Myelodysplastic Syndrome Treated by Integrated Chinese and Western Medicine: A Case Report.

Context: Myelodysplastic syndrome (MDS) is a group of highly heterogeneous, malignant clonal diseases derived from hematopoietic stem cells. PD-1 monoclonal antibodies can have a synergistic effect with hypomethylating agents (HMAs), especially for patients with drug resistance to demethylation drugs. TCM in the treatment of MDS can improve hematological indexes, and for some patients, control the proliferation of primitive cells and delay or even block the transformation to leukemia. Objective: The study intended to examine the therapeutic effects of programmed cell death-1 (PD-1) inhibitors and azacitidine combined with the Yisuifang Thick Decoction in the treatment of MDS with older, high-risk patients. Design: The research team performed five prospective case studies. Setting: The study took place at the East Hospital affiliated with Beijing University of Chinese Medicine in Beijing, China. Participants: Participants were five older, high-risk MDS patients at the hospital who received PD-1 and azacitidine combined with Yisuifang Thick Decoction between April 2020 and June 2021. Outcome Measures: The research team measured: (1) treatment duration, (2) curative effects, (3) myelosuppression, (4) immune-related adverse reactions, (5) ending outcomes, and (6) progression-free survival (PFS). Results: The male to female ratio for the five participants was 3:2, and the median age was 69 years, with a range from 62 to 79 years. Four participants had refractory HR-MDS and one had primary MDS. The median treatment duration was 3 months, with a range from 2 to 4 months, and the median progression-free survival (PFS) was 5 months, with a range from 3 to 14 months. All participants achieved a partial response (PR) or a complete remission with incomplete count recovery (CRi) and showed improvement in serological indexes. Conclusions: Older, high-risk MDS patients generally have poor physical conditions, often accompanied by a poor karyotype prognosis and a poor prognosis for survival. Therefore, the combination of PD-1, azacytidine, and Yisuifang Thick Decoction may be an effective way to treat HR-MDS.

[Effect of cerebral hemodynamic changes on white matter damage in premature infant with patent ductus arteriosus].

OBJECTIVE: To investigate the effect of cerebral hemodynamic changes on white matter damage in premature infant with patent ductus arteriosus(PDA). METHODS: A total of 106 premature infants were enrolled in the study, including 35 PDA infants with hemodynamic changes (hsPDA group), 35 PDA infants without hemodynamic changes (non-hsPDA group) and 36 non-PDA infants (control group). Serum level of neuron-specific enolase (NES) was detected and craniocerebral ultrasound examination was performed on d3, d7 and d14 after birth. The correlation between blood flow rate of PDA and gray scale value of lateral ventricle was analyzed. RESULTS: Gray scale values of lateral ventricle and serum levels of NES in hsPDA group were higher than those in control group on d3, d7 and d14 (P<0.01), but no significant difference was observed between non-hsPDA group and control group (P>0.05). There was a positive correlation between the blood flow rate of PDA and gray scale value of lateral ventricle (r=0.876, P<0.01) in premature infants. CONCLUSION: Patent ductus arteriosus with hemodynamic changes is closely related to white matter damage in premature infants, and early intervention is necessary.

Hybrid Cathode Interlayer Enables 17.4% Efficiency Binary Organic Solar Cells.

With the emergence of fused ring electron acceptors, the power conversion efficiency of organic solar cells reached 19%. In comparison with the electron donor and acceptor materials progress, the development of cathode interlayers lags. As a result, charge extraction barriers, interfacial trap states, and significant transport resistance may be induced due to the unfavorable cathode interlayer, limiting the device performances. Herein, a hybrid cathode interlayer composed of PNDIT-F3N and PDIN is adopted to investigate the interaction between the photoexcited acceptor and cathode interlayer. The state of art acceptor Y6 is chosen and blended with PM6 as the active layer. The device with hybrid interlayer, PNDIT-F3N:PDIN (0.6:0.4, in wt%), attains a power conversion efficiency of 17.4%, outperforming devices with other cathode interlayer such as NDI-M, PDINO, and Phen-DPO. It is resulted from enhanced exciton dissociation, reduced trap-assisted recombination, and smaller transfer resistance. Therefore, the hybrid interlayer strategy is demonstrated as an efficient approach to improve device performance, shedding light on the selection and engineering of cathode interlayers for pairing the increasing number of fused ring electron acceptors.

