Research progress of KRAS inhibitors / 中国药科大学学报

@#Abstract: KRAS protein, a small GTPase encoded by the Kirsten rat sarcoma viral oncogene homologue (KRAS) gene, is involved in cell proliferation, differentiation, migration and cell survival, and is known as a regulatory switch for the cell life cycle. However, KRAS gene is prone to mutation, leading to hyperactivation of its downstream signaling pathways, and has a vital role in driving tumorigenesis. KRAS mutations predominantly take place at residue G12, G13 or Q61, and different mutants have varying effects on protein physiological functions and tumor types. Due to its smooth surface and high affinity for nucleotides, KRAS had been considered to be “undruggable” until the launch of selective KRAS G12C inhibitors sotorasib and adagrasib, which broke the dogma. This review introduces the structure and functions of KRAS, as well as the status and progress of inhibitors directly targeting KRAS mutants (G12C, G12D, G12R, G12S) and pan-KRAS inhibitors, aiming to provide some insightful reference for the development of KRAS inhibitors.

Effect of traditional Chinese medicine and compounds for supplementing qi and activating blood circulation and inducing resuscitation on regulating stem cells to promote nerve repair of acute ischemic stroke / 中国组织工程研究

BACKGROUND:Endogenous neurogenesis and exogenous stem cell transplantation in the brain show great therapeutic potential for neurological diseases including ischemic stroke,repairing and replacing lost neurons,promoting synaptic remodeling,and inhibiting apoptosis.Traditional Chinese medicine and compound therapy for supplementing qi,activating blood circulation and inducing resuscitation for the treatment of neurological dysfunction after ischemia have certain advantages,targeting nerve repair through a variety of ways,including promoting endogenous neurogenesis and exogenous stem cell survival,proliferation,homing,and inducing neuronal differentiation. OBJECTIVE:To summarize the mechanism of traditional Chinese medicine and compound for supplementing qi,activating blood circulation and inducing resuscitation to promote nerve repair in the acute phase of ischemic stroke,in order to provide a reference for the research and treatment of new drugs in ischemic stroke. METHODS:The articles from CNKI and PubMed databases about traditional Chinese medicine and compound for supplementing qi,activating blood circulation and inducing resuscitation in promotion of nerve repair in the acute phase of ischemic stroke from 2010 to 2022 were searched,with"supplementing qi and activating blood circulation;inducing resuscitation;traditional Chinese medicine(TCM);compounds;ischemic stroke;nerve repair;stem cells"as Chinese and English search terms.After excluding old and duplicate views,the retrieved literature was analyzed and collated,and a total of 124 articles were included for analysis. RESULTS AND CONCLUSION:(1)The definition of stem cells,ischemic stroke and the nerve repair pathway in the acute phase of ischemic stroke were sorted out.(2)The mechanism of action of traditional Chinese medicine and compound for supplementing qi,activating blood circulation and inducing resuscitation to promote nerve repair in the acute phase of ischemic stroke was summarized,mainly including promoting stem cell proliferation,improving stem cell viability and survival rate,promoting nerve cell homing,inducing stem cell differentiation to neurons,inhibiting apoptosis of nerve cells,promoting axon regeneration,regulating angiogenesis and remodeling,improving the level of neurotrophic factors and repairing the integrity of the blood-brain barrier.(3)Through the existing research,the relevant factors and signaling pathways of traditional Chinese medicines and compounds for supplementing qi,activating blood circulation and inducing resuscitation to promote nerve repair in the acute phase of ischemic stroke were summarized,such as Nestin protein expression,DCX protein expression,brain-derived neurotrophic factor,vascular endothelial growth factor and Wnt/β-catenin signaling pathway,Notch signaling pathway,PI3k/Akt signaling pathway,BDNF/TrkB signaling pathway and ERK/MAPK signaling pathway.It provides a relevant reference for future research on ischemic stroke-specific drugs and new clinical treatment methods.

