Therapeutic drug monitoring of linezolid and exploring optimal regimens and a toxicity-related nomogram in elderly patients: a multicentre, prospective, non-interventional study.

BACKGROUND: The concentrations of linezolid, its optimal regimen and the associated side effects in elderly patients remain unclear. METHODS: In this multicentre, prospective study, elderly patients receiving linezolid at four tertiary hospitals in Beijing between May 2021 and December 2022 were included. Linezolid concentrations and haematological toxicity were monitored dynamically. Risk factors for linezolid overexposure and moderate-to-severe linezolid-induced thrombocytopenia (M/S LIT) were analysed, and a predictive model of M/S LIT was developed. RESULTS: A total of 860 linezolid concentrations were measured in 313 patients. The median trough concentrations of linezolid were 24.4 (15.3, 35.8) mg/L at 36-72 h and 26.1 (17.0, 38.1) mg/L at 5-10 days (P = 0.132). Severe linezolid exposure was independently associated with age, estimated glomerular filtration rate (eGFR) and the worst SOFA score (SOFA1), and we further recommended dose regimens for elderly patients based on these findings. The incidences of linezolid-induced thrombocytopenia(LIT) and M/S LIT were 73.5% and 47.6%, respectively. M/S LIT was independently correlated with treatment duration, average trough concentration (TDMa), baseline platelet count, eGFR and baseline SOFA score (SOFA0). The developed nomogram predicted M/S LIT with an area under the curve of 0.767 (95% CI 0.715-0.820), a sensitivity of 71.1% and a specificity of 73.2%. CONCLUSIONS: Linezolid trough concentrations increased dramatically in the elderly, by about 10 mg/L in patients aged 65-80 years, followed by a further increase of 10 mg/L for every 10 years of age. Therapeutic drug monitoring is recommended in elderly patients receiving linezolid. The developed nomogram may predict M/S LIT and guide dosage adjustments of linezolid. Clinical trial registration number: ChiCTR2100045707.

Necessity for higher teicoplanin doses in older adults: a multicenter prospective observational study in China.

BACKGROUND: Many older adult patients receive low-dose teicoplanin with varied regimens, leading to a lack of clarity on its optimal regimens and toxicity profiles in China. This study aimed to clarify these aspects by analyzing teicoplanin treatment concentrations and toxicities. METHODS: We included older adult patients administered teicoplanin at four tertiary hospitals in Beijing from June 2021 to July 2023, targeting a trough concentration (Cmin) ≥ 10 mg/L. Teicoplanin concentrations and toxicities were monitored dynamically. RESULTS: From 204 patients, we obtained 632 teicoplanin concentrations. Most patients (83.3%) received low-dose regimens. Suboptimal concentrations were found in 66.4% of patients within 7 days of treatment and 17.0% after 15 days. Cmin gradually increased with treatment duration and was influenced initially by creatinine and by both body weight and creatinine from days 8 to 14. The target concentration was achieved in 53.1%, 33.9%, 15.6%, and 5.5% of patients at 3, ≤ 7, 8-14, and ≥ 15 days after withdrawal, respectively. Slow elimination was associated with average Cmin and eGFR. Nephrotoxicity, hepatotoxicity, and thrombocytopenia occurred in 12.5%, 4.1%, and 31.5% of patients, respectively, without significant differences between concentrations. CONCLUSIONS: Most older adult patients were underdosed, indicating a need for dose adjustment. Given the varied risk factors for suboptimal concentrations in different treatment stages, a one-size-fits-all regimen was ineffective. We recommend an initial dose of 400 mg at 12-h intervals for the first three days, with subsequent doses from days 4 to 14 adjusted based on creatinine and body weight; after day 14, a maintenance dose of 200 mg daily is advised. TRIAL REGISTRATION: ChiCTR2100046811; 28/05/2021.

