Feasibility of wearable sensor signals and self-reported symptoms to prompt at-home testing for acute respiratory viruses in the USA (DETECT-AHEAD): a decentralised, randomised controlled trial.

BACKGROUND: Early identification of an acute respiratory infection is important for reducing transmission and enabling earlier therapeutic intervention. We aimed to prospectively evaluate the feasibility of home-based diagnostic self-testing of viral pathogens in individuals prompted to do so on the basis of self-reported symptoms or individual changes in physiological parameters detected via a wearable sensor. METHODS: DETECT-AHEAD was a prospective, decentralised, randomised controlled trial carried out in a subpopulation of an existing cohort (DETECT) of individuals enrolled in a digital-only observational study in the USA. Participants aged 18 years or older were randomly assigned (1:1:1) with a block randomisation scheme stratified by under-represented in biomedical research status. All participants were offered a wearable sensor (Fitbit Sense smartwatch). Participants in groups 1 and 2 received an at-home self-test kit (Alveo be.well) for two acute respiratory viral pathogens: SARS-CoV-2 and respiratory syncytial virus. Participants in group 1 could be alerted through the DETECT study app to take the at-home test on the basis of changes in their physiological data (as detected by our algorithm) or due to self-reported symptoms; those in group 2 were prompted via the app to self-test only due to symptoms. Group 3 served as the control group, without alerts or home testing capability. The primary endpoints, assessed on an intention-to-treat basis, were the number of acute respiratory infections presented (self-reported) and diagnosed (electronic health record), and the number of participants using at-home testing in groups 1 and 2. This trial is registered with ClinicalTrials.gov, NCT04336020. FINDINGS: Between Sept 28 and Dec 30, 2021, 450 participants were recruited and randomly assigned to group 1 (n=149), group 2 (n=151), or group 3 (n=150). 179 (40%) participants were male, 264 (59%) were female, and seven (2%) identified as other. 232 (52%) were from populations historically under-represented in biomedical research. 118 (39%) of the 300 participants in groups 1 and 2 were prompted to self-test, with 61 (52%) successfully completing self-testing. Participants were prompted to home-test more frequently due to symptoms (41 [28%] in group 1 and 51 [34%] in group 2) than due to detected physiological changes (26 [17%] in group 1). Significantly more participants in group 1 received alerts to test than did those in group 2 (67 [45%] vs 51 [34%]; p=0·047). Of the 61 individuals who were prompted to test and successfully did so, 19 (31%) tested positive for a viral pathogen-all for SARS-CoV-2. The individuals diagnosed as positive for SARS-CoV-2 in the electronic health record were eight (5%) in group 1, four (3%) in group 2, and two (1%) in group 3, but it was difficult to confirm if they were tied to symptomatic episodes documented in the trial. There were no adverse events. INTERPRETATION: In this direct-to-participant trial, we showed early feasibility of a decentralised programme to prompt individuals to use a viral pathogen diagnostic test based on symptoms tracked in the study app or physiological changes detected using a wearable sensor. Barriers to adequate participation and performance were also identified, which would need to be addressed before large-scale implementation. FUNDING: Janssen Pharmaceuticals.

Engagement with health research summaries via digital communication to All of Us participants.

OBJECTIVE: Summaries of health research can be a complementary way to return value to participants. We assess how research participants engage with summaries via email communication and how this can be improved. MATERIALS AND METHODS: We look at correlations between demographic subgroups and engagement in a longitudinal dataset of 305 626 participants (77% are classified as underrepresented in biomedical research) from the All of Us Research Program. We compare this against engagement with other program communications and use impact evaluations (N = 421 510) to measure the effect of tailoring communication by (1) eliciting content preferences, (2) Spanish focused content, (3) informational videos, and (4) article content in the email subject line. RESULTS: Between March 2020 and October 2021, research summaries reached 67% of enrolled participants, outperforming other program communication (60%) and return of results (31%), which have a high uptake rate but have been extended to a subset of eligible participants. While all demographic subgroups engage with research summaries, participants with higher income, educational attainment, White, and older than 45 years open and click content most often. Surfacing article content in the email subject line and Spanish focused content had negative effects on engagement. Video and social media content and eliciting preferences led to a small directional increase in clicks. DISCUSSION: Further individualization of tailoring efforts may be needed to drive larger engagement effects (eg, delivering multiple articles in line with stated preferences, expanding preference options). Our findings are likely a conservative representation of engagement effects, given the coarseness of our click rate measure. CONCLUSIONS: Health research summaries show promise as a way to return value to research participants, especially if individual-level results cannot be returned. Personalization of communication requires testing to determine whether efforts are having the expected effect.

