Finite element analysis of cervical intervertebral discs after removing different ranges of uncinate processes / 解剖学报

Objective To study the stress change characteristics of the cervical disc after removing different ranges of the uncinate process by establishing a three⁃dimensional finite element model of the C

Biograph Vision 600 PET performance testing and analysis / 中国辐射卫生

Objective To test and analyze the performance of Biograph Vision 600 PET/CT according to the NEMA NU2—2012 standard to achieve reliable, repeatable, and inter-system comparable performance measurement, and to provide a basis for future equipment stability testing and status detection. Methods The Biograph Vision PET equipment features a detector based on silicon photomultipliers, with 3.2 mm lutetium oxyorthosilicate crystals and full cover of the scintillation region. The spatial resolution, sensitivity, noise-equivalent count rate, scatter fraction, coincidence count rate, image quality, scatter correction, and time-of-flight resolution of Biograph Vision PET were tested by referring to the test model and method of the NEMA NU2—2012 standard. Results The Biograph Vision 600 PET equipment showed lateral and axial spatial resolutions of 3.69 mm and 3.81 mm at 1 cm off-center of the field of view, respectively and of 4.29 mm and 4.48 mm at 10 cm, respectively. The sensitivity was 17.5 kcps/MBq. The time-of-flight resolution changed from 210 ps to 215 ps as the count rate increased to the peak noise equivalent count rate. The NEMA peak noise-equivalent count rate was 247 kcps at 30.3 kBq/ml. The corresponding scatter fraction was 34.8%. With the NEMA module, the overall image quality contrast range was 73.6%-92.8%, and the background variability was 2.3%-6.5%; the mean lung residual error was 3.4%; and the time-of-flight resolution was 210 ps. Conclusion This performance test was performed according to the NEMA NU2—2012 standard, showing that all parameters were better than the ex-factory standard, which can provide a reference for other institutions selecting equipment and also provide a basis for future equipment stability testing and status detection.

Role of epigenetic regulation of biological clock genes in tumors / 中国药理学通报

The circadian clock is regulated at the molecular level by transcriptional-translational feedback loop of clock genes, which ensures that a variety of physiological processes have a-round 24 h circadian rhythms, including cell metabolism, cell proliferation, cell apoptosis and tumorigenesis, to maintain the homeostasis. Thus, the disturbance of circadian clock will disrupt homeostasis, causing various diseases, including neoplasm, metabolic syndrome, Parkinson's disease, COPD and cardiovascular diseases. Disturbance of circadian clock is closely related with tumorigenesis, and acts on various molecules and pathways leading to tumorigenesis, including oncogene and tumor suppressor gene, cell cycle, metabolic reprogramming, immune escape, endocrine disruption, alteration of gastrointestinal microbiome. This review focuses on changes in clock genes expression which disrupt cell cycle and may play a role in tumorigenesis, and epi-geneties, an important way to regulate gene expression, which can alter clock gene expression, thus playing an important role in the process of " the alternation of clock gene expression-disruption of cell cycle-tumorigenesis".

Application of meridian and acupoint diagnosis of three yin meridians of foot in the treatment for gynecological diseases with acupuncture and moxibustion / 中国针灸

With three representative types of gynecological diseases (dysmenorrhea, pelvic inflammation, polycystic ovary syndrome) as examples, the application methods of meridian and acupoint diagnosis for gynecological diseases treated with acupuncture and moxibustion are discussed. During clinical diagnosis and treatment, it is recommended to examine the patient's leg segment along the three yin meridians of foot, aiming to explore the positive reactions of the meridians and acupoints (color, shape, skin temperature, sensory abnormalities, etc.). Acupuncture and moxibustion treatment at this positive reaction place can improve the clinical efficacy. Meridian and acupoint diagnosis could provide basis for meridian syndrome differentiation, thus guiding the selection of acupoint prescriptions; it is also helpful to clarify the deficiency, excess, cold and heat of the disease nature, thus guiding the selection of acupuncture and moxibustion methods. In addition, it is an auxiliary method to estimate the prognosis and outcome of the disease.

