with acute respiratory failure, and the safety and feasibility of using the strategy to replace traditional methods., Methods: A total of 102 children, aged between 1 month to 14 years old, who had acute respiratory failure and were admitted to the pediatric ICU of West China Second University Hospital, Sichuan University between January 2019 and December 2020 were enrolled and randomly assigned to treatment group 1 ( n =55) and treatment group 2 ( n =47). In addition, 53 children who had the same condition in the 12 month prior to the beginning of the study were included in the control group. In the two treatment groups, the patients were extubated first, and then weaned off the ventilator. In group 1, when the patient met the invasive-non-invasive switching criteria, the tracheal tube was pulled out and non-invasive bi-level positive airway pressure (BiPAP) ventilation was used for respiratory support. In group 2, high-flow nasal cannula (HFNC) oxygen therapy was used for respiratory support. The traditional progressive weaning method was adopted for the control group (extubing and weaning were performed at the same time). The incidence of ventilator-associated pneumonia (VAP) during the period of tracheal intubation was compared and the mortality of the two groups was evaluated from the point when the patients were recruited. At the time of extubation in the treatment groups and extubation plus weaning in the control group, the pressure support levels, or PC above PEEP, intubation time, sequential time (between 2 treatment groups only), weaning failure rate, and the incidence of laryngeal edema and nasal pressure ulcer were compared., Results: The subjects of the study were predominantly infants (93 cases, 60%) and young children (31 cases, 20%). Among the 155 cases, 82 (53%) were male. There was no statistical difference in age distribution or gender among the groups. There was no significant difference in the clinical indicators among the three groups before tracheal intubation. At the time of extubation, the PC above PEEP in the two treatment groups was higher than that in the control group, and higher in group 1 than that of group 2, the difference being statistically significant ( P <0.05). The intubation time of the two treatment groups was shorter than that of the control group, and shorter in group 1 than that of group 2 ( P <0.05). The sequential time of group 2 was shorter than that of group 1 ( P <0.05). The extubation failure rate and the incidence of VAP in the two treatment groups were lower than those in the control group, and there was no statistically significant difference between the two treatment groups. The incidence of nasal pressure ulcers in group 1 was higher than that in the other two groups ( P <0.05). There was 1 death in treatment group 1, and no deaths in treatment group 2 or the control group. There was no significant difference in mortality or the incidence of laryngeal edema after extubation in the three groups., Conclusion: Early extubation and then switching to non-invasive mechanical ventilation can be well tolerated by the patients, and can be used in clinical practice as an effective weaning method for children with acute respiratory failure., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China., Methods: According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017., Results: A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66)., Conclusions: Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.

Objective: To investigate the incidence of neonatal asphyxia and possible contributing factors for the development of severe asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture, China., Methods: A total of 16 hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture were selected as research centers. A retrospective analysis was performed for the clinical data of 22 294 live births in these 16 hospitals from January to December, 2016 to investigate the incidence rate of neonatal asphyxia and possible contributing factors for the development of severe asphyxia., Results: Of the 22 294 neonates born alive, 733 (3.29%) were diagnosed with neonatal asphyxia, among whom 627 had mild asphyxia and 106 had severe asphyxia. The neonates with low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight had a higher incidence of severe asphyxia (P<0.05)., Conclusions: The incidence rate of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture is higher. Low maternal education level, maternal anemia during pregnancy, chorioamnionitis, abnormal amniotic fluid, abnormal umbilical cord, placenta previa, placental abruption, Tujia Minority, preterm birth, and low birth weight may be related to the development of severe neonatal asphyxia.

