Predictors of delayed function independence in patients with acute vertebrobasilar artery occlusion achieved successful recanalization after endovascular therapy / 国际脑血管病杂志

Objective:To investigate the prevalence and predictors of delayed function independence (DFI) in patients with acute vertebrobasilar artery occlusion (VBAO) achieved successful recanalization after endovascular therapy.Methods:Patients with acute VBAO received endovascular treatment in the Departments of Neurology, the First Affiliated Hospital of University of Science and Technology and General Hospital of Eastern Theater Command, PLA from December 2015 to December 2018 were retrospectively enrolled. The demographic, clinical, laboratory and imaging data were collected. Early functional independence (EFI) was defined as the modified Rankin Scale score 0-2 at discharge, and DFI was defined as the modified Rankin Scale score 0-2 at 90 d after discharge for non-EFI patients. Multivariate logistic regression analysis was used to determine the independent predictors of DFI. Results:A total of 122 patients with acute VBAO were included. Their age was 61.8±11.9 years old and 91 (74.6%) were male. The median Glasgow Coma Scale (GCS) score was 7, the median National Institutes of Health Stroke Scale (NIHSS) score was 26.5, and the median posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) score was 9. Twenty-four patients (20.0%) had EFI; of the 98 patients with non-EFI, 18 (18.4%) had DFI. Multivariate logistic regression analysis showed that male (odds ratio [ OR] 0.038, 95% confidence interval [ CI] 0.002-0.658; P=0.025), cardiogenic embolism ( OR 0.116, 95% CI 0.023-0.579; P=0.009), baseline NIHSS score ( OR 1.136, 95% CI 1.040-1.242; P=0.005) and lung infection ( OR 6.089, 95% CI 1.451-25.562; P=0.014) were the independent predictors of DFI. Conclusions:Nearly 1/5 of the non-EFI patients have DFI. Male, cardiogenic embolism, lower baseline NIHSS score and without pulmonary infection are the independent predictors of DFI.

Research progress of sarcopenic obesity and chronic liver disease / 中华肝脏病杂志

Sarcopenia has attracted increasing attention with the study of nutrition in patients with liver disease. Sarcopenia is an independent risk factor for a poor prognosis of liver disease and is becoming increasingly common in patients with liver disease. Studies have shown that patients with liver disease and sarcopenic obesity have a worse prognosis than patients with liver disease and simple sarcopenia or obesity. In clinical practice, it is easy to recognize patients with malnutrition and decreased muscle mass, but we often ignore those patients with normal body weight or even obesity who will likewise experience muscle mass loss. Simply relying on the monitoring of body mass and body mass index to assess the nutritional and muscle status of patients with liver disease is not accurate. At present, our understanding of the relationship between chronic liver disease and sarcopenic obesity is still poorly understood. In this paper, the research progress on chronic liver disease, sarcopenia, and sarcopenic obesity in recent years is reviewed so as to provide a theoretical basis for improving the clinical prognosis of patients with liver disease.

Research advances in brain lactate level and hepatic encephalopathy / 临床肝胆病杂志

Hepatic encephalopathy (HE) is a common complication and an independent risk factor for death in patients with liver cirrhosis. Brain lactate level is associated with the progression and severity of HE, and research on brain lactate level may help to further explain the pathogenesis of HE. This article summarizes the metabolic process of brain lactate, the association between brain lactate level and HE, and the potential therapeutic targets for HE and provides a reference for clinicians to further systematically evaluate the progression, treatment outcome, and prognosis of patients with HE, in order to reduce the medical burden of patients and improve the prognosis of patients with HE.

Association between spontaneous portosystemic shunt and hepatorenal syndrome in liver cirrhosis / 临床肝胆病杂志

