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Journal of International Translational Medicine
Journal of International Translational Medicine
JITM, ISSN 2227-6394
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Editor-in-chief:Feng Jifeng, China
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2015 Vol. 3, No. 4
Published: 11 December 2015

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Analysis of Imaging Characteristics of 18F-FDG PET/CT in Misdiagnosed Bone Tuberculosis: A Report of 12 Cases

DING Qi-yong1, LI Tian-nyv1, CHEN Jian-wei1, LIU Lian-ke2*
Journal of International Translational Medicine, 2015, 3(4): 233-237 | doi:10.11910/2227-6394.2015.03.04.01
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Objective: To analyze the imaging characteristics of 18F-fluorodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT) in 12 cases of misdiagnosed bone tuberculosis so as to explore the differential diagnostic method with metastatic bone tumors.
Methods: The images of 12 patients with bone tuberculosis diagnosed by 18F-FDG PET/CT were retrospectively analyzed. Distribution of lesion locations in the whole body and characteristics of glucose metabolism were analyzed by qualitative and semi-quantitative methods, especially for bone lesion location, number and range, glucose uptake form and CT imaging characteristics, and the maximum of standardized uptake value (SUVmax) was measured and recorded. 
Results: Of 12 patients, 1 showed increased glucose uptake of diffuse bone marrow in the whole body, whereas the rest suffered from 19 bone lesions, in which each one had 1 bone lesion in 9 cases, accounting for 75.0%. The images of PET/CT in 12 patients primarily manifested annular or nonuniform increase of glucose uptake (63.2%), sequestrum within osteolytic lesions (31.6%), injured intervertebral disc caused by vertebral lesions (61.5%) and cold abscesses around the lesions (68.4%). The glucose uptake rate of cold abscesses was higher than that of bone lesion locations. The tuberculosis complicated with other parts included lymphatic tuberculosis (100.0%), pulmonary tuberculosis (66.7%), pericardial or pleural tuberculosis (25.0%) and hepatolienal tuberculosis (8.3%). 
Conclusion: The characteristics of bone tuberculosis lesions are prominent in 18F-FDG PET/CT imaging, which could contribute to diagnosis of whole body tuberculosis and has a greater value in the differentiation of bone tuberculosis and metastatic bone tumors.


Clinical Study of S-1 Plus Oxaliplatin Versus S-1 Plus Cisplatin as First-Line Treatment for Elderly Patients with Advanced Gastric Cancer

BO Deng-feng *, HU Xiu-fu
Journal of International Translational Medicine, 2015, 3(4): 238-242 | doi:10.11910/2227-6394.2015.03.04.02
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Objective: To explore the efficacy and safety of S-1 plus oxaliplatin versus S-1 plus cisplatin as the first-line treatment for elderly patients with advanced gastric cancer. Methods: A total of 60 patients with advanced gastric cancer admitted in Xi’an Yanliang Railway Hospital from Jan., 2011 to Oct., 2013 were selected as study objects and randomly divided into 2 groups: S1 plus oxaliplatin group (SOX group, 30 cases) and S1 plus cisplatin group (SP group, 30 cases). SOX group were given intravenous drip of 130 mg/m2 oxaliplatin for 2 h on d1. And S-1 was also given according to body surface area: body surface area <1.25 m2, 40 mg once; 1.25-1.5 m2, 60 mg once; >1.5, 28 d as 1 cycle. SP group was administered with intravenous drip of 25 mg/m2 cisplatin during d1-d3. Treatment was discontinued until the occurrence of disease progression or patients’ intolerance to chemotherapy. Results: SOX group was non-inferior to SP group in overall response rate (ORR) (53.3% vs. 43.3%), disease control rate (DCR) (83.3% vs. 80.0%), median progression-free survival (PFS) (7.0 vs. 6.0 months) and median overall survival (OS) (11.0 vs. 10.5 months). However, the difference was statistical significant in the rate of increased KPS score (86.7% vs. 46.7%, χ2=10.800, P=0.001) and the rate of increased FACT-G score (73.3% vs. 36.7%, χ2=8.148, P=0.004). The main toxic and side effects of two groups was hematological toxicity. There was no degree III-IV toxic and side effects occurring in non hematological toxicity in two groups. The main toxic effect was peripheral neuritis in SOX group, and nausea and vomiting and renal dysfunction in SP group, and there were statistical differences in the above toxic and side effects between two groups (P<0.05). Conclusion: SOX regimen is as safe and effective as SP regimen for elderly patients with advanced gastric cancer, with better quality of life and less toxic and side effects.

