Wernicke's encephalopathy misdiagnosed as schizophrenia： a case report / 四川精神卫生

This article presents a case report of Wernicke's encephalopathy misdiagnosed as schizophrenia. The patient was hospitalized and diagnosed with schizophrenia at a local psychiatric hospital over a month ago. Twelve days ago， the patient gradually developed symptoms such as salivation， difficulty in eating， trembling hands， unsteady walking， glossoptosis and so on. The above symptoms were interpreted as drug-induced adverse reactions and managed accordingly， whereas the patient showed a poor response to treatment， and began to experience intermittent consciousness disorder. After referral to our hospital， findings were diagnostic for Wernicke's encephalopathy and peripheral polyneuropathy. Due to the progression of the disease， the family members abandoned further treatment and requested discharge from the hospital， and the patient died outside the hospital. This case report aims to improve the prognosis of Wernicke's encephalopathy in patients with mental disorder by raising the awareness of the disease and enhancing the early prevention.

The performance of digital chest radiographs in the detection and diagnosis of pulmonary nodules and the consistency among readers / 中华肿瘤杂志

Objective: To investigate the detection and diagnostic efficacy of chest radiographs for ≤30 mm pulmonary nodules and the factors affecting them, and to compare the level of consistency among readers. Methods: A total of 43 patients with asymptomatic pulmonary nodules who consulted in Cancer Hospital, Chinese Academy of Medical Sciences from 2012 to 2014 and had chest CT and X-ray chest radiographs during the same period were retrospectively selected, and one nodule ≤30 mm was visible on chest CT images in the whole group (total 43 nodules in the whole group). One senior radiologist with more than 20 years of experience in imaging diagnosis reviewed CT images and recording the size, morphology, location, and density of nodules was selected retrospectively. Six radiologists with different levels of experience (2 residents, 2 attending physicians and 2 associate chief physicians independently reviewed the chest images and recorded the time of review, nodule detection, and diagnostic opinion. The CT imaging characteristics of detected and undetected nodules on X images were compared, and the factors affecting the detection of nodules on X-ray images were analyzed. Detection sensitivity and diagnosis accuracy rate of 6 radiologists were calculated, and the level of consistency among them was compared to analyze the influence of radiologists' seniority and reading time on the diagnosis results. Results: The number of nodules detected by all 6 radiologists was 17, with a sensitivity of detection of 39.5%(17/43). The number of nodules detected by ≥5, ≥4, ≥3, ≥2, and ≥1 physicians was 20, 21, 23, 25, and 28 nodules, respectively, with detection sensitivities of 46.5%, 48.8%, 53.5%, 58.1%, and 65.1%, respectively. Reasons for false-negative result of detection on X-ray images included the size, location, density, and morphology of the nodule. The sensitivity of detecting ≤30 mm, ≤20 mm, ≤15 mm, and ≤10 mm nodules was 46.5%-58.1%, 45.9%-54.1%, 36.0%-44.0%, and 36.4% for the 6 radiologists, respectively; the diagnosis accuracy rate was 19.0%-85.0%, 16.7%-6.5%, 18.2%-80.0%, and 0%-75.0%, respectively. The consistency of nodule detection among 6 doctors was good (Kappa value: 0.629-0.907) and the consistency of diagnostic results among them was moderate or poor (Kappa value: 0.350-0.653). The higher the radiologist's seniority, the shorter the time required to read the images. The reading time and the seniority of the radiologists had no significant influence on the detection and diagnosis results (P>0.05). Conclusions: The ability of radiographs to detect lung nodules ≤30 mm is limited, and the ability to determine the nature of the nodules is not sufficient, and the increase in reading time and seniority of the radiologists will not improve the diagnostic accuracy. X-ray film exam alone is not suitable for lung cancer diagnosis.

