Effect of different blood purification modes on short-term complications and prognosis in uremic patients / 中华肾脏病杂志

Objective:To explore the effects of different blood purification modes on short-term complications, quality of life and survival prognosis of patients with uremia.Methods:The patients with uremia who received hemodialysis treatment at two blood purification centers in the First Affiliated Hospital of Dalian Medical University and Renal Care Hospital from January 1, 2017 to December 1, 2019 were enrolled in this study. According to the different blood purification modes, the patients were divided into high-flux hemodialysis (HFHD) group (HFHD group), HFHD+hemodiafiltration (HDF) per month group (HDF once a month group) and HFHD+HDF per week group (HDF once a week group). The three groups were matched with the ratio of 1∶1∶1 on the duration of hemodialysis based on the HDF once a week group. The differences of clinical indicators, medication and rehospitalization between baseline and end points were compared. The patients were followed up to 12 months after enrolled in the study or death. Patients in each group were divided into two subgroups, newly imported group and non-newly imported group based on whether or not they were newly enrolled in HD therapy from January 1, 2017 to December 1, 2019. Kaplan-Meier survival curve and Cox regression model were used to analyze the difference of survival prognosis in non-newly imported patients with different dialysis modes, and the EuroQol-5 Dimensions (EQ-5D-5L) was used to evaluate the difference of quality of life in newly imported patients after different dialysis modes treatment.Results:A total of 139 patients were enrolled, including 43 cases in the HFHD group, 47 cases in the HDF once a month group, and 49 cases in the HDF once a week group. After treatment, the levels of serum creatinine, serum urea nitrogen and serum potassium in the HDF once a week group were significantly lower than those in the other two groups (both P<0.05). Compared with the other two groups, the consumptions of erythropoietin and intravenous iron, the hospitalization times and hospitalization days in the HDF once a week group were significantly decreased, and the level of albumin in the HDF once a week group were significantly increased (all P<0.05). Kaplan-Meier survival curve analysis of non-newly imported hemodialysis patients showed that the survival rate in the HDF once a week group was higher than that in the other two groups (Log-rank χ2=7.020, P=0.030). Multivariate Cox regression analysis showed that HDF was a protective factor for post-dialysis survival in uremia patients ( HR=0.472, 95% CI 0.188-0.836, P=0.023). The total efficacy of EQ-5D-5L of the newly imported patients in the HDF once a week group was significantly higher than that in the other two groups ( F=7.293, P=0.002). Conclusions:The combination of HFHD with HDF per week therapy can significantly improve the short-term quality of life and nutritional status, and reduce the hospitalization frequency, length of hospital stay, the consumption of erythropoietin and intravenous iron and mortality risk in uremia patients.

Effect of thermophilic bacterium HB27 manganese superoxide dismutase in a rat model of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) / 亚洲男科学杂志(英文版)

We investigated the therapeutic effects of superoxide dismutase (SOD) from thermophilic bacterium HB27 on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and its underlying mechanisms. A Sprague-Dawley rat model of CP/CPPS was prepared and then administered saline or Thermus thermophilic (Tt)-SOD intragastrically for 4 weeks. Prostate inflammation and fibrosis were analyzed by hematoxylin and eosin staining, and Masson staining. Alanine transaminase (ALT), aspartate transaminase (AST), serum creatinine (CR), and blood urea nitrogen (BUN) levels were assayed for all animals. Enzyme-linked immunosorbent assays (ELISA) were performed to analyze serum cytokine concentrations and tissue levels of malondialdehyde, nitric oxide, SOD, catalase, and glutathione peroxidase. Reactive oxygen species levels were detected using dichlorofluorescein diacetate. The messenger ribonucleic acid (mRNA) expression of tissue cytokines was analyzed by reverse transcription polymerase chain reaction (RT-PCR), and infiltrating inflammatory cells were examined using immunohistochemistry. Nuclear factor-κB (NF-κB) P65, P38, and inhibitor of nuclear factor-κBα (I-κBα) protein levels were determined using western blot. Tt-SOD significantly improved histopathological changes in CP/CPPS, reduced inflammatory cell infiltration and fibrosis, increased pain threshold, and reduced the prostate index. Tt-SOD treatment showed no significant effect on ALT, AST, CR, or BUN levels. Furthermore, Tt-SOD reduced inflammatory cytokine expression in prostate tissue and increased antioxidant capacity. This anti-inflammatory activity correlated with decreases in the abundance of cluster of differentiation 3 (CD3), cluster of differentiation 45 (CD45), and macrophage inflammatory protein 1α (MIP1α) cells. Tt-SOD alleviated inflammation and oxidative stress by reducing NF-κB P65 and P38 protein levels and increasing I-κBα protein levels. These findings support Tt-SOD as a potential drug for CP/CPPS.