Application of cochlear nerve action potential monitoring in the resection of vestibular schwannomas / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the application of cochlear nerve action potential (CNAP) monitoring in the resection of vestibular schwannoma, especially evaluating its significance for hearing preservation. Methods: From April 2018 to December 2021, 54 patients with vestibular schwannoma who underwent resection via retrosigmoid approach were collected in Chinese PLA General Hospital. Before surgery, all patients had effective hearing (AAO-HNS grade C or above). Brainstem auditory evoked potential (BAEP) combined with CNAP monitoring was performed during surgery. The CNAP monitoring was combined with continuous monitoring and cochlear nerve mapping. And patients were divided into hearing preservation group and non-preserved group according to postoperative AAO-HNS grade. SPSS 23.0 software was used to analyze the differences of CNAP and BEAP parameters between the two groups. Results: A total of 54 patients completed intraoperative monitoring and data collection, including 25 males (46.3%) and 29 females (53.7%), aged 27-71 years with an average age of 46.2 years. The maximum tumor diameter were (18.1±5.9) mm (range 10-34 mm). All tumors were totally removed with preserved facial nerve function (House-Brackmann grade I-II). The hearing preservation rate of 54 patients was 51.9% (28/54). During surgery, the V wave extraction rate of BAEP waveform was 85.2% (46/54) before tumor resection, 71.4% (20/28) in the hearing preservation group after tumor resection, and disappeared in the hearing preservation group (0/26). CNAP waveform was elicited in 54 patients during operation. Differences were found in the distribution of CNAP waveforms after tumor resection. The waveforms of the hearing-preserving group were triphasic and biphasic, while those in the non-preserving group were low-level and positive. For hearing preservation group, the amplitude of N1 wave after tumor resection was significantly higher than that before tumor resection[14.45(7.54, 33.85)μV vs 9.13(4.88, 23.35)μV, P=0.022]; However, for the non-preserved group, the amplitude of N1 wave after tumor resection was significantly lower than that before tumor resection [3.07(1.96, 4.60)μV vs 6.55(4.54, 9.71)μV, P=0.007]; After tumor resection, the amplitude was significantly higher than that of the unreserved group [14.45(7.54, 33.85)μV vs 3.07(1.96, 4.60)μV, P<0.001]. Conclusions: BAEP combined with CNAP monitoring is conducive to intraoperative hearing protection, and the application of cochlear nerve mapping can prompt the surgeon to avoid nerve injury. The waveform and N1 amplitude of CNAP after tumor resection have a certain value in predicting postoperative hearing preservation status.

Corticostriatal Neurons in the Anterior Auditory Field Regulate Frequency Discrimination Behavior / 神经科学通报·英文版

The anterior auditory field (AAF) is a core region of the auditory cortex and plays a vital role in discrimination tasks. However, the role of the AAF corticostriatal neurons in frequency discrimination remains unclear. Here, we used c-Fos staining, fiber photometry recording, and pharmacogenetic manipulation to investigate the function of the AAF corticostriatal neurons in a frequency discrimination task. c-Fos staining and fiber photometry recording revealed that the activity of AAF pyramidal neurons was significantly elevated during the frequency discrimination task. Pharmacogenetic inhibition of AAF pyramidal neurons significantly impaired frequency discrimination. In addition, histological results revealed that AAF pyramidal neurons send strong projections to the striatum. Moreover, pharmacogenetic suppression of the striatal projections from pyramidal neurons in the AAF significantly disrupted the frequency discrimination. Collectively, our findings show that AAF pyramidal neurons, particularly the AAF-striatum projections, play a crucial role in frequency discrimination behavior.

Research progress of sphingosine kinase and sphingosine-1-phosphate (S1P) /S1P receptor signaling in tumor microenvironment / 药学学报

Sphingosine kinase (SphK), sphingosine-1-phosphate (S1P) and S1P receptor (S1PR) are involved in the tumor biological processes such as tumor cell proliferation and migration, and play an important role in the development of cancer. In recent years, researchers have increasingly focused on the interaction between cancer cells and the tumor microenvironment. The tumor microenvironment is genetically stable and can be induced to an antitumor phenotype, which has significant therapeutic advantages. Studies have shown that SphK/S1P/S1PR can regulate multiple aspects of the tumor microenvironment. This review summarizes the effects of SphK and S1P/S1PR signaling on the tumor microenvironment from four perspectives: tumor immune microenvironment, cancer associated fibroblasts, tumor angiogenesis and tumor hypoxic microenvironment, and also outlines potential drug research related to these signal molecules, aiming to elucidate the role of SphK/S1P/S1PR in tumor occurrence and development and provide new ideas for the research of anti-tumor drugs.

