Comprehensive treatment and a rare presentation of Cronkhite–Canada syndrome: Two case reports and review of literature

BACKGROUND Cronkhite–Canada syndrome(CCS)is a rare sporadic polyposis syndrome that presents with gastrointestinal and ectodermal symptoms in addition to nutritional deficiencies.CCS combined with hypothyroidism is an even rarer condition,with no standard treatment guidelines.CASE SUMMARY The present study described 2 patients with CCS:A 67-year-old woman with concomitant hypothyroidism and 68-year-old man treated with endoscopic mucosal resection(EMR).Both patients had multiple gastrointestinal symptoms and ectodermal changes,along with multiple gastrointestinal polyps.Microscopic examination showed that the mucosa in both patients was hyperemic and edematous,with pathologic examination showing distorted,atrophic,and dilated glands.Patient 1 had concomitant hypothyroidism and was treated with levothyroxine.Due to her self-reduction of hormone dose,her disease relapsed.Patient 2 underwent EMR,but refused further hormonal or biological treatments.Subsequently,he was treated with an oral Chinese medical preparation.CONCLUSION Pharmacotherapy can induce and maintain remission in CCS patients,with adjuvant EMR,long-term follow-up,and endoscopic surveillance being necessary.Case 1:Based on the aforementioned findings,Patient 1 was diagnosed with CCS and hypothyroidism.Case 2:Based on the aforementioned findings,Patient 2 was diagnosed with CCS.

Expert consensus of Chinese Association for the Study of Pain on the radiofrequency therapy technology in the Department of Pain

On the basis of continuous improvement in recent years,radiofrequency therapy technology has been widely developed,and has become an effective method for the treatment of various intractable pain.Radiofrequency therapy is a technique that uses special equipment and puncture needles to output ultra-high frequency radio waves and accurately act on local tissues.In order to standardize the application of radiofrequency technology in the treatment of painful diseases,Chinese Association for the Study of Pain(CASP)has developed a consensus proposed by many domestic experts and scholars.

Protective effect of Wnt-5a against amyloid beta-induced memory impairment in rats

Recent studies suggest that the activation of the Wnt signaling pathway improves memory function in rats.This study investigated the effects of Wnt-5a on amyloid β （Aβ）-induced cognitive impairment.Aβ25-35 was injected into the rat right lateral ventricle to induce Alzheimer＇s disease-associated pathology,and Wnt-5a was injected as a potential therapeutic treatment.Immunofluorescence staining showed that compared with normal rats,Aβ25-35 significantly decreased postsynaptic density-95 protein expression in the rat hippocampal CA1 region,but Wnt-5a pretreatment blocked this decrease.This study shows that Wnt-5a can reduce Aβ-induced cognitive impairment,and that it has the potential to be a new therapeutic strategy for the treatment of Alzheimer＇s disease.

A plastic stabilizer dibutyltin dilaurate induces subchronic neurotoxicity in rats

Dibutyltin dilaurate functions as a stabilizer for polyvinyl chloride. In this study, experimental rats were intragastrically administered 5, 10, or 20 mg/kg dibutyltin dilaurate to model sub-chronic poisoning. After exposure, our results showed the activities of superoxide dismutase and glutathione peroxidase decreased in rat brain tissue, while the malondialdehyde and nitric oxide content, as well as nitric oxide synthase activity in rat brain tissue increased. The cell cycle in the right parietal cortex was disordered and the rate of apoptosis increased. DNA damage was aggravated in the cerebral cortex, and the ultrastructure of the right parietal cortex tissues was altered. The above changes became more apparent with exposure to increasing doses of dibutyltin dilaurate. Our experimental findings confirmed the neurotoxicity of dibutyltin dilaurate in rat brain tissues, and demonstrated that the poisoning was dose-dependent.

