CT radiomics-based long-term survival prediction for locally advanced non-small cell lung cancer patients treated with concurrent chemoradiotherapy using features from tumor and tumor organismal environment.

BACKGROUND: Definitive concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced non-small cell lung cancer (LANSCLC) patients, but the treatment response and survival outcomes varied among these patients. We aimed to identify pretreatment computed tomography-based radiomics features extracted from tumor and tumor organismal environment (TOE) for long-term survival prediction in these patients treated with CCRT. METHODS: A total of 298 eligible patients were randomly assigned into the training cohort and validation cohort with a ratio 2:1. An integrated feature selection and model training approach using support vector machine combined with genetic algorithm was performed to predict 3-year overall survival (OS). Patients were stratified into the high-risk and low-risk group based on the predicted survival status. Pulmonary function test and blood gas analysis indicators were associated with radiomic features. Dynamic changes of peripheral blood lymphocytes counts before and after CCRT had been documented. RESULTS: Nine features including 5 tumor-related features and 4 pulmonary features were selected in the predictive model. The areas under the receiver operating characteristic curve for the training and validation cohort were 0.965 and 0.869, and were reduced by 0.179 and 0.223 when all pulmonary features were excluded. Based on radiomics-derived stratification, the low-risk group yielded better 3-year OS (68.4% vs. 3.3%, p < 0.001) than the high-risk group. Patients in the low-risk group had better baseline FEV1/FVC% (96.3% vs. 85.9%, p = 0.046), less Grade ≥ 3 lymphopenia during CCRT (63.2% vs. 83.3%, p = 0.031), better recovery of lymphopenia from CCRT (71.4% vs. 27.8%, p < 0.001), lower incidence of Grade ≥ 2 radiation-induced pneumonitis (31.6% vs. 53.3%, p = 0.040), superior tumor remission (84.2% vs. 66.7%, p = 0.003). CONCLUSION: Pretreatment radiomics features from tumor and TOE could boost the long-term survival forecast accuracy in LANSCLC patients, and the predictive results could be utilized as an effective indicator for survival risk stratification. Low-risk patients might benefit more from radical CCRT and further adjuvant immunotherapy. TRIAL REGISTRATION: retrospectively registered.

[Influence of Optimal Land Use Allocation on Phosphorus Loss in the Process of Rainfall and Runoff].

In order to explore the impact of optimized land use allocation on phosphorus loss in the runoff process of a small watershed in the Three Gorges Reservoir area, a traditional agricultural model catchment area (CG) and a catchment area after optimized land use allocation in the Shipanqiu watershed in Zhong County, Chongqing (EG) were selected as the research object, sampling at the outlets of the two catchment areas, respectively, to monitor the runoff process and different forms of phosphorus in rainfall events and to analyze the influence of land use configuration on the law of phosphorus loss. The results showed that:① in the 10 monitored rainfall and runoff processes, the ρ[total phosphorus (TP)] of EG was lower than that of CG, and the ranges of the two were 0.09-0.75 mg·L-1 and 0.13-2.82 mg·L-1, respectively. Compared with that of CG, EG significantly reduced the peak value of TP. ② The average EMC of TP, total dissolved phosphorus (TDP), dissolved inorganic phosphorus (DIP), and particulate phosphorus (PP) in the process of rainfall and runoff was lower than that of CG, and EG and CG showed significant differences in EMC of TP, TDP, and DIP (P<0.05); the main form of phosphorus loss in the two catchment areas in the process of rainfall and runoff was TDP, but the average TDP/TP of EG was larger. ③ The output load of EG was 45%, 43%, 57%, and 47% lower than that of the TP, TDP, DIP, and PP in CG. The output load of EG and CG of various forms of phosphorus was significantly correlated with the total runoff (P<0.01). In addition, the slope of the linear fitting of various phosphorus forms in the CG catchment area to the total amount of runoff was 1.66 to 1.75 times that of EG. The output load of various phosphorus forms of CG was more sensitive to runoff than that of EG, and the output per unit area in the process of rainfall and runoff was more sensitive than that of EG. The amount of sand could have caused the difference in phosphorus concentration and output load more than the output per unit area. Optimizing land use configuration can effectively reduce the loss of various forms of phosphorus and provide a reference for the prevention and control of phosphorus loss in small watersheds in the Three Gorges Reservoir area.

