Volume 100 ·  Issue 46 ·  2020

Lung cancer is currently the most common and fatal malignant tumor in the world. In 2018, there were more than 2.09 million new cases of lung cancer worldwide, and the number of deaths caused by lung cancer was as high as 1.76 million^[1]。 Lung cancer is the most common cancer in men in China^[2]In 2018, there were about 774,000 new lung cancer cases in China, and about 690,000 people died of lung cancer.

To explore the value of speculating etiology of the magnetic resonance imaging (MRI) T1 weighted imaging (T1WI) labyrinthine high signal ratio in patients with unilateral sudden deafness accompanied by vertigo and tinnitus and its relationship with hearing prognosis.

Fifty-two patients with unilateral sudden deafness accompanied by vertigo and tinnitus who were admitted to Beijing Tongren Hospital Affiliated to Capital Medical University from January 2016 to July 2019 were collected, including 27 males and 25 females, aged (47.7±15.1) years. The inner ear MRI data of 52 patients (17 plain scan, 35 enhanced scan) with unilateral sudden deafness were retrospectively analyzed. Two radiologists independently measured the labyrinthine high signal intensity of the affected side and the contralateral normal side on T1WI and enhanced T1WI and calculated the signal ratio (the normal labyrinth signal was subtracted from the affected signal and then divided by the normal signal). The etiology of the enhanced group was judged based on two methods, including whether the abnormal high signal was enhanced or not (unenhancement indicated hemorrhage and enhancement indicated inflammation), and the locations of labyrinthine involvement on enhanced three-dimensional fluid attenuated inversion recovery (3D-FLAIR) (inflammation usually involved the perilymph spaces, while hemorrhage involved the perilymph and endolymph spaces). In the plain group, the locations of labyrinthine involvement on 3D-FLAIR was applied to infer the potential etiology.

The two methods presumed that 8 cases might be hemorrhage (22.9%, 8/35) and 27 be inflammation (77.1%, 27/35) in the enhanced group, which had a high consistency, while it was speculated that 7 patients might be hemorrhage (7/17) and 10 patients be inflammation (10/17) in the plain group. The measurement results of the two radiologists were highly consistent within and between the groups [the intraclass correlation coefficient (ICC) values were greater than 0.800]. The area under the receiver operating characteristic (ROC) curve (AUC) of the T1WI high signal ratio in the enhanced group for speculating etiology was 0.949 (P<0.01), when the predictive threshold value was 0.467, with a sensitivity of 96.3% and a specificity of 87.5%. It might be hemorrhage when the ratio was higher than the threshold value, otherwise it was inflammation. The T1WI labyrinthine high signal ratio was higher in the hemorrhage group than that of the inflammation group, and the hearing prognosis was worse (allP<0.05). The T1WI labyrinthine high signal ratio of the unrecovered group was higher than that of the recovered group (P=0.034).

The etiology of labyrinthine high signal formation can be inferred by quantitative values combined with the involved sites. The high signal in the labyrinth indicates poor hearing prognosis, the higher the signal intensity, the greater the possibility of hemorrhage and the worse the hearing prognosis.

To investigate the correlation between the clinical features of low-frequency sudden deafness and endolymphatic hydrops on gadolinium contrast in the inner ear.

From July 2019 to January 2020, adult patients with unilateral low-frequency sudden deafness who were hospitalized in the outpatient clinic or ward of the Department of Otorhinolaryngology, Eye and ENT Hospital of Fudan University were selected and examined by audiology and gadolinium magnetic resonance (MR) angiography of inner ear. The same treatment plan was given, and the curative effect was recorded and followed up for more than 3 months. SPSS 20.0 software was used to analyze the correlation between the accompanying symptoms, deafness, and endolymphatic hydrops.