Preparation of a new high-performance calcium-based desulfurizer using a steam jet mill.

Dry flue gas desulfurization is an increasingly attractive technique in SO2 emission control. However, the low efficiency in dry desulphurization is the bottleneck of this technology. To find a high-performance desulfurizer is an urgent task. This research utilized a steam jet mill digestion to prepare a desulfurizer at steam temperature of 220 ℃ and pressure of 0.45 MPa, and compared this product with the conventional digestion desulfurizer. Our results show that the digestion in steam jet mill can transform all the calcium oxide into calcium hydroxide. The calcium hydroxide had good fluidity and with honeycomb morphological characteristics. The experiments of dry flue gas desulfurization demonstrated that under the relative humidity of 15, 30 and 45%, the total dead times were 340, 640 and 720 min, the working time for keeping a 100% desulfurization efficiency were 120, 420 and 580 min, and the total sulfur fixation were 124.05, 274.58 and 332.09 mg. Compared with the desulfurizer by conventional dry digestion, the desulfurizer prepared in this research had a significantly superior performance. This experiment provides a new method for high-performance desulfurizer via quicklime digestion, which is an important step in pushing forward the application of dry flue gas desulfurization.

Dendrobium Officinale Polysaccharide Alleviates Hepatic Fibrosis via Epithelial-Mesenchymal Transition / 中山大学学报(医学科学版)

ObjectiveTo investigate the effect of Dendrobium officinale polysaccharide （DOP）on CCl4-induced hepatic fibrosis（HF）and its mechanism. MethodsA total of 56 male SD rats were randomly divided into seven groups： normal group（NG），model group（MG），colchicine group（CG， 0.1 mg/kg）， Fuzheng Huayu group（FG， 0.45 g/kg），low-dose DOP group（LDG， 0.05 g/kg），middle-dose DOP group（MDG， 0.1 g/kg）and high-dose DOP group（HDG，0.2 g/kg），with 8 rats in each group. HF rat model was established by subcutaneous injection with 40% CCl4 olive oil mixture， every 3-day for 10 weeks. At the end of the sixth week， the drug groups were treated with colchicine， Fuzheng Huayu and DOP solution by gavage respectively， once a day for 4 weeks. NG and MG groups were similarly handled with an equal amount of 0.9 % normal saline. Liver histopathology was detected using hematoxylin-eosin （HE）， Masson and Sirius red staining； blood biochemistry was tested for liver function and four indicators of HF； RT-qPCR and Western Blot were used to measure the expression of α-SMA， Col-I， E-cadherin， and ZEB1 genes and proteins in the liver tissues of rats， respectively. ResultsHE， Masson， and Sirius red staining showed that the liver tissue of MG rats had typical pathologic features of HF， and the degree of HF was alleviated in LDG， MDG， and HDG rats， respectively. Liver function test results showed that the serum AST， TBIL， and AKP levels were significantly lower in LDG， MDG， and HDG， compared with those of the MG （P < 0.05 or < 0.01）. Meanwhile， ALT levels in serum deceased remarkably except in LDG （P < 0.05 or < 0.01）. The four results of HF showed that the serum HA， LN， PC-Ⅲ， and COL-Ⅳ levels in LDG， MDG， and HDG rats were significantly decreased compared with those of the MG （P < 0.05 or < 0.01）. The relative expressions of α-SMA， COL-I， and ZEB1 genes and proteins were significantly decreased in the liver tissues of LDG， MDG， and HDG （P < 0.05 or < 0.01）， and the relative expression of E-cadherin gene and protein increased （P < 0.05 or < 0.01）. In addition， the expressions of HA， α-SMA， COL-I， ZEB1 and E-cadherin were dependent on the dose of DOP. ConclusionDOP alleviated the degree of CCl4 induced HF in rats by inhibiting the epithelial-mesenchymal transition in liver tissue.

