Metformin and buparlisib synergistically induce apoptosis of non-small lung cancer (NSCLC) cells via Akt/FoxO3a/Puma axis.

Non-small cell lung cancer (NSCLC) is a global health issue lacking effective treatments. Buparlisib is a pan-PI3K inhibitor that shows promising clinical results in treating NSCLC. However, chemoresistance is inevitable and hampers the application of buparlisib. Studies show that a combination of phytochemicals and chemotherapeutics enhances its effectiveness. Here, we evaluated the role of metformin, an agent with multiple pharmacological properties, in enhancing the anti-tumour activities of buparlisib against NSCLC cells. Our results showed that metformin and buparlisib synergistically inhibited cell viability, migration, and invasion of NSCLC cells. In addition, co-treatment of metformin and buparlisib also induced cell cycle arrest and cell death in NSCLC cells. Mechanistically, metformin and buparlisib repressed Mcl-1 and upregulated Puma in NSCLC cells in a p53-independent manner. Moreover, they inhibited the PI3K/Akt signalling pathway, leading to activation of the FoxO3a/Puma signalling in NSCLC cells. Our findings suggest that combined treatment of metformin and buparlisib might provide a promising strategy for treating NSCLC.

Clinical characteristics of liver function injury in patients with coronavirus disease 2019 / 中华传染病杂志

Objective:To investigate the incidence of liver injury in patients with coronavirus disease 2019 (COVID-19), and to explore its impact on the condition and prognosis of patients.Methods:The medical records of 67 patients with COVID-19 who presented with pneumonia hospitalized at Tongji Hospital, Huazhong University of Science and Technology from February 11 to March 28, 2020 were collected. The results of liver biochemistry and coagulation function test at admission were analyzed. Data were compared by chi-square test, analysis of variance or Kruskal-Wallis H test. Results:Among 67 patients, total bilirubin increased in seven (10.4%) patients, which was slightly abnormal, albumin decreased in 36(53.7%) cases, and was below 30 g/L in 15(22.4%) cases, alanine transaminase (ALT) and aspartate transaminase (AST) were elevated in 19(28.4%) and 12(17.9%) cases, respectively. A total of 22(32.8%) cases had elevated ALT and (or) AST. The incidences with elevated ALT and (or) AST in moderate and severe patients were 33.3%(10/30) and 26.9%(7/26), respectively. Five of 11 critical patients had elevated ALT and (or) AST. There was no significant difference among the three groups ( χ2=1.21, P=0.546). Abnormal alkaline phosphatase and (or) γ-glutamyl transpeptidase were observed in 11(16.4%) cases. The prolongation of prothrombin time (PT) and activated partial thromboplastin time (APTT) occurred in 10(14.9%) and 17(25.4%) patients, respectively, while most of them were slightly abnormal. Only one patient presented with prolongation of PT and APTT meeting the standard of liver failure. A total of 61.2%(41/67) and 65.7%(44/67) of cases showed increase of fibrinogen and D-dimer, respectively, and 28.4%(19/67) and 19.4%(13/67), respectively increased to an obvious extent. The albumin levels in moderate, severe and critical patients were (37.85±6.19) g/L, (32.96±4.33) g/L and (33.02±3.63) g/L, respectively, which were significantly different ( F=7.36, P=0.001). There were significant differences in PT, APTT, fibrinogen and D-dimer among the three groups ( F=3.22, 3.31, 4.06 and H=17.63, respectively, all P<0.05). Conclusions:COVID-19 only leads to mild liver injury and has only mild impact on liver function. The decrease of albumin level and the increase of fibrinogen and D-dimer may be early predicting indexes for the disease severity.

Effect of rhythmic auditory stimulation on gait of patients with cerebral palsy: a systematic review / 中国康复理论与实践

ObjectiveTo systematically review the effect of rhythmic auditory stimulation on gait of patients with cerebral palsy. MethodsRelevant literature on gait improvement of patient with cerebral palsy by rhythmic auditory stimulation were retrieved from Web of Science, PubMed, EBSCO, CNKI and Wanfang database from establishment to December, 2022. Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality of the articles, and the relevant data was extracted. A systematic review was conducted. ResultsA total of 1 339 literatures were retrieved, and ten were finally included. The patients mainly came from America, Egypt, Israel, South Korea and Greece. The intervention sites were mainly in hospitals and communities, and some patients received home-based intervention. The publication date was mainly after 2010. Adding rhythmic auditory stimulation on the basis of conventional rehabilitation training increased the range of motion of the joints of patients with cerebral palsy; improved the walking speed, step length and stride length; improved the movement mode, and enhanced the intervention effect of gait training. ConclusionRhythmic auditory stimulation is effective on the range of motion, walking speed, step length and stride length of patient with spastic cerebral palsy, which can improve gait.

