6'-O-galloylpaeoniflorin alleviates inflammation and oxidative stress in pediatric pneumonia through activating Nrf2 activation

Objective: To assess the therapeutic effect and mechanism of 6'-o-galloylpaeoniflorin (GPF) in pediatric pneumonia.Methods: The effects of lipopolysaccharide (LPS) and GPF on cell viability and apoptosis were examined by cell counting kit-8 assay and flow cytometry analysis. The oxidative stress and inflammatory response were assessed by detecting expression levels of superoxide dismutase, glutathione, r-glutamyl cysteingl+glycine, myeloperoxidase, and malondialdehyde as well as tumor necrosis factor-α, Interleukin-18, and Interleukin-10 by using enzyme-linked-immuno-sorbent serologic assay. Moreover, the activation of nuclear factor erythroid 2-related factor 2 (Nrf2) pathway was detected by immunoblot assay, and the influence of Nrf2-knockdown on cell viability, oxidative stress, and inflammation response was also investigated.Results: The results established that GPF increased the viability of LPS-induced pneumonia cells. In addition, GPF reduced LPS-induced oxidative stress in pneumonia cells. It was further discovered that GPF reduced LPS-induced inflammation in pneumonic cell. GPF improved the activity of Nrf2 in LPS-treated pneumonic cells, and therefore alleviated inflammation and oxidative stress in pediatric pneumonia.Conclusion: GPF could serve as a promising drug for treating pediatric pneumonia (AU)

Research progress on the role of circular RNA in eye diseases / 国际眼科杂志(Guoji Yanke Zazhi)

@#Circular RNA(circRNA)is a single-stranded covalently closed RNA molecule produced by reverse splicing, which is an evolutionarily conserved and stable transcript, and widely exists in various eukaryotic cells. CircRNA is more stable and conserved than linear transcripts because of the absence of 5'cap and 3'polyadenylation tail in circRNA. A variety of bioactive processes are regulated by circRNA, such as cell differentiation, proliferation, angiogenesis and cell apoptosis. CircRNAs were shown to be key regulators of various diseases, especially cancers, neurodegenerative and cardiovascular. Recently, with the rapid development of RNA high-throughput sequencing technology, accumulating evidence shows that there are multiple differentially expressed circRNAs in ocular tissues and they play important roles in initiation, progression, and prognosis of diverse ocular diseases, such as glaucoma, cataract, retinopathy, ocular tumors and ocular immunologic diseases. In this article, the research on the relationship between circRNA and ophthalmic diseases in the recent years is briefly reviewed, and the purpose is to provide reference for its clinical treatment and prognosis.

Clinical Effect of Xijiao Dihuangtang Combined with Acupuncture on Treatment of Systemic Lupus Erythematosus with Syndrome of Intense Heat Toxin / 中国实验方剂学杂志

ObjectiveTo observe the clinical effect of Xijiao Dihuangtang combined with acupuncture on the treatment of systemic lupus erythematosus （SLE） with syndrome of intense heat toxin. MethodA total of 102 cases of SLE with syndrome of intense heat toxin （admitted from January 2020 to December 2021） were divided into a control group and an observation group by random number table method， with 51 cases in each group. Patients in the control group received conventional western medicine treatment （hydroxychloroquine sulfate + poonisone acetate tablets）. Patients in the observation group were given Xijiao Dihuangtang combined with acupuncture based on the treatment of the control group. Clinical efficacy， onset time， symptom improvement time， skin lesion regression time， and hospital stays were recorded. Blood routine index change， 24 h urine protein levels， double-stranded DNA （ds-DNA） antibodies resistance index changes， traditional Chinese medicine （TCM） syndrome integral changes， and changes in serum cytokine indexes， blood rheology indexes， and T lymphocyte subsets indexes were observed. SLE changes in disease activity index （SLEDAI-2000）， quality of life （SF-36） scores， and adverse reactions were explored. ResultThe total effective rate was 96.08% （49/51） in the observation group， higher than 84.31% （43/51） in the control group （χ2=3.991， P<0.05）. The onset time， symptom improvement time， skin lesion regression time， and hospital stays in the observation group were shorter than those in the control group （P<0.05，P<0.01）. Before treatment， erythrocyte sedimentation rate （ESR）， platelet count （PLT）， hemoglobin （HGB）， white blood cell count （WBC）， and other blood routine indexes， 24h urinary protein levels， anti-ds-DNA， TCM syndrome integral core， serum cytokine indexes including interleukin-4 （IL-4）， IL-6， soluble interleukin-2 receptor （sIL-2R）， blood rheology indexes （fibrinogen， plasma viscosity， and whole blood viscosity），T lymphocyte subsets indexes （CD4+， CD8+， and CD4+/CD8+）， SLEDAI-2000， and SF-36 score comparison in both groups had no statistical significance. After treatment， the above indicators were improved in each group （P<0.05）， and the indicators in the observation group was better than that in the control group （P<0.05）. In terms of the adverse reactions， there was 1 case of digestive tract reaction， 1 case of elevated aminotransferase， and 1 case of insomnia in the observation group. There were 2 cases of digestive tract reaction，1 case of infection， and 1 case of elevated transaminase in the control group. The difference of the adverse reactions between the two groups had no statistical significance. ConclusionXijiao Dihuangtang combined with acupuncture has good clinical effect on the treatment of SLE with syndrome of intense heat toxin， and the method is safe， reliable， and worthy of application.