ObjectiveTo investigate the association between spontaneous portosystemic shunt （SPSS） and hepatorenal syndrome （HRS） in patients with liver cirrhosis. MethodsA retrospective analysis was performed for 93 patients with SPSS from Dezhou Hospital， Qilu Hospital of Shandong University， from January 2015 to January 2022， and the patients were followed up for 12 months with the onset of HRS as the observation endpoint. According to the presence or absence of HRS， the 93 patients with SPSS were divided into HRS group with 38 patients （40.86%） and non-HRS group with 55 patients （59.14%）， and the two groups were compared in terms of clinical data， laboratory data， complication， and shunt diameter. Based on the maximum shunt vein diameter of 1.5 cm， the 93 patients with SPSS were divided into high shunt group with 52 patients （55.91%） and low shunt group with 41 patients （44.09%）， and with the onset of HRS as the observation endpoint， the two groups were compared in terms of the incidence rate of HRS and survival time curve. The independent-samples t test was used for comparison of normally distributed continuous data with homogeneity of variance between two groups， and the chi-square test was used for comparison of categorical data between two groups. The receiver operating characteristic （ROC） curve was used to predict cut-off values， the Kaplan-Meier curve was used for comparison of survival time， and the Log-rank test was used to compare the differences in survival curves. The multivariate Cox regression analysis was used to investigate risk factors. ResultsCompared with the non-HRS group， the HRS group had significant increases in Child-Pugh score， Child-Pugh class， MELD score， serum creatinine， blood urea nitrogen， alanine aminotransferase， aspartate aminotransferase， maximum shunt vein diameter， the incidence rates of hepatic encephalopathy and spontaneous bacterial peritonitis， and the degree of ascites， as well as significant reductions in main portal vein diameter， serum sodium and albumin （all P<0.05）. Compared with the low shunt group， the high shunt group had a significant increase in the incidence rate of HRS （51.92% vs 26.83%， χ²=5.974， P=0.015） and a significant reduction in the time to the onset of HRS （Log-rank P=0.033）. A maximum shunt vein diameter of >1.5 cm （hazard ratio ［HR］=1.123， 95% confidence interval ［CI］： 1.041‍ ‍—‍ ‍1.211， P=0.003）， an increase in MELD score （HR=1.205， 95%CI： 1.076‍ ‍—‍ ‍1.437， P=0.039）， a reduction in serum albumin （HR=0.890， 95%CI： 0.814‍ ‍—‍ ‍0.974， P=0.011）， an increase in the degree of ascites （HR=2.099， 95%CI： 1.066‍ ‍—‍ ‍4.130， P=0.032）， and spontaneous bacterial peritonitis （HR=2.259， 95%CI： 1.020‍ ‍—‍ ‍5.003， P=0.045） were independent risk factors for the onset of HRS in SPSS patients. ConclusionThere is an association between SPSS and HRS， and shunt diameter >1.5 cm was an independent risk factor for HRS in SPSS patients， which should be taken seriously and require early intervention in clinical practice.

Effect of community management based on Roy′s adaptation model in patients with chronic obstructive pulmonary disease / 中华健康管理学杂志

Objective:To determine the effect of community management based on the Roy′s adaptation model (RAM) in patients with chronic obstructive pulmonary disease (COPD).Methods:This study was a cluster randomized controlled study, with the community as the cluster unit, and selected 805 COPD patients from 8 communities in Xuzhou City who had completed community registration before June 2019. A total of 735 patients actually completed follow-up and participated in intervention evaluation. They were randomly divided into control group (362 cases) and intervention group (373 cases) by random number table method. The control group received routine follow-up, while the intervention group received RAM intervention for 6 months. The forced expiratory volume in 1 second (FEV1)/forced volume vital capacity (FVC) ratio (FEV 1/FVC) and the modified British medical research council (mMRC) were used to assess the pulmonary function. The hospital anxiety and depression scales (HADS) were used to evaluate the mental health. The Chinese version of the Short Form Coping and Adaption Processing Scale (CAP-15) was used to assess the adaptive capacity. And the St. George′s Respiratory Questionnaire (SGRQ) was used to evaluate the quality of life in COPD patients. The t test or χ 2 test was used for pre-intervention comparisons between groups, and the repetitive measure analysis of variance (ANOVA) was used for post-intervention comparisons between groups. Results:After 6 months intervention, there were no significant differences in FEV 1/FVC radio between the two groups [(0.61±0.11) vs (0.62±0.12)] ( P=0.172). The scores of mMRC [(2.04±0.33) vs (2.77±0.31) points], HAD-A [(5.28±4.28) vs (6.99±4.41) points], HAD-D [(5.82±5.12) vs (7.27±4.93) points] and SGRQ [(40.17±9.30) vs (53.69±9.77) points] were all lower in the intervention group than those in the control group (all P<0.001). The CAPS-15 score was higher in the intervention group than that in the control group [(35.87±3.62) vs (26.1±3.47)] ( P<0.001). Conclusion:RAM could be used in community management of COPD patients, which could improve their dyspnea symptoms and psychological and physiological functions, also improve their adaptability and quality of life.

Effect of group cognitive behavioral therapy on anxiety, depression and quality of life in patients with chronic obstructive pulmonary disease in community / 中华行为医学与脑科学杂志