BECN1 regulates FADD/RIPK1/Caspase-8 complex formation via RIPK1 ubiquitination by downregulating OTUD1 in MI/R induced myocyte apoptosis.

BACKGROUND: Cardiomyocyte apoptosis plays a vital role in myocardial ischemia-reperfusion (MI/R) injury; however, the role of beclin1 (BECN1) remains unclear. This study aimed at revealing the function of BECN1 during cardiomyocyte apoptosis after MI/R injury. METHODS: In vivo, TTC and Evan's blue double staining was applied to verify the gross morphological alteration in both wild type (WT) mice and BECN1 transgene mice (BECN1-TG), and TUNEL staining and western blot were adopted to evaluate the cardiomyocyte apoptosis. In vitro, a hypoxia/reoxygenation (H/R) model was established in H9c2 cells to simulate MI/R injury. Proteomics analysis was preformed to verify if apoptosis occurs in the H/R cellular model. And apoptosis factors, RIPK1, Caspase-1, Caspase-3, and cleaved Caspase-3, were investigated using western bolting. In addition, the mRNA level were verified using RT-PCR. To further investigate the protein interactions small interfering RNA and lentiviral transfection were used. To continue investigate the protein interactions, immunofluorescence and coimmunoprecipitation were applied. RESULTS: Morphologically, BECN1 significantly attenuated the apoptosis from TTC-Evan's staining, TUNEL, and cardiac tissue western blot. After H/R, a RIPK1-induced complex (complex II) containing RIPK1, Caspase-8, and FADD was formed. Thereafter, cleaved Caspase-3 was activated, and myocyte apoptosis occurred. However, BECN1 decreased the expression of RIPK1, Caspase-8, and FADD. Nevertheless, BECN1 overexpression increased RIPK1 ubiquitination before apoptosis by inhibiting OTUD1. CONCLUSIONS: BECN1 regulates FADD/RIPK1/Caspase-8 complex formation via RIPK1 ubiquitination by downregulating OTUD1 in C-Caspase-3-induced myocyte apoptosis after MI/R injury. Therefore, BECN1 can function as a cardioprotective candidate.

Risk Factors for Cancer Malnutrition after Radical Tumor Resection.

Objective: To investigate the risk factors for cancer malnutrition after radical tumor resection. Methods: A total of 110 cancer patients who used parenteral nutrition from January 2022 to June 2023 were selected for retrospective analysis and 50 patients who did not need parenteral nutrition support after radical tumor resection were selected as the control group to analyze the general data of the two groups. Univariate and multivariate logistic analyses were used to determine the factors influencing malnutrition in patients supported by parenteral nutrition after radical tumor resection. Results: The age(P = .032), body mass index(P = .012), education level(P = .025), per capita monthly household income(P = .029), concurrent chemotherapy ratio(P = .035), phobia disease progression(P = .037), and depression(P = .038) of patients who underwent parenteral nutrition after radical tumor resection were all influencing factors, and the differences were statistically significant (P < .034). After undergoing a radical tumor resection, patients with dysphagia grade 2-3, loss of appetite grade 2-3, and nausea and vomiting grade 2-3, as well as diarrhea grade 2-3, require parenteral nutrition support. The risk factors for malnutrition in patients who require such support include age, education, per capita household income, fear of disease progression, depression, pain, and diarrhea. Conclusion: Patients may suffer from malnutrition after radical tumor resection and need parenteral nutrition support, including age, education level, per capita monthly household income, fear of disease progression, depression, pain, diarrhea, etc., so in clinical nursing, nursing staff should pay more attention to such high-risk factors, so as to carry out personalized nursing programs for patients undergoing radical tumor resection and improve the effectiveness of disease treatment.

