Construction of pharmacogenomics-guided individualized medication list for elderly patients / 中国药房

OBJECTIVE To develop an individualized medication list for elderly patients by evidence-based pharmacy method， and to support clinical decisions on rational use of METHODS　Firstly， drugs with risk genetic information were screened out by systematically reviewing evidence-based pharmacy information. Secondly， researchers investigated the included drugs in lists from different data E- sources. Drugs included in three or more data sources and drugs proposed by the expert committee were then included in the medication list. Thirdly， for the drugs included in two data sources， researchers designed questionnaires to investigate the necessity of drug-related gene testing. According to the scoring results of the expert questionnaire， drugs with higher scores were included in the list. Data sources included real-world data （list of high frequency medication in hospitals， high frequency medication for elderly outpatients and inpatients in National Health Care Claims Data， drugs related to frequent medication errors and so on） and evidence-based pharmacy evidence （the websites of Clinical Pharmacogenomics Implementation Consortium， Dutch Pharmacogenetics Working Group， Food and Drug Administration and so on）. RESULTS　The study obtain 68 drugs with risk genetic information which were included in three data sources. Combined with 23 drugs proposed by the expert committee， a list containing 74 drugs was preliminarily formed after de-duplication. A total of 37 drugs included in two databases with risk genetic information were scored through the questionnaire survey to form a supplementary list of 26 drugs. This is the final composition of the list of 100 drugs developed in this study. Among them， there are 43 drugs for the central nervous system， 15 drugs for the cardiovascular system， 12 anti-tumor drugs and so on. Twelve drugs were included in six or more data sources， which mainly consisted of drugs for digestive system， all proton pump inhibitors. CONCLUSION　In this study， a list of 100 commonly used drugs which require individualized medication for the elderly was developed by evidence-based pharmacy method. The drug list will be updated in time as available evidence changes， and can provide guidance for rational use of medicines for elderly patients.

Application of neurally adjusted ventilatory assist in the weaning from prolonged mechanical ventilation in pediatrics / 中华实用儿科临床杂志

Objective:To investigate the clinical effect of neurally adjusted ventilatory assist (NAVA)on weaning from prolonged mechanical ventilation (PMV) in pediatrics and its influence on related parameters of respiratory mechanics.Methods:A retrospective analysis was conducted on 12 children in the pediatric intensive care unit (PICU) of Children′s Hospital, Capital Institute of Pediatrics from July 2014 to July 2020.All the cases adopted NAVA for weaning from PMV, and the type of NAVA included invasive NAVA and non-invasive neurally adjusted ventilatory assist with NAVA.The main diagnosis, etiology, oxygenation index (OI), pediatric critical illness score (PCIS), treatment of mechanical ventilation(MV), respiratory mechanics indexes, length of stay in PICU and prognosis were recorded.Besides, the complications that happened after transition to NAVA were evaluated.The rank sum test was used for comparison of respiratory mechanics indexes and blood gas values before and after NAVA ventilation. Results:Among the 12 children, 11 cases had basic diseases.There were 8 premature infants complicated with chronic lung diseases.Two cases had Wilson-Mikity syndrome.One case had congenital omphalocele, 1 case had Prader-Willi syndrome (PWS), 1 case had spinal muscular atrophy (SMA). The main diagnosis of 8 children was acute respiratory distress syndrome (ARDS). The median duration of MV and PICU stay was 32.0 (25.0, 39.0) days and 39.5(29.5, 48.5) days.The median duration of invasive NAVA and non-invasive-NAVA was 5.5 (3.8, 6.3) days and 7.0(5.0, 9.5) days.All cases were successfully weaned from MV(100%), and the survival-to-discharge rate was 100%.There were no complications related to NAVA.After ventilation for 6 hours, no significant difference was observed in respiratory mechanical parameters between synchronized intermittent mandatory ventilation (SIMV) and NAVA (all P>0.05). However, compared with SIMV, NAVA significantly decreased the arterial partial pressure of carbon dioxide[43.50 (41.75, 46.00) mmHg vs.48.50 (45.25, 56.00) mmHg, 1 mmHg=0.133 kPa] ( Z=-2.253, P=0.024), increased the arterial partial pressure of oxygen[68.00 (65.00, 72.25) mmHg vs.62.00 (59.00, 64.75) mmHg] ( Z=-2.733, P=0.006), and reduced the value of OI[3.70 (3.38, 5.60) vs.5.90 (4.58, 7.08)]( Z=-2.272, P=0.023). Conclusions:NAVA is a safe and effective approach to weaning from PMV in children.Compared to SIMV, NAVA can greatly improve ventilation and oxygenation.NAVA is strongly recommended to PMV infants with chronic lung diseases who have failed to wean from ventilation.

