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Objective:To analyze the clinical presentations and diagnostic and treatment process of one patient with autoimmune encephalitis(AE)with double positive anti-N-methyl-D-aspartate receptor(NMDAR)and anti-γ-aminobutyric acid B receptor(GABABR)secondary to herpes simplex virus encephalitis(HSVE),and to improve the clinicians'awareness of this disease.Methods:The clinical data of one AE patient with double positive anti-NMDAR and anti-GABABR secondary to HSVE were collected,the diagnostic and therapeutic processes were summarized,and the relevant literatures were reviewed.Results:The patient,a 36-year-old male,developed a headache followed by limb convulsions,and progressed to disturbed consciousness.After admission,the routine biochemistry of the cerebrospinal fluid(CSF)was abnormal,and the herpes simplex virus-1(HSV-1)IgG antibody showed positive in the CSF;both CSF and serum tests for NMDAR antibodies were positive;the head magnetic resonance imaging(MRI)results showed abnormal signals in the right occipital white matter,leading to the diagnosis of HSVE secondary to anti-NMDAR encephalitis.Several months later,the patient experienced psychiatric behavior abnormalities,cognitive dysfunction,and sleep disorders,and both the serum NMDAR and GABABR antibodies showed positive results,prompting the diagnosis of HSVE secondary anti-NMDAR encephalitis and anti-GABABR encephalitis.After treatment with steroid pulse therapy and intravenous immunoglobulin(IVIG),the patient's condition was improved and the patient was discharged.At one-year follow-up,the patient's psychiatric symptoms had completely resolved,leaving mild cognitive impairment.Conclusion:If the clinical symptoms of the patients recovering from antiviral treatment for HSVE is worsened,secondary AE should be highly suspected;it is important to complete autoimmunity antibody testing as soon as possible for the early diagnosis and treatment to improve the prognosis of the patient.
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Objective To explore the levels of interleukin-37(IL-37)and CC type modified chemokine 11(CCL11)in serum of pregnant women infected with group B streptococcus in late pregnancy and their predic-tive efficacy for maternal and infant outcomes.Methods A total of 86 pregnant women with reproductive tract B streptococcus infection in late pregnancy treated in the hospital from December 2020 to December 2022 were selected as the study group,and 76 pregnant women with normal physical examination admitted during the same period were selected as the control group.The levels of IL-37 and CCL11 in serum of all pregnant women were detected by enzyme-linked immunosorbent assay.According to whether the pregnant women with group B streptococcus infection in late pregnancy had adverse maternal and infant outcomes,they were divided into normal pregnancy outcome group(50 cases)and adverse pregnancy outcome group(36 cases).Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum IL-37 and CCL11 on maternal and infant outcomes of pregnant women with reproductive group B streptococcus infection in late pregnancy.Multivariate Logistic regression was used to analyze the factors affecting maternal and in-fant outcomes of pregnant women with reproductive group B streptococcus infection in late pregnancy.Results The levels of IL-37 and CCL11 in the study group were higher than those in the control group(P<0.05).The incidence rate of adverse outcomes in the study group was significantly higher than that in the control group(P<0.05).The proportion of abortion history and the proportion of vaginal microecological disorders and levels of IL-37 and CCL11 and in adverse pregnancy outcome group were higher than those in normal pregnancy outcome group(P<0.05).ROC curve results showed that the area under the curve(AUC)of IL-37 and CCL11 for predicting adverse maternal and infant outcomes of pregnant women infected with group B streptococcus in late pregnancy were 0.876(95%CI:0.824-0.920)and 0.788(95%CI:0.748-0.830),re-spectively.The AUC of the combined prediction of adverse maternal and infant outcomes of pregnant women infected with group B streptococcus were 0.927(95%CI:0.889-0.970).Multivariate Logistic regression a-nalysis results showed that serum IL-37(OR=3.604,95%CI:2.106-6.166),CCL11(OR=4.250,95%CI:2.074-8.709),abortion history(OR=2.707,95%CI:1.688-4.342)and vaginal microecological disorders(OR=3.504,95%CI:1.993-6.162)were risk factors for adverse maternal and infant outcomes in pregnant women infected with group B streptococcus in late pregnancy(P<0.05).Conclusion The levels of IL-37 and CCL11 in serum of pregnant women infected with reproductive group B streptococcus in late pregnancy are in-creased,which are related to adverse pregnancy outcomes,and are expected to be effective indicator for predic-ting adverse pregnancy outcomes of pregnant women infected with reproductive group B streptococcus in late pregnancy.