Standards for the interpretation of constitutional copy number gain: Recommendation from the American College of Medical Genetics and Genomics (ACMG) and Clinical Genome Resource (ClinGen) / 中华医学遗传学杂志

Copy number variants (CNVs) are common causes of human genetic diseases. CNVs detection has become a routine component of genetic testing, especially for pediatric neurodevelopmental disorders, multiple congenital abnormalities, prenatal evaluation of fetuses with structural anomalies detected by ultrasound. Although the technologies for CNVs detection are continuously improving, the interpretation is still challenging, with significant discordance across different laboratories. In 2020, the American College of Medical Genetics and Genomics (ACMG) and the Clinical Genome Resource (ClinGen) developed a guideline for the interpreting and reporting of constitutional copy number variants, which introduced a quantitative, evidence-based scoring framework. Here, we detailed the key points of interpreting the copy number gain based on the guideline, used six examples of different categories to illuminate the scoring process and principles. We encourage a professional understanding and application of this guideline for the detected copy number gains in China in order to further improve the clinical evaluation accuracy and consistency across different laboratories.

Neonatal mortality analysis of Chifeng city / 中国新生儿科杂志

Objective:To study the current neonatal mortality rate and causes of deaths in Chifeng city to further reduce neonatal mortality.Methods:From 2018 to 2019, neonatal mortality data of Chifeng, Inner Mongolia were reviewed. Neonatal mortality, causes of deaths, the distribution of mortality in different groups of neonates and different tiers of hospitals were analyzed.Results:A total of 172 neonatal deaths were included. The top five causes of deaths were asphyxia (23.8%), respiratory distress syndrome (RDS) (22.7%), severe congenital malformation (18.0%), infection (11.6%) and preterm birth (9.3%). Among the 172 neonates, 61 were full-term (35.5%). The leading causes of deaths were asphyxia (34.4%), severe congenital malformation (32.8%) and RDS (13.1%). 111 were premature infants (64.5%), including 16 infants (14.4%) with gestational age (GA)≤30 weeks died without treatment. The leading causes of deaths in premature infants receiving treatment were RDS (29.7%), asphyxia (18.0%) and infection (15.3%). 124 cases (74.0%) were early neonatal death (END) (death within 7 d after birth). The top 3 causes of END in preterm infants were RDS (43.1%), asphyxia (27.7%) and severe congenital malformations (12.3%). The top 3 causes of END in full-term infants were asphyxia (44.2%), severe congenital malformations (23.3%) and RDS (18.6%). 48 cases (26.0%) were late neonatal death (LND) (death after 7 d of age). The top 3 causes of LDN in preterm infants were infection (33.3%), RDS (10.0%) and severe congenital malformations (10.0%).The top 3 causes of LND in full-term infants were severe congenital malformations (55.6%), asphyxia (11.1%) and genetic diseases (11.1%). Compared with Tier II hospitals, the GA [(33.1±4.2) weeks vs. (35.0±5.1) weeks] and the birth weight (BW) [(2 000±480) g vs. (2 620±515) g] were lower in Tier Ⅲ hospitals ( P<0.05). For full-term infants, the proportion of asphyxia as the cause of deaths in Tier Ⅱ hospitals was significantly higher than Tier Ⅱ hospitals ( P<0.05). Conclusions:Neonatal deaths mainly occur within the first week after birth with asphyxia, prematurity, severe congenital malformations, infection and RDS as the leading causes. The causes of deaths of preterm and full-term infants are different at different postnatal ages. For full-term infants, the incidences of deaths due to asphyxia are higher in Tier Ⅱ hospitals than Tier Ⅲ hospitals.