Clinical features and risk factors of left ventricular systolic dysfunction in children with septic shock / 中华急诊医学杂志

Objective:To investigate the clinical features and risk factors of left ventricular systolic dysfunction in children with septic shock.Methods:A retrospective analysis was performed on the clinical data of children diagnosed with septic shock in the Department of Critical Care Medicine of Children’s Hospital, Capital Institute of Pediatrics from February 2016 to June 2021. Inclusion criteria: (1) patients met the diagnostic criteria of septic shock; (2) Cardiac ultrasound was performed within 48 h after shock treatment and was dynamically monitored during shock treatment. Exclusion criteria: (1) Previous history of chronic cardiac insufficiency, cardiomyopathy, or organic heart disease; (2) patients with acute cerebral infarction, cerebral hemorrhage and necrotizing encephalopathy; (3) congenital genetic metabolic diseases; and (4) incomplete information. Left ventricular systolic dysfunction was defined as a left ventricular ejection fraction (LVEF) <50% and a ≥10% decrease in the patient’s initial LVEF assessed on admission. Patients with left ventricular systolic dysfunction and without left ventricular systolic dysfunction were compared. Comparisons between groups were performed with unpaired Student’s t test, or Mann-Whitney U test, or chi-square test. Multivariate logistic regression analysis was used to analyze the correlation factors of left ventricular systolic dysfunction. Results:The incidence of left ventricular systolic dysfunction in children with septic shock was 30.0% with the lowest LVEF of (42±8)%. Left ventricular systolic dysfunction occurred on (2.4±1.3) days after shock onset, and the LVEF returned to normal on (6.7±3.3) days. Hematogenous infection was more frequent (77.8% vs. 40.5%, P=0.018), ventilator application (83.3% vs. 50.0%, P=0.033) and inotropes and vasopressor drugs (100.0% vs. 64.3%, P=0.009) were used more frequently in patients with left ventricular systolic dysfunction(n =18), compared with patients without left ventricular systolic dysfunction(n =42). Patients with left ventricular systolic dysfunction had a lower LVEF [(42±8)% vs. (67±5)%, P<0.001], a lower pediatric critical illness score [(64±13) vs. (76±14), P=0.003], a lower resuscitation success rate at 6 h (38.9% vs. 73.8%, P=0.010), a higher lactate at admission [3.80 (3.15, 5.88) mmol/L vs. 2.70 (1.85, 3.80) mmol/L, P=0.001) and a higher 28-d mortality (38.9% vs. 12.8%, P=0.025) compared with patients without left ventricular systolic dysfunction. Hematogenic infection ( OR=7.358, 95% CI: 1.198~45.197, P=0.031) and lactate at admission ( OR=1.743, 95% CI: 1.041~2.917, P=0.034) were independent risk factors for left ventricular systolic dysfunction. Conclusions:The incidence of left ventricular systolic dysfunction in children with septic shock was 30.0%. Left ventricular systolic dysfunction usually occurred on (2.4±1.3) days after shock onset and resolved within 7 days, which was associated with 28-d mortality. Hematogenous infection and high lactate value were independent risk factors for left ventricular systolic dysfunction.

Association between dietary retinol and prognosis of patients with esophageal squamous cell carcinoma / 上海预防医学

ObjectiveTo explore the association between dietary retinol intake and prognosis of patients with esophageal squamous cell carcinoma. MethodsThe study enrolled 388 cases with primary esophageal squamous cell carcinoma that was pathologically diagnosed in the first affiliated hospital of Fujian medical university and the cancer hospital of Fujian medical university from July 2014 to August 2019. Chi-square test was used to determine the relationship between retinol and patients' characteristics. Kruskal-Wallis rank sum test was used to analyze the relationship between retinol and multiple nutrients. Cox proportional hazards regression model was used to explore the association between dietary retinol and esophageal squamous cell carcinoma. ResultsPatients with esophageal squamous cell carcinoma did not significantly differ in gender， age， TNM stage， tumor length or nutrient intake by different retinol intakes （P>0.05）. Multivariate Cox regression analysis showed that the high retinol intake group had a better prognosis （overal survial：HR=0.279，95%CI：0.150‒0.520，P<0.001；disease-free survival：HR=0.306，95%CI：0.181‒0.516，P<0.001）. ConclusionHigh dietary retinol intake may improve the prognosis of patients with esophageal squamous cell carcinoma.

Effect of Yiqi Jiedu Prescription-containing Serum on Proliferation of mTEC and Regulatory T Cells in Myasthenia Gravis Patients with Thymus Hyperplasia / 中国实验方剂学杂志

