Vascular Reactivity Index as an Effective Predictor of Mortality in Patients With Septic Shock: A Retrospective Study.

BACKGROUND: Sepsis is a serious complication that occurs after trauma, burns, and infections, and it is an important cause of death in intensive care unit (ICU) patients. Despite many new measures being proposed for sepsis treatment, its mortality rate remains high; sepsis has become a serious threat to human health, and there is an urgent need to carry out in-depth clinical research related to sepsis. In recent years, it has been found that septic shock-induced vasoplegia is a result of vascular hyporesponsiveness to vasopressors. Therefore, this study intended to establish an objective formula related to vasoplegia that can be used to assess the prognosis of patients and guide clinical treatment. MATERIALS AND METHODS: A retrospective cohort study was conducted using data from 106 septic shock patients admitted to the ICU of Jining No. 1 People's Hospital from January 2020 to December 2022. The patients were divided into mortality and survival groups based on 28-day survival, and hemodynamics were monitored by the pulse index continuous cardiac output system. The dose and duration of vasopressors, major hemodynamic parameters, lactic acid (Lac) levels, and Sequential Organ Failure Assessment scores were recorded within 48 h of hospital admission. Multifactorial logistic regression was used to analyze the independent risk factors affecting the prognosis of patients, and the predictive value of the vascular response index (VRI) was analyzed by the receiver operating characteristic (ROC) curve. RESULTS: The differences between the survival and mortality groups in terms of age, sex ratio, body weight, ICU length of stay, distribution of infection sites, underlying disease conditions, baseline Lac levels, and some hemodynamic parameters were not statistically significant (P > .05). The results of multifactorial logistic regression showed that the admission Acute Physiology and Chronic Health Evaluation II score, Lac level at 24 h of treatment, maximal vasoactive inotropic score at 24 h (VISmax24), maximal vasoactive inotropic score at 48 h (VISmax48), and VRI were independent risk factors affecting 28-day mortality. Within 48 h of receiving vasopressor therapy, the VRI was lower in the mortality group than in the survival group. The area under the ROC curve for the VRI was 0.86, and the best cutoff value of the VRI for predicting 28-day mortality was 32.50 (YI = 0.80), with a sensitivity of 0.90, a specificity of 0.90, and a better prediction of mortality than the other indicators. CONCLUSIONS: The VRI is a good predictor of mortality in patients with septic shock, and a lower VRI indicates more severe vasoplegia, poorer prognosis, and higher mortality in patients with septic shock.

Long non-coding RNA MM2P suppresses M1-polarized macrophages-mediated excessive inflammation to prevent sodium taurocholate-induced acute pancreatitis by blocking SHP2-mediated STAT3 dephosphorylation.

M1 macrophage-mediated excessive inflammatory response plays a key role in the onset and progression of acute pancreatitis (AP), and this study aimed to investigate the role and underlying mechanisms by which the macrophage polarization-related long noncoding RNA (lncRNA) MM2P participated in the regulation of AP progression. By performing quantitative reverse-transcription PCR (qRT-PCR) assay, lncRNA MM2P was found to be downregulated in both sodium taurocholate-induced AP model mice tissues and lipopolysaccharide (LPS)-stimulated RAW264.7 cells, and gain-of-function experiments confirmed that overexpression of lncRNA MM2P counteracted inflammatory responses, reduced macrophage infiltration and facilitated M1-to-M2 transformation of macrophages to ameliorate AP development in vitro and in vivo. Further mechanical experiments revealed that lncRNA MM2P inhibited Src homology 2 containing protein tyrosine phosphatase 2 (SHP2)-mediated signal transducer and activator of transcription 3 (STAT3) dephosphorylation to activate the STAT3 signaling, and silencing of SHP2 suppressed M1 type skewing in LPS-induced RAW264.7 cells. Interestingly, our rescuing experiments verified that lncRNA MM2P-induced suppressing effects on M1-polarization of LPS-treated RAW264.7 cells were abrogated by co-treating cells with STAT3 inhibitor stattic. Collectively, our data for the first time revealed that lncRNA MM2P suppressed M1-polarized macrophages to attenuate the progression of sodium taurocholate-induced AP, and lncRNA MM2P might be an ideal biomarker for AP diagnosis and treatment.

