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Clinical pharmacists participated in the anti-infection treatment of a patient with Bartonella henselae meningitis.According to the clinical manifestations and the quantitative metagenomic second-generation sequencing(mNGS)of cerebrospinal fluid,the patient was diagnosed as Bartonella henselae infection.According to the relevant clinical guidelines and foreign case treatment reports,it is recommended to use minocycline hydrochloride capsule oral treatment combined with rifampicin injection.Follow-up treatment of the patient was dynamically adjusted based on the reexamination results of cerebrospinal fluid and related inflammatory indicators.In the treatment process,clinical pharmacists give full play to their professional expertise,provide the patient with individualized pharmaceutical care,optimize anti-infection programs,and further promote clinical rational drug use.
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Objective:To investigate the hot topics and trends of implementation science in the transformation of clinical practice guidelines, in order to provide ideas and references for clinical managers to reasonably apply and implement scientific promotion guidelines.Methods:CiteSpace6.2.R3 software was used to visualize the literature, which retrieved from the core database of Web of Science, including the number of articles, countries and high-frequency keywords and keyword clustering and emergence for visual analysis, etc.Results:A total of 4 593 articles were included in the final analysis. Since 1993, the number of published papers had increased year by year. The hot topics focused on primary care, attitudes, knowledge translation, clinical trials, risk factors and machine learning. The research trends included older adults and artificial intelligence.Conclusions:The rapid development of implementation science in guideline translation research suggests that scholars from various countries, especially hospital administrators should reasonably apply implementation science framework to integrate evidence into clinical practice, and promote the implementation of clinical practice guidelines.
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Objective:To compare the differences of brain activation in patients with neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) under contact heat stimulation (CHS), and to explore the characteristics of pain-related brain networks in NMOSD and MS patients.Methods:Fourteen NMOSD patients (NMOSD group) and 12 MS patients (MS group) admitted to Affiliated Hospital of North Sichuan Medical College from September 2022 to December 2022 who met the diagnostic criteria were collected. Twelve healthy individuals (HC group) matched with gender and age were recruited during the same period. Visual Analogue Scale (VAS) score was used to evaluate the pain of the subjects, CHS painful stimuli were given, and task-state functional magnetic resonance imaging (fMRI) scans were performed at the same time, and the differences in brain activation among the 3 groups were analyzed and compared.Results:(1) Compared with the HC group, the NMOSD group had a stronger activation degree than the HC group in the brain regions including the cortex around the left distance fissure, bilateral medial superior frontal gyrus; the activation degree of the NMOSD group was weaker than that of the HC group in the brain areas including the left medial and paracingulate gyrus, right superior parietal gyrus, left postcentral gyrus, and right supplementary motor area (all P<0.05). (2) Compared with the HC group, the brain regions whose activation degree was weaker in the MS group included the left caudate nucleus, left medial and paracingulate gyrus, left paracentral lobule, right superior parietal gyrus, left postcentral gyrus, left precuneus, right supplementary motor area, right superior temporal gyrus and right thalamus, and there was no brain area in the MS group whose activation degree was stronger than that of the HC group (all P<0.05). (3) Compared with the MS group, the brain regions with stronger activation degree in the NMOSD group included the left perifissure cortex and right thalamus, but no brain regions with weaker activation degree were found in the NMOSD group (all P<0.05). (4) There was a correlation between somatic pain VAS scores and activation of the medial superior frontal gyrus in the NMOSD group ( r=0.66, P<0.05). Conclusions:The results of CHS-fMRI in the NMOSD group, MS group and HC group showed that multiple brain regions were activated, indicating that multiple brain regions were involved in the generation and processing of pain, and there was a pain-related brain network. Pain-related brain networks were altered in NMOSD patients and MS patients, and there were differences in pain-related brain networks between the two diseases.
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Objective:To observe the changes in brain functional magnetic resonance imaging (fMRI) in migraine patients under olfactory stimuli and analyze the characteristics of olfactory-related brain networks.Methods:Twenty-seven migraine patients (migraine group) enrolled in the Department of Neurology, Affiliated Hospital of North Sichuan Medical College from January 2021 to January 2022 were included, and 20 healthy adults were recruited as control group during the same period. All subjects underwent synchronous fMRI scanning under olfactory task stimulation, and magnetic resonance imaging data processing was performed using SPM12 and Matlab2019b softwares, and statistical analysis was performed with SPSS 23.0 software.Results:The activated brain regions in the control group included the left cerebellum, left inferior temporal gyrus, left fusiform gyrus, right middle frontal gyrus, right anterior central gyrus, insula, right central sulcus, superior marginal gyrus, right lenticular putamen, middle cingulate gyrus, paracentral lobule, and superior parietal gyrus ( P<0.05). The activated brain regions in the migraine group included the left cerebellum, right fusiform gyrus, right inferior temporal gyrus, right anterior central gyrus, and right posterior central gyrus ( P<0.05). Compared with the control group, the activation intensity of the migraine group was weaker in the right insula, right middle frontal gyrus orbit, left inferior frontal gyrus orbit, right dorsolateral superior frontal gyrus, right superior temporal gyrus, right superior occipital gyrus, medial and paracingulate gyrus, and right superior parietal gyrus ( P<0.05). Conclusion:Migraine patients have multiple brain regions involved in olfactory processing and have specific olfactory-related brain networks.