Objective:To explore the effect of group cognitive behavior therapy (GCBT) on anxiety, depression and quality of life in patients with chronic obstructive pulmonary disease (COPD) in community.Methods:From August to November 2019, patients with moderate COPD in 18 communities in Xuzhou City were randomly divided into the intervention group ( n=240) and the control group ( n=223). The control group received routine management and the intervention group received group cognitive behavioral therapy intervention for 8 weeks on the basis of routine management.Before and after the intervention, FEV 1% predicted value and FEV 1/FVC were measured by pulmonary function tester.Hospital Anxiety and Depression Scale (HADS) was used to evaluate the anxiety and depression of patients.St.George's respiratory questionnaire (SGRQ), COPD assessment test (CAT) and modified medical research council dyspnea (mMRC) were used to evaluate the quality of life of patients.SPSS 20.0 software was used for analysis.The χ 2 test, independent sample t-test, paired sample t-test were used for statistical analysis. Results:After 8 weeks of intervention, the anxiety and depression scores of the intervention group were lower than those of the control group (anxiety: (8.23±4.02) vs (10.71±3.60); depression: (7.87±3.73) vs (10.20±3.72)( t=6.415, 6.185, both P<0.01). After the intervention, there was no significant difference in FEV 1%((51.7±12.3)% vs (52.0±12.6)%) predicted value and FEV 1/FVC((57.3±10.8)% vs (56.9±10.7)%) between the two groups( t=-0.259, 0.400, both P>0.05). The scores of CAT, mMRC and SGRQ in the intervention group were lower than those in the control group((17.35±5.78) vs (20.90±8.00), (1.55±0.82) vs (2.30±1.21), (41.78±21.56) vs (57.08±24.46))( t=-5.061, -7.227, -6.580, all P<0.01). Conclusion:Group cognitive behavioral therapy can relieve the anxiety and depression and improve the quality of life of patients with COPD.

Clinical effect of Traditional Chinese Medicine combined with pressure therapy in the treatment of eczema / 国际中医中药杂志

Objective:To observe the clinical effect of Traditional Chinese Medicine (TCM) collapsibility combined with pressure therapy in the treatment of eczema.Methods:From January 2021 to August 2021, 60 patients with lower extremity venous ulcers who were treated in Wangjing Hospital, China Academy of Chinese Medical Sciences were selected and randomly divided into the control group (30 patients) and observation group (30 patients). The control group was treated by the routine pressure therapy, and the observation group was by the TCM nursing intervention on the basis of the control group. Both groups were treated for 2 weeks. The visual analogy scale (VAS),chronic Venous Insufficiency Questionnaire (CIVIQ), Self-rating Anxiety Acale (SAS), and Self-rating Depression Scale (SDS) were measured and evaluated at baseline and after treatment.Results:The total response rate was 100.0% (30/30) in the observation group and 86.7% (26/30) in the control group, and the difference was statistically significant ( χ2=4.29, P=0.038). The VAS (2.47±0.68 vs. 2.97±0.14, t=3.95), SAS (40.31±11.93 vs. 55.87±4.53, t=4.73), SDS (44.30±5.38 vs. 47.61±5.33, t=2.39) scores were significantly lower than those in the control group ( P<0.05), CIVIQ score (86.63±2.74 vs. 84.67±3.23, t=2.54) was significantly higher than that of the control group ( P<0.05). Conclusion:TCM combined with pressure therapy can promote the healing of ulcers in patients with eczema, relieve pain, and improve the quality of life of patients.

Dihydromyricetin mediates epithelial mesenchymal transformation and regulates the proliferation and apoptosis of esophageal squamous cell carcinoma cells / 中华肿瘤杂志