The Latest Research Progress on Cell-Free DNA and Prospects of Its Forensic Application / 法医学杂志

In recent years,with the continuous progress of DNA extraction and detection technology,cell-free DNA(cfDNA)has been widely used in the life science field,and its potential application value in forensic identification is becoming more and more obvious.This paper reviews the concept,formation mechanism,and classification of cfDNA,etc.,and describes the latest research progress of cfDNA in personal identification of crime scene touch DNA samples and non-invasive prenatal pater-nity testing(NIPPT).Meanwhile,this paper summarizes the potential application of cfDNA in injury inference,and discusses the advantages and disadvantages of common cfDNA analysis methods and techniques,and its application prospects,to provide a new idea for the wide application of cfDNA in the field of forensic science.

Discussion on syndrome differentiation and treatment of acupuncture-moxibustion encephalopathy based on Shi's Xingnao Kaiqiao theory / 国际中医中药杂志

By exploring the core ideas of the "Xingnao Kaiqiao" theory, analyzing the relationship between the "Xingnao Kaiqiao" theory and the TCM encephalopathy, and exploring the necessity of acupuncture for the treatment of TCM encephalopathy, in order to clarify how to diagnose and treat brain diseases in acupuncture and moxibustion. The "Xingnao Kaiqiao" is the core of the theory of the "Tiaoshen", the acupuncture of "Xingnao Kaiqiao" was based on the principle of "Xingnao","Xingshen" and "Tiaoshen", the idea of the "Tiaoshen" was inseparable from the diagnosis and treatment of the TCM encephalopathy. Based on the special features of acupuncture therapy and complexity and particularity of TCM encephalopathy, acupuncture and moxibustion treatment of encephalopathy was supposed to have their own unique system of syndrome differentiation and treatment. During the practice of acupuncture, the diagnosis and treatment of TCM encephalopathy should be based on "brain", "Xingnao Tiaoshen" as a general rule, adding and subtracting from the main points of the "Xingnao Kaiqiao", and the different brain diseases are matched with appropriate treatments.

Modified Fuzheng Yiliu Decoction Combined with XELOX Regimen for the Treatment of Postoperative Patients with Advanced Gastric Cancer of Qiand Yin Deficiency Type:A Randomized Controlled Study / 广州中医药大学学报

Objective To investigate the clinical efficacy of modified Fuzheng Yiliu Decoction(composed of Astragali Radix,Codonopsis Radix,Ligustri Lucidi Fructus,Hedyotis Diffusae Herba,Moutan Cortex,Visci Herba,etc.)combined with XELOX regimen(Oxaliplatin plus Capecitabine)for the treatment of postoperative patients with advanced gastric cancer of qi and yin deficiency type.Methods A total of 80 postoperative patients with advanced gastric cancer of qi and yin deficiency type were randomly divided into the Chinese medicine group and the control group,with 40 cases in each group.Both groups received chemotherapy with XELOX regimen,while the Chinese medicine group was given modified Fuzheng Yiliu Decoction.Three weeks constituted a course of treatment,the medication of Chinese medicine decoction lasted for two weeks or more in each course of treatment,and a total of 8 courses of treatment were performed.The incidence of adverse reactions during chemotherapy was monitored and changes in serum tumor markers of serum carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199)and alpha-fetoprotein(AFP)were observed in the two groups before and after treatment.Moreover,the patients'quality of life was assessed by the scores of Karnofsky's Performance Status(KPS)and World Health Organization Quality of Life Measurement Scale(WHOQOL-100).Long-term follow-up was carried out for the evaluation of the prognostic indicators such as overall survival and one-year and 2-year overall survival rates.Results(1)Patients in the two groups were all followed up,and the median follow-up time was 27 months(95%CI:23.59-27.86).(2)After treatment,the levels of serum CEA and AFP in the Chinese medicine group were significantly lower than those before treatment(P＜0.05 or P＜0.01),while serum CA199 tended to decrease compared with those before treatment,but the difference was not statistically significant(P＞0.05);in the control group,the levels of serum CEA,CA199,and AFP were not significantly decreased after treatment(P＞0.05).The intergroup comparison showed that the decrease of serum CEA,CA199 and AFP levels in the Chinese medicine group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(3)The adverse reactions during chemotherapy in the two groups mainly involved bone marrow suppression,gastrointestinal reactions and liver function abnormalities,etc.The incidences of all adverse reactions in the Chinese medicine group tended to be lower than those in the control group,but the differences were not statistically significant(P＞0.05).(4)After treatment,the KPS scores of patients in both groups were improved compared with those before treatment(P＜0.01),and the improvement in the Chinese medicine group was significantly superior to that in the control group(P＜0.01).(5)After treatment,the scores of the four dimensions of WHOQOL-100 such as health status,mobility,life feelings,and other activities of daily life in the Chinese medicine group were significantly improved compared with the pre-treatment(P＜0.05),whereas there was no significant improvement in the control group(P＞0.05).The intergroup comparison showed that the improvement of the scores of each dimension of the WHOQOL-100 in the Chinese medicine group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(6)The median survival in the Chinese medicine group was 29.0 months(95%CI:25.95-31.70)and that in the control group was 22.0 months(95%CI:19.67-25.58),indicating that the median survival was significantly prolonged in Chinese medicine group(P＜0.01).The one-year and 2-year postoperative survival rates were 97.5%and 77.5%in the Chinese medicine group and 92.5%and 47.5%in the control group,respectively.The intergroup comparison showed that the one-year and 2-year postoperative survival rates in the Chinese medicine group were higher than those in the control group(P＜0.01).Conclusion Modified Fuzheng Yiliu Decoction can effectively alleviate the adverse reactions during adjuvant chemotherapy for postoperative patients with advanced gastric cancer of qi and yin deficiency type,improve the quality of life of patients,and prolong the survival time of patients.

