Preparation and quality evaluation of Eriodictyol chewable tablet / 中国药房

OBJECTIVE To prepare the Eriodictyol chewable tablet and to evaluate its quality. METHODS The chewable tablet was prepared by the wetting granulation method by using microcrystalline cellulose （MCC） and mannitol as fillers， polyvinylpyrrolidone （PVP） as adhesive， citric acid and sucralose as flavor correction agents， magnesium stearate as lubricant. The comprehensive evaluation was conducted on Eriodictyol chewable tablets with the dosage of each excipient as a factor using the appearance， taste， flavor and texture as indicators. The ratio of excipients was optimized by orthogonal test， and the quality of Eriodictyol chewable tablets prepared by optimized formulation was evaluated in terms of appearance， weight difference， hardness， fragility， eriodictyol content， dissolution and content uniformity. RESULTS The optimal formulation was as follows： 26.4% eriodictyol （50 mg each piece）， 45% mannitol， 25% MCC， 0.3% citric acid， 0.3% sucralose， 1% magnesium stearate， 2% PVP （preparing 5% solution using purified water）. The scores of 3 batches of Eriodictyol chewable tablets in the validation test were 8.76， 8.75 and 8.80 （RSD＝0.30%， n＝3）， respectively. The Eriodictyol chewable tablet had a complete appearance and a smooth surface； the average tablet weight was 192.57 mg， the average hardness was 57.36 N， the fragility was 0.09%， the average content of eriodictyol per tablet was 50.74 mg， the cumulative dissolution within 30 min was exceeding 80%， and the content uniformity was 5.51. CONCLUSIONS Eriodictyol chewable tablet prepared by optimal formulation conforms to the requirements of the 2020 edition of Chinese Pharmacopoeia.

Prevalence of Mycoplasma pneumoniae among children undergoing physical examination / 中华微生物学和免疫学杂志

Objective:To investigate the prevalence of Mycoplasma pneumoniae ( Mp) in children undergoing physical examination. Methods:This study randomly enrolled 1 303 children at the age of 6-12 years who underwent physical examination in 2023. Their oral and pharyngeal swabs as well as venous blood samples were collected. The prevalence of Mp in these subjects was detected using isolation and culturing, nucleic acid detection and serological test. Chi-square test was used for statistical analysis. Results:Among the 1 303 children, the detection rate of Mp was 4.1% (53/1 303) by culturing, 7.3% (95/1 303) by nucleic acid detection and 13.6% (177/1 303) by serological test. Statistical analysis showed that there were significant differences in the the detection rates of Mp among children undergoing physical examination between the three methods ( P<0.05). Conclusions:The detection rate of Mp in children undergoing physical examination in 2023 was about 4.1%. Isolation and culturing was more accurate than nucleic acid detection and serological test in the detection of Mp in healthy population as the latter two methods would overestimate the rate.

Outcomes in pregnant women with leukemia and their offsprings / 中华围产医学杂志

Objective:To analyze the maternal and neonatal outcomes of pregnant women with leukemia.Methods:This retrospective study analyzed the clinical data of singleton pregnant women with leukemia and their neonates at the Obstetrics Department of Peking University People's Hospital from June 2009 to May 2021. Statistical analysis was performed using a two-sample t-test, the Wilcoxon Mann-Whitney rank sum test, and the Chi-square test (or Fisher's exact test). Results:(1) Ninety-one pregnant women were enrolled in this study, accounting for 2.8‰ of all deliveries during the same period. Among them, there were 15 (16.5%) with acute lymphoblastic leukemia, 38 (41.8%) with acute myeloid leukemia, and 38 (41.8%) with chronic myelogenous leukemia. Twenty-nine of the 91 pregnancies (31.9%) were terminated in the second or third trimester, and 62 babies (68.1%) were born through spontaneous delivery or cesarean section. The 62 parturients were (30.1±5.0) years old, of whom two died of complications of leukemia within 7 d after delivery, and five were transferred to the intensive care unit after delivery. Of the 62 cases, 18 (29.0%) received a blood transfusion and 12 (19.3%) received chemotherapy during pregnancy. (2) The proportion of patients with unremitted leukemia during pregnancy or newly developed leukemia was higher in women with terminated pregnancy than in those who continued the pregnancy [96.6% (28/29) vs 54.8% (34/62), χ2=15.83, P<0.001]. (3) The gestational age of the 62 newborns was (37.7±2.7) weeks. Premature, low birth weight and small-for-gestational-age infants accounted for 29.0% (18/62), 25.8% (16/62), and 12.9% (8/62), respectively. Hyperbilirubinemia occurred in 10 neonates (16.1%) and hypoglycemia in two (3.2%). Perinatal anoxia and asphyxia were reported in 13 cases (21.0%). Appearance, organ malformations, or chromosomal abnormalities were found in four neonates (6.4%) whose mothers did not receive chemotherapy during pregnancy. Fifty-nine infants underwent routine blood tests within 3 d after birth. The results showed that the mean white blood cell count, hemoglobin concentration, and platelet count were (16.1±7.0)×10 9/L, (181.5±20.0) g/L and (266.2±63.7)×10 9/L, respectively, and no juvenile cells were detected in their peripheral blood samples. Twenty children were followed up to 4 years and 4 months (9 months to 10 years and 3 months). No abnormalities in physical or mental development, motor function, or hematological system were reported. Conclusions:Pregnancy complicated by leukemia is rare and dangerous, which requires an individualized management strategy besides therapy for leukemia. A good prognosis is still expected with appropriate treatment.