Feasibility study on rapid identification of methicillin-resistant Staphylococcus aureus by different algorithms of MALDI-TOF mass spectrometry / 中华检验医学杂志

Objective:To explore the feasibility of rapid identification of methicillin-resistant Staphylococcus aureus using different algorithms of the matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometer. Methods:Totally 314 clinical isolates of Staphylococcus aureus were selected from the bacterial bank at Beijing Tongren Hospital from January 2017 to June 2019. The samples were identified by MALDI-TOF MS, and screened by cefoxitin disk method (inhibition ring diameter ￡21 mm) and PCR mecA gene. The strains were divided into a methicillin-resistant Staphylococcus aureus (MRSA) group (130 strains) and a methicillin-susceptible Staphylococcus aureus (MSSA) group (184 strains). Then, after collecting the spectrograms of these samples using formic acid extraction, the MRSA group and MSSA group were divided into three subgroups each, namely MRSA-1 (43 strains), MRSA-2 (42 strains), MRSA-3 (45 strains) and MSSA-1 (60 strains), MSSA-2 (61 strains) and MSSA-3 (63 strains). The groups were studied using genetic algorithm (GA), fast classification algorithm (QC) and supervised neural network algorithm (SNN) in the ClinProTools software on the Bruker MALDI-TOF mass spectrometer, and the convolutional neural network algorithm (CNN) in the Ex-SmartSpec software on the Zhongyuan Hui-Ji mass spectrometer. These studies were repeated for 3 rounds. The first round with MRSA-1 and MRSA-2, MSSA-1 and MSSA-2 being model groups, MRSA-3 and MSSA-3 being validation groups. The validation groups were rotated for each round. The areas under the receiver operating characteristic (ROC) curve expansions of the four algorithms were used to confirm each program′s performance. Then, 38 MRSA strains and 40 MSSA clinical strains were selected from the bacterial bank of the Laboratory of Beijing Tongren Hospital from July 2019 to December 2019, and were put through the formic acid extraction method to collect their spectra. These samples were tested independently with their convolutional neural network models. Results:After three rounds of modeling and verification, the areas under the ROC curves of the three Bruker ClinProTools programs were as follows: for genetic algorithm, the areas were 0.89, 0.74, and 0.64 respectively; for fast classification algorithm, the areas were 0.77, 0.95, and 0.94 respectively; and for supervised neural network algorithm, the areas were 0.90, 0.98, and 0.98 respectively. The areas under the ROC curves of the convolutional neural network algorithm with Zhongyuan Huiji mass spectrometer′s Ex-SmartSpec software were 0.95, 0.99, and 0.99 respectively. The independent test results of convolutional neural network algorithm showed that these results have an accuracy, specificity, sensitivity and AUC of 88.82% (810/912), 81.15% (779/960), 84.88% (1 589/1 872) and 0.92 respectively.Conclusions:The supervised neural network algorithm of Bruker′s ClinProTools and the convolutional neural network algorithm of Zhongyuan Hui-Ji mass spectrometer′s EX-Smartspec is clinically acceptable for rapid identification of MRSA performance indicators. Using convolutional neural network algorithm and MALDI-TOF mass spectrometry, MRSA strains can be identified quickly, providing timely advice for clinical medications.

CircDTL Functions as an Oncogene and Regulates Both Apoptosis and Ferroptosis in Non-small Cell Lung Cancer Cells.