Severity of loneliness and factors associated with social and emotional loneliness among the elderly in three districts in Shanghai / 复旦学报（医学版）

Objective To explore the severity of loneliness among the elderly in communities in Shanghai,and to identify factors associated with social and emotional loneliness respectively.Methods A cross-sectional study was conducted in older adults aged 65 years or above in Pudong New Area,Jing'an District and Huangpu District in Shanghai from Mar to Jun 2021.In Pudong New Area,multi-stage stratified random sampling was conducted based on the age and gender distribution of Shanghai,while in Huangpu District and Jing'an District convenience sampling was conducted.A total of 635 samples were included in the study.Loneliness was assessed using the De Jong Gierveld Loneliness Scale with social and emotional loneliness subscales.Logistic regression analyses were conducted to identify factors associated with social and emotional loneliness.Results Among the 635 participants,only 53 older adults(8.4%)were not lonely.Female(OR=0.46,95%CI:0.31-0.70),higher self-efficacy(OR=0.97,95%CI:0.94-1.00),more objective social support(OR=0.96,95%CI:0.93-0.99)were associated with less severe social loneliness.Meanwhile,higher level of education(secondary education,OR=0.56,95%CI:0.34-0.95;college or above,OR=0.30,95%CI:0.11-0.83)and higher self-efficacy(OR=0.96,95%CI:0.93-0.99)were associated with less severe emotional loneliness,while depression(OR=3.41,95%CI:1.76-6.60)and worse social capital(OR=2.02,95%CI:1.29-3.16)were associated with more severe emotional loneliness.Conclusion Up to 91.6%of the elderly in our study sample were moderately lonely or above.The factors associated with social loneliness include self-efficacy,gender and social support.The factors associated with emotional loneliness are self-efficacy,education level,depression,and social capital.

