Controlled release of dexamethasone from fibrin sealant for intratympanic administration in inner ear therapy

The aim of the present work was to show the sustainability of fibrin sealant in releasing dexamethasone and adjust the protocol for clinical application of the novel method in the treatment of Meniere’s disease (MD) and sudden sensorineural hearing loss (SSHL).Gelation occurred shortly after mixing dexamethasone-containing fibrinogen with thrombin.Dexamethasone was constantly released for at least 16 d at a stable level after 7d in protocol 1 (low-dose),while it was robustly released within 4 d and slowed afterward until 10 d in protocol 2(high-dose).There were significant differences among the time points in Protocol 2 (p<0.01,ANOVA),and the exponential model with the formula y=15.299*e~(-0.483*t) fits the association.The estimated concentration of dexamethasone released on 7 d in protocol 2 was slightly lower than that observed in protocol 1.The fibrin sealant is capable of constantly releasing dexamethasone with adjustable dynamics.Targeted and minimally invasive administration of the material can be achieved in the clinic by sequential injections of the fluids using a soft-tipped catheter.

Predictive value of preoperative routine examination for the prognosis of patients with pT2N0M0 or pT3N0M0 colorectal cancer

BACKGROUND In recent years,the incidence of colorectal cancer(CRC)has been increasing.With the popularization of endoscopic technology,a number of early CRC has been diagnosed.However,despite current treatment methods,some patients with early CRC still experience postoperative recurrence and metastasis.AIM To search for indicators associated with early CRC recurrence and metastasis to identify high-risk populations.METHODS A total of 513 patients with pT2N0M0 or pT3N0M0 CRC were retrospectively enrolled in this study.Results of blood routine test,liver and kidney function tests and tumor markers were collected before surgery.Patients were followed up through disease-specific database and telephone interviews.Tumor recurrence,metastasis or death were used as the end point of study to find the risk factors and predictive value related to early CRC recurrence and metastasis.RESULTS We comprehensively compared the predictive value of preoperative blood routine,blood biochemistry and tumor markers for disease-free survival(DFS)and overall survival(OS)of CRC.Cox multivariate analysis demonstrated that low platelet count was significantly associated with poor DFS[hazard ratio(HR)=0.995,95% confidence interval(CI):0.991-0.999,P=0.015],while serum carcinoembryonic antigen(CEA)level(HR=1.008,95%CI:1.001-1.016,P=0.027)and serum total cholesterol level(HR=1.538,95%CI:1.026-2.305,P=0.037)were independent risk factors for OS.The cutoff value of serum CEA level for predicting OS was 2.74 ng/mL.Although the OS of CRC patients with serum CEA higher than the cutoff value was worse than those with lower CEA level,the difference between the two groups was not statistically significant(P=0.075).CONCLUSION For patients with T2N0M0 or T3N0M0 CRC,preoperative platelet count was a protective factor for DFS,while serum CEA level was an independent risk factor for OS.Given that these measures are easier to detect and more acceptable to patients,they may have broader applications.

Endoscopic band ligation or endoscopic tissue adhesive injection in the treatment of gastric varices:Which is better?

The combination of endoscopic ultrasound with endoscopic treatment of type 1 gastric variceal hemorrhage may improve the robustness and generalizability of the findings in future studies.Moreover,the esophageal varices should also be included in the evaluation of treatment efficacy in subsequent studies to reach a more convincing conclusion.

Serum urate is associated with an increased risk of inflammatory bowel disease: A bidirectional Mendelian randomization study

BACKGROUND Previous studies have indicated bidirectional associations between urate levels and inflammatory bowel disease(IBD),including ulcerative colitis(UC)and Crohn’s disease(CD).However,it remains unclear whether the observations are causal because of confounding factors.AIM To investigate the causal associations between urate levels and IBD using bidirec-tional Mendelian randomization(MR).METHODS Independent genetic variants for urate levels and IBD were selected as instru-mental variables from published genome-wide association studies(GWASs).Summary statistics for instrument-outcome associations were retrieved from three separate databases for IBD(the UK Biobank,the FinnGen database and a large GWAS meta-analysis)and one for urate levels(a large GWAS meta-analysis).MR analyses included the inverse-variance-weighted method,weighted-median estimator,MR-Egger and sensitivity analyses(MR-PRESSO).A meta-analysis was also conducted to merge the data from separate outcome databases using a fixed-effects model.RESULTS Genetically higher serum urate levels were strongly associated with an increased risk of UC[odds ratio(OR):1.95,95%confidence interval(CI):1.86-2.05]after outlier correction,and the ORs(95%CIs)for IBD and CD were 0.94(95%CI:0.86-1.03)and 0.91(95%CI:0.80-1.04),respectively.Animal studies have confirmed the positive association between urate levels and UC.Moreover,genetically predicted IBD was inversely related to urate levels(OR:0.97,95%CI:0.94-0.99).However,no association was observed between genetically influenced UC or CD and urate levels.CONCLUSION Urate levels might be risk factors for UC,whereas genetically predicted IBD was inversely associated with urate levels.These findings provide essential new insight for treating and preventing IBD.