Efficacy of Argentum-Quartz Solution in the Treatment of Perianal Fistulas: A Preliminary Study Hot!

Journal of International Translational Medicine, 2015, 3(4): 243-247 | doi:10.11910/2227-6394.2015.03.04.03
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Background: Nowadays, an optimal and effective medical surgery remains the gold standard for perianal fistulas. Hereby we reported preliminary results in favor of using Argentum-quartz solution for both primary and recurrent perianal fistulas. Methods: Three patients with intersphincteric and extrasphincteric fistulas were enrolled. Argentum-quartz solution was administrated twice a week for a period of 4 weeks, followed by a pause of 8 days and then another 4 weeks of treatment, totally 16 administrations. After treatment, all patients were monitored for a 4-month follow-up. Results: Complete closures of 2 extrasphincteric fistulas and a partial closure with absence of inflammation and superative phenomena in the intrasphincteric fistula were both manifested. Conclusion: Selective treatment of perianal fistulas with an argentum-quartz solution is safe and effective, and may represent a reliable alternative.

Translational Research on Epidermal Growth Factor Receptor Gene Mutations in Targeted Therapy for Patients with Advanced Non-Small Cell Lung Cancer Hot!

WANG Xiao-yan, ZHOU Er-xi*
Journal of International Translational Medicine, 2015, 3(4): 248-252 | doi:10.11910/2227-6394.2015.03.04.04
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Objective: To explore the significance of epidermal growth factor receptor (EGFR) gene mutations in targeted therapy for patients with advanced non-small cell lung cancer (NSCLC).
Methods: One hundred and seventeen patients with advanced NSCLC admitted in Maternal and Child Health Care Center of Zibo City from Jan., 2011 to Jan., 2014 were performed with EGFR gene detection and then divided into 3 groups according to the detecting results. Patients in group A and group B were given oral gefitinib, 250 mg/d while patients in Group C with docetaxel, 75 mg/m2. Chemotherapy for 3 groups was discontinued until severe adverse reactions or disease progression occurred, or continuous treatment was considered to be unfavorable by the doctors, or patients asked for withdrawal from the study. The relationship between clinicopathological features and EGFR mutations were analyzed. The short-term and long-term efficacy and adverse drug reactions of 3 groups were observed.
Results: Of the 31 cases with EGFR mutations, there were 16 cases (51.6%) of mutations in exon 19, 14 (45.2%) in exon 21 and 2 (6.45%) in exon 18. No EGFR mutation was found in exon 20. EGFR mutations were associated with histological types of tumors and whether patients were smoking. The median follow-up time was 26 months and 62 patients were dead. None of CR was in 3 groups. The disease control rate (DCR) in Group A was obviously higher than that in Group B (χ2=9.382, P=0.002), which was also higher in Group C than that in Group B (χ2=4.674, P=0.031). The 1-year survival rate in Group A was obviously higher than that in group B and group C (P<0.05, or P<0.01), which was prominently higher in Group C than that in Group B (P<0.01). The median progression-free survival (PFS) and median overall survival (OS) were the longest in Group A was and the shortest in Group B. The adverse reactions of two kinds of drugs mainly included rash, nausea and vomiting, myelosuppression as well as diarrhea.
Conclusion: EGFR mutations are the main indicators for guiding the targeted therapy for patients with advanced NSCLC.

Correlation Between Th1, Th2 Cells and Levels of Serum MMP-2, MMP-9 in Children with Asthma Hot!

WANG Xuan, ZHANG Xi-rong, LI Gang
Journal of International Translational Medicine, 2015, 3(4): 253-257 | doi:10.11910/2227-6394.2015.03.04.05
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Objective: To explore the correlation between Th1 and Th2 cells and the levels of serum matrix metalloproteinase-2 (MMP-2) and MMP-9 in children with asthma. Methods: A total of 89 children with asthma were divided into acute group (n=48) and chronic group (n=41) according to the course of disease, and 40 healthy children at the same term were collected as control group. The ratios of Th1 and Th2 cells as well as levels of MMP-2 and MMP-9 were compared in three groups, and the correlation between Th1 and Th2 cells and levels of MMP-2, MMP-9 was analyzed in acute group and chronic group. Results: When compared with control group, the ratios of Th1 and Th2 cells went down in both acute group and chronic group (P<0.01), while the levels of serum MMP-2 and MMP-9 up (P<0.01). The levels of serum MMP-2 and MMP-9 in acute group were dramatically higher than those in chronic group, and there was statistical significance (P<0.01). Pearson correlation analysis revealed that there was no significant correlation between Th1 and Th2 cells and MMP-2 level (r=0.148, P=0.314, r=0.299, P=0.058; r=0.183, P=0.214, r=0.289, P=0.067), whereas both Th1 and Th2 cells were negatively correlated with MMP-9 level in acute group and chronic group (r=-0.489, P=0.000, r=-0.324, P=0.039; r=-0.352, P=0.014, r=-0.357, P=0.022). Conclusion: Aberrant secretion of Th cells can not only damage the immune function of children with asthma, but also decrease the level of serum MMP-9, consequently affecting the collagen degradation and airway remodeling.