Light/dark box as an animal model of state anxiety in Kunming mouse: Conditions and factors / 中国药理学通报

Aim To explore the factors on behavior patterns of light/dark box(LDB)as an animal model of state anxiety in Kunming mice.Methods The behavior of adult,male,Kunming mice in LDB was recorded for five minutes,respectively.The following parameters were evaluated:percentage of time in the light area(Ltime%),percentage of squares crossing in the light area(Lcross%),percentage of rears in the light area(Lrear%),total number of squares crossing in the whole apparatus(Cross),total number of rears in the whole apparatus(Rear),total(Cross plus Rear),transitions between two areas(Transition),and number of fecal bolis in light box and dark box(Fbs).Subsequently,the factors,such as day-night rhythm,illumination area(L3/5 or L2/5 for ratio between Light box and Dark box:3:2 or 2:3,respectively),illumination color(in Dark box)and illumination intensity(in Light box),were investigated to screen the best experimental conditions.Results t-test showed that compared with night cycle,there was no significant difference in all LDB parameters during day cycle(P>0.05),while compared with 3/5 and 2/5,LDB parameters during day cycle such as Lcross%(t=5.363,P0.05),but a statistical influence of illumination area on Ltime%(F(1,20)=18.361,P0.05).Conclusions LDB as an animal model of state anxiety in Kunming mice can evaluate anxiety-,locomotion-exploration and emotionality- related behaviors,which cannot be affected by day-night rhythm,but illumination area(Ltime%,Lcross%,Lrear%),illumination color(Rear)and illumination intensity(Cross,Total).So it is recommended to adopt the uniform and fixed conditions,such as illumination area,color and intensity(less than 100 W).

Bioinformatics analysis identifies aging/senescence-induced genes in calcified plaques / 生理学报

Vascular calcification is an important pathophysiological basis of cardiovascular disease with its underlying mechanism unclear. In recent years, studies have shown that aging is one of the risk factors for vascular calcification. The purpose of this study was to investigate the microenvironmental characteristics of vascular calcification, identify aging/senescence-induced genes (ASIGs) closely related to calcified plaques, and explore the evolution trajectory of vascular calcification cell subsets. Based on the bioinformatics method, the single cell transcriptome sequencing data (Gene Expression Omnibus: GSE159677) of carotid artery samples from 3 patients undergoing carotid endarterectomy were grouped and annotated. Vascular calcification-related aging genes were identified by ASIGs data set. The pseudotime trend of ASIGs in cell subsets was analyzed by Monocle 3, and the evolution of vascular calcification cells was revealed. After quality control, all cells were divided into 8 cell types, including B cells, T cells, smooth muscle cells, macrophages, endothelial cells, fibroblasts, mast cells, and progenitor cells. Ten ASIGs related to vascular calcification were screened from the data set of ASIGs, which include genes encoding complement C1qA (C1QA), superoxide dismutase 3 (SOD3), lysozyme (LYZ), insulin-like growth factor binding protein-7 (IGFBP7), complement C1qB (C1QB), complement C1qC (C1QC), Caveolin 1 (CAV1), von Willebrand factor (vWF), clusterin (CLU), and αB-crystallin (CRYAB). Pseudotime analysis showed that all cell subsets were involved in the progression of vascular calcification, and these ASIGs may play an important role in cell evolution. In summary, AGIS plays an important role in the progression of vascular calcification, and these high expression genes may provide ideas for early diagnosis and treatment of vascular calcification.

Clinical efficacy comparison between hydromorphone and morphine subcutaneous injection analgesia for cancer outbreak pain / 肿瘤研究与临床