Background: Circular RNAs (circRNA) play an essential role in the tumorigenesis of non-small cell lung cancer (NSCLC). CircDTL is a novel identified circRNA with little information regarding its biological role. However, the role of circDTL in NSCLC has not been investigated yet. Method: In this study, the levels of circDTL in tissues and cells were measured by RT-PCR. Cell viability was measured by the CCK-8 assay. Cell migration and invasion were evaluated using the wound healing assay and transwell assay, respectively. Cell death was measured by the cell death ELISA kit. The levels of Fe2+, ROS, MDA and GSH were measured using the commercial kits. The interactions between miR-1287-5p and circDTL/3'UTR GPX4 were verified by dual-luciferase activity assay. The effects of circDTL on tumor growth were evaluated in vivo. Results: CircDTL was found to be upregulated and acted as an oncogene in NSCLC cells. Knockdown of circDTL promoted both apoptosis and ferroptosis of NSCLC cells. It was identified that circDTL exerts its oncogenic effects via the circDTL/miR-1287-5p/GPX4 axis and GPX4 inhibits both ferroptosis and apoptosis. Finally, this study showed that silencing of circDTL promoted the sensitivity of NSCLC cells to chemotherapeutic agents and inhibited the growth of tumors in vivo. Conclusion: CircDTL acts as an oncogene and exerts its effects via the miR-1287-5p/GPX4 axis in NSCLC, providing a potential therapeutic target for NSCLC cancer therapy.

Valproic acid concentration and biochemical indexes in epilepsy outpatients during monotherapy or combination therapy / 中南大学学报(医学版)

OBJECTIVES@#Due to the narrow therapeutic window of valproic acid (VPA), grievous adverse reactions such as hepatotoxicity, nephrotoxicity may occur in patients with epilepsy for a long time. This study aimed to explore the effect of VPA concentration on biochemical and routine blood test related to liver, renal, and hematology in epileptic outpatients treated with VPA alone or combined with other antiepileptic drugs.@*METHODS@#A total of 3 194 Chinese epileptic outpatients from Xiangya Hospital, were analyzed in a crude analysis after stratifying through dosage regimens. The plasma VPA concentration was detected by gas chromatography method and then standardized through dosage and body weight. Ten biochemical indexes related to liver, renal, and hematology were evaluated.@*RESULTS@#Of all patients, blood urea nitrogen (BUN), serum creatinine (SCr) level, and erythrocyte count (RBC) showed positive correlations with standardized VPA concentration (=0.494, =0.157, =0.596, respectively), while platelet specific volume (PCT) and blood platelet (PLT) showed negative correlations with standardized VPA concentration (=-5.500, =-0.086, respectively). After stratifying through dosage regimens, significantly positive associations between SCr and standardized VPA concentration were found in the juvenile patients from the monotherapy group and combination therapy group (=1.800, =0.352, respectively). In addition, PLT and leukocyte count (WBC) in the juvenile patients from the combination therapy group were negatively correlated with standardized VPA concentration (=-1.463, =-0.079, respectively), while RBC showed a positive association with standardized VPA concentration in the juvenile patients from the monotherapy group (=0.068).@*CONCLUSIONS@#SCr level is significantly associated with plasma VPA concentration. Drug combination and age are important factors leading to hematological disorders. The finding provides potential theoretical guidance for the rational and safe clinical use of VPA.

Association of valproic acid and 2-propyl-4-pentenoic acid concentrations with adverse reaction in 254 Chinese patients with epilepsy / 中南大学学报(医学版)

Objective:To investigate the correlation of the concentrations of valproic acid (VPA) and 2-propyl-4-pentenoic acid (4-ene-VPA) with their adverse reactions,and to guide the clinical safety and rational use of VPA.Methods:We collected 254 epilepsy outpatients who took long-term use of sodium valproate oral solution single or combined with other antiepileptic drugs from Xiangya Hospital.The plasma concentrations of VPA and 4-ene-VPA in patients were determined by gas chromatography-mass spectrometry (GC-MS).The double variable correlation analysis was performed to analyze the effect of plasma 4-ene-VPA and VPA concentrations on adverse reactions.Results:The correlations between the PLT level and the dosage ofVPA (P＜0.01 and P＜0.05,respectively),and the RBC level and the concentration of VPA (All P＜0.01) were significant negatively.The concentrations of 4-ene-VPA,VPA,ALT,and AST in the polytherapy group were much higher than those in the monotherapy group (All P＜0.05).In the monotherapy group,the ALT and AST levels in patients younger than or equal to 2 years old were significantly higher than those over 2 years old (P＜0.001).In the polytherapy group,the levels of AST,WBC,and PLT in patients younger than or equal to 2 years old were higher than those over 2 years old (P＜0.05).The levels of AST did not show positive correlation with the concentrations of 4-ene-VPA and VPA (r=0.031,r=0.035,all P＞0.05),and the levels of ALT also did not show positive correlation with the concentrations of 4-ene-VPA and VPA (r=-0.064,r=-0.089,all P＞0.05).Conclusion:VPA may affect blood routine indexes.Age and combination therapy with the non-enzyme-induced anti-epileptic drugs are risk factors for VPA-related liver dysfunctions and renal impairment.The determination of VPA and 4-ene VPA is not a suitable tool for early warning of the VPA-induced liver dysfunction.