Clinical Application of Zanubrutinib in B-Cell Lymphoma --Review / 中国实验血液学杂志

Zanubrutinib is a highly selective second-generation BTK inhibitor developed in China and first approved by the U.S. Food and Drug Administration (FDA) as a novel antineoplastic drug. In recent years, with the birth of molecularly targeted drugs, the treatment of B-cell lymphoma have entered the era of targeted therapy, and immunotherapy has been widely accepted. Especially in some relapsed and refractory lymphomas, zanubrutinib has shown deep and sustained remissions and a favorable safety, which lays a foundation for precision therapy. In this review the clinical application and new progress for zanubrutinib in B-cell lymphoma was summarized briefly.

Clinical Efficacy of Qinghao Fuzheng Jiedu Decoction in Treatment of Systemic Lupus Erythematous / 中国实验方剂学杂志

Objective:To study the clinical effect of Qinghao Fuzheng Jiedu decoction on systemic lupus erythematous （SLE）. Method:A total of 109 SLE patients admitted to the Rheumatology and Immunology Department of Wuhan No. 1 Hospital from December 2019 to October 2020 were selected and divided into an observation group （55 cases） and a control group （54 cases） using the random number table. Two cases in the observation group dropped out， leaving a total sample of 53， and one case in the control group dropped out， with 53 cases finally included. Patients in the control group were treated with prednisone tablet and azathioprine. On this basis， those in the observation group further received Qinghao Fuzheng Jiedu decoction. The clinical efficacy， traditional Chinese medicine （TCM） syndrome score， TCM syndrome efficacy， immunoglobulin （Ig） G， IgA， IgM， and complements C3 and C4 of the two groups were compared. The conversion of positive antinuclear antibody （ANA） and anti-double-stranded deoxyribonucleic acid antibody （DS-DNA） titers to negative in two groups after treatment was analyzed. Result:The total clinical efficacy rate of the observation group was significantly higher than that of control group （92.45% vs 73.58%，<italic>χ²</italic>=6.692，<italic>P</italic><0.05）. Before treatment， there were no significant differences in IgG， IgA， IgM， complements C3 and C4， and serum ANA and ds-DNA titers between two groups. After treatment， the levels of IgG， IgA， and IgM and serum ANA and ds-DNA titers in both groups obviously declined， whereas the levels of complements C3 and C4 rose （<italic>P</italic><0.05）. Besides， the levels of IgG， IgA， and IgM and serum ANA and ds-DNA titers in the observation group were lower than those in the control group， while the levels of complements C3 and C4 were higher （<italic>P</italic><0.05）. The negative rates of ANA and ds-DNA in observation group were significantly higher than those in control group （<italic>χ²</italic>=8.040，<italic>P</italic><0.05）. TCM syndrome scores were decreased in both groups after treatment （<italic>P</italic><0.05）， and the score in observation group was lower than that in control group （<italic>P</italic><0.05）. In terms of TCM syndrome efficacy， the total effective rate of observation group was significantly increased as compared with that of the control group （94.34% vs 50.94%，<italic>χ²</italic>=25.112，<italic>P</italic><0.05）. Conclusion:Qinghao Fuzheng Jiedu decoction is effective in treating SLE and has a certain clinical application value.