[Effects of Different Land Use Practices on Nitrogen Loss from Runoff During Rainfall Events].

To understand the effect of nitrogen from runoff during rainfall events for different land uses, sub-catchments A and B in the small Shipanqiu watershed in Zhong County, Chongqing-which were managed using different land use practices-were taken as research objects. Runoff flow and nitrogen levels at the outlet of the catchment were monitored. Sub-catchment A is an agroforestry-water complex and sub-catchment B is the site of traditional agriculture. EMC was used to evaluate the average concentration of runoff nitrogen during rainfall events, and the effect of this runoff nitrogen on the small watershed with different land use systems was analyzed. The results showed that the TN concentration in catchment B (1.37-15.17 mg·L-1) > catchment A (0.84-9.28 mg·L-1); the ratio of the first peak to the second peak in catchment A was 62%, which was far less than the 97% in catchment B; the average DN/TN values were 69% and 75% in catchments A and B, respectively; and the average NN/DN values were 67% and 80% in catchments A and B, respectively. The different land use practices have significant impacts on nitrogen loss. Compared with the catchment where traditional agricultural practices were followed, the agroforestry-water complex catchment effectively reduced the loss of nitrogen and decreased the first TN peak value and DN/TN and NN/DN values. This study provides a scientific basis for the prevention and control of non-point source pollution in small watersheds in the area of the Three Gorges Reservoir.

Activating transcription factor 3 involved in Pseudomonas aeruginosa PAO1-induced macrophage senescence.

Pseudomonas aeruginosa (PA) is one of the most prevalent pathogens that cause nosocomial infection in critical patients. Previously, we reported PA induced macrophage to senescence under the circumstance of infection. As an oxidative stress responsiveness element, activating transcription factor 3 (ATF3) might be involved in the macrophage senescence process. To test this presumption, we manipulated the expression of ATF3 in macrophage by using a PAO1 infection system. In the present study, ATF3 expression in macrophage was increased, following the duration and colony counts of PAO1 infection. Knockdown of ATF3 in macrophage resulted in increased percentage of senescent macrophage under PAO1 infection, while overexpressing ATF3 partly blocked PAO1-induced macrophage senescence. In accordance with the senescent phenotype, elevated reactive oxygen species (ROS) production was shown in ATF3 knockdown macrophages. Also, capacity of phagocytosis was also affected by manipulation of ATF3 expression in macrophages, and increased phagocytosed fluorescent beads was found in ATF3 knockdown macrophage. ATF3 might regulate the senescence process through influence on NF-κB translocation. During infection, the overexpression or downregulation of ATF3 in macrophage negatively modulated the translocation of NF-κB p65 and its phosphorylation at Ser-536. As a result, IL-6 and TNFα was elevated, while IL-10 decreased in case of ATF3 knockdown. In conclusion, ATF3 negatively regulates NF-κB translocation and activation, and participates in PA-induced macrophage senescence. As oxidative stress and inflammation induced element, ATF3 may modulate macrophage-related host defense.

Accumulated Clinical Experiences from Successful Treatment of 1377 Severe and Critically Ill COVID-19 Cases.

In late December 2019, COVID-19 was firstly recognized in Wuhan, China and spread rapidly to all of the provinces of China. The West Campus of Wuhan Union Hospital, the designated hospital to admit and treat the severe and critically ill COVID-19 cases, has treated a large number of such patients with great success and obtained lots of valuable experiences based on the Chinese guideline (V7.0). To standardize and share the treatment procedures of severe and critically ill cases, Wuhan Union Hospital has established a working group and formulated an operational recommendation, including the monitoring, early warning indicators, and several treatment principles for severe and critically ill cases. The treatment experiences may provide some constructive suggestions for treating the severe and critically ill COVID-19 cases all over the world.

Using ROS as a Second Messenger, NADPH Oxidase 2 Mediates Macrophage Senescence via Interaction with NF-κB during Pseudomonas aeruginosa Infection.