Objective: To study the effects of dihydromyricetin (DMY) on the proliferation, apoptosis and epithelial mesenchymal transition (EMT) of esophageal squamous cell carcinoma (ESCC) cell KYSE150 and KYSE410. Methods: KYSE150 and KYSE410 cells were treated with different concentrations of DMY (0, 25, 50, 100, 150, 200 μmol/L) for 24 hours. The median inhibition concentration (IC50) values of KYSE150 and KYSE410 were detected by cell counting kit-8 (CCK-8) method. Then 0.5‰ dimethyl sulfoxide (DMSO) was used as control group, dihydromyricetin (DMY), dihydromyricetin and transforming growth factor-β1 (DMY+ TGF-β1), transforming growth factor-β1 (TGF-β1) were used as experimental group. Cell proliferation and apoptosis rates were measured by clonal formation and flow cytometry. Transwell invasion and wound healing assay were used to detect cell invasion and migration. The protein expression levels of Caspase-3, Caspase-9, Bcl-2, Bax, Smad2/3, phosphorylation-Smad2/3 (p-Smad2/3) and Vimentin were detected by western blot. Results: The IC50 values of DMY on KYSE410 and KYSE150 cells were 100.51 and 101.27 μmol/L. The clone formation numbers of KYSE150 and KYSE410 in DMY group [(0.53±0.03) and (0.31±0.03)] were lower than those in DMSO group [(1.00±0.10) and (1.00±0.05), P<0.05]. The apoptosis rates of KYSE150 and KYSE410 cells in DMY group [(1.84±0.22)% and (2.80±0.07)%] were higher than those in DMSO group [(1.00±0.18)% and (1.00±0.07)%, P<0.05]. The invasion numbers of KYSE150 and KYSE410 cells in DMY group [(0.42±0.03) and (0.29±0.05)] were lower than those in DMSO group [(1.00±0.08) and (1.00±0.05), P<0.05]. The migration rates of KYSE150 and KYSE410 cells in DMY group [(0.65±0.14)% and (0.40±0.17)%] were lower than those in DMSO group [(1.00±0.10)% and (1.00±0.08)%, P<0.05]. The clone formation numbers of KYSE150 and KYSE410 in TGF-β1 group [(1.01±0.08) and (0.99±0.25)] were higher than those in DMY+ TGF-β1 group [(0.73±0.10) and (0.58±0.05), P<0.05]. The apoptosis rates of KYSE150 and KYSE410 cells in TGF-β1 group [(0.81±0.14)% and (1.18±0.10)%] were lower than those in DMY+ TGF-β1 group [(1.38±0.22)% and (1.85±0.04)%, P<0.05]. The invasion numbers of KYSE150 and KYSE410 cells in TGF-β1 group [(1.19±0.11) and (1.39±0.11)] were higher than those in DMY+ TGF-β1 group [(0.93±0.09) and (0.93±0.05), P<0.05]. The migration rates of KYSE150 and KYSE410 cells in TGF-β1 group [(1.87±0.19)% and (1.32±0.04)%] were higher than those in DMY+ TGF-β1 group [(0.86±0.16)% and (0.77±0.12)%, P<0.05]. The protein expression levels of Bax, Caspase-3 and Caspase-9 in KYSE150 and KYSE410 cells in DMY group were higher than those in DMSO group, while the protein expression level of Bcl-2 was lower than that in DMSO group (P<0.05). The protein expression levels of p-Smad2/3, Smad2/3 and Vimentin in KYSE150 and KYSE410 cells in DMY group were lower than those in DMSO group (P<0.05). The protein expression levels of Bax, Caspase-3 and Caspase-9 in KYSE150 and KYSE410 cells in TGF-β1 group were lower than those in DMY+ TGF-β1 group, and the protein expression level of Bcl-2 was higher than that in DMY+ TGF-β1 group (P<0.05). The protein expression levels of Bax, Caspase-3 and Caspase-9 in KYSE150 and KYSE410 cells in DMY+ TGF-β1 group were lower than those in DMY group, and the protein expression level of Bcl-2 was higher than that in DMY group (P<0.05). The protein expression levels of p-Smad2/3, Smad2/3 and Vimentin in KYSE150 and KYSE410 cells in TGF-β1 group were higher than those in DMY+ TGF-β1 group (P<0.05). Conclusion: DMY can inhibit the proliferation and EMT of ESCC mediated by TGF-β1 and promote cell apoptosis.

Practice of clinical pharmacists participating in fine management of pharmaceutical affairs in gastroenterology department based on DRG data / 中国药房

OBJECTIVE To explor e the effect of clinical pharmacists participatin g in fine management of pharmaceutical affairs among the inpatients in the department of gastroenterology based on diagnosis related groups （DRG）data. METHODS The discharged patients in the gastroenterology department of our hospital were selected as the research objects to compare the changes of DRG indicators and hospitalization related indicators before （from April to December 2019）and after （from April to December 2020 and from April to December 2021） pharmacists participating in fine management of pharmaceutical affairs in the gastroenterology department. The key DRG with the highest number of enrolled cases and DRG cases of the total cost overrun were analyzed to explore the deviation of various costs. The rationality of drug use was evaluated for the cases in each DRG that exceeded the benchmark hospital payment standard by three times ，with the help of prescription doctor ’s advice review. RESULTS In the first year of intervention ，the case combination index value of gastroenterology department was increased ，meanwhile，the cost consumption index ，time consumption index and average hospital stay were decreased significantly （P＜0.01）. In the second year of intervention ，total weight of the cases in gastroenterology department was increased ，while cost consumption index ，time consumption index ，hospitalization cost per time ，drug cost per time and average hospital stay were all decreased significantly ， compared with before intervention （P＜0.01）. Among the top five DRG ，the drug cost per time in the GZ 15，GZ13 and GJ 15 were all decreased significantly in the first year of intervention ；hospitalization cost per time and drug cost per time in the GZ 15，GZ13， GJ15 and GJ 13 were all decreased significantly in the second year of intervention （P＜0.01）；after the intervention of clinical pharmacists in DRG over-expenditure cases ，the over-expenditure rate decreased significantly （P＜0.001）. CONCLUSIONS The fine management of pharmaceutical affairs in our hospital has achieved certain results and promotes the rationality of clinical drug use，and provides a new entry point for the cost control and utilization of medical institutions under the background of 〔2020〕68号） DRG.

Advances in immunotherapy for neuroendocrine neoplasms / 中华胃肠外科杂志

Neuroendocrine neoplasms (NEN) is a rare and heterogeneous tumor. Different pathologic morphology, differentiation, grade and clinical stages of the tumors had various treatment and prognosis. Patients with recurrent or metastatic NEN have limited treatment options and poor prognosis. In recent years, PD-1 pathway blockade has become integral components of disease management for many cancers. Immunotherapy is being explored in NEN. Studies have shown that the efficacy of immune monotherapy in NEN is limited, and it can be considered for selected patients. Biomarkers for predicting efficacy of immunotherapy include PD-L1 expression, TMB-H, MSI-H/dMMR, etc. Combined regimens of anti-CTLA-4 and anti-PD-1/PD-L1 inhibitors, and immune checkpoint inhibitor combined with anti-angiogenic drugs or chemotherapy are promising in patients with NEN, and it is worthwhile to further explore of the responding populations.