Small cell lung cancer starting with diabetes mellitus: Two case reports and literature review

BACKGROUND Small-cell lung cancer(SCLC)is a type of fatal tumor that is increasing in prevalence.While these are unpleasant facts to consider,it is vitally important to be informed,and it is important to catch the disease early.Typically,lung cancer does not show severe clinical symptoms in the early stage.Once lung cancer has progressed,patients might present with classical symptoms of respiratory system dysfunction.Thus,the prognosis of SCLC is closely related to the early diagnosis of the disease.Ectopic adrenocorticotropic hormone(ACTH)syndrome(EAS)is related to cancer occurrence,especially for SCLC with the presence of Cushing's syndrome,which is dependent on markedly elevated ACTH and cortisol levels.CASE SUMMARY In the current report,we describe two middle-age patients who were originally diagnosed with diabetes mellitus with no classical symptoms of lung cancer.The patients were eventually diagnosed with SCLC,which was confirmed by bronchoscopic biopsy and histopathology.SCLC-associated diabetes was related to EAS,which was an endogenous ACTH-dependent form of Cushing’s syndrome with elevated ACTH and cortisol levels.Multiple organ metastases were found in Patient 1,while Patient 2 retained good health at 2 years follow-up.EAS symptoms including thyroid dysfunction,hypercortisolism and glucose intolerance were all resolved after anticancer treatment.CONCLUSION In conclusion,SCLC might start with diabetes mellitus and increased cortisol and hypokalemia or other EAS symptoms.These complex clinical features were the most significant factors to deteriorate a patient’s condition.Early diagnosis and treatment from clinicians were essential for the anti-cancer treatment for patients with SCLC.

Expert consensus of Chinese Association for the Study of Pain on the application of ozone therapy in pain medicine

This consensus was compiled by first-line clinical experts in the field of pain medicine and was organized by the Chinese Association for the Study of Pain.To reach this consensus,we consulted a wide range of opinions and conducted indepth discussions on the mechanism,indications,contraindications,operational specifications and adverse reactions of ozone iatrotechnique in the treatment of pain disorders.We also referred to related previous preclinical and clinical studies published in recent years worldwide.The purpose of this consensus is to standardize the rational application of ozone iatrotechnique in pain treatment,to improve its efficacy and safety and to reduce and prevent adverse reactions and complications in this process.

Observation on TCM syndromes effect of Shujinjianyao Pill in the Treatment of Lumbar Spinal Stenosis (Ganshenbuzu and Fengshiyuzu Syndrome)

Objective:To observe the TCM(Traditonal Chinese Medcine)syndromes effect and safety of Shujinjianyao Pill in the treatment of LSS(Lumbar Spinal Stenosis)(Ganshenbuzu and Fengshiyuzu Syndrome).Methods:120 LSS patients fit the inclusion criteria were separated into two groups,90 in the experimental group and 30 in the control group.No significant difference was existed in the basic data between the two groups.The experimental group was given Shujinjianyao Pill and Danlutongdu Tablet Simulator orally,while the control group was given Shujinjianyao Pill Simulator and Danlutongdu Tablet orally for 4 weeks.The VAS score,total TCM(Traditonal Chinese Medcine)syndrome score and single TCM symptom score on day 0,14 and 28 were observed,and adverse reactions were recorded.Result:There were significant differences in total TCM syndrome score between the two groups at baseline,14 day and 28 day(P<0.01).There was a significant difference in total TCM syndrome score between the two groups at 28 day(P<0.05).Significant differences were existed between this two groups in total effective rate of total TCM syndromes and waist-knee pain-weak in single TCM syndromes on the 28 day(P<0.05).There was no significant difference in the incidence of adverse events and serious adverse events between the two groups(P>0.05).Conclusion:Shujinjianyao Pill is effective on TCM syndromes in the treatment of Ganshenbuzu and fengshiyuzu syndrome LSS,especially in improving the score of total TCM syndromes and waist-knee pain-weak of single TCM syndrome,and has high safety.

Obesity in children and adolescents:Overview of the diagnosis and management

Childhood obesity is one of the biggest public health challenges globally.It is associated with various adverse health consequences throughout life.Prevention and early intervention represent the most reasonable and costeffective approaches.Considerable progress has been achieved in the management of obesity in children and adolescents;yet,implementation in the real world remains a challenge.This article aimed to present an overview of the diagnosis and management of obesity in children and adolescents.

