Volume 97  ·  Issue 45  ·  2017

Alzheimer's disease (AD) is the most common type of senile dementia. It is a progressive central nervous system degenerative disease. The main clinical manifestations are comprehensive decline of cognitive function, accompanied by abnormal personality and mental behavior, and final loss of daily life ability. The World Health Organization (WHO) estimates that the prevalence of AD in the global population over 65 years old is 4% to 7%, and in the elderly population over 85 years old, the prevalence of AD can be as high as 20% to 30%. It is estimated that there will be more than 80 million patients with AD worldwide by 2040. AD not only brings great pain to patients, but also brings heavy mental pressure and medical and care burden to families and society. It has become a social public health problem that cannot be ignored. Therefore, the research on AD has become one of the hot spots in the research of senile degenerative diseases.

To investigate the damage of gray matter structure in MRI-negative epilepsy patients with different symptoms by voxel-based morphometry (VBM).

From June, 2009 to October, 2016, ninety MRI-negative epilepsy patients and thirty-five healthy volunteers underwent the 3T magnetic resonance imaging scan in Nanjing General Hospital. The patients were divided into three groups, including idiopathic generalized tonic-clonic seizure (I-GTCS), secondarily generalized tonic-clonic seizure (S-GTCS), and partial seizure (PS) according to different symptoms. The three-dimensional high-resolution T1 structural MRI data was obtained for the voxel-based morphometry. Data of gray matter structure from four groups were compared using one-way analysis of variance (ANOVA). An independent-sample t test was performed in order to compare gray matter volume of the three patient groups with controls respectively. According the results of ANOVA, impaired brain regions were selected as regions of interest in order to carry out correlation analysis between gray matter volume and disease duration.

ANOVA showed significant differences in gray matter structure of bilateral thalamus and frontal lobe between four groups (alphasim correction, P<0.01). Independent-samplet test showed that the volume of bilateral thalamus and frontal lobe decreased in all three patients groups (alphasim correction, P<0.01) .The volume of bilateral thalamus showed significantly negatively correlation with disease duration in I-GTCS patients (r=-0.466, P<0.01).

Generalized seizures and partial seizures all can cause damage to the gray matter structure, especially in thalamus and frontal lobe. The impairments of thalamus and frontal lobe in patients with different seizure types are different with the progression of disease, which suggests that influences of different epilepsy seizures on the thalamo-cortical network are different.

To investigate the features of cognitive impairment and potential physiopathologic mechanism using neuropsychological assessment and resting state functional magnetic resonance imaging (rs-fMRI) in patients with leukoaraiosis (LA).

A total of 13 patients with LA (LA group) and 13 healthy controls (NC group) from Shanxi Provincial People′s Hospital between January and June 2016 were recruited. The two groups were matched for age, sex, education, and vascular risk factors. All the subjects underwent neuropsychological assessment and the scan of rs-fMRI. The neuropsychological scores and the brain areas had significant differences of cerebral spontaneous activity in resting state of the two groups were compared, and the relationship between the scores and the amplitude of low frequency fluctuation (ALFF) were evaluated in these areas.

LA group was associated with comprehensive cognitive impairment, including minimum mental state examination (MMSE) (LA group: 23.3±10.7 vs NC group: 29.7±0.6), montreal cognitive assessment (MoCA) (22.7±10.7 vs 29.5±0.7), digit span test (DS) forwards (6.5±3.2 vs 8.7±1.1) and backwards (4.2±2.2 vs 6.2±0.9), trail making test (TMT) part A (168±136 vs 47±10), immediate memory (6.1±3.5 vs 11.0±2.2) and delayed memory (4.7±2.8 vs 11.0±2.4) of auditory verbal learning test (AVLT), Stroop B (60±34 vs 32±7) and C (127±72 vs 48±12), verbal similarity test (16.5±8.1 vs 23.1±2.5) (all P<0.05). Compared with the NC group, patients with LA showed decreased ALFF in areas of the right posterior cingulate cortex (PCC), precuneus_R, cuneus, postcentral_R, precentral_R, calcarine_R (allP<0.05). After adjustment for the influences of age, sex and education, the correlation analysis showed that right PCC, precuneus_R, cuneus, postcentral_R, etc, were closely related with cognitive impairment.