Relationship of sleep duration and annual changes in sleep duration with the incidence of gastrointestinal cancers: a prospective cohort study / 中华医学杂志(英文版)

BACKGROUND@#Prospective analyses have yet to identify a consistent relationship between sleep duration and the incidence of gastrointestinal (GI) cancers. The effect of changes in sleep duration on GI cancer incidence has scarcely been studied. Therefore, we aimed to examine the association between baseline sleep duration and annual changes in sleep duration and GI cancer risk in a large population-based cohort study.@*METHODS@#A total of 123,495 participants with baseline information and 83,511 participants with annual changes in sleep duration information were prospectively observed from 2006 to 2015 for cancer incidence. Cox proportional-hazards models were used to calculate hazard ratios (HRs) and their confidence intervals (CIs) for GI cancers according to sleep duration and annual changes in sleep duration.@*RESULTS@#In baseline sleep duration analyses, short sleep duration (≤5 h) was significantly associated with a lower risk of GI cancer in females (HR: 0.31, 95% CI: 0.10-0.90), and a linear relationship between baseline sleep duration and GI cancer was observed (P = 0.010), especially in males and in the >50-year-old group. In the annual changes in sleep duration analyses, with stable category (0 to -15 min/year) as the control group, decreased sleep duration (≤-15 min/year) was significantly associated with the development of GI cancer (HR: 1.29; 95% CI: 1.04-1.61), especially in the >50-year-old group (HR: 1.32; 95% CI: 1.01-1.71), and increased sleep duration (>0 min/year) was significantly associated with GI cancer in females (HR: 2.89; 95% CI: 1.14-7.30).@*CONCLUSIONS@#Both sleep duration and annual changes in sleep duration were associated with the incidence of GI cancer.

Delivery room resuscitation and short-term outcomes of extremely preterm and extremely low birth weight infants: a multicenter survey in North China / 中华医学杂志(英文版)

BACKGROUND@#Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.@*METHODS@#The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD.@*RESULTS@#A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to ≥2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation ≥7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05).@*CONCLUSION@#Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.

Monitoring mechanism for high group behavior based on the big data diagnosis-intervention packet / 中华医院管理杂志

One of the challenges to diagnosis-intervention packet is how to detect and avoid the institutional behavior of pursuing a higher score group. Based on the analysis method of big data, the authors analyzed the objective distribution characteristics of the treatment methods corresponding to a diagnosis, and compared the distribution of diseases with high and low scores in the region to find out the selection trend of treatment methods for the same diagnosis in various hospitals. Combined with hospital positioning, the authors found out whether there was a tendency of pursuing a higher score group. Scientific support will be provided for the reasonable payment of medical insurance expenses and the development planning of hospitals.

Research on price-formation in the big data diagnosis-intervention packet / 中华医院管理杂志

Objective:To explore the price formation method and price standard in the big data diagnosis-intervention packet.Methods:The expenditure data and income data of 95 medical institutions in Shanghai in 2018 were used for analysis, including 33 municipal hospitals and 62 district hospitals. After using the standardized data of disease score, the medical institutions in the region were divided into four quadrants with the regional average of unit price per index and cost per index as the coordinate axis. The best quadrant of income and cost was found out, namely the high quality range. The geometric center was calculated in the high quality range, and the unit price per index of the geometric center was taken as the cost standard.Results:For the district hospitals, there were 20 hospitals in the first quadrant, 8 in the second quadrant, 24 in the third quadrant and 10 in the fourth quadrant; For the municipal hospitals, there were 7 hospitals in the first quadrant, 5 in the second quadrant, 12 in the third quadrant and 9 in the fourth quadrant. In the third quadrant, the average income and cost of medical institutions were lower than the average of the city, and the income could cover the cost. The third quadrant was the high quality range. The unit price per index of the third quadrant geometric center of district hospitals was 14 115.4 yuan, and that in municipal hospitals was 15 559.1 yuan, which could be used as the corresponding cost standard.Conclusions:The price discovery mechanism based on objective data and high-quality interval geometric center method can remove the impact of unreasonable charges or unreasonable behavior on medical income, and reflect the guidance of the standard price of medical insurance payment.

