Real-World Study on Hematological Toxicities of Cyclin-dependent Kinase 4/6 Inhibitors Based on FAERS Database / 医药导报

Objective To evaluate adverse events(AEs)of hematological toxicities in cyclin-dependent kinase 4/6(CDK4/6)inhibitors based on the FDA adverse event reporting system(FAERS)database,and to provide a reference for rational drug use in the clinic.Methods A total of 29 quarterly AEs were extracted from the FAERS database from January 2015 to March 2022.Reported odds ratio(ROR)and proportional reported ratio(PRR)were used for data mining of CDK4/6 inhibitor AEs.Results A total of 7 872 AEs related to CDK4/6 inhibitors were reported,and the proportion of hematological AEs of each inhibitor was palbociclib(80.31%),ribociclib(15.36%),and abemaciclib(4.33%).Neutropenia and anemia were common in hematological toxicities.Palbociclib(2 982/6 322,47.17%)and ribociclib(613/1 209,50.70%)caused more neutropenia than abemaciclib(117/341,34.31%).Hematological toxicities mainly occurred 60 days after drug initiation(1 630,61.86%).Palbociclib had the longest median onset time,and 32.9%of patients still had hematological toxicities after 90 days of treatment.The clinical features and intensity were different among CDK4/6 inhibitors.Conclusions Palbociclib,abemaciclib,and ribociclib all cause significant hematological toxicities,among which abemaciclib has fewest reports of hematological toxicities.Still,the risk of death after anemia caused by abemaciclib should be noted.Complete blood cell count should be closely monitored within the first two months after treatment to monitor the patient's neutrophils and hemoglobin.The occurrence of hematological AEs associated with CDK4/6 inhibitors should be noted in the clinic.

Preliminary survey report on the clinical validation of in-use electronic sphygmomanometers in China / 中华心血管病杂志

Objective: To explore the percentage of in-use electronic sphygmomanometers independently validated clinically in China. Methods: We conducted a cross-sectional survey and Beijing, Shenzhen, Shijiazhuang, Datong, and Shihezi were selected according to the geographical location and economic level. In each site, one tertiary hospital, two community health centers, and 20 families with electronic sphygmomanometers in use were chosen. The information of electronic sphygmomanometers including brand, model, manufacturer and production date were obtained by the trained staff. Ten electronic sphygmomanometers from each hospital, five electronic sphygmomanometers from each community health center, and one electronic sphygmomanometer from each family were surveyed, and the user's subjective judgment results and judgment basis on the accuracy of the electronic sphygmomanometer measurement were collected. We searched six registration websites (Medaval, Stride BP, dabl Educational Trust, British and Irish Hypertension Society, American Medical Association and Hypertension Canada) and two research databases (PubMed and CNKI) for the clinical validation status of each electronic sphygmomanometer. Results: A total of 200 electronic sphygmomanometers were investigated in this study, of which only 29.0% (58/200) passed independent clinical validation. When stratified by users, the percentage of being clinical validated was 46.0% (23/50) for electronic sphygmomanometers in hospitals, 42.0% (21/50) for those in community health centers and 14.0% (14/100) for those in home use, respectively, and the proportions between the three groups were significantly difference (P<0.001). Doctors in tertiary hospitals and community health service centers judged the accuracy of electronic sphygmomanometers mainly on the basis of "regular correction" (41.0% (41/100)) and "comparison with other electronic sphygmomanometers" (20.0% (20/100)), while among home users, 41.0% (41/100) were not clear about the accuracy of electronic sphygmomanometers, and 40.0% (40/100) made the judgment by "comparison with the devices in hospitals". Conclusion: The clinical validation of in-use electronic sphygmomanometers in China is low. Most of users, including healthcare professionals, are not aware of clinical validation of electronic sphygmomanometers.