Shexiang Huangqi compound dripping pills-containing serum promotes proliferation and differentiation of bone marrow mesenchymal stem cells / 中国组织工程研究

BACKGROUND:Bone marrow mesenchymal stem cells have been widely used to treat neurological diseases.However,due to limitations of the blood-brain barrier,low survival rate and differentiation rate of stem cells at damaged sites,the therapeutic effect is limited. OBJECTIVE:To investigate the effects of Shexiang Huangqi compound dripping pills on proliferation,migration and astrocyte differentiation of bone marrow mesenchymal stem cells. METHODS:Male SD rats were treated with Shexiang Huangqi compound dripping pills for 5 days after continuous gavage.Blood was collected from the abdominal aorta and serum was separated for later use.The effect of 5%,10%and 20%drug-containing serum on the proliferation of bone marrow mesenchymal stem cells was detected by CCK-8 assay.The effect of 10%drug-containing serum on lateral migration of bone marrow mesenchymal stem cells was observed by scratch test.Bone marrow mesenchymal stem cells were cultured in Transwell cells.The effects of 10%drug-containing serum on longitudinal migration of bone marrow mesenchymal stem cells were observed by crystal violet staining and DAPI nuclear staining.Differentiation of bone marrow mesenchymal stem cells into astrocytes was observed by inducing solution with 10%drug-containing serum or co-culture with astrocytes. RESULTS AND CONCLUSION:(1)10%and 20%drug-containing serum promoted cell proliferation more significantly on days 2 and 3,and there was no statistical difference between the two concentrations.(2)At 30 and 48 hours,bone marrow mesenchymal stem cell migration in 10%drug-containing serum group was significantly higher than that in the control group.(3)The number of bone marrow mesenchymal stem cells filtered through Transwell cells in 10%drug-containing serum group was higher than that in the control group.(4)10%drug-containing serum might promote the differentiation of bone marrow mesenchymal stem cells to astrocytes,but the differentiation effect was weak,and astrocytes might further promote the differentiation of bone marrow mesenchymal stem cells into astrocytes induced by drug-containing serum.(5)The results exhibited that the 10%drug-containing serum could promote the proliferation and migration of bone marrow mesenchymal stem cells in vitro.Co-culture with astrocytes may promote the differentiation of bone marrow mesenchymal stem cells towards astrocytes.

Simulation Analysis of Firefighter Training Postures with Loads / 医用生物力学

Objective To study the injury risk and fatigue status of firefighters with different training postures under load-bearing conditions to reduce the occurrence of physical injuries and occupational diseases.Methods First,a questionnaire was administered to investigate the training injury conditions of firefighters in a fire-rescue brigade.Considering the exercise fatigue factor,which accounts for the highest proportion of injury causes,lower back analysis,static strength analysis,fatigue analysis,comfort analysis,and other human factor analysis tools in Jack software were used to analyze four common firefighter water-shooting training postures.Training postures while climbing a five-storey building with loads and a hooked ladder were also simulated.Results Injury caused by exercise fatigue accounted for 69.8%of injuries and was the most important injury-causing factor.The risk of knee and ankle joint injuries increased in all four water-shooting postures.The comfort levels of the four water-shooting postures from high to low were shoulder,standing,kneeling,and lying postures.For the entire dynamic training process,while climbing the five-storey building with loads and climbing the hooked ladder,firefighters did not have an increased risk of lower back injury but had an increased risk of ankle and knee joint injuries.Conclusions Some training postures are uncomfortable for firefighters,and they experience body discomfort during firefighting training with loads,thereby increasing injury risk.These results provide scientific references for the prevention and reduction of firefighter training injuries,and the formulation of reasonable training plans and targeted protective measures.

A clinical and electrodiagnostic study of peripheral neuropathy in prediabetic patients / 中华神经科杂志