ObjectiveTo investigate the effect of Yiqi Jiedu prescription-containing serum on the proliferation of medullary thymic epithelial cells （mTEC） and regulatory T （Treg） cells in myasthenia gravis （MG） patients with thymus hyperplasia. MethodAccording to serological methods，35 SD rats were adaptively fed for one week and randomized into the low-，medium-， and high-dose Yiqi Jiedu prescription groups，control group， and prednisone group，with seven rats in each group， which were then gavaged with the corresponding drugs for one week for preparing the drug-containing serum. The effect of Yiqi Jiedu prescription-containing serum at different concentrations on the proliferation of mTEC and Treg cells were determined by cell counting kit-8 （CCK-8） assay. Besides， the effect of mTEC and Yiqi Jiedu prescription-containing serum on Treg cell proliferation were observed through co-culture. ResultThymocytes were cultured for a period of time. Their mean positive rate revealed by flow cytometry using mTEC characteristic marker Ulex europaeus agglutinin Ⅰ （UEAI） was 92.54%. Treg cells were sorted by magnetic beads. The purity of Treg cells after repeated magnetic bead sorting was as high as 92%. mTEC and Treg cells showed high positive expression rates，and their cell purity met the requirements of subsequent experiments. When the concentration of Yiqi Jiedu prescription-containing serum was 2.5%-15%，it exhibited an inhibitory effect against mTEC and Treg cells. When the concentration was equal to or greater than 20%，it promoted cell proliferation，which was further enhanced with the extension of action time. The results after 48 h of culture showed that compared with the control group，prednisone and low-dose Yiqi Jiedu prescription had no significant effect on the proliferation of these two kinds of cells，but the medium- and high-dose Yiqi Jiedu prescription remarkably reduced their proliferation inhibition rate （P<0.01）. After co-culture with mTEC， the control group was not significantly different from the prednisone group and the low-dose Yiqi Jiedu prescription-containing serum group in the proliferation of Treg cells，while the medium- and high-dose Yiqi Jiedu prescription-containing serum groups significantly lowered the proliferation inhibition rate （P<0.01）. ConclusionYiqi Jiedu prescription-containing serum affects the proliferation of mTEC and Treg cells in MG patients with thymus hyperplasia. Compared with the solely cultured Treg cells isolated from MG patients，the Treg cells co-cultured with mTEC exhibit enhanced proliferation in MG patients，suggesting that mTEC can regulate the proliferation of Treg cells. This effect becomes more obvious after the intervention with Yiqi Jiedu prescription-containing serum，indicating that intervention effect of Yiqi Jiedu prescription on Treg cells can be produced during its treatment of mTEC， which may be one of the mechanisms of Yiqi Jiedu prescription-containing serum in alleviating MG.

Prestin-Mediated Frequency Selectivity Does not Cover Ultrahigh Frequencies in Mice / 神经科学通报·英文版

In mammals, the piezoelectric protein, Prestin, endows the outer hair cells (OHCs) with electromotility (eM), which confers the capacity to change cellular length in response to alterations in membrane potential. Together with basilar membrane resonance and possible stereociliary motility, Prestin-based OHC eM lays the foundation for enhancing cochlear sensitivity and frequency selectivity. However, it remains debatable whether Prestin contributes to ultrahigh-frequency hearing due to the intrinsic nature of the cell's low-pass features. The low-pass property of mouse OHC eM is based on the finding that eM magnitude dissipates within the frequency bandwidth of human speech. In this study, we examined the role of Prestin in sensing broad-range frequencies (4-80 kHz) in mice that use ultrasonic hearing and vocalization (to >100 kHz) for social communication. The audiometric measurements in mice showed that ablation of Prestin did not abolish hearing at frequencies >40 kHz. Acoustic associative behavior tests confirmed that Prestin-knockout mice can learn ultrahigh-frequency sound-coupled tasks, similar to control mice. Ex vivo cochlear Ca2+ imaging experiments demonstrated that without Prestin, the OHCs still exhibit ultrahigh-frequency transduction, which in contrast, can be abolished by a universal cation channel blocker, Gadolinium. In vivo salicylate treatment disrupts hearing at frequencies <40 kHz but not ultrahigh-frequency hearing. By pharmacogenetic manipulation, we showed that specific ablation of the OHCs largely abolished hearing at frequencies >40 kHz. These findings demonstrate that cochlear OHCs are the target cells that support ultrahigh-frequency transduction, which does not require Prestin.

Sagittaria sagittifolia polysaccharides regulates Nrf2/HO-1 to relieve liver injury caused by multiple heavy metals in vivo and in vitro / 中国中药杂志

This study explored whether Sagittaria sagittifolia polysaccharides(SSP) activates the nuclear factor erythroid-2-related factor2(Nrf2)/heme oxygenase-1(HO-1) signaling pathway to protect against liver damage jointly induced by multiple heavy metals. First, based on the proportion of dietary intake of six heavy metals in rice available in Beijing market, a heavy metal mixture was prepared for inducing mouse liver injury and HepG2 cell injury. Forty male Kunming mice were divided into five groups: control group, model group, glutathione positive control group, and low-and high-dose SSP groups, with eight mice in each group. After 30 days of intragastric administration, the liver injury in mice was observed by HE staining. In the in vitro experiment, MTT assay was conducted to detect the effects of SSP at 0.25, 0.5, 1, and 2 mg·mL~(-1) on HepG2 cell survival at different time points. The content of alanine transaminase(ALT) and aspartate aminotransferase(AST) in the 48-h cell culture fluid was measured using micro-plate cultivation method, followed by the detection of the change in reactive oxygen species(ROS) content by flow cytometry. The mRNA expression levels of Nrf2 and HO-1 in cells were determined by RT-PCR, and their protein expression by Western blot. HE staining results showed that compared with the model group, the SSP administration groups exhibited significantly alleviated inflammatory cell infiltration and fatty infiltration in the liver, with better outcomes observed in the high-dose SSP group. In the in vitro MTT assay, compared with the model group, SSP at four concentrations all significantly increased the cell survival rate, decreased the ALT, AST, and ROS content(P<0.05), and down-regulated Nrf2 and HO-1 mRNA and protein expression(P<0.05). SSP significantly improves inflammatory infiltration in the liver tissue of mice exposed to a variety of heavy metals and corrects the liver fat degeneration, which may be related to its regulation of the Nrf2/HO-1 signaling pathway, reduction of ROS, and alleviation of oxidative damage.