The big data diagnosis-intervention packet payment method: experience from Shanghai and Guangzhou / 中华医院管理杂志

Medical insurance payment model is transforming from project-based purchases to service bundle-based strategic purchases. The new form of bundled purchases should found on a scientifically-led design process of such bundles. The core to bundled purchase would be the payment standard, and the key to its success would be process control. Establishment of such a foundation, a core, and a key, would promote the current price standards, and lead service providers to a standardized medical service standard, so as to ensure a precise rewarding system of payment and service. The big data diagnosis-intervention packet(DIP)is able to fulfill mentioned ambitions by integrating insurance payment and supervision into one management. DIP is a full-process payment mode that encompasses pre-service estimation, in-service process control, post-service grading, and resource allocation. It is an innovative practice in line with China′s national conditions for the modern governance of medical security and medical services.

Spongiosum-combined glanuloplasty reduces glans complications after proximal hypospadias repair / 亚洲男科学杂志(英文版)

We aim to design a new glanuloplasty procedure combined with spongiosum to reduce the incidence of glans dehiscence and coronal fistula after proximal hypospadias repair. Patients who underwent urethroplasty by dorsal preputial island flap for proximal hypospadias between January 2014 and December 2016 were reviewed in this retrospective cohort study. Those who underwent spongiosum-combined glanuloplasty comprised the new-maneuver group, whereas those who underwent conventional glanuloplasty comprised the control group. The incidence of complications was then compared. In the new-maneuver group, dysplastic corpus spongiosum alongside lateral Buck's fascia (0.3-0.4 cm wide) on both sides of the urethral plate was separated from the proximal normal spongy tissue, joining into the glans wings to increase tissue volume and covering the neourethra in the glans penis. In the control group, the neourethra was covered with superficial fascia under the coronal sulcus. As a result, the new-maneuver and control groups comprised 47 and 28 patients, respectively. In the new-maneuver group, no glans dehiscence was detected; however, two (4.3%) patients had coronal fistula, two (4.3%) had urethral stricture, and four (8.5%) had diverticulum. In the control group, two (7.1%) patients had glans dehiscence, eight (28.6%) had coronal fistula, four (14.3%) had urethral stricture, one (3.6%) had diverticulum, and one (3.6%) had penile curvature recurrence. The new-maneuver group had less incidences of coronal fistula (P < 0.001), glans dehiscence (P = 0.033), and urethral stricture (P = 0.008) but had a higher incidence of diverticulum than the control group (P = 0.040). It clearly demonstrates that spongiosum-combined glanuloplasty can significantly reduce the incidences of coronal fistula and glans dehisce.

Visualization analysis of traditional Chinese medicine for neurogenesis research based on CiteSpace / 中国中药杂志