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Chronic refractory pain is an excruciating pain caused by various reasons, which is easily recurrent and barely responded to multiple drugs. It affects more than 10% of the global population and thus causes a huge burden on the society and the economy. With the development of neuroscience, neuromodulation technologies have been well concerned, which guide a novel direction in the treatment of chronic refractory pain. This review summarizes the research progresses on repetitive transcranial magnetic stimulation, transcranial direct current stimulation, transcranial focused ultrasound stimulation, optogenetics and other non-invasive neuromodulations in the treatment of chronic refractory pain.
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Fatty acid binding protein 7 (FABP7) is a small molecular cytoplasmic protein. As a cellular fatty acid chaperone, it binds specifically to ligands such as DHA and is widely involved in physiological and pathological processes. During brain development, FABP7 is heavily expressed in neural stem cells, astrocytes and oligodendrocyte precursor cells, which plays a key role in regulating the pathology process of the central nervous system diseases. This article reviews the structure, expression and function of FABP7 and its related research progress in central nervous system disease.
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Nanoparticles (NPs) have shown potential in cancer therapy, while a single administration conferring a satisfactory outcome is still unavailable. To address this issue, the dissolving microneedles (DMNs) were developed to locally deliver functionalized NPs with combined chemotherapy and photothermal therapy (PTT).
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Objective:To compare the similarities and differences of four telemedicine diagnostic projects, for providing evidence-based policy-making advice for the development of telemedicine diagnostic projects in China.Methods:Four projects led by the government, close medical alliances, loose medical alliances and companies were selected from November 2018 to June 2019. Through semi-structured interviews with different leaders, the authors analyzed the characteristics, problems and difficulties of different projects from three dimensions of organizational system, working conditions and operational effects.Results:A total of 18 people were interviewed. Projects were different from each other in leaders, connection mechanism and effectiveness, participants and timeliness as well. The projects led by the government and close medical alliances had limited local participants with strong connection, clear but limited sources of diagnostic doctors and relatively large workload. While the projects led by loose medical alliances and companies had a wide range of participants, relatively weak connection efficiency and long response time.Conclusions:Different types of telemedicine diagnostic projects have supplemented the manpower shortage of diagnosis physicians at primary medical institutions, introduced new service participants, as well as improved the medical service system.
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Objective@#To compare the similarities and differences of four telemedicine diagnostic projects, for providing evidence-based policy-making advice for the development of telemedicine diagnostic projects in China.@*Methods@#Four projects led by the government, close medical alliances, loose medical alliances and companies were selected from November 2018 to June 2019. Through semi-structured interviews with different leaders, the authors analyzed the characteristics, problems and difficulties of different projects from three dimensions of organizational system, working conditions and operational effects.@*Results@#A total of 18 people were interviewed. Projects were different from each other in leaders, connection mechanism and effectiveness, participants and timeliness as well. The projects led by the government and close medical alliances had limited local participants with strong connection, clear but limited sources of diagnostic doctors and relatively large workload. While the projects led by loose medical alliances and companies had a wide range of participants, relatively weak connection efficiency and long response time.@*Conclusions@#Different types of telemedicine diagnostic projects have supplemented the manpower shortage of diagnosis physicians at primary medical institutions, introduced new service participants, as well as improved the medical service system.