Clinical application and experience of PICC catheter guided by intracavitary electrocardiogram / 中国基层医药

Objective To investigate the peripherally inserted central catheter (PICC) to improve the accuracy of three valve PICC head end position of the fortune with endocardial mapping method.Methods 204 patients with PICC were randomly divided into observation group and control group according to the digital table,102 cases in each group.The observation group used saline infusion method by three valve PICC guided endocardial mapping catheter tip location.The control group received conventional positioning surface positioning method.The accurate rate of end position of the two groups was compared.Results The head position accuracy of the observation group was significantly higher than that of the control group (100.00％ vs.93.14％,x2 =3.003,P =0.004).Conclusion The use of saline drip instillation to guide intracardiac electrogram during PICC catheter placement can reduce ectopia and improve the accuracy of the head end position of the catheter,and it is worthy of promotion.

Effects of Budesonide and Formoterol on Pulmonary Ventilation Function and Prognosis in Patients with Acute Exacerbation of Mild to Moderate Bronchial Asthma / 中国药房

OBJECTIVE:To observe therapeutic efficacy and safety of budesonide and formoterol in the treatment of acute exacerbation of mild to moderate asthma.METHODS:A total of 89 patients with acute exacerbation of mild to moderate asthma were randomized divded into study group (45 cases) and control group (44 cases).Study group was given Budesonide and formoterol dry powder inhalation,one inhalation,q6 h,gargling 5 times after inhalation,6 inhalation per day at most+Montelukast tablet 10 mg orally,once a day.Control group received Prednisone tablet 25 mg orally after breakfast,once a day,d1-5+Theophylline sustained-release capsule 0.2 g,twice a day+Montelukast tablet 10 mg,once a day in the evening.Both groups were treated for 5 d.Acute AQLQ score,FEV1,PEF％pred and SpO2 were observed in 2 groups before and after treatment,and the occurrence of ADR was recorded.RESULTS:Before treatment,there was no statistical significance in acute AQLQ score,FEV1,PEF％pred or SpO2 between 2 groups(P＞0.05).After treatment,acute AQLQ score,FEV1,PEF％pred and SpO2 of 2 groups were significantly higher than before treatment,with statistical significance (P＜0.05),but there was no statistical significance between 2 groups (P＞ 0.05).There was statistical significance in the incidence of ADR between 2 group(P＜0.05).CONCLUSIONS:Budesonide and formoterol can improve pulmonary ventilation function and prognosis in patients with acute exacerbation of mild to moderate asthma with good safety.

Resting-state functional MRI study at the baseline in mild cognitive impairment converting to Alzheimer's disease / 中华放射学杂志

Objective To explore the features of resting state functional magnetic resonance imaging (rs-fMRI) in the patients with mild cognitive impairment (MCI) after during the process of converting to Alzheimer's disease (AD) dementia. To study the correlation of the brain function imaging and neuropsychological scores in converted MCI subjects with the purpose of finding the potential functional biomarkers which may predict the conversion of MCI to AD dementia in short term using resting state functional MRI. Methods Twenty-seven patients with MCI and 31 age, gender and years of education matched normal controls (NC) were enrolled in this study and neuropsychological assessment and rs-fMRI data were acquired respectively at the baseline and follow-up. Functional connectivity strength (FCS) analyses were used to assess the functional differences among the groups of MCI-converters (MCI-c) , MCI-non converters (MCI-nc) and NC. Variance analyses were used to compare the group differences in age, years of education and each neuropsychological assessment. In addition, Chi-squared test was used to compare group differences in gender. Then, Kruskal-Wallis test was used to compare group differences in the interval time of twice data collection. Group differences in FCS values were analyzed by general linear model. Finally, correlation analyses were used to evaluate the relationships between the FCS values of the brain regions with group differences and neuropsychological assessment scores in MCI patients. Results (1) Significant group differences of FCS among the MCI-c, MCI-nc and NC groups were observed in bilateral angular gyri, bilateral orbitofrontal cortex, right precentral gyrus, left paracentral lobule, left precuneus, right fusiform, right middle occipital gyrus, right superior occipital gyrus, left cerebellum. (2) The MCI-c showed decreased FCS in bilateral angular gyri, right middle occipital gyrus, right superior occipital gyrus, right inferior occipital gyrus, right fusiform, left precuneus, and left paracentral lobule, as compared to MCI-nc, the cluster was 149, 114, 186, 56, 48, 33, 38 and 102 voxels, respectively;P<0.05, respectively. The correlation analysis showed that the FCS values of the right angular gyrus were negative correlated with the MMSE scores (r=-0.561, P=0.017) . Conclusions This study revealed that the comparison of rs-fMRI imaging data between MCI-c and MCI-nc at baseline is of great benefits in analysing the imaging characteristics of patients during converting from MCI to AD. The feature of FCS in rs-fMRI in right angular gyrus might serve as early indicators for the dysfunction and progression from MCI to AD.