To analyze the research hotspots and trends of traditional Chinese medicine(TCM) for neurogenesis with use of CiteSpace 5.7.R3 software. The bibliometrics analysis on the literatures of TCM for neurogenesis from 1987 to 2020 included in the CNKI database was conducted to visualize the number of papers, authors, institutions and keywords. Totally 736 literatures were included and the volume of annual publications showed an upward in volatility. At present, several stable research teams have been formed, which were represented by DING Fei, ZHOU Chong-jian and ZHOU Yong-hong, but the cooperation was not close among the teams. According to the analysis of research institutions, Institute of Diagnostics of Hunan University of Chinese Medicine and Acupuncture Research Center of Tianjin University of Traditional Chinese Medicine produced largest number of literatures. The cooperation among institutions, with universities of TCM and affiliated hospitals as the main research force, was characterized by dominant cooperation among regional institutions and less cross-regional cooperation. Keywords analysis showed that in the field of TCM for neurogenesis, a lot of studies mainly focused on the disease field, treatment and medication, TCM therapy and molecular mechanism. The research on TCM therapy and molecular mechanism for neurogenesis of central nervous system will be the research hotspots in future.

Effect of acupoint thread-embedding on macrophage polarization of epididymis adipose tissue in obese mice / 中国针灸

OBJECTIVE@#To observe the effect of acupoint thread-embedding at "Zusanli" (ST 36) and "Fenglong" (ST 40) on the macrophage polarization of epididymis adipose tissue in obese mice, and to explore the action mechanism of acupoint thread-embedding on weight control.@*METHODS@#Among 30 male C57BL/6 mice, 10 mice were randomly selected and fed with normal diet, and the remaining 20 mice were fed with high-fat diet to establish the obesity model. Sixteen mice with successful obesity model were randomly divided into a model group and an acupoint thread-embedding group, 8 mice in each group. Eight mice were selected from mice which were fed with normal diet as the normal group. On the next day of successful modeling, acupoint thread-embedding was performed at "Zusanli" (ST 36) and "Fenglong" (ST 40) in the acupoint thread-embedding group, once every 10 days for 4 times. The body weight was recorded at 0, 8, 16, 24, 32, 40 days into intervention; the level of glucose metabolism was compared after intervention; the level of lipid metabolism and weight of epididymal adipose tissue were compared at the end of the intervention; the mRNA expression of M1 and M2 macrophage-related cytokines interleukin-10 (IL-6), monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) were detected by real-time PCR; the mRNA and protein expression of M1 macrophage labeled inducible nitric oxide synthase (iNOS) and M2 macrophage labeled arginase-1 (Arg-1) were detected by real-time PCR and Western blot.@*RESULTS@#Compared with the normal group, the body weight at 0, 8, 16, 24, 32, 40 days into intervention in the model group was increased (@*CONCLUSION@#Acupoint thread-embedding at "Zusanli" (ST 36) and "Fenglong" (ST 40) may play a role in weight control by regulating the polarization of macrophages.

Mis-estimation of coronary lesions and rectification by SYNTAX score feedback for coronary revascularization appropriateness / 中华医学杂志(英文版)

BACKGROUND@#Imprecise interpretation of coronary angiograms was reported and resulted in inappropriate revascularization. Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score is a comprehensive system to evaluate the complexity of the overall lesions. We hypothesized that a real-time SYNTAX score feedback from image analysts may rectify the mis-estimation and improve revascularization appropriateness in patients with stable coronary artery disease (CAD).@*METHODS@#In this single-center, historical control study, patients with stable CAD with coronary lesion stenosis ≥50% were consecutively recruited. During the control period, SYNTAX scores were calculated by treating cardiologists. During the intervention period, SYNTAX scores were calculated by image analysts immediately after coronary angiography and were provided to cardiologists in real-time to aid decision-making. The primary outcome was revascularization deemed inappropriate by Chinese appropriate use criteria for coronary revascularization.@*RESULTS@#A total of 3245 patients were enrolled and assigned to the control group (08/2016-03/2017, n = 1525) or the intervention group (03/2017-09/2017, n = 1720). For SYNTAX score tertiles, 17.9% patients were overestimated and 4.3% were underestimated by cardiologists in the control group. After adjustment, inappropriate revascularization significantly decreased in the intervention group compared with the control group (adjusted odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.73-0.95; P = 0.007). Both inappropriate percutaneous coronary intervention (adjusted OR: 0.82; 95% CI: 0.74-0.92; P < 0.001) and percutaneous coronary intervention utilization (adjusted OR: 0.88; 95% CI: 0.79-0.98; P = 0.016) decreased significantly in the intervention group. There was no significant difference in 1-year adverse cardiac events between the control group and the intervention group.@*CONCLUSIONS@#Real-time SYNTAX score feedback significantly reduced inappropriate coronary revascularization in stable patients with CAD.@*CLINICAL TRIAL REGISTRATION@#Nos. NCT03068858 and NCT02880605; https://www.clinicaltrials.gov.

