Effects of exogenous calcium and calcium inhibitor on physiological characteristics of winter turnip rape (Brassica rapa) under low temperature stress.

Low temperature is one of the environmental factors that restrict the growth and geographical distribution of Brassica. To investigate the effects of exogenous calcium and calcium inhibitor on the ability of winter turnip rapeseed (Brassica rapa L.) to withstand low temperatures (4℃), we used a strong cold-resistant variety Longyou 7 (L7) and a weak cold-resistant variety Longyou 99 (L99) as the materials. The seedlings were treated with CaCl2 (20 mmol·L-1) and calcium inhibitor LaCl3 (10 mmol·L-1) at 0 h (CK), 6 h, 12 h, 24 h and 48 h after 4℃ treatments. Physiological characteristics, Ca2+ flux and Ca2+ concentration in roots after treatments were analyzed. Results illustrated that under 4℃ treatment, activities of superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT) increased by both CK and exogenous CaCl2 treatments. Contents of soluble protein (SP) and proline (Pro) increased, while contents of malondialdehyde (MDA) decreased, resulting in reduced membrane lipid peroxidation. But enzyme activity decreased and MDA content increased following treatment with exogenous LaCl3. The rate of Ca2+ flow showed a higher uptake in L7 roots compared with L99. L99 showed Ca2+ efflux with a rate of 30.21 pmol‧cm-2‧s-1, whereas L7 showed short efflux then returned to influx. Calcium ion content in roots decreased in both cultivars after CaCl2 treatment. Results of RNA-seq revealed that genes were differentially expressed in response to low temperatures, hormones, photosystem II, chloroplasts, DNA replication, ribosomal RNA processing, and translation. This study found significant expression genes related to cellular signal transduction (MAPK signaling pathway) and material metabolism (nitrogen metabolism, glycerol ester metabolism).It was also analyzed by WGCNA that two modules had the strongest correlation with physiological indicators. Eight candidate genes were identified among MAPK signaling pathway and the two modules.

Long-Term Triclocarban Exposure Induced Enterotoxicity by Triggering Intestinal AhR-Mediated Inflammation and Disrupting Microbial Community in Mice.

Exposure to triclocarban (TCC), a commonly used antibacterial agent, has been shown to induce significant intestine injuries and colonic inflammation in mice. However, the detailed mechanisms by which TCC exposure triggered enterotoxicity remain largely unclear. Herein, intestinal toxicity effects of long-term and chronic TCC exposure were investigated using a combination of histopathological assessments, metagenomics, targeted metabolomics, and biological assays. Mechanically, TCC exposure caused induction of intestinal aryl hydrocarbon receptor (AhR) and its transcriptional target cytochrome P4501A1 (Cyp1a1) leading to dysfunction of the gut barrier and disruption of the gut microbial community. A large number of lipopolysaccharides (LPS) are released from the gut lumen into blood circulation owing to the markedly increased permeability and gut leakage. Consequently, toll-like receptor-4 (TLR4) and NF-κB signaling pathways were activated by high levels of LPS. Simultaneously, classic macrophage phenotypes were switched by TCC, shown with marked upregulation of macrophage M1 and downregulation of macrophage M2 that was accompanied by striking upregulation of proinflammatory factors such as Il-1ß, Il-6, Il-17, and Tnf-α in the intestinal lamina propria. These findings provide new evidence for the TCC-induced enterotoxicity.

One case of diabetic peripheral neuropathy complicated with chronic Guillain-Barre syndrome / 中华内分泌代谢杂志

Chronic Guillain-Barre syndrome, also known as chronic inflammatory demyelinating polyradiculoneuropathy(CIDP), is an immune-mediated demyelinating peripheral neuropathy. This article analyzes the clinical data of a CIDP patient presenting primarily with limb numbness, pain, and weakness. Along with literature review, this study explores the differential diagnosis between CIDP and diabetic peripheral neuropathy in terms of the pathogenesis, clinical manifestations, laboratory tests, and treatment.