Efficacy of ginseng-based Renshenguben oral solution for cancer-related fatigue among patients with advanced-stage hepatocellular carcinoma:A prospective multicenter cohort study

Background:Cancer-related fatigue(CRF)is a common and debilitating symptom experienced by patients with advanced-stage cancer,especially those undergoing antitumor therapy.This study aimed to evaluate the efficacy and safety of Renshenguben(RSGB)oral solution,a ginseng-based traditional Chinese medicine,in alleviating CRF in patients with advanced hepatocellular carcinoma(HCC)receiving antitumor treatment.Methods:In this prospective,open-label,controlled,multicenter study,patients with advanced HCC at BCLC stage C and a brief fatigue inventory(BFI)score of≥4 were enrolled.Participants were assigned to the RSGB group(RSGB,10 mL twice daily)or the control group(with supportive care).Primary and secondary endpoints were the change in multidimensional fatigue inventory(MFI)score,and BFI and functional assessment of cancer therapy-hepatobiliary(FACT-Hep)scores at weeks 4 and 8 after enrollment.Adverse events(AEs)and toxicities were assessed.Results:A total of 409 participants were enrolled,with 206 assigned to the RSGB group.At week 4,there was a trend towards improvement,but the differences were not statistically significant.At week 8,the RSGB group exhibited a significantly lower MFI score(P<0.05)compared to the control group,indicating improved fatigue levels.Additionally,the RSGB group showed significantly greater decrease in BFI and FACT-Hep scores at week 8(P<0.05).Subgroup analyses among patients receiving various antitumor treatments showed similar results.Multivariate linear regression analyses revealed that the RSGB group experienced a significantly substantial decrease in MFI,BFI,and FACT-Hep scores at week 8.No serious drug-related AEs or toxicities were observed.Conclusions:RSGB oral solution effectively reduced CRF in patients with advanced HCC undergoing antitumor therapy over an eight-week period,with no discernible toxicities.These findings support the potential of RSGB oral solution as an adjunctive treatment for managing CRF in this patient population.

Chemical profile of the secondary metabolites produced by a deep-sea sediment-derived fungus Penicillium commune SD-118

Bioassay-guided fractionation of the crude extract from Penicillium commune SD-118, a fungus obtained from a deep-sea sediment sample, resulted in the isolation of a known antibacterial compound, xanthocillin X (1), and 14 other known compounds comprising three steroids (2-4), two ceramides (5 and 6), six aromatic compounds (7-12), and three alkaloids (13-15). Xanthocillin X (1) was isolated for the first time from a marine fungus. In the bioassay, xanthocillin X (1) displayed remarkable antimicrobial activity against Staphylococcus aureus and Escherichia coli, and significant cytotoxicity against MCF-7, HepG2, H460, Hela, Du145, and MDA-MB-231 cell lines. Meleagrin (15) exhibited cytotoxicity against HepG2, Hela, Du145, and MDA-MB-231 cell lines. This is the first report of the cytotoxicity of xanthocillin X (1).