Objective: To investigate the relationship of the characteristics of sperm donors with the results of screening and provide some reference for the screening of sperm donors., Methods: We statistically analyzed the screening data about 12 362 sperm donors at the Guangdong Human Sperm Bank from January 2003 to June 2017 and the relationship of the eligibility rate of screening with the donors' age, education, occupation, marriage, and fatherhood., Results: Of the 12 362 sperm donors, 3 968 (32.1%) met the standards of semen quality and 3 127 (25.3%) filled all the requirements of sperm donation. The eligibility rate of screening was 27.7% in the donors aged 20－24 years, 24.3% in those aged 25－29 years, 23.8% in those aged 30－34 years, and 17.5% in those aged =≥35 years (P < 0.01); 23.5% in the senior high school students, 24% in the junior college students, 25.9% in the undergraduates, and 30.3% in the postgraduates (P < 0.01); 29.3% in the students versus 22.9% in the others (P < 0.01), 41.5% in the married versus 20.7% in the unmarried (P < 0.01), and 45.6% in the fathers versus 20.9% in the childless husbands (P < 0.01)., Conclusions: A higher eligibility rate of screening was found among the sperm donors aged <35 years or with a bachelor's or higher degree, particularly among students.

Objective: To explore the mechanisms of neuroprotective effects of c-Jun N-terminal kinase (JNK)/FOXO3a transcription factor signaling pathway inhibition on hypoxic-ischemic neuronal apoptosis in neonatal rats with hypoxic-ischemic brain damage (HIBD)., Methods: Sixty-four 7-day-old Sprague-Dawley rats were divided into four groups: hypoxia-ischemia (HI), sham-operated, JNK specific inhibitor AS601245-treated, and DMSO vehicle. Rats' cerebral cortexes were collected at 24 hours after HI. Western blot was used to detect the protein expression of JNK, p-JNK, FOXO3a, nuclear and cytoplasmic FOXO3a, Bim, and CC3. TUNEL staining was used to detect the apoptotic cells., Results: Compared with the sham-operated group, p-JNK protein increased (P<0.01), nuclear protein of FOXO3a increased (P<0.01), cytoplasmic protein decreased (P<0.01), and pro-apoptotic proteins Bim and CC3 increased 24 hours after HI (P<0.01). Compared with the HI and DMSO vehicle groups, p-JNK protein was reduced (P<0.01), nuclear protein of FOXO3a was also reduced (P<0.01), cytoplasmic protein increased (P<0.01), and Bim and CC3 proteins decreased (P<0.01) in the AS601245-treated group 24 hours after HI. TUNEL positive cells were reduced in the AS601245-treated rats compared with the HI and DMSO vehicle groups 24 hours after HI (P<0.01)., Conclusions: JNK activity increases in the neonatal rat brain with HI damage. JNK activity inhibition can inhibit FOXO3a translocation from cytoplasm to nucleus and downregulate the levels of pro-apoptotic proteins Bim and CC3, leading to the reduction of neuronal apoptosis.

Objective: To investigate the safety and efficay of low-dose furosemide in the correction of oliguria in the patients undergoing gynecologic surgery., Methods: A total of 120 patients, aged between 20 to 50 years old, who were scheduled to receive elective gynecological open surgery under general anesthesia, were randomly divided into 3 groups: the control group, furosemide 0. 05 mg/kg (F0.5) group and furosemide 0. 1 mg/kg (F1) group (n=40). During surgery, blood volume and blood pressure was maintained in the normal range. The urine volume was recorded every 30 minutes. Oliguria was defined as the urine volume less than 0. 5 mL/(kg . h), When oliguria was observed, flurosemide or saline was given to the patients based on the enrollment status. If the patients were still oliguric 30 min later, the treatment was repeated. The total time of surgery, net fluid infusion volume, urine volume per unit time per body weight at the completion of surgery, the incidence of intraoperative oliguria, the total amount of furosemide and the average specific gravity of urine were recorded., Results: There was no statistically significant difference in sex, age, fasting time, the total time of surgery and intraoperative net fluid infusion volume among the three groups (P>0. 05). The urine volume per unit time per body weight in control group was significantly lower than that of the other two groups (P<0. 01). The incidence of intraoperative oliguria in the three groups (control, low dose, high dose groups) were 52. 5%, 12. 5% and 0%, respectively (P<0. 01)., Conclusion: Low-dose of furosemide could maintain normal urine volume and specific gravity of urine during gynecological surgery.