Effect of exosomes derived from bone mesenchymal stem cells on postoperative cognitive function and SIRT1/NF-κB signaling pathway in aged mice / 中华麻醉学杂志

Objective:To evaluate the effect of exosomes derived from bone mesenchymal stem cells (BMSCs-EXO) on the postoperative cognitive function and silent infomation regulator 1 (SIRT1)/ nuclear factor kappa B (NF-κB) signaling pathway in aged mice.Methods:BMSCs-EXO were isolated by differential centrifugation method and then identified. Twenty healthy male C57BL/6 aged mice, aged 18 months, weighing 35-40 g, were divided into 4 groups ( n=5 each) using a random number table method: sham operation group (Sham group), operation group (O group), BMSCs-EXO group and EX527 (SIRT1 inhibitor)group. The abdomen regions were shaved for sterilization without exploratory laparotomy in Sham group. Exploratory laparotomy was performed in O group. BMSCs-EXO 50 μg was injected through the tail vein at 1 h before surgery in BMSCs-EXO group. EX527 5 mg/kg was intraperitoneally injected daily at 1-3 days before surgery, and BMSCs-EXO 50 μg was injected through the tail vein at 1 h before surgery in EX527 group. Morris water maze test was used to evaluate the learning and memory ability for 5 consecutive days staring from the 1st day after surgery. Mice were sacrificed at 1 h after the end of Morris water maze test on day 5 after surgery, and the hippocampal tissues were collected for observation of the pathological changes of hippocampal CA1 region and for determination of the expression of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and IL-1β mRNA (quantitative real-time polymerase chain reaction) and SIRT1 and NF-κB p65 (by Western blot). Results:Compared with Sham group, the escape latency was significantly prolonged, the times of original platform crossing were decreased, the swimming time spent in the original platform quadrant was shortened, the expression of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and IL-1β mRNA was up-regulated, the SIRT1 expression was down-regulated, the NF-κB p65 expression was up-regulated ( P<0.05), and the pathological changes of hippocampal tissues in CA1 region were found in O group. Compared with O group, the escape latency was significantly shortened, the times of original platform crossing were increased, the swimming time spent in the original platform quadrant was prolonged, the expression of TNF-α, IL-6 and IL-1β mRNA was down-regulated, the expression of SIRT1 was up-regulated, the expression of NF-κB p65 was down-regulated ( P<0.05), and the pathological changes of hippocampal tissues in CA1 region were significantly attenuated in BMSCs-EXO group ( P<0.05). Compared with BMSCs-EXO group, the escape latency was significantly prolonged, the times of original platform crossing were decreased, the swimming time spent in the original platform quadrant was shortened, the expression of TNF-α, IL-6 and IL-1β mRNA was up-regulated, the SIRT1 expression was down-regulated, the NF-κB p65 expression was up-regulated ( P<0.05), and the pathological changes of hippocampal tissues in CA1 region were accentuated in EX527 group. Conclusions:BMSCs-EXO can improve the postoperative cognitive function in aged mice, and the mechanism may be associated with the activation of SIRT1/NF-κB signaling pathway.

Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus disease 2019 (version 2023) / 中华创伤杂志

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.