A total of 48 patients were included in the study, including 18 males and 30 females. The age ranged from 21 to 52 (37.3±10.0) years. All of them were unilateral, including 28 cases of left ear and 20 cases of right ear. The course of the disease was less than 2 weeks in all cases. The endolymphatic hydrops group included 14 cases, including vestibular hydrocele (6 cases), cochlear hydrops (2 cases), and cochlear and vestibular hydrops (6 cases). The incidence of dizziness in the endolymphatic hydrops group was higher than that in the non-hydrops group (6/14 vs 0/34, P<0.001). There was no significant difference in hearing values between the two groups at 125, 250, 500, 4 000 and 8 000 Hz (allP>0.05). The hearing in the endolymphatic hydrops group was worse than that in the non-hydrops group at 1 000 and 2 000 Hz.

Compared with those without endolymphatic hydrops, patients with hydrops tend to have a higher incidence of dizziness, worse hearing at 1 000 and 2 000 Hz, and a worse prognosis.

To investigate the success rate, safety and repeatability of gadolinium (Gd)-enhanced inner ear magnetic resonance (MR) by tympanic membrane puncture.

The imaging and clinical data of 1 126 cases with Gd-enhanced inner ear MR by tympanic membrane puncture from February 2010 to June 2020 were retrospectively analyzed. All cases were reexamined in the outpatient clinic after MR gadolinium contrast to check the tympanic membrane and external auditory canal. The success rate was identified by whether there was gadolinium contrast in the labyrinth. Meanwhile, the pure tone hearing threshold data of asymptomatic ears before and after gadolinium contrast was collected and compared. The consistency in the scores of the asymptomatic ears in patients who underwent twice Gd-enhanced MR was analyzed, in which the scores of vestibular, cochlea, and semicircular canals were acquired respectively.

Among 1 126 patients [including 506 males and 620 females, aged (54±17) years old], 45 were reviewed once, while 4 patients were reviewed twice. There were 958 cases who were examined on both sides, and 168 cases were checked only on one side. There were 166 cases of Meniere′s disease (14.7%), 219 cases of sudden sensorineural hearing loss (19.5%) and 741 cases of being remained to be investigated (65.8%), respectively. A total of 2 084 ears underwent first gadolinium angiography, of which 63 ears had no contrast agent in the labyrinth, with a success rate of 97.0% (2 021/2 084). Only 1 case had tympanic membrane perforation while the rest had no complications. The hearing threshold before and after otography in 57 asymptomatic ears had no differences at any frequency (all P>0.05). Moreover, the consistency in the scores of two radiography within the 21 asymptomatic ears in vestibular and cochlea was good [both intraclass correlation coefficient (ICC) values>0.75].

The success rate and safety of Gd-enhanced inner ear MR is high by tympanic membrane puncture, and the results can be repeated well.

To investigate the effects of miR-191-5p on cell migration, clone formation and proliferation of gastric cancer (GC) cells.

The level of miR-191-5p expression was detected by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) in 60 paired GC tissues and their adjacent normal tissues. miR-191-5p overexpression was achieved by transfection of construct pcDNA-miR-191-5p into GC cells. The migration, clone formation and proliferation of GC cells were detected by the scratch wound assay, clone formation assay and cell counting kit-8 (CCK-8), respectively. Low expression of miR-191-5p was achieved with miRNA-191-5p inhibitor. The binding sites of cyclin-dependent kinase 6 (CDK6) and miR-191-5p were analyzed using TargetScan software, and the interaction of CDK6 and miR-191-5p was verified using dual-fluorescence reporter gene expression. Western blot (WB) was used to detect the effect of miR-191-5p on the expression of p21 and CDK6 proteins.

miR-191-5p decreased in 53 cases (88%) of GC tissues compared to their controls. Furthermore, overexpression of miR-191-5p effectively inhibited the migration, clone formation and proliferation of GC cells (P<0.05). Dual-fluorescence reporter confirmed that miR-191-5p bound to 3′UTR of CDK6. WB showed that pcDNA-miR-191-5p inhibited the CDK6 expression but promoted the p21.

Down-regulation of miR-191-5p has a correlation with the progression of GC. Overexpression of miR-191-5p can decrease the expression of CDK6 and inhibit the growth of GC cells.

To study the expression and clinical significance of calcineurin B homologous protein 2 (CHP2) in gastric cancer (GC) and its effect on malignant phenotype of GC cells.