A study on the association of postprandial hypotension with insulin and neurotensin in very old adults / 中华老年医学杂志

Objective:To investigate the association of postprandial hypotension(PPH)with insulin and neurotensin(NT)in very old adults.Methods:In this retrospective study, 22 people with PPH and 21 without non-PPH, aged ≥80, were enrolled from patients hospitalized at the First Division of the Health Department of China-Japan Friendship Hospital between September 2015 and October 2021.The levels of blood pressure, blood glucose, insulin and NT at fasting and 30, 60, 90 and 120 minutes after a meal were monitored.Changes in values of each parameter before and after a meal were compared between the two groups, and the correlation of the maximum decrease in postprandial blood pressure with the maximum increase in blood glucose, insulin and neurotensin was analyzed.Results:The maximum decrease in postprandial systolic blood pressure(SBP)in the PPH group was significantly higher than that in the non-PPH group[(35.5±13.2)mmHg(1 mmHg=0.133 kPa) vs.(16.0±8.6)mmHg, t=4.135, P<0.01)]. The maximum increase in postprandial insulin was significantly higher than that in the non-PPH group[(20.9±4.2)mU/L vs.(12.1±4.1)mU/L, t=3.949, P<0.01)]. There was no statistically significant difference between the PPH and non-PPH groups in the maximum increase in postprandial blood glucose[(3.6±1.8)mmol/L vs.(2.5±0.5)mmol/L, t=1.912, P>0.05)]or NT[65.7(22.0, 110.1)ng/L vs.112.2(47.2, 270.2)ng/L, Z=1.817, P>0.05)]. There was a significant positive correlation between the maximum decrease in postprandial systolic blood pressure and the maximum increase in insulin( r=0.907, P<0.05). There was no correlation between the maximum decrease in postprandial systolic blood pressure and the maximum increase in blood glucose( r=0.016, P>0.05). There was no correlation between the maximum decrease in postprandial systolic blood pressure and the maximum increase in NT( r=0.396, P>0.05). Conclusions:The PPH is related to abnormal increases in postprandial insulin secretion.

Influencing factors of community hospice care service needs of the elderly based on structural equation model / 中华健康管理学杂志

Objective:To analyze the influencing factors of community hospice care service needs of the elderly based on structural equation model.Methods:A multi-stage sampling method was used to survey 564 elderly people from 40 community health service centers in four districts of Chaoyang District in Beijing from September to November 2020 with a self-designed questionnaire. The survey content included three dimensions: tendency characteristics (population characteristics, health beliefs), enabling resources and demand factors. The chi-square test and rank sum test were used to analyze the influencing factors of the community hospice care needs of the elderly. At the same time, based on Anderson theory, structural equation model was used to analyze the action path and effect size of the influencing factors.Results:Registered residence, occupation, understanding of community elderly care services, recognition of community medical convenience, recognition of community health services in reducing family burden, recognition of community health services in improving their own health, understanding of community hospice care services, mean monthly income of their families, degree of income satisfaction, self-paid medical expenses of the previous year, living status, acceptance of community medical expenses, satisfaction with the number of community medical staff, self-assessment of health status, whether the elderly was ill in the last two weeks and the number of chronic diseases and etc affected the needs of the elderly for community hospice care services (all P<0.05). In the three dimensions of Anderson model, enabling resources had a direct effect, and could also be affected by demand factors indirectly, the total effect value was 0.404; demand factors had direct impact, and the effect value was 0.193; propensity characteristics exerted impact indirectly through enabling resources and demand factors, and the total effect value was 0.176. Among them, the acceptance of community health service fees in the enabling resource dimension has the greatest impact (FL=0.535), the number of chronic disease in the demand factor dimension had the greatest impact (FL=1.018), and the recognition of community health service in reducing family burden in the propensity characteristic dimension had the greatest impact (FL=0.612) (all P<0.05). Conclusions:There are various factors and action paths that affect the needs of community hospice care services for the elderly. Among them, the acceptance of community health service fees, the number of chronic disease, and the recognition of community health service in reducing family burden have a greater impact.