Effect of wuzhi capsules on the blood concentration of tacrolimus relative to diltiazem and CYP3A5 gene polymorphisms / 药学学报

To determine the relationship between the effect of wuzhi capsules on the blood concentration of tacrolimus as compared to diltiazem and with regard to cytochrome P450 (CYP)3A5 gene polymorphisms, 170 patients who underwent renal transplantation from November 2014 to March 2018 and used tacrolimus combined with diltiazem 30 mg bid were selected in this study retrospectively. Patients were divided into an observation group (105 patients) and a control group (65 patients) according to whether they used wuzhi capsules after the operation. The polymorphisms of CYP3A5*3 were determined and the effect of wuzhi capsules on the blood concentration of tacrolimus, as compared with that of diltiazem was determined in patients with different CYP3A5*3 genotypes. This study complies with relevant ethical norms. The results show that compared with diltiazem, an increase of tacrolimus C0/D was significantly correlated with the patient's CYP3A5*3 genotype in both the self-control and the control group. CYP3A5 expressers in the observation group were able to increase the tacrolimus C0/D by about 76.8% by replacing the wuzhi capsules with diltiazem, but this effect was not observed in CYP3A5 non-expressers. In CYP3A5 expressers wuzhi capsules had a greater ability relative to diltiazem to increase the blood concentration of tacrolimus.

An investigation of short physical performance battery score and its influencing factors among the elderly in communities of Shanghai / 中华老年医学杂志

Objective:To explore the main influencing factors for physical performance assessed by the short physical performance battery(SPPB)in the elderly in communities in Shanghai.Methods:A total of 500 elderly subjects from four communities in Shanghai who met the inclusion criteria with 165 males and 335 females aged 60-95 years(70.5±7.8)years were enrolled.A questionnaire was used to assess the general situation.International Physical Activity Questionnaire-Short Form(IPAQ-SF)was used to assess physical activity(PA). The appendicular skeletal muscle mass(ASM)was measured by bioelectrical impedance analysis, and the relative skeletal muscle mass index(RSMI). The lower extremity muscle strength(quadriceps strength, QS)was measured by a hand-held dynamometer.Lower body muscle quality(LB-MQ) was ascertained by taking the ratio of strength to muscle mass for lower extremity.SPPB score was used to assess physical activity, including full tandem test, 4-meter walking speed test and five timed chair stands test.Results:The age, RSMI, ASM and quadriceps strength were higher, and the body fat content was lower in males than in females(all P<0.001). There were no significant differences in BMI, SPPB scores, LBMQ, and PA between males and females( P>0.05). Pearson correlation analysis showed that SPPB score was negatively correlated with age( r=-0.615, P<0.001)and body fat content( r=-0.103, P=0.022), but SPPB score was positively correlated with quadriceps strength( r=0.351, P<0.001), RSMI( r=0.134, P=0.003), LBMQ( r=0.268, P<0.001)and amount of PA( r=0.204, P<0.001), however, SPPB score had no relationship with gender( r=0.068, P=0.132). Conclusions:Aging and frailty are the main factors for the decline of physical performance in the elderly.Participating physical activity, reducing body fat, maintaining muscle mass, and especially increasing muscle quality, may be the main interventions to prevent the further deterioration of physical performance in the elderly.