Objective:To explore the clinical and electrophysiological characteristics of peripheral neuropathy in prediabetic patients.Methods:Subjects aged 20-65 years with high-risk factors of impaired glycemia enrolled in Beijing Tiantan Hospital, Capital Medical University from 2019 to 2022 were recruited to conduct oral glucose tolerance test, after excluding other causes of neuropathy or radiculopathy. Patients with impaired fasting glucose or impaired glucose tolerance were defined by American Diabetes Association criteria. These patients were divided into clinical polyneuropathy (PN) and clinical non-PN groups, according to the 2010 Toronto consensus criteria and the presence of PN symptoms and signs or not. Nerve conduction studies (NCS), F wave, sympathetic skin response (SSR), R-R interval variation (RRIV) and current perception thresholds (CPT) were performed and the abnormal rate was compared between different electrodiagnostic methods and between clinical subgroups.Results:Among the 73 prediabetic patients ultimately enrolled, only 20 (27.4%) can be diagnosed as clinical PN according to the Toronto consensus criteria. The abnormal rate of CPT (68.5%, 50/73) was significantly higher than those of F wave (2.7%, 2/73), lower limb NCS (0, 0/73), upper limb NCS changes of carpal tunnel syndrome (26.0%, 19/73), SSR (6.8%, 5/73) and RRIV (5.5%, 4/73; McNemar test, all P<0.001). With sinusoid-waveform current stimuli at frequencies of 2 000 Hz, 250 Hz and 5 Hz, the CPT device was used to measure cutaneous sensory thresholds of large myelinated, small myelinated and small unmyelinated sensory fibers respectively. CPT revealed a 21.9% (16/73) abnormal rate of unmyelinated C fiber in the hands of prediabetic patients, significantly higher than that of large myelinated Aβ fibers [8.2% (6/73), χ2=5.352, P=0.021]. Both abnormal rates of small myelinated Aδ [42.5% (31/73)] and unmyelinated C fibers [39.7% (29/73)] in the feet of prediabetic patients were significantly higher than that of large myelinated Aβ fibers [11.0% (8/73), χ2=18.508, 15.965, both P<0.001]. Compared with the clinical non-PN group, the abnormal rates of CPT [90.0% (18/20) vs 60.4% (32/53), χ2=5.904, P=0.015] and SSR [20.0% (4/20) vs 1.9% (1/53), P=0.016) were significantly higher in the clinical PN group. Conclusions:Peripheral neuropathies in prediabetic patients are usually asymptomatic or subclinical, and predispose to affect unmyelinated and small myelinated sensory fibers. Selective electrodiagnostic measurements of small fibers help to detect prediabetic neuropathies in the earliest stages of the disease.

Historical evolution and clinical application of classical prescription Yigongsan / 中国药房

Yigongsan， derived from QIAN Yi’s Key to Therapeutics of Children’s Diseases in the Song Dynasty， is a classic pediatric prescription that is included in the Catalogue of Ancient Classic Prescriptions （the Second Batch of Pediatrics） released by the National Administration of Traditional Chinese Medicine in 2022. This paper verifies and analyzes the historical origin， composition， dosage， processing， decoction method and efficacy of Yigongsan by systematically combing ancient books and modern documents. As a result， Yigongsan is composed of five herbs： Panax ginseng， Poria cocos， Atractylodes macrocephala， Citrus reticulata and Glycyrrhiza uralensis， of which P. cocos should be peeled， A. macrocephala is fried with soil， G. uralensis is roasted with honey while P. ginseng and C. reticulata are raw products. According to the dosage of ancient and modern times， each medicinal herb must be ground into fine powder， 1.6 g for each， added with 300 mL of water， 5 pieces of Zingiber officinale， and 2 Ziziphus jujuba， decocted together to 210 mL， and taken before meals. In ancient books， Yigongsan is used to treat vomiting， diarrhea， spleen and stomach deficiency， chest and abdominal distension， and lack of appetite， etc. Modern research showed that Yigongsan could also be used in the diseases of immune system， respiratory system， blood system， etc.， involving infantile anorexia， asthma， anemia， tumors and so on.

Practice and reflection on continuing education and training of clinical pharmacists in the neurology department / 中国药房

OBJECTIVE To provide a reference for continuing education and training of clinical pharmacists. METHODS The revision of the syllabus and the improvement of training methods of practical skills training class for clinical pharmacists in the neurology department held by Xuanwu Hospital of Capital Medical University from 2007 to 2022 was sorted to summarize its advantages and characteristics. RESULTS Training programs were developed to benefit clinical pharmacists at different levels， and the training contents were adjusted according to the training programs and the needs of trainees. Teachers with teaching experience were selected to participate in the teaching. Theory teaching was combined with practice teaching in the teaching process， and case teaching and question-based teaching methods were adopted to benefit both senior clinical pharmacists and new clinical pharmacists. In addition， the influence of the training class was expanded through online teaching， so that doctors and pharmacists could communicate and learn together on the platform of the training class. For example， when designing the training program， we replaced one common neurological disease every two years， and carried rollover study on its new progress and new ideas； clinical pharmacist skill course was reduced， drug history writing， information retrieval and test index interpretation were compressed into clinical pharmacy skill course. CONCLUSIONS The continuing education platform is established for clinical pharmacists； new knowledge and concepts that clinical pharmacists of this specialty need to be familiar with are compiled into the teaching syllabus， and the experts who are familiar with the training of clinical pharmacists are selected to explain to the students so that the students could follow the platform to constantly update their knowledge and improve the ability of clinical pharmacists to participate in the clinic work.