UGT1A1 gene polymorphisms in patients with Gilbert syndrome and Crigler-Najjar syndrome type Ⅱ / 临床肝胆病杂志

Objective To investigate the differences in UGT1A1 gene mutation sites, haplotypes, and diplotypes between patients with Gilbert syndrome (GS) and those with Crigler-Najjar syndrome type Ⅱ (CN-2). Methods A retrospective analysis was performed for the clinical data of 138 patients with GS or CN-2 who attended Beijing YouAn Hospital, Capital Medical University, from January 1, 2010 to December 31, 2019, with 109 patients in the GS group and 29 patients in the CN-2 group, and the differences in mutation sites were analyzed between the two phenotypes. The Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. SNPStats software was used to perform linkage disequilibrium (LD) and haplotype analyses of mutation sites. Strong LD was defined as both | D ′| and r 2 > 0.8, and moderate LD was defined as | D ′| > 0.8 and r 2 > 0.4. Results UGT1A1 gene detection was performed for all patients, and mutations mainly included -3279T > G mutation (104 patients, 75.36%) and -3152G > A mutation (82 patients, 59.42%) in the upstream promoter PBREM region, a promoter TATA box TA insertion mutation (88 patients, 63.77%), and c.211G > A mutation in Exon 1 of the coding region (66 patients, 47.83%). Compared with the CN-2 group, the GS group had a significantly higher proportion of PBREM region -3279T > G mutation (82.57% vs 48.28%, χ 2 =14.508, P A mutation (68.81% vs 24.14%, χ 2 =18.955, P (TA) 7 mutation (72.48% vs 31.03%, χ 2 =17.027, P 0.8, r 2 > 0.8) between (TA) 6 > (TA) 7 and -3152G > A and moderate LD (| D ′| > 0.8, r 2 > 0.4) between (TA) 6 > (TA) 7 and -3279T > G, between -3152G > A and -3279T > G, between (TA) 6 > (TA) 7 and c.211G > A, and between -3279T > G and c.211G > A. Haplotype frequency analysis showed that compared with the CN-2 group, the GS group had a significantly higher frequency of haplotype -3279G—-3152A—(TA) 7 (45.72% vs 17.24%, χ 2 =7.833, P =0.005) and significantly lower frequencies of c.1456G (4.10% vs 16.48%, χ 2 =4.873, P =0.027) and c.211A—c.1456G (1.86% vs 24.90%, χ 2 =15.210, P < 0.001). The diplotype analysis showed that diplotypes consisting of haplotype c.1456G or c.211A—c.1456G were associated with a higher level of total bilirubin (TBil). Conclusion There are differences in common mutation sites and major haplotypes of the UGT1A1 gene between patients with GS and those with CN-2, and the common diplotypes of CN-2 correspond to a higher level of TBil.

A retrospective study on combined percutaneous transhepatic one-step biliary fistulation followed by two stages cholangioscopic treatment for type Ⅰ and Ⅱa hepatolithiasis after cholangiojejunostomy / 中华肝胆外科杂志

Objective:To study the treatment outcomes of combining percutaneous transhepatic one-step biliary fistulation (PTOBF) followed by two stages cholangioscopic treatment for type Ⅰ and Ⅱa hepatolithiasis which developed after Roux-en-Y cholangiojejunostomy, and in treatment of cholangiojejunostomy stenosis.Methods:The clinical data of 95 patients with type Ⅰ and Ⅱa hepatolithiasis which developed after Roux-en-Y cholangiojejunostomy and were treated at Shandong Second Provincial General Hospital from September 2016 to December 2020 were analyzed retrospectively. There were 36 males and 59 females, with the age of (51.2±15.3) years (range 14 to 75 years). These patients initially underwent PTOBF rigid choledochoscopy, followed by electronic choledochoscopy via the fistula tract after 6-8 weeks. The hepatolithiasis removal, complications and hepatolithiasis recurrence rates, and the cholangio-intestinal anastomotic stenosis rate and treatments were recorded. The follow-up was performed to analyse prognosis.Results:All 95 patients successfully underwent PTOBF rigid choledochoscopy and electronic choledochoscopy via the fistula tract. In 92 patients (96.8%), stones were completely removed. In 3 patients, small amounts of peripheral bile duct stones were left behind. Of 49 patients had cholangio-intestinal anastomotic strictures. On cholangioscopic examination, the strictures were caused by anastomotic knots in the suture line in 25 patients and cicatricial stenosis in 24 patients. After biliary balloon dilation and removal of anastomotic suture line knots, the strictures were relieved in 49 patients. There were 2 patients who developed biliary bleeding and 2 patients pleural effusion after PTOBF rigid choledochoscopy. Hepatolithiasis recurred in 4 patients in 6 to 36 months later.Conclusion:PTOBF followed by two stages cholangioscopic treatment were safe and effective in treatment of type Ⅰ and Ⅱa hepatolithiasis after Roux-en-Y cholangiojejunostomy. A high hepatolithiasis removal rate was obtained. Balloon dilation and removal of biliary intestinal anastomotic suture knots effectively relieved biliary intestinal anastomotic stenosis. The long-term results needs to be further determined.