Impact of the LAmbre device on left atrial appendage adjacent structures and left atrium / 中华超声影像学杂志

Objective:To explore the effects of the LAmbre device and mitral annulus(MA), as well as left atrium(LA) in patients with non-valvular atrial fibrillation(NVAF) after left atrial appendage closure (LAAC) using real-time-three-dimensional transesophageal echocardiography (3D TEE).Methods:Fity-six consecutive patients who underwent LAAC with the LAmbre device in Zhongshan Hospital of Fudan University from June 2019 to March 2023 were retrospectively enrolled, with no or less than moderate mitral regurgitation (MR). All patients underwent pre-operative and follow-up two-and three-dimensional transesophageal echocardiography (2D TEE, 3D TEE) at 60 days after the operation. The quantitative parameters of MA and LA were obtained by offline analysis using QLab 13.0 (Philips Healthcare, Andover, MA). Importantly, mitral annular measurements were made at seven time points throughout the cardiac cycle: early diastole, mid-diastole, late diastole, mitral valve closure, early systole, mid-systole, and late systole, which facilitates constructing the dynamic model of MA to assess the annular morphology and dynamics.Results:The values of AP diameter (APD), AL-PM diameter (ALPMD), 3D annulus circumference (3DAC), 3D annulus area (3DAA) decreased significantly compared with pre-operative values at all time points of the cardiac cycle (all P<0.05), while non-planar angle (NPA) and AH/CD were not apparently changed (all P>0.05 ). Throughout the cardiac cycle, MA showed regular changes, gradually increased in systole with the saddle shape deepened, and gradually decreased in diastole with the saddle shape shallowed.During systole, there was an increase in the rate of change of AP in MA [pre-operative (3.01±2.64)%, post-operative (3.81±3.51)%, P=0.037] after LAAC, with no significant difference in the rate of change of ALPM, 3DAC, and 3DAA.Meanwhile, we observed an evident reduction in LA minimal volume (LAVmin) [pre-operative (78.36±25.16)ml, post-operative (70.73±22.78)ml, P=0.004] and an obvious increase in LA ejection function [pre-operative (22.88±10.09)%, post-operative (31.41±12.28)%, P<0.05] during follow-up. Conclusions:3D TEE can accurately assess the impact of LAAC on the MA and LA. The LAmbre device can affect the morphology of MA, as well as the structure and function of LA, while the change of the dynamics of MA is not so prominent.

Applied Research of Extractive Reference Substance for the Quality Analysis of Fritillariae Thunbergii Bulbus Formula Granules / 中药新药与临床药理

Objective To analyze the quality of 22 batches of Fritillariae thunbergii bulbus Formula Granules from 12 different manufacturers by using water-extraction reference substance of Fritillariae thunbergii bulbus(ZBM ERS ST)and water-extraction reference substance of Fritillariae hupehensis bulbus(HBBM ERS ST)as references.Methods Ethyl acetate-methanol-triethylamine-water(17∶1∶1∶0.5)was used as the developing solvent for high-performance thin-layer chromatography(HPTLC)fingerprint analysis.The high-performance liquid chromatography(HPLC)fingerprint analysis was performed on a Agilent Eclipse XDB-C18 column(4.6 mm×250 mm,5 μm)with the gradient mobile phase consisted of acetonitrile-0.03%diethylamine solution.The column temperature was set at 25℃and evaporative light-scattering detector was used.The determination was conducted according to standard test method for measurement of Fritillariae thunbergii bulbus Formula Granules(Guangdong PFKL00117).Results The results of HPTLC and HPLC analysis showed that there are significant differences among the 22 batches of Fritillariae thunbergii bulbus Formula Granules.There were 4 batches of Fritillariae thunbergii bulbus Formula Granules from 3 manufacturers among them showed fingerprint characteristics of Fritillariae hupehensis bulbus.The total amount of peimine and peiminine in the remaining 18 batches of Fritillariae thunbergii bulbus Formula Granules was 0.291-3.179 mg·g-1,which were quite different.Conclusion Currently,the quality of Fritillariae thunbergii bulbus Formula Granules on the market varies greatly.Standardized water-extract reference substance has better applicability for the analysis of the quality of Fritillariae thunbergii bulbus Formula Granules than the control medicinal materials.