Historical Evolution and Clinical Application of Famous Classical Formulas Zhulingtang / 中国实验方剂学杂志

The classic formula Zhulingtang, derived from the medical work Treatise on Cold Damage (《伤寒论》) compiled by ZHANG Zhongjing, a medical sage in the Eastern Han Dynasty, has been included in the Catalogue of Ancient Classic Formulas (First Batch) published by the National Administration of Traditional Chinese Medicine in 2018. Using the method of textual research, this study systematically reviewed ancient and modern literature to conduct a historical and textual analysis of Zhulingtang, including its origin, composition, dosage, processing, decoction methods, efficacy, and applications. A total of 733 pieces of relevant information related to Zhulingtang were collected, involving 206 ancient Chinese medical texts, with 52 of them providing detailed records of the composition, dosage, processing, and efficacy of Zhulingtang. The results of the analysis showed that Zhulingtang was composed of Polyporus, Poria, Alismatis Rhizoma, Asini Corii Colla, and Talcum. Polyporus and Poria should be used without their peels, Asini Corii Colla should be stir-fried with clam powder, and Talcum should be ground into powder or soaked in water. Based on the conversion of ancient and modern dosages, Polyporus, Poria, Alismatis Rhizoma, and Talcum, 15.63 g for each one, were decocted with 800 mL of water to 400 mL. Then the drug residue was removed, and 15.63 g of Asini Corii Colla was added to the drug juice for melting by heating. The decoction should be taken warm, 140 mL each time, three times a day. Zhulingtang has the effects of promoting diuresis, nourishing yin, and clearing heat, and it is mainly used to treat water-heat combination syndrome, characterized by symptoms such as difficult urination, fever, and thirst. Modern research indicates that Zhulingtang is commonly used to treat diseases such as cirrhotic ascites, chronic glomerulonephritis, nephrotic syndrome, diarrhea, and urinary tract infections. This study provides key information about the famous formula Zhulingtang, which can serve as a reference for further development and research on its application.

Anti-hyperuricemia activity and its mechanism of flavonoid extract from saffron floral bio-residues / 中国中药杂志

A hyperuricemic rat model induced by adenine and ethambutol was established to investigate the anti-hyperuricemia activity and its mechanism of the flavonoid extract from saffron floral bio-residues. Sixty-seven SD rats were randomly divided into control group, model group, positive control group, and flavonoid extract groups(with 3 doses), respectively, and each group contained 11 or 12 rats. The hyperuricemic model was established by continuous oral administration of adenine(100 mg·kg~(-1)) and ethambutol(250 mg·kg~(-1)) for 7 days. At the same time, the positive control group was given allopurinol(20 mg·kg~(-1) per day) and the flavonoid extract groups were given the flavonoid extract at doses of 340, 170 and 85 mg·kg~(-1) per day, respectively. On day 8, rat serum, liver, kidney, and intestinal tissues were collected, and the levels of uric acid in serum and tissue, the xanthine oxidase activities and antioxi-dant activities in serum and liver were evaluated, and the kidney histopathology was explored. In addition, an untargeted serum metabolomics study was performed. According to the results, the flavonoid extract effectively reduced the uric acid levels in serum, kidney and ileum and inhibited the xanthine oxidase activities and elevated the antioxidant activities of serum and liver in hyperuricemic rat. At the same time, it reduced the levels of inflammation factors in kidney and protected renal function. Moreover, 68 differential metabolites of hyperuricemic rats were screened and most of which were lipids and amino acids. The flavonoid extract significantly retrieved the levels of differential metabolites in hyperuricemic rats, such as SM(d18:1/20:0), PC[18:0/18:2(92,12Z)], palmitic acid and citrulline, possibly through the following three pathways, i.e., arginine biosynthesis, glycine, serine and threonine metabolism, and histidine metabolism. To sum up, the flavonoid extract of saffron floral bio-residues lowered the uric acid level, increased the antioxidant activity, and alleviated inflammatory symptoms of hyperuricemic rats, which may be related to its inhibition of xanthine oxidase activity and regulation of serum lipids and amino acids metabolism.