Pseudomonas aeruginosa (PA) is one of the most prevalent pathogens that cause nosocomial infection in critical patients. However, the mechanisms underlying macrophage growth status and functional changes during PA infection are yet unknown. In the present study, NADPH oxidase, gp91phox (NOX2) mediated macrophage to senescence in a PAO1 colony-dependent manner. gp91phox might regulate the senescence process through mutual interaction with the NF-κB pathway. During infection, the overexpression or downregulation of gp91phox in macrophage could affect the nuclear activity of NF-κB p65, while the downregulation of NF-κB p65 led to a suppressed expression of gp91phox. Reactive oxygen species (ROS) served as the second messenger between both molecules as the ROS inhibitor, N-acetylcysteine (NAC), could partially restore these changes. Consequently, the level of ROS and inflammatory cytokines, including IL-6 and TNFα, elevated during PAO1 infection, and their production altered as a result of the genetic manipulation of gp91phox and NF-κB p65, as well as NAC treatment. Also, the senescent phenotypes, SA-ß-gal staining and p16ink4a, changed after genetic manipulation with gp91phox and NF-κB p65 and NAC treatment. The capacity of phagocytosis in macrophages was decreased during senescence. In conclusion, PA directs the macrophage towards senescence, and senescent macrophages exhibit a decreased ability of phagocytosis. This process of senescence was regulated by the interactions between NADPH oxidase gp91phox and NF-κB p65 via ROS as a second messenger.

Activation of M1 macrophages plays a critical role in the initiation of acute lung injury.

The goal of the present study was to investigate the role of M1 macrophages in acute lung injury (ALI). To address this, we used lipopolysaccharide (LPS)-treated wild-type and CD11b-DTR mice, and examined their M1 macrophage levels, and the extent of their inflammation and pulmonary injuries. In addition, we evaluated pulmonary function by measuring the expressions of SP-A and SP-B in infiltrated M1 macrophages. Finally, we co-cultured the mouse type II-like alveolar epithelial cells (AT-II) and mouse pulmonary microvascular endothelial cells (PMECs) with M1 macrophages in the presence of TNF-α or H2O2 and assessed them for viability and apoptosis. After LPS treatment, we observed that the number of pulmonary M1/M2 macrophages and the serum levels of interleukin-1ß (IL-1ß), tumor necrosis factor α (TNF-α), and reactive oxygen species (ROS) significantly increased. Furthermore, the increase in cytokines was accompanied with the initiation of lung injury indicated by the decreased levels of SP-A and SP-B. In macrophage-depleted CD11b-DTR mice, ALI was attenuated, serum levels of IL-1ß, TNF-α and ROS were reduced, and lung levels of monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-2 (MIP-2) were decreased. After administering TNF-α and H2O2, the proapoptotic effect of M1 macrophages on AT-II or PMECs significantly increased, the cell viabilities significantly decreased, and apoptosis significantly increased. Our results suggest that M1 macrophages are recruited to the lungs where they significantly contribute to an increase in TNF-α and ROS production, thus initiating ALI.

Pseudomonas aeruginosa induces cellular senescence in lung tissue at the early stage of two-hit septic mice.

We presume that severe secondary Pseudomonas aeruginosa (PA) infection can lead to cellular senescence in lung tissue and thus contribute to high mortality. We established a two-hit mouse model using cecal ligation and puncture (CLP) followed by sublethal PA lung infection. In lung tissue, increased infiltration of inflammatory cells, elevated lung injury and augmented cellular senescence was shown in mice with CLP followed by sublethal PA infection, and these observations reached a higher rank when higher (H) loads PA (PAO1) were administered to CLP mice (CLP + PAO1-H). Accordingly, oxidative stress-related element gp91phox and inflammation regulator NF-κB were greatly activated in CLP + PAO1-H mice compared to others. There was no obvious inflammation or cellular senescence in sham control, PAO1-infected mice. Consequently, CLP + PAO1-H mice had the highest expression levels of inflammatory cytokines IL-6, TNFα and iNOS among those groups. There was lower bacterial clearance ability in CLP + PAO1-H mice than in other mice. CLP + PAO1-H only had approximately 10% survival after 7 days of investigation and was much lower than others. In conclusion, higher mortality due to increased lung inflammation and cellular senescence are observed in mice with increased loads of PA infection secondary to CLP.

Multifunctional nanocomposite based on halloysite nanotubes for efficient luminescent bioimaging and magnetic resonance imaging.