Antimicrobial resistance and related risk factors of carbapenem-resistant Klebsiella pneumoniae isolated from blood / 中国感染控制杂志

Objective To explore the antimicrobial resistance of carbapenem-resistant Klebsiella pneumoniae(CRKP)isolated from blood and the related risk factors for infection in patients.Methods Clinical data of 383 KP-infected patients from whose blood Klebsiella pneumoniae(KP)were isolated during hospitalization period in a hos-pital from January 2018 to December 2021 were retrospectively analyzed.Patients were divided into CRKP group(n=114)and non-CRKP group(n=269)based on antimicrobial resistance.According to the prognosis,114 patients in the CRKP group were subdivided into the death group(n=30)and the survival group(n=84).General informa-tion,underlying diseases,antimicrobial use,and infection outcomes of two groups of patients were compared,and risk factors for infection and death after infection were analyzed.Results The resistance rates of KP to tigecycline and compound sulfamethoxazole showed upward trends,with statistically significant differences(both P=0.008).The CRKP group had higher resistance rates to amikacin,aztreonam,compound sulfamethoxazole,ciprofloxacin,cefepime,cefoperazone/sulbactam,piperacillin/tazobactam,tigecycline,ceftazidime,tobramycin,and levofloxacin,as well as higher in-hospital mortality than the non-CRKP group,with statistically significant differences(all P＜0.05).Acute pancreatitis prior to infection(OR=16.564,P＜0.001),hypoalbuminemia(OR=8.588,P＜0.001),stay in in-tensive care unit prior to infection(OR=2.733,P=0.017),blood transfusion(OR=3.968,P=0.001),broncho-scopy(OR=5.194,P=0.014),surgery within 30 days prior to infection(OR=2.603,P=0.010),and treatment with carbapenems(OR=2.663,P=0.011)were independent risk factors for the development of CRKP blood-stream infection(BSI).Cardiac insufficiency before infection(OR=11.094,P=0.001),combined with pulmonary infection(OR=20.801,P=0.010),septic shock(OR=9.783,P=0.002),disturbance of consciousness(OR=11.648,P=0.001),and receiving glucocorticoid treatment(OR=5.333,P=0.018)were independent risk factors for mortality in patients with CRKP BSI.Conclusion The resistance rate of KP from BSI to tigecycline and com-pound sulfamethoxazole presents upward trend.Underlying diseases,invasive procedures,and carbapenem treat-ment are closely related to CRKP BSI.Cardiac insufficiency,pulmonary infection,septic shock,disturbance of con-sciousness,and glucocorticoid treatment can lead to death of patients with CRKP BSI.

Quality evaluation of Huanglian Shangqing tablets(pills and granules)based on GC characteristic chromatogram of volatile oil / 中国药师

Objective To establish the GC characteristic choromatogram of Huanglian Shangqing tablets(pills and granules),and to investigate the quality of the medicinal materials(Weeping Forsythia,Mentha Hyplocalyx and Herba Schizonepetae)containing volatile oil in Huanglian Shangqing tablets(pills and granules).Methods Agilient HP-5 capillary column(30 m×0.32 mm,0.25 μm)was used with temperature programming,the split ratio was 5∶1,the split flow was 5 mL·min-1,the injection volume was 1 μL,and the inlet temperature was 250℃.A hydrogen flame ionization detector was used,with the detector temperature of 260℃,and the column flow was 1 mL·min-1.The quality of samples from different manufacturers was evaluated by using the GC characteristic choromatogram of volatile oil and the identification of characteristic peaks,combined with similarity analysis and principal component analysis.Results The characteristic chromatograms of 192 batches of samples from 56 manufacturers were established.The peaks of Weeping Forsythia,Mentha Hyplocalyx and Herba Schizonepetae were identified as α-pinene and β-pinene,menthol and menthone,and pulegone respectively.The GC choromatogram of volatile oil components in Huanglian Shangqing tablets(pills)from different manufacturers were quite different,and some peaks of indicator components in the products from a few manufacturers have missing.Conclusion The established GC characteristic chromatograms can reflect the product quality status and can be used for the quality evaluation and product quality control of Huanglian Shangqing tablets(pills and capsules).Huanglian Shangqing tablets(pills and capsules)from some manufacturers are insufficient in the active ingredients of volatile oil,therefore,the product quality needs to be improved.

Impact of acute pancreatitis during pregnancy in Chinese women: a meta-analysis.