Countermeasures for the construction of occupational health information standard system / 中华劳动卫生职业病杂志

As an important part of health information standard system, occupational health information standard system is the foundation and guarantee of promoting the construction of occupational health information. This article is based on the literature research about current situation of domestic and foreign health information standards and occupational health information standard system, thus take "the National Health Information Standardization System" and "the National Public Health Information Construction Standards and Norms" into account, focus on the requirements of occupational health information construction and related work. Thus, put forward suggestions on the construction of occupational health information standard system, to accelerate the occupational health information construction, data collection, transmission and application.

Two cases of airway dysfunction related to diacetyl exposure / 中华劳动卫生职业病杂志

Occupational exposure to diacetyl can lead to bronchiolitis obliterans. In this paper, two patients with severe obstructive ventilation disorder who were exposed to diacetyl at a fragrance and flavours factory were analyzed. The clinical manifestations were cough and shortness of breath. One of them showed Mosaic shadows and uneven perfusion in both lungs on CT, while the other was normal. Field investigation found that 4 of the 8 workers in the factory were found to have obstructive ventilation disorder, and 2 had small airway dysfunction. This paper summarizes the diagnostic process of patients in order to improve the understanding of airway dysfunction caused by occupational exposure to diacetyl and promote the development of relevant standards.

Prenatal diagnosis and genetic analysis of three fetuses with duodenal atresia or stenosis / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for three fetuses with duodenal atresia or stenosis detected by ultrasonography.@*METHODS@#Clinical data of three fetuses identified at the Women's Hospital Affiliated to Zhejiang University School of Medicine between January 2021 and August 2022 were collected. Umbilical cord blood and amniotic fluid samples of the fetuses and peripheral blood samples of their parents were collected and subjected to G-banded chromosomal karyotyping and single nucleotide polymorphism array (SNP array) analysis.@*RESULTS@#Prenatal ultrasound of the three fetuses revealed duodenal atresia or stenosis. No karyotypic abnormality was detected, whilst SNP array has identified 1.4 ~ 1.9 Mb duplications at 17q12 in all of them, which were all predicted to be pathogenic copy number variations (CNVs).@*CONCLUSION@#The 17q12 duplications probably underlay the duodenal atresia and stenosis in these fetuses, and chromosomal CNVs should be considered in duodenal atresia and stenosis.

Analysis of work stress and its influencing factors among nursing staff in Tianjin City / 中华劳动卫生职业病杂志

Objective: To explore the current situation of work stress among nursing staff in Tianjin City and analyze its influencing factors. Methods: From August to October 2020, 26002 nursing staff from tertiary hospitals, secondary public hospitals, secondary private hospitals, primary hospitals, and other medical institutions in Tianjin City were selected as objects, and their general situation and working stress situation were surveyed by the general information questionnaire and the Nurse's Work Stressor Scale. Single factor analysis and multiple linear regression analysis were used to explore the influencing factors of work stress among nursing staff. Results: The average age of 26002 nursing staff was (33.86±8.28) years old, and the average working years were (11.84±9.12) years. There were 24874 women (95.66%) and 1128 men (4.34%). The total score of work stress was (79.82±21.69), and the average score of workload and time allocation dimension was the highest (2.55±0.79). The results of multiple linear regression analysis showed that marital status (β=-0.015, P=0.014), employment form as contract system (β=0.022, P=0.001), post as clinical nursing (β=0.048, P<0.001), education level (β=0.024, P<0.001), age (β=0.050, P<0.001), working years (β=0.075, P<0.001), and professional title (β=0.036, P<0.001) were the influencing factors of work stress, which explained 22.8% of the total variation in work stress of nursing staff (F=24.25, P<0.001) . Conclusion: The work stress among nursing staff in Tianjin City is high, the corresponding departments and nursing managers should adopt scientific management methods to reduce the workload of nursing staff according to the influencing factors of work stress, so as to create a good atmosphere for further promoting the healthy development of nursing career and nursing industry in the new era.