Research progress on the relationship between extracellular vesicles and male infertility / 中国综合临床

Infertility is gradually becoming a major problem affecting health worldwide, and male factors also play an important role in infertility. Extracellular vesicles (EVs) are ultramicro membranous vesicles released by cells during activation or apoptosis, which play an important role in cell communication. Relevant studies have shown that extracellular vesicles contain a variety of bioactive substances and participate in infertility related pathophysiological processes by influencing the content of intercellular transmission. Therefore, we reviewed the relationship between extracellular vesicles and male infertility, and expounded the occurrence and potential treatment of male infertility from another perspective.

Analysis of laboratory characteristics and evaluation of prognostic value of patients with NPM1 mutated acute myeloid leukemia / 中华检验医学杂志

Objective:To analyze the clinical and laboratory characteristics of acute myeloid leukemia (AML) patients with NPM1 mutation, and to explore the prognostic factors.Methods:A total of 77 AML patients with NPM1 gene mutation admitted to Hebei Yanda Ludaopei Hospital from May 1st 2012 to December 31st 2021 were enrolled in the study, including 34 male and 43 female patients. The median age was 40 (3, 68) years old. Patients were selected and divided into 4 groups according to the morphological FAB classification. There were 29 cases (37.7%) of M1 type, 13 cases (16.9%) of M2 type, 23 cases (29.9%) of M4 type, and 12 cases (15.5%) of M5 type. The clinical characteristics, bone marrow/peripheral blood cell morphology, immunophenotype, cytogenetics, molecular biology and overall survival of different groups were retrospectively analyzed, and the risk factors affecting the prognosis of AML were also explored. Cox multivariate regression was used to analyze the clinical influencing factors of survival and prognosis.Results:The white blood cell counts were highest in M4 and M5 patients and lowest in M2 patients, while no significant difference in the red blood cell, hemoglobin, and platelet counts( P>0.05). Morphologically, there were significant differences in the percentage of blasts and blasts with cup-like nuclei on bone marrow (BM) and peripheral blood (PB). The proportion of blasts in BM and PB was the highest in M1 and the lowest in M2 ( P<0.001). The positive rate of blasts with cup-like nuclei was the highest in M1 and the lowest in M5 of BM ( P<0.001), while the highest in M2 and the lowest in M5 of PB ( P=0.006). The scores of myeloperoxidase and chloroacetate esterase were all the highest in M1 and the lowest in M5 ( P<0.001, 0.001, respectively). In terms of molecular biology, the occurence rate of blasts combined with DNMT3A mutation was the highest in M4 and the lowest in M2 ( P=0.044), while those combined with FLT3-ITD mutation was the highest in M4 and the lowest in M5 ( P=0.002). In immunophenotype, there were significant differences in the expression positivities of seven antigens including HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO ( P<0.05). Multivariate COX regression analysis showed that no recurrence after treatment ( P<0.001), complete remission after treatment ( P=0.015) and transplantation ( P<0.001) were correlated with overall survival (OS). No recurrence after treatment ( P=0.033), transplantation ( P=0.027), no mutation of FLT3-ITD ( P=0.040), and hemoglobin concentration ( P=0.023) were associated with relapse-free survival (RFS). Survival analysis by Kaplan-Meier curve showed that there was no significant difference in survival time between the M1, M2, M4 and M5 groups in OS and RFS. Conclusion:There were significant differences in the white blood count, the percentage of blasts and blasts with cup-like nuclear morphology, cytochemical staining (MPO integration, CE integration and percentage of NAS-DCE), gene mutation (DNMT3A and FLT3-ITD) and immunophenotypes (HLA-DR, CD56, CD11c, CD15, CD14, CD96 and cMPO) between the four groups. The multivariate analysis revealed that no recurrence after treatment and transplantation were independent prognostic factors in NPM1 mut AML patients. On the other hand, FLT3-ITD mutation and hemoglobin concentration were associated with RFS and complete remission after treatment was associated with OS in the entire NPM1 mut cohort.