Effects of Inotodiol Extracts from Inonotus Obliquus on Proliferation Cycle and Apoptotic Gene of Human Lung Adenocarcinoma Cell Line A549

Objective： To observe the proliferation inhibition, apoptosis, and cell proliferation cycle of human lung carcinoma cell line A549 treated with Inotodiol extracts from Inonotus obliquus and explore the possibility of Inotodiol extracts from Inonotus obliquus as a new tumor chemopreventive drug. Methods： Human lung cancer cell line A549 was treated with different concentrations of Inotodiol, the effects of Inotodiol on cell apoptosis, the expression of Ki-67, Bcl-2, Bax, and p53 and cell cycle were detected by TUNEL assay, immunohistochemistry, and flow cytometry assay respectively. Results： Inotodiol extracts had antiproliferation effect on human lung carcinoma cell line A549. The expression of Ki-67 decreased with the increase of Inotodiol concentration and exposure time （P〈0.05）, in a close-dependent and time-dependent manner. The typical characteristics of the apoptosis of A549 cells treated with Inotodiol were observed, and the apoptotic rate of A549 cell at 48 h was the highest by TUNEL assay. Inotodiol arrested A549 cells in the S phase, and apoptotic peak was observed by flow cytometry. Immunocytochemistry indicated that the expression of Bcl-2 protein decreased, while the expression of p53 and Bax proteins increased in A549 cells treated with Inotodiol, compared with the control cells （P〈0.05）. Conclusion： Inotodiol can inhibit proliferation and induce the apoptosis of A549 cells, and its molecular mechanism may be associated with the up-regulating expression of p53 and bax proteins and down- regulating expression of Bcl-2 protein, which arrested A549 cells in S phase.

Oriented Antibody Immobilization and Immunoassay Based on Boronic Acid-containing Polymer Brush

High sensitive immunoassay platforms have gained intense attention due to their vital roles in early-stage disease diagnosis and therapeutic information feedback. Although random covalent-binding of antibody has been widely adopted in immunoassays due to its simplicity and effectiveness, it readily loses its activity and fails to exhibit high antigen-binding capacity. In this work, copolymer of zwitterionic sulfobetaine methacrylate（SBMA） and glycidyl methacrylate（GMA） brushes were immobilized onto inert polypropylene（PP） via surface-initiated atom transfer radical polymerization（ATRP） based on biomimetic dopamine pretreatment. Subsequently, boronic acid（BA） groups were covalently bonded via active GMA units, followed by the introduction of oriented immobilization of antibody. Owing to the oriented immobilization of antibody facilitated by BA groups in polymer brush, the bioactivity of antibody is well preserved, which endows the surface with significantly enhanced antigen-binding capacity. Moreover, the existence of SBMA segments in polymer brushes renders the surface high resistance to nonspecific protein adsorption, significantly alleviating the signal interference of antigen recognition. This strategy could find potential applications in developing high sensitive immunoassay platforms based on the different substrates.

Role of fibroblast growth factor 23 in patients with chronic kidney disease

Fibroblast growth factor 23(FGF23)is a vital osteocyte-derived hormone that regulates the metabolism of phosphorus and 1,25-dihydroxyvitamin D(1,25[OH]2D).1,25(OH)2D and high dietary intake of phosphate up-regulate FGF23 expression,leading to increased renal phosphate excretion and decreased 1,25(OH)2D synthesis,and then suppression of FGF23,thus completing a negative feedback loop.

Evaluation of Safety and Efficacy of Qinming8631 DR Implantable Cardiac Pacemaker in Chinese Patients： A Prospective, Multicenter, Randomized Controlled Trial of the First Domestically Developed Pacemaker of China