Objective:To explore the clinical effects and adverse reactions of hydromorphone versus morphine subcutaneous injection analgesia for cancer outbreak pain.Methods:A total of 98 patients with cancer outbreak pain admitted to Xuzhou Central Hospital were selected. According to the random number table method, the patients were divided into the observation group (receiving subcutaneous injection of hydromorphone for analgesia) and the control group (receiving subcutaneous injection of morphine for analgesia), 49 cases in each group. The numerical rating scale (NRS) scores and quality of life (QOL) scores, pain relief effects, serum β-endorphin, substance P, 5-hydroxytryptamine levels and the incidence of adverse reactions were compared between the two groups.Results:The NRS scores of the two groups after treatment were decreased compared with those before treatment (all P < 0.05); and the NRS score of the observation group was lower than that of the control group after treatment [(2.4±0.4) scores vs. (3.2±0.5) scores, t = 8.69, P < 0.001]; the QOL scores of the two groups after treatment were higher than those before treatment (all P < 0.05); and there were no statistically significant difference in QOL scores after treatment between the two groups [(46±7) scores vs. (43±7) scores, t = 1.62, P = 0.109]. The total effective rate of pain relief of the observation group was higher than that of the control group [93.88% (46/49) vs.79.59% (39/49), χ2 = 4.35, P = 0.037]. The serum β-endorphin, substance P, 5-hydroxytryptamine levels of the two groups after treatment were decreased compared with those before treatment (all P < 0.05). β-endorphin, substance P and 5-hydroxytryptamine of the observation group were lower than those of the control group after treatment[β-endorphin: (85±15) ng/L vs. (98±17) ng/L, substance P: (2.1±0.3) μg/ml vs. (2.4±0.4) μg/ml, 5-hydroxytryptamine: (0.31±0.05) ng/L vs.(0.38±0.06) ng/L; t values were 3.75, 3.63, 6.27, all P < 0.05). Compared with the control group, the incidence of adverse reactions like skin pruritus, nausea and vomiting of the observation group were lower (all P < 0.05). Conclusions:Compared with subcutaneous injection of morphine for analgesia, hydromorphone can better alleviate the pain of patients with cancer outbreak pain, decrease the level of pain mediators, and reduce the incidence of skin pruritus, nausea and vomiting.

Effect of Naozhenning on Hippocampal Mitochondrial Function in Model Rats with Post-concussion Syndrome / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of Naozhenning on learning and memory ability and neuron damage in hippocampal CA1 region of post-concussion syndrome model rats based on mitochondrial function. MethodMultiple cerebral concussion （MCC） was induced in SPF Wistar rats with the free-fall impact method. Then the model rats were randomly classified into model group （equivalent volume of distilled water）， piracetam （0.43 g·kg-1， ig） group， and low-， medium-， and high-dose NZN （5.4， 10.8， 21.6 g·kg-1， respectively， ig） groups， with 10 rats in each group， and another 10 normal rats were included in the normal control group （equivalent volume of distilled water）. The administration lasted 14 days and then relevant indexes were detected. Morris water maze test was used to observe the changes of learning and memory ability in each group， such as escape latency， residence time in primary quadrant， and times of crossing platform. The pathological changes of hippocampal CA1 region were observed based on hematoxylin-eosin （HE） staining and Nissl staining. The ultrastructure of mitochondria was observed under the transmission electron microscope （TME） and the activity of mitochondrial respiratory chain complex Ⅰ was detected by colorimetry. The content of adenosine triphosphate （ATP） was determined by fluorescence probe and mitochondrial membrane potential （MMP） by fluorescein enzyme-linked fluorescence immunoassay. ResultCompared with the normal control group， the model group showed long escape latency， short residence time in target quadrant， few times of crossing the platform， significant decrease in counts of neurons and Nissl bodies in hippocampal CA1 region， damage of neuronal morphology and mitochondrial structure， and significant reduction of MMP and the content of mitochondrial ATP and respiratory chain complex I （P<0.05， P<0.01）. The NZN groups demonstrated short escape latency， long residence time in target quadrant， increased times of crossing the platform， small number of neurons and Nissl bodies in hippocampal CA1 region， alleviated damage of neuronal morphology and mitochondrial structure， and increase in MMP and the content of mitochondrial ATP and respiratory chain complex I （P<0.05， P<0.01）. ConclusionNZN can improve the learning and memory ability of MCC rats by improving mitochondrial structure and function and alleviating hippocampal neuron injury.