Comparison of Active Ingredient Content of Nanwuweizi and Beiwuweizi Collected in Different Seasons Detected by HPLC-DAD Hot!

YAO Feng1, CHEN Da-shuai2*
Journal of International Translational Medicine, 2015, 3(4): 258-262 | doi:10.11910/2227-6394.2015.03.04.06
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Objective: To compare the active ingredient content of Nanwuweizi (Kadsura longepedunculata) and Beiwuweizi (Fructus Schisandrae Chinensis) collected in different seasons.
Methods: Microwave-assisted extraction was applied to extract the active ingredients in Nanwuweizi and Beiwuweizi, with methanol as the solvent. High performance liquid chromatography-diode array detection℃; mobile phase: water (A) - acetonitrile (B); gradient elution: 0.8 mL/min; and detection wavelength: 225 nm. (HPLC-DAD) method was used to analyze the content of each ingredient, with chromatographic conditions as follows: Brava BDS C18 column (250 mm×4.6 mm, 5 μm); column temperature: 30
Results: All ingredients waiting for detection reached their peaks within 75 min, with excellent degree of separation and higher number of theoretical plates. Standard curves were drawn, and the mean value of phase relationship of each ingredient was >0.999. The content of active ingredients in lignans of Nanwuweizi and Beiwuweizi showed tendency of increase first and then decreased. In addition, all ingredients in Beiwuweizi reached their peaks in September while those in Nanwuweizi in August.
Conclusion: This method can be used to detect the content of multiple ingredients in Wuweizi (Schisandra chinensis) simultaneously because it is simple in operation, precise in results and excellent in repeatability.

Influence of Depressive State on Levels of Homocysteine and Thyroid Hormone in Patients with Hypertension Hot!

WANG Wei-wei1*, WANG Yan-ling2
Journal of International Translational Medicine, 2015, 3(4): 263-266 | doi:doi: 10.11910/2227-6394.2015.03.04.07
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Objective: To explore the influence of depressive state on the levels of homocysteine (Hcy) and thyroid hormone in patients with hypertension.
Methods: Totally 179 patients with primary hypertension were selected and divided into depression group (n=97) and non-depression group (n=82) according to whether to be complicated with depressive disorder. The venous blood was drawn for detecting the level of Hcy of 2 groups by enzymatic cycling assay, and serum free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropic hormone (TSH) by chemiluminiscence. The correlation between Hamilton depression scale (HAMD) scores and levels of plasma Hcy and serum FT3, FT4 and TSH was analyzed.
Results: Compared with non-depression group, the level of plasma Hcy increased and the levels of FT3 and FT4 decreased in depression group (P<0.05), but there was no statistical difference between 2 groups (P>0.05). HAMD scores in depression group had a positive correlation with the level of plasma Hcy (r=0.593, P=0.024), a negative correlation with the level of serum FT3 (r=-0.421,P=0.011), and no relationships with the levels of serum FT4 and TSH (r=-0.137, P=0.334; r=0.058, P=0.576).
Conclusion: Hypertensive patients complicated with depression have abnormal level of Hcy and thyroid hormones. Moreover, the depressive degree of patients is positively correlated with the level of Hcy and negatively with the level of FT3.


Effect of Intrahepatic Cholestasis of Pregnancy on Cytokines, Hemorheology and Coagulation Function of Pregnant Women