Background：High cost of imported pacemakers is a main obstacle for Chinese patients suffering from bradyarrhythmia,and a domestically developed pacemaker will help lower the burden.This study aimed to evaluate the safety and efficacy ofQinming8631 DR （Qinming Medical,Baoji,China）,the first domestically developed dual-chamber pacemaker of China,compared with a commercially available pacemaker Talos DR （Biotronik,Berlin,Germany） in Chinese patients.Methods：A prospective randomized trial was conducted at 14 centers in China.Participants were randomized into trial （Qinming8631 DR） and control （Talos DR） groups.Parameters of the pacing systems were collected immediately after device implantation and during follow-ups.The effective pacing rate at 6-month follow-up was recorded as the primary end point.Electrical properties,magnet response,single-and double-pole polarity conversion,rate response function,and adverse events of the pacing system were analyzed.The Cochran-Mantel-Haenszel Chi-square test,paired t-test,and Wilcoxon signed-rank test were used for measuring primary qualitative outcomes and comparing normally and abnormally distributed measurement data.Results：A total of 225 patients with a diagnosis ofbradyarrhythmia and eligible for this study were randomly enrolled into the trial （n =113） and control （n =112） groups.They underwent successful pacemaker implantation with acceptable postoperative pacing threshold and sensitivity.Effective pacing rates of trial and control groups were comparable both in the full analysis set and the per protocol set （81.4% vs.79.5%,P =0.712 and 95.4% vs.89.5%,P =0.143,respectively）.In both data sets,noninferiority of the trial group was above the predefined noninferiority limit（-9.5%）.Conclusions：This study established the noninferiority ofQinming8631 DR to Talos DR.The safety and efficacy ofQinming8631 DR pacemaker were comparable to those of Talos DR in treating patients with cardiac bradyarrhythmia.

Rational Fabrication of Size Tunable SnO2 Hollow Microspheres

A designed solution route was developed to fabricate size tunable SnO2 hollow microspheres based on the sol-gel theory. The hydrolysis of SnSO4 released protons to form SnO2 particulates and induced the decrease of pH value. To minimize the high surface energy, the SnO2 particulates tended to assemble into large particles, the size of which was affected by the electrolyte concentration or pH value. Elevating SnSO4 content aroused the decrease of the pH value that directed to the shrinkage of the aggregated particle size of SnO2. Size tunable SnO2 hollow micro- spheres were then rationally fabricated under solvothermal conditions via Ostwald ripening by simply adjusting the SnSO4 concentration. The in situ pH decrease directed to the shrinkage of the particle size from 270 nm to 112 nm. The formation mechanism was confirmed and rationally elucidated by the time dependant morphology evolution. Charge-discharge tests revealed that the reduced particle size aroused an improved lithium ion battery performance.

Detection of an anti-angina therapeutic module in the effective population treated by a multi-target drug Danhong injection:a randomized trial

It's a challenge for detecting the therapeutic targets of a polypharmacological drug from variations in the responsed networks in thedfferentiated populations with complex diseases,as stable coronary heart disease.Here,in an adaptive,31-center,randomized,double-blind trial invoving 920 patients with moderate symptomatic stable angina treated by 14-day Danhong injection(DHI),a kind of polyphamacological drug with high quality control,or placebo(0.9%saline),with 76-day following-up,we firstly confrmed that DHl couldincrease the proportion of patients with clinically significant changes on angina-frequency assessed by Seattle Angina Questionnaire(ASAQ-AF220)(12.78%at Day 30,95%confidence interval[C]5.86-19.71%,P=0.0003,13.82%at Day 6C0,95%CI 6.82-20.82%,P=0.0001and 8.95%at Day 90,95%CI 2.06-15.85%,P=0.01).We also found that there were no significant differences in new-onset major vascularevents(P=0.8502)and serious adverse events(P=0.9105)between DHl and placebo.After performing the RNA sequencing in 62 selectedpatients,we developed a systemic modular approach tp identfy differentilly expressed modules(DEMs)of DHI with the Z_(summay)valueless than 0 compared with the control group,calculated by weighted gene co-expression network analysis(WGCNA),and sketched out thebasic framework on a modular map with 25 functional modules targeted by DII.Furthermore,the effective therapeutic module(ETM),defined as the highest corelation value with the phenotype alteration(SAQ-AF,the change in SAQ-AF at Day 30 from baseline)calculatedby WGCNA,was identifed in the population with the best effect(ASAQ-AF240),which is related to anticoagulation and regulation ofcholesterol metabolism.We assessed the modular flexbility of this ETM using the global topological D value based on Euclidean distance,which is corelated with phenotype alteration(r^(2):0.8204,P=0.019)by linear regression.Our study identified the ant-angina therapeuticmodule in the effective population treated by the multi-target drug.Modular methods facilitate the discovery of network pharmacologicalmechanisms and the advancement of precision medicine.(ClinicalTrials.gov identifier:NCTO1681316).