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Objective To observe the clinical efficacy of modified Shehuang Ointment(mainly composed of Cnidii Fructus,Phellodendri Chinensis Cortex,and Zanthoxyli Pericarpium)for the treatment of facial seborrheic dermatitis(SD).Methods Seventy-two patients with facial SD were randomly divided into observation group and control group,with 36 patients in each group.Both groups of patients were given oral use of Acrivastine Capsules and Vitamin B6 Tablets,and additionally,the observation group was given topical application of modified Shehuang Ointment and the control group was given topical application of 2%Ketoconazole cream.The course of treatment covered 4 weeks.The changes of clinical symptom scores and dermatology life quality index(DLQI)scores in the two groups were observed before and after treatment,and the clinical efficacy and safety of the two groups were also evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 88.89%(32/36),and that of the control group was 72.22%(26/36).The intergroup comparison showed that the efficacy of the observation group was significantly superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,the clinical symptom scores of erythema,scales,grease,rash area,itchiness and other clinical symptoms of the patients in the two groups were significantly decreased compared with those before treatment(P<0.05),and the clinical symptom scores of the observation group were significantly lower than those of the control group,the differences being statistically significant(P<0.05).(3)After treatment,the DLQI scores of patients in the two groups were significantly lower than those before treatment(P<0.05),and the DLQI scores in the observation group were significantly lower than those in the control group after treatment,the difference being statistically significant(P<0.05).(4)During the treatment period,no significant adverse reactions occurred in the two groups of patients,with high safety.Conclusion The conventional western medicine treatment combined with topical application of modified Shehuang Ointment exerts certain effect in the treatment of facial SD,which can effectively relieve the clinical symptoms and improve the quality of life of patients.
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Objective:To explore effect and molecular mechanism of transcription factor SP1 on apoptosis and inflammatory response of diabetic retinopathy(DR).Methods:To construct a DR model of human retinal microvascular endothelial cells(hRMECs),cells were divided into Control group,HG group,HG+si-NC group,HG+si-SP1 group,HG+si-SP1+oe-NC group and HG+si-SP1+oe-MAP3K1 group by transfection.RT-qPCR was used to detect expressions of SP1 and MAP3K1;flow cytometry was used to detect cell apoptosis;ELISA was used to detect contents of inflammatory factors TNF-α,IL-1β and IL-6 in cells;binding site between SP1 and MAP3K1 promoter were found by bioinformatics,and ChIP-qPCR was used to detect binding of SP1 to the MAP3K1 promoter.Results:Compared with control group,expressions of SP1 and MAP3K1 in hRMECs treated with HG were increased(P<0.05).Inhibition of SP1 expression,apoptosis rate was significantly decreased(P<0.05),and contents of inflammatory factors TNF-α,IL-1β and IL-6 were significantly decreased(P<0.05).Inhibition of SP1 reduced expression of MAP3K1.Further overexpression of MAP3K1 reversed inhibitory effect of si-SP1 on HG-induced apoptosis and inflammatory responses in hRMECs.Conclusion:Transcription factor SP1 promotes apoptosis and inflammatory response of DR cells by promoting expression of MAP3K1.
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OBJECTIVE To investigate the improvement effects of glycyrrhizin (GL) on Helicobacter pylori (HP)-associated gastritis in rats and its mechanism. METHODS HP-associated gastritis rat model was induced by inoculating with 1×109 cfu/mL HP. The model rats were randomly divided into model group, positive control group (HP standard quadruple group), GL low-dose, medium-dose and high-dose groups (5, 20, 50 mg/kg), with 12 rats in each group. Another 12 healthy rats were selected as normal control group. Except the normal control group and model group were given constant volume of normal saline intragastrically, the other groups were given corresponding drugs intragastrically, once a day, for 30 consecutive days. After administration, rats received 13C urea breath test, and delta-over-baseline (DOB) was recorded; the pathological and cellular morphological changes of gastric mucosa in rats were observed, and pathological scoring was performed; the levels of interleukin-8 (IL-8), IL-1β, tumor necrosis factor-α (TNF-α), reactive oxygen species (ROS) and malondialdehyde (MDA) were detected in gastric mucosa of rats; mRNA expressions of high mobility group box-1 protein (HMGB1) and nuclear factor-κ-B (NF-κB), relative expressions of nitric oxide synthases (iNOS) and HMGB1, the phosphorylation level of NF- κBp65 were also detected in rats. RESULTS Compared with normal control group, the DOB value, histopathological score of gastric mucosa, the levels of IL-8, IL-1β, TNF-α, ROS and MDA, relative expressions of HMGB1 and NF- κB mRNA, relative expressions of iNOS and HMGB1 protein and the phosphorylation level of NF-κB p65 were all increased significantly in model group (P<0.05); the epithelial cells of gastric mucosa in rats were incomplete in structure and decreased in the number, with an increase in cell fragments and vacuoles, and significant cell pyknosis. Compared with model group, the changes of the above indexes in GL groups and positive control group were significantly reversed (P<0.05); the changes in the above indicators in the GL high-dose group were more significant than GL low-dose and medium-dose groups (P<0.05); the pathological changes of gastric mucosal cells in rats had all improved. CONCLUSIONS GL may inhibit inflammation and oxidative stress by inhibiting the activation of HMGB1/NF-κB pathway, thus relieving HP-induced gastric mucosal injury.