YU Cui-ge*, LI Lian-xiang, LIU Xiao-qin, SHI Jian-yong
Journal of International Translational Medicine, 2015, 3(4): 267-271 | doi:10.11910/2227-6394.2015.03.04.08
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Objective: To explore the effect of intrahepatic cholestasis of pregnancy (ICP) on the cytokines, hemorheology and coagulation function of pregnant women. Methods: A total of 43 singleton pregnant women with ICP delivered in Shaanxi Provincial People’s Hospital from June 2014 to June 2015 were selected as observation group, and 45 singleton healthy pregnant women accompanied by indications of cesarean section were selected as control group. Automatic Viscometer was used to detect the hematological indexes, Automatic Coagulometer to detect the indexes related to coagulation function and radioimmunoassay to determine the levels of cell inflammatory factors, and the pregnancy outcomes were closely observed. Results: The levels of interleukin-12 (IL-12), interleukin-18 (IL-18), tumor necrosis factor-α (TNF-α), high and low shear rates of whole blood viscosity, hematokrit, plasma viscosity and erythrocyte sedimentation rate (ESR) in observation group were all dramatically higher than those in control group, and all the differences were statistically significant (P<0.01). There was no statistical significance between two groups with regard to prothrombinWhen compared with control group, the levels of D-dimer (D-D) and fibrinogen (FIB) in observation group increased dramatically (P<0.01), but platelet (PLT) decreased markedly (P<0.01). The incidence of amniotic fluid pollution and premature delivery in observation group was higher than in control group (P<0.05 or P<0.01), and that of fetal distress, neonatal asphyxia and low birth weight tended to be higher than in control group, but there was no statistical significance (P>0.05). Conclusion: Both the hemorheology and coagulation function of pregnant women with ICP manifest significantly high viscosity and hypercoagulability, and the release of cell inflammatory factors increases, which all exert adverse influence on pregnancy outcome. time (PT) and activated partial thromboplastin time (APTT) (P>0.05).

Practices of Translational Medicine in Chinese Herbal Compound: Study on Pharmacological Material Basis of Qingganning Tablet based on HPLC Hot!

ZHONG Shui-sheng1&, XIONG Yu-ping2&, WANG Ming-zhi1*, ZHANG Chao1, TIAN Ya-jie2
Journal of International Translational Medicine, 2015, 3(4): 272-277 | doi:10.11910/2227-6394.2015.03.04.09
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Objective: To provide a stable and reliable analysis method for the study on pharmacological material basis of Qingganning Tablet (Tablet for Clearing Away Liver Heat).
Results: The detection concentration of puerarin, geniposide and paeoniflorin in Qingganning Tablet was 2-12 μg·mL-1, 1-6 μg·mL-1 and 4-8 μg·mL-1, respectively, in which the linear relationships were favorable. The average sample-adding recovery rate was 100.3%, 99.6% and 99.8%, while degree of precision (RSD) was 1.0%, 0.9% and 1.3% in puerarin, geniposide and paeoniflorin, respectively.
Conclusion: HPLC is simple and accurate in operation with excellent repeatability, and can detect the content of puerarin, geniposide and paeoniflorin simultaneously under the same chromatographic condition.

Translational Research in Enteral and Parenteral Nutrition Support for Patients with Severe Head Injury Hot!

LIN Fa-liang1, CHI Nan2, LI Wei1, XIE Lin1, WANG Xue-xin1*
Journal of International Translational Medicine, 2015, 3(4): 278-282 | doi:10.11910/2227-6394.2015.03.04.10
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Objective: To explore the key points of the translational research in enteral and pareenteral nutrition support for patients with severe head injury (SHI), and to analyze the influence of different nutritional support routes on the prognosis of SHI patients. Methods: Totally 141 patients with severe craniocerebral injury were selected as study subjects, 47 cases for each group, and were given early enteral nutrition (EEN), delayed enteral nutrition (DEN), and parenteral nutrition (PN), respectively. The effect of different nutritional support routes on SHI patients was observed. Results: After 14 d of treatment, Glasgow coma scale (GCS) scores of 3 groups were higher than treatment before (P<0.01), and with statistical differences among groups (P<0.05, or P<0.01). The levels of serum albumin, total serum protein and hemoglobin were higher in EEN group than the other groups (P<0.01). The level of serum albumin was lower in PN group than in DEN group (P<0.05). There were statistical differences in the incidence of complications among three groups (χ2=9.2487, P=0.0098). Conclusion: EEN support is more conductive to the improvement of the nutrition status, reduction of the incidence of complications, and promotion of the prognosis of SHI patients than DEN and PN.

Systematic Evaluation on Clinical Efficacy of External Application of Traditional Chinese Medicine in Treatment of Breast Hyperplasia