A preliminary study on the role of V-domain Ig suppressor of T cell activation in juvenile idiopathic arthritis / 中国当代儿科杂志

OBJECTIVES@#To study the expression of V-domain Ig suppressor of T cell activation (VISTA) in peripheral blood of children with juvenile idiopathic arthritis (JIA) and its role in the pathogenesis of JIA.@*METHODS@#In this prospective study, peripheral blood was collected from 47 children with different subtypes of JIA and 10 healthy children. Flow cytometry was used to measure the expression levels of VISTA, interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α) on CD14+ mononuclear cells, CD4+ T lymphocytes, and CD8+ T lymphocytes.@*RESULTS@#The children with JIA had a significantly lower expression level of VISTA than the healthy children (P<0.05). There was a significant difference in the expression of VISTA between the children with different subtypes of JIA, with the lowest expression level in those with systemic JIA (P<0.05). There was also a significant difference in the expression of VISTA between different immune cells, with a significantly higher expression level on the surface of monocytes (P<0.05). Correlation analysis showed that VISTA was negatively correlated with the expression of IFN-γ and TNF-α on CD4+ T cells (r=-0.436 and -0.382 respectively, P<0.05), CD8+ T cells (r=-0.348 and -0.487 respectively, P<0.05), and CD14+ mononuclear cells (r=-0.582 and -0.603 respectively, P<0.05).@*CONCLUSIONS@#The insufficient expression of VISTA may be associated with the pathogenesis of JIA, and enhancing the immunomodulatory effect of VISTA might be one option for the treatment of JIA in the future.

Establishment of A Mouse Model of Hematopoietic Stem Cell Transplantation Infected with Respiratory Syncytial Virus / 中国实验血液学杂志

OBJECTIVE@#To establish a mouse model of respiratory syncytial virus (RSV) infection after hematopoietic stem cell transplantation, so as to lay the foundation for future research on RSV infection and related complications after hematopoietic stem cell transplantation.@*METHODS@#Bone marrow cells and spleen cells were transplanted to C57BL/6 mice after myeloablative treatment to establish a mouse model of allogeneic hematopoietic stem cell transplantation. The chimerism rate was detected by flow cytometry 3 and 7 weeks after transplantation. The transplanted mice were infected with RSV by nasal drops. The lung tissues were collected 5 days after infection for identification of infection, and lung tissues were analyzed for pathology 2 weeks and 2 months after infection.@*RESULTS@#The chimerism rate was > 90% at 3 and 7 weeks after transplantation. Successful infection was detected 5 days after RSV infection, and there were severe and persistent pathological changes in the lung tissues of the mice 2 weeks and 2 months after infection.@*CONCLUSION@#RSV infection in stable chimeric mice after hematopoietic stem cell transplantation can cause significantly persistent lung disease, which lays foundation for the prevention and treatment of RSV infection and the mechanism of later bronchiolitis obliterans after hematopoietic stem cell transplantation.

Atrophy of entorhinal cortex in evaluation of cognitive performance in patients with diabetes mellitus / 中国医学影像技术

Objective To evaluate the potential cerebral cortical volume alterations in type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI) compared with T2DM patients and healthy controls,and to observe the correlations with the scores of neuropsychological scales.Methods Cortical volume based on high-resolution MR T1WI data from 30 healthy controls (HC),30 T2DM patients and 30 T2DM with MCI patients were evaluated with FreeSurfer software and compared with variance analysis.The correlations between cerebral cortical volume which had statistical difference and the scores of neuropsychological scales were analyzed.Results There were significant differences in auditory verbal learning test (AVLT) scores,complex figure test-delayed recall (20 min) scores,digit symbol-coding subtest scores,MoCA scores and higher trail-making test-A scores,as well as trail-making test-B scores between T2DM and T2DM with MCI patients (all P＜0.05).Compared with T2DM patients,cortical volume of left entorhinal cortex,left lateral orbitofrontal gyrus,left posterior cingulate gyrus and the right lateral orbitofrontal gyrus,right pars orbitalis,right insula reduced in T2DM with MCI patients (all P＜0.05).In T2DM with MCI patients,AVLT scores were positively correlated with volume of the left entorhinal cortex (r=0.452,P=0.018).Conclusion Several cortical volume reductions are exhibited in T2DM patients with MCI.The volume of the left entorhinal cortex may be a potential biomarker to diagnose and evaluate MCI in T2DM.