Objective: To evaluate safety and effectiveness of nasopharyngeal airway used for neurosurgery patients during the anesthesia recovery period., Methods: A total of 60 patients (ASAI-II), aged between 25 to 67 years old, who were scheduled to undergo elective neurosurgery operation under general anesthesia, were randomly divided into the oropharyngeal airway group (group O) and the nasopharyngeal airway group (group N), with 30 cases in each group. After respiratory recovery was satisfactory at the end of operation, endotracheal tube was extubated under deep anesthesia. Afterwards, oropharyngeal airway was intubated in group O, and nasopharyngeal airway was intubated in group N. BP and HR before induction (T0), before airway intubation (T1), at 1 min (T2) and 5 min (T3) after airway intubation were recorded. Meanwhile, one-time success rate of airway intubation, the airway retention time, the times of airway regulation due to location change and the change of respiration and circulation in each groups during airway retention period were recorded. In addition, adverse reactions during airway retention period and tolerance scores of patients in both groups were recorded., Results: BP and HR in group N at T1 and T2 increased significantly compared with T0 (P < 0.05), Compared with T1, BP and HR increased significantly at T2 in group N (P < 0.05). Compared with T1 and T2, the same index reduced significantly at T3 (P < 0.05). BP and HR in group N were significantly higher than those in group O at T2 (P < 0.05). Airway retention time in group N was significantly longer than that in group O [(137.4 +/- 18.32) min vs. (64.2 +/- 8.25) min, P < 0.053; the times of airway location regulation in group N was less than that in group O (0.34 +/- 0.21 vs. 2.80 +/- 0.54) (P < 0.05). During airway retention period the incidence of BP and HR exceeding the base value by 15% in group O was higher than that in group N (80.0% vs. 46.7%)(P < 0.01), and the incidence of SPO2 less than 95% in group O was higher than that in group N (26.7% vs. 6.7%) (P < 0.05). The incidence of nausea, upper airway obstruction and restlessness in group O was significantly higher than that in group N (P < 0.05). Moreover, airway tolerance score of patients in group N was significantly better than that in group O (P < 0.05)., Conclusion: Nasopharyngeal airway could better maintain unobstructed upper airway in neurosurgery patients during the anesthesia recovery period with advantages such as small circulatory effect, good tolerance and fewer complications.

CD40 and its receptor CD40L are a very important pair of co-stimulating molecule in immune response, which have extensive biological effects. After stimulating CD40 signal, it can exert corresponding function through MAPK (JNK, ERK, p38) pathway, PI3K cascade, as well as NF-κB and STAT. The CD40 signal is closely related to tumor immunity, this moleculer has already become targeted-molecule for cancer treatment. Recently, there have been many anti-CD40 monoclonal antibodies displaying good anti-cancer effect, among which CHIR-12.12, SGN-40 and CP-870, 893 developed rapidly and successively have entered clinical research stage. This review focuses the status of anti-CD40 monoclonal antibody, including distribution of CD40, physiological function of CD40, CD40 and tumor immunity, anti-CD40 monoclonal antibodies and so on.

Objective: To investigate the effects of surfentanyl and fentanyl on spontaneous contractions of isolated uterine smooth muscles of rabbits., Methods: Thirty isolated uterine smooth muscles strips of rabbits with rhythmic spontaneous contraction were randomly divided into three groups: control group (n = 10) fentanyl group (n = 10) and surfentanyl group (n = 10). The effects of fentanyl and surfentanyl on spontaneous contractions intensity, frequency and duration of isolated uterine smooth muscles of rabbits in different concentrationswere monitored., Results: There were no effect on the spontaneous contraction of isolated uterine muscles of rabbits at the concentration of 1 x 10(-8) mol/L in fentanyl group. The spontaneous contraction intensity was decreased significantly when the concentration of fentanyl more than 3 x 10(-8) mol/L (P < 0.05). The spontaneous contraction intensity, frequency and duration was inhibited more than 50% when the concentration of fentanyl more than 3 x 10(-7) mol/L (P < 0.05). And the spontaneous contraction duration was inhibited more than 50% when the concentration of surfentanyl more than 1 x 10(-7) mol/L (P < 0.05). Compared with surfentanyl group, there were significant difference on spontaneous contraction intensity when the concentration of fentanyl more than 3 x 10(-8) mol/L (P < 0.05). Difference on frequency, more than 3 x 10(-8) mol/L (P < 0.05) and difference on duration, at the concentration of 1 x 10(-7) and 1 x 10(-7) mol/L (P < 0.05)., Conclusion: Fentanyl restrained the spontaneous contractions of isolated uterine smooth muscles of rabbits in concentration-dependent manner. Surfentanyl could reduce the spontaneous contractions duration on isolated uterine smooth muscles of rabbits. But there were no effect on frequency and duration.