Lyu Yan-hong1, XIANG Jing-fang2, ZHANG Kang3*, LU Qin4
Journal of International Translational Medicine, 2015, 3(4): 283-291 | doi:10.11910/2227-6394.2015.03.04.11
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Objective: To evaluate the clinical efficacy of external application of traditional Chinese medicine (TCM) in the treatment of breast hyperplasia.
Methods: Randomized controlled clinical trial literatures on external application of TCM in the treatment of breast hyperplasia published in PubMed, Excerpta Medica Database (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure Database (CNKI) and Chinese Biomedical Abstract Database (CBM) from January 2000 to August 2015 were retrieved, and screened by researchers to data extraction. RevMan 5.3 was applied for Meta analysis.
Results: A total of 15 clinical trials with 2 107 patients with breast hyperplasia were included, in which 1 151 were divided into treatment group treated with external application of TCM while 956 into control group. Meta analysis indicated that the clinical response rate and clinical symptom score improvement (lump size) as well as serum levels of estradiol (E2), progesterone (P) and prolactin (PRL) in treatment group were superior to the control group and the differences were statistically significant (P<0.05). Although external application of TCM had a tendency of alleviating clinical symptom (lump pain, hardness and range as well as complicated symptoms), there was no statistically significant difference between two groups (P>0.05).
Conclusion: External application of TCM, to some extent, can improve the clinical efficacy in the treatment of breast hyperplasia, and it is necessary to carry out higher-quality, multicenter, large-scale, prospective and double-blind clinical experiments for further validation.

Advances in Targeted Therapy of Lymphoma Hot!

Feng Ji-feng
Journal of International Translational Medicine, 2015, 3(4): 292-297 | doi: 10.11910/2227-6394.2015.03.04.12
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Lymphoma is the most common hematologic malignancy, and its incidence increases year by year. It is estimated that there are over 80 000 new cases of Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL) in 2015 and more than 20 000 deaths. In recent years, the 5-year survival rate of patients with lymphoma has been over 50% as molecular targeted agents come out, and combination of novel specific targeted agents and traditional cytotoxic drugs brings about a revolution in the treatment of cancers. This review mainly discussed the novel targeted agents in the treatment of lymphoma from the following three aspects, including receptors and antigens acting on cell surface, signaling pathways and proteins acting on cells as well as tumor micro-environment.

Research Advances of Atherosclerosis in Translational Medicine

YANG Zhuo-xin1, DENG Rong2, PI Min1, YU Hai-bo1
Journal of International Translational Medicine, 2015, 3(4): 298-304 | doi:10.11910/2227-6394.2015.03.04.13
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Atherosclerotic cardiovascular diseases (ASCVD) are defined as a series of diseases caused by atherosclerosis (AS), including coronary heart disease (CHD), myocardial infarction (MI), stable or unstable angina pectoris, revascularization of coronary artery or other arteries, stroke, transient cerebral ischemic onset or atherosclerotic peripheral arterial disease. AS has common pathological basis with ASCVD as it is a general arterial regressive disease of human beings. With the industrialization progression, AS morbidity increases annually and it also leads to coronary atherosclerotic heart disease, cerebral stroke and peripheral artery stenosed occlusion or dilation, thus becoming the main cause for high disability and mortality. The main purpose of translational medicine is to break the intrinsic barrier between basic medicine with drug research and development as well as clinical and public healthcare, and establish a direct connection between them. It is also can rapidly transform basic research results to new clinical preventive and therapeutic methods. This study mainly reviewed AS from the aspect of translational medicine, aiming to provide a reliable basis for the prevention and treatment of AS.


Exosomes and Their Significance in Diagnosis and Treatment of Tumors

WANG Jian1&, LI Chao2*&, LI Wei3
Journal of International Translational Medicine, 2015, 3(4): 305-312 | doi:10.11910/2227-6394.2015.03.04.14
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In the research field of biological markers for tumor diagnosis, the appearance of exosomes has resolved the problem that RNA molecules can be easily degraded. Exosomes carry various RNAs and can protect them from being degraded. They are defined as polymorphism vesicle-like corpuscles (diameter: 30-100 nm) derived from late endosome or multi-vesicular endosomes in cellular endocytosis system, which contain abundant biological information, including multiple lipids, proteins and nucleic acids, etc. Exosomes are extracellular nanoscale vesicae formed in a series of regulating process of cellular “endocytosis-fusion-excretion”, and they carry proteins and transport RNAs, thus playing an important role in the intercellular material and informational transduction. There are still large amount of mRNAs and miRNAs in exosomes. Exosomes can not only protect in-vitro RNA stability, but also transfer RNA to specific target cells as effective carriers so as to play their regulatory function. Exosomes realize their biological information exchanges and transition via endocrine, paracrine and autocrine, and regulate cellular biological activities through direct action on superficial signal molecules or extracellular release and membrane fusion of biological active ingredients. They can directly act on tumors to impact tumor progression, or improve tumor angiogenesis and metastasis by regulating immunological function. Additionally, they can also be used for tumor diagnosis. Therefore, this study mainly summarized the biological characteristics of exosomes and their application in the regulation, diagnosis and treatment of tumors, hoping to provide references for the application of exosomes in tumors.
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