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ObjectiveTo investigate the prevalence of overweight, obesity and fatty liver disease (FLD) in adult residents in a suburban area of Shanghai, and to explore the relationship between these conditions and eating out of home (EOH). MethodsAdult residents from Zhongshan Street, Songjiang, Shanghai, were invited to report their frequency of EOH and undergo a physical examination using B-ultrasonography from May to September 2017. Binary logistic regression analyses were conducted to examine the relationship between EOH and conditions of overweight, obesity, and FLD. ResultsAmong the final sample size of 6 608 participants, the prevalence rates of overweight, obesity, and FLD were 41.65%, 14.71% and 38.29%, respectively. After adjusting for potential confounders, logistic analyses revealed that participants with an EOH frequency > once/week had a 1.44-fold higher prevalence of obesity (P=0.006), a 1.35-fold higher prevalence of overweight/obesity (P=0.005), and a 1.36-fold higher prevalence of FLD (P=0.008). ConclusionThe prevalence of overweight, obesity, and FLD is relatively high in Songjiang, Shanghai. EOH may be a risk factor for these diseases, and residents are recommended to reduce the frequency of EOH.
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AIM: To revise the referral criteria for the SPOT Vision Screener in children under 6 years old and assessed its accuracy based on the American Association for Pediatric Ophthalmology and Strabismus(AAPOS)uniform guidelines for instrument-based pediatric vision screen validation 2021.METHODS: Children who visited the Maternal and Child Health Center of Yuhuatai District in Nanjing city from January 2022 to April 2023 were included in the study and underwent SPOT refractive screening, cycloplegic retinoscopy, and other examinations. Abnormal children were defined according to AAPOS guidelines with amblyopia risk factors(ARFs)and visually significant refractive error(VSRE). Receiver operating characteristic(ROC)curve was used to calculate the optimal referral criteria and compared with manufacturer criteria, Wu's criteria, and Peterseim's criteria.RESULTS: A total of 959 children were examined, with 342 in the <4-year-old group and 617 in the ≥4-year-old group. The optimal referral criteria for the <4-year-old group were myopia ≤-2.75 D, hyperopia ≥+2.25 D, astigmatism ≤-2.75 D, and anisometropia ≥1.00 D. For the ≥4-year-old group, the criteria were myopia ≤-1.75 D, hyperopia ≥+2.00 D, astigmatism ≤-2.25 D, and anisometropia ≥1.00 D. The Youden index was 0.38 and 0.52, respectively, which were higher than other criteria.CONCLUSION: The use of new referral criteria for refractive screening in children under 6 years old demonstrates higher accuracy compared to previous criteria. It provides valuable guidance for pediatric eye care and vision health in children.