Association Between Psychosocial Disorders and Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis

Background/Aims@#The incidence of gastroesophageal reflux disease (GERD) is increasing annually. Studies have suggested that psychosocial disorders may be linked to the development of GERD. However, studies evaluating the association between psychosocial disorders and GERD have been inconsistent. Thus, we conducted a systematic review and meta-analysis of observational studies that evaluated the association between psychosocial disorders and GERD. @*Methods@#We systematically searched the PubMed, Embase, Cochrane, and Web of Science databases until October 17, 2020. Pooled OR with 95% CI and subgroup analyses were calculated using a random-effects model. Subgroup analyses were performed to identify thesources of heterogeneity. Sensitivity analysis by one-study removal was used to test the robustness of our results. @*Results@#This meta-analysis included 1 485 268 participants from 9 studies. Studies using psychosocial disorders as the outcome showed that patients with GERD had a higher incidence of psychosocial disorders compared to that in patients without GERD (OR, 2.57; 95% CI, 1.87-3.54; I2 = 93.8%; P < 0.001). Studies using GERD as an outcome showed an association between psychosocial disorders and an increased risk of GERD (OR, 2.23; 95% CI, 1.42-3.51; I2 = 97.1%; P < 0.001). The results of the subgroup analysis showed that the non-erosive reflux disease group had a higher increased risk of anxiety than erosive reflux disease group (OR, 9.45; 95% CI, 5.54-16.13; I2 = 12.6%; P = 0.285). @*Conclusion@# @*Results@#of our meta-analysis showed that psychosocial disorders are associated with GERD; there is an interaction between the two.

Effect of Danggui Shaoyao San on cognitive function of vascular dementia model rats and its mechanisms / 中华行为医学与脑科学杂志

Objective:To investigate the effects of Danggui Shaoyao San(DSS) on cognitive function and neuronal apoptosis in vascular dementia (VD) rats.Methods:Fifty SPF grade male SD rats aged 6-7 weeks were randomly divided into sham operation group, model group, positive drug group (nimodipine group, 9.45 mg·kg -1), DSS low-dose group (1.6 g·kg -1), DSS high-dose group (6.4 g·kg -1) according to random number table, with 10 rats in each group. The VD rat model was established by permanent ligation of bilateral common carotid arteries. Seven days after modeling, the rats in different groups were administrated by gavage according to corresponding interventions, once a day, for 28 days. Morris water maze test was used to evaluate the learning and memory ability of rats.The levels of malondialdehyde (MDA), superoxide dismutase (SOD) and reactive oxygen species (ROS) in hippocampal area of rat brain were detected by ELISA.The protein expressions of apoptosis-related proteins Bcl-2, Bax, cleaved Caspase-3 and leptin receptor/glycogen synthase kinase 3β microtubule-associated protein tau(LEP-R/GSK-3β/tau) signaling pathway were detected by Western blot. GraphPad Prism 9 software was used for statistical analysis of data, repeated measure ANOVA and one-way ANOVA were used for comparison between multiple groups, and SNK- q test was used for further pairwise comparison. Results:The results of water maze experiment showed that the time and group interaction of escape latency of the five groups were not significant ( F=1.223, P>0.05), the main effect of group and time were significant ( F=74.65, 18.32, both P<0.05). On the 5th day, the escape latency of nimodipine group, DSS low-dose group and DSS high-dose group were lower than that of model group ( q=14.425, 7.477, 21.392, all P<0.05), and that of DSS high-dose group was lower than that of nimodipine group ((15.28±2.46)s, (22.78±3.31)s, q=6.966, P<0.05). There was statistically significant difference in the number of crossing platforms of rats in 5 groups ( F=17.331, P<0.05). The numbers of platform crossing in nimodipine group and DSS high-dose group were higher than that in model group ( q=6.789, 10.635, 5.270, all P<0.05), and the number of platform crossing in DSS high-dose group was higher than that in nimodipine group ((6.84±1.63), (5.22±1.75), q=3.846, P<0.05). ELISA results showed that the levels of MDA, ROS and SOD in hippocampal tissues of rats in 5 groups were significantly different ( F=49.338, 38.518, 15.440, all P<0.05). The levels of MDA and ROS in hippocampus of DSS high-dose group were lower than those of model group ( q=16.061, 13.541, both P<0.05) and nimodipine group ( q=4.317, 5.162, both P<0.05), SOD level of DSS high-dose group was higher than those of model group ( q=8.179, P<0.05) and nimodipine group ( q=4.135, P<0.05). Western blot results showed that the levels of apoptosis-related proteins Bcl-2/Bax and Caspase-3 were significantly different in the 5 groups ( F=30.692, 43.384, both P<0.01). The level of Bcl-2/Bax in DSS high-dose group was higher than that in model group ( q=10.562, P<0.05) and nimodipine group ( q=3.820, P<0.05), the level of Caspase-3 was lower than those of model group ( q=12.139, P<0.05) and nimodipine group ( q=7.734, P<0.05). The levels of LEP-R, p-GSK-3β, p-S404 tau and p-S202 tau expression level in hippocampal tissues of the 5 group were significantly different ( F=80.927, 59.230, 159.784, 105.923, all P<0.01). The levels of LEP-R and p-GSK-3β protein in nimodpine group and DSS high-dose group were higher than those in model group ( q=16.275, 20.104, both P<0.05; q=12.942, 17.257, both P<0.05), the levels of p-S404 Tau and p-S202 Tau in the two groups were lower than those in model group ( q=19.121, 27.456, both P<0.05; q=17.559, 22.780, both P<0.05). The levels of LEP-R(0.98±0.15), (0.86±0.14)) and p-GSK-3β((0.95±0.16)s, (0.82±0.13)) in DSS high-dose group were higher than those in nimodipine group ( q=3.829, 4.314, both P<0.05), the levels of p-S404 Tau((0.41±0.03)s, (0.58±0.07)) and p-S202 Tau((0.48±0.05)s, (0.59±0.06)) in DSS high-dose group were lower than those of nimodipine group ( q=8.335, 5.220, both P<0.05). Conclusion:DSS can improve the cognitive function of VD rats, and the mechanism may be related with reducing oxidative stress level, inhibiting neuronal apoptosis, and upregulating LEP-R/GSK-3β/Tau signaling pathway.