Clinical pharmaceutical practice of constructing mind map by clinical pharmacists for the consultation of pulmonary nocardiosis / 中国药房

OBJECTIVE To explore the construction of mind map by clinical pharmacists for the consultation of pulmonary nocardiosis and its application in clinical practice， and to provide reference for promoting the correct selection of nocardiosis treatment drugs in clinical practice and ensuring drug safety and efficacy. METHODS A total of 7 patients with Nocardia pulmonary infection from January 2017 to April 2022 in our hospital were collected. Based on evidence-based medicine， a consultation mind map （mainly including understanding the medical history， identifying infectious bacteria， identifying risk factors， developing treatment plans， and conducting evaluations） was constructed to address the difficulties of large differences in drug sensitivity among different strains of Nocardia and numerous adverse reactions of Compound sulfamethoxazole as a first-line drug. The treatment plan was developed for 7 patients with pulmonary nocardiosis， and whole-process pharmaceutical care was provided. RESULTS Combined with the mind map， different antibiotic combination regimens were given according to the drug sensitivity results of Nocardia， the different species of Nocardia， and the patient’s allergy history. Among them， 4 cases were treated with imipenem cilastatin， the patients receiving Compound sulfamethoxazole and linezolid for a long time were given full pharmaceutical care， and the adverse drug reactions were timely treated.CONCLUSIONS Clinical pharmacists apply the consultation mind map of pulmonary nocardiosis to the treatment of inpatients， take advantage of pharmacy， participate in clinical drug therapy， and really play a role in the clinical treatment team so as to promote rational drug use.

ZJU index and the risk of nonalcoholic fatty liver disease in the Uygur population in the rural area of Xinjiang Uygur Autonomous Region： A cohort study / 临床肝胆病杂志

ObjectiveTo investigate the association between ZJU index and the onset of nonalcoholic fatty liver disease （NAFLD） in the Uygur population and the value of ZJU index in predicting the risk of NAFLD. MethodsThe Uighur community of The 51st Regiment of The Third Division of Xinjiang Kashgar Corps was selected as the investigation site， and the Uygur residents who lived in this area and had an age of >18 years were selected as subjects. Follow-up studies were conducted in 2019， 2020， and 2021， and the investigation of outcomes was completed in June to August of 2021. Finally 10 597 subjects were enrolled for analysis. The Kruskal-Wallis H test was used for comparison of continuous variables between groups， and the chi-square test was used for comparison of categorical variables between groups. The subjects were divided into Q1-Q4 groups according to the level of ZJU index. The Kaplan-Meier curve was used to predict the incidence rate of NAFLD， and the Cox regression model was used to analyze the association between ZJU index and the risk of NAFLD； the area under the ROC curve （AUC） was used to evaluate the value of ZJU index in predicting the risk of NAFLD. ResultsDuring the median follow-up time of 4.92 years， the incidence rate of NAFLD was 9.4% （992/10 597） among the study population. After adjustment for multiple factors， there was a significant increase in the risk of NAFLD with the increase in ZJU index， with a hazard ratio of 2.55 （95% confidence interval ［CI］： 1.60‍ — ‍4.06）， 7.32 （95%CI： 4.78‍ — ‍11.20）， and 21.74 （95%CI： 14.32‍ — ‍33.00）， respectively （all Ptrend<0.001）. The ROC curve showed that ZJU index had a higher value in predicting NAFLD （AUC=0.816）， and the male subgroup had a significantly higher predictive accuracy of ZJU index than the female subgroup （AUC： 0.829 vs 0.809）. ConclusionZJU index is a predictive factor for the onset of NAFLD in the Uygur population in rural areas of Xinjiang and has a good value in predicting the risk of NAFLD.

Efficacy of chemotherapy combined with sorafenib for FLT3-ITD-positive acute myeloid leukemia / 中国基层医药

Objective:To investigate the effect of chemotherapy combined with sorafenib on the prognosis of FLT3 internal tandem duplication (FLT3-ITD)-positive acute myeloid leukemia and to find a more effective treatment.Methods:The clinical data of 60 patients who were newly diagnosed with acute myeloid leukemia and who received treatment in The Second Affiliated Hospital of Qiqihar Medical University from January 2015 to January 2017 were retrospectively analyzed. The patients were divided into three groups according to whether they were positive for FLT3-ITD and the treatment method they used. The observation group (FLT3-ITD-positive, n = 19) were treated with sorafenib based on routine chemotherapy. The control group 1 (FLT3-ITD-positive, n = 21) was treated only with routine chemotherapy. The control group 2 (FLT3-ITD-negative, n = 20) was treated only with routine chemotherapy. After the first and fourth courses of treatment, clinical efficacy was compared among the three groups. Results:After the first course of treatment, the complete remission rate in control group 2 was 50.0% (10/20), which was significantly higher than 15.8% (3/19) in the observation group and 4.8% (1/21) in the control group 1 ( H = 13.39, P < 0.05). After the fourth course of treatment, the complete remission rate in the observation group, control group 2, and control group 1 was 63.2% (12/19), 60.0% (12/20), and 4.8% (1/21), respectively, and the differences were statistically significant ( H = 19.21, P < 0.05). Four-year follow-up results showed that the median survival time in the observation group, control group 1, and control group 2 was 36.63, 24.15, and 45.00 months respectively. The event-free survival in the observation group, control group 1, and control group 2 was 18.00, 9.82, and 24.90 months, respectively. The median survival time and the event-free survival in the control group 2 were significantly longer than those in the observation group and control group 1 ( χ2 = 19.93, 23.04, both P < 0.001). Conclusion:Chemotherapy combined with sorafenib for treating newly-diagnosed FLT3-ITD-positive acute myeloid leukemia can provide comprehensive benefits and have advantages for survival over chemotherapy without sorafenib and chemotherapy alone.