Patients with LA exhibits significant cognitive impairment, such as executive function, memory, attention and information processing speed. And cognitive impairment of LA is related to abnormal cerebral spontaneous activity, especially in areas of right PCC, precuneus_R, cuneus, etc.

Using magnetic resonance diffusion kurtosis imaging (DKI) to evaluate the microstructure changes of deep brain nucleus in Parkinson′s disease (PD) as well as the correlation with clinical manifestations.

Thirty-two PD patients were recruited into this study. Twenty gender and age matched healthy subjects served as the control group. All participants underwent MRI examinations, including T₁WI, T₂WI, DWI, susceptibility weighted imaging (SWI) and DKI. The original DKI imaging data were processed offline to calculate two parametric maps, including mean kurtosis (MK) value and fractional anisotropy (FA) value. Two DKI parameters measured from head of substantia nigra were compared between the two groups using t-test or Mann-Whitney U test according to data distribution. The correlations of the two DKI parameters in the substantia nigra of PD patients with the disease duration and clinical scales were tested by Spearmen or Pearson analysis according to data distribution. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of MK value in the substantia nigra for PD.

MK value in the substantia nigra of PD group (1.29±0.05) was significant higher than that of the control group (1.26±0.06) (t=2.24, P=0.03). There was no significant difference in FA value between the two groups. Spearmen correlation analysis revealed that there was no significant association of two DKI parameters in substantia nigra of PD patients with the disease duration and clinical scales.

MR DKI of deep brain nucleuses can be useful for the diagnosis of PD, but it is not suitable to evaluate the degree of PD clinical symptoms.

To study resting-state functional connectivity (FC) of default mode network (DMN) in adolescent patients with first-episode drug-naive major depressive disorder (MDD).

We enrolled thirty first-episode and drug-naive adolescent MDD patients and twenty-nine adolescent healthy control (HC) participants in the First Affiliated Hospital of Zhengzhou University. There were no differences in age, sex, and education between the MDD and HC group. Resting-state functional magnetic resonance images (fMRI) was performed. We selected posterior cingulate cortex (PCC) and medial prefrontal cortex (MPFC) of DMN as regions of interests (ROI). The differences of these regions from the whole brain functional connectivity were analyzed. The relations between abnormalities in FCs of DMN and clinical variables were further investigated.

Compared to the HCs, the MDD patients had congruently reduced FCs between the PCC and cerebellum, temporal cortices, occipital cortices, fusiform, dorsolateral prefrontal cortex. MPFC not only had reduced FCs with fusiform, temporal cortices, anterior cingulate cortex, but also had enhanced FCs with occipital cortices, parietal cortices, and precentral gyrus. In addition, the increased FC between the right MPFC and right precentral gyrus was positive correlated with Hamilton Rating Scale for Depression (HAMD) scores (r=0.38, P=0.04). The reduced FC between the left middle temporal gyrus and left PCC as well as the enhanced FC between the right middle cingulum and right MPFC were positive correlated with the duration of depression since onset (r=0.39, P=0.03; r=0.38, P=0.04).

These findings show dysfunctional DMN connectivity of adolescent MDD patients. Neurodevelopmental abnormalities in DMN may present in adolescent MDD.

The study was designed to evaluate the effect of follicular fluid from patients with endometriosis, follicle stimulating hormone (FSH), bone morphogenetic protein 15 (BMP-15) on the proliferation and progesterone secretion of human luteinized granular cells in vitro.