Intraoperative triggered electromyographic monitoring of pedicle screw efficiently reduces the lumbar pedicle breach and re-operative rate-a retrospective analysis based on postoperative computed tomography scan.

BACKGROUND: To investigate whether intraoperative triggered electromyographic (T-EMG) monitoring could effectively reduce the breach rate of pedicle screws and the revision rate. METHODS: Patients with posterior pedicle screw fixation from L1-S1 were enrolled between June 2015 and May 2021. The patients in whom T-EMG was utilized were placed in the T-EMG group, and the remaining patients were considered in the non-T-EMG group. Three spine surgeons evaluated the images. The two groups were divided into subgroups based on screw position (lateral/superior and medial/inferior) and breach degree (minor and major). Patient demographics, screw positions, and revision procedures were reviewed. RESULTS: A total of 713 patients (3403 screws) who underwent postoperative computed tomography (CT) scans were included. Intraobserver and interobserver reliabilities were perfect. The T-EMG and non-T-EMG groups had 374(1723 screws) and 339 (1680 screws) cases, respectively. T-EMG monitoring efficiently reduced the overall screw breach (T-EMG 7.78% vs. non-T-EMG 11.25%, p = 0.001). in the subgroup analysis, the medial/inferior breach rate was higher in the T-EMG group than in the non-T-EMG group (T-EMG 6.27% vs. non-T-EMG 8.93%, p = 0.002); however, no difference was observed between the lateral and superior breaches (p = 0.064). A significant difference was observed between the minor (T-EMG 6.21% vs. non-T-EMG 8.33%, p = 0.001) and major (T-EMG 0.06% vs. non-T-EMG 0.6%, p = 0.001) medial or inferior screw breach rates. Six screws (all in the non-T-EMG group) underwent revision, with a significant difference between the groups (T-EMG 0.0% vs. non-T-EMG 3.17%, p = 0.044). CONCLUSIONS: T-EMG is a valuable tool in improving the accuracy of screw placement and reducing the screw revision rate. The screw-nerve root distance is vital in causing symptomatic screw breach. TRIAL REGISTRATION: The study is retrospective registered in China National Medical Research Registration and Archival information system in Nov 17th 2022.

Review and prospect of radiodiagnosis and radiotherapy supervision in the past 16 years / 中国辐射卫生

In 2003, the responsibility of radiation source safety supervision was redivided and transferred from the health department to the environmental protection department. After the promulgation and implementation of the Rule on the Administration of Radiodiagnosis and Radiotherapy in 2006, due to the incorporation of a large number of medical practice supervision rules, the radiation health supervision of medical institutions has evolved into the radiodiagnosis and radiotherapy supervision. In the past 16 years, radiation, occupational health supervision, and medical practice supervision have not been well integrated, and there are many legal problems in radiodiagnosis and radiotherapy supervision. The regulation rules of environmental protection, metrology, and other relevant departments on radiation sources and radiation devices have been constantly changing, resulting in overly complex regulatory requirements on radiodiagnosis and radiotherapy, which increases the burden of medical institutions. This paper reviews the historical evolution and legal system changes of radiodiagnosis and radiotherapy supervision, analyzes the problems and challenges faced by the relevant regulatory departments, and proposes ways to improve the supervision system.

Risk factors of carbapenem-resistant Klebsiella pneumoniae infection in ICU patients and construction of a prediction model for infection / 中华临床感染病杂志