A novel multifunctional halloysite nanotube (HNT)-based Fe3O4@HNT-polyethyleneimine-Tip-Eu(dibenzoylmethane)3 nanocomposite (Fe-HNT-Eu NC) with both photoluminescent and magnetic properties was fabricated by a simple one-step hydrothermal process combined with the coupling grafting method, which exhibited high suspension stability and excellent photophysical behavior. The as-prepared multifunctional Fe-HNT-Eu NC was characterized using various techniques. The results of cell viability assay, cell morphological observation, and in vivo toxicity assay indicated that the NC exhibited excellent biocompatibility over the studied concentration range, suggesting that the obtained Fe-HNT-Eu NC was a suitable material for bioimaging and biological applications in human hepatic adenocarcinoma cells. Furthermore, the biocompatible Fe-HNT-Eu NC displayed superparamagnetic behavior with high saturation magnetization and also functioned as a magnetic resonance imaging (MRI) contrast agent in vitro and in vivo. The results of the MRI tests indicated that the Fe-HNT-Eu NC can significantly decrease the T2 signal intensity values of the normal liver tissue and thus make the boundary between the normal liver and transplanted cancer more distinct, thus effectively improving the diagnosis effect of cancers.

Induction of GADD45α protects M17 neuroblastoma cells against MPP*.

Growth arrest and DNA-damage-inducible protein 45α (GADD45α) is an important member of the family of growth arrest and DNA damage-inducible (GADD) proteins. The expression patterns and possible roles of GADD45α in Parkinson's disease (PD) are so far less understood. In this study, we found that 1-methyl-4-phenylpyridinium (MPP+) treatment up-regulates the expression of GADD45α in both a time-dependent manner and a dose-dependent manner in human dopamine neuroblastoma M17 cells. The up-regulation of GADD45α was abolished by pretreatment with the c-Jun N-terminal kinases (JNK) inhibitor SP600125 but not the p38 specific inhibitor SB203580. Further study revealed that c-Jun silencing abolished the effects of MPP+ on the expression of GADD45α. Important, ChIP studies verified the ability of c-Jun to bind to the GADD45 promoter. In addition, we found that inhibition of GADD45α by small RNA interference exacerbates the impaired cell viability, LDH release, and apoptosis induced by MPP+. Correspondingly, silence of GADD45 exacerbated Caspase-3 activation induced by MPP+. These data suggested a neuroprotective effect of GADD45α against MPP+ neurotoxicity.

Comparison of the lung function change in patients with COPD and bronchial asthma before and after treatment with budesonide/formoterol.

OBJECTIVE: This study investigated the rapid onset of bronchodilation effect and compared lung function changes following budesonide/formoterol (Symbicort Turbuhaler®) inhalation in Chinese patients with moderate-severe chronic obstructive pulmonary disease (COPD) and bronchial asthma. METHODS: In this open-label, parallel-group clinical study, patients eligible for study were divided into COPD group (n=62, mean age 68.16±8.75 years) and asthma group (n=30, mean age 45.80±12.35 years). Lung function tests (include FEV1, FVC, FEV1/FVC, and IC) were performed at baseline (t=0 min time point, value before inhalation of budesonide/formoterol), and then eligible patients received two inhalations of budesonide/formoterol (160/4.5 µg). Lung function tests were reassessed at t=3, 10 and 30 min time point. The primary end-point was lung function change 3 min after drug inhalation, and the secondary end-points were comparison of the gas flow rate (ΔFEV1) and volume responses (ΔFVC, ΔIC) between COPD and asthma patients after inhalation of budesonide/formoterol. RESULTS: Compared with the baseline, all patients significantly improved their lung function (included FEV1, FVC, FEV1/FVC, and IC) at 3 min (P<0.05). Greater bronchodilation efficacy was found in the asthma group compared with the COPD group (P<0.05). In the asthmatic patients, the curves of FEV1, FVC, FEV1/FVC, IC, showed improvement with an ascending trend at all time points from 3 to 30 min. Whereas in the COPD patients, only the curves of FEV1, FVC, IC showed similar pattern. We found that ΔFVC was significantly higher than ΔFEV1 in both groups (P<0.05), but no significant difference between ΔIC and ΔFEV1 (P>0.05). Compared with COPD group, asthma group had higher level of ΔFEV1 and ΔIC (P<0.05), but no significant difference for ΔFVC can be found. CONCLUSIONS: Budesonide/formoterol has a fast onset of bronchodilation effect in patients with moderate-severe COPD and asthma. Greater efficacy was found in the asthma group compared with the COPD group. The gas flow rate and volume responses in patients with COPD differ from those with asthma after inhalation of Budesonide/formoterol.