Diagnosis of pulmonary artery sarcoma and differential diagnosis of pulmonary embolism with double-detector spectral CT: a case report / 中国医师杂志

Objective:The differential diagnosis of pulmonary artery sarcoma (PAS) and pulmonary embolism (PE) by double-detector spectral computerized tomography (CT) provides a new way to improve the detection rate of PAS and reduce the misdiagnosis rate.Methods:In the way of retrospective study, the Philips Nebula Workstation (ISP) was used to reconstruct electron density map, iodine density map and spectral curve in the spectral CT plain scan and enhancement of the PAS patient. In the plain scan image, the low density areas of the ascending aorta and the right pulmonary trunk were selected to measure their electronic density values. In the chest enhancement image, the iodine density of PAS area and PE area were measured respectively, and the spectral curves of PSA area and PE area were compared.Results:The electron density of the ascending aorta and the right pulmonary trunk in the low density area of the PAS patient during the plain scan of spectral CT were 104.4% EDW (relative to the percentage of the electron density of water) and 102.2% EDW, respectively, which were lower than those in the normal ascending aorta area. The fusion image of mixed energy and electron density clearly reflected the scope of the lesion. The iodine density in PAS area was 1.89 mg/ml, and the iodine density in PE area was 0.03 mg/ml during the enhancement phase. The iodine uptake in PAS area was significantly higher than that in PE area. The slope of PAS region was 2.08, and the slope of PE region was -1.86. The slopes of the two spectral curves were inconsistent.Conclusions:The electronic density, iodine density and spectral curve measured by double-detector spectral CT may provide powerful imaging basis for the diagnosis of PAS and the differentiation of PAS from PE, which is helpful for the early diagnosis of the lesions, and also provide basis for the biopsy location of the mixed lesions of PAS and PE.

Correlation of cognitive function and clinical characteristics in adolescent depressive disorder patients with self-injury behavior / 中华行为医学与脑科学杂志

Objective:To investigate the correlation between cognitive function and addiction, impulsivity, and anhedonia in adolescent depressive disorder patients with self-injury behavior.Methods:From September 2021 to October 2022, adolescents with depressive disorders who visited the outpatient department of the Qingdao Mental Health Center were enrolled and divided into self-injury group and non self-injury group based on the presence or absence of self-injury behaviors, each with 60 participants.A self-compiled general information questionnaire, the 17 items Hamilton depression rating scale (HAMD-17), the Ottawa self-injury inventory (OSI), the Chinese version of the Barratt impulsiveness scale (BIS-11), and the temporal experience of pleasure scale(TEPS) were used to evaluate both groups.The Chinese brief cognitive test(C-BCT) was used to assess cognitive function in both groups.SPSS 26.0 software was used for statistical analysis, including t-test, χ2 test, Pearson correlation analysis, and multiple linear regression analysis. Results:The self-injury group had higher scores for OSI addiction factors (9.43±8.29) and BIS-11 (67.09±11.48) compared to the non self-injury group (OSI addiction factor scores: 0, BIS-11 scores: 53.70±7.12, t=6.22, 5.91, both P<0.05). TEPS score and C-BCT scores in various dimensions were lower in the self-injury group than those in the non self-injury group ( t=-2.93, -2.01, -2.88, -2.20, -5.35, all P<0.05). Information processing speed was negatively correlated with BIS-11 score ( r=-0.296, P<0.05), and attention score were negatively correlated with OSI addiction factor score and BIS-11 score ( r=-0.303, -0.561, both P<0.05) and positively correlated with TEPS score ( r=0.364, P<0.05), including a positive correlation with the scale of anticipatory anhedonia score ( r=0.318, P<0.05). Working memory score was negatively correlated with OSI addiction factor score and BIS-11 score ( r=-0.312, -0.416, both P<0.05). Comprehensive ability and executive function scores were negatively correlated with OSI addiction factor score and BIS-11 score ( r=-0.308, -0.679, both P<0.05), and positively correlated with TEPS score ( r=0.304, P<0.05). Multiple linear regression analysis showed that BIS-11 scores were influencing factors of C-BCT dimensions ( β=-0.260, -0.592, -0.557, -1.797, t=-2.150, -3.314, -2.285, -5.165, all P<0.05). Conclusion:In adolescent depressive patients with self-injury, cognitive function is correlated with addiction, impulsivity and anhedonia, among which impulsivity is a risk factor for cognitive function.