Decision tree analysis of pelvic MRI in diagnosis of endometrial cancer with ovarian malignant tumor / 中国介入影像与治疗学

Objective To explore the value of pelvic MRI combined with clinical information in diagnosis of endometrial cancer (EC) with ovarian malignant tumor (OMT) using decision tree analysis.Methods The clinical information and pelvic MRI characteristics of 58 cases with ovarian malignant tumor (EC-OMT group) and 743 cases without ovarian malignant tumor (EC group) were reviewed and compared.The diagnostic efficacy of pelvic MRI was evaluated.Decision tree analysis was used in determining the performance on the diagnosis.Results In EC-OMT group,the depth of myometrial invasion,the frequency of cervical and cornua uteri involvement,adnexal mass,pelvic or para-aortic lymph nodes involvement and peritoneum metastasis were higher than those in EC group (all P＜0.01).Para-uterine involvement showed no significant difference between two groups (1.72％ vs 0.40％,P=0.26).In diagnosis of EC with OMT,the sensitivity and specificity value of MRI was 51.72％ (30/58) and 99.87％ (742/743),respectively.Cornua uteri involvement,adnexal mass and CA125 level were screened as helpful indicators for pre-operation diagnosis by decision tree,and the sensitivity was 89.66％ (52/58).Conclusion The diagnosis model of pelvic MRI combined with clinical information by using decision tree analysis can promote sensitivity in diagnosis of EC with OMT.

Adverse reactions and symptomatic treatment of immunological checkpoint inhibitors in tumor therapy / 国际肿瘤学杂志

Immunological checkpoint inhibitors include monoclonal antibodies of cytotoxic T lymphocyte antigen-4 (CTLA-4) and programmed cell death-1 (PD-1).Anti-CTLA-4 drug ezetimab (ipilimumab)and anti-PD-1 drug (pembrolizumab and nivolumab) are approved for the treatment of melanoma and non-small cell lung cancer.The effects of these drugs on renal cell carcinoma,bladder cancer,breast cancer,gastrointestinal cancer and other types of cancers are still in large-scale clinical trials.These drugs have good effects in the clinical application,but they inevitably lead to many adverse reactions.

Antibacterial steroidal alkaloids from Holarrhena antidysenteriaca / 中国天然药物

Two new steroidal alkaloids, isoconkuressine and N-formylconessimine, together with 6 known steroidal alkaloids including conkuressine, conessine, isoconessimine, conimine, conarrhimine, and funtudienine, were isolated from the seeds of Holarrhena antidysenteriaca Wall.ex A.DC. Their intrinsic antibacterial activities and synergistic effects with penicillin and vancomycin were analyzed in methicillin sensitive staphylococcus aureus (MSSA) and methicillin resistant staphylococcus aureus (MRSA). Two of the steroidal alkaloids including one new compound (N-formylconessimine) showed potential antibacterial activity and possessed synergistic effects with penicillin and vancomycin, respectively.

Mechanism of beryllium sulfate-induced apoptosis in human embryonic lung fibroblast / 中国职业医学