A random-effects meta-analysis was performed in English and Chinese databases since its inception to August 2020 to assess the incidence, causes and severity of acute pancreatitis (AP) at various stages of pregnancy, maternal and foetal mortality. A total of 154 articles representing 4034 patients with AP during pregnancy in China were included for the analysis. The incidence of AP during pregnancy was 0.0469 (95% confidence interval [CI], 0.0349; 0.0627) in the first trimester, whereas it was 0.2518 (95% CI, 0.2210; 0.2854) and 0.6323 (95% CI, 0.5870; 0.6753) in the second and third trimester, respectively. The major causes of AP were hypertriglyceridaemia (0.351 [95% CI, 0.3202; 0.3834]) and biliary pancreatitis (0.424 [95% CI, 0.4094; 0.5002]). The severity of AP was mild in majority of the patients. The incidence of AP at maternal mortality was 0.0184 (95% CI, 0.0126; 0.0269) and foetal mortality was 0.1018 (95% CI, 0.0867; 0.1192). Our meta-analysis revealed that hypertriglyceridaemia and biliary pancreatitis remain the major causes of AP during pregnancy. Foetal mortality requires further investigation. IMPACT STATEMENTWhat is already known on this subject? Acute pancreatitis (AP) in pregnant women is characterised by acute onset and delay in understanding the interaction of the metabolic changes with pancreatic pathophysiology, and thus becomes difficult to diagnose the disease and provide timely treatment to the patients. This poses a greater health risk among women and their foetus by increasing their chances of mortality.What the results of this study add? We performed an exhaustive, random-effects meta-analysis involving 154 articles representing 4034 patients to assess the incidence of AP at various stages of pregnancy, the causes of AP and the severity of AP during pregnancy, maternal and foetal mortality.What are the implications of these findings for clinical practice and/or further research? Our meta-analysis revealed that hypertriglyceridaemia and biliary pancreatitis remain the major causes of AP during pregnancy. Although the rates of maternal mortality have decreased in the recent years, foetal mortality still remains high and requires further investigation.

Acute Pancreatitis in Pregnancy: A Ten-Year Noninterventional, Retrospective Cohort Experience.

Background: The study is aimed at evaluating the clinical attributes, types, and risk factors associated with poor outcomes in women with acute pancreatitis (AP) during pregnancy. Methods: From 2011 to 2020, 45 antenatal mothers with AP were included in this noninterventional, retrospective study. The correlation between etiology of AP, its severity, biochemical parameters, length of stay, and treatment was analyzed. Based on the presence of organ failure and systemic complications, the severity of AP was classified according to the revised Atlantic criteria. Results: In total, 19 (42.2%), 15 (33.3%), and 11 (24.2%) patients had mild AP (MAP), moderately severe AP (MSAP), and severe AP (SAP), respectively. The major cause of AP in these patients was hypertriglyceridemia (26.6%), while only 2 (4.44%) suffered from biliary pancreatitis. The median length of stay at hospital was significantly longer in patients with SAP (P = 0.034), and these patients had significantly higher triglycerides and total cholesterol levels when compared to MAP and MSAP. It was observed that levels of liver function enzymes such as alanine aminotransferase serum levels and aspartate aminotransferase serum levels were significantly higher in patients who stayed in hospital for >13 days. The presence of hypertriglyceridemia significantly increased the duration of stay (>13 days, P = 0.04) and induced SAP (P = 0.001). Majority of patients with SAP received blood purification than those with MAP and MSAP (P < 0.001). Conclusion: Hypertriglyceridemia was associated with AP during pregnancy in our study. Early diagnosis of AP and assessment of its severity are very important for the general management of this disease.

Observation of the efficacy and safety of the Song-Relaxing and Zhen-Vibrating abdomen manipulation for patients with prediabetes / 针灸推拿医学（英文版）