Protective effect of astrocyte exosomes on hypoxic-ischemic neurons / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the effect of astrocyte exosomes on hypoxic-ischemic neurons.</p><p><b>METHODS</b>Rat astrocytes were cultured in vitro, and differential centrifugation was used to obtain the exosomes from the cell supernatant. Transmission electron microscopy, Nanosight, and Western blot were used for the identification of exosomes. BCA method was used to measure the concentration of exosomes. Rat neurons were cultured in vitro and then divided into control group, exosome group, oxygen glucose deprivation (OGD) group, and OGD+exosome group (n=3 each). The OGD and OGD+exosome groups were cultured in glucose-free medium under the hypoxic condition. The exosome and OGD+exosome groups were treated with exosomes at a final concentration of 22 μg/mL. The control and OGD groups were given an equal volume of phosphate-buffered saline. ELISA was used to measure the level of lactate dehydrogenase (LDH) in neurons. The terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling was used to measure the apoptotic index of neurons.</p><p><b>RESULTS</b>The identification of exosomes showed that the exosomes extracted by differential centrifugation had the features of exosomes. Compared with the control and exosome groups, the OGD group had significant increases in LDH level and apoptotic index (P<0.05). Compared with the OGD group, the OGD+exosome group had significant reductions in LDH level and apoptotic index (P<0.05).</p><p><b>CONCLUSIONS</b>The exosomes from astrocytes have a protective effect on neurons with hypoxic-ischemic injury.</p>

Current status of the application of H-magnetic resonance spectroscopy in neonates with hypoxic-ischemic encephalopathy / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the current status of the application of H-magnetic resonance spectroscopy (H-MRS) in neonates with hypoxic-ischemic encephalopathy (HIE), and to describe the trend of research in the field.</p><p><b>METHODS</b>PubMed, EMBASE, and Web of Science were searched for English articles published up to January 10, 2018, with the combination of key words and MeSH terms. The articles were screened according to inclusion and exclusion criteria. Excel 2016, Bicomb 2.0, and VOSviewer1.6.6 were used to analyze the key words, to perform a cluster analysis of hot words, and to plot the knowledge map.</p><p><b>RESULTS</b>A total of 66 articles were included, and 27 high-frequency key words were extracted. The results showed that H-MRS was mainly used in four directions of the clinical practice and scientific research on HIE. In clinical practice, H-MRS attracted wide attention as a clinical examination for HIE and a tool for prognostic evaluation; in scientific research, H-MRS was used in animal experiments and studies associated with mild hypothermia therapy.</p><p><b>CONCLUSIONS</b>As an auxiliary means of magnetic resonance imaging, H-MRS plays an important role in investigating the pathogenesis of neonatal HIE, improving existing therapies, and evaluating the prognosis of neonates with HIE.</p>

Analysis of cataract prevalence and operation status in people aged 65 years old in the eastern Fengxian of Shanghai / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analysis of cataract prevalence and operation status in people aged 65 years old in the eastern Fengxian of Shanghai.?METHODS:In the period of January to December 2015, random stratified sampling in the whole group was taken in 3050 people over 65 years, in Situan and Fengcheng, two towns at the Eastern District of Fengxian Town. Ophthalmologic examination and questionnaire survey were given to those people, including slit lamp microscopy and visual acuity ( LogMAR ) and the conditions on cataract surgery.?RESULTS: Totally 1244 cases of cataract were found in 3050 subjects, the prevalence rate was 40. 79％. The prevalence rates in the subjects of different ages were different, as the age increases, the prevalence rate was rising. The difference of prevalence rate in different age groups was statistically significant (x2=558. 6, P<0. 001);the prevalence rate of male and female were 31. 06％ and 49. 94％, the difference was statistically significant ( x2 =112. 4, P<0. 001 ); the rate of illiterate and literate was 52. 04％ and 38. 76％ respectively with significantly difference (x2 = 28. 78, P<0. 001). Cataract surgery was taken in 765 cases, surgical coverage rate was 61. 25％;difference on age, gender was not statistically significant;the degree of education: the rate in literate was significantly far higher than in the illiterate, the difference was statistically significant ( x2 = 39. 72, P < 0. 001 ). Postoperative corrected visual acuity ≥ 0. 3 was considered as removing from disable and postoperative corrected visual acuity≥0. 05 as removing from the blind. The rate removing from disable was 71. 50％, the rate removing from the blind was 95. 29％. In 765 eyes receiving surgery, postoperative complications occurred in 29 eyes, 3. 79％ of the total eye receiving surgery.?CONCLUSION: Cataract is the common blind causing disease in the elderly, and the prevalence rate of cataract in eastern Fengxian of Shanghai is high. Although in recent years, the Restoring Vision Project has been developed, the surgical coverage has been improved, and the prevention and control of cataract is still the primary task of blind prevention.