Research progress on radiotherapy and radiation-associated adverse effects of high-risk neuroblastoma / 中华放射肿瘤学杂志

High-risk neuroblastoma (NB) is highly aggressive and has poor prognosis. Treatment of NB mainly includes comprehensive therapies, of which radiotherapy serves as a part of consolidation therapy. For patients who receive complete resection of the primary lesion, usually an irradiation dose of 21-23.4 Gy is given; for patients with incomplete resection, further study focused on radiation dose is necessary. Recurrence is most commonly observed in the bone lesions involved at presentation. Currently, the principle of irradiation to the metastatic sites is to treat lesions where metaio-dobenzylguanidine (MIBG) uptake remains positive after induction chemotherapy, or those become negative uptake but still at high risk of recurrence. On the premise of lacking of MIBG imaging, positron emission tomography CT (PET-CT) may assist in screening for metastatic sites requiring irradiation. The late side effects of radiotherapy are mainly mild musculoskeletal abnormalities. No significant increase is observed in the incidence of second primary tumor during short-term follow-up.

Change point analysis of normal distribution based on the likelihood ratio principle and its application in the number of outpatients analysis / 中华地方病学杂志

Objective:The authors introduced the change point analysis of normal distribution based on the likelihood ratio principle, analyzed the number of outpatients in a hospital of Luohu District, Shenzhen, to provide scientific basis for rational allocation of health resources.Methods:The authors collected totally 636 number of outpatients' data from 8: 00 to 12: 00 a.m. at 48 time windows at 5 minutes intervals in a hospital of Luohu District, Shenzhen, and analyzed it with single change point analysis of simultaneous change of mean and variance, and discussed when the change point occurred.Results:The average number of outpatient was 13.250 0 for every time window, the change point occurred at 8: 50, the probability was 0.000 025, the average number of outpatient per 5 minutes from 8: 00 to 8: 50 was 7.000 0, the average number of outpatient per 5 minutes from 8: 50 to 12: 00 was 14.897 4, and the ratio of number of outpatients before and after the change point occurred was 1∶2.Conclusion:In the case of no need to determine the base period or compare the data, the change point analysis of normal distribution based on the principle of likelihood ratio provides a new way of statistical analysis and statistical monitoring for the rational allocation of health resources based on the number of patients.

Construction of predictive ceRNA network and identification of the patterns of immune cells infiltrated in Graves ' ophthalmopathy / 中南大学学报(医学版)

OBJECTIVES@#Graves' ophthalmopathy (GO) is a multifactorial disease, and the mechanism of non coding RNA interactions and inflammatory cell infiltration patterns are not fully understood. This study aims to construct a competing endogenous RNA (ceRNA) network for this disease and clarify the infiltration patterns of inflammatory cells in orbital tissue to further explore the pathogenesis of GO.@*METHODS@#The differentially expressed genes were identified using the GEO2R analysis tool. The Kyoto encyclopedia of genes and genomes (KEGG) and gene ontology analysis were used to analyze differential genes. RNA interaction relationships were extracted from the RNA interactome database. Protein-protein interactions were identified using the STRING database and were visualized using Cytoscape. StarBase, miRcode, and DIANA-LncBase Experimental v.2 were used to construct ceRNA networks together with their interacted non-coding RNA. The CIBERSORT algorithm was used to detect the patterns of infiltrating immune cells in GO using R software.@*RESULTS@#A total of 114 differentially expressed genes for GO and 121 pathways were detected using both the KEGG and gene ontology enrichment analysis. Four hub genes (SRSF6, DDX5, HNRNPC,and HNRNPM) were extracted from protein-protein interaction using cytoHubba in Cytoscape, 104 nodes and 142 edges were extracted, and a ceRNA network was identified (MALAT1-MIR21-DDX5). The results of immune cell analysis showed that in GO, the proportions of CD8+ T cells and CD4+ memory resting T cells were upregulated and downregulated, respectively. The proportion of CD4 memory resting T cells was positively correlated with the expression of MALAT1, MIR21, and DDX5.@*CONCLUSIONS@#This study has constructed a ceRNA regulatory network (MALAT1-MIR21-DDX5) in GO orbital tissue, clarifying the downregulation of the proportion of CD4+ stationary memory T cells and their positive regulatory relationship with ceRNA components, further revealing the pathogenesis of GO.