Practice and study on the establishment of transformation-oriented scientific research program in medical field: Taking a medical new research & development institution of Haihe Laboratory of Cell Ecosystem as an example / 中华医学科研管理杂志

Objective:To explore the innovation mode of independent transformation-oriented science and technology research program approval by medical new research & development (R&D) institution.Methods:Through analyzing the program layout, funds, review experts, undertaking units, chief experts and interdisciplinarity to summarize the experiences of the independent transformation-oriented municipal program approval by Haihe laboratory of Cell Ecosystem in 2022.Results:As a new medical R&D institution, which vigorously constructed by Tianjin, Haihe laboratory of Cell Ecosystem has carried out the practice of the independent transformation-oriented municipal program through the measures of layout of full-chain transformation, conducting transformation-oriented review, gathering high-level research talents, and emphasizing interdisciplinarity.Conclusions:The experiences of Haihe laboratory of Cell Ecosystem make significance for medical new R&D institutions to explore and cultivate scientific research program with transformation potential and to promote the transformation of scientific and technological achievements, which are powerful factors for new R&D institutions to play a role of pilot and provide important support to scientific and technological innovation and transformation.

Application of narrative medicine in the clinical teaching of oral mucosal diseases / 中华医学教育探索杂志

Objective:To investigate the effect of teaching practice under the concept of narrative medicine on improving the empathy level of interns in oral mucosal diseases.Methods:The interns of stomatology in the class of 2018 in School of Stomatology, Shanghai Jiao Tong University, were divided into narrative medicine teaching group (27 interns receiving narrative medicine concepts and methods before and during internship) and traditional teaching group (21 interns received patients directly under the guidance of teachers without the addition of narrative medicine concepts and methods). A questionnaire was used to collect the general information of students, and the Chinese version of Jefferson Scale of Physician Empathy (JSPE) (the version for medical students) was used to measure the empathy level of students. After the end of internship, a statistical analysis was performed for the scores of both groups, and a questionnaire survey was conducted to investigate the acceptance of internship under the guidance of narrative medicine among the students in the narrative medicine teaching group. GraphPad Prism 9.3.0 was used to perform the t-test and the rank sum test. Results:There was a significant difference in JSPE score between the traditional teaching group and the narrative medicine teaching group (92.26±8.23 vs. 104.20±15.65, t=2.70, P=0.005), and in addition, 88.89% (24/27) of the students in the narrative medicine teaching group were interested in participating in internship under the guidance of narrative medicine. However, there was no significant difference in the score of internship between the narrative medicine teaching group and the traditional teaching group (87.28±2.77 vs. 85.47±4.31, t=1.68, P=0.100). Conclusions:Incorporating the concepts and methods of narrative medicine into clinical teaching of oral mucosal diseases can significantly improve the empathy ability of interns and raise the awareness that empathy is as important as scientific literacy among students.

Research progress in aging rodent models / 中国实验动物学报

Aging is a process of degenerative change that occurs as a result of time-related accumulation,associated with age-related diseases.Understanding the causes and mechanisms of aging and finding drugs that can effectively delay aging and prevent and cure age-related diseases currently present a great challenge for humans.Aging animal models thus represent an important tool in aging research,and various aging animal models have been created using different aging mechanisms.These different models having specific advantages and disadvantages,making them suitable for different research purposes.This review considers aging rodent models to provide information for aging research.

Clinical application of Doppler ultrasound with contrast-enhanced ultrasound in septic acute kidney injury: from macroscopic to microscopic renal perfusion perspectives / 中华超声影像学杂志