Screening of differential metabolites in urine of adult patients with Kashin-Beck disease by non-targeted metabonomics / 中华地方病学杂志

Objective:To screen differential metabolites and metabolic pathways in urine of adult patients with Kashin-Beck disease (KBD), so as to provide scientific basis for finding specific biomarkers and pathogenesis of KBD.Methods:In Yongshou County, the KBD area in Shaanxi Province, adult KBD patients were selected as the case group, and healthy people without clinical symptoms of KBD were selected as the control group in the same disease area. The subjects' fasting mid-morning urine was collected, and liquid chromatography-mass spectrometry (LC-MS) technology was used to detect small-molecule metabolites in the urine. Multivariate statistical analysis [partial least square discriminant analysis (PLS-DA)] and comparison with KEGG and human metabonomics database (HMDB) were used to identify and screen differential metabolites and metabolic pathways in KBD patients.Results:A total of 58 subjects were included, 39 cases in the case group, including 23 males and 16 females; the age was (61.2 ± 7.8) years old; the body mass index was (22.7 ± 6.5) kg/m 2. There were 19 cases in the control group, including 10 males and 9 females; the age was (50.0 ± 9.0) years old; the body mass index was (24.3 ± 5.5) kg/m 2. Three first-order differential metabolites (HT-2 toxin, T-2 tetraol and seleno-adenosine selenomethionine) were identified and screened, which were highly related to the pathogenesis of KBD, and all were down-regulated. There were 38 second-order differential metabolites, among them, 10 were up-regulated and 28 were down-regulated. Nine differential metabolic pathways were screened, mainly involving amino acid metabolism, lipid metabolism and energy metabolism. Conclusions:The urine metabolism profiles of adult KBD patients and healthy people are significantly different, mainly involving amino acid metabolism, lipid metabolism and energy metabolism. The first-order differential metabolites HT-2 toxin, T-2 tetraol and seleno-adenosine selenomethionine are highly correlated with the pathogenesis of KBD.

Advances in research on therapeutic strategies of targeting pancreatic cancer stroma / 中国药科大学学报

@#Pancreatic cancer stroma plays a critical role in tumor progression, invasion, metastasis and resistance.Targeting tumor cell alone could not meet the demand for prolonging patients'' survival.Growing studies have laid emphasis on developing combined regimens between targeting pancreatic cancer stroma and chemotherapy, radiotherapy and immunotherapy.We are faced with some new opportunities in spite of the great challenges brought to the research and development of targeting drugs owing to the complicated stroma components, crosstalking signal pathways and abnormal angiogenesis of pancreatic cancer.In this article, recent advances in therapeutic strategies of targeting pancreatic cancer stroma are reviewed and analyzed from the aspects of extracellular matrix (ECM), cancer associated fibroblasts (CAFs) and vessels, in the hope of providing some novel ideas for targeting therapy against pancreatic cancer.

Effect of cognitive-behavioral therapy on psychological stress and quality of life in patients with pulmonary tuberculosis / 中华全科医师杂志

Objective:To explore the effect of cognitive-behavioral therapy on psychological stress and quality of life in patients with pulmonary tuberculosis.Methods:According to two-level cluster random design 461 patients with tuberculosis from 20 communities in Pizhou county of Jiangsu province were selected in the study from September 2018 to November 2018. The intervention group received cognitive-behavioral therapy for two months, while control group received routine follow-up. Anxiety, depression and quality of life were assessed by GAD-7, PHQ-9 and SF-36 scales, respectively. At the same time, the comparison between the two groups was conducted by independent sample t test, and the difference between the two groups before and after treatment was analyzed by paired sample ttest. Results:A total of 454 participants were finally included in this analysis; there were 230 cases in the intervention group and 224 cases in the control group. In the intervention group the scores of anxiety and depression after intervention were significantly lower than the baseline scores [(7.57±5.27) vs. (5.93±2.56), t=-4.245, P<0.01; (8.13±6.01) vs. (6.02±2.67); t=-4.866, P<0.01], and the quality of life score was significantly higher than the baseline score [(58.46±12.71) vs. (74.31±13.22); t=13.108, P<0.01]; while in the control group there were no significant differences in the scores of anxiety, depression and quality of life after intervention, compared with those at baseline [(7.62±5.41) vs.(7.65±5.38); (8.00±5.84) vs. (8.07±5.91); (59.11±13.25) vs. (60.51±13.76); t=0.059, t=0.126, t=1.104, all P>0.05]. However, only for patients with mild and moderate anxiety and depression symptoms in the intervention group, the anxiety and depression scores were decreased after intervention [(7.29±1.21) vs. (5.54±1.71), (11.99±1.31) vs. (9.17±1.55); (7.01±1.47) vs. (4.42±1.22), (11.88±1.12) vs. (8.39±2.33); t=8.056, t=10.020, t=13.558, t=8.852,all P<0.01]. Conclusion:Cognitive-behavioral therapy can relieve the psychological pressure and improve the quality of life in pulmonary tuberculosis patients with mild or moderate anxiety/depression symptoms.