Astrocytes regulate glial scar formation in cerebral ischemic stroke / 中国组织工程研究

BACKGROUND:Cerebral ischemic stroke is one of the main fatal and disabling diseases in the clinic,but only a few patients benefit from vascular recanalization in time,so it is urgent to explore new and effective therapy.As one of the critical pathological changes of ischemic stroke,the glial scar formed mainly by astrocytes is one major cause that hinders axonal regeneration and neurological recovery at the late stage of stroke. OBJECTIVE:To elucidate the pathological process and crucial signal regulatory mechanism of astrocytes in the formation of glial scar after ischemic stroke,as well as the potential therapeutic targets,to provide a theoretical reference for intervening astrocytic scar formation against ischemic stroke effectively,and novel strategies for promoting post-stroke rehabilitation. METHODS:The relevant articles published in CNKI,PubMed and Web of Science databases from 2010 to 2022 were retrieved.The search terms were"Ischemic stroke,Brain ischemi*,Cerebral ischemi*,Astrocyt*,Astroglia*,Glial scar,Gliosis,Astrogliosis"in Chinese and English.Finally,78 articles were included after screening and summarized. RESULTS AND CONCLUSION:(1)Astrocytes play an important role in the maintenance of central nervous system homeostasis.After ischemic stroke,astrocytes change from a resting state to an active state.According to the different severities of cerebral ischemic injury,astrocyte activation changes dynamically from swelling and proliferation to glial scar formation.(2)Mature astrocytes are stimulated to restart the cell cycle,then proliferate and migrate to lesions,which is the main source of the glial scar.Neural stem cells in the subventricular zone,neuron-glial antigen 2 precursor cells and ependymal precursor cells in the brain parenchyma can also differentiate into astrocytes.Endothelin-1,aquaporin 4,ciliary neurotrophic factor and connexins are involved in this process.In addition,chondroitin sulfate proteoglycan,as the main component of the extracellular matrix,forms the dense glial scar barrier with proliferated astrocytes,which hinders the polarization and extension of axons.(3)Activation or inhibition of crucial signal molecules involved in astrocyte activation,proliferation,migration and pro-inflammation functions regulate the glial scar formation.Transforming growth factor beta 1/Smad and Janus kinase/signal transducer and activator of transcription 3 are classical pathways related to astrogliosis,while receptor-interacting protein 1 kinase and glycogen synthase kinase 3β are significant molecules regulating the inflammatory response.However,there are relatively few studies on Smad ubiquitination regulatory factor 2 and Interleukin-17 and their downstream signaling pathways in glial scar formation,which are worthy of further exploration.(4)Drugs targeting astrogliosis-related signaling pathways,cell proliferation regulatory proteins and inflammatory factors effectively inhibit the formation of glial scar after cerebral ischemic stroke.Among them,the role of commonly used clinical drugs such as melatonin and valproic acid in regulating glial scar formation has been verified,which makes it possible to use drugs that inhibit glial scar formation to promote the recovery of neurological function in patients with stroke.(5)Considering the protective effects of glial scar in the acute phase,how to choose the appropriate intervention chance of drugs to maintain the protective effect of the glial scar while promoting nerve regeneration and repair in the local microenvironment is the direction of future efforts.

Frontier hot trends in ischemic stroke and vascular regeneration based on bibliometric analysis / 中国组织工程研究

BACKGROUND:Vascular regeneration,as one of the crucial repair processes after its onset,necessitates visual analysis between the two. OBJECTIVE:To analyze the literature on ischemic stroke and vascular regeneration in the past decade using bibliometrics and sort out the current status,hotspots,and future research trends in this field. METHODS:We used a bibliometric approach to search the Web of Science database for literature on ischemic stroke and vascular regeneration published between January 2011 and May 2023.The obtained data were systematically analyzed using the VOSviewer visualization software to identify the number of articles,countries,keywords,institutions,authors,citations,and trends. RESULTS AND CONCLUSION:We searched and selected 1 484 articles and found that the relationship between ischemic stroke and vascular regeneration has emerged as a research hotspot in the cerebrovascular field,with the number of published articles continuing to rise.Most of these articles were authored by institutions from China and the United States.Shanghai Jiao Tong University was the most cited institution.The most influential author was Hermann DM,whose article had been cited 1 003 times.The current hot research topics in the field include extracellular vesicles,microRNAs and mesenchymal stem cells,which are being studied for their correlations with relevant diseases.To conclude,the bibliometric analysis provides a visual analysis of ischemic stroke and vascular regeneration,which is found to be an emerging focus as well as a valuable reference for future trends and highlights in ischemic stroke and vascular regeneration.

Practice and Technical Analysis of Intelligent Pharmaceutical Services for Traditional Chinese Medicine / 医药导报

Objective To analyze the development status of intelligent pharmaceutical services for traditional Chinese medicine,to summarize the practical experience of intelligent pharmaceutical services for traditional Chinese medicine,and to explore its technical requirements and development direction.Methods The Affiliated Hospital of Chengdu University of traditional Chinese medicine launched the Smart Traditional Chinese Medicine Room project in January 2018 and established a Smart Traditional Chinese Medicine Pharmacy to undertake pharmaceutical services such as outpatient dispensing,decoction,and distribution of traditional Chinese medicine decoction pieces.Results A total of 5.572 million pairs of traditional Chinese medicine decoction pieces were delivered until May 2023,and 231 400 patients were served in 2022.The service process was more straightforward;there was no need to wait for medication or go to the hospital again.The service efficiency was high,improving the patient's medical experience.Conclusions Intelligent pharmaceutical services for traditional Chinese medicine are developing rapidly.A comprehensive intelligent service system will be established based on technological progress in the future.