Objective: To observe the safety of the Song-Relaxing and Zhen-Vibrating abdomen manipulation in treating patients with prediabetes and its effects on blood glucose and lipid metabolism.Methods: One hundred and two patients with prediabetes were divided into a manipulation group and a control group according to the random number table method, with 51 cases in each group. All patients received the general behavioral intervention for prediabetes, with additional Song-Relaxing and Zhen-Vibrating abdomen manipulation in the manipulation group and oral metformin hydrochloride tablets in the control group. Both groups received the intervention for six months. Results: Fourteen patients dropped out during the treatment, and a total of 88 patients completed the trial, including 45 cases in the manipulation group and 43 cases in the control group. After the treatment, the prediabetes control rate was 93.3％ in the manipulation group and 74.4％ in the control group, and the difference between the two groups was statistically significant (P<0.05); no patient in the manipulation group progressed to diabetes, while the rate of conversion to diabetes in the control group was 6.9％, with a significant difference between the two groups (P<0.05). After the treatment, the body mass index (BMI), glycosylated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), 2-hour postload plasma glucose (2hPG) level during an oral glucose tolerance test (OGTT), fasting insulin (FINS), homeostasis model assessment-2 of insulin resistance (HOMA2-IR), total cholesterol (TC), and triglycerides (TG) decreased in both groups versus baseline, with significant differences within the groups; the levels of all indicators were lower in the manipulation group than in the control group (P<0.05), and the differences between the two groups were more prominent at the sixth month (P<0.01). At the sixth month, the high-density lipoprotein cholesterol (HDL-C) in the manipulation group was increased, while there was no significant change in the control group. In the control group, three patients reported mild gastrointestinal reactions at the initial dosing, which improved after medication adjustment. No other adverse events were observed in either group. Conclusion: Both metformin hydrochloride tablets and the Song-Relaxing and Zhen-Vibrating abdomen manipulation can improve blood glucose and lipid metabolism and reduce insulin resistance and clinical discomfort in patients with prediabetes, but the Song-Relaxing and Zhen-Vibrating abdomen manipulation has higher efficacy and safety.

Analysis on the current situation of hospice care service in a district of Beijing / 中华医院管理杂志

Objective:To analyze the terminal survey data of hospice care services in a district of Beijing in 2020, and discuss its current situation and existing problems of hospice care services in this district for countermeasures, hence providing reference for the development of hospice care services.Methods:Data were collected from the " Terminal Survey Forms of the Second Batch of Hospice Care Pilot Areas in China in 2020" , which were reported by 4 tertiary hospitals and 5 community health service centers in a district of Beijing. The reporting timeframe ranged from January to December 2020. Text analysis method was used to analyze the hospice care mode, relevant security policies, hospice care team, case diagnosis categories, average hospitalization days and patient cost burden. All the data were subject to descriptive analysis.Results:In 2020, only 4 tertiary hospitals carried out outpatient, consultation and inpatient services of hospice care among the 9 medical institutions in a certain district of Beijing, and none of them carried out home hospice care services. The number of doctors and nurses engaged in hospice care in the four hospitals was 35 and 40 respectively; There were 267 inpatient cases of hospice care, including 121 cases of malignant tumors, accounting for 45.32%; The average hospitalization days of hospice patients (40.0 days) was more than that of the hospital (7.8 days); The average daily hospitalization cost of hospice patients (3 428.7 yuan) was lower than that of the hospital (3 605.6 yuan); Hospice care services had not been included in the scope of medical insurance payment, and the relevant security policies were not perfect.Conclusions:The work of hospice care service in a district of Beijing remains at an initial stage, and the professional team building and supporting policies for hospice care fail to catch up with the demand in this district. The authors suggest to speed up the development of hospice care in primary medical institutions, build a network of " hospital -community-family" levels, enhance training of professionals and technical personnel of hospice care, as well as establish and improve the medical security system, so as to promote the rapid development of hospice care services in this district.

Risk factors and prognosis analysis of carbapenem-resistant Klebsiella pneumoniae infection for inpatients in hepatobiliary surgery / 中华肝胆外科杂志

