A novel computed tomography scoring system for evaluating the risk of dural defects in anterior surgery for cervical ossification of the posterior longitudinal ligament.

OBJECTIVE: To develop and validate a computed tomography (CT)-based scoring system for evaluating the risk of dural defects (DDs) in anterior surgery for cervical ossification of the posterior longitudinal ligament (OPLL). METHODS: We retrospectively analyzed CT imaging features of 114 OPLL patients in our institute who received anterior decompression surgery. Intraoperative DDs were found in 16 patients. A multivariable logistic regression was used to evaluate the predictors. According to the odd ratio of the included risk factors, we developed a CT scoring system for evaluating the risk of DDs in anterior OPLL surgery. The system was further validated in an independent group of 39 OPLL patients. RESULTS: We developed a CT scoring system as follows: hook sign (2 points), K-line (-) (1 point) and broad base (1 point). Thus, the system comprised 4 total points, and patients were at high risks of dural defects when the score ≥3 points. The operating characteristics of a score ≥3 for predicting DDs in the validation group were: sensitivity of 0.83, specificity of 0.94, LR positive of 13.75, LR negative of 0.18 and AUC of 0.886. The discriminatory ability of the proposed score could be demonstrated in the validation cohort. CONCLUSIONS: The relatively simple and easy-to-use scoring system we propose integrates the 3 most reliable spinal CT findings observed in patients with OPLL and a DD. The likelihood to identify the underlying risks of spinal CSF leaks may be useful to triage patients who may benefit from indirect decompression techniques.

SaraNet: Semantic aggregation reverse attention network for pulmonary nodule segmentation.

Accurate segmentation of pulmonary nodule is essential for subsequent pathological analysis and diagnosis. However, current U-Net architectures often rely on a simple skip connection scheme, leading to the fusion of feature maps with different semantic information, which can have a negative impact on the segmentation model. In response to this challenge, this study introduces a novel U-shaped model specifically designed for pulmonary nodule segmentation. The proposed model incorporates features such as the U-Net backbone, semantic aggregation feature pyramid module, and reverse attention module. The semantic aggregation module combines semantic information with multi-scale features, addressing the semantic gap between the encoder and decoder. The reverse attention module explores missing object parts and captures intricate details by erasing the currently predicted salient regions from side-output features. The proposed model is evaluated using the LIDC-IDRI dataset. Experimental results reveal that the proposed method achieves a dice similarity coefficient of 89.11%and a sensitivity of 90.73 %, outperforming state-of-the-art approaches comprehensively.

Efficacy and safety of Tongxin formula after stent implantation for acute coronary syndrome: A multicenter, double-blind, placebo-controlled randomized trial.

OBJECTIVE: The aim of this study is to comprehensively evaluate both the efficacy and safety profile of integrating the Tongxin formula with optimal medical therapy (OMT) for patients experiencing acute coronary syndromes subsequent to coronary stenting, over the course of one year. METHODS: We enrolled 150 patients diagnosed with acute coronary syndromes who had received stent placement within one month and exhibited a TCM syndrome characterized by Qi deficiency and blood stasis. This group comprised patients with unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction. The participants were divided equally, allocating 75 to the Tongxin formula group and 75 to a placebo-controlled group. After undergoing percutaneous coronary intervention (PCI) surgery, both groups received conventional Western medical care, including dual antiplatelet therapy and lipid-lowering medications. The placebo-controlled group received a placebo, while the Tongxin formula group were administered Tongxin formula granules orally. Both study cohorts were monitored for a duration of 6 months. The primary endpoints included the occurrence of major adverse cardiovascular events and the rate of lumen diameter reduction post-treatment in both groups, with the Seattle Angina Scale serving as a secondary assessment tool. Safety evaluations encompassed the measurement of liver and kidney function, coagulation parameters, and other relevant indicators. RESULTS: The rate of adverse cardiovascular events in the placebo-controlled group was 42.46 % within a year of surgery, whereas it was 16.90 % in the Tongxin formula group (P < 0.05). Comparing the Tongxin formula group to the placebo-controlled group, there was a decrease in the frequency of unstable angina and readmission due to cardiovascular events (P < 0.05). Coronary angiography performed 6 months after surgery revealed that the Tongxin formula group had considerably less lumen loss than the placebo-controlled group in a number of segments, including the entire segment, within the stent, at the proximal end, and at the distal end (P < 0.05). Six months after surgery, the Seattle angina score was higher in the Tongxin formula group than in the placebo-controlled group (P < 0.05). There were no significant changes in indicators such as liver and renal function as well as coagulation indexes in both groups within the first 12 months after surgery (P > 0.05). CONCLUSION: Tongxin formula has been shown to lower the occurrence of major adverse cardiovascular events, minimize narrowing of blood vessel lumen, enhance clinical symptoms, and enhance the quality of life of patients following PCI surgery, all while maintaining a good safety profile.