Objective: To establish a method for analyzing the PTEN-induced kinase 1 gene (PINK1) exon copy number and apply it to the analysis of PINK1 gene exon copy number variation (CNV) in patients with autosomal recessive early-onset Parkinsonism (AREP)., Methods: Real-time PCR was used to analyze the exon copy number in 22 probands with AREP from unrelated Chinese Han families and 30 healthy controls., Results: Copy numbers of exons 1-8 of the PINK1 gene were analyzed, and satisfactory reaction conditions and primers for exons of the PINK1 gene were obtained. No exon CNV in the PINK1 gene was detected in this group., Conclusion: An analytical method for PINK1 gene exon copy number was established. The exon CNV in the PINK1 gene was rare in Chinese patients with AREP.

Objective: To investigate the mutation characteristics of ATP13A2 gene in Chinese patients with familial autosomal recessive early-onset parkinsonism (AREP)., Methods: Mutations of ATP13A2 gene were screened by polymerase chain reaction combined with DNA direct sequencing in patients with familial AREP., Results: No pathogenic mutations in ATP13A2 gene were detected in this group. Six reported polymorphisms were identified. They were IVS6+70A>G, IVS12+66A>G, m.1849C>T, IVS20-56 G>A, m2671C>T and m2824G>A., Conclusion: ATP13A2 gene mutations may be rare in Chinese patients with familial autosomal recessive early-onset parkinsonism.

Objective: To evaluate the effect of treatment for tonifying qi, nourishing yin, activating blood circulation and removing stasis on insulin resistance (IR) in patients of type 2 diabetes mellitus (T2DM) complicated with hypertension., Methods: Forty-five patients of T2DM with hypertension enrolled from authors' special clinics were equally randomized into two groups: the test group (20 patients) and the control group (25 patients). Both groups received orally hypoglycemic drugs, such as glipizide sustained-release tablets, pioglitazone, and metformin, and antihypertensive drug as nifedipine sustained-release tablets as well. Additionally, Sanqidan Granules (SQD), a Chinese patent medicine was given to the test group. The course of treatment lasted for 8 weeks. The clinical efficacy of Chinese medicine syndromes, blood pressure, T2DM related indices and blood lipids in the two groups were observed., Results: The effect in improving Chinese medicine syndromes in the test group was better than that in the control group significantly (P <0.05). After treatment, all the indices were examined, except FINS and TG were improved in the test group, showing significant difference as compared with those before treatment; while in the control group, significant difference was only shown in terms of fasting blood glucose (FBG), HbA1 c, systolic blood pressure (SBP) and HDL-C (P <0.01). Comparison between groups showed that the effect in the former was better than that in the latter group in terms of decreasing FBG, HbA1c, SBP and increasing of HDL-C (P <0.05), while a downward trend of ISI in the test group was shown but with no statistical significance (P = 0.230)., Conclusions: SQD can relieve the clinical symptoms in patients of syndrome of qi-yin deficiency and inner blockage of blood stasis, increase the insulin sensitivity and reduce the IR in patients, so as to decrease their FBG, blood pressure and HbAlc. It also can increase HDL-C level, and lower TC and LDL-C levels, which is beneficial to anti-atherosclerosis.