Effects of humor styles and individual authenticity on depression among college students / 中华行为医学与脑科学杂志

Objective:To explore the mediating effect of humor styles between individual authenticity and depression among college students.Methods:A total of 247 college students were surveyed by the humor styles questionnaire, the authenticity questionnaire and the Chinese version of the Beck depression inventory-Ⅱ.SPSS 26.0 was used for descriptive statistics and correlation analysis, and AMOS 23.0 software was used for structural equation model test.The Bootstrap method was applied to test the mediating effect.Results:(1)The individual authenticity score was (53.35±7.80), the depression score was 6.00(3.00, 11.00), and the scores of self-defeating, self-enhancing and affiliative humor styles were (15.00±3.45), (17.70±3.04) and (27.21±4.17). (2) Correlation analysis showed that individual authenticity was positively correlated with self-enhancing humor ( r=0.20, P<0.01), and negatively correlated with self-defeating humor and depression ( r=-0.16, P<0.05; r=-0.30, P<0.01). Self-enhancing humor was negatively correlated with depression ( r=-0.17, P<0.01). (3) The results of mediating analysis showed that the total effect between self-enhancing humor and depression was -0.318.The self-enhancing humor style had a partial mediating effect between individual authenticity and depression, with an effect value of -0.055 (95% CI=-0.103, -0.007), accounting for 17.3% of the total effect.The direct effect value of individual authenticity on depression was -0.245 (95% CI=-0.376, -0.119), accounting for 77.0% of the total effect. Conclusion:It indicates that individual authenticity can directly affect depression and also can affect depression through self-enhancing humor.It is helpful to understand the relationship between individual authenticity and mental health, and provide a strategic reference for preventing and intervention of depression among college students.

Clinical characteristics, seasonal characteristics and related factors in patients with atypical depression / 中华行为医学与脑科学杂志

Objective:To know the clinical characteristics, seasonal pattern and influencing factors of atypical depression(AD) patients.Methods:A total of 203 depressed outpatients of Peking University Sixth Hospital from January 2021 to August 2021 were included.They were assessed with demographic questionnaire, inventory of depressive symptomatology self-report(IDS-SR30) and seasonal pattern assessment questionnaire(SPAQ). According the score of IDS-SR30, all patients were classified as atypical depression(AD) and non-atypical depression(non-AD). The data were analyzed by t-test, non-parametric test and Logistic regression using SPSS 26.0 software. Results:The prevalence of AD among depressed patients was 36.0% (95% CI=29.3%-42.6%). The IDS-30 score of the AD group was (41.59±10.59), and IDS-30 score of the non-AD group was (36.08±13.17), and the difference between the two groups was statistically significant ( t=3.062, P<0.05). The global seasonal score of the AD group was 6 (3, 9), and 17.8% of the AD group had seasonal pattren.The global seasonal score of the non-AD group was 5 (3, 8), and 14.6% of the non-AD group had seasonal pattern.There was no significant difference in the global seasonal score and the proportion of seasonal pattern between the two groups ( Z=0.389, χ2=0.359, P>0.05). Depression patients who were females ( β=1.08, OR=2.95, 95% CI=1.32-6.59, P<0.05), low self-evaluation ( β=0.82, OR=2.27, 95% CI=1.12-4.59, P<0.05)and psychomotor retardation ( β=0.93, OR=2.54, 95% CI=1.33-4.85, P<0.05) were more likely to be diagnosed as AD, and depression patients having mood variation ( β=-0.94, OR=0.39, 95% CI=0.19-0.81, P<0.05) were more likely to be diagnosed as non-AD. Conclusion:Women, low self-evaluation, psychomotor retardation and unobvious mood variation can predict and help to diagnose atypical depression in depressed patients.

Coronary artery lesions in infants younger than 6 months with Kawasaki disease: clinical characteristics and prognosis / 中国小儿急救医学

Objective:To analyze the characteristics of coronary artery lesions in infants under 6 months of age with Kawasaki disease(KD), and to explore their regression and risk factors.Methods:The clinical data of 61 infants with KD[34 boys, 24 girls, aged 2.2 (1.7, 3.1) months] admitted to the department of critical care medicine and neonatology, Children′s Hospital, Capital Institute of Pediatrics from October 2015 to February 2020 were retrospectively analyzed.Persistent coronary artery aneurysm(CAA)was defined as the persistent enlargement of coronary arteries(coronary Z-score≥2.5)on echocardiograms at 12 months after KD onset.Cox proportional hazards mode was conducted to evaluate the potential risk factors of persistent CAA.Results:The incidence of CAA in 61 infants with KD was 52.5% (32/61) and occurred on 5 (4, 8)d of the disease course.During a follow-up of 547 (399, 782)d, five(8.2%, 5/61)infants satisfied the definition of persistent CAA.The median recovery time of CAA was 20 (12, 82)d after KD onset.Cox proportional hazards mode revealed that the maximal coronary Z-score was an independent factor of CAA regression( HR=0.451, 95% CI 0.293-0.694, P<0.001). Receiver operating characteristic curve analysis showed that the best cutoff value of coronary Z-score for predicting persistent CAA was 6.15(sensitivity 80.0%, specificity 97.7%). Conclusion:CAA is common in infants younger than 6 months with KD.The maximal coronary Z-score is an independent factor of persistent CAA.