The cardioprotective effect of Shengmai Zhenwu decoction on patients with chronic heart failure based on the levels of soluble interleukin 1 receptor-like 1.

Objective: The purpose of this study was to evaluate the protective effect of Shengmai Zhenwu decoction on patients with chronic heart failure (CHF) based on the levels of soluble interleukin 1 receptor-like 1 (ST2). Methods: We included a total of 80 outpatients and inpatients with CHF who were undergoing treatment at the Shanghai Municipal Hospital of Traditional Chinese Medicine between March 2020 and March 2022. We randomly divided them into the observation group (n = 40) and the control group (n = 40). Patients in the control group received treatments as per conventional Western medicine, while those in the observation group were treated with the Shengmai Zhenwu decoction in conjunction with Western medicine for eight consecutive weeks. We then compared the pre- and post-treatment levels of ST2 and N-terminal pro-brain natriuretic peptide (NT-proBNP) of the patients in the two groups. Results: There were no significant differences in the pre-treatment levels of ST2 and NT-proBNP indexes between the two groups (P > 0.05), while the post-treatment comparison between the two groups in terms of ST2 and NT-proBNP levels suggested that the effect in the observation group was better, with statistical significance (P < 0.05). Conclusion: Shengmai Zhenwu decoction was beneficial in patients with CHF, suggesting that it could be a promising and effective method for the treatment of CHF.

Rare and First Manifestation of Lupus Panniculitis as Lupus Mastitis: A Case Report and Literature Review.

INTRODUCTION: This case report presents a rare occurrence of lupus mastitis affecting the breast. CASE PRESENTATION: An induration with mild discomfort was detected in the upper inner quadrant of the right breast of a 27-year-old Chinese woman with regular menstrual cycles. The patient is currently unmarried and has no previous history of full-term pregnancies or lactation. An ill-defined, subcutaneous, hyperechoic lesion with no calcification was visualized on breast ultrasound. Peripheral and internal blood flow signals demonstrated high intensity. Pathological analysis of a breast needle biopsy revealed fat lobule necrosis accompanied by mixed lymphoplasmacytic and histiocytic aggregates. CONCLUSION: The diagnosis of lupus mastitis necessitates a comprehensive evaluation of the patient's medical history, serological testing, imaging studies, and histopathological analysis.

An Analysis of Predictive Factors for Severe Neonatal Infection and the Construction of a Prediction Model.

Objective: To investigate the primary predictive factors for the occurrence of severe neonatal infection, construct a prediction model and assess its effectiveness. Methods: A total of 160 neonates hospitalised in the Department of Neonatology at Suixi County Hospital from January 2019 to June 2022 were retrospectively analysed. Clinical data was analyzed to determine the primary predictive factors for the occurrence of severe neonatal infection. Predictive efficacy was evaluated using a receiver operating characteristic curve, and a nomogram model was constructed according to the predictors. A bootstrap technique was used to verify the accuracy of the model. Results: The neonates were divided, based on the degree of infection, into a mild infection group (n = 80) and a severe infection group (n = 80) according to a 1:1 ratio. Multivariate logistic regression analysis showed that compared with the recovery stage, white blood cell count (WBC) and platelet count (PLT) in the two groups were significantly decreased in the early stage of infection, and the ratio of mean platelet volume to PLT, as well as C-reactive protein (CRP) and procalcitonin levels, was elevated (P < 0.05). The area under the curves (AUCs) of decreased WBC, decreased PLT and elevated CRP levels, and the combination of these three indicators, were 0.881, 0.798, 0.523 and 0.914, respectively. According to the filtered indicators, two models (a dichotomous variable equation model and a nomogram model) of continuous numerical variables were constructed, and their AUCs were 0.958 and 0.914, respectively. The calibration curve of the nomogram model was validated with a consistency index of 0.908 (95% confidence interval [0.862, 0.954]). Conclusion: Decreased WBC and PLT levels and an elevated CRP level were the primary independent predictors of severe neonatal infection.