Objective:To analyze the risk factors of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection in intensive care unit (ICU) patients and to construct a prediction model for infection. Methods:The clinical data of 204 patients with Klebsiella pneumoniae infection admitted in ICU of Jining First Hospital during January 2020 to December 2022 were retrospectively analyzed. Patients admitted during January 2020 to December 2021 were selected as model set ( n=150), and patients admitted during January to December 2022 were selected as validation set ( n=54). In model set, there were 59 cases infected with CRKP (CRKP group) and 91 cases infected with carbapenem-sensitive Klebsiella pneumonia (CSKP group). The risk factor of CRKP infection in ICU patients were analyzed with multivariate Logistic regression, based on which an infection prediction model was constructed. The predictive value of the model was evaluated by ROC, and verified in the validation group. Results:Multivariate Logistic regression analysis showed that empirical use of beta-lactam antibiotics( OR=6.985, 95 % CI 1.658-29.423, P=0.008), central vein catheterization( OR=7.486, 95 % CI 2.776-20.186, P<0.001)and tracheal intubation/incision( OR=10.695, 95 % CI 2.701-42.351, P=0.001)were risk factors for CRKP infection in ICU patients. The regression equation for predicting the risk of infection was -4.851+ empirical use of beta-lactam antibiotics×1.944+ central vein catheterization×2.013+ tracheal intubation/incision×2.370. The area under the ROC curve (AUC) of the model for predicting infection in the model group was 0.905, with sensitivity and specificity of 79.7% and 90.1%, respectively. The AUC of the model for predicting infection in validation group was 0.881, with sensitivity and specificity of 84.2% and 85.7%, respectively. Conclusion:The constructed infection prediction model in the study can effectively predict CRKP infection in ICU patients.

Delayed Hemorrhage Followed by Vertebral Artery Injury during Cervical Anterior Controllable Antedisplacement and Fusion Surgery: Case Report and Literature Review.

BACKGROUND: Vertebral artery injury (VAI) during cervical spine surgery is rare. Anterior controllable ante-displacement and fusion (ACAF) surgery is a novel technique for treating degenerative cervical spine disorders, especially ossification of the posterior longitudinal ligament. To date, there have been no reports of VAI during cervical ACAF surgery. Here, we report a rare case of perioperative complication of VAI during ACAF surgery. The available English literature that provides treatment instructions were reviewed. CASE PRESENTATION: A patient diagnosed with mixed ossification of the posterior longitudinal ligament (OPLL) underwent ACAF surgery from C2-C6. Two level transverse foramina were ruptured, and severe bleeding was encountered during ACAF osteotomy. Hemostatic tamponade was performed using bone waxes. The patient had delayed hemorrhage on postoperative day 6. Emergence angiography revealed two vertebral artery pseudoaneurysms in the ruptured transverse foramina. A balloon-expandable covered stent was deployed to treat the pseudoaneurysm. The patient recovered without complications. CONCLUSION: ACAF surgery is a good choice for multiple-level OPLL disease, but special attention should be paid to VAI in the perioperative period. Intraoperative tamponade with bone wax and postoperative digital subtraction angiography (DSA) are effective in preventing disaster-related hemorrhage.

Risk factors of primary acute mesenteric venous thrombosis in plateau area / 中华普通外科杂志

Objective:To explore the risk factors of primary acute mesenteric venous thrombosis (AMVT) in plateau area.Methods:Data of 54 primary AMVT cases admitted to the People's Hospital of Tibet Autonomous Region between Jan 2015 and Jul 2021 were retrospectively analyzed. There were 42 males and 12 females, aged from 29-79 years. One hundred and ninty matched volunteers severed as control. Logistic multivariate regression analysis was used to screen out independent risk factors. The receiver operating characteristic (ROC) curve and the area under the curve are used to evaluate the value of each indicator and model prediction.Results:Univariate analysis showed that the two groups were significantly different in gender, smoking history, drinking history, and hemoglobin concentration ( P<0.05); there was no significant difference in age, altitude of residence, uric acid and BMI ( P>0.05). Logistic multivariate regression analysis showed that male ( OR=2.466, 95% CI: 1.166-5.212, P=0.018), elevated hemoglobin levels ( OR=2.761, 95% CI: 1.411-5.403, P=0.003) were independent risk factors for primary AMVT. The area under the ROC curve of the two predictors and prediction model are 0.639 (95% CI: 0.559-0.719), 0.650 (95% CI: 0.563-0.737), 0.697 (95% CI: 0.618-0.776). Conclusion:Male and elevated hemoglobin levels are independent risk factors for primary AMVT in plateau areas.