Clinical Observation of Montelukast Combined with Moxifloxacin in the Treatment of Cough of Acute Bac-terial Bronchitis / 中国药房

OBJECTIVE:To observe clinical efficacy and safety of montelukast combined with moxifloxacin in the treatment of cough of acute bacterial bronchitis. METHODS:A total of 139 cases of cough of acute bacterial bronchitis selected from out-patient department of Ningbo Yinzhou District Qianhu Hospital during Jan.-Dec. 2016 were divided into control group(69 cases) and observation group(70 cases)according to random number table. Control group was given Moxifloxacin hydrochloride tab-lets 0.4 g,po,qd;observation group was additionally given Montelukast sodium tablets 10 mg,po,once every night,on the basis of control group. Both groups were treated for 6 d. Cough symptom scores,peripheral blood WBC and CRP contents were compared between 2 groups before and after treatment. Clinical efficacies,the occurrence of ADR and clinical outcome were ob-served in 2 groups. RESULTS:Before treatment,there was no statistical significance in cough symptom scores,peripheral blood WBC or CRP contents between 2 groups(P>0.05). Compared to before treatment,cough symptom scores,peripheral blood WBC and CRP contents of 2 groups were decreased significantly after treatment,and the cough symptom score of observa-tion group after 3 d of treatment was significantly lower than that of control group at the same time,with statistical significance (P<0.05). There was no statistical significance in above indexes between 2 groups after 6 d of treatment(P>0.05). Cure rate of observation group was 64.29%,which was significantly higher than 44.93% of control group,with statistical significance (P<0.05). Response rates of observation group and control group were 97.14% and 97.10%,there was no statistical signifi-cance(P>0.05). No ADR was found in 2 groups during treatment,and good clinical outcome was obtained. CONCLUSIONS:Montlukast combined with moxifloxacin not only relieve cough symptom and inflammation,but also improve cure rate significantly with good safety.

Resting-state functional MRI study at the baseline in mild cognitive impairment converting to Alzheimer's disease / 中华放射学杂志

Objective To explore the features of resting state functional magnetic resonance imaging (rs-fMRI) in the patients with mild cognitive impairment (MCI) after during the process of converting to Alzheimer's disease (AD) dementia. To study the correlation of the brain function imaging and neuropsychological scores in converted MCI subjects with the purpose of finding the potential functional biomarkers which may predict the conversion of MCI to AD dementia in short term using resting state functional MRI. Methods Twenty-seven patients with MCI and 31 age, gender and years of education matched normal controls (NC) were enrolled in this study and neuropsychological assessment and rs-fMRI data were acquired respectively at the baseline and follow-up. Functional connectivity strength (FCS) analyses were used to assess the functional differences among the groups of MCI-converters (MCI-c) , MCI-non converters (MCI-nc) and NC. Variance analyses were used to compare the group differences in age, years of education and each neuropsychological assessment. In addition, Chi-squared test was used to compare group differences in gender. Then, Kruskal-Wallis test was used to compare group differences in the interval time of twice data collection. Group differences in FCS values were analyzed by general linear model. Finally, correlation analyses were used to evaluate the relationships between the FCS values of the brain regions with group differences and neuropsychological assessment scores in MCI patients. Results (1) Significant group differences of FCS among the MCI-c, MCI-nc and NC groups were observed in bilateral angular gyri, bilateral orbitofrontal cortex, right precentral gyrus, left paracentral lobule, left precuneus, right fusiform, right middle occipital gyrus, right superior occipital gyrus, left cerebellum. (2) The MCI-c showed decreased FCS in bilateral angular gyri, right middle occipital gyrus, right superior occipital gyrus, right inferior occipital gyrus, right fusiform, left precuneus, and left paracentral lobule, as compared to MCI-nc, the cluster was 149, 114, 186, 56, 48, 33, 38 and 102 voxels, respectively;P<0.05, respectively. The correlation analysis showed that the FCS values of the right angular gyrus were negative correlated with the MMSE scores (r=-0.561, P=0.017) . Conclusions This study revealed that the comparison of rs-fMRI imaging data between MCI-c and MCI-nc at baseline is of great benefits in analysing the imaging characteristics of patients during converting from MCI to AD. The feature of FCS in rs-fMRI in right angular gyrus might serve as early indicators for the dysfunction and progression from MCI to AD.