Cumulus granulosa cells were collected from the patients who underwent in vitro fertilization and embryo transfer (IVF-ET) ovulation due to tubal or male factor infertility on the day of the retrieval. The cells in the control group were cultured with complete medium of DMEM/F-12, an extra of FSH at a dose of 12 μg/L was added in the FSH group, an extra of BMP-15 at a dose of 6 μg/L was added to the BMP-15 group, an extra of 5% of the follicular fluid from the patients with tubal or male factor infertility was added to the tubal group, an extra of 5% of the follicular fluid from the patients with endometriosis infertility was added to the endometriosis group, an extra of 5% of the follicular fluid from the patients with endometriosis infertility plus FSH at a dose of 12 μg/L were added to the endometriosis plus FSH group, and an extra of 5% of the follicular fluid from the patients with endometriosis infertility plus BMP-15 at a dose of 6 μg/L were added to the endometriosis plus BMP-15 group. Hemacytometer counting method was used to observe the growth of cells after 48 hours, and chemiluminescence method was utilized to measure the level of progesterone in culture supernatant.

The cell proliferation was enhanced in the FSH group, while the proliferation was inhibited in the endometriosis group and the endometriosis plus BMP-15 group, compared to the control group, both of which, were statistically significant. Compared to the control group, the progesterone levels from the culture supernatant of granular cells were significantly elevated in the FSH group, tubal group and endometriosis group. The secretion of progesterone in the endometriosis group was lower than that in the tubal group. After addition of FSH into the endometriosis group (the endometriosis plus FSH group), the secretion level of progesterone was significantly increased, compared to the control group and the endometriosis group. After adding BMP-15 into the endometriosis group (the endometriosis plus BMP-15 group), the secretion level of progesterone was increased, compared to the control group.

FSH, but not BMP-15, was able to enhance the proliferation and progesterone secretion of granular cells. The proliferation of granular cells and secretion of progesterone were inhibited by the follicular fluid from patients with endometriosis, which was reversed by FSH. However, BMP-15 had no effect on the outcome of follicular fluid from patients with endometriosis.

To evaluate incidence of postoperative ventricular arrhythmias in patients who received cardiac resynchronization therapy defibrillator (CRT-D ) with left ventricular quadripolar lead.

The patients received CRT-D who had complete follow-up data in Anhui Provincial Hospital from June 2013 to June 2016 were included and divided into quadripolar lead group and bipolar lead group according to the type of left ventricular lead. And ventricular arrhythmia (VA), implantable cardioverter-defibrillator (ICD) shocks treatment, antitachycardia pacing therapy (ATP), and other indicators of the two groups were compared. Prognosis of the two groups was assessed by re-hospitalization for heart failure and cardiac death.

Of the 220 patients enrolled in the study, 58 patients were in quadripolar lead group and 162 in bipolar lead group, and there were no significant differences in baseline characteristics between the two groups. The VA episode per patient was not significantly different between the two groups [(0.60±2.38) VA per person vs (0.93±2.24) VA per person, P=0.055]; the quadripolar lead group had significantly lower burden of VA compared with bipolar lead group [(0.22±0.91) per person-year vs (0.46±1.13) per person-year, P=0.044]. Compared with bipolar lead group, there were significant reduction in both the ICD shocks per patient and the burden of ICD shocks in quadripolar lead group: [(0.12±0.36) shocks per person vs (0.23±0.52) shocks per person, P=0.034] and [(0.04±0.17) per person-year vs (0.12±0.46) per person-year, P=0.029], respectively. There were no significant differences between the two groups in both the ATP per patient and the burden of ATP: [(1.07±3.77) ATP per person vs (1.26±3.01) ATP per person, P=0.073] and [(0.38±1.39) per person-year vs (0.63±1.48) per person-year, P=0.058], respectively. And there were no significant differences between the two groups for the survival (P=0.496).

Compared with bipolar lead group, the burden of VA could be significantly reduced after CRT-D in the quadripolar lead group.

To compare the early clinical effect of septal myectomy and percutaneous transluminal septal myocardial ablation (PTMSA) on the left ventricular outflow obstruction and the rate of complication in patients with hypertrophic obstructive cardiomyopathy (HOCM).

A total of 204 patients with HOCM who received septal reduction treatment were recruited. These patients were divided into two groups, surgery group (n=135) (65 patients with modified Morrow procedure, 70 patients with non-Morrow myomectomy) and PTMSA group (n=69). The baseline characteristics, disease status, other history of surgery and echocardiography parameters before and after septal reduction were collected, as well as the complication within 1 week after operation.