Progress on clinical diagnosis and treatment of sepsis-induced cardiomyopathy / 中国小儿急救医学

Although sepsis-induced cardiomyopathy(SICM) has been recognized as a distinct entity since 1984, there is still no commonly agreed upon diagnostic criteria.SICM has become a focus of many studies on the strategies of pathogenesis, diagnosis and management during the last two decades.SICM is likely under diagnosed which can lead to poor prognosis.There continues to be a dearth of large clinical trials evaluating the treatment of SICM and current consensus focusing on supportive measures such as vasopressors and inotropes by hemodynamic monitoring and tissue perfusion.Serial echocardiography allowed early diagnosis SICM and optimal adjustment of therapy, individualized work-up and management of these patients is crucial to improve prognosis.

Chinese version of Tilburg Pregnancy Distress Scale and its reliability and validity test / 中国实用护理杂志

Objective:To translate the Tilburg Pregnancy Distress Scale (TPDS) into Chinese and test its reliability and validity.Methods:The Chinese version of TPDS was formed by adopting forward and back translation, cross-cultural semantic equivalence assessment and pilot testing. A questionnaire survey was conducted among 309 pregnant women who were examined in the obstetrical clinic of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science & Technology from September 2019 to January 2020 by convenience sampling method to test the reliability and validity of questionnaire.Results:The content validity of each item ranged from 0.83 to 1.00, while the total table was 0.91. Confirmatory factor analysis showed that the two-factor model fitted well, χ 2/df was 1.380, goodness of fit index was 0.955, normal of fit index was 0.941, Tucker-Lewis index was 0.977, comparative fit index was 0.983, root mean square error of approximation was 0.035. The Cronbach α coefficient of the total scale was 0.834, and the test-retest reliability was 0.826. Conclusions:The Chinese version of TPDS has good reliability and validity, and can be used to measure the level of pregnancy distress in Chinese pregnant women.

Effect of baicalein on the expression of glutamate receptor related protein in PC12 cells damaged by Aβ 25-35 / 国际中医中药杂志

Objective:To study the effect of baicalein on the expression of glutamate receptor related protein in PC12 cells injured by Aβ 25-35. Methods:PC12 cells were divided into control group, model group, estradiol group and baicalein group with different concentrations. The survival condition of PC12 cells in each group were detected by thiazole blue (MTT). PC12 cells were divided into control group, model group, estradiol group and baicalein group. The control group and model group were cultured with DMEM medium, and the estradiol group was added with 1×10 -3 μmol/L estradiol DMEM medium, baicalein group was added with 1 μmol/L baicalein DMEM medium. After 2 hours of intervention, 20 μmol/L Aβ 25-35 was added to the model group, estradiol group and baicalein group with induced PC12 cell injury. After 22 hours of intervention, flow cytometry was used to detect the apoptosis of PC12 cells. The expression of estrogen receptor β (ER β), phosphorylated c-Jun N-terminal kinase (p-JNK/JNK) and ionic receptor N-methyl-D-aspartate receptor 1 (NMDAR1), glutamate receptor 2 (GluR2) and calcium/calmodulin dependent protein kinase Ⅱ (CaMK Ⅱ) were detected by Western blot. Results:Compared with model group, 1 μmol/L baicalein significantly increased the proliferation rate [(95.80±2.47)% vs. (64.34±3.84)%]. The apoptosis rate of PC12 cells[(7.83±0.67)% vs. (12.84±0.91)%] was significantly decreased in baicalein group ( P<0.01). The expression of NMDAR1 (0.582±0.012 vs. 0.352±0.012), GluR2(0.538±0.017 vs. 0.355±0.006), ER β (0.362±0.015 vs. 0.262±0.018) in baicalein group were significantly increased ( P<0.01), the expression of p-JNK/JNK (0.476±0.013 vs. 0.752±0.014) and CaMK Ⅱ(0.499±0.019 vs. 0.670±0.016) in baicalein group were significantly decreased ( P<0.01). Conclusions:Baicalein has a protective effect on PC12 cells injured by Aβ 25-35. Its mechanism may be related to the inhibition of p-JNK/JNK activity by activating ERβ and regulating the expression of glutamate receptor related protein.