Transfusion Strategy for Rare Anti-LW Antibody Autoimmune Hemolytic Anemia Patients with Neonatal Hemolytic Disease / 中国实验血液学杂志

OBJECTIVE@#To analyze the causes of positive irregular antibody screening test and incompatibility of cross matching in one patient with autoimmune hemolytic anemia complicated with neonatal hemolytic disease, and to accurately identify the type of antibodies in patients, and to select a reasonable strategy for blood transfusion.@*METHODS@#One children was enrolled, blood group positive and reverse typing, Rh typing, direct anti-human globulin test, free test, dispersal test and cross matching test were carried out by test tube method and microcolumn gel card; irregular antibodies were identified by the reaction of DTT treatment and untreated panel cells with patients' plasma.@*RESULTS@#The blood group of the patient was RhD positive B and irregular antibody screening positive, while the blood group of the mother was RhD positive O and irregular anti-screening negative, the result showed that the anti-LW detected in the plasma of the patient was autoantibody and ABO neonatal hemolytic disease (ABO-HDN) was present. Both O type RhD positive washing RBCs and B type RhD negative RBCs were transfused effectively.@*CONCLUSION@#Irregular antibodies in patients are anti-LW antibodies, and transfusion of homotype RhD negative suspended erythrocytes after the exclusion of ABO-HDN shows a better effect.

Effects of manual loading on calcitonin gene-related peptide and nerve growth factor in rats with chronic low back pain / 中国骨伤

OBJECTIVE@#To observe the analgesic effect of manipulation loading on chronic low back pain (CLBP) model rats and the expression of inflammatory factors in psoas major muscle tissue, and to explore the improvement of manipulation on local inflammatory microenvironment.@*METHODS@#Thirty two SPF male SD rats weighing 340-360g were randomly divided into blank group, sham operation group, chronic low back pain model group and treatment group, with 8 rats in each group. In the model group, L@*RESULTS@#There was no significant difference in PWT and PWL between the blank group and the sham operation group after modeling (@*CONCLUSION@#Local massage loading has analgesic effect on CLBP rats, at the same time, it can inhibit the content of CGRP and NGF in psoas muscle tissue of CLBP rats, and improve the local inflammatory microenvironment.

Progress of studies on anti-breast tumor mechanism of alkaloids / 中国中药杂志

Breast tumor has become one of the malignant tumors with the highest incidence, and is a serious threat to human health, especially to women. Chemotherapy is an important anti-breast tumor therapy, which can be used in almost every stage of breast tumor therapy alone or in the combination with surgery and radiation therapy. Alkaloids are a kind of ubiquitous natural products, and important active components of various medicinal plants. A large number of studies have shown that alkaloids could exert an anti-breast tumor effect by inhibiting proliferation, metastasis and angiogenesis, resisting mitosis, promoting apoptosis and autophagy, and triggering cell cycle arrest. The extensive anti-breast tumor effect makes alkaloids an important candidate drug source. This paper reviews the anti-breast tumor mechanism of natural products of alkaloids.