The prevalence rates of major chronic diseases in retired and in-service Chinese military officers(2000-2016): a meta-analysis

Background:Chronic diseases cause a tremendous burden to the military medical system.However,the prevalence rates of major chronic diseases among military officers remain unclear in China.Methods:China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database for Chinese Technical Periodicals(VIP),Pub Med and Web of Science were searched for studies(from 2000 to 2016)concerning 6 major chronic diseases:hypertension,hyperlipidemia,diabetes mellitus,heart diseases,cerebrovascular diseases,and chronic obstructive pulmonary diseases(COPD)in Chinese military officers following strict inclusion and exclusion criteria.Three researchers independently extracted data from the included studies,and a fourth researcher reviewed and solved every disagreement.Statistical analysis was performed with STATA 14.0 and R 3.3.2.Heterogeneity was evaluated by the I^2 value.A random effect model was performed to combine the heterogeneous data.The Egger test was performed to test the publication bias.Results:A total of 90,758 military officers derived from 75 articles were pooled together.Publication bias was only observed in 37 studies reporting heart disease(P_(Egger test)=0.01).The overall prevalence rates of hypertension,hyperlipidemia,diabetes mellitus,heart diseases,cerebrovascular diseases,and COPD were 46.6%(95%CI 41.8%–51.5%),30.9%(26.4%–35.7%),20.7%(16.5%–25.7%),48.2%(41.7%–54.9%),20.2%(14.8%–26.9%)and 16.6%(12.9%–21.0%),respectively.The prevalence rates of hypertension,diabetes,heart disease,cerebrovascular disease,and COPD,rather than hyperlipidemia,increased with age in Chinese military officers.Heart diseases(P_(Q-test)<0.001)and hypertension(P_(Q-test)<0.001)increased sharply in retired officers compared with officers in service.Cerebrovascular disease was more frequent in Northern Theater Command than in any other theater command(P_(Q-test)<0.001).Conclusion:Major chronic diseases heavily affect Chinese military officers,especially retirees.Medical intervention should be enforced on the prevention of cerebrovascular diseases in those working in cold areas in the north,as well as hypertension and heart diseases in retirees.

Medical rescue of naval combat: challenge and future

There has been no large-scale naval combat in the last 30 years. With the rapid development of battleships, weapons manufacturing and electronic technology, naval combat will present some new characteristics. Additionally, naval combat is facing unprecedented challenges. In this paper, we discuss the topic of medical rescue at sea: what challenges we face and what we could do. The contents discussed in this paper contain battlefield self-aid buddy care, clinical skills, organized health services, medical training and future medical research programs. We also discuss the characteristics of modern naval combat, medical rescue challenges, medical treatment highlights and future developments of medical rescue at sea.

Relationship between acute stress and sleep disorder in grass-root military personnel:Mediating effect of social support

Background: To explore the relationship between acute stress, social support and sleep disorder in grass-root military personnel, and construct the relational model through structural equation modeling. Methods: A total of 2,411 grass-root military personnel were randomly selected by cluster sampling, and administered the Chinese Military Personnel Sleep Disorder Scale, Military Acute Stress Scale and Social Support Rating Scale.Results: The total score of acute stress scale was positively correlated with the total score and factor scores of sleep disorder scale(r=0.209~0.465, P<0.01); The total score of social support scale was positively correlated with the total score of acute stress scale and the total score and factor scores of sleep disorder scale(r=0.356~0.537, P<0.01). The analysis of mediating effects showed that lack of social support partially mediated between acute stress and the factors of sleep disorder. The analysis of structural equation model showed that acute stress not only had a direct effect on sleep disorder(the path coefficient was 0.29, P=0.000), but also on lack of social support(the path coefficient was 0.39, P=0.000); lack of social support had a direct effect on sleep disorder(the path coefficient was 0.48, P=0.000).Conclusions: Acute stress and lack of social support are two significant factors of sleep disorder in grass-root military personnel. Well-established social support could alleviate sleep disorder induced by acute stress. Lack of social support was a partial mediator between acute stress and sleep disorder.

Secondary acute promyelocytic leukemia following chemotherapy for gastric cancer: A case report

Therapy-related acute myeloid leukemia(t-AML) refers to a heterogeneous group of myeloid neoplasms that develop in patients following extensive exposure to either cytotoxic agents or radiation.The development of t-AML has been reported following treatment of cancers ranging from hematological malignancies to solid tumors; however, to our knowledge, t-AML has never been reported following treatment of gastric cancer.In this study, we report the development of t-acute promyelocytic leukemia in a cT 4N1M0 gastric cancer patient after an approximate 44 mo latency period following treatment with 4 cycles of oxaliplatin(OXP)(85 mg/m2 on day 1) plus capecitabine(1250 mg/m2 orally twice daily on days 1-14) in combination with recombinant human granulocyte-colony stimulating factor treatment.Karyotype analysis of the patient revealed 46,XY,t(15;17)(q22;q21)[15]/46,idem,-9,+add(9)(p22)[2]/46,XY[3], which, according to previous studies, includes some "favorable" genetic abnormalities.The patient was then treated with all-trans retinoic acid(ATRA, 25 mg/m2/d) plus arsenic trioxide(ATO, 10 mg/d) and attained complete remission.Our case illuminated the role of certain cytotoxic agents in the induction of t-AML following gastric cancer treatment.We recommend instituting a mandatory additional evaluation for patients undergoing these therapies in the future.