Molecular interactions between the main components of Shuanghuanglian injection and ciprofloxacin injection based on self-assembly / 药学学报

The combination of Shuanghuanglian injection (SHLI) and ciprofloxacin injection (CIPI) is frequently prescribed in clinical practice, but the basis for the combination is weak. In this study, isothermal titration calorimetry and ultraviolet-visible absorption spectrometry were applied to identify the molecular interactions of SHLI and its main components, chlorogenic acid and neochlorogenic acid with CIPI. Scanning electron microscopy, Fourier-transform infrared spectroscopy, and cold-spray ionization mass spectrometry were performed to confirm that this molecular interaction was related to the formation of self-assembled supramolecular systems induced by chlorogenic acid and neochlorogenic acid with CIPI through weak intermolecular bonds. The antibacterial activity toward Pseudomonas aeruginosa (P. aeruginosa) was evaluated via molecular interactions, and the inhibitory ability of SHLI, chlorogenic acid and neochlorogenic acid against P. aeruginosa was significantly reduced after interaction with CIPI. A molecular docking study demonstrated that the reduced antibacterial ability was closely related to the competitive binding of drug molecules to the same binding site of the DNA gyrase B (GyrB) subunit of P. aeruginosa. The present study uncovered the intermolecular interactions of SHLI and its main components chlorogenic acid and neochlorogenic acid with CIPI from the perspective of molecular self-assembly and contribute to the reduction of its antibacterial ability, providing a basis for the clinical combination of SHLI and CIPI.

Interpretation for Evidence-based Practice Guideline of Medication Therapy of High-dose Methotrexate in China / 中国药房

Evidence-based Practice Guideline of Medication Therapy of High-dose Methotrexate in China was published in the British Journal of Clinical Pharmacology in February 2022. The guideline followed the latest definition of clinical practice guideline and the methodology specification for the guideline development of WHO. The Grading of Recommendations Assessment ， Development，and Evaluation （GRADE）approach was applied to rate the quality of evidence and determine the strength of recommendations. Finally ，this guideline presents 28 recommendations covering the whole process of clinical medication of high-dose methotrexate ，involving evaluation prior to administration （liver and renal function ，pleural effusion and ascites ， comedication，genetic testing ），pre-treatment and routine dosing regimen （pretreatment of hydration and alkalization ，urine alkalization，routine dosing regimen ），therapeutic drug monitoring （necessity，method，timing，target concentration ），leucovorin rescue（rescue timing ，rescue regimen ，rescue dose optimization ），and management of toxicities （liver and kidney function monitoring，supportive treatment ，blood purification treatment ）. This article aims to summarize and interpret the recommendations of this guideline ，so as to promote the better promotion and implementation of this guideline and provide comprehensive technical support and suggestions for whole-course individualized administration of high-dose methotrexate in China.

Comparison of two quantitative real-time PCR methods for serum HBV RNA in patients with HBeAg-positive chronic hepatitis B: A propensity score matching study / 临床肝胆病杂志

Objective To investigate the consistency between Shengxiang (S) and Xinbo (X) real-time PCR methods in the quantification of HBV RNA. Methods In the prospective follow-up cohort of 108 chronic hepatitis B (CHB) patients established from July 2007 to August 2008, 20 patients with HBeAg seroconversion were selected, and 20 patients without seroconversion were selected by propensity score matching at a ratio of 1∶ 1. The two quantification methods from S and X companies were used, and a retrospective analysis was performed for HBV RNA in serum samples at baseline and weeks 12, 24, and 48. The paired t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data. The Pearson correlation coefficient, intraclass correlation coefficient (ICC), and the Bland-Altman method were used to evaluate the consistency of the two quantification methods. Results A total of 132 serum samples were tested by S reagent, and 154 were tested by X reagent; the detection rate of HBV RNA was 100% by both reagents. A total of 131 serum samples were tested by both reagents, with 34 samples at baseline and 29, 35, and 33 samples, respectively, at weeks 12, 24, and 48 of follow-up; at these four time points, the HBV RNA quantification data detected by X reagent were significantly higher than those detected by S reagent (5.75±1.64/5.43±1.73/5.13±1.54/4.76±1.55 log 10 copies/mL vs 4.80±1.48/4.52±1.53/4.10±1.50/3.92± 1.43 log 10 copies/mL, t =8.348, t =5.341, Z =-5.086, Z =-4.762, all P < 0.001). The correlation analysis of the two methods showed a Pearson correlation coefficient of 0.915 (95% confidence interval [ CI ]: 0.836-0.957) and an ICC of 0.771(95% CI : -0.021 to 0.931) at baseline, a Pearson correlation coefficient of 0.849(95% CI : 0.701-0.927) and an ICC of 0.733(95% CI : 0.138-0.902) at week 12, a Pearson correlation coefficient of 0.951(95% CI : 0.905-0.975) and an ICC of 0.776(95% CI : -0.058 to 0.942) at week 24, and a Pearson correlation coefficient of 0.933(95% CI : 0.867-0.967) and an ICC of 0.804(95% CI : -0.014 to 0.944) at week 48 (all P < 0.05). The Bland-Altman analysis showed that the difference of 96.18%(126/131) samples tested by the two methods was within the mean difference±1.96 standard deviation. Conclusion HBV RNA quantification by X reagent is higher than that by S reagent, while the two real-time PCR quantification methods show a good consistency in CHB patients with HBeAg seroconversion and those without seroconversion.