Astragaloside IV Attenuates Polymicrobial Sepsis-Induced Cardiac Dysfunction in Rats via IKK/NF-κB Pathway / 中国结合医学杂志

OBJECTIVE@#To evaluate the protective effects of Astragaloside IV (AST) in a rat model of myocardial injury induced by cecal ligation and puncture (CLP).@*METHODS@#The model of sepsis-induced cardiac dysfunction was induced by CLP. Using a random number table, 50 specific pathogen free grade of Sprague Dawley rats were randomized into 5 groups: the sham group (sham), the model group (CLP, 18 h/72 h) and AST group (18 h/72 h). Except the sham group, the rats in other groups received CLP surgery to induce sepsis. CLP groups received intragastric administration with normal saline after CLP. AST groups received intragastric administration with AST solution (40 mg/kg) once a day. The levels of inflammatory mediators and oxidative stress markers in the serum of the septic rats were determined via enzyme-linked immunosorbent assay (ELISA) at different time point, such as interleukin 6 (IL-6), IL-10, high mobility group box-1 protein B1 (HMGB-1), superoxide dismutase (SOD), and malondialdehyde (MDA). Cardiac function was determined by echocardiography. Moreover, changes in myocardial pathology were evaluated using hematoxylin and eosin staining. The levels of lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) were analysed to determine the status of CLP-induced myocardium. In addition, the apotosis of myocardial cells was analysed by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL). The protein levels of B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X (Bax), IκB kinase α (IKKα), nuclear factor kappa B p65 (NF-κB p65) were detected by Western blot analysis. Moreover, survival rate was investigated.@*RESULTS@#AST improved the survival rate of CLP-induced rats by up to 33.3% (P<0.05). The cardioprotective effect of AST was observed by increased ejection fraction, fractional shortening and left ventricular internal diameter in diastole respectively (P<0.01 or P<0.05). Subsequently, AST attenuated CLP-induced myocardial apoptosis and the ratio of Bcl-2/Bax in the myocardium, as well as the histological alterations of myocardium (P<0.01 or P<0.05); the generation of inflammatory cytokines (IL-6, IL-10, HMGB-1) and oxidative stress markers (SOD, MDA) in the serum was significantly alleviated (P<0.01 or P<0.05). On the other hand, AST markedly suppressed CLP-induced accumulation of IKK-α and NF-κB p65 subunit phosphorylation (P<0.01 or P<0.05).@*CONCLUSIONS@#AST plays a significant protective role in sepsis-induced cardiac dysfunction and survival outcome. The possible mechanism of cardioprotection is dependent on the activation of the IKK/NF-κB pathway in cardiomyocytes.

Effect of Tongguan Capsules () on Restenosis after Coronary Stent Implantation: Study Protocol for A Randomized Controlled Trial / 中国结合医学杂志

BACKGROUND@#Although percutaneous coronary intervention (PCI) had become widely employed therapeutic procedure for coronary artery disease, stent restenosis limited the benefits of this revascularization and the question how to prevent such events remained unresolved. While numerous empirical observations suggested Tongguan Capsules (), a patented Chinese Medicine, could decrease frequency and duration of angina pectoris attacks, evidence supporting its efficacy on restenosis remained inadequate.@*OBJECTIVE@#This trial was designed to determine whether Tongguan Capsules would reduce restenosis rate in patients after successful stent implantation.@*METHODS@#Approximately 400 patients undergoing percutaneous coronary stent deployment were enrolled and randomized to control group or Tongguan Capsules (4.5 g/d) for 3 months. All patients received standard anti-platelet, anti-coagulation and lipid-decreasing treatments, concurrently. The primary clinical endpoint was the 12-month incidence of the major adverse cardiovascular events (defined as cardiac death, myocardial infarction, and recurrence of symptoms requiring additional revascularization). The angiographic end point was restenosis rate at 6 months.@*CONCLUSION@#This study would provide important evidence for the use of Tongguan Capsules in patients after stent implantation in combination with routine therapies, which may significantly reduce incidence of the restenosis so as to potentially improve the clinical outcomes. (registration number: ChiCTR-TRC- ChiCTR-IIR-17011407).