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OBJECTIVE To investigate the impacts of isorhynchophylline (IRN) on airway inflammation in asthmatic mice by regulating the monocyte chemotactic protein-1 (MCP-1)/CC chemokine receptor 2 (CCR2) signaling pathway. METHODS The asthmatic mice model was established by injecting and inhaling ovalbumin. The successfully modeled mice were randomly grouped into asthma group, IRN low-dose group (IRN-L, intragastric administration of 10 mg/kg IRN), IRN high-dose group (IRN-H, intragastric administration of 20 mg/kg IRN), IRN-H+CCL2 group [intragastric administration of 20 mg/kg IRN+intraperitoneal injection of 7.5 ng CC chemokine ligand 2 (CCL2)] and positive control group (intraperitoneal injection of 2 mg/kg dexamethasone). The mice injected and inhaled with sterile phosphate-buffered solution were included in the blank control group, with 10 mice in each group. The mice in administration groups were given relevant medicine once a day, for consecutive 2 weeks. The levels of airway hyperreactivity indexes such as enhanced (Penh) value, tumor necrosis factor-α (TNF-α),interleukin-13 (IL-13) and IL-4 in serum, the number of eosinophil (EOS), lymphocyte (LYM) and neutrophils (NEU) in alveolar lavage fluid and the protein expressions of MCP-1 and CCR2 in lung tissue were observed in each group; the pulmonary histopathological changes were observed, and inflammatory cell infiltration score was evaluated. RESULTS Compared with the blank control group, the infiltration of inflammatory cells in the lung tissue of mice was more significant in the asthma group, and there was swelling and shedding of cells; inflammatory infiltration score, Penh value, the levels of IL-4, IL-13 and TNF-α, the number of EOS, NEU and LYM, the protein expressions of MCP-1 and CCR2 were increased significantly (P<0.05). Compared with the asthma group, the pathological injuries of the IRN-L group, IRN-H group and positive control group were improved, and the above quantitative indexes were decreased significantly (P<0.05). Compared with the IRN-L group, the above quantitative indexes of the IRN-H group and positive control group were decreased significantly (P<0.05). There was no statistical significance in the above quantitative indexes between the IRN-H group and the positive control group (P>0.05). Compared with the IRN-H group, the above quantitative indexes of the IRN-H+CCL2 group were increased significantly (P<0.05). CCL2 reversed the protective effect of high-dose IRN on asthmatic mice. CONCLUSIONS IRN may reduce the release of airway inflammatory factors in asthmatic mice by inhibiting the activation of the MCP-1/CCR2 signaling pathway, so as to achieve the purpose of improving asthma.
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In January 2022, after an eight-year hiatus, the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) published the latest version of AAPOS uniform guidelines for instrument-based pediatric vision screen validation.Based on recent studies, the new guidelines have been updated and supplemented in many aspects, such as screening population, key points, methods and diagnosis criteria, including clinically significant refractive errors and myopia, simplified age subgroups, and adopted meridional refractive power.The updated guidelines will improve pediatric eye care, early detection of amblyopia and refractive screening, reduce excessive referral and ultimately improve the effectiveness of vision screening.In this article, the background and specific content of the updated guidelines were interpreted to guide clinical practice.
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Methods The model of heart failure after myocardial infarction was established by left coronary artery liga-tion in rats. Two weeks after modeling, all rats were randomly divided into model group, LGZGD group, and captopril group. Meanwhile sham operation group was set up. The rats were given continuous intragastric administration with drug or distilled water for 28 days, once a day. The behavioral signs of rats in each group were observed. The cardiac function of rats in each group was examined by echocardiography. Serum BNP and NT-ProBNP content were detected by enzyme-linked immunoassay; The changes of myocardial his-topathological and collagen fibers in rats were detected using sirius staining. The contents of oxidative stress index including ROS, SOD in myocardial tissue of rats in each group were observed by DCFH-DA fluorescent probe and Enzyme-linked immunoassay. The ultra-structure of mitochondria was observed by transmission electron microscopy. Expressions of apoptotic proteins ( mitochondrial CytC, cytoplasmic CytC) were detec- ted by Western blot. Expression of proteins related to the Nrf2/BNIP3 pathway were examined by immunoflu-orescence and Western blot. Results LGZGD could significantly improve the cardiac function of rats, reduce the contents of BNP and NT-ProBNP, inhibit the excessive deposition of collagen in myocardial interstiti-um, reduce ROS, increase the content of SOD, improve mitochondrial structure damage, up-regulate the expression of Nrf2 and nuclear translocation, and reduce the expression of BNIP3. Conclusions LGZGD can inhibit the ventricular remodeling and prevent the occurrence of heart failure after myocardial infarction. Its pharmacological effects are mainly related to regulating the Nrf2/BNIP3 pathway, activating Nrf2, promoting its nuclear transfer, and further down-regulating BNIP3 , protecting mitochondrial function, and reducing cardiomyocyte apoptosis.