Serum PCT, CRP and CD64 levels in predicting early infection after internal fixation of limb fractures / 中华临床感染病杂志

Objective:To investigate serum C-reactive protein (CRP) , procalcitonin (PCT) and neutrophil CD64 in predicting early infection after internal fixation of limb fractures.Methods:A total of 2 572 patients with limb fractures undergoing internal fixation in Taishun County People’s Hospital from January 2016 to December 2022 were enrolled. Postoperative infection occurred in 121 cases (infected group) and did not occur in 2 451 cases (uninfected group). Serum levels of PCT, CRP and CD64 were tested at admission and d1, d3, d5 and d7 after operation. Repeated measurement analysis of variance was used to compare the serum levels of PCT, CRP and CD64 at different time points between two groups, the receiver operating characteristic curve (ROC) was used to evaluate the predictive value of each index or in combination for early infection after internal fixation of limbs fractures.Results:The early infection rate after internal fixation was 4.70% (121/2 572). The levels of PCT, CRP and CD64 in the infection group began to rise after operation and decreased on d7; there were significant differences in PCT, CRP and CD64 levels between the two groups on d3, d5 and d7 after operation (PCT: Ftime=678.607, Fintergroup=2 218.323, Finteraction=653.150; CRP: Ftime=392.724, Fintergroup=1 812.502, FInteraction =379.577; CD64: Ftime=373.686, Fintergroup=4 817.438, Finteraction=528.353, all P< 0.001) . The area under the ROC curve of combined detection of PCT, CPR, and CD64 for predicting early infection was 0.856; the sensitivity and specificity of combined detection were 69.2% and 94.7%, respectively. The combined detection of three indicators showed better prediction values than PCT, CRP and CD64 alone ( Z=6.176, 3.838 and 2.431, P<0.01 or <0.05), and also better than combined detection of PCT and CRP ( Z=2.875, P=0.019). Conclusions:The combined detection of CD64, PCT and CRP is of value in prediction of postoperative infection after internal fixation of limb fractures, which is worthy of clinical application.

The "time-response" effect of Wenyang Pingchuan Formula on miR-19a in asthmatic mice experiment.

BACKGROUND: Wenyang Pingchuan Formula (WPCF) is an empirical formula for the treatment of acute childhood asthma. However, the "time-effect" relationship of this prescription is not clear. This paper explores the relationship between Janus activated kinase signal transducer and activator of transcriptions (JAK/STAT), nuclear factor-κB (NF-κB), and microRNA (miR-19a), and also preliminarily determines the best time-effect relationship of WPCF in reducing the airway inflammation in asthmatic mice. METHOD: 80 BALB/c mice were randomly divided into four groups: control (CON) group, model (MDL) group, dexamethasone (DEX) group, and WPCF group. MDL group was established through intraperitoneal injection of 10% ovalbumin (OVA) and Al(OH)3 solution and the inhalation of aerosolized 5% OVA solution. Enzyme-linked immunosorbent assay (ELISA), real-time PCR and Western blot were conducted to determine the levels of interleukin (IL)-4, IL-13, interferon-γ (IFN-γ) in bronchoalveolar lavage fluid (BALF), contents of miR-19a mRNA and STAT6, phosphorylated signal transducers and activators of transcription 6 (p-STAT6), p65, phosphorylated p65 (p-p65), suppressors of cytokine signaling 1 (SOCS1), and tumor necrosis factor α-induced protein-3 (Tnfaip3) proteins after 7 and 28 days of intervention respectively. RESULTS: Significant down-regulation of IL-4 and IL-13 expression (P<0.05) and up-regulation of IFN-γ expression (P<0.05) in BALF have been observed for WPCF group compared with the MDL group. The significant down-regulation of miR-19a mRNA and STAT6, p-STAT6, p65, p-p65 proteins (P<0.05) and up-regulation of SOCS1 and Tnfaip3 proteins (P<0.05) in BALF was also observed for WPCF group compared to the MDL group. During the experiment, the weight of the mice in DEX group significantly decreased (P<0.05) compared with the other groups. CONCLUSIONS: WPCF could restore Th1/Th2 balance. The longer the intervention time, the more effective the treatment. The down-regulation of miR-19a mRNA by activating JAK/STAT and NF-κB signal pathways may be a possible mechanism by which WPCF alleviates airway inflammation.