Variation of occipital protuberance and occipital bunning of Holocene Chinese population / 解剖学报

Objective To analyze the characteristics and variation of occipital protuberance and occipital bunning of Chinese Holocene population. Methods Based on 275 adult male skulls, Neolithic Age ( 49 cases ), Bronze and Iron Age (171 cases) and modern (55 cases), the occipital protuberance and occipital bunning were divided into several categories, and the occurrence rates were analyzed and compared among different time periods. Results The characteristics and variation of occipital protuberance and occipital bunning were also different in different ages. The degree of the occipital protuberance was more and more significant with the age, which changed greatly from Neolithic Age to Bronze and Iron Age. In the Holocene, most people did not appear occipital bunning on the skull, but the relatively significant occipital bunning appeared in the Bronze and Iron Age. Conclusion The variation of occipital protuberance may be related to the change of skull size and overuse of trapezius muscle in Holocene. The occipital bunning appearance may reflect the relative development speed of the brain and skull to some extent.

Using metabolism related factors constructing a predictive model for the risk of cardiovascular diseases in Xinjiang Kazakh population / 中华内分泌代谢杂志

Objective:To construct and confirm a predictive model for the risks of cardiovascular diseases (CVD) with metabolic syndrome (MS) and its factors in Xinjiang Kazakh population.Methods:A total of 2 286 Kazakh individuals were followed for 5 years from 2010 to 2012 as baseline survey. They were recruited in Xinyuan county, Yili city, Xinjiang. CVD cases were identified via medical records of the local hospitals in 2013, 2016 and 2017, respectively. Factor analysis was performed on 706 MS patients at baseline, and main factors, age, and sex were extracted from 18 medical examination indexs to construct a predictive model of CVD risk. After excluding the subjects with CVD at baseline and incomplete data, 2007 were used as internal validation, and 219 Kazakhs in Halabra Township were used as external validation. Logistic regression discriminations were used for internal validation and external validation, as well as to calculate the probability of CVD for each participant and receiver operating characteristic curves.Results:The prevalence of MS in Kazakh was 30.88%. Seven main factors were extracted from the Kazakh MS population, namely obesity factor, blood lipid and blood glucose factor, liver function factor, blood lipid factor, renal metabolic factor, blood pressure factor, and liver enzyme factor. The area under the curve (AUC) for predicting CVD in the internal validation was 0.773 (95% CI 0.754-0.792). In the external validation, the AUC for predicting CVD was 0.858 (95% CI 0.805-0.901). Conclusions:The CVD risk prediction model constructed by 7 main factors extracted from Kazakh MS patients has high validation efficiency and can be used for risk assessment of CVD in Xinjiang Kazakh population.

Using metabolism related factors constructing a predictive model for the risk of cardiovascular diseases in Xinjiang Kazakh population / 中华内分泌代谢杂志

Objective@#To construct and confirm a predictive model for the risks of cardiovascular diseases (CVD) with metabolic syndrome (MS) and its factors in Xinjiang Kazakh population.@*Methods@#A total of 2 286 Kazakh individuals were followed for 5 years from 2010 to 2012 as baseline survey. They were recruited in Xinyuan county, Yili city, Xinjiang. CVD cases were identified via medical records of the local hospitals in 2013, 2016 and 2017, respectively. Factor analysis was performed on 706 MS patients at baseline, and main factors, age, and sex were extracted from 18 medical examination indexs to construct a predictive model of CVD risk. After excluding the subjects with CVD at baseline and incomplete data, 2007 were used as internal validation, and 219 Kazakhs in Halabra Township were used as external validation. Logistic regression discriminations were used for internal validation and external validation, as well as to calculate the probability of CVD for each participant and receiver operating characteristic curves.@*Results@#The prevalence of MS in Kazakh was 30.88%. Seven main factors were extracted from the Kazakh MS population, namely obesity factor, blood lipid and blood glucose factor, liver function factor, blood lipid factor, renal metabolic factor, blood pressure factor, and liver enzyme factor. The area under the curve (AUC) for predicting CVD in the internal validation was 0.773 (95%CI 0.754-0.792). In the external validation, the AUC for predicting CVD was 0.858 (95%CI 0.805-0.901).@*Conclusions@#The CVD risk prediction model constructed by 7 main factors extracted from Kazakh MS patients has high validation efficiency and can be used for risk assessment of CVD in Xinjiang Kazakh population.