Tripterygium glycosides in treatment of henoch-schonlein purpura nephritis: a systematic review of randomized controlled trials / 中国中药杂志

To evaluate the clinical efficacy and safety of tripterygium glycosides (TG) in the treatment of henoch-schonlein purpura nephritis(HSPN). Seven English and Chinese databases (up to Nov. 9, 2017), were searched to collect the RCTs on TG for HSPN. Two researchers independently screened the literature according to inclusion criteria and exclusion criteria, extracted data, and evaluated the quality of the literature. After completion, cross-checking was performed and Meta-analysis was performed using RevMan 5.3 software. At the same time, different outcomes of the interventions were analyzed subgroupically. A total of 46 RCTs were included, with 1 659 in the experimental group and 1 596 in the control group. All the clinical studies showed a low quality. In terms of complete remission rate, the group with TG performed better than the group with conventional therapy or GC（RR=1.82，95%CI[1.39，2.39];RR=2.03，95%CI[1.37，2.99]），the group with TG+GC performed better than the group with GC（RR=1.46，95%CI[1.32，1.60]），and the group with CTX+GC performed better than the group with TG+GC（RR=0.35，95%CI[0.16，0.75]）. In terms of total effective rate, the group with TG performed better than the group with conventional therapy or GC（RR=1.44，95%CI[1.19,1.74];RR=1.30，95%CI[1.16，1.46]），the group with TG+GC performed better than the group with GC（RR=1.27，95%CI[1.21，1.34]），and the group with CTX+GC performed better than the group with TG+GC（RR=0.60，95%CI[0.43，0.85]）. No significant difference was found between the group with TG+GC and LEF+GC（RR=0.68，95%CI[0.30，1.53]）. In terms of urinary protein, urine occult blood negative time，the group with TG performed better than the group with conventional therapy（MD=-9.00，95% CI[-11.99，-6.01];MD=-12.00，95%CI[-16.13，-7.87]），the group with TG+GC performed better than the group with GC（MD=-8.86，95%CI[-10.08，-7.64];MD=-16.24，95%CI[-23.80，-8.67]）. In terms of recurrence rate, the group with TG+GC was lower than the group with GC（RR=0.13，95%CI[0.06，0.25]）, but there were no significant difference between the group with TG and conventional therapy（RR=0.43，95%CI[0.15，1.19]）. In adverse reactions, the common adverse effects of TG were gastrointestinal discomfort, liver damage and leucopenia. TG for the treatment of HSPN can improve clinical efficacy, reduce recurrence, and the adverse reactions are relatively safe. Due to the generally low methodological quality of the included studies, which affected the accuracy and reliability of the result. Therefore, more high-quality, large samples and multi-center randomized controlled trials are necessary for further evidence.

A visualization analysis of current research on stem cell transplantation in the treatment of neonatal hypoxic-ischemic encephalopathy / 中国当代儿科杂志

OBJECTIVE@#To reveal the current research status on stem cell transplantation in the treatment of neonates with hypoxic-ischemic encephalopathy (HIE), and to summarize the recent hotspots of the research in this field.@*METHODS@#Using the key words of "stem cells" and "HIE", a computerized search was performed for the articles in English published before June 1, 2018 in PubMed, EMBASE, and Web of Science. Microsoft Office Excel 2013 was used for the statistical analysis of key words. Bicomb 2.0 and VOSviewer 1.6.6 were used for the cluster analysis of hot words and plotting of knowledge maps, respectively.@*RESULTS@#A total of 106 articles were included and 43 high-frequency key words were extracted. The words of "cell transplantation" and "hypoxia-ischemia" were in the core position of the co-word map. The cluster analysis showed that the studies of stem cell transplantation in the treatment of neonatal HIE mainly focused on umbilical cord blood cell transplantation (32.6%), mesenchymal stem cells and neural stem cells (29.5%), perinatal brain injury (28.1%), and other topics (9.8%).@*CONCLUSIONS@#In the current studies of stem cell transplantation in the treatment of neonatal HIE, umbilical cord blood cell transplantation, mesenchymal stem cells, neural stem cells, and perinatal brain injury are popular research topics at different levels.