The “time-response” effect of Wenyang Pingchuan Formula on miR-19a in asthmatic mice experiment

Background: Wenyang Pingchuan Formula (WPCF) is an empirical formula for the treatment of acute childhood asthma. However, the “time-effect” relationship of this prescription is not clear. This paper explores the relationship between Janus activated kinase signal transducer and activator of transcriptions (JAK/STAT), nuclear factor-κB (NF-κB), and microRNA (miR-19a), and also preliminarily determines the best time-effect relationship of WPCF in reducing the airway inflammation in asthmatic mice.Method: 80 BALB/c mice were randomly divided into four groups: control (CON) group, model (MDL) group, dexamethasone (DEX) group, and WPCF group. MDL group was established through intraperitoneal injection of 10% ovalbumin (OVA) and Al(OH)3 solution and the inhalation of aerosolized 5% OVA solution. Enzyme-linked immunosorbent assay (ELISA), real-time PCR and Western blot were conducted to determine the levels of interleukin (IL)-4, IL-13, interferon-γ (IFN-γ) in bronchoalveolar lavage fluid (BALF), contents of miR-19a mRNA and STAT6, phosphorylated signal transducers and activators of transcription 6 (p-STAT6), p65, phosphorylated p65 (p-p65), suppressors of cytokine signaling 1 (SOCS1), and tumor necrosis factor α-induced protein-3 (Tnfaip3) proteins after 7 and 28 days of intervention respectively.Results: Significant down-regulation of IL-4 and IL-13 expression (P<0.05) and up-regulation of IFN-γ expression (P<0.05) in BALF have been observed for WPCF group compared with the MDL group. The significant down-regulation of miR-19a mRNA and STAT6, p-STAT6, p65, p-p65 proteins (P<0.05) and up-regulation of SOCS1 and Tnfaip3 proteins (P<0.05) in BALF was also observed for WPCF group compared to the MDL group. During the experiment, the weight of the mice in DEX group significantly decreased (P<0.05) compared with the other groups.Conclusions: WPCF could restore Th1/Th2 balance (AU)

Epidemiological characteristics of dengue fever in Mengla County， Yunnan Province in 2019 / 上海预防医学

ObjectiveTo analyze the epidemic characteristics of dengue fever in Mengla County and provide basis for scientific prevention and control of dengue fever. MethodsWe collected the case information of dengue fever in Mengla County reported by the infectious disease reporting information system of China Center for Disease Control and prevention from January 1 to December 31， 2019 and the case field investigation records. The case data were analyzed by descriptive epidemiological method. ResultsIn 2019， Mengla County reported 369 cases of dengue fever， all of which were unclassified， including 354 clinically diagnosed cases， 15 confirmed cases， 6 severe cases， and there was no deaths. The annual incidence rate was 120.98/105. Mengla Town had the most cases （145 cases， 39.30%） followed by 63 cases （17.07%） in Mengpeng Town. The reported cases were mainly local cases （65.85%）. The ratio of male to female was 1.25∶1. The age distribution was mainly in the group of 21‒60 years old （82.38%）. Farmers （112 cases， 30.35%） and business service providers （85 cases， 23.04%） were the majority. The annual cases were distributed from May to November， of which the most were reported in September， and the number of cases reported from July to October accounts for 93.22% of all cases. ConclusionMengla County is still a high incidence area of dengue fever in Yunnan Province， and the vector Aedes is widespread. It is suggested to strengthen mosquito prevention and control in the epidemic season， actively carry out patriotic health campaign， carry out special rectification of the environment in rural areas， and conduct effective public education.

Salidroside inhibits phenotypic transformation of rat pulmonary artery smooth muscle cells induced by hypoxia / 中国中药杂志

This study investigated the effect of salidroside on phenotypic transformation of rat pulmonary artery smooth muscle cells(PASMCs) induced by hypoxia. Rat pulmonary arteries were isolated by tissue digestion and PASMCs were cultured. The OD values of cells treated with salidroside at different concentrations for 48 hours were measured by cell counting kit-8(CCK-8) to determine the appropriate concentration range of salidroside. The cells were divided into a normal(normoxia) group, a model(hypoxia) group, and three hypoxia + salidroside groups(40, 60, and 80 μg·mL~(-1)). Quantitative real-time PCR(qRT-PCR) was used to detect the mRNA expression of cell contractile markers in each group, such as α-smooth muscle actin(α-SMA), smooth muscle 22(SM22), and calcium-binding protein(calponin), and synthetic marker vimentin. The expression levels of cell phenotypic markers and proliferating cell nuclear antigen(PCNA) were detected by Western blot. The proliferation of cells in each group was detected by the 5-ethynyl-2'-deoxyuridine(EdU) assay. Cell migration was measured by Transwell assay. As revealed by results, compared with the normal group, the model group showed decreased mRNA and protein expression of contractile phenotypic markers of PASMCs and increased mRNA and protein expression of synthetic markers. Compared with the conditions in the model group, salidroside could down-regulate the mRNA and protein expression of synthetic markers in PASMCs and up-regulated the mRNA and protein expression of contractile phenotypic markers. Compared with the normal group, the model group showed potentiated proliferation and migration. Compared with the model group, the hypoxia + salidroside groups showed blunted proliferation and migration of cells after phenotypic transformation. The results suggest that salidroside can inhibit the expression of synthetic markers in PASMCs and promote the expression of contractile markers to inhibit the hypoxia-induced phenotypic transformation of PASMCs. The mechanism of salidroside in inhibiting the proliferation and migration of PASMCs is related to the inhibition of the phenotypic transformation of PASMCs.