Comparison between metabolic syndrome and framingham risk score as predictor of cardiovascular disease among Kazakhs population / 中华内分泌代谢杂志

Objective@#To compare metabolic syndrome(MS)with Framingham risk score as predictors of cardiovascular disease(CVD)among Kazakhs population.@*Methods@#The participants were the residents who had been followed up for more than 5 years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting development of CVD using Cox regression and receiver operating characteristic curve.@*Results@#The incidence of CVD was 13.87%. The incidence of CVD was higher in the MS group than it in the non-MS group(21.59% vs 11.10%, P<0.001). The area under the receiver operating characteristic(ROC)curve of MS risk score was significantly larger than that of MS classification(0.727 vs 0.585, P<0.001); the area under the curve of MS risk score was close to that of Framingham risk score(0.732 vs 0.727, P=0.673). The association between CVD and each quintile of MS risk score was more significant than that between Framingham risk score and CVD under the same exposed condition(4.61, 9.33, 14.15, 22.29 vs 3.69, 6.36, 8.47, 16.99).@*Conclusion@#MS risk score that included age may be a better predictor of CVD among Kazakhs population.

Comparison between metabolic syndrome and framingham risk score as predictor of cardiovascular disease among Kazakhs / 中华内分泌代谢杂志

Objective To compare metabolic syndrome(MS)with Framingham risk score as predictors of cardiovascular disease( CVD) among Kazakhs. Methods The participants were the residents who had been followed up for more than 5 years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting years in representative areas of Kazakhs in Xinjiang. We assigned MS a continuous risk score for predicting the development of CVD based on the weights of MS components. MS and Framingham risk score were compared in terms of their ability in predicting development of CVD using Cox regression and receiver operating characteristic curve. Results The incidence of CVD was 13.87％. The incidence of CVD was higher in the MS group than it in the non-MS group(21.59％ vs 11.10％, P<0.001). The area under the receiver operating characteristic(ROC)curve of MS risk score was significantly larger than that of MS classification(0.727 vs 0.585, P<0.001);the area under the curve of MS risk score was close to that of Framingham risk score ( 0. 732 vs 0.727, P=0.673). The association between CVD and each quintile of MS risk score was more significant than that between Framingham risk score and CVD under the same exposed condition(4.61、9.33、14.15、22.29对3.69、6.36、8.47、16.99) . Conclusion MS risk score that included age may be a better predictor of CVD among Kazakhs.

Clinical application of extracorporeal pneumatic reduction combined with bone-filled mesh bag implantation for the treatment of thoracolumbar osteoporotic burst fracture without spinal cord injury / 中国骨伤