Mediating role of depression between workplace violence and job burnout among healthcare workers / 中南大学学报(医学版)

OBJECTIVES@#Health workers are at risk of workplace violence, which can seriously affects their mental health and work status. This study aims to explore the mediating role of depression between workplace violence and job burnout among healthcare workers.@*METHODS@#From January 10 to February 5, 2019, a questionnaire was distributed to frontline healthcare workers through the wenjuanxing platform using convenient sampling (snowball sampling). The questionnaire included the Chinese version of the Workplace Violence Scale, Maslach Burnout Inventory, and Patient Health Questionnaires (PHQ-2). Descriptive statistics, correlation analysis, and mediation model tests were conducted on the cross-sectional data collection.@*RESULTS@#The study included 3 684 participants, with (31.63±7.69) years old. Among them 2 079(56.43%) were experienced workplace violence, 687(18.65%) were screened positive for depression, and 2 247(60.99%) were experienced high levels of occupational burnout. Correlation analysis showed positive association between workplace violence and depression, workplace violence and occupational burnout, depression and occupational burnout (r=0.135, r=0.107, r=0.335, respectively, all P<0.001). After controlling for covariates, workplace violence had an indirect effect on occupational burnout through depression, with a standardized coefficient of 0.25 (SE=0.02, 95% CI 0.21 to 0.28), accounting for 13.87% of the total effect.@*CONCLUSIONS@#The study highlights the close relationship between workplace violence, depression, and occupational burnout among healthcare workers, with depression acting as a mediator between workplace violence and occupational burnout. This study suggests that it is necessary to improve the communication skills of healthcare workers, increase the installation of security systems and emergency plans, use new media platforms to convey positive energy between doctors and patients, and open channels for medical consultation and complaints. It is also necessary to provide guidance for healthcare workers' depressive emotions. Addressing depression among health care workers will help reduce the harm caused by workplace violence, protect the physical and mental health of healthcare workers, and reduce work burnout.

Effect of diabetes on sepsis in patients with pyogenic liver abscess / 中华肝胆外科杂志

Objective:To study the effect of diabetes mellitus (DM) on sepsis in patients with pyogenic liver abscess (PLA).Methods:The clinical data of 116 patients with PLA treated in the Affiliated Hospital of Jiangnan University from January 2021 to May 2022 were retrospectively analyzed, including 64 males and 52 females, aged (62.3±12.6) years old. Patients were divided into DM group ( n=56) and non-DM group ( n=60), which were also divided into the sepsis group ( n=29) and the non-sepsis group ( n=87). The clinical features were compared among the groups, the risk factors of PLA complicated with sepsis were analyzed by multivariate logistic regression. Mediation model was used to analyze how DM affects the development of sepsis. Results:Compared with the non-DM group, patients in DM group had higher incidences of hypertension and acute physiology and chronic health evaluation II, a higher proportion of blood neutrophil count, a higher serum levels of triglyceride, urea nitrogen, fasting blood glucose and glycated hemoglobin at admission. The DM group also higher incidences of hypoproteinemia, pleural effusion, and sepsis, with longer hospital stay and higher hospitalization cost (all P<0.05). The levels of hemoglobin, albumin and hematocrit were lower in DM group (all P<0.05). Multivariate logistic regression analysis showed that comorbidity of DM ( OR=3.431, 95% CI: 1.245-9.455) and abscess with a larger diameter ( OR=1.664, 95% CI: 1.258-2.220) were associated with a higher risk of developing sepsis (all P<0.05). Mediation model showed that neutrophil count and triglyceride were the mediating variables of sepsis in patients with PLA. Conclusion:Comorbidity of diabetes is an independent risk factor of developing sepsis in patients with pyogenic liver abscess. Diabetes may induce sepsis by affecting the neutrophils and triglyceride.

Famine exposure during early life and risk of metabolic syndrome in adulthood in China: a meta-analysis / 中华内分泌代谢杂志

Objective:To analyze the relationship between early-life famine exposure and the risk of metabolic syndrome in Chinese population.Methods:Relevant literature on the relationship between early-life famine exposure and the risk of metabolic syndrome in the Chinese population was retrieved from databases such as CNKI, Wanfang, VIP, CBM, Web of Science, and PubMed. The search was conducted from the inception of the databases up to October 2022. Two researchers independently extracted and systematically evaluated the data from the literature, and meta-analysis was performed using Stata 16.0 software. Results:A total of 12 publications met the inclusion criteria, including 71 470 study subjects. Meta-analysis results showed that early-life famine exposure increased the risk of metabolic syndrome in the Chinese population( OR=1.28, 95% CI 1.16-1.40). Subgroup analysis showed that both fetal famine exposure( OR=1.25, 95% CI 1.03-1.52) and childhood famine exposure( OR=1.29, 95% CI 1.15-1.45) increased the risk of developing metabolic syndrome compared to the non-exposed group, and this significant association was only found in the female population. Conclusion:Early-life exposure to famine may increase the risk of developing metabolic syndrome in adulthood in the Chinese population, particularly among females.