Functional predication of differentially expressed circRNAs/lncRNAs in the prefrontal cortex of Nrf2-knockout mice.

In the central nervous system, nuclear factor erythroid-2-related factor 2 (Nrf2) protects neurons from oxidant injury, thereby ameliorating neurodegeneration. We explored the key circular RNAs (circRNAs) and long non-coding RNAs (lncRNAs) involved in Nrf2-induced neuroprotection. We used microarrays to examine the circRNAs (DEcircRNAs), lncRNAs (DElncRNAs) and mRNAs (DEmRNAs) differentially expressed between Nrf2 (+/+) and Nrf2 (-/-) mice and identified DEcircRNA/DElncRNA-miRNA-DEmRNA interaction networks. In total, 197 DEcircRNAs, 685 DElncRNAs and 356 DEmRNAs were identified in prefrontal cortical tissues from Nrf2 (-/-) mice. The expression patterns of selected DEcircRNAs (except for mmu_circ_0003404) and DElncRNAs in qRT-PCR analyses were generally consistent with the microarray analysis results. Functional annotation of the DEmRNAs in the DEcircRNA/DElncRNA-miRNA-DEmRNA networks indicated that five non-coding RNAs (mmu_circ_0000233, ENSMUST00000204847, NONMMUT024778, NONMMUT132160 and NONMMUT132168) may contribute to Nrf2 activity, with the help of mmu_circ_0015035 and NONMMUT127961. The results also revealed that four non-coding RNAs (cicRNA.20127, mmu_circ_0012936, ENSMUST00000194077 and NONMMUT109267) may influence glutathione metabolism. Additionally, 44 DEcircRNAs and 7 DElncRNAs were found to possess coding potential. These findings provide clues to the molecular pathways through which Nrf2 protects neurons.

Effect of Prescription Tongxin on Endothelial Progenitor Cells in Peripheral Blood.

CONTEXT: Coronary heart disease (CHD) refers to a disease where coronary atherosclerosis induces stenosis or obstruction of the blood vessels. Endothelial progenitor cells (EPCs) function to protect and repair the vascular endothelium, and their functional activity state reflects the ability of the body to repair vascular damage. In the peripheral blood of patients with CHD, the density of EPCs decreases, and the function of EPCs is low. OBJECTIVE: This study aimed to investigate the effects of a China Food and Drug Administration (CFDA)-approved prescription medicine, Tongxin, on the density and function of endothelial progenitor cells (EPCs) in peripheral blood. DESIGN: In this study, a randomized, single blind, parallel controlled clinical trial was used. The single blind subjects were subjects. SETTING: The study took place in the Cardiology and Emergency Departments at Shanghai Municipal Hospital of Traditional Chinese Medicine in Shanghai, China. PARTICIPANTS: Participants were 48 patients with coronary heart disease at the hospital. INTERVENTION: Participants were randomly divided into 2 groups (n = 24 each): a control group and an intervention group. Both groups received routine drug treatments, such as platelet inhibitors, nitrates, ß-receptor blockers, statins, angiotensin-converting-enzyme (ACE) inhibitors, angiotensin II receptor antagonists (ARBs), and calcium blockers. The control group was treated with the Shexiang Baoxin Pill, while the intervention group was treated with prescription Tongxin. The course of treatment was 3 months for both groups. OUTCOME MEASURES: Changes in the density and function of EPCs in the peripheral blood of the 2 groups were measured at baseline and postintervention, and the clinical efficacy of the 2 treatments was statistically analyzed. RESULTS: The density of EPCs was significantly higher in both groups after 3 months of treatment, compared to the densities at baseline (P < .05). The change in density between baseline and postintervention was significantly greater for the intervention group than for the control group (P < .05). For the control group, the proliferative vitality [optical density (OD)] value of the EPCs was significantly higher than that at baseline from the fourth day of treatment (P < .05). In the intervention group, the OD value was significantly higher than that at baseline from the first day of treatment (P < .05). Furthermore, the intervention group's cells began to enter the logarithmic growth phase of increase from the fifth day of treatment, and the group's increase as significantly higher than the control group's from the fifth to the seventh dayof treatment (P < .05 for all 3 days). Moreover, the total effective rate was higher in the intervention group than in the control group (P < .05). CONCLUSIONS: Prescription Tongxin can stimulate the release of EPCs from the bone marrow to the peripheral blood of patients with CHD, can significantly increase the proliferation of EPCs in the peripheral blood, and can improve the clinical symptoms of patients. Its curative effect was greater than that of the control treatment.