The protein expression of CHP2 in 297 GC tissue and 198 normal gastric tissue samples were detected by immunohistochemistry. The relationship between the expression of CHP2 and clinicopathologic parameters of GC were analyzed. CHP2-overexpression plasmids and CHP2-interference plasmids were transfected into GC cell lines respectively. Wound healing assay and Transwell experiment was used to detect the invasion and migration ability of GC cells, and cell counting kit-8 (CCK-8) method was used to detect the proliferation ability of GC cells.

The positive expression rate of CHP2 in GC was 68.7% (204/297), which was higher in benign margin (34.1%) (31/91), chronic gastritis (59.1%) (13/22), intestinal metaplasia (34.2%) (13/38), low-grade intraepithelial neoplasia (40.0%) (12/30) and high-grade intraepithelial neoplasia (41.2%)(7/17). The positive expression of CHP2 was correlated with tumor, node and metastasis (TNM) stage, lymph node metastasis and distant metastasis (all P<0.05), but not with gender, age, Laurén classification, human epidermal growth factor receptor 2 (HER2) levels, depth of invasion, carcinoembryonic antigen (CEA) level and CEA 19-9 level (allP>0.05). The results of multivariate analysis showed that high expression of CHP2 and TNM stage were both independent parameters for predicting GC patient prognosis (bothP<0.05). Interference of CHP2 expression in HGC-27 cells suppressed proliferation and migration significantly (P<0.05). However, over-expression CHP2 in AGS cells promoted proliferation, and migration significantly (P<0.05).

CHP2 plays an important role in the development of GC, which is expected to be a molecular marker for patient prognosis and a potential target of targeted therapy for GC patients.

During the COVID-19 pandemic, the electronic "questionnaire star" was employed to investigate the general situation, medication situation and pandemic impact of children diagnosed with asthma in our hospital and enrolled in the electronic platform of the Chinese Children′s Asthma Action Plan (CCAAP). The internet technology and big data were used to grasp the trend and asthma control of children who had been at home for a long time due to the pandemic, so as to facilitate the management.

By random cluster sampling survey method, according to the needs and medication adherence score, the electronic "questionnaire star" was designed to conduct a survey among children (0 to 14 years old) who diagnosed with asthma and joined the CCAAP on the basis of bronchial asthma medication adherence scale. Finally, the results of electronic questionnaire survey were analyzed.

A total of 423 questionnaires were sent out, 422 of which were valid, with an effective response rate of 99.7%. The results of questionnaire survey showed that 296 cases were male, accounting for 70.1%, and 126 cases were female, accounting for 29.9%, with an average age of (5.4±2.6) years old. The average age of males and females was (5.3±2.6) and (5.4±2.6) years old, respectively. There were more children aged ≥5 years than children who were younger than 5 years. Additionally, 13.95% of the parents thought that the pandemic had more than moderate impact on children with asthma, and 76.12% of the children were in the green zone and had no asthma attack. The proportion of green zone inhaled drugs (79.8%) was higher than yellow zone and red zone (49.8%). After using the CCAAP platform, the dissatisfaction rate was only 1.42%. Moreover, 71.87% of the children′s medical expenses decreased, and the proportion of frequent use and intermittent use of antibiotics reduced, however, the proportion of occasional use and never use of antibiotics increased significantly (all P<0.05). The average score of drug compliance was 4.56, and the more frequently the platform was used, the higher the score of medication compliance was (P<0.05).

After using CCAAP management with the aid of internet technology, children with asthma who had been isolated at home for a long time were less affected by COVID-19, with high medication compliance, generally lower medical expenses, significantly reduced use of antibiotics, and high satisfaction. This management mode provides a new idea for internet medicine.

To determine the oxidative stress and endoplasmic reticulum stress and their changes after α-lipoic acid (α-LA) intervention, and to explore the effect and mechanism of fluoride-induced reproductive lesion.