Role of calf circumference in the evaluation and diagnosis of sarcopenia in the elderly in Shanghai / 中华临床营养杂志

Objective:To investigate the relationship between calf circumference and appendicular skeletal muscle mass (ASM) index, handgrip strength and gait speed in the elderly in Shanghai, and to explore the optimal cut-off point of calf circumference as a simple proxy marker of skeletal muscle mass, strength and function.Methods:A total of 2 294 participants were recruited from physical examination centers in Huadong Hospital Affiliated to Fudan University and 4 communities (954 males and 1 340 females) with an average age of (71.6±8.7) years. Appendicular skeletal muscle mass (ASM), Upper (UMM) and lower (LMM) limbs skeletal muscle mass were measured by bioelectrical impedance analysis (BIA). The ASM index (ASM/height 2) were calculated.Gait speed was measured.Muscle strength was measured by handgrip strength using an electronic hand dynamometer.Height, weight, right calf circumference and waist circumference were measured. Results:The age, body mass index (BMI), waist circumference and gait speed were not statistically different (all P>0.05) between both genders. Height, weight, ASM, ASM/height 2, UMM, LMM, handgrip strength, calf circumference were significantly higher in men than in women (all P<0.05). The calf circumference of the elderly with age ≥ 80 was significantly lower than that of the 70-79 age group and 60-69 age group ( P<0.05). The calf circumference of older women (age≥80) was significantly lower than that of the elderly women in the 70-79 age group and 60-69 age group ( P<0.05). Calf circumference was correlated negatively with age( P<0.01) and positively with ASM/height 2, height, weight, BMI, handgrip strength, UMM and LMM( P<0.01). There was no correlation between calf circumference and gait speed ( P>0.05). In the receiver operating characteristic curve (ROC), the cut-off value of calf circumference for low muscle mass was 35.1 cm for male(specificity, 0.721; sensitivity, 0.803, ROC, 0.809) and 33.6 cm for female(specificity, 0.774; sensitivity, 0.778; ROC, 0.827). Conclusions:Calf circumference decreases with ageing in the elderly. The optimal cut-off value of calf circumference for low muscle mass is 35.1 cm for males and 33.6 cm for females. We should pay attention to the importance of calf circumference in evaluation and diagnosis of sarcopenia.

Network pharmacological analysis and mechanism prediction of Xingnaojing Injection in treatment of neurological damage caused by SARS-CoV-2 / 中草药

Objective: To explore the active compounds, targets and signaling pathways of Xingnaojing Injection (XNJI) for the treatment of neurological damage caused by SARS-CoV-2, so as to explore its mechanism. Methods: Using TCMSP, BATMAN, Swiss Target Prediction, and other databases, the chemical compounds and targets of XNJI were retrieved. Cytoscape software was used to construct XNJI efficacy network of "drug-compounds-targets" for coronavirus and neuroprotection, and the action mechanism was predicted by Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. Then core compounds were verified by molecular docking with 3CL Mpro, ACE2, and 2019-nCoV RBD/ACE2-B0AT1 complex. Results: A total of 105 active compounds of XNJI, 928 drug targets, 741 targets of coronavirus, 611 targets of neuroprotection, 83 drug-disease common targets, 12 core compounds, and seven key targets were obtained. The function enrichment analysis of GO yielded 204 entries, KEGG pathway enrichment screened 120 signaling pathways, which included Hepatitis B, pathways in cancer, TNF, HIF-1, and VEGF signaling pathway, and so on. The results of molecular docking showed that core compounds of XNJI had a good bonding activity with 3CL Mpro, ACE2 and complex. The chlorogenin and kaempferol had the lowest binding energy with three proteins and might play an important role in treatment. Conclusion: The core compounds in XNJI including chlorogenin, kaempferol, 5-hydroxy- 6,7,3',4',5'-pentamethoxyflavone, 3-methylkempferol, morin, gardenin, quercetin, artemisetin, genistein, dryobalanone, curcumin, and elemicin, which might interfere with various signaling pathways by acting on key targets like PARP1, PTGS2, MMP9, CDK2, ADORA2A, ALOX5, GSK3B, and regulate the inflammatory response, apoptosis, oxidative stress, angiogenesis, and other processes to improve the neurological damage caused by SARS-CoV-2, and inhibit virus replication and prevent infection of the host cell by binding with 3CL Mpro, ACE2 and complex, which suggest that XNJI may have a positive therapeutic effect on the neurological damage caused by SARS-CoV-2.