OBJECTIVE: To investigate the effect of beryllium sulfate( BeSO_4) on apoptosis of human embryonic lung fibroblast( MRC-5 cell). METHODS: MRC-5 cells were cultured in vitro and randomly divided into 6 groups: a control group,a low-,medium- and high-dose BeSO_4 group,an antagonist group,and an activator group. The former 4 groups were given final concentrations of 0,1,10 and 100 μmol / L of BeSO_4,respectively. The combined treatment of BeSO_4and2-aminoethoxydiphenyl borate( 10 μmol / L final concentration) was used in the antagonist group. The combined treatment of BeSO_4 and inositol triphosphate( IP3)( 10 μmol / L final concentration) was used in the activator group. After 24 and48 hours of culture,the cells were harvested. The apoptosis of MRC-5 cells was detected by flow cytometry. The intracellular calcium ion( Ca~(2+)) was detected using laser scanning confocal microscope. Quantitative real-time polymerase chain reaction was used to detect the relative expression of IP_3RⅢ and B-cell lymphoma-2( BCL-2) mRNA and the protein expression of IP_3RⅢ and IP3 were detected by enzyme-linked immunosorbent assay. RESULTS: The apoptosis rates of cells in the 3 BeSO_4 dose groups at the time points of 24 and 48 hours were lower than those in the control group at the same time points( P < 0. 05). The apoptosis rate of the antagonist group was lower than those in medium-dose BeSO_4 group and control group at the same time points( P < 0. 05). At the time point of 48 hours,the apoptosis rate of the activator group was lower than that of control group( P < 0. 05) and higher than that of the medium-dose BeSO_4group( P < 0. 05). As for the Ca~(2+)concentration at time point of 24 hours,the low-dose BeSO_4 group was lower than the control group( P < 0. 05),and the high-dose BeSO_4 group was higher than the control group( P < 0. 05). The Ca~(2+)concentrations at time point of 48 hours in the medium- and high-dose BeSO_4 groups were lower than that in the control group( P < 0. 05). Compared with the medium-dose BeSO_4 group and control group at time points of 24 and 48 hours,the Ca~(2+)concentrations in the antagonist group decreased( P < 0. 05),while thoes of the activator group increased( P < 0. 05). The expression of BCL-2and IP_3RⅢmRNA in the 3 BeSO_4 groups,the activator and antagonist group were higher than those of the control group( P <0. 05). The expression of IP3 R Ⅲ protein at the time point of 24 hours in the medium-dose BeSO_4 group,the activator group and the antagonist group were lower than that of control group( P < 0. 05). The expression of IP_3RⅢ protein at the time point of 48 hours,the high-dose BeSO_4 group was lower than the control group( P < 0. 05); the activator and antagonist groups were higher than the medium-dose BeSO_4group( P < 0. 05). The expression of IP3 protein in the lowand medium-dose BeSO_4 groups and the activator group were higher than that in the control group( P < 0. 05). The expression of IP3 protein in activator group was higher than the medium-dose group( P < 0. 05). CONCLUSION: BeSO_4 might change the Ca~(2+)concentration and inhibite the apoptosis of MRC-5 cell through regulating the IP3 R / Ca~(2+)pathway,IP3 can improve the decrease of Ca~(2+)concentration in MRC-5 cells induced by BeSO_4.

Study of gonadal hormone drugs in blocking filovirus entry of cells in vitro / 药学学报

This study was designed to discover filovirus entry inhibitors in a drug library of commercial medicines. One thousand and six hundred drugs were screened using the ZEBOV-GP/HIV model, a pseudovirus formed by an HIV-core packed with the Zaire Ebola virus glycoprotein. We identified 12 gonadal hormone drugs with inhibitory activities in ZEBOV-GP/HIV entry at final concentration of 10 μmol x L(-1). Among them, three drugs exhibited strong activities with IC50 < 1 μmol x L(-1), such as toremifene citrate (IC50: 0.19 ± 0.02 μmol x L(-1)), tamoxifen citrate (IC50: 0.32 ± 0.01 μmol x L(-1)) and clomiphene citrate (IC50: 0.53 ± 0.02 μmol x L(-1)); seven drugs had moderate activities with IC50 between 1 and 10 μmol x L(-1), such as estradiol benzoate (IC50: 1.83 ± 5.69 μmol x L(-1)), raloxifene hydrochloride (IC50: 3.48 ± 0.07 μmol x L(-1)), equilin (IC50: 4.00 ± 9.94 μmol x L(-1)), estradiol (IC50: 5.26 ± 9.92 μmol x L(-1)), quinestrol (IC50: 6.36?5.37 gmol-L1), estrone (IC50: 6.87 ± 0.03 μmol-L1) and finasteride (IC50: 9.94 ± 0.45 μmol x L(-1)); two drugs, hexestrol (IC50: 14.20 ± 0.55 μmol x L(-1)) and chlormadinone acetate (IC50: 24.60 ± 0.36 μmol x L(-1)), had weak activities against ZEBOV. Further, toremifene citrate, tamoxifen citrate, clomiphene citrate, raloxifene hydrochloride and quinestrol could block both pseudovirus type Sudan ebola virus (SEBOV-GP/HIV) and Marburg virus (MARV-GP/HIV) entries.