Structure and function of OprD protein in Pseudomonas aeruginosa: from antibiotic resistance to novel therapies.

Pseudomonas aeruginosa (P. aeruginosa) is a common pathogen isolated from patients with nosocomial infections. Due to its intrinsic and acquired antimicrobial resistance, limited classes of antibiotics can be used for the treatment of infection with P. aeruginosa. Of these, the carbapenems are very important; however, the occurrence of carbapenem-resistant strains is gradually increasing over time. Deficiency of the outer membrane protein OprD confers P. aeruginosa a basal level of resistance to carbapenems, especially to imipenem. Functional studies have revealed that loops 2 and 3 in the OprD protein contain the entrance and/or binding sites for imipenem. Therefore, any mutation in loop 2 and/or loop 3 that causes conformational changes could result in carbapenem resistance. OprD is also a common channel for some amino acids and peptides, and competition with carbapenems through the channel may also occur. Furthermore, OprD is a highly regulated protein at transcriptional and post-transcriptional levels by some metals, small bioactive molecules, amino acids, and efflux pump regulators. Because of its hypermutability and highly regulated properties, OprD is thought to be the most prevalent mechanism for carbapenem resistance in P. aeruginosa. Developing new strategies to combat infection with carbapenem-resistant P. aeruginosa lacking OprD is an ongoing challenge.

Meta-analysis and systematic review of procalcitonin-guided therapy in respiratory tract infections.

Circulating procalcitonin (PCT) is a biomarker that can be used in diagnosing bacterial infections. We performed a quantitative meta-analysis of available randomized controlled trials to determine whether antibiotic therapy based on PCT measurements alters clinical outcomes and antibiotic use in patients with lower respiratory tract infections. We identified studies through MEDLINE (1996 to 2010), the ISI Web of Knowledge (1996 to 2010), and Ovid. Studies that met our criteria were prospective, randomized controlled trials involving patients with respiratory tract infections. Outcomes of mortality, intensive care unit (ICU) admission, length of hospital stay, number of antibiotic prescriptions, and duration of antibiotic treatment were evaluated. Eight studies randomizing 3,431 patients met our criteria for inclusion. Pooled analysis showed a significant reduction in number of antibiotic prescriptions and duration of antibiotic use in patients with PCT-guided antibiotic treatment compared to standard therapy. In addition, the use of PCT-guided antibiotic therapy did not impact mortality, ICU admission, or length of hospital stay in these studies. A high degree of heterogeneity was identified in 3 of 5 outcomes that were evaluated, and sensitivity analysis indicated that heterogeneity was decreased among studies using the same PCT-based treatment algorithm. In conclusion, PCT-guided antibiotic therapy in patients with respiratory tract infections appears to reduce antibiotic use without affecting overall mortality or length of stay in the hospital.

Frequency of pleural effusions in patients with pulmonary arterial hypertension associated with connective tissue diseases.

BACKGROUND: Pleural effusions frequently accumulate in patients with left-sided heart failure. However, our recent study in patients with idiopathic and heritable pulmonary arterial hypertension (PAH) demonstrated that pleural effusions frequently occur in patients with isolated right-sided heart failure (RHF). The objective of this study was to determine the frequency of pleural effusions in patients with PAH associated with connective tissue disease (CTD). METHODS: We retrospectively studied consecutive patients with PAH associated with CTD who were treated in the Vanderbilt Pulmonary Vascular Center. Pleural effusions were identified by chest radiograph, chest CT scan, thoracic ultrasonography, or autopsy. RESULTS: Thirty-five of 89 patients (39.3%) with PAH associated with CTD had pleural effusions: 23 of 51 (45.1%) with scleroderma, six of 16 (37.5%) with systemic lupus erythematosus, five of 18 (27.8%) with mixed connective tissue disease, and one of two (50.0%) with Sjögren syndrome. There were alternative explanations for the pleural effusions in six of these patients. Of the 29 patients without alternative explanation for their pleural effusions, 28 had RHF. When compared with the patients without pleural effusions, the 29 patients with pleural effusions had significantly higher mean right atrial pressures (11.3 ± 5.1 mm Hg vs 8.3 ± 4.0 mm Hg, P = .004) and lower cardiac indices (2.1 ± 0.6 L/min/m(2) vs 2.5 ± 0.7 L/min/m(2), P = .011). The pleural effusions were predominantly trace to small (58.6%) in size and bilateral (51.7%) in distribution. CONCLUSIONS: Pleural effusions frequently accumulate in patients with PAH associated with CTD and are associated with RHF.