A total of 40 male Sprague-Dawley (SD) rats were randomly divided into four groups, control group(0.9% sodium chloride), α-LA group(100 mg/kg α-LA), NaF group(25 mg/kg NaF), and NaF+α-LA group(25 mg/kg NaF+100 mg/kg α-LA). Each group was treated in the way of intragastric administration for eight weeks. Sperm quality and the content of NaF in testis were analyzed. The morphologic changes of the testis were observed with the use of HE staining and the apoptosis was detected by the TUNEL assay. Biochemical method was used to measure oxidative stress. Western blot was used to detect the expression of endoplasmic reticulum stress markers, such as GRP78, PERK, and CHOP.

Compared with the control group, the NaF group had a low level in sperm density [(5.99±1.45)×10⁶/ml to (10.96±1.83)×10⁶/ml, P<0.01] and sperm vitality [(33.40±2.71)% vs (66.41±3.33)%,P<0.01], but a high level in sperm abnormality rate [(26.43±2.43)% vs (11.44±1.55)%,P<0.01]. Compared with the NaF group,the NaF+α-LA group had a high level in both sperm density [(8.47±0.82)×10⁶/ml vs (5.99±1.45)×10⁶/ml, P<0.05] and sperm vitality [(49.97±3.51)% vs (33.40±2.71)%,P<0.05], but a low level in sperm abnormality rate [(22.69±2.39)% vs (26.43±2.43)%,P<0.05].There was a significantly higher content of NaF in testis in the NaF group [(11.14±0.77) μg/g vs (5.78±0.28) μg/g,P<0.01] than the control group. Optical microscope was used to observe the morphologic changes of the testis, and it was showed that loose structure appeared both in spermatogenic cells and mature sperm cells while the amount of them decreased. However, after the administration of α-LA, there were complete organelles structure and exfoliated cells in the lumen ameliorated. TUNEL assay found that the apoptotic cells were in a high level in the NaF group [(61.32±7.14)% vs (6.99±2.17)%,P<0.01], while α-LA significantly suppressed the percentage of apoptotic cells in the NaF+α-LA group compared with the Naf group [(45.96±5.31)% vs (61.32±7.14)%,P<0.01].Oxidative stress assays showed that there were higher express of Malondialdehyde(MDA) content [(5.46±0.30) nmol/mgprot vs (3.24±0.58) nmol/mgprot,P<0.01], the activity of Superoxide Dismutase(SOD) [(6.04±0.71) U/mgprot vs (7.19±0.52) U/mgprot,P<0.01] and Glutathione peroxidase(GSH-Px) [(23.67±0.99) U/mgprot vs (26.91±1.67) U/mgprot,P<0.01] in the NaF group than the control group. To compared with the NaF group, the counterpart in the NaF+a-LA group of MDA content was less [(4.66±0.70) nmol/mgprot vs (5.46±0.30) nmol/mgprot,P<0.05] and the GSH-Px activity was high [(25.90±1.93) U/mgprot vs (23.67±0.99) U/mgprot,P<0.05]. Towards the detection of endoplasmic reticulum stress, we found that there were all in higher level in the NaF group that the expression of GRP78 [(0.79±0.05) vs (0.45±0.09),P<0.01], PERK [(0.71±0.04) vs (0.40±0.05),P<0.01], and CHOP[(0.79±0.09) vs (0.19±0.08),P<0.01] than the control group, and to compared with the NaF group, α-LA significantly supressed the expression of GRP78 [(0.46±0.06) vs (0.79±0.05),P<0.01] and CHOP[(0.52±0.09) vs (0.79±0.09),P<0.01].

α-lipoic acid plays a protective role in fluoride-induced reproductive lesion in rats by oxidative stress-mediated endoplasmic reticulum stress.

To systematically review the advances in population research methods of dietary nutrition and human immunity.

Related studies on the relationship between dietary nutrition and human immunity were searched in PubMed, Web of Science, Wanfang and China National Knowledge Infrastructure (CNKI) databases from the start date to January 10, 2020. A systematic review of the literatures that met the requirements was carried out.