Objective: GRP78 is a sensitive marker of endoplasmic reticulum stress. Caspase-12 is involved in apoptosis induced by endoplasmic reticulum stress. This study was designed to explore the changes of GRP78 and caspase-12 mRNA in neonatal rats with experimental hypoxic-ischemic white matter damage (WMD) and investigate the roles of endoplasmic reticulum stress in the WMD., Methods: Two-day-old rats were randomized to WMD and control groups (n=49 each). The pups were sacrificed at 0, 2, 4, 6, 12, 24 and 72 hrs after hypoxia-ischemia (HI). The light microscope was used to observe the brain pathological changes. Real time PCR was used to detect the expression of GRP78 mRNA and caspase-12 mRNA in the white matter tissue., Results: The expression of GRP78 mRNA began increasing 2 hrs after HI and peaked at 6 hrs in the WMD group, demonstrating significant differences at 2, 4, 6, 12, 24 and 72 hrs compared with the control group (P<0.05). The caspase-12 mRNA expression in the WMD group began increasing 6 hrs after HI and demonstrated significantly increased levels 6, 12 and 24 hrs after HI compared with those in the control group (P<0.05)., Conclusions: GRP78 and caspase-12 mRNA expression increased significantly in neonatal rats with WMD. This suggests that endoplasmic reticulum stress may be induced following HI. Endoplasmic reticulum stress seems to be involved in the apoptosis of oligodendrocytes induced by HI in neonatal rats with WMD.

Colloidal silver nanoparticles were synthesized in water-in-oil microemulsion using silver nitrate solubilized in the water core of a microemulsion as source of silver ions, hydrazine hydrate solubilized in the water core of another one as reducing agent, cyclohexane as the continuous phase, and sodium bis(2-ethylhexyl) sulfosuccinate (AOT) as the surfactant. The main factors affecting the formation of silver nanoparticles were systematically studied. Ultraviolet-visible (UV-Vis) spectra were used for analyzing the effects of reaction parameters, including the type of reducing agents, the molar ratio of water to surfactant and the concentration of AgNO3 and AOT and so on, on the formation of silver nanoparticles. Original results for the controllable synthesis of silver nanoparticles were obtained when the synthesis proceeded in AOT-cyclohexane-AgNO3 microemulsion. The UV-Vis spectra of silver sols formed in the microemulsion with various parameters were studied systematically. The results show that the amount and average size of the obtained nanoparticles obviously depend on the above parameters. When the concentration of AgNO3 is lower, smaller silver nanoparticles are easy to form by increasing the concentration of AgNO3 appropriately. The higher W value was found to form larger numbers of silver nanoparticles with larger particle size. Compared to the solubility of NaBH4 in AOT reverse micelles, hydrazine hydrate is well soluble in these micelles, and thus it is favorable to reduce the silver ions solubilized in the water core of AOT-cyclohexane-AgNO3 microemulsion. The increase in the concentration of AOT induces an increase in the number of AOT micelles and a decrease in the molar ratio of water to surfactant. As a result, the solubilization capacity of reactants in the micelles increases and the radii of the micelles decrease. That is to say, with the increase in AOT concentration, the amount of the formed nanoparticles increases and the average size of the particles decreases.

Objective: To discuss the method of microsurgical treatment for jugular foramen tumor (JFT)., Methods: Ten patients with dumbbell-shaped JFTs who were microsurgically treated by the same group were retrospectively studied, the surgical approaches includes infratemporal approach and modified far lateral approach according to tumors' size, blood feeding, hearing and growth manner. Cranial nerve function, pre- and postoperative complications, follow-up data were presented and discussed., Results: Gross total tumor removal was achieved in 7 patients, subtotal removal in 2 cases, partial removal in 1 case, postoperative cerebrospinal fluid leaking in 1 cases, postoperative new cranial nerve defects in 1 cases, aggravation in 2 cases. Postoperative deficits of the cranial nerves improved in 80 percent of the patients. Favorable facial function in 6 months postoperatively (House-Brackmann grade system in Grade 1 and Grade 2) was noted in 7 of the 10 patients. The postoperative level of hearing was preserved in 3 of the 6 patients with residual hearing. Recurrence was noted in 1 case during the follow-up period., Conclusions: Surgical total removal of JFT is possible depends on microsurgical operation with the two approaches with lowly additional neurological deficits. The function of preoperative affected cranial nerves can be recovered.

In order to prove the feasibility of preparation of the drug-incorporated stent by immersing stent wires in the monoclonal antibody (mAb) solution, fluorescence stain and image analysis were used to evaluate the L-PLA-coated stent. Absorption was measured using a radioisotope technique after preparing the mAb-incorporated stent, and the absorption curve was determined from the absorption data. In an in vitro perfusion circuit, the antibody was eluted from the stent matrices, and the related influence factors were evaluated based on the release data.