Patterns of multimorbidity in hospitalized older adults based on factor analysis / 中华老年医学杂志

Objective:To explore the multimorbidity patterns in older inpatients adults, and their differences between Northern and Southern China.Methods:A total of 4 348 elderly patients aged 60 and above from the geriatrics departments of 12 grade A tertiary hospitals in 7 cities in China were investigated.Factor analysis was used to explore the comorbidity patterns and analyze the differences in comorbidity patterns between Southern and Northern China.Results:The study population consisted of 4 348 patients over the age of 60, with an average age of(74.15±8.01)years.The total sample had a Kaiser-Meyer-Olkin(KMO)sampling adequacy index of 0.657 and a cumulative variance percentage of 43.97%.Factor analysis revealed there were five major multimorbidity patterns in the patients.These were: the metabolic pattern; the liver-kidney pattern; the degenerative pattern; the neuropsychiatric pattern; dementia.Further factor analysis for the South and the North was conducted.Older inpatients in Southern regions had a KMO sampling adequacy index of 0.654 and a cumulative variance percentage of 43.50%.In Southern China, the multimorbidity patterns were similar to the overall patterns.In Northern regions, older inpatients had a KMO sampling adequacy index of 0.648 and a cumulative variance percentage of 45.16%.The liver-kidney pattern, metabolic disease pattern, lung-dementia pattern, degenerative disease pattern, and neuropsychiatric pattern were the main multimorbidity patterns in Northern China.Conclusions:Multimorbidity patterns were different between Northern and Southern China and should be differentiated in their management.In the North, older adults should pay more attention to the prevention and management of respiratory system diseases and dementia, while in the South, older adults should pay more attention to the prevention and management of degenerative disease.Early disease prevention based on multimorbidity patterns is one of the approaches to the reduction of chronic diseases in older adults.

Application of flipped classroom based on POA theory in the teaching of standardized training in the Department of Joint and Sports Medicine / 中华医学教育探索杂志

Objective:To explore the application of the flipped classroom based on the production-oriented approach (POA) theory in the teaching of standardized training in the Department of Joint and Sports Medicine.Methods:A total of 37 standardized training physicians who rotated in the Department of Joint and Sports Medicine in Zhongnan Hospital of Wuhan University from January 2019 to December 2019 were selected as the control group, and the traditional teaching was adopted. Another 39 standardized training physicians who rotated from April 2020 to March 2021 were selected as the study group, and the flipped classroom based on POA theory was adopted. At the end of the rotation, the scores of theoretical knowledge and practical operation skills, the scores of mini-clinical evaluation exercise (Mini-CEX) and the teaching satisfaction were compared. SPSS 22.0 was used for t-test and Chi-square test. Results:The various scores and total score of theoretical knowledge and practical operation skills in the study group at the end of rotation were significantly higher than those in the control group ( P < 0.05). There was no significant difference in the various scores and total score of Mini-CEX between the two groups at the time of admission ( P > 0.05). The above scores in the two groups at the end of rotation were significantly higher than those at the time of admission ( P < 0.05), and the above scores of the study group were significantly higher than those of the control group ( P < 0.05). The overall teaching satisfaction rate of the study group was higher than that of the control group ( P < 0.05). Conclusion:The application of the flipped classroom based on POA theory in the teaching of standardized training in the Department of Joint and Sports Medicine can significantly improve the teaching effect and quality, and improve the clinical comprehensive ability and teaching satisfaction of the standardized training physicians, which is worthy of popularization and application.

An investigation of hospitalization management and radiation protection in 131I treatment for thyroid cancer / 中国辐射卫生

Objective To investigate the status and problems of hospitalization management and radiation protection in 131I treatment for thyroid cancer, and to provide suggestions for medical institutions to implement relevant standards. Methods We investigated the status of radiation protection and management in 10 medical institutions conducting 131I treatment for thyroid cancer (6 in Shanghai, 2 in Zhejiang Province, and 2 in Jiangsu Province, China) by consulting written materials, expert interviews, and on-site inspection and testing. Results The average activity of 131I therapy for thyroid cancer in the 10 medical institutions was 110~120 mCi (4.07~4.44 GBq). All patients who received the treatment were hospitalized, with a stay of 3~7 days. Seven institutions carried out 131I dispensing, 6 of which used automatic 131I dispensing instruments. Nine institutions had an independent ventilation system in the wards, 8 of which regularly changed the filters. All the 10 institutions set special toilets and shower rooms in the wards, and had shielding facilities between sickbeds, with the lead equivalent from 0.5 mm Pb (lowest) to 10 mm Pb (highest). All the 10 institutions had intercom and monitoring facilities in the wards, 9 of which had a one-way access control system, and 4 of which had dose monitoring equipment. Nine institutions carried out surface pollution monitoring in the workplace, but none performed air pollution testing. All the 10 institutions required the radioactivity in the body of patients be less than 400 MBq before discharge, and five of them estimated the activity by measuring the dose rate at a certain distance from the body surface of patients. All the 10 institutions had radioactive sewage decay ponds, but none of them conducted regular monitoring. Rapid on-site surface pollution testing in the wards showed that highest value was 31.9 Bq/cm2. Conclusion The 10 medical institutions carried out 131I treatment for thyroid cancer basically according to the requirements of national laws, regulations, and standards, but there are still some problems in ward construction, radiation protection facilities, and patient hospitalization management, which should be further standardized.