Totally 114 articles were included, including 4 Chinese articles and 110 English articles. There were 22 cross-sectional studies, 16 case-control studies, 41 cohort studies and 35 intervention studies, respectively. The research methods showed a trend of diversification over time. In recent years, the derivative types of case-control studies such as nested case-control studies and case cohort studies received attention. Research factors gradually shifted from a single nutrient or dietary ingredient to food and dietary patterns. The protective effect of nutrition on gene damage, the effect on altering gene expression, and the regulatory effect of genetic polymorphism on the sensitivity of nutrients and inflammatory markers became research hotspots.

The epidemiologic research methods of dietary nutrition and human immune function are constantly improving and developing, which play an important role in fully demonstrating the relationship between nutrition and human immune function.

To systematically review the studies on impact of macronutrients and micronutrients on human′s immunity including cell-meditated immunity and humoral immunity as well as disease outcome.

The database searched included Wan Fang Data, China National Knowledge Infrastructure, PubMed and Web of Science. "Nutrients" , "food" , "diet structure" , "diet pattern" , "protein" , "fat" , "vitamin" , "mineral" etc. were searched in Chinese and English for nutrition related terms, and "inflammation" , "inflammatory" , "oxidative stress" , "immune" , "immunity" etc. were searched for immunity related terms in Chinese and English respectively for published articles till Jan. 10th, 2020.

A total of 53 articles including 18 Chinese articles and 35 English articles were included in this review. Studies mainly focused on the relationship between nutrients such as iron, zinc, vitamin A, vitamin D, vitamin E and fatty acids and immunity. In a summary, insufficiency or deficiency of nutrients would impact immunity of humans which was mostly reflected in changes of CD3⁺, CD4⁺, CD4⁺/CD8⁺, IgA and IgG levels. Furthermore, nutrient intake level or serum level was associated with disease outcomes such as prevalence, occurring risk or severity of symptoms. Interventions studies on n-3 polyunsaturated fatty acid (n-3 PUFA), zinc and vitamin A confirmed the positive effects of such nutrients on immunity and disease outcome.

The intake level or serum level of nutrients is associated with cell-meditated immunity and humoral immunity. Optimal status of nutrients plays an important role in effectively strengthening immune system and disease defense of humans.

In percutaneous nephrolithotomy (PCNL), it is essential to establish safe access to stone removal with the help of imaging equipment. Literature reports show that the success rate of ultrasound-guided percutaneous lithotomy for non-hydronephrotic kidney stones is significantly lower than that of patients with hydronephrosis (82% vs. 98.2%). In addition, puncture is more challenging for patients with renal dysplasia and scoliosis. The syngo iGuide navigation system is a three-dimensional (3D) virtual needle tracking system that helps predict and observe the trajectory of the needle, enabling real-time monitoring of the target. In order to study the establishment of percutaneous nephrolithotomy access for non-hydronephrotic kidney stones, the study collected the data of 442 patients with non-hydronephrotic kidney stones admitted from May 2014 to May 2015 who needed to establish percutaneous nephrolithotomy access for PCNL. 33 of them underwent C-arm CT with 3D virtual navigation to establish percutaneous nephrolithotomy access after conventional ultrasound-guided operation failed. The results showed that the technical success rate was 97% (32/33). The puncture sites were in the upper calyx of the kidney in 18 cases, the middle calyx of the kidney in 8 cases and the lower calyx of the kidney in 6 cases. One-needle puncture was successful in 22 cases (66.7%), and adjustment of puncture needle was successful in 10 cases (30.3%). A female patient with severe chronic obstructive pulmonary disease had a calculus of 2.5 cm diameter in the inferior calyx of the left kidney. More than 10 attempts to adjust the puncture needle were unsuccessful due to the poor quality of the C-arm CT image due to her difficulty in holding her breath. The calculus-free rate confirmed by CT scan after surgery was 93.8%. Two patients with staghorn calculi had residual calyces in the inferior calyces due to the difficulty of nephroscopy to access the inferior calyces through a single superior calyces channel. One patient (3.1%) experienced fever (39.1 °C) 1 h after establishment of pelvic lithotomy access, which returned to normal after injection of lysypyrine (0.9 g), and one elderly patient (3.1%) experienced a decrease in hemoglobin (5 g/L), was given volume expansion therapy with infusion, no blood transfusion, and the vital signs were stable.