Analysis of influencing factors of tuberculosis related health behaviors among college freshmen with health belief model / 中华行为医学与脑科学杂志

Objective:To explore the influencing factors of tuberculosis related health behaviors among college freshmen with health belief model, so as to provide a scientific basis for the intervention of health behaviors among students.Methods:From January to February 2021, the questionnaire survey was conducted among 5 254 college freshmen from 11 universities.The survey included general demographic data, tuberculosis related health behaviors, and tuberculosis related knowledge, disease threat perception and disease policy cognition.The SPSS 23.0 software was used for data analysis, independent sample t-test and one-way ANOVA were used for inter group comparison, and Logistic regression analysis was used to explore the influencing factors of health behavior holding. Results:The total score of tuberculosis related health behaviors among freshmen was 3~12 (11.01±1.10), and the overall holding rate of tuberculosis related health behaviors was higher.Male( B=-0.753, OR(95% CI)=0.471(0.417-0.531)), and tuberculosis history ( B=-1.088, OR(95% CI)=0.337(0.157-0.722)) were risk factors for tuberculosis related health behaviors among freshmen.Birth in city( B=0.117, OR(95% CI)=1.124(0.944-1.338)), father's education level college /undergraduate and above ( B=0.177, OR(95% CI)=1.194(1.024-1.392)), mother's education level high school/secondary school( B=0.356, OR(95% CI)=1.428(1.126-1.810)), college/undergraduate and above( B=0.194, OR(95% CI)=1.214(1.029-1.433)), take the initiative to understand tuberculosis knowledge ( B=0.208, OR(95% CI)=1.231(1.095-1.385)), higher tuberculosis knowledge score ( B=0.088, OR(95% CI)=1.092(1.041-1.145)), higher disease threat perception score ( B=0.082, OR(95% CI)=1.086(1.031-1.144)) and higher disease policy cognition score( B=0.320, OR(95% CI)=1.378(1.265-1.500)) were protective factors for tuberculosis related health behaviors among first-year undergraduates(all P<0.05). Conclusion:The application of health belief model can analyze and explain the influencing factors of tuberculosis-related health behaviors of freshmen, which is helpful to strengthen health education and advocate tuberculosis-related health behaviors.

Benzodiazepines in complex biological matrices:Recent updates on pretreatment and detection methods / 药物分析学报

Benzodiazepines(BDZs)are used in clinics for anxiolysis,anticonvulsants,sedative hypnosis,and muscle relaxation.They have high consumptions worldwide because of their easy availability and potential addiction.They are often used for suicide or criminal practices such as abduction and drug-facilitated sexual assault.The pharmacological effects of using small doses of BDZs and their detections from complex biological matrices are challenging.Efficient pretreatment methods followed by accurate and sensitive detections are necessary.Herein,pretreatment methods for the extraction,enrichment,and preconcentration of BDZs as well as the strategies for their screening,identification,and quantitation developed in the past five years have been reviewed.Moreover,recent advances in various methods are summarized.Characteristics and advantages of each method are encompassed.Future directions of the pretreatment and detection methods for BDZs are also reviewed.

Ultrasensitive quantification of trace amines based on N-phosphorylation labeling chip 2D LC-QQQ/MS / 药物分析学报

Trace amines(TAs)are metabolically related to catecholamine and associated with cancer and neuro-logical disorders.Comprehensive measurement of TAs is essential for understanding pathological pro-cesses and providing proper drug intervention.However,the trace amounts and chemical instability of TAs challenge quantification.Here,diisopropyl phosphite coupled with chip two-dimensional(2D)liquid chromatography tandem triple-quadrupole mass spectrometry(LC-QQQ/MS)was developed to simul-taneously determine TAs and associated metabolites.The results showed that the sensitivities of TAs increased up to 5520 times compared with those using nonderivatized LC-QQQ/MS.This sensitive method was utilized to investigate their alterations in hepatoma cells after treatment with sorafenib.The significantly altered TAs and associated metabolites suggested that phenylalanine and tyrosine metabolic pathways were related to sorafenib treatment in Hep3B cells.This sensitive method has great potential to elucidate the mechanism and diagnose diseases considering that an increasing number of physiological functions of TAs have been discovered in recent decades.

The efficacy of neuroendoscope-assisted drainage with lumbar cistern and large bone flap decompression in the treatment of craniocerebral trauma complicated with temporal uncinate herniation / 中国医师进修杂志