Researches on drug-eluting stents are now focusing on three main aspects: the stent materials, the coating matrix material and the selection, adhesion and controlled release of the biological agents. The current development progresses of the coating materials, their characteristics, and the coating method for metallic stents are reviewed in this paper.

Solid phase microextraction (SPME) is a simple, cost-effective, time-saving extraction technique. It is rapid and highly sensitive. In this study, organic acids in cigarette smoke were extracted with 85 microns polyacrylate coated fiber. Volatile and semi-volatile organic acids, such as butanoic acid, hexanoic acid, 2-furancarboxylic acid, octanoic acid, nonanoic acid, benzoic acid, phenylacetic acid, tetradecanoic acid, and hexadecanoic acid from cigarette smoke were converted to their esters by using methanolic derivatization agent. The esters were extracted by using headspace solid phase microextraction and determined quantitatively by gas chromatography with selected ion monitoring mode mass spectrometry. Qualitative analysis of 4 brands cigarette smoke demonstrated the usefulness of this analytical technique of volatile and semi-volatile acids in cigarette smoke. More than sixty organic acids were detected by using this method.

Transcervical cannulation of the proximal oviduct was performed with a tube catheter and flexible guidewire under hysteroscopic guidance to evaluate and treat intramural fallopian tube obstruction in 37 patients. Hysteroscopic cannulation with direct visualization by laparoscopy was successful in 69.2% of the obstructed tubes, 77.4% of the cases. 74% of the obstructed tubes diagnosed by HSG and/or laparoscopy was patent after hydrotubation and cannulation by hysteroscopy. Transcervical cannulation of the proximal oviduct is an effective method for evaluation and treatment of cornual obstruction.

The results of transcervical salpingography and tubal recanalization by means of modified Thurmond and Rösch's technique were reported. Proximal tubal obstruction was diagnosed in 20 infertile women by X-ray hysterosalpingography and/or laparoscopy. Our results showed that tubal recanalization was achieved in 19(95%) of 20 patients, four patients became pregnanCy following the procedure. Distal tubal diseases were seen in 8 of 20 patients. Follow up studies revealed tubal patency was maintained in 7(54%) of 13 patients. The mean radiation dosage received by the patient was 6.35mGy. Compared with Thurmond and Rösch technique the modified technique has the advantage of decreasing the time of fluoroscopy and is a safe, effective and simple method for the diagnosis and treatment of infertile women with proximal tubal obstruction.

The endometrial concentration of 6-keto-PGF1 alpha and TXB2 were measured by RIA in women with Tcu-IUD induced menorrhagia (MBL greater than 80 ml) and in levonorgestrel-IUD users with oligomenorrhea or amenorrhea. Non-IUD users with normal menses (MBL less than 80 ml) were chosen as control. It was found that the Tcu-IUD group showed a significantly higher 6-keto-PGF1 alpha concentration than the other two groups (P less than 0.01). Conversely, the TXB2 concentration of levonorgestrel-IUD group was significantly higher than that of the other groups (P less than 0.05). As a result, the 6-keto-PGF1 alpha/TXB2 ratio was much higher in Tcu-IUD group (P less than 0.01). Our results indicated that the unbalance of PGI2/TXA2 ratio may be the direct cause of the IUD-induced menorrhagia.

Ultrasonic study of tubal patency using 1.5% hydrogen peroxide as the contrast medium during hydrotubation was performed in 147 sterile women. Hysterosalpingography was also done for the same patients. In 42 cases, laparoscopic examination of the tubes was carried out to assess the accuracy of the above two diagnostic procedures. The correspondence rate between laparoscopic findings and ultrasonography was 88.0% and 60.0% with hysterosalpingography. The difference was statistically significant (P less than 0.05). Animal experiment did not reveal any untoward effect of 1.5% hydrogen peroxide on the local tissues exposed to the solution except a transient increase of lymphocyte infiltration and exudate. Regardless of its numerous advantages, neither hysterosalpingography nor ultrasonic examination can demonstrate minute pathologic changes in the lumen of the tube. The authors pointed out that ultrasonic study combined with laparoscopic examination is the best choice diagnosis for tubal abnormalities.