The mean age in surgery group was (46±14) years old, with 76 males (56.3%); mean age was (47±11) years old and with 51 males (73.9%) in PTMSA group. There was no significant difference in age, gender, the time of symptom and diagnosis, syncope, family history and atrial fibrillation between the two groups (all P>0.05). The proportion of mitral valve prolapse in the surgery group was higher than that in PTMSA group (75.8% vs 44.2%,P<0.05). Baseline left ventricular outflow tract (LVOT) gradient was comparable (82.7 mmHg in surgery group vs 77.7 mmHg in PTMSA group,P>0.05). The mean resting LVOT gradient after septal reduction therapy was lower (16.55 mmHg in surgery group, 26.68mmHg in PTMSA group) than that before operation, with lower gradient in surgery group (P<0.05). Compared with PTMSA group, the duration of hospitalization was longer in surgery group (P<0.05). There was similar rate of operation related complications in the two groups.

Both septal reduction therapies can improve the LVOT obstruction, more significant in surgery group, but with longer hospital stay. The rate of operation related complication is similar in both groups.

To explore the clinical efficacy of rivaroxaban in the prevention and treatment of postoperative deep vein thrombosis (DVT) for severe traumatic brain injury (sTBI).

Patients with sTBI who met the inclusion criteria were enrolled in this study, including 119 males (75.8%) and 38 females (24.2%), aged (38.75 ± 11.98) years old. DVT was prevented and treated according to the DVT screening and anticoagulation regimen. Intermittent venous compression was used on all of the patients to prevent DVT, and D-dimer dynamic monitoring and regular ultrasound were performed to screen for DVT. For patients with stable intracranial hemorrhage, rivaroxaban was used when the D-dimer was declining continuously and high risks exist at the same time, or the DVT was diagnosed. Drug withdrawal was performed according to the regimen. The clinical information, D-dimer dynamic changes, rivaroxaban application, DVT, and bleeding complications were analyzed retrospectively.

None of the patients with continuously declining D-dimer was diagnosed with DVT according to the ultrasound examination. Of the 45 patients without progressively declining D-dimer, 43 cases were diagnosed with DVT. Rivaroxaban was used in 47 cases (29.9%) to prevent DVT and 43 cases (27.4%) to treat DVT, and the medication time was (16.3±6.5) and (49.3 ± 9.9) days, respectively. None was diagnosed with DVT after prophylactic administration, and 1 case relapsed after therapeutic administration. During the 6-months follow-up after injury, hematuria occurred in 3 cases, tracheotomy errhysis in 1 case and hemorrhoids bleeding in 1 case. Symptomatic pulmonary embolism, intracranial hemorrhage and fatal bleeding did not occur in any of the cases.

The application of rivaroxaban is safe and effective in preventing and treating the postoperative DVT.

To evaluate gray matter structure changes in long-term male smokers by voxel-based morphological method.

Fifty long-term smokers and 37 non-smoking healthy volunteers were scanned with Siemens Skyro 3.0T magnetic resonance scanner from August 2014 to August 2016. The subjects underwent routine MRI (excluding intracranial lesions) sequences and 3D-T1 structural sequences (3D-mprage). SPM8 pretreatment based on Matlab was used to analyze the structural data. All of the data were analyzed by SPM8 software. The data were compared between groups with independent sample t test. Spearman correlation analysis was used to analyze the relationship between gray matter volume (GMV) and smoking data of two groups.

The gray matter volume of bilateral thalamic, right supramarginal gyrus, left supramarginal gyrus and left putamen of smoking group were (0.55±0.07), (0.40±0.05), (0.48±0.07) and (0.14±0.04) voxels, respectively, and the gray matter volume of the corresponding gyri in control group were (0.61±0.09), (0.43±0.06), (0.54±0.07) and (0.16±0.03) voxels, respectively; and the gray matter volume of smoking group were all lower than those in control group (t=-3.81, -3.51, -3.86, -2.33, all P<0.05), family wise error (FWE) correction (P<0.05). The gray matter volume of bilateral thalamus, right supramarginal gyrus and left putamen was negatively correlated with smoking index (r=-0.368, -0.189, -0.274, all P<0.05), and also negatively correlated with smoking years (r=-0.391, -0.221, -0.355, all P<0.05), and bilateral thalamus gray matter volume was negatively correlated with daily cigarette smoking (r=-0.186, P<0.05).