Clinical Observation of Montelukast Combined with Moxifloxacin in the Treatment of Cough of Acute Bac-terial Bronchitis / 中国药房

OBJECTIVE:To observe clinical efficacy and safety of montelukast combined with moxifloxacin in the treatment of cough of acute bacterial bronchitis. METHODS:A total of 139 cases of cough of acute bacterial bronchitis selected from out-patient department of Ningbo Yinzhou District Qianhu Hospital during Jan.-Dec. 2016 were divided into control group(69 cases) and observation group(70 cases)according to random number table. Control group was given Moxifloxacin hydrochloride tab-lets 0.4 g,po,qd;observation group was additionally given Montelukast sodium tablets 10 mg,po,once every night,on the basis of control group. Both groups were treated for 6 d. Cough symptom scores,peripheral blood WBC and CRP contents were compared between 2 groups before and after treatment. Clinical efficacies,the occurrence of ADR and clinical outcome were ob-served in 2 groups. RESULTS:Before treatment,there was no statistical significance in cough symptom scores,peripheral blood WBC or CRP contents between 2 groups(P>0.05). Compared to before treatment,cough symptom scores,peripheral blood WBC and CRP contents of 2 groups were decreased significantly after treatment,and the cough symptom score of observa-tion group after 3 d of treatment was significantly lower than that of control group at the same time,with statistical significance (P<0.05). There was no statistical significance in above indexes between 2 groups after 6 d of treatment(P>0.05). Cure rate of observation group was 64.29%,which was significantly higher than 44.93% of control group,with statistical significance (P<0.05). Response rates of observation group and control group were 97.14% and 97.10%,there was no statistical signifi-cance(P>0.05). No ADR was found in 2 groups during treatment,and good clinical outcome was obtained. CONCLUSIONS:Montlukast combined with moxifloxacin not only relieve cough symptom and inflammation,but also improve cure rate significantly with good safety.

Prevalence and treatment of chronic obstructive pulmonary disease in Ningbo region / 中华健康管理学杂志

Objective To determine the prevalence and treatment of chronic obstructive pulmonary diseases (COPD) among citizens in Ningbo. Methods A multi-stage stratified random sampling was applied to select 8 neighborhoods and 3 villages out of 7 districts in Ningbo, people who were older than or equal to 40 years were enrolled as subjects. Information on the prevalence rate and treatment conditions of COPD was collected through respiratory symptoms and treatment questionnaire and lung function screening. Results A total of 5865 people were screened, 5674 of them met inclusion criteria and completed questionnaire and lung function test. Among whom, 3044 people were men (53.6%, the average age is 55.7±11.4), 2630 women (46.4%, the average age was 55.3 ± 10.7);473 of them were diagnosed with COPD, the overall prevalence rate was 8.3%, including 354 cases who had never been diagnosed as COPD, accounted for 74.8% of the total cases diagnosed with COPD, mainly in stage ⅠandⅡof the disease. There were statistically significant differences between diagnosed and undiagnosed patients in the overall COPD group and among different gender groups ( stagesⅠandⅡ) and (stagesⅢandⅣ). Among the 473 COPD cases, 119 (diagnostic yield 25.2%) of whom had been diagnosed with bronchitis, only 48 (41.2%of the diagnosed) received drug treatment, only 13 patients were treated regularly with medication. Conclusion The overall prevalence rate of COPD among those over 40 years of age in Ningbo was quite high and mainly had stagesⅠandⅡof the disease. The number of the diagnostic yield and those who received regular treatment are quite low. The current situation of diagnosis and treatment are far from satisfaction, management of COPD should be strengthened to reduce the burden for family and society.