Observation on the response of rats and human to motion sickness stimulated by vertical motion on simulated ship / 解放军医学杂志

Objective To observe the pathogenesis of motion sickness with different frequencies and accelerations of heave motion. Methods Sixty-four adult male healthy rats were randomly divided into four groups (n=16): Vertical motion mode A (frequency 0.20 Hz, acceleration 0.05 g), vertical motion mode B (frequency 0.40 Hz, acceleration 0.13 g), vertical motion mode C (frequency 0.80 Hz, acceleration 0.48 g) and static control group. The severity of motion sickness was evaluated by three indicators: Frequency of conditioned gaping (nausea like reaction), number of defecation particles and spontaneous activity. Thirty-six male healthy volunteers were randomly divided into four groups (n=9): Vertical motion mode I (frequency 0.42 Hz, acceleration 0.22 g), vertical motion mode II (frequency 0.42 Hz, acceleration 0.44 g), vertical motion mode III (frequency 0.30 Hz, acceleration 0.33 g), and vertical motion mode IV (frequency 0.25 Hz, acceleration 0.44 g). A modified version of motion-sickness susceptibility questionnaire (MSSQ) was used to evaluate the susceptibility to motion sickness before the test, and Graybiel motion sickness scale to evaluate the severity of motion sickness during the test. MATLAB software was used to establish a population test mathematical model and draw a trend chart. ResultsCompared with the static control group, rats receiving mode A stimulation did not show significant symptoms of motion sickness, and both the number of conditioned gaping and the number of defecation particles in the vertical motion group B and the vertical motion group C significantly increased, while the spontaneous locomotion activity was significantly reduced after the motion sickness stimulation (P<0.05 or P<0.001). Symptoms became more obvious as the frequency of stimulation increases. Besides, the results of the crowd test indicated that after receiving different stimulations of modes I, II, III and IV, the Graybiel scores were 7.67±6.36, 4.22±4.97, 1.44±1.51, 0.22±0.44 respectively, with the highest incidence of nausea in the vertical motion group I. MATLAB software analysis shows that as the stimulus frequency increases, the score of motion sickness increases, while when the frequency was fixed, Graybiel score increased first and then decreased as the acceleration increased. ConclusionThe occurrence rules of simulated seasickness in rats and human under the stimulation of vertical motion have been preliminarily clarified, which could provide an experimental basis for anti-seasickness simulation training.

Clinical significance of D-dimer in early diagnosis of mesenteric vasculitis in systemic lupus erythematosus / 医学研究生学报

ObjectiveLupus mesenteric vasculitis (LMV) can lead to extensive necrosis of the small intestine, and it is easy to be misdiagnosed and missed in the early stage of the disease. This study aims to evaluate the clinical significance of serum D-dimer level in the early diagnosis of LMV.MethodsRetrospective analysis was performed on 38 patients with systemic lupus erythematosus (SLE) admitted to Nanjing Drum Tower Hospital from January 2006 to January 2019. There were 15 LMV patients (LMV Group) and 23 non-LMV patients (Non-LMV Group). The main observation indicators of statistical analysis were serum D-dimer level on the first day of treatment in the two groups, while the secondary indicators included patient general condition, SLE disease activity index (SLEDAI), enhanced CT examination results, laboratory examination results and serum D-dimer level after treatment.ResultsThere was no significant difference in age, SLE duration and SLEDAI between the two groups (P>0.05). On admission, CT showed LMV patients with intestinal dilatation, mesenteric edema and typical target symptoms. After high-dose hormone therapy, the dilatation of intestinal canal and intestinal wall were significantly relieved, and the target signs on CT disappeared before discharge. The serum D-dimer level of patients in the LMV Group [917 (756,1848) μg/L] was significantly higher than that in the Non-LMV Group [570 (356,896) μg/L], and the difference was statistically significant (P=0.006). ROC curve analysis showed that the critical value of serum D-dimer in early diagnosis of LMV was 624 μg/L, and the sensitivity and specificity were 93% and 61%, respectively (AUC=0.77).ConclusionSerum D- dimer level can be used as an effective index for early diagnosis of LMV patients.