The changes of brain structure of smokers mainly occur on reward-related pathways and marginal systems, and related to accumulation of cigarette smoking.

To investigate the image quality and radiation dose with wide-detector(80 mm) and adaptive statistical iterative reconstruction-V (ASIR-V) technique at abdominal contrast enhanced CT scan.

In the first phantom experiment part, the percentage of ASIR-V for half dose of combined wide detector with ASIR-V technique as compared with standard-detector (40 mm) technique was determined. The human experiment was performed based on the phantom study, 160 patients underwent contrast-enhanced abdominal CT scan were prospectively collected and divided into the control group (n=40) with image reconstruction using 40% ASIR (group A) and the study group (n=120) with random number table. According to pre-ASIR-V percentage, the study group was assigned into three groups[40 cases in each group, group B: 0 pre-ASIR-V scan with image reconstruction of 0-100% post-ASIR-V (interval 10%, subgroups B0-B10); group C: 20% pre-ASIR-V with 20%, 40% and 60% post-ASIR-V (subgroups C1-C3); group D: 40%pre-ASIR-V with 40% and 60% post-ASIR-V (subgroups D1-D2)]. Image noise, CT attenuation values and CNR of the liver, pancreas, aorta and portal vein were compared by using two sample t test and One-way ANOVA. Qualitative visual parameters (overall image quality as graded on a 5-point scale) was compared by Mann-Whitney U test and Kruskal-Wallis H test.

The phantom experiment showed that the percentage of pre-ASIR-V for half dose was 40%. With the 40% pre-ASIR-V, radiation dose in the study group was reduced by 35.5% as compared with the control group. Image noise in the subgroups of B2-B10, C2-C3 and D1-D2 were lower (t=-14.681--3.046, all P<0.05) while CNR in the subgroups of B4-B10, C2-3 and D1-D2 were higher(t=2.048-9.248, all P<0.05)than those in group A, except the CNR of liver in the arterial phase (AP) in C2, D1 and D2 and the CNR of pancreas in AP in D1 (t=0.574-1.327, all P>0.05). The subjective image quality scores increased gradually in the range of 0-60% post-ASIR-V and decreased with post-ASIR-V larger than 70%. The overall image quality of subgroup B3-B8, C2-C3 and D1-D2 were higher than that in group A (Z=-2.229--6.533, all P<0.05).

Compared with stand-detector together with ASIR technique, wide-detector combined with 40% pre-ASIR-V technique with 60% post-ASIR-V image reconstruction can reduce radiation dose while maintain good overall image quality.

To evaluate the feasibility of susceptibility weighted imaging (SWI) to reflect the progression of renal fibrosis (RF) induced by unilateral ureteral obstruction (UUO) in rabbits.

Total of 32 New Zealand white rabbits (aged 4-5 months) were used to establish the UUO model (RF group) and were divided into 4 subgroups (including RF-2W group, RF-4W group , RF-6W group and RF-8W group) according to the duration of obstruction(2, 4, 6 and 8 weeks). Another 8 rabbits, underwent sham operation, were used as the control group (Sham group). T2 weighted imaging (T₂WI) and SWI sequences were performed on the rabbits at 2, 4, 6 and 8 weeks after UUO, respectively. Rabbits were sacrificed and specimens were obtained after MR examination, then hematoxylin&eosin staining and Masson staining were performed to explore the renal tubular injury and interstitial fibrosis. The relationship between the relative signal-to-noise ratio(rSNR)measured on the SWI fusion maps and the degree of renal fibrosis was analyzed. Analysis of variance was used to compare the difference of rSNRs among 5 groups.