Effect of Tongxinluo on carotid artery stenosisthe,hs-CRP and D-Dimer in patients with cerebral infarction / 国际检验医学杂志

Objective To investigate the effect of Tongxinluo on carotid artery stenosis,and the levels of high sensitive C reactive protein(hs-CRP) and D-Dimer in patients with cerebral infarction.Methods 168 patients with cerebral infarction treated in this hospital from June 2014 to June 2015 were randomly divided into experimental group and control group,with 84 cases in each group.The patients in both group received routine treatment.In addition to that,patients in the experimental group also used Tongxinluo capsule for 6 months as a course of treatment.After a course of treatment,Doppler ultrasound diagnosis instrument was used to detect carotid arterial intima-media thickness,plaque area and carotid artery stenosis rate.Hs-CRP and D-Dimer levels were also detected.Results After treatment,the carotid arterial intima-media thickness,plaque area and carotid vascular stenosis rate in two group were significantly decreased(P<0.05),but the three indicators in experimental group were decreased more significantly(P<0.05).After a course of treatment,the levels of D-Dimer and hs-CRP in peripheral blood of the two groups were significantly decreased(P<0.05),but the content of D-Dimer and hs-CRP was much lower in the experimental group(P<0.05).Conclusion Tongxinluo treatment could effectively reduce the level of hs-CRP and D-Dimer in patients with cerebral infarction,and alleviate the carotid artery stenosis,which might be worthy of clinical application.

Effects of Folic Acid Combined with Vitamin B12 on Related Indicators of Patients with Hypertension,Cere-bral Stroke and Vascular Cognitive Impairment / 中国药房

OBJECTIVE:To explore the effects of folic acid combined with vitamin B12 on the vascular cognitive impairment (VCI)and homocysteine(Hcy)of patients with hypertension and cerebral stroke. METHODS:80 VCI patients with hypertension and cerebral stroke were regarded as observation group,and another 20 healthy volunteers were regarded as healthy control group. Observation group was treated with enhanced homogenized meal 300-500 ml,3 times a day+Folic acid tablet 5 mg,3 times a day+Vitamin B12 tablet 25 μg,3 times a day. Observation groups were treated for continuous 2 months with no nasal administration by themselves. The Mini-Mental State Examination(MMSE)score,the level of folic acid,vitamin B12 and Hcy before and after treat-ment were observed and compared with healthy control group,and the incidence of adverse reactions was recorded. RESULTS:Af-ter treatment,MMSE score,the level of folic acid,vitamin B12 in observation group were significantly higher than before and low-er than healthy control group,the level of Hcy was significantly lower than before and higher than healthy control group,the differ-ences were statistically significant(P<0.05). The incidence of adverse reactions was 5.00%. There were no serious adverse reac-tions. CONCLUSIONS:Folic acid combined with vitamin B12 can reduce the cognitive impairment degree of patients with hyperten-sion,cerebral stroke and vascular cognitive impairment and level of Hcy,with good safety.

Investigation of the Cause of Death in Patients with Spinal Cord Injury from Tangshan Earthquake (1976) / 中国康复理论与实践

Objective To discuss the cause of death in patients with spinal cord injury from Tangshan earthquake 37 years latter, and compare them with the survey before. Methods The causes of death of the spinal cord injury patients lived in 1 sanatorium and 1 rehabilita-tion village in Tangshan city, and 6 sanatoriums in villages from 2003 were surveyed. The questionnaire included their general condition, the main cause of death, time of death, age at death, etc., and the findings in 1988 and 2003 were compared. Results Uremia and pressure sore infection were the most major causes of death, in which pressure sore infection was the first cause in the village, and uremia was the first both in the village and city, and the epidemiology of them decreased than before. Cardiovascular disease and cerebrovascular disease were the second and third causes of death respectively. The epidemiology of malignancies increased in this survey, and the longest life time of pa-tients with cervical spinal cord injury was 36 years. Conclusion The top causes of death in spinal cord injury patients from Tangshan earth-quakeare uremia, pressure sore infection, cardiovascular disease and cerebrovascular disease. 37 years after Tangshan earthquake, the cause of death and the life expectancy of patients with spinal cord injury have been close to general levels.