Research progress on the relationship between macrophage polarization and type 2 diabetes mellitus / 中国糖尿病杂志

In recent years,the incidence of type 2 diabetes mellitus(T2DM)keeps increasing in China,and seriously affects people's health.The M1/M2 polarization of macrophages is unbalanced in patients with T2DM,which is manifested by the increase of pro-inflammatory M1 macrophages and the decrease of anti-inflammatory M2 macrophages.Macrophage polarization imbalance can cause insulin resistance or damage pancreatic islets β cells through various ways.Adjusting the polarization of macrophages plays a therapeutic role in T2DM.This article reviews the research progress on the relationship between macrophage polarization and T2DM.

An inter-provincial comparative study on the separate payment policy for national medical insurance negotiated drugs in China / 中国卫生政策研究

Objective:This study aims to analyze the provincial policy text of separate payment for National medical insurance negotiated drugs,summarize the key measures and characteristics,and provide reference for the formulation and improvement of separate payment policies in various provinces.Methods:The retrieved policy texts were analyzed by searching the websites of the medical security bureaus of various provinces,municipalities,and autonomous regions.Results:There are differences in the separate payment policies of different provinces in terms of catalogue publishing,catalogue selection,drug management,policy treatment level and policy cohesion.Conclusion:The separate payment policy is the key driver of Joint Reformation for Public Health Services,Medical Insurance,and Medical Production-Circulation.And all provinces should balance the various policy elements of the separate payment catalogue,deal with the control of medical insurance funds and patients'sense of gain,and clarify the relationship between the separate payment policy and support the development of innovative drugs,so as to reduce the obstacles of Joint Reformation for Public Health Services,Medical Insurance,and Medical Production-Circulation.

New progress in the treatment of immunoglobulin A nephropathy / 中国医师杂志

Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide, characterized by the deposition of IgA in the mesangial area of the glomerulus. At present, the pathogenesis of IgAN is not yet clear, and there has been a lack of specific and recognized treatment plans. In recent years, many domestic and foreign researchers have conducted research on important pathways and key molecules in its pathogenesis, aiming to explore new therapeutic drugs. This review mainly summarizes the latest progress in the treatment of IgAN, including drugs that have been proven effective against IgAN and drugs that are currently being evaluated in clinical studies.

Efficacy of trastuzumab deruxtecan in treatment of metastatic breast cancer with overexpression or low expression of HER2 and the influencing factors of prognosis / 肿瘤研究与临床

Objective:To investigate the effect of trastuzumab deruxtecan (T-DXd) in the treatment of metastatic breast cancer (MBC) patients with different expression levels of human epidermal growth factor receptor 2 (HER2) and the influencing factors of prognosis.Methods:The retrospective case series analysis and cohort study were conducted. Clinical data of 20 MBC patients with different expression levels of HER2 treated with T-DXd at Xi'an International Medical Center Hospital from August 2021 to August 2023 were retrospectively collected to analyze the efficacy and safety of T-DXd. The Cox proportional hazards model was used for multivariate analysis of prognostic factors.Results:All 20 patients were female, with a median age [ M ( Q1, Q3)] of 49 years old (40 years old, 58 years old). Of the 20 cases, 12 had low expression of HER2 [immunohistochemistry HER2+, or immunohistochemistry ++ and fluorescence in situ hybridization (FISH)-negative], and 8 had overexpression of HER2 (immunohistochemistry HER2+++, or immunohistochemistry ++ and FISH-positive); median number of lines of treatment with T-DXd was 6 lines (3 lines, 7 lines); 14 patients had partial remission, 3 patients had stable disease, and 3 patients had disease progression, with an objective remission rate (ORR) of 70% (14/20) and a disease control rate of 85% (17/20). Eight patients with overexpression of HER2 had objective remission in 6 cases, and 12 patients with low expression of HER2 had objective remission in 8 cases, and the ORR difference between the two groups was not statistically significant ( P = 1.000). The main adverse reactions of the patients were nausea (14 cases), vomiting (12 cases), leukopenia (10 cases), elevated aspartate aminotransferase (10 cases), elevated alanine aminotransferase (9 cases), anemia (8 cases), fatigue (8 cases), alopecia (8 cases), neutropenia (6 cases), and thrombocytopenia (5 cases); ≥ grade 3 adverse reactions were bone marrow suppression and gastrointestinal reactions, all with an incidence of ≤10%. The median follow-up time was 7.1 months (1.9 months, 11.5 months). The median progression-free survival (PFS) time was 6.5 months (95% CI: 3.9-9.1 months), and the median PFS time of patients with overexpression of HER2 was longer than that of patients with low expression of HER2 [7.0 months (95% CI: 6.4- 7.6 months) vs. 4.0 months (95% CI: 1.7-6.3 months)], and the difference in PFS between the two groups was statistically significant ( P = 0.025). Multivariate Cox regression analysis showed that overexpression of HER2 was an independent protective factor for PFS in MBC patients treated with T-DXd ( HR = 0.265, 95% CI: 0.075-0.945, P = 0.041). Conclusions:MBC patients with overexpression or low expression of HER2 have a good therapeutic effect and safety profile when treated with T-DXd. The overexpression of HER2 may predict good PFS in MBC patients treated with T-DXd, and may serve as a biomarker for predicting PFS in such patients, but it may not affect the ORR.