Objective:To analyse the changes in color Doppler and contrast-enhanced ultrasound (CEUS) blood flow parameters in patients with septic acute kidney injury (AKI) from the perspective of macroscopic circulation and microscopic circulation perfusion, in order to explore the value of clinical application of ultrasound in this disease.Methods:A total of 53 ICU-admitted patients diagnosed with septic AKI at the Second Affiliated Hospital of Soochow University from January 2021 to May 2022 were selected.Patients with septic AKI were classified into stages 1-3 according to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) AKI diagnostic criteria, with stage 1 being the mild group(17 cases), stages 2 and 3 being the severe group(21 cases), and septic patients without AKI in the same period being the control group(15 cases). The ultrasound parameters such as the relative blood flow(RBF) and time-averaged velocity(TAV) of the renal artery as well as the cardiac output (CO) and cardiac index (CI) in the macroscopic circulation were measured, and the time-intensity curve was analysed by the CEUS analysis software to calculate the microscopic parameters such as time to peak(TTP), rise time(RT), fall half time(FHT) and mean transit time(MTT), and the cardiac output and cardiac index were also measured. The differences in ultrasound Doppler and CEUS parameters among the various groups were compared. The diagnostic effectiveness of each parameter for severe AKI was assessed using ROC curve analysis.Results:①In macrocirculation, the renal blood flow (RBF) and time-averaged velocity (TAV) gradually decreased ( P=0.004, P<0.001) as the disease progressed in AKI patients. But the difference of CO and CI among the three groups were not statistically significant in each group ( P=0.17, 0.12). ②In microcirculation, the renal interlobar artery Doppler parameters pulsatility index (PI), resistance index (RI), and systolic/diastolic flow ratio (S/D) gradually increase in patients with septic AKI ( P<0.05) and the CEUS parameters TTP, RT, FHT and MTT were prolonged ( P<0.001, P=0.003, P=0.004, P=0.009). ③The combined diagnosis of RI and TTP was more beneficial in diagnosing septic AKI in critically ill patients [AUC=0.93(0.85-1.00)]. Conclusions:Color Doppler ultrasound combined with CEUS can detect reduced macroscopic and microscopic circulation in patients with septic AKI, especially in those with severe AKI, and this is independent of changes in CO or CI.

Clinical analysis of 15 cases with myeloperoxidase antineutrophil cytoplasmic antibody associated hypertrophic pachymeningitis / 中华内科杂志

To study the clinical features of myeloperoxidase(MPO) antineutrophil cytoplasmic antibody (ANCA) associated hypertrophic pachymeningitis (HP). Clinical data of 15 cases diagnosed with MPO-ANCA vasculitis complicated with HP were retrospectively analyzed. Nine cases were males and the other 6 were females, with an average age of (58±8) years. All cases presented with chronic headache. Contrast-enhanced magnetic resonance imaging (MRI) scan showed local or diffused thickening of cerebral and/or spinal dura matter while brain parenchyma were normal. Nine cases developed multiple cranial nerve paralysis, with trigeminal nerve and auditory nerve involved most commonly. The main clinical manifestations were facial pain, hearing loss and tinnitus. Two cases were complicated with hypertrophic spinal pachymeningitis (HSP) and 4 cases were complicated with pulmonary diseases. Positive serum perinuclear pattern ANCA (pANCA) and MPO could be found in all cases, positive serum IgG 4 was seen in two patients. erythrocyte sedimentation rate(ESR;25-116 mm/1h) and C-reactive protein (CRP;29.02-146.00 mg/L) were both elevated in 14 cases. Nine cases had elevated intracranial pressure[180-235 mmH 2O (1 mmH 2O=0.009 8 kPa)] and abnormal protein level (457.6-3710.0 mg/L) in cerebrospinal fluid. Six cases were treated with glucocorticoids (prednisone 20-60 mg/d) and 9 cased with glucocorticoids and immunosuppressants (methotrexate 15 mg/week or cyclophosphamide 100 mg/d po). All patients achieved remission. MPO-ANCA associated HP is a special type of central nervous system involvement in ANCA associated vasculitis (AAV). It rarely involves the lung or kidney. Steroids and immunosuppressive agents are effective. In HP with unknown underlying diseases, it is suggested to screen ANCA and IgG 4 tests for AAV or IgG 4-related disease.

The clinical value of enhanced whole-body CT in the early treatment of severe trauma / 中华急诊医学杂志