English Forum on Medical Humanities of SMMU:An interdisciplinary innovative teaching practice

To conform to the college English teaching reform from English for General Purposes (EGP) to English for Academic Purposes (EAP) in the vital transfer era, the Foreign Language Department of Second Military Medical University (SMMU) launched an English for Medical Academic Purpose (EMAP) curriculum with English Forum on Medical Humanities (EFMH), a project-based teaching practice. Based on Rogers' learner-centered humanistic teaching approach which emphasizes students' involvement and experiences in learning, EFMH puts students and their practice in a central place. After four-year exploration and operation, the Forum has developed from a small-scaled embryo into an internationalized, standardized and professionalized event, having produced fruitful outcomes. It is expected that the success of EFMH will provide inspiring experiences and enlightenments for higher medical education in terms of academic English teaching and teachers' responsibilities to foster high-quality medical students.

Current situation on the reporting quality of randomized controlled trials in 5 leading Chinese medical journals

Objective:The Consolidated Standards for Reporting of Trials(CONSORT) statement has already proved to be an efficient standard for reporting quality of randomized controlled trials(RCTs).However,most of the Chinese medical journals have not endorsed the CONSORT statement.The current situation about the reporting quality of RCTs in Chinese medical journals is still unclear.The purpose of the study was to evaluate the reporting quality of RCTs on papers published in 5 leading Chinese medical journals.Methods:We evaluated 232 original RCT papers using a reporting quality scale based on CONSORT statement from 2001 to 2006 in 5 Chinese medical journals(Journal type 1) without adoption of CONSORT and Chinese Journal of Evidence-based Medicine(Journal type 2) which adopted CONSORT in 2004.We measured the inclusion of 26 items for the reporting quality scale and 6 core items of each RCT report,gave score to each item and calculated the total score obtained in each report and the proportion of reports including individual items.The reporting quality of RCT trials from 2001 to 2003(pre-adoption period) was compared with that from 2004 to 2006(post-adoption period).Results:The average reporting quality of RCTs was moderate(mean score,15.18),and the mean score of the 6 core items was low(mean score,1.09) in 5 leading journals.The difference in the total score and the score of the 6 core items between pre-adoption period(2001-2003) and post-adoption period(2004-2006) was statistically significant(P=0.003;P=0.000).Interaction between journal type and period was not significant(F=0.76;P=0.383).We concluded that the change tendency of reporting quality between Journal type 1 and 2 was not different.But as to the core items of sequence concealment and intention-to-treat analysis,the increases were greater for Journal type 2 when evaluated against Journal type 1(P=0.038;P=0.016).Conclusion:The reporting quality of RCT trials in 5 leading Chinese medical journals is improving.However,the lack of important items in RCT trials remains a serious problem.We recommend the endorsement of the Consolidated Standards for Reporting of Trials statement in Chinese medical journals and the continuing education on evidence-based medicine in China.

Humanity factors and more: A little heads up for medical students and future doctors

Exactly how can we become a successful doctor in the future? It has been widely accepted that chasing perfection in our field of expertise alone is not enough. Here in China, doctors have the liability to do more. Chinese doctors are relatively more prone to confronting difficult situations in a more complex manner. Therefore, the humanity factor in medical practice is discussed, and some essential communication skills are suggested for medical practitioners, with heartfelt anticipation for a better medical environment as well as a more pleasant Doctor-Patient relationship.

Establishment of an index system for evaluating outstanding biomedical scientists for science foundation of Shanghai

Objective:To establish a scientific,objective and applicable index system for evaluating out- standing biomedical scientists for science foundation of Shanghai.Methods:According to the principal in- dices that have been used in the developed countries for evaluating their talented personnel and the reality of our country,an index system was set up to evaluate the outstanding biomedical scientists for Shanghai science foundation.The following parameters were used to simplify the indices.,correlation coefficient, multiple correlation coefficient,partial correlation coefficient,creditability,and discriminatory power. And analytic hierarchy process was used to determine the weights of each index.Results and Conclusions: The established index system is scientific and applicable;it is helpful for cultivating and evaluating out- standing biomedical scientists.