Analysis of hot spots in emergency medicine research from 2015 to 2019--visualization analysis based on CiteSpace / 中华急诊医学杂志

Objective:To analyze the knowledge graph of the papers published in the core journals of emergency medicine from 2015 to 2019, to present the overall situation of the research in the field of emergency medicine, to highlight the important contents in the research progress, and to unearth the research hotspots reported in the journals of emergency medicine.Methods:The relevant literatures of 7 core journals of emergency medicine were retrieved and exported from CNKI and Wanfang databases published in 2015-2019. A total of 7753 valid literatures were included. The visualization software CiteSpace was used to analyze the information of authors, institutions and keywords in the exported literatures to generate visual graphs.Results:By analyzing the knowledge graph from 2015 to 2019, it is found that Yu Xuezhong, Zhu Huadong, Zhang Jinsong, Zhang Mao, Liu Xinwei, Liu Yin, Xu Jun, and Nie Sinnan were the backbone of the author group in the field of emergency medicine. Emergency Department of Peking Union Medical College Hospital, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Emergency Department of PLA General Hospital, Emergency Medicine Department of Eastern Theater General Hospital, Emergency Department of Xijing Hospital, and Emergency Medicine Department of Shenyang Military Region General Hospital were the institutions with the most publications. In recent 5 years, the core journals of emergency medicine focused on the topics on mortality, acute lung injury, cardiac arrest, prognosis, mechanical ventilation, acute myocardial infarction and hemoperfusion.Conclusions:The visual graphs generated by CiteSpace helps to intuitively understand the critical path, development trend and frontier hot spots of the evolution of the research field of emergency medicine, and provides more basis for future related research.

The definition of ‘important components’ of radiodiagnosis and radiotherapy equipment / 中国辐射卫生

It is an important technical means to ensure that the radiodiagnosis and radiotherapy equipment can be put into use normally to carry out acceptance test after the newly installed, maintained or replaced important components. Health inspection found that medical institutions are often easy to ignore the acceptance test in the process of use, and do not carry out acceptance test on the radiodiagnosis and radiotherapy equipment after maintenance or replacement of important components. However, it is difficult to ask medical institutions to correct them without the definition and scope of ‘important components’ according to laws or technical standards. This paper studies and discusses the definition of ‘important components’ of radiodiagnosis and radiotherapy equipment, and puts forward some suggestions onthe practical application of the research results.

Expert consensus on emergency medicine procedure optimization guided by routine prevention and control strategy for COVID-19

The outbreak of coronavirus disease 2019 (COVID-19) was declared a global public health emergency on 31 January 2020. Emergency medicine procedures in Emergency Department should be optimized to cope with the current COVID-19 pandemic by providing subspecialty services, reducing the spread of nosocomial infections, and promoting its capabilities to handle emerging diseases. Thus, the Chinese Society of Emergency Medicine and Wuhan Society of Emergency Medicine drafted this consensus together to address concerns of medical staffs who work in Emergency Department. Based on in-depth review of COVID-19 diagnosis and treatment plans, literatures, as well as management approval, this consensus proposes recommendations for improving the rationalization and efficiency of emergency processes, reducing the risk of nosocomial infections, preventing hospital viral transmission, and ensuring patient safety.