Advances in the Adjunctive Treatment of Lennox-Gastaut Syndrome with Clobazam and Cannabidiol / 罕见病研究

Lennox-Gastaut syndrome (LGS) is a severe, epileptic encephalopathy.In recent years, a variety of drugs have been approved for the treatment of LGS. The U.S. Food and Drug Administration approved clobazam and cannabidiol as adjunctive therapy for LGS in October 2011 and June 2018, respectively. This article provides an overview of clobazam and cannabidiol, including their chemical structures, pharmacological actions, curative effects, safety profile, drug interactions, to introduce the current state of research and the achievements of both drugs.

Progress in the Diagnosis and Treatment of Infantile Epileptic Spasm Syndrome / 罕见病研究

Infantile epileptic spasm syndrome (IESS) is a new concept proposed recently. IESS is a unique and age-specific refractory epilepsy syndrome. The recent advances in molecular biology, neuroimmunology and the in-depth study of anti-epileptic mechanism in antiepileptic drugs have led to the achievements in the definition and treatment of infantile epileptic spasm. At present, the use of traditional antiepileptic drugs is decreasing, while the use of new antiepileptic drugs is increasing. In this paper, based on the relevant literature in recent years, the authors discuss the pathogenesis, epidemiology, etiology, diagnosis, treatment, therapeutic drugs, clinical progress, efficacy, and safety of infantile epileptic spasm, hoping to introduce the latest status in research and achievements of IESS.

CT features of Chlamydia psittaci pneumonia / 中国现代医生

@#Objective To investigate CT features of Chlamydia psittaci(C.psittaci)pneumonia patients.Methods Ten patients with C.psittaci pneumonia were collected retrospectively based on macro gene second-generation sequencing(mNGS).The radiological manifestations of the disease were analyzed.Results Seven patients(70%)had contact history with birds(poultry)or their feces.Chest CT on the day of admission was mainly mass patchy consolidation,all of which were located in single lung,involving 8 cases(80%)with one lobe and 2 cases(20%)with two lobes.All of them were accompanied by air bronchogram,9 cases(90%)with ground glass shadow and 8 cases(80%)with interstitial changes.One case(10%)showed a reversed halo sign,and 1 case(10%)showed fan-shaped consolidation.Nine cases(90%)showed progress with increased fusion or new lesions within nine days.Conclusion CT findings of C.psittaci pneumonia have certain characteristics,and combining with history of contacting birds(poultry)can suggest diagnosis.