Application of logistic regression model and decision tree model in the analysis of the recurrence of acute pancreatitis / 中华肝胆外科杂志

Objective:To study the logistic regression model and Chi-square automatic interaction detection decision tree model in the prediction of the recurrence of acute pancreatitis (AP).Methods:Clinical data of 364 patients with AP admitted to the Affiliated Hospital of Jiangnan University from June 2021 to June 2022 were retrospectively analyzed, including 219 males and 145 females, aged 53 (19-91) years. The patients were divided into the recurrence group ( n=63), those who experienced a second or more episodes of AP, and the initial group ( n=301), those who were diagnosed of AP for the first time. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with recurrence of AP, and the decision tree model was used to analyze those factors. Receiver operating characteristic (ROC) curve were plotted to analyze the predictive performance of the two models. Results:Multivariate logistic regression analysis showed that age ( OR=0.969, 95% CI: 0.949-0.990, P=0.004), body mass index ( OR=1.142, 95% CI: 1.059-1.232, P=0.001), and hyperlipidemia ( OR=3.034, 95% CI: 1.543-5.964, P=0.001) were independent factors influencing the recurrence of AP. The accuracy of the model in predicting recurrence was 83.2% (303/364). The decision tree model showed that hyperlipidemia and body mass index were factors influencing the recurrence of AP, with an accuracy of 82.7% (301/364) in predicting recurrence. The area under the ROC curve was larger in the logistic regression model compared to that in the decision tree model (0.776 vs 0.730, Z=2.02, P=0.043). Conclusion:The logistic regression model and the Chi-square automatic interaction detection decision tree model can help predict the recurrence of AP. It is recommended to combine the two models to better guide clinical practice.

Standard for monitoring and evaluation of two-dimensional- and three-dimensional-transesophageal echocardiography during transcatheter tricuspid valve replacement / 中华超声影像学杂志

Transcatheter tricuspid valve intervention is the new frontier of interventional cardiology. The LuX-Valve is a radial force-independent orthotopic tricuspid valve replacement device developed in China. The LuX-Valve Plus transcatheter tricuspid valve replacement (TTVR) system is changed from the trans-atrial to the transjugular approach, which further reduces trauma and pulmonary complications compared with the first generation LuX-Valve. The first-in-human study has been completed at Zhongshan Hospital, Fudan University and an exploratory multicentre clinical study is underway. Echocardiography plays an important role in pre-TTVR screening, intraoperative guidance and postoperative evaluation and follow-up, especially two-dimensional transoesophageal echocardiography (2D-TEE) and three-dimensional transoesophageal echocardiography (3D-TEE). However, there is a lack of appropriate intraoperative guidance and assessment protocols. In this study, we briefly described the protocols and imaging considerations for intraoperative 2D-TEE and 3D-TEE to ensure the successful implantation of TTVR.

Relationship between non-high density lipoprotein cholesterol and leptomeningeal collaterals in patients with acute middle cerebral artery occlusion / 实用医学杂志

Objective To explore the relationship between non-high density lipoprotein cholesterol(non-HDL-C)level and leptomeningeal collateral circulation in patients with acute middle cerebral artery occlusion.Methods A total of 85 patients with first-onset acute cerebral infarction with middle cerebral artery M1 segment occlusion were enrolled.According to the results of DSA,LMC circulation was assessed by American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology Collateral Circulation Assess-ment System.All patients were assigned to better LMC circulation group(score 2～4,n = 30)and worse LMC circulation group(score 0～1,n = 55),and the levels of non-HDL-C were compared between the two groups.Results The levels of LDL-C and non-HDL-C in worse LMC circulation group were significantly higher than those of the better LMC circulation group(P = 0.026,P = 0.010).non-HDL-C was an independent risk factor for the worse LMC circulation(OR = 3.019,95%CI:1.053～8.658,P = 0.04).LMC circulatory score of patients was negatively correlated with the levels of non-HDL-C level(r =-0.228,P = 0.036).The AUC of non-HDL-C predicted for the worse LMC circulation was 0.638(95%CI:0.521～0.755,P = 0.036).Conclusions non-HDL-C in patients with acute cerebral infarction was significantly related to worse LMC circulation,and was a risk factor for worse LMC circulation.It is suggested that the higher expression of non-HDL-C could be used to predict worse LMC circulation as a serological indicator.