Objective:To explore the risk factors and prognosis of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection for inpatients in hepatobiliary surgery. Methods:The clinical data of patients with Klebsiella pneumoniae infection admitted to the Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital from January 2016 to December 2020 were retrospectively analyzed. For each patient with CRKP infection, two patients with non-carbapenem-resistant Klebsiella pneumoniae (non-CRKP) infection were selected for matching. A total of 720 patients with Klebsiella pneumoniae infection were involved, including 444 males and 276 females, aged (58.0±11.6) years old. According to the infection conditions, they were divided into two groups: CRKP group ( n=240) and non-CRKP group ( n=480). The 240 CRKP patients were divided into two subgroups according to their prognosis: death group ( n=34) and survival group ( n=206). The general information, laboratory test results, antibiotic use and infection outcomes of patients were recorded to analyze the risk factors of infection and death after infection. Results:Acute pancreatitis ( OR=3.473, 95% CI: 1.844-6.541), chronic cardiovascular disease before infection ( OR=2.028, 95% CI: 1.228-3.347), chronic renal failure ( OR=1.873, 95% CI: 1.142-3.073), hypoalbuminemia ( OR=3.060, 95% CI: 1.869-5.010), use of carbapenems ( OR=3.882, 95% CI: 2.518-5.985), admission to intensive care unit ( OR=1.783, 95% CI: 1.034-3.075) and surgery within 30 days before infection ( OR=13.463, 95% CI: 7.482-24.223) were independent risk factors for CRKP infection inpatients in hepatobiliary surgery(all P<0.05). Chronic respiratory disease before infection ( OR=3.784, 95% CI: 1.420-10.089), mechanical ventilation ( OR=5.085, 95% CI: 1.436-18.011), disturbance of consciousness ( OR=40.710, 95% CI: 3.564-464.943), hormone therapy ( OR=14.977, 95% CI: 3.819-58.743) and treatment of quinolone antibiotics ( OR=4.102, 95% CI: 1.226-13.726) were independent risk factors for death of inpatients with CRKP infection in hepatobiliary surgery (all P<0.05). The resistance of amikacin, tobramycin, ceftazidime, cefepime, aztreonam, ciprofloxacin, levofloxacin, co-sulfamethoxazole and piperacillin/tazobactamand in CRKP group were significantly different compared with non-CRKP group (all P<0.05). Conclusion:The occurrence of CRKP infection for inpatients in hepatobiliary surgery is related to various factors such as underlying diseases, antibiotic use and self-barrier destruction, and these factors affect the infection outcome of patients.

Surgical management for lumbar brucella spondylitis: Posterior versus anterior approaches.

ABSTRACT: There has been no ideal surgical approach for lumbar brucella spondylitis (LBS). This study aims to compare clinical efficacy and safety of posterior versus anterior approaches for the treatment of LBS.From April 2005 to January 2015, a total of 27 adult patients with lumbar brucella spondylitis were recruited in this study. The patients were divided into 2 groups according to surgical approaches. Thirteen cases in group A underwent 1-stage anterior debridement, fusion, and fixation, and 14 cases in group B underwent posterior debridement, bone graft, and fixation. The clinical and surgical outcomes were compared in terms of operative time, intraoperative blood loss, hospitalizations, bony fusion time, complications, visual analog scale score, recovery of neurological function, deformity correction.Lumbar brucella spondylitis was cured, and the grafted bones were fused within 11 months in all cases. It was obviously that the operative time and intraoperative blood loss of group A were more than those of group B (P = .045, P = .009, respectively). Kyphotic deformity was signifcantly corrected in both groups after surgery; however, the correction rate was higher in group B than in group A (P = .043). There were no significant differences between the two groups in hospitalizations, bony fusion time, and visual analog scale score in the last follow-up (P = .055, P = .364, P = .125, respectively).Our results suggested that both anterior and posterior approaches can effectively cure lumbar brucella spondylitis. Nevertheless, posterior approach gives better kyphotic deformity correction, less surgical invasiveness, and less complications.

Brain connectivity markers for the identification of effective contacts in subthalamic nucleus deep brain stimulation.

The clinical benefit of deep brain stimulation (DBS) for Parkinson's disease (PD) is relevant to the tracts adjacent to the stimulation site, but it remains unclear what connectivity pattern is associated with effective DBS. The aim of this study was to identify clinically effective electrode contacts on the basis of brain connectivity markers derived from diffusion tensor tractography. We reviewed 77 PD patients who underwent bilateral subthalamic nucleus DBS surgery. The patients were assigned into the training (n = 58) and validation (n = 19) groups. According to the therapeutic window size, all contacts were classified into effective and ineffective groups. The whole-brain connectivity of each contact's volume of tissue activated was estimated using tractography with preoperative diffusion tensor data. Extracted connectivity features were put into an all-relevant feature selection procedure within cross-validation loops, to identify features with significant discriminative power for contact classification. A total of 616 contacts on 154 DBS leads were discriminated, with 388 and 228 contacts being classified as effective and ineffective ones, respectively. After the feature selection, the connectivity of contacts with the thalamus, pallidum, hippocampus, primary motor area, supplementary motor area and superior frontal gyrus was identified to significantly contribute to contact classification. Based on these relevant features, the random forest model constructed from the training group achieved an accuracy of 84.9% in the validation group, to discriminate effective contacts from the ineffective. Our findings advanced the understanding of the specific brain connectivity patterns associated with clinical effective electrode contacts, which potentially guided postoperative DBS programming.