Objective:To observe the effect of neuroendoscope-assisted drainage with lumbar cistern and large bone flap decompression in the treatment of craniocerebral injury complicated with temporal uncinate herniation.Methods:A total of 80 patients with craniocerebral trauma and temporal uncinate herniation hospitalized in Lanling County People′s Hospital from January 2017 to October 2020 were retrospectively included and divided into the observation group and the control group according to the surgical methods, with 40 patients in each group. Surgical procedures were performed by the same group of experienced neurosurgeons. The observation group was treated with neuroendoscope-assisted drainage with lumbar cistern and large bone flap decompression, while the control group was treated with large bone flap decompression only. Cephalic CT was reexamined before and 48 h after the surgery to compare the appearance rates of cisterna ambiens and suprasellar cistern. Intracranial pressure (ICP) was monitored at 3, 5 and 7 d after the surgery, and the scores of Glasgow coma scale(GCS) was recorded. Drainage time, postoperative cerebral edema and cerebral infarction complications were recorded and compared between the two groups. Six months after the surgery, the prognosis was assessed by the Glasgow prognostic scale (GPS).Results:The occurrence rates of cisterna ambiens and suprasellarcistern in the observation group were higher than those in the control group: 67.50%(27/40) vs. 45.00%(18/40), 65.00%(26/40) vs. 42.50%(17/40), χ2 = 4.11, 4.07, P<0.05. The ICP value in the observation group at 3, 5 and 7 d after the surgery were significantly lower than those in the control group, and the scores of GCS in the observation group were significantly higher than those in the control group, there were statistical differences( P<0.05). There was no statistically significant difference in drainage time between the two groups ( P>0.05). The incidence of postoperative cerebral edema in the observation group was lower than that in the control group:7.50%(3/40) vs. 25.00%(10/40), χ2 = 4.50, P<0.05. The incidence of postoperative cerebral infarction in the observation group was lower than that in the control group, and the volume of cerebral infarction was smaller than that in the control group: 5.00%(2/40) vs. 22.50%(9/40), (6.68 ± 1.75) cm 3 vs. (8.20 ± 2.15) cm 3, there were statistical differences ( P<0.05). The incidence of postoperative complications in the observation group was lower than that in the control group: 7.50%(7/40) vs. 40.00%(16/40), χ2 = 4.94, P<0.05. Six months after the surgery, the rate of good prognosis in the observation group was higher than that in the control group: 62.50%(25/40) vs. 35.00%(14/40), χ2 = 6.05, P<0.05. Conclusions:Neuroendoscope-assisted drainage with lumbar cistern and large bone flap decompression in the treatment of craniocerebral trauma and temporal uncinate herniation has good efficacy and safety.

Diurnal variation of serum hypoxia inducible factor-1 α in obese patients with obstructive sleep apnea / 国际外科学杂志

Objective:To observe the diurnal changes of serum hypoxia inducible factor-1α (HIF-1α) and its relationship with polysomnography (PSG) parameters in obese patients with obstructive sleep apnea (OSA).Methods:In this study, 64 obese subjects with OSA (experimental group) and 24 normal subjects (control group) were included. PSG monitoring was performed in all subjects, and peripheral blood samples were collected at night and next early morning to detect the expression level of HIF-1 α mRNA and protein concentration in serum. The data were analyzed by SPSS25.0 software. The counting data was represented by n(%), and t-tests were used for inter group comparisons. The measurement data of normal distribution adopted mean ± standard deviation ( ± s), and the inter group comparison adopted Chi-square. Serum HIF-1α mRNA levels and protein concentrations in the two groups were compared and analyzed by Two-way ANOVA, and Spearman rank correlation was used to analyze the correlation. Results:The ratio of male to female in the control group was 15: 9 and the average age was (39.25 ±10.58) years old, while that in the experimental group was 41∶24 with an average age of (41.31 ±15.20) years. The body mass index (BMI) of experimental group was higher, while all the relevant parameters recorded by PSG were significantly different between two groups ( P<0.001). The results showed that there was no significant difference in the expression of HIF-1α mRNA between the control group and the experimental group ( P=0.914), or between night and morning ( P=0.167). The concentration of HIF-1α protein in the control group was significantly lower than that in the experimental group ( P<0.001), but there was no significant difference in the concentration of HIF-1α protein in the same group at night and in the morning ( P=0.798). The results of correlation analysis showed that there was a significant correlation between PSG related indexes(AHI, minimum blood oxygen, mean blood oxygen and SIT90), night and morning mRNA expression and protein concentration ( P<0.05). Conclusions:Compared with normal people, the concentration of serum HIF-1 α protein in obese patients with OSA is higher, but there is no difference between night and morning. The process of HIF-1 α induced by CIH may be involved in post-translational regulation rather than transcription, and other compensatory mechanisms may also be involved.