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Objective:To compare the effect and biotoxicity of tert-butyl acetate (TBA) and ethyl butyrate (EB) on stone dissolution in vitro.Methods:Ten gallstone samples from patients with multiple gallbladder stones were selected and the cholesterol content was analyzed by HPLC. Stone dissolution tests of TBA and EB were performed on cholesterol gallstone in vitro, and the weight of stone at each time point was recorded, meanwhile, methyl tert-butyl ether (MTBE) was used as the control. The inhibitory effects of MTBE, TBA and EB on proliferation of human normal liver cell line LO2 were analyzed by cell proliferation inhibition assay. Flow cytometry was used to analyze the effects of MTBE, TBA and EB on the early and late apoptosis of LO2 cells, and the changes of reactive oxygen species level in LO2 cells were also analyzed.Results:Of the 10 gallbladder gallstones, 6 were cholesterol gallstones and 4 were non-cholesterol gallstones. Stone dissolution experiment showed that the remaining stones of MTBE, TBA and EB groups were (47.83±3.84)%, (58.12±4.53)% and (75.75±4.61)% 30 minutes later. The remaining stones were (18.38±6.47)%, (33.82±6.22)% and (56.38±3.91)% 90 minutes later. MTBE had the best stone dissolution effect in vitro, the stone dissolution effect of TBA was slightly weaker than MTBE, and the stone dissolution effect of EB was relatively weak in all ( P<0.05). The cell proliferation inhibition experiment showed that the cell viability of the control group, MTBE group and TBA group were (100.00±4.46)%, (96.79±4.32)% and (93.72±3.51)%, respectively, and there were no significant differences among the three groups ( P>0.05). However, the cell viability of EB group (87.57±5.29)% was lower than the above three groups, and the differences were statistically significant ( P<0.001). The early apoptosis and late apoptosis of the control group were (1.67±0.15)% and (1.27±0.06)%, respectively. EB induced early apoptosis (15.90±0.53)% ( P<0.001) and late apoptosis (5.13±0.76)% ( P<0.05). However, MTBE and TBA had no significant effect on cell apoptosis ( P>0.05). Compared with control group, MTBE, TBA and EB all significantly inhibited the level of reactive oxygen species ( P<0.05), and the inhibitory effect of EB was the most obvious. Conclusions:TBA has good stone dissolution effect and biosafety for gallbladder cholesterol stones in vitro, while EB has relatively poor performance. TBA is a potential drug for gallstone dissolution.
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Objective:To observe the efficacy and adverse reactions of fractional radiofrequency (FRF) in the treatment of facial acne scars.Methods:Fifty-seven patients with facial acne depressed scars were enrolled with the nature of Dreno scars as the diagnostic criteria. They were treated with lattice radiofrequency. The treatment heads were arranged in a matrix with a treatment area of 1.2 cm ×1.2 cm, an energy density of 80-100 mJ/pin, and an interval of five-seven once a week. And they were followed up and evaluated for the clinical efficacy and adverse reactions 6 months after the last treatment. Scoring was carried out according to the ECCA weight scores, and the efficacy judged according to complete improvement, significant improvement, moderate improvement, and mild improvement.Results:After 3 times of fractional radiofrequency treatment of 57 patients, the effective rate was 44 cases, accounting for 77.2%; the ECCA weight scores before and after treatment were 65.9±25.0 and 47.7±20.2, respectively; the difference was statistically significant ( t=13.92, P<0.001); At the same time of improvement, 32 cases of patients' complexion, fineness of pores, and skin elasticity had been improved to varying degrees, and patient satisfaction was high. Adverse reactions were mainly mild burning sensation, erythema and edema, and some patients had pale yellow exudate, etc, which could be relieved in 5-7 days. Conclusions:Fractional radiofrequency treatment of facial acne scars is safe and effective, with short recovery period, few adverse reactions and high patient satisfaction.
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Objectives@#The association between long sleep duration and mortality is frequently attributed to the confounding influence of comorbidities. Nevertheless, past efforts to account for comorbidities have yielded inconsistent outcomes. The objective of this study was to evaluate this relationship using a large prospective cohort in Korea. @*Methods@#The study included 114 205 participants from the Health Examinees Study, who were followed for a median of 9.1 years. A composite comorbidity score was developed to summarize the effects of 21 diseases. Using Cox proportional hazards regression, hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause, cancer, and cardiovascular mortality associated with sleep duration were estimated. These estimates were adjusted for socio-demographic factors, lifestyle factors, body mass index, and comorbidity score. Additionally, a stratified analysis by subgroups with and without comorbidities was conducted. @*Results@#Throughout the follow-up period, 2675 deaths were recorded. After all adjustments, an association was observed between a sleep duration of 8 hours or more and all-cause mortality (HR, 1.10; 95% CI, 1.01 to 1.20). However, no such association was detected in the stratified analysis for the subgroups based on comorbidity status. @*Conclusions@#Long sleep duration was found to be associated with all-cause mortality among Koreans, even after adjusting for comorbidities. Additional studies are required to explore the mechanism underlying the association between sleep duration and major causes of mortality.