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Objective:To investigate the status of removing iodized salt, water iodine, and iodine nutrition of children in water source high iodine areas in Taiyuan City, Shanxi Province, so as to provide basis for the implementation of prevention and control measures in high iodine areas according to local conditions.Methods:From 2012 to 2017, four administrative villages were selected from each of the high iodine townships in the water source high iodine areas (Qingxu County and Xiaodian District) in Taiyuan City, and 15 households in each administrative village were sampled for salt iodine detection by semi quantitative method. According to the "National Monitoring Program for Water Source High Iodine Areas (Trial)" (2012 edition), 1-2 high iodine villages were selected respectively in Qingxu County and Xiaodian District every year as monitoring sites, and grouped by water iodine of 150-300 μg/L and > 300 μg/L. If the monitoring site had been implemented the water improvement project, one tap water sample shall be collected. Whereas, if the monitoring site had not been implemented the water improvement project, two drinking water samples shall be collected from each household in the five directions of east, west, south, north and middle, and the water iodine shall be detected using the "Research on Methods for Water Iodine Testing in Iodine Deficiency and High Iodine Areas" recommended by the National Iodine Deficiency Disorders Reference Laboratory of the Chinese Center for Disease Control and Prevention. A total of 100 children aged 8-10 years old were selected from village primary schools or central primary schools in townships where the monitoring sites were located, and their thyroid volume was detected by B-ultrasound; urine samples were taken from more than 30 children and urinary iodine was detected by arsenic-cerium catalytic spectrophotometry.Results:From 2012 to 2017, the rate of non-iodized salt in Qingxu County ranged from 91.7% (165/180) to 96.1% (173/180); the rate of non-iodized salt in Xiaodian District were all 100.0% (120/120). A total of 52 water samples were tested, and the median water iodine was 282.3 μg/L, ranged from 121.1 to 546.3 μg/L. A total of 1 401 children's thyroid were examined, and the goiter rate was 7.5% (105/1 401). A total of 597 children's urine samples were tested, and the median urinary iodine was 458.1 μg/L, ranged from 21.0 to 1 778.7 μg/L. The median urinary iodine (327.1 μg/L) and goiter rate (4.9%, 34/697) of children in the 150-300 μg/L water iodine group were compared with those in the > 300 μg/L water iodine group (552.9 μg/L; 10.1%, 71/704), the differences were statistically significant ( Z = - 8.934, χ 2 = 13.698, P < 0.01). Conclusions:From 2012 to 2017, the median water iodine is 282.3 μg/L in water source high iodine areas in Taiyuan City, the status of removing iodized salt is good (the rate of non-iodized salt > 90%). However, children have excessive iodine (median urinary iodine ≥300 μg/L) and goiter rate (> 5%). It is suggested that the main measures should be taken to improve water quality and reduce iodine content in drinking water in water source high iodine areas, continuously monitor water iodine, and timely adjust the prevention and control measures according to the change of water iodine.
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Objective@#To determine whether intrauterine infection with hepatitis B virus (HBV) occurs in early pregnancy and to characterize associated virulence factors.@*Methods@#Villi tissues and blood samples of 45 HBV surface antigen (HBsAg)-positive pregnant women were collected during the first trimester and HBV DNA loads were quantified by quantitative reverse transcription polymerase chain reaction (qRT-PCR). The expression of GCM1, HBsAg and hepatitis B core antigen (HBcAg) in villi tissues were detected by immunohistochemical method.@*Results@#Data from qRT-PCR showed that HBV DNA was detected in 14 of 45 villi tissues (positive rate of 31.11%), and 24 of 45 blood samples (positive rate of 53.33%), further statistical analysis showed that the positive rates of HBV DNA between blood samples and villi tissues were not significantly different (χ2=4.555, P=0.054). Among them, 12 samples were consistently positive between the villi and blood specimens, and HBsAg, HBeAg, HBeAb, HBV DNA from peripheral blood in these pregnant women were significantly higher than those of the other women (P value was 0.007, 0.004, 0.000, and 0.000 respectively). The multivariate logistic regression analysis showed that blood HBV DNA greater than 106 IU/ml was independently associated with HBV DNA positive in villi, and the HBsAg, HBeAg, villi tissues HBV DNA positive rates of these pregnant women were significantly higher than those of the other pregnant women (all P value were 0.000). Immunohistochemistry results showed that all 45 cases were positive for GCM1 expression in the cell nucleus. Nine cases also had HBsAg expression in the cytoplasm. Only one case was found to express HBV core antigen (HBcAg) in the nucleus.@*Conclusions@#HBV DNA and HBsAg can be detected from villi tissues harvested during the first trimester in HBsAg-positive pregnant women, and the results suggest an early occurrence of intrauterine infection of fetuses with high HBV levels.
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Objective To explore the ideal living states and expectations of the elderly residing in Chengdu city,Sichuan Province and the most favorite pension system they want.To provide a theoretical basis for our country to build a suitable pension system and improve the quality of life and happiness of the elderly.Methods Qualitative-quantitative combined methods and convenient sampling were used in this study.The qualitative data with semi-structured in-depth interviews had been obtained from the selected 40 elderly who live in Chengdu,while the quantitative data with the questionnaires were obtained from other 130 elderly.Results Family location,gender,educational background,age had impact on the expected pension system of the elderly(P＜0.05).Conclusion Different elderly have different expectation on the pension system,the current pension system should be reformed according to their expectations.