Clinical significance of D-dimer in early diagnosis of mesenteric vasculitis in systemic lupus erythematosus / 医学研究生学报

ObjectiveLupus mesenteric vasculitis (LMV) can lead to extensive necrosis of the small intestine, and it is easy to be misdiagnosed and missed in the early stage of the disease. This study aims to evaluate the clinical significance of serum D-dimer level in the early diagnosis of LMV.MethodsRetrospective analysis was performed on 38 patients with systemic lupus erythematosus (SLE) admitted to Nanjing Drum Tower Hospital from January 2006 to January 2019. There were 15 LMV patients (LMV Group) and 23 non-LMV patients (Non-LMV Group). The main observation indicators of statistical analysis were serum D-dimer level on the first day of treatment in the two groups, while the secondary indicators included patient general condition, SLE disease activity index (SLEDAI), enhanced CT examination results, laboratory examination results and serum D-dimer level after treatment.ResultsThere was no significant difference in age, SLE duration and SLEDAI between the two groups (P>0.05). On admission, CT showed LMV patients with intestinal dilatation, mesenteric edema and typical target symptoms. After high-dose hormone therapy, the dilatation of intestinal canal and intestinal wall were significantly relieved, and the target signs on CT disappeared before discharge. The serum D-dimer level of patients in the LMV Group [917 (756,1848) μg/L] was significantly higher than that in the Non-LMV Group [570 (356,896) μg/L], and the difference was statistically significant (P=0.006). ROC curve analysis showed that the critical value of serum D-dimer in early diagnosis of LMV was 624 μg/L, and the sensitivity and specificity were 93% and 61%, respectively (AUC=0.77).ConclusionSerum D- dimer level can be used as an effective index for early diagnosis of LMV patients.

Research on the Development Status and Suggestions of TCM Enterprises of Nantong City / 中国药房

OBJECTIVE： To study the development status of TCM enterprises of Nantong city and provide suggestions， and to promote the sustainable development of TCM enterprises of Nantong city. METHODS： Taking Nantong city as an example， questionnaires were issued to 15 TCM enterprises in Nantong （including 4 TCM decoction piece enterprises， 11 TCM pharmaceutical preparation enterprises）. The statistical analysis was carried out in respects of scale structure， development （including economic development and staff） and development potential （by enterprise R&D funds and R&D personnel input intensity） of enterprises during 2013-2017. RESULTS & CONCLUSIONS： In terms of the scale and structure of the enterprise， there were no large-scale enterprises in Nantong city， only 3 medium-sized enterprises， 12 small enterprises； the overall scale of enterprises was small； the overall concentration of TCM enterprises was not high， in which the market structure of TCM decoction piece enterprises was oligopolistic， and the structure of preparation enterprises was competitive. The concentration of TCM decoction enterprises was higher than that of TCM preparation enterprises. In terms of economic development， the annual average GDP and profit growth rate are 14.98％ and 19.09％ from 2014 to 2017； the economic development situation was good， but the brand variety advantage was not developed fully. In terms of staff， employee’s education level was mainly college degree （34.01％） and the staff category was mainly salesperson （32.73％）. In terms of the company’s development potential， enterprise R&D funds and R&D personnel input intensity were in low levels （average 2.96％， 11.32％ in 5 years）， the number of patents （16 in 2013 vs. 17 in 2017） and innovative products （7 in 2013 vs. 12 in 2017） increases slowly， and only one had opened up overseas markets. In response to the issues， TCM enterprises of Nantong city or other areas should merge and reorganize appropriately to expand the scale of the industry and improve the market concentration； increase research funds and talented personnel investment， insist the protection and in novation of TCM. In addition， build a big data “healthy cloud” platform to break the traditional industrial chain； at the same time， seize the “Belt and Road” policy finance and taxation opportunities to promote overseas and develop markets to promote the sustainable development of TCM enterprise.

Brucella induces unfolded protein response and inflammatory response via GntR in alveolar macrophages.