A retrospective analysis of occupational pneumoconiosis in Zibo City from 1949 to 2021 / 中国职业医学

Objective: To analyze the base incidence, distribution characteristics, survival status and social security of occupational pneumoconiosis (hereinafter referred to as "pneumoconiosis") in Zibo City. Methods: The new pneumoconiosis patients in Zibo City from 1949 to 2021 were selected as the research subjects using a cross-sectional survey. Household survey or telephone follow-up were carried out, and the distribution characteristics, living conditions and social security situation were retrospectively analyzed. Results: A total of 8 910 patients with pneumoconiosis were investigated, and 96.0% of them were male. The stage Ⅰ pneumoconiosis patients accounted for 91.3%. From 1949 to 2021, the number of pneumoconiosis patients showed a stepwise upward trend with time. Most of the patients suffered from coal worker pneumoconiosis and silicosis, which accounted for 48.7% and 38.9%, respectively. The average age of onset was (52.7±11.4) years, and the average length of service exposed to dust was (21.1±9.4) years. The patients were concentrated in Zichuan District, Boshan District and Zhangdian District, that accounted for 87.8%. The industry distribution was mostly mining industry and manufacturing industry, accounting for 61.1% and 31.6% respectively. Among the 8 910 cases of pneumoconiosis, 543 cases were lost in follow-up. A total of 8 367 patients were followed-up, with a follow-up rate of 93.9%. The mortality rate of patients who completed follow-up was 50.5%, and the mortality rate decreased with the increase of the stage of pneumoconiosis (P<0.01). The rate of adoring social security in the 4 138 surviving patients was 98.4%. Conclusion: The situation of prevention and treatment of pneumoconiosis in Zibo City is challenging. It is necessary to strengthen the special control of dust hazards in mining and manufacturing industries in key areas such as Zichuan District, Boshan District and Zhangdian District.

Management of anticoagulant therapy in a patient with complex venous thromboembolism complicated with acute renal insufficiency / 中国药房

OBJECTIVE To provide a reference for the safe use of drugs in patients with complex venous thromboembolism （VTE） and acute renal insufficiency. METHODS Clinical pharmacists participated in the management of anticoagulant therapy for a patient with complex VTE complicated with acute renal insufficiency， and evaluated the patient as high-risk thrombosis and bleeding based on their medical history， laboratory test results， etc.； combined with the complexity of thrombosis and renal insufficiency， clinical pharmacists suggested that enoxaparin sodium should be used in the acute stage of thrombosis （5 to 21 days after onset）， and then warfarin should be adopted for oral anticoagulation treatment. Because the patient’s anticoagulation was not up to the standard （the target range of the international normalized ratio was 2-3）， clinical pharmacists suggested increasing the warfarin dose， detecting the warfarin metabolism genotype， and adjusting the warfarin dose according to the genotype； at the same time， clinical pharmacists developed an anticoagulation monitoring plan to ensure the safety of anticoagulation treatment. RESULTS Doctors had adopted all the recommendations of clinical pharmacists. The patient did not experience adverse events such as bleeding or worsening of thromboembolism during anticoagulation in the hospital. When the anticoagulation met the standards， the patient was allowed to be discharged with medication. CONCLUSIONS By participating in the anticoagulation treatment management of patients with complex VTE and acute renal insufficiency， clinical pharmacists have assisted doctors in formulating personalized anticoagulation plans to promote the compliance with the anticoagulation treatment standard and ensure the safety and effectiveness of medication for patients.

A survey of interventional radiology resources and radiation protection equipment and personal dosimeter wearing rate in Qingdao, China / 中国辐射卫生

Objective To investigate the current status of interventional radiology resources, radiation protection equipment, and the rate of wearing of personal dosimeters in Qingdao, China, and to provide a data basis for strengthening radiation protection and health management for interventional radiation workers. Methods A questionnaire survey was performed on all medical institutions with interventional radiation services in Qingdao. The data from April 1, 2020 to March 31, 2021 were pooled and analyzed. Results A total of 31 medical institutions in Qingdao were investigated, including 23 (74.20%) tertiary hospitals and 8 (25.80%) secondary hospitals. There were 88 pieces of interventional radiation equipment in total in Qingdao, 89.77% of which were in tertiary hospitals. A total of 921 interventional professionals participated, with 865 (93.92%) from tertiary hospitals and 56 (6.08%) from secondary hospitals. The mean annual number of visits to interventional services was 5.72 per 1000 people. Among personal protective equipment, the equipment rates of lead-rubber aprons, lead-rubber caps, and lead-rubber collars were highest, all being 100%. The rate of equipment of interventional protective gloves was lowest, which was only 51.61%. The mean number of each accessory protective equipment for each interventional machine was less than 1. The rate of wearing of dual-dosimeters was 84.36%. Conclusion Tertiary hospitals were dominant among the medical institutions in this survey of interventional radiology services in Qingdao. The most frequently equipped personal protective goods were lead-rubber aprons, caps, and collars. The equipment rates of interventional protective gloves and protective accessories and the rate of wearing of dual-dosimeters were relatively low.