Clinical Predictors of Outcome in Patients with Anti-neutrophil Cytoplasmic Autoantibody-related Renal Vasculitis: Experiences from a Single-center / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Primary anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a chronic autoimmune disease associated with multisystem dysfunction. Renal involvement is common and closely associated with outcome. The purpose of this study was to investigate the clinical determinants of mortality of patients with AAV-related renal injury in the first 2 years after diagnosis in a single West Chinese center.</p><p><b>METHODS</b>Demographic and laboratory parameters of 123 consecutive patients with AAV-related renal injury diagnosed in Renal Division and Institute of Nephrology, Sichuan Provincial People's Hospital between 2004 and 2012 were collected retrospectively. All patients were followed up for 2 years after diagnosis. Survivors were compared with nonsurvivors to identify the clinical baseline variables associated with mortality. Multivariate Cox regression model was used to determine the independent predictors of mortality.</p><p><b>RESULTS</b>Of the 123 patients, 46 (37.4%) died by the end of 2 years after diagnosis, with 41 (33.3%) patients dying within the first 12 months. In comparison with the survivors, Birmingham Vasculitis Activity Score (BVAS), the incidence of pulmonary hemorrhage and digestive system (DS) involvement, serum creatinine, and erythrocyte sedimentation rate were significantly higher in nonsurvivors, whereas lymphocyte counts, hemoglobin, and complement 3 (C3) were significantly lower. Renal replacement therapy was more common in nonsurvivors. High BVAS (hazard ratio [HR] = 1.058, 95% confidence interval [CI]: 1.002-1.117; P = 0.042), pulmonary hemorrhage (HR = 1.970, 95% CI: 1.033-3.757; P = 0.04), DS involvement (HR = 2.911, 95% CI: 1.212-6.911; P = 0.017), and serum creatinine >400 μmol/L (HR = 2.910, 95% CI: 1.271-6.664; P = 0.012) were independent predictors of death in patients with AAV-related renal injury.</p><p><b>CONCLUSIONS</b>Patients with AAV-related renal injury have high early mortality. Those with high BVAS (particularly with pulmonary or DS involvement) and serious renal dysfunction should receive aggressive therapy and careful monitoring to reduce the occurrence of adverse events and improve prognosis.</p>

Surveillance on iodine nutritional status among target population in Shanghai / 上海预防医学

Objective To ascertain iodine nutritional status of pregnant women and children in Shanghai since the implementation of "Salt Iodine Content Standard" in 2011.Methods By population proportion probability sampling,30 sub-districts(towns) were chosen,with one primary school was randomly sampled in eachsub-districts(towns).And 50 students aged 8-10 in every school were randomly selected to test their urinary iodine and thyroid volume,and their household iodized salt concentration determined.And 20 pregnant women were selected to test their urinary iodine in each sub-districts(towns).Results The goiter rate of 8-10 aged children was 0.9%.The medians of urinary iodine concentration of 8-10 aged children and pregnant women were 171.40 μg/L and 126.53 μg/L,respectively.The consumption rates of qualified iodized salt were 72.52%.The median of iodine content concentration in salt was 24.8 mg/kg.Conclusion In Shanghai,the goiter rate of children was lower than that of the national standard.Iodine nutritional status of children was proper,but the pregnant women were deficient in iodine nutrition.Therefore,iodized salt concentration should be improved to the optimal level.Health education for pregnant women should be strengthened.

Comprehensive assessment on iodine nutrition and dietary iodine intake among Shanghai residents / 上海预防医学

Objective To assess the changes in iodine status and dietary iodine intake among Shanghai residents since common salt was iodized 20 years ago.Methods As-CE Catalysis spectrophotometry was used to determinate the urine iodine level in school-age children,pregnant women,wet nurse and adults of Shanghai between 1995 and 2015.B ultrasonic was used to determinate the thyroid volume of school-age children.And then the goiter rate was calculated.Direct titration or arbitration methods were applied to detect the household salt iodine level quantitatively.The survey was conducted by using 3 days 24-hour dietary questionnaire and condiment weighing methods to analyze the level of iodine intake and sources for the cases of all iodized salt consumption and all consumption of non-iodized salt.Results The median urine iodine concentration (UIC) of school age children was 72.3 μg/L in 1995,rose to 214-231 μg/L from 1997-1999,and then became stable between 100 μg/L and 200 μg/L since 2002.The goiter rate was below 5% among children aged 8-10 from 1995-2015 in Shanghai.The median urine iodine of pregnant women was between 126.5 μg/L and 139.8 μg/L.The median UIC of other populations were all between 100 μg/L and 200 μg/L: with adults,lactating women,infants and young children and women of childbearing age,the median urinary iodine was 138.4,123.1-131.1,150.1 and 125.6 μg/L.The qualified iodized salt at household consumption rate was 90% from 2001 to 2009,the percentage declined year by year from 2010.In the cases of all taking iodine salt,the median iodine intake volume for male aged 7-10,11-13,14-18 and over 18 was 200.3,235.5,252.7 and 215.4 μg/L;women aged 7-10,11-13,14-18 and over 18 was 193.0,213.8,208.3 and 186.1 μg/L.The contribution rate of iodine salt in the diet were 51.6%-54.1% and 49.1%-53% in men and women.Kelp,seaweed and fish and shrimp on the contribution of iodine are 7.6%-16.6% and 4.5%-7.4%.Conclusion In the past about 20 years,iodine nutritional status of residents in Shanghai has stabilized totally in a appropriate and safe level.However,the iodine nutrition of pregnant women was insufficient.As iodized salt is the major source of dietary iodine in coastal areas,it is still necessary to continue the policy of universal salt iodized in Shanghai to ensure residents'' needs for iodine and control the risk of iodine deficiency.