Brucella is an intracellular bacterium that causes the zoonosis brucellosis worldwide. Alveolar macrophages (AM) constitute the main cell target of inhaled Brucella. Brucella thwarts immune surveillance and evokes endoplasmic reticulum (ER) stress to replicate in macrophages via virulence factors. The GntR regulators family was concentrated as an important virulence factor in controlling virulence and intracellular survival of Brucella. However, the detailed underlying mechanism for the host-pathogen interaction is poorly understood. In this study the BSS2_II0438 mutant (ΔGntR) was constructed. The type IV secretion system (T4SS) virulence factor genes (VirB2, VirB6, and VirB8) were down-expression in ΔGntR. ΔGntR could infect and proliferate to high titers in GAMs without a significant difference compared with the parental strain. ΔGntR infection increased the expression of ER stress marker genes GRP78, ATF6, and PERK in the early stages of its intracellular cycle but decreased the expression of these genes in the late stages. ΔGntR increased greatly the number of Brucella CFUs in the inactive ER stress state in GAMs. Meanwhile, ΔGntR infection increased the levels of IFN-γ, IL-1ß, and TNF-α, indicating ΔGntR could induce the secretion of inflammatory but not anti-inflammatory cytokines IL-10. Taken together, our results clarified the role of the GntR in B. suis. S2 virulence expression and elucidated that GntR is potentially involved in the signaling pathway of the Brucella-induced UPR and inflammatory response in GAMs.

Analysis of flavonoids and antitumor activity of transgenic Saussurea involucrate / 中国中药杂志

The aim of this paper was to investigate the flavonoids of callus of transgenic and non-transgenic Saussurea involucrate and its antitumor activity on the esophageal cancer CaEs-17 cells. The species and content of mono-phenols were detected by high performance liquid chromatography. The growth of human esophageal cancer CaEs-17 cells was detected using CCK-8 assay, apoptosis morphology observation and flow cytometry. Expression of related apoptotic genes Bax and Bcl-2 were determined by qPCR. The results showed that the content of total flavonoids in the transgenic callus was 2.72 times that of the non-transgenic callus. The cyanidin-galactoside was detected in the transgenic callus, but not in the non-transgenic callus. The inhibitory effect of the extracts from the transgenic callus on CaEs-17 cells was more significant than that of the non-transgenic callus, and the IC₅₀ value had a decreased of 26.4%. Flow cytometry analysis results showed that the apoptosis induction effect of the extracts from the transgenic callus on CaEs-17 cells was significantly better than that of the non-transgenic callus. Fluorescence quantitative PCR analysis results showed that the extracts from the transgenic callus could up-regulate the expression of proapoptotic gene Bax and down-regulate the expression of apoptotic gene Bcl-2, and the regulation effect of the transgenic callus was more significant. Therefore, compared with the non-transgenic callus, the antitumor activity of the extracts from the callus of transgenic S. involucrate on the esophageal cancer CaEs-17 cells was significantly increased, which was closely related to the accumulation of cyanidin-galactoside and its metabolism-related flavonoid compounds in the transgenic callus.

[Efficacy of Shengxue Mixture Combined with Intraosseous Infusion for Treatment of Aplastic Anemia].

OBJECTIVE: To evaluate the efficacy and safety of Shengxue mixture combined with intraosseous blood infusion for treatment of aplastic anemia patients. METHODS: From 2011 to 2015, Institute of blood diseases of Shaanxi Medical University admitted 53 patients with aplastic anemia. The patients were treated with shengxue mixture 200 ml, orally, twice a day. Stanozolol tablets, Adult 2 mg, three times a day, mycophenolate mofetil 1.0 g, twice a day. Intraosseous infusion of the following medicine were administered in patients: recombinant human EPO 10000 U, recombinant human G-CSF 450 µg, recombinant human IL-11 4.5 mg, dexmethasone 20 mg, once a week, a total of four times. One month later, the blood cell counts and bone marrow biopsy were performed. Consolidation treatment continued for 3 to 6 months after discharge, and therapeutic effect was observed and followed-up for more than a year. RESULTS: After one month of treatment, 40 patients were basically cured (75.47%), 8 patients were remitted(15.09%), Hemoglobin level, white blood cell count and platelet count were significantly improved after treatment (P<0.01). The overall response rate was 90.57%(48 patients). Patients with bone marrow hyperplasia was 46 (86.79%), versus 9(16.98%) before treatment. There was a difference (P<0.05). After 3 to 6 months of treatment, 40 patients were cured (75.47%); 8 patients were remitted(15.09%); 3 patients were obviously improved(5.66%); 2 patients were ineffective(3.77%). The overall response rate was 96.23%(51 cases). No obvious side effects were observed. No patients were relapsed after one year. CONCLUSION: Shengxue mixture combined with Intraosseous infusion is a fast, efficient, safe method for the treatment of aplastic anemia.