[Effect of catgut implantation at acupoint on gonadal hormone and beta-endorphin in patients of climacteric syndrome].

OBJECTIVE: To explore the clinical therapeutic effect of catgut implantation at acupoint on climacteric syndrome (CS) and its mechanism. METHODS: Sixty cases were randomly divided into a catgut implantation group and a western medicine group, 30 cases in each group. The catgut implantation group was treated by catgut implantation at Shenshu (BL 23), Zigong (EX-CA 1), Sanyinjiao (SP 6). The western medicine group was treated by oral administration of Diethylstilbestrol tablet. Their therapeutic effects and changes of content of follicle-stimulating hormone (FSH), luteotrophic hormone (LH), estradiol (E2) and beta-endorphin (beta-EP) in serum were observed. RESULTS: The total effective rate was 93.3% in the catgut implantation group and 70.0% in the western medicine group with a significant difference between the two groups (P < 0.05). After treatment, the beta-EP concentration in the catgutation implant group was significantly increased (P < 0.05), the FSH concentration was significantly reduced and E2 concentration was significantly increased as compared with those in the western medicine group (P < 0.05, P < 0.01). CONCLUSION: Catgut implantation at acupoint has an obvious therapeutic effects on CS. It can significantly improve the ovaries function and has a favorable regulative action on the endogenous opioid peptides.

[The effects and therapeutic duration of oral corticosteroids in patients with acute exacerbation of chronic obstructive pulmonary diseases].

OBJECTIVE: To observe the clinical efficacy and therapeutic duration of oral corticosteroids in patients with acute exacerbations of chronic obstructive pulmonary diseases (AECOPD). METHODS: A randomized, double-blinded, placebo-controlled clinical study was designed. One hundred and thirty hospitalized patients with AECOPD were randomly divided into three groups: group 1 (n = 44) received 30 mg/d of prednisone for 7 days and then placebo for another 7 days; group 2 (n = 43) received 30 mg/d of prednisone for 10 days, then tapered to 15 mg/d for 4 days; group 3 (n = 43) received placebo for 14 days. The lung functions, arterial blood gas, length of stay, symptom scores, failure rate of treatment, side-effect of corticosteroids and the rate of relapse were evaluated before and after treatments. The results were analyzed by statistical package for social science (SPSS version 11.0). Measurement data were expressed by (-x) +/- s, and t test was used for the comparison of the data before and after treatments. Chi-square test was used for the comparison of count data. Analysis of variance was applied to test for differences between the three groups. Multiple comparison was analyzed by SNK test. Fisher exact test was used for the comparison of the failure rate of treatment, the rate of relapse and safety evaluation. RESULTS: Compared with the placebo group [group 3, (0.74 +/- 0.32)L], the FEV(1) in [group 1 (0.87 +/- 0.23) L and in group 2 (0.93 +/- 0.30) L] were significantly increased (F = 4.53, P < 0.05). The PaO(2) in group 1 (79 +/- 9) mm Hg (1 mm Hg = 0.133 kPa) and in group 2 (80 +/- 10) mm Hg were also increased significantly [group 3 was (73 +/- 12) mm Hg] (F = 3.98, P < 0.05). The length of stay (LOS) in group 1 (12.5 +/- 3.5) d and in group 2 (12.4 +/- 4.1) d were shortened [group 3 was (13.5 +/- 3.6) d] (F = 3.82, P < 0.05). However, no difference of FEV(1), PaO(2) and LOS was found between 7-day and 14-day durations of corticosteroids therapy. There were no differences in symptom scores, failure rate of treatment, side-effect of corticosteroids and the rate of relapse among the 3 groups. CONCLUSIONS: Oral prednisone results in improvement of FEV(1), PaO(2) and LOS in hospitalized patients with AECOPD. A 7-day or 14-day duration of oral prednisone is of the same clinical efficacy. From these results, we recommend that 30 mg/d of prednisone for a 7-day duration is appropriate for the treatment of AECOPD.

[Event-related potentials of emotional excitement in middle-aged and aged adults].