Effect of UGT2B7 genetic variants on serum valproic acid concentration / 中南大学学报(医学版)

Objective: To investigate the effect of UGT2B7 A268G and UGT2B7 G211T genetic polymorphism on serum drug concentration of valproic acid (VPA). Methods:Genetic polymorphisms of UGT2B7 A268G and UGT2B7 G211T were tested in 248 epileptic patients by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP). Data including basic information, epilepsy type, times and doses of drug, treatment response and liver and kidney functions were collected. Statistical analysis was performed by SPSS 13.0 through multivariate linear regression, one-way ANOVA,χ2 test, and paired T-test. Results:Based on multivariate linear regression, there was no significant difference between gender, age, or body mass index and VPA, but concentration-to-dose ratios (CDRs) were positively correlated with VPA. hTe genetic polymorphisms of UGT2B7 A268G and UGT2B7 G211T were consistent with Hardy-Weinberg equilibrium. UGT2B7-268A>G allele frequency distribution A was 30.05%, and G was 69.95%. Variance analysis showed that serum drug concentration was significantly different in the genotype of AA, AG, or GG (F=5.477, P=0.005). Further analysis of paired T test showed that AA type was significantly different from GG type (P=0.048), and that serum concentration of AA type was much higher than that of GG type, while no signiifcant difference between AA type and AG type, GG type and AG type. UGT2B7 G211T allele frequency distribution G was 77.24%, and T was 22.58%. hTere was no signiifcant difference in standardized serum concentration among genotypes of GG, GT, and TT. Conclusion:hTis study reveals UGT2B7 A268G genetic polymorphism distribution in Chinese epilepsy population. UGT2B7 A268G plays an important role in VPA’s metabolism, and has certain effect on VPA’s serum concentration. Epilepsy patient with this genotype should be adjusted the dose of VPA to make a therapeutic effect.

Quinolones resistance genes in multi-drug resistant Klebsiella pneumonia and Klebsiella planticola / 中华临床感染病杂志

Objective To investigate the multi-drug resistance of Klebsiella strains and its mechanism.Methods Twenty strains of Klebsiella were isolated from the Affiliated Hospital of Medical College,Ningbo University from October 2009 to March 2011,in which 18 isolates were Klebsiella pneumonia and 2 were Klebsiella planticola. Drug sensitivity was determined by K-B tests. Drug resistant genes gyrA,parC (chromosome mediated) and aac( 6′)-I b-Cr,qnrA,qnrB,qnrS,qepA (plasmid mediated) were amplified by PCR and verified by direct automated fluorogenic sequencing. Results Resistance to β-1actams,aminoglycosides and quinolones was observed in 20 strains,and resistant rates were all above 80％.Klebsiella planticola strains were sensitive to imipenem and meropenem.Mutations of gyrA and parC genes existed in 18 strains (90％),and the positive rates of aac (6') -I b-C r,qnrB and qnrS were 60％ (12/20),20％ (4/20) and 20％ (4/20),respectively.Conclusion The mutations ofgyrA and parC genes may be the main cause of the resistance to quinolones in these strains.

Significance of detecting human papillomaviral DNA in cervical disease / 中国基层医药

Objective To study the detection and significance of human papillomaviral DNA(HPV-DNA) in cervical disease. Methods The express of HPV-DNA were detected by hybrid capture 2 in the patients with chronic cervicitis ( n = 166), cervical intraepithelial neolasia ( GIN ) ( n = 89 ) and uterine cervix cancer ( UCC ) ( n = 23 ). Results The positive expression rate of HPV-DNA in GIN Ⅰ , Ⅱ , Ⅲ grade and UCC were 70.8% (17/24) ,79. 3% (23/29) ,88.9% (32/36) ,91. 3% (21/23). They were significantly higher than those in chronic cervicitis 30.7% (51/166) (P ＜ 0. 01 );As the development of cervical disease, HPV-DNA positive expression had increasing trend.Conclusion The detection of HPV-DNA had an important role for the early UCC screening,prevention and treatment.