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Objective: Total neoadjuvant therapy has been used to improve tumor responses and prevent distant metastases in patients with locally advanced rectal cancer (LARC). Patients with complete clinical responses (cCR) then have the option of choosing a watch and wait (W&W) strategy and organ preservation. It has recently been shown that hypofractionated radiotherapy has better synergistic effects with PD-1/PD-L1 inhibitors than does conventionally fractionated radiotherapy, increasing the sensitivity of microsatellite stable (MSS) colorectal cancer to immunotherapy. Thus, in this trial we aimed to determine whether total neoadjuvant therapy comprising short-course radiotherapy (SCRT) combined with a PD-1 inhibitor improves the degree of tumor regression in patients with LARC. Methods: TORCH is a prospective, multicenter, randomized, phase II trial (TORCH Registration No. NCT04518280). Patients with LARC (T3-4/N+M0, distance from anus ≤10 cm) are eligible and are randomly assigned to consolidation or induction arms. Those in the consolidation arm receive SCRT (25Gy/5 Fx), followed by six cycles of toripalimab plus capecitabine and oxaliplatin (ToriCAPOX). Those in the induction arm receive two cycles of ToriCAPOX, then undergo SCRT, followed by four cycles of ToriCAPOX. Patients in both groups undergo total mesorectal excision (TME) or can choose a W&W strategy if cCR has been achieved. The primary endpoint is the complete response rate (CR, pathological complete response [pCR] plus continuous cCR for more than 1 year). The secondary endpoints include rates of Grade 3-4 acute adverse effects (AEs) etc. Results: Up to 30 September 2022, 62 patients attending our center were enrolled (Consolidation arm: 34, Induction arm:28). Their median age was 53 (27-69) years. Fifty-nine of them had MSS/pMMR type cancer (95.2%), and only three MSI-H/dMMR. Additionally, 55 patients (88.7%) had Stage III disease. The following important characteristics were distributed as follows: lower location (≤5 cm from anus, 48/62, 77.4%), deeper invasion by primary lesion (cT4 7/62, 11.3%; mesorectal fascia involved 17/62, 27.4%), and high risk of distant metastasis (cN2 26/62, 41.9%; EMVI+ 11/62, 17.7%). All 62 patients completed the SCRT and at least five cycles of ToriCAPOX, 52/62 (83.9%) completing six cycles of ToriCAPOX. Finally, 29 patients achieved cCR (46.8%, 29/62), 18 of whom decided to adopt a W&W strategy. TME was performed on 32 patients. Pathological examination showed 18 had achieved pCR, four TRG 1, and 10 TRG 2-3. The three patients with MSI-H disease all achieved cCR. One of these patients was found to have pCR after surgery whereas the other two adopted a W&W strategy. Thus, the pCR and CR rates were 56.2% (18/32) and 58.1% (36/62), respectively. The TRG 0-1 rate was 68.8% (22/32). The most common non-hematologic AEs were poor appetite (49/60, 81.7%), numbness (49/60, 81.7%), nausea (47/60, 78.3%) and asthenia (43/60, 71.7%); two patients did not complete this survey. The most common hematologic AEs were thrombocytopenia (48/62, 77.4%), anemia (47/62, 75.8%), leukopenia/neutropenia (44/62, 71.0%) and high transaminase (39/62, 62.9%). The main Grade III-IV AE was thrombocytopenia (22/62, 35.5%), with three patients (3/62, 4.8%) having Grade IV thrombocytopenia. No Grade V AEs were noted. Conclusions: SCRT-based total neoadjuvant therapy combined with toripalimab can achieve a surprisingly good CR rate in patients with LARC and thus has the potential to offer new treatment options for organ preservation in patients with MSS and lower-location rectal cancer. Meanwhile, the preliminary findings of a single center show good tolerability, the main Grade III-IV AE being thrombocytopenia. The significant efficacy and long-term prognostic benefit need to be determined by further follow-up.
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Humans , Middle Aged , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemoradiotherapy , Immune Checkpoint Inhibitors/therapeutic use , Neoadjuvant Therapy , Prospective Studies , Rectal Neoplasms/pathology , Thrombocytopenia/drug therapy , Treatment OutcomeABSTRACT
From the fungus Trichoderma sp., we isolated seven novel 18-residue peptaibols, neoatroviridins E-K (1-7), and six new 14-residue peptaibols, harzianins NPDG J-O (8-13). Additionally, four previously characterized 18-residue peptaibols neoatroviridins A-D (14-17) were also identified. The structural configurations of the newly identified peptaibols (1-13) were determined by comprehensive nuclear magnetic resonance (NMR) and high-resolution electrospray ionization tandem mass spectrometry (HR-ESI-MS/MS) data. Their absolute configurations were further determined using Marfey's method. Notably, compounds 12 and 13 represent the first 14-residue peptaibols containing an acidic amino acid residue. In antimicrobial assessments, all 18-residue peptaibols (1-7, 14-17) exhibited moderate inhibitory activities against Staphylococcus aureus 209P, with minimum inhibitory concentration (MIC) values ranging from 8-32 μg·mL-1. Moreover, compound 9 exhibited moderate inhibitory effect on Candida albicans FIM709, with a MIC value of 16 μg·mL-1.