The rSNRs of the inner medulla gradually decreased over time, the rSNRs of Sham group, RF-2W group, RF-4W group, RF-6W group and RF-8W group was 2.29±0.18, 1.73±0.30, 1.67±0.08, 1.42±0.28, 1.12±0.15, respectively (F=25.876, P<0.01). In RF-2W group, the rSNRs of the outer medulla and cortex increased when compared with those in the Sham group, then they decreased gradually over time in the other groups (F=5.230, 7.621, both P<0.05). The pathological results demonstrated that the morphology of renal tubules in Sham group was normal and no apoptosis or necrosis was seen in the tubular epithelial cells. In the RF-2W group, the main pathological manifestations included renal tubules dilatation, tubular epithelial cell degeneration or necrosis and the infiltration of inflammatory cell. In Masson staining, lots of blue areas were present in the interstitial. As the obstruction time prolonged, the renal tubular collapse, inflammatory cells and fibroblasts increased significantly. Meanwhile blue area also increased significantly in Masson staining.

SWI can be used as a noninvasive method to evaluate the pathological progression of fibrosis in the rabbit UUO model.

To reduce the stemness maintenance ability of endometrial cancer stem cell and increase its sensitivity to chemotherapy by inducing hypoxia inducible factor 1α (HIF-1α) protein deSUMOylation.

Lentiviral plasmid mediated ubiquitin carrier protein 9 (Ubc9) gene silencing was transgened into KLE endometrial carcinoma cells. The expression of Ubc9, small ubiquitin-related modifier 1(SUMO1) and HIF-1α protein was detected by Western blotting. Then tumor stem cells clones were cultured in 96 well plates, and these clone balls diameter were calculated. Cell cycles were determined by flow cytometry. MTT cytotoxicity assay and flow cytometry method were used to test sensitivity of cisplatin to endometrial cancer stem cell.

The results of Western blotting showed that Ubc9 gene was silenced well, and the covalent binding state of SUMO-1 and HIF-1α protein levels were significantly decreased (P<0.05). Ubc9 gene silencing in endometrial cancer cells reduced clone formation rate by (31.61±5.29)% down to (11.42±3.07)%, while the cell cycle shift from G1 to G2. IC50 of cisplatin decreased from 44.37 mg/L to 7.39 mg/L, and the rate of cell apoptosis by (41.59±5.37)% down to (26.22±4.03)%.

The stemness maintenance ability of endometrial cancer stem cell can be reduced through deSUMOylation of HIF-1α protein by silencing Ubc9 gene expression, and their sensitivity to chemotherapy be enhanced, which provides a new reference for future gene therapy of endometrial carcinoma.

To study the effect of intermittent negative pressure on matrix metalloproteinase 9 (MMP)-9 and transforming growth factor β of tendon-bone interface and joint fluid after reconstruction of anterior cruciate ligament in rabbits.

A total of twenty-four New Zealand white rabbits were randomly selected hind leg of negative group, contralateral hind leg as control.Reconstruction of the anterior cruciate ligament was done by autogenous semitendinosus of rabbit.Joint of the negative pressure side placed drainage tube connecting the micro-negative pressure aspirator, and maintained an intermittent, low-intensity negative pressure.Control side placed ordinary drainage tube.Drainage tube of both sides was pulled out at the same time after 5 days.After 6 weeks, joint fluid and femur-ligament-tibia complex were obtained for study of expression of MMP-9 and TGF-β in joint fluid and tendon-bone interface.

Twenty-three rabbits were included in the study because of one rabbit joint infections.Detection of joint fluid showed that MMP-9 content is significantly lower in negative group than that in the control group, and the difference is statistically significant [(8.9±1.3) pg/L vs (12.3±1.8) pg/L (P=0.002)]. TGF-β content is significantly higher in negative group in joint fluid than that in the control group, and the difference is statistically significant [(19.0±2.2) pg/L vs (15.2±1.4) pg/L (P=0.000)]. Study of immunohistochemistry in tendon-bone interface found that expression of MMP-9 is lower in negative pressure group than that in the control group, and the difference is statistically significant (P=0.000). TGF-β expression is significantly higher in negative group in tendon-bone interface than that in the control group, and the difference is statistically significant (P=0.000).