Construction and prospect of healthy enterprises in the new era / 中华劳动卫生职业病杂志

The construction of health enterprises practice the concept of big health. It is an important solution to protect the overall health of occupational groups in the new era, which is of great significance to promoting a healthy city and helping to build a healthy China. This paper clarifies the connotation of healthy enterprises in the new era, discusses the key points of healthy enterprise construction around the "four in one" construction content, "PDCA" construction procedures, and evaluation methods of healthy enterprises. It focuses on the progress of healthy enterprise construction, analyzes the problems faced by the construction of health enterprises in China, and puts forward suggestions to improve the construction efficiency, with a view to providing ideas for further promoting the construction of health enterprises in China.

Research progress in emergency drug stockpile for nuclear and radiological accidents / 中华放射医学与防护杂志

In the current international situation, there is the possibility of nuclear war and nuclear terrorism. The nuclear and radiological emergency in the event of an accident should be enhanced. The World Health Organization (WHO) issued a publication on January 27, 2023, updating the list of drugs recommended for stockpiling in response to radiation and nuclear emergencies, which was the first update since 2007. The list of recommended drug stocks in the publication includes drugs to prevent or reduce the effects of radiation, as well as drugs used to treat injuries after exposure. Based on the list of drugs, this article reviews the emergency response to nuclear and radiological accidents, the general situation of emergency drug stockpiles, drug reserves in some countries, and current considerations, with a view to providing references for emergency medical rescue in nuclear and radiological accidents in China.

Application prospect of molecular imaging technology in Mongolian medicine treatment research / 中华核医学与分子影像杂志

Long-term clinical practice shows that Mongolian medicine not only has a unique effect on frequently-occurring and common diseases, but also has particularly remarkable effects on difficult diseases such as cardiovascular diseases, cancer, etc. Molecular imaging technology, which based on imaging technology, displays special molecules on the tissue, cell, and subcellular level. By reflecting the changes on molecular level in vivo, lesions can be located, quantitatively and qualitatively imaged and analyzed. Non-invasive imaging in vivo is the most significant feature of molecular imaging technology. In the research of Mongolian medicine treatment, molecular imaging technology can present the characteristics of the lesions before and after treatment in vivo and in real time, dynamically evaluate the effect of drug treatment, and provide new ideas for exploring the efficacy of Mongolian medicine and developing new drugs.

Modified Mohs micrographic surgery for the treatment of five cases of eccrine porocarcinoma / 中华皮肤科杂志

Objective:To investigate the efficacy of modified Mohs micrographic surgery in the treatment of eccrine porocarcinoma.Methods:Clinical data were collected from 5 patients with eccrine porocarcinoma, who treated with modified Mohs micrographic surgery in Department of Dermatology, Wuhan No.1 Hospital from 2016 to 2020, and retrospectively analyzed.Results:Among the 5 patients, 2 were males and 3 were females, their age ranged from 52 to 80 years, and the course of disease ranged from 1 to 50 years. Skin lesions were located on the scalp, face, abdomen, thighs and feet, with diameters ranging from 1 to 6 cm. Tumor excision was performed with 1-cm margins, and was deep to the superficial fascial layers. For histopathologically negative surgical margins, the defects were closed with skin flaps or grafts; for histopathologically positive margins, the excision margin continued to be widened until it was clean. The 5 patients were followed up for 1 - 5 years without recurrence, and 1 died 2 years later due to liver cancer metastasis.Conclusion:Modified Mohs micrographic surgery can ensure clean resection margins and reduce the loss of normal tissues in the treatment of eccrine porocarcinoma.

Correlating nerve conduction studies with cross-sectional area measured using ultrasound in patients with neuromuscular disease / 中华神经科杂志