Clinical Study of Modified Chushi Juanbitang Combined with Pedicle Vertebrotomy on Kyphosis of Ankylosing Spondylitis Due to Syndrome of Dampness-heat Obstruction / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of modified Chushi Juanbitang combined with pedicle vertebrotomy on kyphosis of ankylosing spondylitis due to syndrome of dampness-heat obstruction. Method:The 90 cases were randomly divided into control group and observation group， 45 cases in each group. The patients in control group received pedicle vertebrotomy + <italic>Tripterygium</italic> glycosides， and the patients in observation group received pedicle vertebrotomy + modified Chushi Juanbitang. The treatment course was 6 months in both groups. Their bath ankylosing spondylitis disease activity index （BASDAI）， bath ankylosing spondylitis measure index （BASMI）， imaging index， traditional Chinese medicine syndromes， serum proinflammatory factor， anti-inflammatory factor， bone metabolism index ［bone-specific alkaline phosphatase （BALP）， tartrate resistant acid phosphatase isomer-5b （TRACP-5 b）， bone morphogenetic protein-2 （BMP-2）， osteocalcin （BGP）］， ossification related proteins ［bone morphogenetic protein-7 （BMP-7）， dickkopf-related protein-1 （DKK-1）， and tissue inhibitor matrix metalloproteinase-2 （TIMP-2）， sclerostin（SOST）］ were observed and detected. The clinical efficacy， recurrence rate and safety indexes were followed up for 12 months and compared. Result:The total effective rate was 97.73% （43/44） in the observation group， higher than 80.95% （34/42） in the control group （<italic>χ</italic>²=5.172， <italic>P</italic><0.05）. In the comparison with control group after treatment， the BASDAI， BASMI， imaging index， traditional Chinese medicine syndromes， proinflammatory factors， TRACP-5b， BMP-7 and TIMP-2 were lower in observation group （<italic>P</italic><0.05）， and the anti-inflammatory factors， BALP， BMP-2， BGP， DKK-1 and SOST were higher in observation group （<italic>P</italic><0.05）. During the follow-up for at least 12 months， the recurrence rate was 4.65% （2/43） in observation group， lower than 26.47% （9/34） in control group （<italic>χ</italic>²=4.261， <italic>P</italic><0.05）. There was no significant difference in the incidence of postoperative complications between the two groups. The incidence of adverse reactions was 2.27% （1/44） in observation group， lower than 38.64% （17/44） in control group （<italic>χ</italic>²=5.763， <italic>P</italic><0.05）. Conclusion:Modified Chushi Juanbitang combined with pedicle vertebrotomy is effective in the treatment of kyphosis of ankylosing spondylitis due to syndrome of dampness-heat obstruction.

Evidence summary for preventing fall among home-based elderly people / 中国实用护理杂志

Objective:To retrieve and select the available evidence on preventing the fall on the home-based elderly people and summarize the best available evidence.Methods:The BMJ Best Practice, UpToData, Registered Nurses′ Association of Ontario (RANO), National Guideline Clearinghouse (NGC), National Institute for Health and Care Excellence (NICE), Joanna Briggs Institute (JBI), Cochrane Library, and complementally the Center for Disease Control and Prevention(CDC), PubMed、CNKI and SinoMed were searched to collect literatures including guideline, evidence summary, best practice information sheet, recommended practice, systematic review/Meta-analysis.Results:13 articles were selected, including 6 guidelines, 1 clinical decision, 1 evidence summary, 5 systematic reviews/Meta-analysis. Finally, 8 items of best evidence were summarized.Conclusions:Healthcare workers should appropriately consult the best evidence to prevent falling and falling injuries for the home-based elderly people, and finally improve their health-related quality of life.

Effect of simvastatin pretreatment on human metapneumovirus infection and its mechanism / 解放军医学杂志

Objective: To investigate the effect of simvastatin pretreatment on human metapneumovirus (hMPV) infection and the related mechanism. Methods: Human bronchial epithelial cells (16HBE) were used in vitro experiments and BALB/c mice were used in vivo experiments. They were randomly divided into control group, simvastatin group, hMPV group, hMPV+simvastatin group. After corresponding treatment, the fluorescence of hMPV was observed with microscopy; virus titer and the expressions of autophagy-related gene recombinant human autophagy-related protein 5 (ATG5), Beclin1, and microtubule-associated protein 1 light chain 3 (LC3) were detected by Fluorescence Quantitative Real-time PCR; Western blotting was performed to detect autophagy-related protein ATG5, Beclin1, LC3 and serine/threonine kinase/mammalian rapamycin target protein (AKT/mTOR) pathway proteins. Results: In vitro experiment, the direct and indirect fluorescence expressions of hMPV and the virus titer were lower in hMPV+simvastatin group (0.260 ± 0.018) than those in hMPV group (1.241 ± 0.030), while the mRNA expression levels of autophagy-related gene ATG5, Beclin1 and LC3 were higher in hMPV+simvastatin group [(7.31±0.15), (8.67±0.88) and (6.55±0.30), respectively] than those in control group [(1.00±0.06), (1.00±0.05) and (1.10±0.06), respectively]; the mRNA and protein levels of autophagy-genes were the highest in hMPV+simvastatin group and the differences were statistically significant (P<0.05). The AKT/mTOR pathway was inhibited in hMPV group and hMPV+simvastatin group. In vivo experiment, the virus titer of the lung tissue and of the lung tissue supernatant inoculated in Vero E6 were lower in hMPV+simvastatin group (0.75±0.26 and 0.42±0.17, respectively) than those in hMPV group (2.46±0.53 and 1.80±0.40, respectively). The mRNA and protein expression levels of autophagy-related genes ATG5, Beclin1 and LC3 were the highest in hMPV+simvastatin group (3.89±0.42, 3.13±0.26 and 3.56±0.22, respectively), higher than those in control group and hMPV group, the differences were statistically significant (P<0.05), and the AKT/mTOR pathway was inhibited in this group; HE staining of lung tissue showed an inflammatory response in the hMPV group, and pre-treatment with simvastatin could reduce the inflammation. Conclusion: Pretreatment with simvastatin may reduce human metapneumovirus infection, which is associated with autophagy and the AKT/mTOR pathway.