OBJECTIVE@#To compare the clinical efficacy of pneumatic reduction combined with bone-filled mesh bag implantation and pneumatic reduction combined with kyphoplasty in the treatment of thoracolumbar burst fracture without spinal cord injury.@*METHODS@#The clinical data of 160 patients with thoracolumbar osteoporotic burst fracture without spinal cord injury treated from January 2014 to July 2017 were retrospectively analyzed. There were 66 males and 94 females, aged from 72 to 84 years old with an average of 76.4 years old. The patients were divided into two groups according to different surgical methods, including 80 cases of pneumatic reduction combined with bone-filled mesh bag implantation(treatment group) and 80 cases of pneumatic reduction combined with kyphoplasty(control group). The intraoperative bone cement leakage rate was compared between two groups. The height of the injured vertebrae was measured by X-rays preoperatively and 6-month postoperatively in order to assess height loss of injured vertebrae. VAS score and ODI score were used for follow-up to assess lumbar back pain and autonomic dysfunction before surgery and 2 weeks, 6 months, 1 year after surgery.@*RESULTS@#In treatment group, 3 cases occurred bone cement leakage during operation and leakage rate was 3.75%(3/80); In control group, 14 cases had cement leakage with leakage rate of 17.5%; The difference between two groups was statistically significant(<0.05). All patients were followed up for 13 to 24 months with an average of 14.6 months. Among them, 2 cases occurred postoperative infections which were superficial infections. After oral antibiotics and outpatient treatment infections were controlled. At 6 months after surgery, the height of the injured vertebra was measured by X-ray. Treatment group recovered (5.12±1.31) % and control group recovered (14.11±1.17) %. The difference between two groups was statistically significant (<0.05). At 1 year after surgery, ODI score was 4.03±1.62 in treatment group and 10.03±1.54 in control group. The difference between two groups was statistically significant(<0.05). VAS score was 1.03±0.62 in treatment group and 2.67±0.55 in control group. The difference between groups was statistically significant(<0.05).@*CONCLUSIONS@#Extracorporeal pneumatic reduction combined with bone-filled mesh bag implantation technique can significantly reduce the occurrence of intraoperative cement leakage in the treatment of thoracolumbar osteoporotic burst fractures, effectively improve reposition of the injured vertebrae, relieve the pain and recover the function of lower back. However, high price of bone-filled mesh bags obstructs its clinical popularization.

Predictors related to condom use behaviors based on the theory of planned behavior among female sex workers / 中华疾病控制杂志

Objective To identify predictors related to condom use in different tiered female sex workers (FSWs) in Hubei Province. Methods A cross-sectional study was conducted in Hubei Province in 2015 to investigate 816 eligible FSWs by using a multistage sampling method. All data were collected by using a structured questionnaire with scales on condom use, which was designed based on the theory of planned behavior (TPB). A structural equation model (SEM) was used to identify predictors of condom use in the different tiered FSWs. Results It showed that low-tier FSWs used less condom than higher-tier FSWs in commercial sexual behaviors of the last time and during the last month(P<0.001). The TPB scores were significantly different in different tiered FSWs. The scores of PBC in low-tier FSWs were lower than those in higher-tier FSWs (11.43±2.86 vs 12.06±2.87, respectively, P=0.002); But the scores of behavioral intentions were higher than those in higher-tier FSWs (5.47±1.11 vs 5.20±1.15, respectively, P=0.001). The PBC was the major factor related to condom use in low-tier FSWs (effect coefficient=0.55, P<0.001), while the behavioral intention was the major factor related to condom use in higher-tier FSWs (effect coefficient=0.33, P<0.001). Behavioral attitude was the major factor of intention to use condoms for both low-tier (effect coefficient=0.49, P<0.001) and higher-tier FSWs (effect coefficient=0.42, P<0.001). Conclusions Changing the attitude to condom use in FSWs is an important measure to promote the behavior intention. Condom promotion interventions should focus on the perceived behavioral control in low-tier FSWs, and promote the behavior intention in higher-tier FSWs.

Rational use of medications and risk assessment during lactation / 中华围产医学杂志

Pregnant and breastfeeding women are perhaps "the last true therapeutic orphans". Due to dearth of adequate research on certain medications and healthcare providers' poor knowledge of lactational pharmacology, nursing mothers are often ill-advised to give up breastfeeding or unlikely to receive appropriate treatment. Accumulating evidence-based data have shown that most medications are safe for nursing mothers. Besides safety concerns, infant's condition and maternal attitude should also be considered when making treatment decisions. Clear understanding of lactational pharmacology and risk assessment tools in breastfed infants would be beneficial to meet the medical needs of nursing mothers and promote breastfeeding.

Expressions of CD96 and CD123 and Their Relationship with Prognosis of Patients with Myelodysplastic Syndrome / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the relationship between expression of CD96 and CD123 and prognosis of patients with myelodysplastic syndrome(MDS).</p><p><b>METHODS</b>Eight-nine MDS patients(MDS group) and 20 persons without hematologic disease as controls(Control group) were enrolled. The patients were grouped by the risk. All participants received bone marrow biopsy. Mononuclear cells were extracted, CD34CD38CD123and CD34CD38CD96cells were counted by using flow cytometry. Expressions of 2 type cells in control group, MDS group and its subgroups were analyzed.</p><p><b>RESULTS</b>The proportion of CD34cells and CD34CD38cells in mononuclear cells of patients in MDS group was higher than in control group (P<0.05). The proportions of CD34CD38CD123cells and CD34CD38CD96cells in CD34CD38cells were significantly higher than that in control group(P<0.05) and the proportion increased with the risk. In the low-and middle-risk group, the rates of complete remission(CR) and partial remission(PR) of patients with CD123and CD96were higher than those in patients with CD123and CD96; in the middle-2 and high risk patients, the PR of patients with CD123was higher than that in patients with CD123(P<0.05). The CR rate of patients with CD96was higher than that of patients with CD96(P<0.05).</p><p><b>CONCLUSION</b>The differentiation of CD34cells in bone marrow of MDS patients is abnormal, and the high expression of CD123 and CD96 cells existes. These findings may partially explain the cause of hematopoietic stem cell malignant clone in MDS patients.</p>