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Peptaibols/chemistry , Trichoderma/metabolism , Tandem Mass Spectrometry/methods , Anti-Infective Agents/pharmacology , Spectrometry, Mass, Electrospray Ionization/methodsABSTRACT
This study aimed to analyze the impact of traditional Chinese medicine(TCM) on the risk of re-admission for ankylosing spondylitis(AS) patients with dampness-heat syndrome. In this study, a telephone follow-up was conducted on 1 295 AS inpatients, and after screening and exclusions, 1 044 successfully followed-up patients were included. A retrospective cohort study was conducted using propensity score matching(PSM), and a Cox proportional risk model was employed to assess the effect of various factors on the risk of re-admission for AS patients with dampness-heat syndrome. Kaplan-Meier survival curves were used to analyze the effect of TCM intervention time on re-admission. The incidence rate of dampness-heat syndrome in AS patients was found to be 51.3% in this study. After 1∶1 PSM, 385 AS patients with dampness-heat syndrome and 385 AS patients without dampness-heat syndrome were included for analysis. The results indicated that the re-admission rate was higher for patients with dampness-heat syndrome compared with those without dampness-heat syndrome(P<0.05). AS patients with dampness-heat syndrome in the TCM group had a lower admission rate than those in the non-TCM group(P=0.01). The cox proportional risk model demonstrated that TCM was an independent protective factor, as it reduced the risk of re-admission by 35%(HR=0.35, 95%CI[0.26, 0.95], P<0.05). Moreover, the subgroup with high exposure(time to use Chinese medicine >12 months) had a significantly lower risk of re-admission than that with low TCM exposure(time to use Chinese medicine ≤12 months). The re-admission rate for AS patients with dampness-heat syndrome was higher than that without dampness-heat syndrome, and TCM was identified as a protective factor in reducing the risk of re-admission. Furthermore, a longer duration of TCM intervention was associated with a lower risk of re-admission.
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Humans , Medicine, Chinese Traditional , Spondylitis, Ankylosing/epidemiology , Retrospective Studies , Hot TemperatureABSTRACT
Objective:To compare efficacy and safety of 308-nm SQ light-emitting diode (LED) light versus 308-nm excimer light in the treatment of facial vitiligo.Methods:Patients with stable facial vitiligo were retrospectively collected from Department of Physical Therapy, Hospital of Dermatology, Chinese Academy of Medical Sciences from June 2018 to June 2020, who received treatment with 308-nm SQ LED light (LED group) or 308-nm excimer light (excimer light group). The treatment was performed once or twice a week, and patients who had received more than 8 sessions of treatment were included in the analysis of efficacy and safety. Statistical analysis was carried out by using chi-square test.Results:Totally, 68 patients with 90 lesions were enrolled into the LED group, including 36 males and 32 females, aged 25.01 ± 13.37 years; 20 patients with 28 lesions were enrolled into the excimer light group, including 13 males and 7 females, aged 27.15 ± 14.30 years. After 8 and 16 sessions of treatment, there was no significant difference in the response rate between the LED group (23.33%, 46.67%, respectively) and excimer light group (14.29%, 46.43%, χ2 = 1.05, < 0.001, respectively, both P > 0.05). During the treatment, 36 (52.94%) patients in the LED group developed persistent erythema, 17 (85%) in the excimer light group developed persistent erythema or blisters. The incidence of adverse reactions was significantly lower in the LED group than in the excimer light group ( χ2 = 16.43, P < 0.001) . Conclusion:Compared with the 308-nm excimer light, the 308-nm SQ LED light showed similar effect but higher safety for the treatment of facial vitiligo.