Application of Serum DBIL,TBIL,DBIL/TBI Detection in the Diagnosis of Drug-induced Liver Injury / 现代检验医学杂志

Objective To analyze the functions of total bilirubin(TBIL)and direct bilirubin(DBIL),DBIL/TBIL detection in the diagnosis of drug-induced liver injury(DILI).Methods The clinical data and laboratory examination results of the pa-tients with drug-induced liver disease in Shaanxi Provincial People's Hospital were collected from January 2014 to December 2016.The factors were assessed by uni-variate and multivariate logistic regression analysis.Results In all,162 cases identi-fied as DILI were included in the study.The main causative group of drugs was Chinese herb(about 88 cases,54.3%).A-mong these 162 cases,124 cases(76.5%)were hepatocellular damage type,30 cases(18.5%)cholestatic damage type and 8 cases(4.9%)mixed type damage.It showed that the complete recovery occurred in 120 patients(74.1%)and the non-re-covery occurred in 41(25.3%),of which one death(0.6%).The binary logistic regression analysis identified the jaundice, DBIL,TBIL and DBIL/TBIL as independent factors of the non-recovery of DILI.Conclusion The main causative group of drugs was Chinese herb and the hepatocellular damage type was the commonest one.What's more,whether the case pro-gress into non-recovery one,was related to jaundice,TBIL,DBIL and DBIL/TBIL.

Clinical value of vitamin B supplementation in senile epilepsy with hyperhomocysteinemia / 中华神经科杂志

Objective To investigate the influence of vitamin B supplementation on the plasma total homocysteine (Hcy), serum folate, serum vitamin B12, serum vitamin B6, and clinical state of senile epilepsy.Methods A total of 132 senile epilepsy patients with hyperhomocysteinemia, who visited the Second Affiliated Hospital of Soochow University from January 2013 to July 2015, were enrolled into this study.Eighty-three patients who accepted the therapy of vitamin B supplementation (folate 2.5 mg/d, vitamin B6 10.0 mg/d, vitamin B12 1.5 mg/d) were selected as treatment group, and 49 patients with no vitamin B supplementation were selected as control group.All patients were followed-up for one year.The differences of serum Hcy, folate, vitamin B12, vitamin B6 and seizure frequency, MMSE scores, Hamilton Depression Rating Scale (HDMA) scores between the treatment and the control groups were compared.According to the concentration of serum Hcy, 132 patients were divided into two groups: 75 patients (46 patients in the treatment group and 29 patients in the control group) with mild hyperhomocysteinemia (Hcy: 15.0-29.9 μmol/L), 57 patients (37 patients in the treatment group and 20 patients in the control group) with moderate-severe hyperhomocysteinemia (Hcy≥30.0 μmol/L).The differences of serum Hcy, folate, vitamin B12, vitamin B6 and seizure frequency, MMSE scores, HDMA scores between the treatment and the control group in the mild hyperhomocysteinemia group and in the moderate-severe hyperhomocysteinemia group were compared.And the influence factors of Hcy were analyzed.Results Correlation analysis revealed that Hcy was positively correlated with age (r=0.269, P=0.002), and negatively correlated with folate (r=-0.222, P=0.010).Hcy was associated with smoking (χ2=7.363,P=0.007), hypertension (χ2=6.187,P=0.013), and two or more antiepileptic drugs polytherapy (χ2=4.708,P=0.030).After vitamin B supplementation in the group of moderate-severe hyperhomocysteinemia, serum Hcy concentration ((15.68±4.85) μmol/L in the treatment group vs (31.14±11.18) μmol/L in the control group, t=5.890, P0.05).Conclusions It is necessary to monitor serum Hcy for senile epilepsy.Vitamin B supplementation is a safe and inexpensive way to reduce the concentration of Hcy, assist to control seizures and improve the clinical symptom of depression and cognitive impairment for senile epilepsy with moderate-severe hyperhomocysteinemia.