Protective Effects of Danlou Tablet () against Murine Myocardial Ischemia and Reperfusion Injury In Vivo / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the in vivo effect of Danlou Tablet (, DLT) on myocardial ischemia and reperfusion (I/R) injury.</p><p><b>METHODS</b>DLT effects were evaluated in mouse heart preparation using 30-min coronary occlusion followed by 24-h reperfusion and compared among sham group (n=6), I/R group (n=8), IPC group (ischemia preconditioning, n=6) and DLT group (I/R with DLT pretreatment for 3 days, 750 mg•kg•day, n=8). The effects of DLT were characterized in infarction size (IS) compared with risk region (RR) and left ventricle using the Evans blue/triphenyltetrazolium chloride double dye staining method in vivo. Furthermore, the dose-dependent effect of DLT on I/R injury was evaluated by double staining method. Five different concentrations of DLT (0.625, 1.25, 2.5, 5 and 10 g•kg•day) were chosen in this study, and dose-response curve of DLT was obtained on these data.</p><p><b>RESULTS</b>The ratio of IS to left ventricle was significantly smaller in the DLT and IPC groups than the I/R group (P<0.05 or P<0.01), the ratio of IS to RR was also reduced in the DLT and IPC groups (P<0.01), while there were no differences in RR among the four groups (P>0.05). Experiments showed incidence of arrhythmias was reduced in the DLT group (P<0.01). Furthermore, DLT produced a dose-dependent inhibitory effect with a half maximal inhibitory concentration of 1.225 g•kg•day.</p><p><b>CONCLUSIONS</b>Our research concluded that DLT was effective in reducing I/R injury in mice, and provided experimental supports for the clinical use of DLT.</p>

Study on the prevalence rate and optimal waist circumference cut-off points of obesity for the components of metabolic syndrome in Uygur from Xinjiang / 中华内分泌代谢杂志

Objective To investigate the prevalence of metabolic syndrome and appropriate cut-off point of waist circumference of abdominal obesity for components of metabolic syndrome in Uygur population in Xinjiang. Methods A questionnaire-based survey, physical examination, and blood testing were conducted according to cluster random sampling in Uygur residents above 18 years old in Xinjiang.There were 3 542 samples collected,based on the International Diabetes Federation(IDF)standard of metabolic syndrome, the relativities of clustering of metabolic syndrome components and different strata of waist circumference for Uygur were analyzed,and looking for the appropriate cut-off points for identifying two or more components of metabolic syndrome within the shortest distance of receiver operating characteristic(ROC)curve.Results According to IDF standard,the waist circumference(85 cm for men,82 cm for women)corresponded to the shortest distance in ROC curve,at these cut-offs of abdominal obesity for component of metabolic syndrome,the prevalences of metabolic syndrome were 21.3%,19.5%in men, while 23.0%in women,the prevalence of women was higher than that of men(P<0.05).The prevalences of≥1,≥2 components of metabolic syndrome were shown an increasing trend with the increasing size of waist circumference, and the odds ratio of clustering of metabolic syndrome components were also increased significantly.Conclusion The prevalence of metabolic syndrome among Xinjiang Uygur population was higher than that of national level.The cut-off points of waist circumference(85 cm for men,82 cm for women)combining other components definition of IDF standard were recommended for identifying metabolic syndrome of Uygurs.