Effects of ulinastatin combined with glutamine on early hemodynamics in patients with severe burns / 中华烧伤杂志

Objective@#To observe the effect of ulinastatin combined with glutamine on early hemodynamics in patients with severe burns.@*Methods@#Thirty-two patients with severe burns who met the inclusion criteria and hospitalized in the Affiliated Huaihai Hospital of Xuzhou Medical University from January 2016 to December 2018 were selected for conducting a prospective randomized controlled trial. According to the random number table, the patients were divided into conventional treatment group (4 males and 4 females), ulinastatin group (5 males and 3 females), glutamine group (5 males and 3 females), and ulinastatin+ glutamine group (4 males and 4 females), with ages of (36±8), (34±8), (35±9), and (38±13) years in turn. From post injury day 2, patients in the 4 groups were given nutritional support of equal nitrogen and equal calories, of which protein was 2.0 g/kg daily. In addition, patients in the ulinastatin group received intravenous injection of 100 kU ulinastatin every 8 hours for 7 consecutive days; 0.3 g/kg of protein given to patients in the glutamine group was provided by alanine glutamine for 7 consecutive days; patients in the ulinastatin+ glutamine group received corresponding treatments of both ulinastatin group and glutamine group. With the help of pulse contour cardiac output (PiCCO) monitoring technology, the cardiac index, stroke volume index (SVI), global end-diastolic volume index (GEDI), systemic vascular resistance index (SVRI), extravascular lung water index (EVLWI), pulmonary vascular permeability index (PVPI) of patients in each group were measured on treatment day (TD) 1, 3, and 7. Data were processed with Fisher′s exact probability method, one-way analysis of variance, analysis of variance for repeated measurement, and Bonferroni method.@*Results@#The cardiac index was low and the SVI value was lower than the normal value on TD 1 in patients of the 4 groups, without statistically significant differences between any two groups (P>0.05), and then they were all gradually increased. On TD 3 and 7, compared with those of the conventional treatment group, the cardiac index and SVI of patients in the other three groups were all increased, and the cardiac index and SVI of patients in the ulinastatin+ glutamine group were significantly increased (P<0.05 or P<0.01). On TD 1, the GEDI of patients in the conventional treatment group, ulinastatin group, glutamine group, and ulinastatin+ glutamine group were at normal low levels, which were (659±58), (661±79), (659±88), and (653±71) mL/m2 respectively, without statistically significant differences between any two groups (P>0.05), and then they all gradually increased. On TD 3 and 7, compared with (684±82) and (742±46) mL/m2 of the conventional treatment group, the GEDI of patients in the ulinastatin group, glutamine group, and ulinastatin+ glutamine group were all elevated, which were (732±53) and (777±33), (725±58) and (783±49), (813±65) and (849±27) mL/m2 respectively, and the GEDI of patients in the ulinastatin+ glutamine group was significantly increased (P<0.05). The SVRI of patients in the four groups were all at high levels on TD 1, without statistically significant differences between any two groups (P>0.05), and then they all gradually decreased. On TD 3 and 7, compared with those of the conventional treatment group, the SVRI of patients in the other three groups were all increased, and the SVRI in the ulinastatin+ glutamine group was significantly increased (P<0.05). On TD 1, the EVLWI of patients in the conventional treatment group, ulinastatin group, glutamine group, and ulinastatin+ glutamine group were all in the normal range, which were (6.6±0.6), (6.3±0.4), (6.5±0.4), and (6.6±0.6) mL/kg respectively, without statistically significant differences between any two groups (P>0.05), and then they all showed the increasing trend. On TD 3 and 7, compared with (7.1±0.9) and (7.9±0.5) mL/kg of the conventional treatment group, the EVLWI of patients in the ulinastatin group, glutamine group, and ulinastatin+ glutamine group were all decreased, which were (6.2±0.6) and (7.1±0.4), (6.3±1.0) and (7.2±0.9), (5.8±0.7) and (6.7±0.6) mL/kg respectively, and the EVLWI of patients in the ulinastatin+ glutamine group was significantly decreased (P<0.05). On TD 1, the PVPI of patients in the four groups were all in the normal range, without statistically significant differences between any two groups (P>0.05), and then they all gradually decreased. On TD 3 and 7, compared with those of the conventional treatment group, the PVPI of patients in the other three groups were all decreased, and the PVPI in the ulinastatin+ glutamine group was significantly decreased (P<0.05).@*Conclusions@#Ulinastatin combined with glutamine can increase the cardiac index, SVI, GEDI, and SVRI and reduce the EVLWI and PVPI in treating patients with severe burns, thereby increasing early cardiac output after injury, promoting tissue and organ perfusion, and reducing pulmonary edema, resulting in significant improvement in early hemodynamics of patients with severe burns.