Synergistic effects of autophagy/mitophagy inhibitors and magnolol promote apoptosis and antitumor efficacy

Mitochondria as a signaling platform play crucial roles in deciding cell fate. Many classic anticancer agents are known to trigger cell death through induction of mitochondrial damage. Mitophagy, one selective autophagy, is the key mitochondrial quality control that effectively removes damaged mitochondria. However, the precise roles of mitophagy in tumorigenesis and anticancer agent treatment remain largely unclear. Here, we examined the functional implication of mitophagy in the anticancer properties of magnolol, a natural product isolated from herbal

Clinical characteristics and associated factors for depression in patients with Parkinson's disease / 中华老年医学杂志

Objective:To investigate the characteristics and associated factors of depression in elderly patients with Parkinson's disease(PD).Methods:A total of 1138 elderly PD patients from Xuanwu Hospital of Capital Medical University were consecutively enrolled.The Hamilton Depression 17-item Scale(HAMD-17)was used to diagnose depression(scores ≥14). The depressive characteristics of PD patients with depression and those without depression were compared, and Logistic regression model was used to analyze the clinical risk factors of depression in PD patients.Results:Among the 1 138 PD patients, 233 cases had depression.The incidence of depression in PD patients was 20.5%, and the treatment rate was only 6.0%(14 cases). The main symptoms of depression in PD patients included sleep disturbance(101 cases, 43.3%), depression(57 cases, 24.5%), work and interest loss(49 cases, 21%). Compared to PD patients without depression, PD patients with depression were more likely women(49.4% vs36.3%), and had lower cognitive scores[(25.56 ± 4.22)scores vs(27.07 ± 3.08)scores], higher rate of freezing of gait(51.0% vs24.0%), higher incidence of disability(87.1% vs28.5%)( P<0.05). A comparison of each part of the unified Parkinson's disease rating scale(UPDRS)between the two groups revealed that the scores of activities of daily living[(16.52 ± 8.71)scores vs(10.15 ± 5.48)scores], the motor examination[(33.78 ± 19.48)scores vs(22.87 ±13.08)scores]and the complications of therapy[2.0(0.0, 6.0)scores vs0.0(0.0, 2.0)scores]were higher in the PD patients with depression group than in the PD patients without depression group( P<0.05). Logistic regression analysis showed that women( OR=1.532, 95% CI: 1.073-2.187, P=0.019), disability( OR=6.357, 95% CI: 4.399-9.186, P<0.001), activities of daily living evaluated by UPDRS( OR=1.093, 95% CI: 1.043-1.146, P<0.001)and motor complications( OR=1.100, 95% CI: 1.014-1.193, P=0.022)were independent risk factors for PD depression. Conclusions:Depression was common in PD patients and usually manifested as sleep disturbance and low motivation, women, motor complications, disability and decreased quality of daily living were independent risk factors for depression.

Electroacupuncture applied at the Sanyinjiao point can relieve stress incontinence by up-regulating the expression of spinal NMDA and α 2 adrenergic receptors / 中华物理医学与康复杂志

Objective:To explore the effect of electroacupuncture on the expression of N-methyl-D-aspartic acid (NMDA) in the spine and the activity of α 2 adrenergic receptors in rats with stress urinary incontinence (SUI). Methods:In all, 48 adult female rats were randomly divided into a sham operation group, a model group and an acupuncture group. The sham operation group received sham vaginal distention. Both the model and acupuncture groups had SUI induced using endovaginal balloon dilatation. The former group then had no further intervention, while the latter was given acupuncture on the sanyinjiao point for one week. Urodynamic testing and leak point pressure (LPP) determination were then conducted with all three groups, as well as urethral sphincter electromyography. The expression of NMDA in the L 6-S 1 spinal segments using the polymerase chain reaction and α 2 adrenergic receptor activity was analyzed using western blotting. Results:No significant differences in the urodynamic variables were observed among the three groups. However, compared with the sham operation group, a significant decrease in the average LPP and the frequency and amplitude of the external urethral sphincter electromyography was observed in the model group. Moreover, compared with the model group, the acupuncture group showed significantly increased average LPP and higher electromyographic frequency and amplitude. The average mRNA and protein expression of NMDA in the spine were also significantly higher in the acupuncture group, as was the average α 2 receptor activity. Conclusions:Vaginal distention is an effective method of establishing urinary incontinence in rats. Electroacupuncture can not only improve the ability to store urine, it also increases urination, which may be related to the up-regulation of the expression of NMDA and α 2 adrenergic receptors.