Association between the Wnt signaling pathway and hepatic fibrosis / 临床肝胆病杂志

Hepatic fibrosis (HF) is a self-healing pathological process after all kinds of chronic liver injuries and can cause diseases such as liver cirrhosis and liver cancer. The Wnt signaling pathway is highly conserved in species evolution and widely exists in invertebrates and vertebrates, and many studies have confirmed that the Wnt signaling pathway is closely associated with the development and progression of HF. This article reviews the mechanisms of the classical and non-classical Wnt signaling pathways in regulating hepatic stellate cells, hepatic macrophages, and hepatic progenitor cells, so as to provide new ideas for subsequent studies on the mechanism of the Wnt signaling pathway in regulating HF and further exploration of therapeutic targets that can reverse HF.

Environmental and health effects of nuclear wastewater —Something beyond Fukushima nuclear wastewater discharge / 中国辐射卫生

In April 2021, the Japanese government decided to discharge nuclear wastewater from the Fukushima Daiichi nuclear power plant into the sea, which aroused widespread concern all over the world. The radioactive substances in nuclear wastewater may affect the environment through the action of ocean circulation, groundwater or carbon cycle. In addition, it may expose people to the health effects of low-dose but long-term pollution once nuclear wastewater is discharged into the sea. Based on this, this paper discusses the possible global environmental impact of nuclear wastewater from a general perspective and illustrates its possible health effects as well as potential mental health problems from an individual perspective, and puts forward some suggestions on the issue of Fukushima nuclear wastewater discharge.

Correlation between 95% spectral edge frequency and depth of anesthesia in patients with schizophrenia / 中国基层医药