Functional connectivity markers of depression in advanced Parkinson's disease.

BACKGROUND: Depression is a common comorbid condition in Parkinson's disease and a major contributor to poor quality of life. Despite this, depression in PD is under-diagnosed due to overlapping symptoms and difficulties in the assessment of depression in cognitively impaired old patients. OBJECTIVES: This study is to explore functional connectivity markers of depression in PD patients using resting-state fMRI and help diagnose whether patients have depression or not. METHODS: We reviewed 156 advanced PD patients (duration > 5 years; 59 depressed ones) and 45 healthy control subjects who underwent a resting-state fMRI scanning. Functional connectivity analysis was employed to characterize intrinsic connectivity networks using group independent component analysis and extract connectivity features. Features were put into an all-relevant feature selection procedure within cross-validation loops, to identify features with significant discriminative power for classification. Random forest classifiers were built for depression diagnosis, on the basis of identified features. RESULTS: 42 intrinsic connectivity networks were identified and arranged into subcortical, auditory, somatomotor, visual, cognitive control, default-mode and cerebellar networks. Six features were significantly relevant to classification. They were connectivity within posterior cingulate cortex, within insula, between posterior cingulate cortex and insula/hippocampus+amygdala, between insula and precuneus, and between superior parietal lobule and medial prefrontal cortex. The mean accuracy achieved with classifiers to discriminate depressed patients from the non-depressed was 82.4%. CONCLUSIONS: Our findings provide preliminary evidence that resting-state functional connectivity can characterize depressed PD patients and help distinguish them from non-depressed ones.

Research progress of coagulation dysfunction in coronavirus disease 2019 / 中华危重病急救医学

The coronavirus disease 2019 (COVID-19) has outbroken globally. As an acute infectious disease, COVID-19 has significant impacts on multiple organs and systems throughout the body. Among patients with COVID-19, especially severe and critical cases, a variety of potential risk factors for coagulation dysfunction exist. Furthermore, the coagulation dysfunction of COVID-19 patients was mainly characterized by elevated D-dimer levels. The coagulation dysfunction could directly affect the prognosis of COVID-19 patients and is a major cause of death in patients with severe COVID-19. In this article, the literatures on the basic clinical manifestations, clinical risk factor, mechanism of coagulation dysfunction and evaluation of coagulation function in COVID-19 were reviewed.

Multiparametric and multiregional diffusion features help predict molecule information, grade and survival in lower-grade gliomas: a feasibility study.

OBJECTIVE: This study was to investigate the relationship of diffusion features with molecule information, and then predict grade and survival in lower-grade gliomas. METHODS: 65 patients with primary lower-grade gliomas (WHO Grade II & III) who underwent conventional MRI and diffusion tensor imaging were retrospectively studied. The tumor region was automatically segmented into contrast-enhancing tumor, non-enhancing tumor, edematous and necrotic volumes. Diffusion features, including fractional anisotropy (FA), axial diffusivity, radial diffusivity and apparent diffusion coefficient (ADC), were extracted from each volume using histogram analysis. To estimate molecule biomarkers and predict clinical characteristics of grade and survival, support vector machine, generalized linear model, logistic regression and Cox regression were performed on the related features. RESULTS: The diffusion features in non-enhancing tumor volume showed differences between isocitrate dehydrogenase mutant and wild-type gliomas. And the mean accuracy of support vector machine classifiers was 0.79. Ki-67 labeling index was correlated with these features, which were combined to significantly estimate Ki-67 expression level (r = 0.657, p < 0.001). These features also showed differences between Grade II and III gliomas. A combination of them for grade classification resulted in an area under the curve of 0.914 (0.857-0.971). Mean FA and fifth percentile of ADC were independently associated with overall survival, with lower FA and higher ADC showing better survival outcome. CONCLUSION: In lower-grade gliomas, multiparametric and multiregional diffusion features could help predict molecule information, histological grade and survival. ADVANCES IN KNOWLEDGE: The multi parametric diffusion features in non-enhancing tumor were associated with molecule information, grade and survival in lower-grade gliomas.