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Objective @#To investigate the correlation between nocturnal sleep duration combined with snoring in the first trimester of pregnancyand small for gestational age(SGA) ,large for gestational age(LGA) .@*Methods @#Multi- variate Logistic regression model was used to analyze the association between nocturnal sleep duration ,snoring, their combined effects and SGA,LGA. @*Results @#Compared to nocturnal sleep duration 7 to 9 h in the first trimester of pregnancy,sleep duration<7 h was positively correlated with SGA in male newborn( OR = 4. 22,95% CI : 1. 69 - 10. 52) ; After stratified by snoring,the sleep duration of snoring women<7 h was positively correlated with SGA ( OR = 5. 68,95% CI : 1. 02-31. 51) ,and the sleep duration of non-snoring women<7 h was positively correlated with LGA ( OR = 2. 10,95% CI : 1. 16 -3. 81) .@*Conclusion @#Sleep duration<7 h in the first trimester of preg- nancy is a risk factor for SGA and LGA,and snoring may enhance the association between sleep duration<7 h in the first trimester of pregnancy and SGA.Pregnant women should keep adequate nocturnal sleep duration to reduce the risk of abnormal neonatal weight.
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OBJECTIVE To provi de reference for standardizing the distribution behavior of drug wholesale enterprises and improving the supervision level of drug supervision departments. METHODS The defective items found in the on-site inspection of 570 drug wholesale enterprises in Hunan province in 2020 were summarized ,the main risks were analyzed to put forward countermeasures and suggestions. RESULTS & CONCLUSIONS The provincial drug regulatory departments conducted daily supervision and inspection among 192 drug wholesale enterprises ,of which 168 enterprises(87.50%)were ordered to make corrections;a total of 1 804 defective items were found ,involving 11 serious defects ,806 major defects and 987 general defects. The provincial drug regulatory departments conducted special inspections among 20 wholesale enterprises of narcotic drugs and psychotropic drugs ,of which 18 enterprises(90.00%)were ordered to make corrections ;a total of 48 defective items were found , involving 33 major defects and 15 general defects ,and no serious defective items were found. The drug regulatory departments of all cities (autonomous prefectures )inspected 358 drug wholesale enterprises ,of which 290 enterprises(81.00%)were ordered to make corrections ;a total of 1 499 defective items were found ,including 665 main defects and 834 general defects ,and no serious defective items were found. According to the statistics of occurrence frequency ,defective items of drug wholesale enterprises in Hunan province were mainly concentrated in storage and maintenance (687 items,20.50%),facilities and equipments (608 items, 18.14%),personnel and training (579 items,17.28%),receipt and acceptance (272 items,8.12%)and quality management system documents (260 items,7.76%),which together accounted for 71.80% of the total defects. The main risks of drug wholesale enterprises included weak enterprise risk awareness ,high frequency of quality risks in drug marketing ,imperfect enterprise quality management system documents ,and fraud in enterprise business behavior. It is recommended that drug wholesale enterprises should establish quality risk management institutions ,evaluation standards and management systems ,improve the operation quality management system ,strengthen the management of drug storage ,standardize the operation and management of enterprises,strengthen personnel training and standardize procurement behavior ,so as to j ointly maintain the safety and efficacy of drugs and controllable quality.
ABSTRACT
OBJECTIVE@#To construct a HEK293 cell line stably overexpressing TrxR1 as a cell model for functional study of TrxR1 and screening of TrxR1-targeting drugs.@*METHODS@#TrxR1 gene was amplified by PCR and ligated with the lentivirus expression vector pLVX-Puro, which was transformed into Escherichia coli and identified by Sanger dideoxy sequencing. HEK293 cells were infected with the recombinant lentivirus vector (pLVX-Puro-TXNRD1) and screened with Puromycin for cell clones with stable TrxR1 overexpression (HEK293-TrxR1-OE cells). HEK293-TrxR1-OE cells, along with HEK293 cells infected with pLVX-Puro vector (HEK293-NC) and normal HEK293 cells, were tested for mRNA and protein expression levels of TrxR1 using RT-qPCR and Western blotting. TrxR1 enzyme activity in the cells was evaluated with insulin endpoint assay and TRFS-green probe imaging. The sensitivity of the cells to auranofin, a specific TrxR1 inhibitor, was determined with CCK8 assay.@*RESULTS@#TrxR1 gene was successfully inserted into the lentiviral vector pLVX-Puro as confirmed by DNA sequencing. The enzyme activity and mRNA and protein expression levels of TrxR1 were significantly higher in HEK293-TrxR1-OE cells than in HEK293 and HEK293-NC cells (P < 0.005). The inhibitory effects of auranofin on proliferation and cellular TrxR1 enzyme activity were significantly attenuated in HEK293-TrxR1-OE cells as compared with HEK293 and HEK293-NC cells (P < 0.005).@*CONCLUSION@#We successfully obtained a HEK293 cell line with stable TrxR1 overexpression, which shows resistance to auranofin and can be used for screening TrxR1 targeting drugs.