Intermittent negative pressure may reduce content of MMP-9 in joint fluid and expression of MMP-9 in tendon-bone interface, increase content of TGF-β in joint fluid and expression of TGF-β in tendon-bone interface after reconstruction of anterior cruciate ligament in rabbits.

The 6-year-old child was transferred to the Department of Pediatrics of Zhengzhou People's Hospital on January 21, 2017 due to "fever, cough for 17 days, vomiting, abdominal pain for 5 days, unsteady walking and drowsiness for 3 days". Usually prone to "respiratory infections". 17 days ago, after catching a cold, he had fever and cough, and the highest body temperature was unknown. He was proposed to be diagnosed with lobar pneumonia, and the treatment effect of drugs such as "azithromycin and cephalosporin antibiotics" was not good. He was transferred to the municipal children's hospital and performed fiberoptic bronchoscopy. He was given "cefotaxime" treatment and the fever stopped. After 5 days of greasy food, abdominal pain and vomiting occurred, accompanied by fatigue, inability to stand, lethargy, and poor treatment effect. 3 days ago, I had instability in sitting, standing and walking, drowsiness, inability to sit up from the recumbent position, no diplopia and blurred vision.

Modern anti-cancer therapy has significantly reduced the mortality of cancer patients, but its cardiovascular toxicity has become the main determinant of patient prognosis. According to the particularity of cancer patients, a new discipline-onco-cardiology or cardio-oncology has emerged. Because large randomized clinical trials mostly exclude cancer patients, little information is available on this population. In order to guide the clinical treatment of this group, expert consensus has recently been issued in Europe and the United States^[1]Position Statement^[2]And guidelines^[3,4]。 This article mainly introduces the evaluation and management of chemotherapy-induced coronary artery toxicity.

Quality of life, as defined by the World Health Organization, is a multidimensional construction of an individual's perception of their position in life in the context of culture and values, in relation to the individual's goals, expectations, standards and concerns. Individual physical health, mental state, degree of independence, social relations, personal beliefs and their relationship with the distinctive characteristics of the environment, etc., affect the quality of life in complex ways^[1]。 Endometriosis (hereinafter referred to as endometriosis) is one of the most common benign gynecological diseases, affecting approximately 10% of women during the reproductive period. The negative impact on the patient's physique, mental psychology and social function leads to problems in all areas of life, including career, personal relationships, sexual life, social and family relationships, etc. The study of quality of life related to endometriosis not only has guiding value for diagnosis and treatment, but also is an important topic related to health economics. In prospective multicenter studies, the economic loss caused by endometriosis was similar to that of other chronic diseases (such as diabetes, Crohn's disease and rheumatoid arthritis)^[2,3], disruption and decline in quality of life levels are predictors of endometriosis-related economic losses. The research on quality of life related to endometriosis has received more attention in recent 10 years, and there were few relevant reports and analyses before 2006.

Globally, liver cancer is one of the malignancies causing a serious disease burden, with the sixth highest incidence and second highest mortality among all malignancies. Its incidence has regional characteristics, with East Asia and Africa as high-incidence areas. In 2012, Chinese patients accounted for 50% of new liver cancer cases worldwide^[1]。 Among primary liver carcinomas, hepatocellular carcinoma accounts for the vast majority. However, Chinese patients with hepatocellular carcinoma have obvious characteristics in terms of demography, risk factors and clinical stage. A total of 18 031 patients with hepatocellular carcinoma from 14 countries were included in a global large retrospective cohort study (BRIDGE study). Among them, 8 683 patients in mainland China were at a young age of onset, had a high rate of hepatitis B virus (HBV) infection (77%), and had a late tumor stage (58% of patients were advanced and terminal at the time of diagnosis).^[2]。 Therefore, there are certain particularities in the comprehensive management of hepatocellular carcinoma patients in China.