Long-term efficacy and safety of electroacupuncture on improving MMSE in patients with Alzheimer's disease / 中国针灸

OBJECTIVE@#To observe the efficacy and safety of electroacupuncture (EA) on improving mini-mental state examination (MMSE) in patients with Alzheimer's disease (AD), and to evaluate the efficacy during follow-up visit.@*METHODS@#Forty patients were randomly divided into a treatment group and a control group, 20 patients in each one (3 patients dropped off in the treatment group and 4 patients in the control group). The patients in the treatment group were treated with acupuncture at Baihui (GV 20), Fengfu (GV 16), Shenting (GV 24), Taiyang (EX-HN 5), Shangyintang (Extra 3) and Dazhong (KI 14); besides, EA was applied at Taiyang (EX-HN 5), Baihui (GV 20) and Shenting (GV 24) with dilatational wave, 10 Hz/50 Hz in frequency, 0.5 to 5.0 mA in intensity, once every two days, three treatments per week. The patients in the control group were treated with oral administration of donepezil hydrochloride tablets, once a day, taken before sleep. The treatment was given for 12 weeks in the two groups. The MMSE was evaluated before treatment, 12 weeks±3 days into treatment, and 24 weeks±7 days after treatment, respectively.@*RESULTS@#The difference of total score of MMSE before and 12 weeks±3 days into treatment was not significant between the two groups (>0.05); the total score of MMSE after treatment was higher than that before treatment (both <0.05); compared before treatment, the short-term memory score was increased in the treatment group (<0.05), and the increasing range was superior to that in the control group (<0.05). Compared before treatment, the total score of MMSE in the two groups were reduced 24 weeks ±7 days after treatment (both <0.05), and the reduction in the treatment group was less than that in the control group (<0.05); the differences of short-term memory score before and after treatment was significant between the two groups (<0.05). No adverse reaction occurred in the two groups.@*CONCLUSION@#The effect of EA on improving MMSE in patients with AD is similar to donepezil supported by evidence-based medicine. The effect of EA may have a certain continuous effect, and may have advantages in instantaneous memory. In addition, the EA is safe.

The Wuhan Twin Birth Cohort Study / 中华流行病学杂志

The prevalence of child and adolescent growth and mental-behavior related diseases are increasing, and the pathogenesis are complex. Twins are excellent natural resources for complex chronic diseases research as they share the maternal intrauterine environment, born at the same time and share the same family environment in early years, which could benefit the adjust ment of confounding factors, such as age, genetic factors and early family environmental factors. Birth cohort with twin families involved could be more effective in exploring the genetic and environmental factors for complex chronic diseases at the very beginning of life. This paper summarizes the objective, content, progress, strengths and potential problems of Wuhan Twin Birth Cohort, with emphasis on the overall design and progress of the study.

Analysis of the changes of blood immune indicators in 291 cases of voluntary blood donors / 国际检验医学杂志

Objective To investigate the changes of lymphocyte subsets of 291 blood donors after dona-tion.Methods 291 cases of voluntary blood donors were enrolled in the study from January 2016 to December 2016.Before and 30 d after blood donation,cellular immune function and humoral immune function.The cellu-lar immune function and humoral immune function of 30 d before and after blood donation were compared,the changes of cellular immune function and humoral immune function before and after donation of 30 d between different genders.Results 30 d after blood donation,CD3+,CD4+lymphocytes and CD4+/CD8+were higher than those before blood donation(P<0.05).There was no significant difference in the levels of IgA,IgM and IgG before and after blood donation(P> 0.05).30 d after blood donation,CD3+,CD4+lymphocytes,and CD4+/CD8+were all higher than those before blood donation in both males and females(P<0.05);CD3+, CD4+lymphocytes,and CD4+/CD8+were detected before and after blood donation,between different genders there was no significant difference(P>0.05).There was no significant difference between males and females in IgA,IgM and IgG before and after blood donation(P>0.05).Conclusion There was no significant change in the humoral immune function in 291 cases of voluntary blood donors,but the proportion of T cell subsets increased.