The application of spinal cord stimulation in the treatment of Parkinson's disease / 中华老年医学杂志

Axial symptoms of Parkinson's disease, such as gait disturbance and postural instability, do not respond well to anti-Parkinson drugs or deep brain stimulation.It has been reported that spinal cord stimulation can improve these symptoms, but the effects are not consistent.This article reviews animal experiments and clinical trials on spinal cord stimulation in the treatment of Parkinson's disease, in order to explore the mechanisms of action of spinal cord stimulation and give some suggestions for future research and clinical application.

Effect of cholesterol on human meniscal fibrochondrocytes / 中华创伤骨科杂志

Objective:To explore the effect of cholesterol on the expression of genes for matrix synthesis and degradation of human meniscal fibrochondrocytes and its mechanism.Methods:Meniscal tissue was taken from patients undergoing arthroscopic surgery to extract fibrochondrocytes. The cells were divided into a control group in which the normal cells were not processed, a positive control group in which interleukin-1 β was used to create a degeneration model, and 2 treatment groups which were subjected to treatment with 15 and 30 μg/mL cholesterol respectively. Safranin O staining, β-galactosidase staining and enzymic kits were used to detect the morphology and total cholesterol (TCH) content of meniscal fibrochondrocytes in the 4 groups. Immunofluorescence and western blot were used to detect the protein expression of type Ⅰcollagen precursor α1 (COL1A1) and type Ⅱ collagen precursor α1 (COL2A1). RT-qPCR was used to detect the mRNA expression of COL1A1, COL2A1, matrix metalloproteinase (MMP) 3, MMP9, MMP13, and genes related to cholesterol efflux pathways [like liver X receptor α (LXR α), ATP binding cassette transporter A1 (ABCA1) and ABCG1]. Results:There was no significant difference between the control and the positive control groups in the TCH content in human meniscal fibrochondrocytes ( P>0.05). The treatments with 15 and 30 μg/mL cholesterol resulted in significantly increased TCH contents in human meniscal fibrochondrocytes in the treatment groups ( P<0.05). Compared with the control group, the mRNA expression of LXR α, ABCA1 and ABCG1 was significantly decreased in the treatment groups ( P<0.05), and the meniscal fibrochondrocytes in the positive group and the treatment groups presented with a lower density, chaotic distribution and obvious signs of degradation. Compared with the control groups, the mRNA expression of matrix synthesis genes (COL1A1 and COL2A1) in the meniscal fibrochondrocytes was significantly inhibited while the mRNA expression of matrix degradation metalloenzymes (MMP3, MMP9 and MMP13) was significantly promoted ( P<0.05). Conclusion:Cholesterol may inhibit the cholesterol efflux pathways of meniscal fibrochondrocytes, and thus cause accumulation of cholesterol in the meniscal fibrochondrocytes, eventually leading to degeneration of meniscus.

Research advances on the chemical constituents and pharmacological effects of snow lotus / 药学学报

Snow lotus is a medicinal plant with a wide range of pharmacological activities. It has been used to treat rheumatoid arthritis, cough with cold, stomach ache, dysmenorrhea, and altitude sickness in traditional medicine. This review summarizes the bioactive components in six species of snow lotus including flavonoids, lignans, phenolic compounds, phenylpropanoids, and sesquiterpenes present in Saussurea involucrate (SI), Saussurea obvallata (SO), Saussurea laniceps (SL), Saussurea medusa (SM), Saussurea stella (SS) and Saussurea tridactyla (ST). We review the pharmacological and related molecular mechanisms by which these components exert antineoplastic, anti-inflammatory, and antioxidant effects and promote lipid catabolism, and provide a reference for the future study of the traditional Chinese medicinal chemistry and pharmacological activities of snow lotus.

Risk factors and prediction tools for falls in Parkinson's disease / 中华老年医学杂志

Parkinson's disease(PD)can lead to falls as the disease progresses, and falls increase the mortality of PD patients.Therefore, it is important to understand the risk factors for falls in PD and use prediction tools with high accuracy in order to predict falls and propose prevention strategies.This paper summarizes the risk factors for falls in Parkinson's disease and reviews studies evaluating the accuracy of prediction tools for falls, with the aim of providing help in clinical practice.