OBJECTIVE: To explore how adjustment of the negative and neutral emotion excitement contribute to the well-being of middle-aged and aged adults in their health, intelligence, working and living. METHODS: Twenty-five middle-aged and aged participants performed recognition tasks of schematic facial representations of positive, neutral and negative emotions and also Chinese characters (equivalent to happy, thinking and fear). RESULTS: The main effects of the facial recognition task occurred in the left temporal-parietal area (40 to 80 ms), bilateral parietal-occipital and temporal-parietal area (160-180 ms and 310-340 ms). The effects of stimulation with the 3 Chinese characters were found in the anterior region (375-475 ms), posterior region (195-255 ms), and whole scalp region (135-175 ms and 275-355 ms). There were no significant interactive effects between schematic facial recognition and stimulation with Chinese characters. CONCLUSION: Positive emotional excitement may promote the well-being of the adults in their health, intelligence, working performance and living.

[Pathological analysis of heroin spongiform leukoencephalopathy].

OBJECTIVE: To investigate the pathological characteristics of heroin spongiform leukoencephalopathy (HSLE). METHODS: Cerebral tissue specimens were obtained from 15 patients with HSLE and the histological observations under optical and electron microscopes were carried out by HE, Bielschowsky's, and chromotrope 2R-brilliant green staining. RESULTS: HSLE was characterized primarily by spongiform vacuolar degeneration of the cerebral white matter. Neurons in the gray matter, Purkinje and granular cells in the cerebella remain intact in all the cases. Numerous vacuoles, which merged to form larger cavities, appeared in the damaged white matter, and the axons survived in the deep white matter. The myelin sheath in the cerebellar white matter sustained more severe damages than those in the cerebral white matter. No vacuoles or lymphocyte infiltration occurred in the small peripheral vessels. CONCLUSION: HSLE is pathologically characterized by vacuolar degeneration due to primary damage of the myelin, and the spongiform vacuolar degeneration is closely associated with the severity of demyelination in the white matter.

Event-related potential of facial expression processing.

OBJECTIVE: To investigate spatial and temporal patterns of event-related potentials (ERP) evoked by facial expression. METHODS: ERP was recorded in 25 healthy subjects while they performed facial recognition task. Repeated-measure one-way ANOVA was adopted to compare the subjects' responses to stimulation by 3 different expressions (positive, neutral and negative) with statistical parametric mapping (SPM). RESULTS: Significant facial expression effects occurred separately in the left parietal and bilateral occipital regions (280-340 ms), left frontal region (400-420 ms), and right prefrontal region (480-500 ms). In 4 time periods, significant difference was observed between positive and neutral emotion wave in the right frontoparietotemporal and left prefrontal regions (60-80 ms), right occipital region (120-140 ms), left occipital region (280-320 ms), and left frontoparietal region (400-440 ms). Significant difference between negative and neutral emotion waves was observed in 5 time periods in the right occipital region (120-140 ms), central frontoparietal region (220-240 ms), central parietal region (280-300 ms), left parietal and right temporopartial regions (320-340 ms) and frontopartial occipitotemporal region (480-500 ms). CONCLUSIONS: The spatiotemporal patterns of ERP suggest that the information processing of facial expression involves extensive brain regions dynamically.

[Glucocortioid treatment for heroin-induced spongiform leucoencephalopathy: a clinical controlled study].

OBJECTIVE: To evaluate the therapeutic effects of the glucocorticoid on heroin-induced spongiform leucoencephalopathy. METHODS: Twenty cases of heroin-induced spongiform leucoencephalopathy were randomly divided into the control group and the treating group with equal number. In the control group, the treatment was constituted by oral administration of vitamin B and coenzyme Q10 in a course of 1 month. In glucocorticoid treatment group, glucocorticoid (20 mg/d) for 10 d were given in addition to vitamin B and coenzyme Q10, and the dose of the glucocorticoid was gradually decreased afterwards. General observation and statistical analysis of function scores were performed in both groups before and 1, 6, 12 months after the treatment respectively. RESULTS: No significant difference in function scores was observed between the 2 groups, while the results of observation before and after the treatment were significantly different (P<0.05). The most significant difference occurred when comparing the observations made 1 month and 6 months respectively after treatment (P<0.001). CONCLUSION: Glucocorticoid has no obvious therapeutic effect on heroin-induced spongiform leucoencephalopathy, and rapid clinical recovery occurs within the initial 6 months of the treatment.