The research progress of PROTACs for breast cancer treatment / 药学学报

Breast cancer is the most common malignant tumor in women worldwide. In breast cancer tumor tissues, a variety of targets related to the occurrence and development of breast cancer have been observed, and many drugs have been used in clinical applications for these targets. However, most of these drugs are small molecule inhibitors. With the long-term use of these drugs, acquired drug resistance often occurs in breast cancer patients. To overcome the drug resistance, the development of more efficient drugs is highly desirable in the treatment of breast cancer. Proteolysis targeting chimera (PROTAC) technology is a new kind of targeted protein degradation technology, which has shown broad prospect of applications in the field of drug development. The use of PROTAC technology to target the degradation of relevant targets in breast cancer has become a feasible strategy for breast cancer treatment.

Progress in diagnosis and treatment of nystagmus / 国际眼科杂志(Guoji Yanke Zazhi)

@#Nystagmus refers to a certain kind of diseases with abnormal eye movements, which is characterized by rhythmic, involuntary, conjugate-symmetric. According to the age of onset, it could be divided into congenital nystagmus and secondary nystagmus. The limited means of examinations and treatments which makes it difficult to understand nystagmus. Over recent years, the means of examinations and treatments are developing. We reviewed the recent progress of nystagmus in this article.

Multicenter investigation and analysis of neonatal respiratory distress syndrome in parts of Inner Mongolia / 中国小儿急救医学

Objective To investigate the diagnosis and treatment status of neonatal respiratory dis-tress syndrome (NRDS) in Inner Mongolia and explore the problems and countermeasures for NRDS diagno-sis and treatment. Methods Data of infants with NRDS in 4 hospitals(3 hospitals were in the west,which were the Affiliated Hospital of Inner Mongolia Medical University,Baotou Steel Three Hospital and Ordos Central Hospital,1 hospital was in the east,which was the Affiliated Hospital of Chifeng Institute) participat-ing in the study during the period from 1th January,2016 to 30th June,2018 were investigated retrospectively with descriptive epidemiological survey,including basic situation,perinatal period, clinical manifestations, treatment,complications and prognosis. Results Among 11406 newborns admitted in 4 hospitals during the study period,748 infants were diagnosed with NRDS,accounting for 6. 56％ . In the eastern region,279 infants were diagnosed with NRDS,the rate was 9. 30％ ,and in the western region were 469(5. 58％ ). The average hospitalization time in the eastern region was longer than that in the western region,and the age of motherswas higher than that in the western region. There were significant differences between the two groups(P <0. 05). The antenatal hormone use,cesarean delivery,multiple gestation,low Apgar score,premature rupture of membrane in the western region were higher than those in the eastern region(P < 0. 05). The proportion of NRDS grade Ⅰ and gradeⅢ,pulmonary surfactant(PS) utilization ratio and INSURE technology usage in the eastern region were higher than those in the western region. The ratio of NRDS(grade Ⅱ) and the first dose of PS in the western region were higher than those in the eastern region(P < 0. 05). The total mortality of neonates with NRDS was 6. 15％ (46 / 748). The incidence rates of patent ductus arteriosus,bronchopulmo-nary dysplasia,necrotizing enterocolitis,ventilator-associated pneumonia in the western region were higher than those in the eastern region(P < 0. 05). Conclusion The level of diagnosis and treatment of NRDS in four hospitals in two districts of Inner Mongolia varies widely. But overall compared with other areas,the treatment of NRDS in Inner Mongolia has the problems of low antenatal hormone use,insufficient use of PS and INSURE technology,and late use of PS. The treatment of NRDS should continue to standardize antenatal hormone use,early and sufficient use of PS,the promotion of the use of INSURE technology.