Objective:To investigate the significant effects of enhanced whole-body computed tomography (EWBCT) and non-enhanced whole-body computed tomography (N-EWBCT) on the missed diagnosis rate, renal function and prognosis of patients with severe trauma.Methods:Clinical data of trauma patients admitted from January 1, 2017 to December 31, 2020 were collected from the trauma database of the Trauma Center of the Second Affiliated Hospital of Soochow University. All patients included in this study were divided into the EWBCT group and N-EWBCT group according to whether they underwent enhanced whole-body computed tomography examination. The differences in baseline data, missed diagnosis rate, renal function and prognosis of the two groups of patients were compared.Results:A total of 459 patients were included in this study, including 184 patients in the EWBCT group and 275 patients in the N-EWBCT group. The missed diagnosis rate of the N-EWBCT group was significantly higher than that of the EWBCT group (18% vs. 5%, P < 0.01). The risk ratio of acute kidney injury (AKI) in the EWBCT group and N-EWBCT group was 9% and 7%, respectively, and there was no statistical difference between the two groups ( P >0.05). The mortality rate of patients in the N-EWBCT group was higher than that in the EWBCT group (23% vs. 12%, P=0.002). Conclusions:Compared with N-EWBCT, EWBCT does not significantly increase the risk of renal damage in patients with severe trauma. For patients with severe trauma, early EWBCT can reduce the missed diagnosis rate and improve the clinical prognosis.

Anterior mediastinal inflammatory myofibroblastic tumor with thymoma: A case report / 中国胸心血管外科临床杂志

@#Anterior mediastinal inflammatory myofibroblastoma is a rare tumor with insidious onset and easy misdiagnosis. In this report, we presented a case of anterior mediastinal inflammatory myofibroblastoma with thymoma. The mediastinal tumor was found by physical examination, and the prognosis was good after surgical treatment. For this disease, operation is an effective method for definite diagnosis and treatment, and complete excision can achieve good outcomes.

Clinical application of non-incision removal of tunneled cuffed catheter / 中华肾脏病杂志

Objective:To explore the effectiveness and complications of non-incision removal of tunneled cuffed catheter (TCC).Methods:The clinical characteristics, surgical plans and complications of patients with TCC removal in the Renal Division of Peking University First Hospital from January 1, 2015 to December 31, 2020 were collected and analyzed retrospectively. The patients were divided into non-incision removal group and traditional incision removal group. The clinical characteristics, procedure success rate, procedural duration and complications were compared between the two groups.Results:A total of 349 patients were included in this study, for whom 368 catheter removal procedures were performed, including 286 procedures in the non-incision removal group, 75 procedures in the traditional incision removal group, and 7 procedures without records of surgical plans. There was no significant difference in age, sex, basic kidney diseases and catheter remaining time and location between the two groups (all P>0.05). Two procedures in the non-incision removal group and 1 procedure in the traditional incision removal group failed respectively, and there was no significant difference in the procedure success rate between the two groups (99.3% vs 98.7%, χ2=0.290, P=0.590). The procedural duration in the non-incision removal group was lower than that in the traditional incision removal group [(5.36±1.70) min vs (17.55±3.28) min, t=44.198, P<0.001]. Among the patients who needed TCC exchange, there was no significant difference in the selection of new catheter position between the two groups ( P=0.330). In terms of complications, there were 2 procedures of local hematoma in the non-incision removal group and 1 procedure of infection in the traditional incision removal group, and there was no severe complication in both groups. Conclusions:There was no significant difference in the procedural success rate and complications between non-incision removal group and traditional incision removal group, and non-incision procedure may be superior in reducing the procedure duration and harm less to the patients. Non-incision procedure is a safe and effective method to remove TCC.

Clinical characteristics and mechanism of COVID-19 vaccine-related myocarditis / 西安交通大学学报(医学版)

【Objective】 To investigate the clinical characteristics and potential mechanism of coronavirus disease 2019 （COVID-19） vaccine-related myocarditis. 【Methods】 We made a systematic literature retrieval based on PubMed to search for all reports on COVID-19 vaccine-related myocarditis published by August 31， 2021. A total of 29 reports involving 71 patients with myocarditis were enrolled after screening. The patients’ demographic data， vaccination， clinical manifestations， biochemical and imaging results， treatments， and outcomes were extracted and summarized. The patients were divided into prior COVID （n=12） and non-prior COVID （n=59） according to their previous medical history. 【Results】 COVID vaccine-related myocarditis was more common in men （91.5%） and after the second dose of mRNA vaccine （81.7%）. The average time to onset was 3 （1， 25） days， and the main symptoms included chest pain （94.4%）， fever （45.1%）， myalgia （26.8%）， and shortness of breath （16.9%）. Abnormal troponin level was present in almost all the patients， with a common elevation of C-reactive protein. Non-steroidal anti-inflammatory drugs and colchicine were widely used in clinical treatment， and the symptoms of one-fifth of the patients were relieved after symptomatic therapy， with 1 to 2 weeks’ length of hospital stay. However， the risk of vaccine-related myocarditis was significantly increased in patients with previous COVID-19 infection， which was more common after the first dose of vaccine （58.3%） other than the second dose. And the clinical symptoms and outcomes were somewhat different from those without COVID-19 infection previously. 【Conclusion】 Myocarditis is one of the serious adverse events related to COVID-19 vaccine， with an overall relatively low incidence， mild clinical severity， and favorable prognosis. Vaccine-related myocarditis may be a combined result of primed immune system and individual susceptibility after infection with COVID-19.