Protective effect of different solvent extracts from platycladi cacumen carbonisatum on LPS-induced human umbilical vein endothelial cells damage / 中国中药杂志

<p><b>OBJECTIVE</b>To study the protective effect of different solvent extracts from Platycladi Cacumen Carbonisatum (PCC) on LPS-induced human umbilical vein endothelial cell damage, and discuss the effective extracts from PCC for protecting vascular endothelial cells and their possible active substances.</p><p><b>METHOD</b>HUVECs were cultured in vitro; And LPS was adopted to establish the human umbilical vein endothelial cell damage model. MTT colorimetric method was used to determine cell activity; Xanthine oxidase method was adopted to detect the activity of superoxide dismutases (SOD) in the cell culture fluid; The TBA method was adopted to determine the content of malondialdehyde (MDA); The nitrate reductase method was used to detect the content of nitric oxide (NO); And UPLC/Q-TOF-MS was used to analyze the difference in flavonoids components among different solvent extracts from PCC.</p><p><b>RESULT</b>Compared with the model group, N-butanol extract (100 mg x L(-1)) and ethylacetate extract (100, 50 mg x L(-1)) could significantly enhance the cell activity (P < 0.05), significantly reduce MDA and NO content, and increase SOD activity (P < 0.05). Among the four solvent extracts, the content of total flavonids were the highest in ethyl acetate extract, the lowest in water extract and equivalent in N-butanol and petroleum benzene extract. In terms of the contents of quercitrin and myricitrin, N-butanol extract were second only to ethyl acetate extract.</p><p><b>CONCLUSION</b>Ethylacetate extract from PCC has a notable antagonistic effect in the damage induced by LPS to HUVECs, and thus is the most effective extract from PCC in protecting vascular endothelial cells. Quercitrin, myricitrin or multiple flavonoids that it contains may be their active substances for protecting vascular endothelial cells. Its mechanism may be related to the decrease in the production of NO and the inhibition of lipid peroxidation in cells.</p>

Cytogenetic abnormalities of 50 MDS patients by FISH detection and conventional karyotype analysis / 中国实验血液学杂志

This study was purposed to compare detectable rate of cytogenetic abnormalities including -5/5q-, -7/7q-, 20q-,+8, and -Y in MDS by FISH and metaphase cytogenetics, and to investigate the relationship between cytogenetic abnormalities and progression from MDS to acute leukemia. Metaphase cytogenetics and FISH testing for -5/5q-, -7/7q-, 20q-,+8, and -Y were performed in 50 bone marrow samples obtained from patients with MDS diagnosed according to the WHO criteria (2008). Evolution from MDS to AML was followed up for each patient. The results showed that the cytogenetic abnormalities including -5/5q-, -7/7q-, 20q-,+8, and -Y were identified in 25 (50%) of 50 by metaphase cytogenetics, and in 20 (40%) of 50 by FISH. -5/5q-, 7/7q-, 20q- , +8, or -Y was identified by metaphase cytogenetics in 3 (6%) of 50, 13 (26%) of 50, 6 (12%) of 50, 12 (24%) of 50, and 1 (2%) of 50, respectively, and by FISH in 3 (6%) of 50, 10 (20%) 0f 50, 3 (6%) of 50, 10 (20%) of 50, and 1 of 50 (2%), respectively. The detectable rate ranking was -7/7q- >+8>20q->-5/5q->-Y. 47 patients received allogeneic hematopoietic stem cell transplantation. In the IPSS poor prognosis group, 6 (46.2%)of 13 received transplantation before progression to acute leukemia. In the IPSS good prognosis group, 10 (45.5% ) of 22 received transplantation before progression to acute leukemia. In the IPSS intermediate prognosis group, 2 (16.7%) of 12 received trans- plantation before progression to acute leukemia. The rate of progression to acute leukemia was 7.7% (1/13) in the IPSS poor prognosis group, 4.5% (1/22) in the IPSS good prognosis group, and 58.3% (7/12) in the IPSS intermediate prognosis group. The low rate of progression to acute leukemia in the IPSS poor prognosis group might be associated with the high rate of allogeneic hematopoietic stem transplantation. It is concluded that there is higher detectable rate for detecting a certain chromosome by FISH probe than that by metaphase cytogenetics, especially for detecting low clone chromosomal abnormalities and mitotic figures less than 20. There is no difference between IPSS good prognosis group and IPSS poor prognosis group in our study probably because of allogeneic hematopoietic stem cell transplantation.