Influence of antiepileptic drugs on levels of serum homecysteine, folate and B vitamins in patients with post-stroke epilepsy / 临床神经病学杂志

Objective To investigate the influence of antiepileptic drugs (AEDs) on levels of serum homocysteine (Hcy),folate,vitamin B12 and B6 in patients with post-stroke epilepsy (PSE).Methods The serum levels of Hcy,folate,vitamin B12 and B6 of 194 PSE patients with AEDs treatment for more than 1 year (AEDs treatment group) and 40 newly diagnosed PSE patients without AEDs therapy (control group) were detected.The effects of AEDs on above indexes were analyzed.Results Compared with control group,the serum level of serum Hcy was significantly increased,and the serum levels of folate,B12 were significantly decreased in AEDs treatment group (all P<0.05).The difference of the serum levels of vitamin B6 among the groups was not significant.Compared with monothetapy subgroup,the serum levels of Hcy was significantly increased in the combination therapy subgroup (P<0.05).Compared with control group,the serum levels of Hcy were significantly increased in patients with Valproate (VPA),Carbamazepine (CBZ) and Oxcarbazepine (OXC) monotherapy,the serum levels of folate were significantly decreased in patients with VPA and CBZ monotherapy,and the serum level of B12 was significantly decreased in patients with VPA monotherapy (all P<0.05).Compared with control group,the serum levels of Hcy were significantly increased in patients with 2 kinds of AEDs combination treatment [VPA+CBZ,VPA+Levetiracetam (LEV),VPA+OXC,CBZ+LEV] or ≥3 kinds of AEDs combination treatment,the serum levels of folate was significantly decreased in patients with 2 kinds of AEDs combination treatment (VPA+LEV,VPA+OXC,CBZ+LEV) or ≥3 kinds of AEDs combination treatment,the serum levels of B12 were siginificantly decreased in patients with 2 kinds of AEDs combination treatment (VPA+CBZ,VPA+OXC,CBZ+LEV) or ≥3 kinds of AEDs combination treatment (all P<0.05).The incidence of hyperhomocysteinemia (HHcy) in AEDs treatment group (36.6%) was significantly higher than that in control group (20.0%) (χ2=4.085,P=0.043).And the difference of HHcy incidence between the combination therapy subgroup (47.6%) and the control group was statistical significant (χ2=6.950,P=0.008).The difference of HHcy incidence between the monotherapy subgroup (33.6%) and the control group was not significant.The HHcy incidence of patients with VPA and CBZ monotherapy (40.5%;43.8%) were significantly higer than those in the control group (χ2=3.871,P=0.049;χ2=4.726,P=0.030).The differences of HHcy incidence between patients with OXC,LEV monotherapy (29.2%;22.9%) and the control group were not significant.Conclusions AEDs therapy has little influence on the serum levels of vitamin B6,while has great influence on the serum levels of Hcy,folate and vitamin B12.Combination treatment of AEDs and monotherapy of VPA,CBZ may increase the incidence of HHcy in PSE patients.

Effect of low-dose focused ultrasound pre-irradiation versus microbubbles for enhancing high-intensity focused ultrasound ablation of VXhepatic tumor in rabbits / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the effect of low-dose focused ultrasound pre-irradiation and microbubbles for enhancing the ablation effect of high intensity focused ultrasound (HIFU) on VXhepatic tumor in rabbits.</p><p><b>METHODS</b>Fifty-five rabbits bearing VXhepatic tumor were randomly divided into low-dose pre-irradiation + HIFU ablation group, microbubbles+HIFU ablation group, and HIFU ablation group for corresponding treatments. The pathological changes in the tumors after low-dose irradiation, time for HIFU ablation, tumor volume with coagulative necrosis, energy efficiency factor (EEF), pathological changes in the ablated tumor, and sound channel of HIFU ablation were observed.</p><p><b>RESULTS</b>Tumor cell edema, vacuolar changes in the cytoplasm and tumor interstitial vascular congestion were observed 24 h after low-dose pre-irradiation. The ablation time were significantly shorter, coagulative necrosis volume was larger, and EEF was lower in low-dose irradiation + HIFU ablation group and microbubbles+HIFU ablation group than in simple HIFU ablation group (P<0.05), but the differences between the former two groups were not significant. The effectiveness and stability of the synergistic effect of low-dose pre-irradiation were inferior to microbubbles, but the former ensured a better safety of the sound channel.</p><p><b>CONCLUSION</b>Low-dose irradiation has comparable synergistic effect in HIFU with microbubbles with such advantages as non-invasiveness, high concentration and good safety, and can be a potentially new method to enhance the efficiency of HIFU.</p>