Correlation of platelet/albumin ratio, platelet/hemoglobin ratio and C-reactive protein/albumin ratio with diabetes in a population-based study / 西安交通大学学报(医学版)

【Objective】 To investigate the association of platelet/albumin ratio （PAR）， platelet/hemoglobin （PHR） and C-reactive protein/albumin （CAR） with diabetes mellitus. 【Methods】 Based on the data of China Health and Nutrition Survey （CHNS2009）， with gender and age matched by their ID， a total of 8 258 individuals with serological test results were finally included and were divided into diabetes group and control group according to the fasting blood glucose and HbA1c， and then the blood lipid and blood cell changes， PAR， PHR and CAR differences between groups were compared， and the correlation analysis of diabetes was performed. 【Results】 Compared with those in the control group， serum uric acid， total cholesterol， triacylglycerol and low-density lipoprotein cholesterol （LDL-C） were significantly increased in diabetes group， while high-density lipoprotein cholesterol （HDL-C） was significantly decreased. Besides， there was no significant difference in PAR or PHR between the two groups， while CAR was significantly increased in diabetes （0.48±0.18 vs. 0.08±0.23， P<0.001）， and was positively correlated with the levels of fasting glucose （r=0.181 8， P<0.001）， HbA1c （r=0.186 6， P<0.001）， and HOMA-IR （r=0.188 1， P=0.003）. However， CAR was not an independent risk factor for diabetes. In addition， increased red blood cell count （B=1.324， 95% CI： 1.182-1.483， P<0.001） and leukocytes count （B=1.230， 95% CI： 1.166-1.298， P<0.001） may be independent risk factors for the incidence of diabetes. 【Conclusion】 CAR is correlated with diabetes mellitus， but it is not an independent risk factor. Dyslipidemia， elevated leukocytes and red blood cell counts may be independent risk factors for diabetes， but further study is needed.

CAT, AGTR2, L-SIGN and DC-SIGN are potential receptors for the entry of SARS-CoV-2 into human cells

Since December 2019, the COVID-19 caused by SARS-CoV-2 has been widely spread all over the world. It is reported that SARS-CoV-2 infection affects a series of human tissues, including lung, gastrointestinal tract, kidney, etc. ACE2 has been identified as the primary receptor of the SARS-CoV-2 Spike (S) protein. The relatively low expression level of this known receptor in the lungs, which is the predominantly infected organ in COVID-19, indicates that there may be some other co-receptors or alternative receptors of SARS-CoV-2 to work in coordination with ACE2. Here, we identified twenty-one candidate receptors of SARS-CoV-2, including ACE2-interactor proteins and SARS-CoV receptors. Then we investigated the protein expression levels of these twenty-one candidate receptors in different human tissues and found that five of which CAT, MME, L-SIGN, DC-SIGN, and AGTR2 were specifically expressed in SARS-CoV-2 affected tissues. Next, we performed molecular simulations of the above five candidate receptors with SARS-CoV-2 S protein, and found that the binding affinities of CAT, AGTR2, L-SIGN and DC-SIGN to S protein were even higher than ACE2. Interestingly, we also observed that CAT and AGTR2 bound to S protein in different regions with ACE2 conformationally, suggesting that these two proteins are likely capable of the co-receptors of ACE2. Conclusively, we considered that CAT, AGTR2, L-SIGN and DC-SIGN were the potential receptors of SARS-CoV-2. Moreover, AGTR2 and DC-SIGN tend to be highly expressed in the lungs of smokers, which is consistent with clinical phenomena of COVID-19, and further confirmed our conclusion. Besides, we also predicted the binding hot spots for these putative protein-protein interactions, which would help develop drugs against SARS-CoV-2.