Objective:To determine whether there is a correlation between the cross-sectional area (CSA) and the parameters as measured on nerve conduction studies.Methods:Twenty-one patients with neuromuscular diseases in Beijing Tiantan Hospital from March 3, 2022 to May 4, 2023 underwent ultrasound measurement of the CSA of the median nerves and ulnar nerves at the wrist, elbow and the upper arm, followed by nerve conduction studies (NCS). A linear regression model was performed to compare NCS and CSA.Results:A total of 180 sets of motor nerve conduction velocity (MCV) and CSA at the different sites including 102 sets of median nerve and 78 sets of ulnar nerve, 220 sets of compound muscle action potential (CMAP) amplitude and CSA at the different sites including 104 sets of median nerve and 116 sets of ulnar nerve, 60 sets of sensory nerve conduction velocity (SCV) and CSA and sensory nerve action potential (SNAP) amplitude and CSA at the wrist including 32 sets of median nerve and 28 sets of ulnar nerve were recorded. The linear correlation between MCV and CSA was statistically significant both in median nerve ( r2=0.10,adjusted r2=0.09, P=0.001) and in ulnar nerve ( r2=0.18,adjusted r2=0.17, P<0.001).When CSA>10 mm 2, the linear correlation between CMAP amplitude and CSA was statistically significant both in median nerve ( r2=0.09,adjusted r2=0.08, P=0.024) and ulnar nerve ( r2=0.19,adjusted r2=0.17, P=0.004). The correlation between CMAP and CSA was not statistically significant when CSA≤10 mm 2. And the correlations between SCV and CSA and between SNAP and CSA were not statistically significant. Conclusions:CSA can better show the characteristics of changes in motor nerve conduction especially in motor conduction velocity. It is suggested that its application prospect in demyelinating peripheral neuropathy with motor nerve damage may be more extensive.

Coaxial catheter technique in carotid artery stenting implantation via radial artery approach:its effectiveness and safety / 介入放射学杂志

Objective To investigate the effectiveness and safety of coaxial catheter technique in carotid artery stent implantation via radial artery approach.Methods The general and clinical data of patients,who underwent carotid artery stent implantation via radial artery approach at the Department of Neurology,Daxing Teaching Hospital of Capital Medical University of China between January 2021 and October 2022,were retrospectively analyzed.During the operation,coaxial catheter technology was used to make a 6F catheter inserting into the target vessel for performing carotid stent implantation,and the rate of successful catheter placement,surgical success rate,and perioperative complications were analyzed.Results A total of 40 patients,who underwent carotid artery stent implantation via radial artery approach,were enrolled in this study.The involved vessels included left internal carotid artery(n=16),right internal carotid artery(n=24),type Ⅰaortic arch(n=13),type Ⅱ aortic arch(n=20),type Ⅲ aortic arch(n=7),and bovine aortic arch(n=1).The rate of successful catheter placement was 100％,the surgical success rate was 95％,and no procedure-related complications occurred.The time spent on surgery was(34.4±13.6)min.No patients developed symptoms of cerebral infarction or myocardial infarction in 30 days after the operation.Conclusion The use of coaxial catheter technology can make the catheter inserting into the target vessel quickly and avoid repeated catheter exchange.Coaxial catheter technology is safe and effective in performing carotid artery stent implantation via radial artery approach.(J Intervent Radiol,2023,32:1169-1173)

Effect of Median Nerve Electrical Stimulation on Synaptic Plasticity in Ischemic Stroke Rats / 昆明医科大学学报

Objective To investigate the effects and mechanisms of median nerve electrical stimulation on synaptic plasticity in ischemic stroke rats.Methods 18 healthy male SD rats were randomly divided into Sham group(n = 6),ischemic stroke group(MCAO group,n = 6)and median nerve electrical stimulation group(MNES group,n = 6).The left middle cerebral artery occlusion model of rats was established by thread plug method.Thread plug was not inserted in sham group.The median nerve electrical stimulation group was given median nerve electrical stimulation intervention on the 3rd day after modeling,and intervention on the next day.After intervention for 7 times,behavioral detection,HE staining was used to detect median nerve injury.Nissl staining was used to detect cerebral infarction volume.Western blot was used for detection of the expression level of proteins related to synaptic plasticity,and electron microscopy was performed.Results HE staining showed that median nerve electrical stimulation did not cause damage to the median nerve in stroke rats,and the median nerve membrane was intact without obvious inflammatory cells.Compared with MCAO group,the neural function,motor function and coordination of the injured forelimb in MNES group were significantly improved(P<0.01).Compared with MCAO group,cerebral infarction volume in MNES group was significantly reduced(P<0.05),the pyknosis of Nissl bodies in ischemic penumbra decreased.Compared with MCAO group,the expression levels of synaptic plastication-related proteins PSD95 and synI in the cortex of MNES group were significantly up-regulated after median nerve electrical stimulation(P<0.05),the number of synapses in the ischemic cortex increased significantly(P<0.01).Conclusion Median nerve electrical stimulation is a safe and effective therapeutic measure to improve nerve function after stroke,and its mechanism is related to promoting synaptic plasticity.