China says no towards the second large- scale COVID- 19 outbreak: voices from the online public

With its fast and wide spread,coronavirus disease 2019(COVID-19)caused by a novel coronavirus broke out suddenly in Wuhan,China at the end of 2019.It posed a grave threat to human life and health,and brought massive challenges to global health.On 30 January 2020,the World Health Organiza-tion(WHO)declared the novel coronavirus constituted a‘public health emergency of international concern’.1 Due to its rapid trans-mission,it drew attention from more than 200 countries and areas worldwide.

Preparation,Rheological Properties and Primary Cytocompatibility of TPU/PLA Blends as Biomedical Materials

A polymer blends containing thermoplastic polyurethane（TPU） and poly（lactic acid）（PLA） as a biomedical material were prepared by a process of modifying thermally induced phase separation（MTIPS） and melt blending.The influences of composition,shear frequency,and temperature on the rheological behaviors of the blends were investigated by small amplitude oscillatory shear rheology.The results revealed that the addition of TPU into PLA significantly decreased the non-Newtonian index of the blends,and increased the sensitivity of the blends on shear rate,suggesting that optimization of the shear rate and temperature could improve the flowability of the blend melts in the extrusion process.In addition,the results of SEM images revealed that TPU distributed well into PLA matrix and showed good compatibility between the TPU and PLA,which made the blends with good toughness.The primary cytocompatibility of the blends was evaluated using C2C12 cells.The results suggested that the TPU/PLA blends did not affect cell growth,showing no cytotoxicity.In short,the TPU/PLA blends with excellent toughness had potential application as biomedical devices.

An epidemic of violence on medical personnel:are we prepared

The incidence of violence against doctors has been increasing, both in China and worldwide. Very often we hear doctors being molested, thrashed and abused by lay public for a trivial medical malpractice or even no fault of theirs. The once glittering halo of medical workers is being shredded thanks to the stressed health system and a lack of evaluation for risk of violence of the patients. Modern China sees a wide disparity between industry standards in rural and urban areas. People seeking health care service are often scared, can't get timely service and turn their anger towards those around them. To change a whole system in this giant nation is too hard a rock. Therefore, our focus is on the prompt awareness and preparation of a possible patient violence. The simplest approaches seem to be the most effective. Medical staffs should re-learn empathy on patients and be better trained on recognizing and reducing conflicts.

Secondary hyperparathyroidism associated with multiple brown tumor:a case report

Brown tumour represents a serious complication of hyperparathyroidism.Definitive diagnosis is based on histological examination,clinical,radiological and laboratory data.Here we report a case of multiple brown tumours localised in collarbone,rib and in the distal ulna due to secondary hyperparathyroidism in a 37-year-old women with chronic renal failure.The clinical management of brown tumour aimed primarily to reduce the elevated parathyroid hormone levels by pharmacological treatment.In our experience,clinicians usually consider brown tumor of hyperparathyroidism is caused by giant cell lesions in maintenance hemodialysis recipients,and multiple brown tumours are rarely seen in these patients.

Facing pressure: How should medical students or future doctors do?

On April 1st2013,HUANG Yang,a medical master student in Fudan University,was poisoned by his roommate,LIN Senhao.Unfortunately,HUANG died 15 days later.It’s quite a shock to the whole society.We have to reconsider our education,and our expectancy to doctors.We have to ask ourselves"How to become a qualified doctor?"Learn to release the pressure from studies and lives;learn to defend ourselves from danger.Is it enough?No!Whatever happened,never do harm to others.Medical humanity is the most important thing we should always remember.

Current Status of Integral Medical Study on Endometriosis

Endometriosis (EM), an estrogen dependent disease that comes from the planting of endometri-al gland and stroma outside the uterine cavity, is characterized by invasiveness, wide planting and liability to relapse. It has been proved by recent studies that the pathogenesis of EM has its genetic background and is closely related with neuro-, en-docrino- and immuno-factors. There has been great progress in the treatment of EM, but the clinical effect is not yet satisfactory. Traditional Chinese medicine (TCM) has definitely played its role in EM treatment. In this article, the current status of integral medical study on EM is reviewed.