Exploring the beneficial role of ROCK inhibitors in sepsis-induced cerebral and cognitive injury in rats.

Sepsis-induced cerebral injury is a systemic inflammatory response associated with high mortality rate and cognitive impairment. Rho/ROCK pathway activation is involved in initiating the inflammatory response and promoting cerebral dysfunction. The present study explored the beneficial effects of ROCK inhibitors in sepsis-induced cerebral injury and cognitive impairment in rats. The model of sepsis was established by employing cecal ligation and puncture (CLP). CLP significantly augmented cerebral injury assessed in terms of intensified activity of caspases-3 and decrease in BCL-2 in the brain along with the release of S100ß and NSE, and assessed on day 7. Significant increase in inflammatory biomarkers IL-1ß and TNF-α as well as increase in the protein levels of ROCK1 and ROCK2 was observed in the brain. A significant decrease in learning and memory ability was observed because of increased escape latency time on day 4 and significant decrease in time spent in the target quadrant on day 7 in CLP-subjected rats. Administration of nonselective ROCK inhibitor, fasudil (10 and 30 mg/kg), and selective ROCK1 inhibitor, Y27632 (10 and 30 mg/kg), attenuated the sepsis-induced increase in the S100ß and NSE, IL-1ß, TNF-α, BCL-2, caspase-3, ROCK1 and ROCK2 in septic rats and significantly memory and learning.The beneficial effects of Y27632 and fasudil were comparable suggesting the key role of ROCK1 in sepsis-induced deleterious effects. It may be concluded that sepsis may increase cerebral and cognitive injury through Rho-kinase/ROCK pathway in septic rats, and ROCK inhibitors may be potentially employed to overcome sepsis-induced deleterious effects in the brain.

Analysis of clinical trials of dermatological drugs in China, 2020 / 中华皮肤科杂志

Objective:To deliver understanding of the latest research progress on clinical trials and approval of dermatological drugs in China in 2020.Methods:A registration and information disclosure platform for drug clinical studies and a query system for domestic and imported drugs in the National Medical Products Administration of China were searched for registered clinical trials and approved dermatological drugs, respectively. The number and stages of clinical trials, indications and classification of involved products, and listed dermatological drugs in 2020 were summarized and depicted.Results:There were 157 dermatological drug trials registered in China in 2020, accounting for 6.16% of all the 2 548 clinical drug trials, including 127 (80.9%) initiated by Chinese pharmaceutical enterprises and 25 (15.9%) international multicenter trials. Among the 127 drug trials initiated by Chinese pharmaceutical enterprises, bioequivalence trials were mostly common, accounting for 55.9% (71/127) . Compared with global pharmaceutical enterprises, domestic pharmaceutical companies initiated significantly decreased proportions of international multicenter trials (1.9% [3/157] vs. 14.0% [22/157], P < 0.001) , but significantly increased proportions of phaseⅠclinical trials and bioequivalence trials (24.4% [31/127] vs. 10.0% [3/30], 55.9% [71/127] vs. 0, respectively, both P < 0.001) . Totally, 90 kinds of dermatological drug were involved in all the trials, psoriasis, atopic dermatitis and melanoma were the most common indications, and innovative drugs accounted for 53.3% (48/90) ; the proportion of innovative drugs was significantly lower in domestic pharmaceutical companies than in global pharmaceutical companies (43.2% [32/74] vs. 16/16, P < 0.001) . In addition, 28 dermatological drugs developed by 22 pharmaceutical companies were approved in China in 2020, of which 21 drugs were developed by domestic pharmaceutical companies. Conclusion:Clinical drug trials carried out by domestic pharmaceutical companies mostly focus on generic drugs, and it is still necessary for domestic pharmaceutical companies to further improve the innovation ability.