Pharmacokinetics of a cisatracurium dose according to fat-free mass for anesthesia induction in morbidly obese patients / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the pharmacokinetics of cisatracurium between normal weight patients and morbidly obese patients.</p><p><b>METHODS</b>Twelve obese ASA I-II patients (BMI≥35 kg/m) undergoing laparoscopic Roux-en-Y gastric bypass and 12 normal weight ASA I-II patients (BMI of 18.5-24 kg/m) undergoing laparoscopic surgery were enrolled. The obese patients were given a cisatracurium dose of 0.15 mg/kg according to the fat-free mass (FFM), and the non-obese patients received a dose of 0.15 mg/kg according to the total body weight. Plasma concentrations of cisatracurium was monitored in the patients with high-performance liquid chromatography (HPLC) before anesthetic induction and at 1, 2, 4, 6, 8, 10, 12, 15, and 20 min after cisatracurium administration and the pharmacokinetic parameters were computed. SBP, DBP, HR, MAP, SpOand PetCOwere recorded before anesthetic induction (T) and at 1 min (T), 2 min (T), 4 min (T) after cisatracurium administration.</p><p><b>RESULTS</b>Compared with those measured at T, SBP, DBP and MAP in the 2 groups were significantly decreased at the time points of T(P<0.05). Compared with the non-obese patients, the obese patients showed significantly increased Hct level (P<0.05). The total clearance, apparent volume of distribution, and distribution and elimination half-life of the drug were similar between the 2 groups (P>0.05). The plasma concentration of cisatracurium at Twas significantly decreased in the obese patients compared with that in the non-obese patients (P<0.05).</p><p><b>CONCLUSION</b>Cisatracurium doses according to fat-free mass is clinically reasonable for inducing anesthesia in morbidly obese patients, but due to a prolonged muscle relax onset time, the timing of tracheal intubation should be delayed by 1-2 min.</p>

Prevalence of Thyroid Nodules and Its Relationship with Iodine Status in Shanghai: a Population-based Study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study was designed to evaluate the prevalence of thyroid nodules (TNs) and its relationship with urine iodine concentrations (UICs) after the regional rapid economic growth and lifestyle changes.</p><p><b>METHODS</b>A cross-sectional survey was conducted in the general population aged 15-69 years. A questionnaire regarding general and personal characteristics and relevant information was administered. Ultrasonography of the thyroid was performed, and serum triiodothyronine (T3), tetraiodothyronine (T4), serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), and TSH receptor antibody (TRAb) levels were measured for each individual subject.</p><p><b>RESULTS</b>The prevalence rates of TNs in the whole population, females and males were 27.76%, 34.04%, and 21.60%, respectively. The prevalence of multiple nodules increased with age, whereas the prevalence peaks differed between males and females. The median UICs in the whole population and females with non-TNs were higher than those of subjects with TNs (P=0.0035, P=0.0068). The median UICs in subjects with a single TN were higher than those in subjects with multiple TNs (P=0.0164, P=0.0127). The result showed a U-shaped curve relationship between UIC and prevalence of TNs. The prevalence of TNs was the lowest when the UIC was 140-400 μg/L.</p><p><b>CONCLUSION</b>The prevalence of TNs was nearly 30% and increased with age. The relationship between UIC and prevalence of TNs is U-shaped, with an increase in risk when the UIC was <140 μg/L and >400 μg/L. Very low or high UIC levels need attention and correction.</p>

Prevention and treatment of energy failure in neonates with hypoxic-ischemic encephalopathy / 中国当代儿科杂志

Hypoxic-ischemic encephalopathy (HIE) in neonates is the brain injury caused by perinatal asphyxia or hypoxia and is a major cause of death in neonates and nervous system dysfunction in infants and young children. Although to a certain degree, mild hypothermia therapy reduces the mortality of infants with moderate to severe HIE, it cannot achieve the expected improvements in nervous system dysfunction. Hence, it is of vital importance to search for effective therapeutic methods for HIE. The search for more therapies and better preventive measures based on the pathogenesis of HIE has resulted in much research. As an important link in the course of HIE, energy failure greatly affects the development and progression of HIE. This article reviews the research advances in the treatment and prevention of energy failure in the course of HIE.