Value of serum chitinase-3-like protein 1 in predicting the risk of decompensation events in patients with liver cirrhosis / 临床肝胆病杂志

Objective To investigate the value of serum chitinase-3-like protein 1 (CHI3L1) in predicting the risk of decompensation events in patients with liver cirrhosis, since prediction of decompensation events and adoption of active preventive measures are the key to improving the survival time of patients with liver cirrhosis. Methods A case-control study was conducted for 305 patients with liver cirrhosis who were diagnosed and treated in Tianjin Second People's Hospital from January 2019 to May 2021, among whom there were 200 patients with compensated liver cirrhosis and 105 patients with decompensated liver cirrhosis at baseline. According to whether decompensation events occurred within 1 year, the 305 patients with liver cirrhosis were divided into decompensation group with 79 patients and non-decompensation group with 226 patients; according to whether decompensation events occurred for the first time within 1 year, the 200 patients with compensated liver cirrhosis were divided into first-time decompensation group with 43 patients and non-first-time decompensation group with 157 patients. The independent samples t -test or the Mann-Whitney U test was used for comparison of normally distributed continuous data between groups, and the Wilcoxon rank-sum test or the chi-square test was used for comparison of categorical data between groups. The binary logistic regression analysis was used to investigate the association between each variable and decompensation events; the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC) were used to investigate the value of each variable in predicting decompensation events, and the maximum value of Youden index was used to determine the optimal cut-off value. Results The patients who experienced decompensation events within 1 year had a significantly higher baseline serum level of CHI3L1 than those who did not experience such events [243.00 (136.00-372.00) ng/mL vs 117.50 (67.75-205.25) ng/mL, U =4720.500, P < 0.001], and the patients who experienced decompensation events for the first time within 1 year had a significantly higher baseline serum level of CHI3L1 than those who did not experience such events [227.98 (110.00-314.00) ng/mL vs 90.00 (58.00-168.50) ng/mL, U =1 681.500, P < 0.001]. Patients with cirrhosis with higher baseline CHI3L1 levels had an increased risk of decompensation events within 1 year ( OR =1.004, 95% CI : 1.002-1.006, P < 0.001); Patients with compensated cirrhosis with higher baseline serum CHI3L1 levels had an increased risk of first decompensated event within 1 year ( OR =1.006, 95% CI : 1.003-1.008, P < 0.001). The baseline serum level of CHI3L1 had an AUC of 0.751 in predicting the risk of first-time decompensation events, with a sensitivity of 90.7% and a specificity of 55.4% at the optimal cut-off value of 95.5 ng/mL. The predictive model based on the combination of serum CHI3L1 level and Child-Pugh class had an AUC of 0.809, with a sensitivity of 72.1% and a specificity of 77.1% at the maximum value of Youden index. Conclusion Serum CHI3L1 level can be used as an effective predictive factor for the risk of first-time decompensation events in patients with compensated liver cirrhosis, and its combination with Child-Pugh class shows a higher predictive value.

Analysis of results of national personal dose monitoring ability assessment in 2016—2021 / 中国辐射卫生

Objective To analyze the results of national personal dose monitoring intercomparison and assessment of Hubei Provincial Hospital for Occupational Disease in 2016—2021, to investigate the influencing factors for monitoring results, and to improve the ability of personal dose monitoring. Methods The assessment was completed according to the requirements of The National Comparison Scheme for Individual Dose Monitoring Ability and Testing Criteria of Personnel Dosimetry Performance for External Exposure (GBZ 207—2016). Results The assessment results were qualified in 2016—2017 and 2020 and excellent in 2018—2019 and 2021. Conclusion The ability of personal dose monitoring in our laboratory has been continuously improved. The monitoring results are accurate and the data processing is standardized, which meet the requirements of relevant standards for personal external exposure dose monitoring.

Diagnosis and Treatment of Klebsiella Pneumoniae Combined with Enterobacter Cloacae in Lumbar Intervertebral Space Infection / 中山大学学报(医学科学版)

ObjectiveTo explore the clinical diagnosis and treatment of rare primary lumbar intervertebral space infection with Klebsiella pneumoniae and Enterobacter cloacae， and provide clinical experience for the diagnosis and treatment of this rare spinal infection. MethodsAn elderly male patient with low back pain and numbness in the left lower extremity for more than 7 months， which aggravated for more than 1 week， was diagnosed with lumbar disc herniation after laboratory and imaging examinations. After admission， the symptoms became acutely aggravated， and re-examination of lumbar enhanced MRI showed local enhancement at the posterior edge of the L3/4 intervertebral space. The VAS score was 9 points， and the lumbar JOA score was 6 points. A posterior lumbar interbody fusion of L3-L5 was performed， and L3/4 intervertebral disc specimens were collected during the operation for bacterial culture. ResultsBacterial culture results showed Klebsiella pneumoniae and Enterobacter cloacae infection. The patient was treated with sensitive antibiotics for 6 weeks after the operation， and the patient was cured during the follow-up of half a year after the operation. ConclusionFor middle-aged and elderly patients with clinical manifestations of acute severe low back pain or lower extremity pain， the possibility of spinal infection should be considered when routine laboratory and imaging examinations suggest lumbar degenerative diseases.