Spontaneous renal hemorrhage: a clinical analysis of 50 patients / 中华肾脏病杂志

Objective:To provide clinical experience for the diagnosis and treatment of spontaneous renal hemorrhage through retrospective analysis of clinical features, imaging manifestations, underlying causes, treatment , and prognosis of spontaneous renal hemorrhage. Methods:By searching hospital information system, medical records scanning system, department of the interventional vascular surgery registry system, and picture archiving and communication systems, the patients with spontaneous renal hemorrhage admitted to Peking University First Hospital between January 1, 2000 to April 10, 2020 were enrolled. The clinical manifestations, investigations, imaging features, treatment, and prognosis of patients were retrospectively reviewed. The diagnostic efficiency and the accuracy of etiological diagnosis of renal hemorrhage by imaging examinations such as ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and angiography were compared and evaluated.Results:A total of 50 patients with 51 events of spontaneous renal hemorrhage were enrolled in the study. Laboratory tests showed hemoglobin was (103.3±29.4) g/L. The most common clinical features were flank or abdominal pain (48 cases, 96.0%), fever (17 cases, 34.0%), nausea (10 cases, 20.0%), vomiting (9 cases, 18.0%), and gross hematuria (4 cases, 8.0%). Nine patients (18.0%) experienced hypovolemic shock (systolic pressure<90 mmHg). With an initial assessment of the imaging method, the diagnostic accuracy of bleeding was 98.0%(49/50), yet the accuracy of underlying causes was 56.0%(28/50). The diagnostic accuracy of bleeding was 100.0%(25/25) by non-contrast abdominopelvic CT. The most common cause of spontaneous renal hemorrhage syndrome was renal tumors (27 cases, 54.0%), among which angiomyolipoma occurred most frequently (20 cases, 40.0%). Other causes included renal cyst (10 cases, 20.0%), autoimmune diseases (4 cases, 8.0%), bleeding diathesis (3 cases, 6.0%), and idiopathic renal hemorrhage (6 cases, 12.0%). Twelve patients (24.0%) received conservative management, 29 patients (58.0%) underwent interventional embolization therapy, and 11 patients (22.0%) received nephrectomy. The success rate on first embolization therapy was 86.2%(25/29), and approximately 13.8%(4/29) required second embolization therapy or nephrectomy.Conclusions:Spontaneous renal hemorrhage has no specific clinical features and is easy to be underdiagnosed or misdiagnosed. Non-contrast CT scan has a high diagnostic value for renal bleeding. Comprehensive judgement consisting of clinical features, laboratory tests, imaging manifestations and pathological examinations should be relied on for finding the underlying causes. Prompt diagnosis and management can guarantee a better prognosis.

Risk scoring system for bronchopulmonary dysplasia in very and extremely preterm infants / 中华围产医学杂志

Objective:To investigate the risk factors and establish a risk scoring system for bronchopulmonary dysplasia (BPD) in very and extremely preterm infants.Methods:From December 2013 to December 2018, 254 very and extremely preterm infants with less than 32 weeks of gestation hospitalized for 28 d and above in the Third Staff Hospital of Baotou Steel Group were retrospectively enrolled. According to the diagnostic criteria of BPD, they were divided into　the BPD group ( n=129) or the non-BPD group ( n=125). Clinical data and the risk factors for BPD were analyzed with univariate t-test, Chi-square test, rank-sum test, and multivariate logistic regression analysis. Based on the results, the risk scoring system was evaluated by receiver operating characteristic (ROC) curve, sensitivity, and specificity. Results:Logistic regression analysis showed that gestational age, neonatal respiratory distress syndrome (NRDS), ventilator-associated pneumonia (VAP), and duration of ventilation >7 d were the risk factors for BPD (all P<0.05). When the area under the ROC curve was 0.868 (95% CI: 0.823-0.913, P<0.001) and the maximum Youden index was 0.644, the sensitivity of the scoring systems for BPD was 0.884 (95% CI: 0.812-0.931), and the specificity was 0.760 (95% CI: 0.674-0.830). Conclusions:Gestational age, NRDS, VAP, and prolonged duration of ventilation were the risk factors for BPD. The risk scoring system established has the prediction value on BPD in very and extremely preterm infants.