Protective role and mechanism of dexmedetomidine on the LPS-stimulated PC12 cells / 解放军医学杂志

Objective To explore the effect ofdexmedetomidine on the lipopolysaccharide (LPS) stimulated PC12 cells and its potential mechanism.Methods PC12 cells were treated by LPS with a concentration of 400μg/ml.The cell viability,the concentrations ofinterleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) in the cell culture supernatant were measured after 3-,6-,or 12-h treatment.The expressions of toll-like receptor 4 (TLR4),myeloid differentiation factor 88 (MyD88) and phosphorylated p65 (p-p65) were measured.In the second part,PC12 cells were cultured under four different treatments,that is,normal culture media in first group,400μg/ml LPS in second group,100μmol/L dexmedetomidine in third group,400μg/ml LPS and100μmol/L dexmedetomidine in fourth group.The indexes mentioned above were measured 6 hours after LPS and DEX treatments.Results The cell viability was decreased after LPS treatment,and the concentrations of IL-6 and TNF-α were increased significantly.Compared with control group,the concentrations in 3-,6-,12-h groups showed statistically significant differences (P＜0.05),especially after 6 hours.The TLR4/MyD88/NF-κB pathway was activated after LPS stimuli and reached the peak value.Compared with LPS treatment group,PC 12 cell apoptosis rate,the concentrations of IL-6 and TNF-α and the expressions of TLR4,MyD88 and p-p65 were decreased.The differences between LPS+DEX group and LPS group was statistically significant (P＜0.05).Conclusion Dexmedetomidine has a protective effect on LPS stimulated PC 12 cells via the inhibition of inflammatory response.

Detection of Na+/H+exchanger regulatory factor 3 protein expression in renal carcinoma and its correlation with malignant biological behavior / 中国医师进修杂志

Objective To study the detection of Na+/H+exchanger regulatory factor 3(NHERF3) protein expression in renal carcinoma and its correlation with malignant biological behavior. Methods Renal clear cell carcinoma and their adjacent tissues of forty- eight patients were collected. Immunohistochemical method was used to detect the positive expression of NHERF3 protein,and specific expression was detected by Western-blot.Patients were further divided into high NHERF3 group and low NHERF3 group according to median expression of NHERF3 protein,and each group had 24 cases.The expressions of proliferation,invasion and autophagy genes in tumor tissues were detected by fluorescent quantitative PCR.Results The positive rate of NHERF3 protein and the expression of NHERF3 protein in renal carcinoma tissue was significantly lower than that in paracancerous tissue(P<0.05).Expressions of proliferation genes such as k-Ras,c-Myc,TRPC1 mRNA in low NHERF3 group were higher than those in high NHERF3 group:141.74 ± 18.95 vs. 100.00 ± 0.00, 135.88 ± 16.32 vs. 100.00 ± 0.00, 137.21 ± 16.98 vs.100.00 ± 0.00;MIIP,FOXO1 mRNA levels were lower than those in high NHERF3 group: 43.19 ± 5.88 vs. 100.00 ± 0.00, 38.76 ± 4.51 vs. 100.00 ± 0.00; expressions of invasion genes such as CD74, Fascin, MACC1, TRPM8 mRNA were significantly higher than those in high NHERF3 group:152.18 ± 17.64 vs. 100.00 ± 0.00, 146.29 ± 17.63 vs. 100.00 ± 0.00, 139.76 ± 15.82 vs. 100.00 ± 0.00,150.47 ± 17.95 vs.100.00 ± 0.00;expressions of autophagy genes such as Beclin-1,LC3 mRNA were significantly lower than those in high NHERF3 group: 63.21 ± 7.09 vs. 100.00 ± 0.00, 56.28 ± 7.15 vs. 100.00 ± 0.00; EZH2 mRNA level was higher than that in high NHERF3 group:159.47 ± 17.82 vs.100.00 ± 0.00,and there were significant differences(P<0.05).Conclusions The positive rate of NHERF3 protein expression and the amount of protein expression in renal carcinoma tissue is increased, and the specific expression is closely related to tumor proliferation, invasion and activity of autophagy.

The Wuhan Twin Birth Cohort Study / 中华流行病学杂志

The prevalence of child and adolescent growth and mental-behavior related diseases are increasing,and the pathogcnesis are complex.Twins are excellent natural resources for complex chronic diseases research as they share the maternal intrauterine environment,born at the same time and share the same family environment in early years,which could benefit the adjust ment of confounding factors,such as age,genetic factors and early family environmental factors.Birth cohort with twin families involved could be more effective in exploring the genetic and environmental factors for complex chronic diseases at the very beginning of life.This paper summarizes the objective,content,progress,strengths and potential problems of Wuhan Twin Birth Cohort,with emphasis on the overall design and progress of the study.