Objective:To investigate the value of 95% spectral edge frequency (SEF) in identifying the depth of anesthesia in patients with schizophrenia subjected to modified electroconvulsive therapy center.Methods:A total of 195 patients with schizophrenia who received treatment in The Affiliated Kangning Hospital of Wenzhou Medical University in April to December 2020 were included in this study. They were randomly divided into three groups with 65 patients each. Three groups of patients received different doses of anesthesia before undergoing MECT as follows: group A: propofol 1.5 mg/kg, atropine 0.5 mg/kg, succinylcholine chloride 1.0 mg/kg; group B: propofol 2.0 mg/kg, atropine 0.5 mg/kg, succinylcholine chloride 1.0 mg/kg; group C: propofol 2.5 mg/kg, atropine 0.5 mg/kg, succinylcholine chloride 1.0 mg/kg. 95% SEF and bispectral index (BIS) were measured when patients were awake before treatment (T 1), when eyelash reflex disappeared (T 2), at the beginning of electrical stimulation (T 3), at 3 minutes after electrical stimulation (T 4), and when patients were completely awake (T 5) and compared between groups. The incidence of adverse reaction was recorded at 1 day after treatment. Results:At T 1-T 5, 95% SEF in the group A was (28.50 ± 0.87) Hz, (21.49 ± 0.91) Hz, (21.99 ± 0.92) Hz, (28.42 ± 1.29) Hz, (28.40 ± 1.15) Hz respectively, and it was (28.34 ± 0.91) Hz, (18.93 ± 0.86) Hz, (19.05 ± 0.83) Hz, (27.54 ± 0.73) Hz, (28.42 ± 1.21) Hz respectively in group B and (28.26 ± 0.90) Hz, (16.41 ± 0.75) Hz, (16.36 ± 0.75) Hz, (26.58 ± 0.64) Hz, (28.48 ± 1.19) Hz respectively in group C. 95% SEF measured at T 2 ( t = 24.49, 48.60, both P < 0.05), T 3 ( t = 28.47, 54.51, both P < 0.05), and T 4 ( t = 7.61, 15.91, both P < 0.05) in groups B and C were significantly lower than those in group A. 95% SEF measured at T 2 ( t = 24.11, P < 0.05), T 3 ( t = 26.04, P < 0.05) and T 4 ( t = 8.30, P < 0.05) in group C were significantly lower than those in group B. At T 1-T 5, BIS in group A was (94.16 ± 2.07), (55.34 ± 1.93), (56.61 ± 1.84), (76.29 ± 1.94) and (93.84 ± 2.39) respectively, and it was (94.51 ± 2.25), (52.39 ± 1.58), (52.45 ± 1.94), (73.58 ± 2.19), (93.28 ± 2.52) respectively in group B and (93.97 ± 2.16), (50.57 ± 1.96), (51.60 ± 2.03), (69.51 ± 2.12), (93.57 ± 2.66) respectively in group C. BIS values measured at T 2 ( t = 24.49, 48.60, both P < 0.05), T 3 ( t = 28.34, 54.28, both P < 0.05), and T 4 ( t = 7.61, 15.91, both P < 0.05) in groups B and C were significantly lower than those in group A. BIS measured at T 2 ( t = 24.11, P < 0.05), T 3 ( t = 25.93, P < 0.05), and T 4 ( t = 8.30, P < 0.05) in group C were significantly lower than those in group B. Correlation analysis showed that 95% SEF measured at T 2 ( r = 0.65, P < 0.05), T 3 ( r = 0.68, P < 0.05) and T 4 ( r = 0.49, P < 0.05) were positively correlated with BIS measured at corresponding time points. There were no significant differences in duration of electrical stimulation [(61.25 ± 4.32) seconds, (45.19 ± 3.68) seconds, and (27.54 ± 2.54) seconds, F = 1 434.14, P < 0.05], post-onset inhibition index [(87.68 ± 5.82)%, (81.59 ± 5.35)%, (75.27 ± 4.87)%, F = 87.09, P < 0.05], and average seizure energy index [(5 668.38 ± 1 264.01) μV2, (4 555.61 ± 1 058.96) μV2, (3 642.25 ± 792.68) μV2, F = 59.97, P < 0.05] among the three groups. Duration of electrical stimulation ( t = 36.07, 75.71, both P < 0.05), post-onset inhibition index ( t = 9.15, 18.66, both P < 0.05), and average seizure energy index ( t = 8.49, 15.46, both P < 0.05) in groups B and C were significantly lower than those in group A. Duration of electrical stimulation, post-onset inhibition index and average seizure energy index in group C were significantly lower than those in group B ( t = 39.64, 9.50, 6.97, all P < 0.05). BIS was positively correlated with duration of electrical stimulation ( r = 0.68, P < 0.05), post-onset inhibition index ( r = 0.55, P < 0.05) and average seizure energy index ( r = 0.42, P < 0.05). There were no significant differences in the incidences of headache, myalgia, nausea and vomiting among the three groups ( P > 0.05). Conclusion:95% SEF was positively correlated with BIS in patients with schizophrenia. BIS measured at T 2 was positively correlated with effect of modified electroconvulsive therapy center.

Efficacy and safety of ledipasvir/sofosbuvir versus elbasvir/grazoprevir in treatment of genotype 1b chronic hepatitis C / 中华临床感染病杂志

Objective:To compare the clinical efficacy and safety of ledipasvir/sofosbuvir (LDV/SOF) and elbasvir/grazoprevir (EBR/GZR) in treatment of patients with chronic hepatitis C (CHC).Methods:The clinical data of 143 patients with genotype 1b CHC treated in Huzhou Central Hospital from January 2020 to December 2021 were retrospectively analyzed, including 74 cases treated with LDV/SOF and 69 cases treated with EBR/GZR. The virological response after 4 and 12 weeks of treatment and 12wk after drug withdrawal was determined; and the serological and liver inflammation indexes before and after treatment in two groups were compared. SPSS 25.0 software was used for statistical analysis of the data.Results:The virological response rates of the LDV/SOF group and EBR/GZR group were 97.30% and 98.55%, 98.65% and 100.00%, 97.30% and 98.55% after 4 and 12 weeks of treatment and 12 weeks after the end of treatment, respectively (all P > 0.05). At the end of treatment, the liver inflammation indexes ALT, AST and GGT in the two groups were significantly lower than the baseline levels ( Z=-7.470 and -6.974, -9.757 and -6.832, -3.578 and -4.054, P<0.01). Adverse reactions in both groups were mild, and no serious adverse events occurred. Conclusion:Both LDV/SOF and EBR/GZR have good clinical efficacy in the treatment of genotype 1b CHC patients. And the patients are well tolerated.