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Dry powder inhalers (DPIs) offer distinct advantages as a means of pulmonary drug delivery and have attracted much attention in the field of pharmaceutical science. DPIs commonly contain micronized drug particles which, because of their cohesiveness and strong propensity to aggregate, have poor aerosolization performance. Thus carriers with a larger particle size are added to address this problem. However, the performance of DPIs is profoundly influenced by the physical properties of the carrier, particularly their particle size, morphology/shape and surface roughness. Because these factors are interdependent, it is difficult to completely understand how they individually influence DPI performance. The purpose of this review is to summarize and illuminate how these factors affect drug-carrier interaction and influence the performance of DPIs.
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Periaxin, a protein of noncompact myelin, is specifically expressed in the peripheral nervous system (PNS). There are two protein isoform L-periaxin and S-Periaxin by alternative splicing of periaxin gene, playing an important role in the initiation of myelin formation. So far, 18 different mutation sites in L-periaxin gene have been found to induce the peripheral demyelinating neurological charcot-marie-tooth diseases subtype 4F (CMT4F). The technique of activation of transcription activator-like effector nucleases (TALENS) was used to knock out the L-periaxin gene in RSC 96 cell line of Rattus. According to the design principle, the knock-out site of L-periaxin was assured to NLS domain of L-periaxin, which is target sequence of left and right arms of TALEN. The knock-out vectors of TALEN-L and TALEN-R were established and transfected into RSC96 cell. After puromycin screening, L-periaxin was knocked out successfully in RSC96 cell, which is confirmed by DNA sequence. The mutation efficiency is 21.6%. S-periaxin, not L-periaxin can be detected by Western blotting in L-periaxin gene knock-out RSC96 cell. The cell growth rate was decreased and the number of cells in G1 increased and decreased in S phase in L-periaxin gene knock-out RSC96 cell by flow cytometry and MTT assay.
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Animals , Rats , Cell Line , Charcot-Marie-Tooth Disease , Genetics , Gene Knockout Techniques , Membrane Proteins , Genetics , Mutation , Protein IsoformsABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship between maternal pre-pregnancy body mass index, weight gain during pregnancy and small for gestational age (SGA) birth so as to provide evidence for the development of comprehensive prevention programs on SGA birth.</p><p><b>METHODS</b>Between March, 2012 and July, 2014, 4 754 pregnant women were asked to fill in the questionnaires which were collected from the First Affiliated Hospital of Shanxi Medical University. Data related to general demographic characteristics, pregnancy and health status of those pregnant women was collected and maternal pre-pregnancy body mass index and maternal weight gain were calculated. Subjects were divided into different groups before the effect of maternal pre-pregnancy body mass index and weight gain during pregnancy on SGA birth were estimated.</p><p><b>RESULTS</b>The overall incidence of SGA birth was 9.26% (440/4 754). Proportions of SGA birth from pre-pregnant, underweight group, normal weight group, overweight and obese groups were 9.85%, 8.54% and 9.45%, respectively. Results from multi-factor logistic regression analyses showed that after adjusting the confounding factors as age, history on pregnancies etc., women with high pre-pregnancy BMI showed a lower incidence of SGA than those under normal pre-pregnancy BMI (OR = 0.714, 95% CI: 0.535-0.953). Different weight gains during pregnancy were statistically significant (χ(2) = 8.811, P = 0.012). Incidence of SGA birth that was below the recommended range in the 2009 Institute of Medicine Guidelines (12.20%) was higher than those within (9.23%) or beyond (8.45%) the recommended range. Results from the multi-factor logistic regression analyses showed that, after adjusting the confounding factors as age, pregnancy history etc., factor as weight gain below the recommended level could increase the risk of SGA (OR = 1.999, 95% CI: 1.487-2.685). In the underweight, normal weight, overweight or obese groups, with weight gain during pregnancy below the range, the incidence of SGA showed an increase (OR = 2.558, 95% CI: 1.313-4.981, OR = 1.804, 95% CI: 1.258-2.587, OR = 3.108, 95% CI: 1.237-7.811). There was no interaction of addictive or multiplicative models between these two factors under 'interaction analysis'.</p><p><b>CONCLUSION</b>Women with high pre-pregnancy BMI presented a lower incidence of SGA than those within the normal range. Insufficient weight gain during pregnancy could increase the risk of SGA delivery. These findings called for attention to be paid to the gestational weight gain, in order to decrease the risk of SGA.</p>