Role of steroid receptor-associated and regulated protein in tumor progression and progesterone receptor signaling in endometrial cancer / 中华医学杂志(英文版)

BACKGROUND@#Steroid receptor-associated and regulated protein (SRARP) suppresses tumor progression and modulates steroid receptor signaling by interacting with estrogen receptors and androgen receptors in breast cancer. In endometrial cancer (EC), progesterone receptor (PR) signaling is crucial for responsiveness to progestin therapy. The aim of this study was to investigate the role of SRARP in tumor progression and PR signaling in EC.@*METHODS@#Ribonucleic acid sequencing data from the Cancer Genome Atlas, Clinical Proteomic Tumor Analysis Consortium, and Gene Expression Omnibus were used to analyze the clinical significance of SRARP and its correlation with PR expression in EC. The correlation between SRARP and PR expression was validated in EC samples obtained from Peking University People's Hospital. SRARP function was investigated by lentivirus-mediated overexpression in Ishikawa and HEC-50B cells. Cell Counting Kit-8 assays, cell cycle analyses, wound healing assays, and Transwell assays were used to evaluate cell proliferation, migration, and invasion. Western blotting and quantitative real-time polymerase chain reaction were used to evaluate gene expression. The effects of SRARP on the regulation of PR signaling were determined by co-immunoprecipitation, PR response element (PRE) luciferase reporter assay, and PR downstream gene detection.@*RESULTS@#Higher SRARP expression was significantly associated with better overall survival and disease-free survival and less aggressive EC types. SRARP overexpression suppressed growth, migration, and invasion in EC cells, increased E-cadherin expression, and decreased N-cadherin and Wnt family member 7A ( WNT7A ) expression. SRARP expression was positively correlated with PR expression in EC tissues. In SRARP -overexpressing cells, PR isoform B (PRB) was upregulated and SRARP bound to PRB. Significant increases in PRE-based luciferase activity and expression levels of PR target genes were observed in response to medroxyprogesterone acetate.@*CONCLUSIONS@#This study illustrates that SRARP exerts a tumor-suppressive effect by inhibiting the epithelial-mesenchymal transition via Wnt signaling in EC. In addition, SRARP positively modulates PR expression and interacts with PR to regulate PR downstream target genes.

Biograph Vision 600 PET performance testing and analysis / 中国辐射卫生

Objective To test and analyze the performance of Biograph Vision 600 PET/CT according to the NEMA NU2—2012 standard to achieve reliable, repeatable, and inter-system comparable performance measurement, and to provide a basis for future equipment stability testing and status detection. Methods The Biograph Vision PET equipment features a detector based on silicon photomultipliers, with 3.2 mm lutetium oxyorthosilicate crystals and full cover of the scintillation region. The spatial resolution, sensitivity, noise-equivalent count rate, scatter fraction, coincidence count rate, image quality, scatter correction, and time-of-flight resolution of Biograph Vision PET were tested by referring to the test model and method of the NEMA NU2—2012 standard. Results The Biograph Vision 600 PET equipment showed lateral and axial spatial resolutions of 3.69 mm and 3.81 mm at 1 cm off-center of the field of view, respectively and of 4.29 mm and 4.48 mm at 10 cm, respectively. The sensitivity was 17.5 kcps/MBq. The time-of-flight resolution changed from 210 ps to 215 ps as the count rate increased to the peak noise equivalent count rate. The NEMA peak noise-equivalent count rate was 247 kcps at 30.3 kBq/ml. The corresponding scatter fraction was 34.8%. With the NEMA module, the overall image quality contrast range was 73.6%-92.8%, and the background variability was 2.3%-6.5%; the mean lung residual error was 3.4%; and the time-of-flight resolution was 210 ps. Conclusion This performance test was performed according to the NEMA NU2—2012 standard, showing that all parameters were better than the ex-factory standard, which can provide a reference for other institutions selecting equipment and also provide a basis for future equipment stability testing and status detection.