Salvianolate reduces murine myocardial ischemia and reperfusion injury via ERK1/2 signaling pathways in vivo / 中国结合医学杂志

<p><b>OBJECTIVE</b>To analyze the effects of salvianolate on myocardial infarction in a murine in vivo model of ischemia and reperfusion (I/R) injury.</p><p><b>METHODS</b>Myocardial I/R injury model was constructed in mice by 30 min of coronary occlusion followed by 24 h of reperfusion and pretreated with salvianolate 30 min before I/R (SAL group). The SAL group was compared with SHAM (no I/R and no salvianolate), I/R (no salvianolate), and ischemia preconditioning (IPC) groups. Furthermore, an ERK1/2 inhibitor PD98059 (1 mg/kg), and a phosphatidylinositol-3-kinase (PI3-K) inhibitor, LY294002 (7.5 mg/kg), were administered intraperitoneal injection (i.p) for 30 min prior to salvianolate, followed by I/R surgery in LY and PD groups. By using a double staining method, the ratio of the infarct size (IS) to left ventricle (LV) and of risk region (RR) to LV were compared among the groups. Correlations between IS and RR were analyzed. Western-blot was used to detect the extracellular signal-regulated kinase 1/2 (ERK1/2) and protein kinase B (AKT) phosphorylation changes.</p><p><b>RESULTS</b>There were no significant differences between RR to LV ratio among the SHAM, I/R, IPC and SAL groups (P>0.05). The SAL and IPC groups had IS of 26.1%±1.4% and 22.3%±2.9% of RR, respectively, both of which were significantly smaller than the I/R group (38.5%±2.9% of RR, P<0.05, P<0.01, respectively). Moreover, the phosphorylation of ERK1/2 was increased in SAL group (P<0.05), while AKT had no significant change. LY294002 further reduced IS, whereas the protective role of salvianolate could be attenuated by PD98059, which increased the IS. Additionally, the IS was not linearly related to the RR (r=0.23, 0.45, 0.62, 0.17, and 0.52 in the SHAM, I/R, SAL, LY and PD groups, respectively).</p><p><b>CONCLUSION</b>Salvianolate could reduce myocardial I/R injury in mice in vivo, which involves an ERK1/2 pathway, but not a PI3-K signaling pathway.</p>

Facilitating the measurement of circulatory hydrogen sulfide with fluorescence probe-coated microplates / 北京大学学报(医学版)

Objective:The hydrogen sulfide (H2 S) role in pathogenesis of various diseases were wildly addressed in recent decade.The circulatory (plasma or serum) and biological fluid H2S measurement is still an enormous issues due to the technical limitation.This paper aimed to develop a novel measurement method based on fluorescence probe.Methods:Firstly,20 μL ethanol was used to dissolve 100 pmol fluorescence probe,then added in a 96-well plate.An equal volume of ethanol was also added to the blank well of the plate.The plate was placed in a dark room for about 1 h until the fluorescence probe was evenly coated in the 96-well microplate and dried.The plate was frozen at-20 ℃ for later use.Secondly,the plasma or serum sample was added with saturated ammonium sulfate buffer (pH 7.8) and then centrifuged to remove the proteins.The equal volume supernatant liquid was added to the probecoated well and the probe-uncoated well.The plate was incubated in a dark environment at 37 ℃ for 2 h.Finally,after incubation,the fluorescence density was acquired at λEx/λEm 340/445 nm in a microplate reader.The differences of the fluorescence density values between the probe-coated well and probeuncoated well were counted and H2S concentration of plasma/serum was calculated by standard curve with NaHiS.Results:The method had high sensitivity (from 0.3 to 100 μmol/L) and specificity for measuring H2S as compared with other biologically relevant reactive sulfur species and sulfur-containing amino acid.Serum H2S concentrations were assayed in 188 health volunteers using this method [(12.1 ±3.5) μmol/L,95％ CI:4.6-19.8 μmol/L],and the frequency distribution showed a normal tendency(one-sample Kolmogorov-Smirnov test,P ＞ 0.1).The serum H2S concentrations in 30 hypertension patients were decreased compared with 22 age-and gender-matched health individuals (paired-samples t test,t =9.937,P ＜ 0.001).There were no differences of H2S concentration in serum [(19.66 ±2.32) μmol/L] or plasma [(18.67 ±2.07) μmol/L],between the samples acquired from artery [(19.34 ±0.51) μmol/L] or vein [(18.99 ±0.50) μ mol/L] of male Wistar rats (repeated measurement of ANOVA,P =0.38).One week frozen samples did not affect the detection.The values of the repeated measurement did not differ (two-way ANOVA,P ＞ 0.05).Conclusion:The present method is easily performed with high sensitivity,specificity and repeatability for circulatory H2S.It is also quick and may apply for large samples.