Role and Possible Mechanism of Clock Gene Rev-erbα in Exercise-induced Mitochondrial Biogenesis / 生物化学与生物物理进展

The clock gene Rev-erbα, also known as nuclear receptor subfamily 1 group D member 1 (Nr1d1), is a crucial regulatory factor in organisms. It exhibits circadian rhythmic expression in metabolically active tissues such as skeletal muscles, heart, liver, and adipose tissue, responding to various environmental stimuli. Rev-erbα plays a significant role in regulating circadian rhythms, metabolic homeostasis, and other physiological processes, earning its designation as an “integrator” of the circadian system and metabolism. Rev-erbα establishes complex connections with other clock genes through the transcriptional-translational feedback loop (TTFL), which is important for the rhythmic output of biological clock system and for the relative stability of phases and cycles. Mitochondrial biogenesis is a physiological process initiated by cells to maintain energy homeostasis by using existing mitochondria as a template for self-growth and division. As the “energy factory” of organism, disruptions in mitochondrial biogenesis are closely associated with the development of various diseases. Studies have shown that not only the factors involved in mitochondrial biogenesis have circadian oscillations, but also the morphology, dynamics and energy metabolism of mitochondria themselves have cyclic fluctuations throughout the day, suggesting that mitochondrial biogenesis is regulated by the biological clock system, in which the clock gene Rev-erbα plays a key role, it drives mitochondrial biogenesis and synergistically regulates autophagy to normalize a number of physiological processes in the body. Rev-erbα is sensitive to both internal and external environmental changes, and disruptions in circadian rhythms, metabolic diseases, and aging are significant inducers of changes in Rev-erbα expression, and its concomitant inflammation and oxidative stress may be an intrinsic mechanism for inhibiting mitochondrial biogenesis. Therefore, the enhancement of mitochondrial biogenesis by regulating the Rev-erbα activity status may be an important way to improve the pathology and promote the health of organism. Exercise, as a commonly accepted non-pharmacological tool, plays an important role in enhancing mitochondrial biogenesis and promoting health. It has been found that there is a close relationship between exercise and Rev-erbα. On the one hand, exercise stimulation directly affects the expression of Rev-erbα, especially high-intensity and long-term regular exercise; on the other hand, Rev-erbα achieves indirect regulation of exercise capacity by mediating processes such as skeletal muscle mitochondrial biogenesis and autophagy, muscle mass maintenance, energy metabolism and skeletal muscle regeneration. Based on the above findings, it is hypothesized that Rev-erbα may serve as a key bridge between exercise and mitochondrial biogenesis. Exercise enhances the transcriptional response of Rev-erbα in the nucleus, upregulates the expression of Rev-erbα protein in cytoplasm, activates the AMP-activated proteinkinase (AMPK)/ silent information regulator 1 (SIRT1)/peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) pathway, regulates Ca2+ flux and downstream signaling molecules; meanwhile, exercise can upregulate antioxidant gene expression and alleviate oxidative stress through Rev-erbα, which ultimately enhances the function of mitochondria, and promotes mitochondrial biogenesis. In conclusion, the clock gene Rev-erbα emerges as a crucial target for exercise-induced enhancement of mitochondrial biogenesis. In this paper, the biological characteristics ofRev-erbα, the role of Rev-erbα in regulating mitochondrial biogenesis and the factors that may influence it, the interaction between exercise and Rev-erbα, and the potential mechanism of exercise-induced mitochondrial biogenesis via Rev-erbα are sorted out and discussed, which can provide theoretical references to the mechanism of exercise-promoted mitochondrial biogenesis.

Genome-wide association analysis of agronomic traits related to eggplant fruits: a review / 生物工程学报

Eggplant is an important horticultural crop and one of the most widely grown vegetables in the Solanaceae family. Eggplant fruit-related agronomic traits are complex quantitative traits with low efficiency and long cycle time for traditional breeding selection. With the rapid development of high-throughput sequencing technology and bioinformatics tools, genome-wide association study (GWAS) has shown great application potential in analyzing the genetic rules of complex agronomic traits related to eggplant fruits. This paper first reviews the progress of genome-wide association analysis in eggplant fruit shape, fruit color and other fruit-related agronomic traits. Subsequently, aiming at the problem of missing heritability, which is common in the genetic studies of eggplant quantitative traits, this paper puts forward the development strategies of eggplant GWAS in the future based on the hot spots of application of four GWAS strategies in the research of agronomics traits related to eggplant fruits. Lastly, the application of GWAS strategy in the field of eggplant molecular breeding is expected to provide a theoretical basis and reference for the future use of GWAS to analyze the genetic basis of various eggplant fruit-related traits and to select fruit materials that meet consumer needs.