Empirical analysis on the regional characteristics and trend of pharmaceutical industry transfer in China / 中国药房

OBJECT IVE To provide reference for relevant decision-makers to formulate policies to guide the transfer of pharmaceutical industry. METHODS Using the statistical data from 2000 to 2019，taking industrial transfer index as index ，on the basis of 4 regions，our country was divided into 8 comprehensive economic areas ：the eastern coastal area ，the southern coastal area，the northern coastal area ，the middle reaches of the Yellow River area ，the middle reaches of the Yangtze River area ，the northeast area ，the southwest area and the northwest area. The regional characteristics and regularity of China ’s pharmaceutical industrial transfer were discussed in terms of space and time. RESULTS & CONCLUSIONS From 2004 to 2019，among the 31 provinces，pharmaceutical industry was transferred in 19 provinces，including Jilin ，Shandong，Henan and Gansu ，accounting for 61.3％；pharmaceutical industry was transferred out in 12 provinces，including Hebei ，Beijing，Xinjiang and Hubei ，accounting for 38.7％. There were 12 provinces whose absolute average values of industrial transfer index were greater than 0.2，indicating that China’s pharmaceutical industry had undergone large-scale migration among provinces ，and the scale of pharmaceutical industrial transfer varied significantly among provinces. From the perspective of regional distribution ，4 pharmaceutical industrial transfer-in centers had been formed in China ，the eastern coastal area ，the northeast area ，the middle reaches of the Yangtze River area and the southern coastal area ；industrial transfer followed the location selection mode from within areas to between areas. From the perspective of time change trend ，there was a phenomenon of gradient deviation in the transfer of pharmaceutical industry in various areas of China ，and there are 5 evolution types ，mainly including “up and down fluctuation ”，“first decrease and then increase”，“first increase and then decrease ”；the transfer of pharmaceutical industry was active in most areas ，and the transfer path remained relatively stable. In some areas ，the roles of transfer-out place and transfer-in place had been exchanged. According to the scale and trend of industrial transfer ，each area should formulate guiding policies to realize the coordinated development of inter-regional pharmaceutical industry.

Progress of new anti-seizure medications in elderly patients with epilepsy / 中华神经科杂志

With the rapid aging of the population, elderly epilepsy probably becomes one of the most common forms of epilepsy. Lacosamide, brivaracetam, eslicarbazepine acetate, and perampanel have been approved by the United States Food and Drug Administration and the European Medicines Agency for monotherapy and (or) adjunctive treatment of seizures in the last few years. This review summarizes the efficacy and tolerability of third-generation anti-seizure medications in elderly epilepsy patients and introduces the effects of anti-seizure medications on cognitive function and mood, as well as drug-drug interactions, aiming to provide a reliable basis for clinicians to choose third-generation anti-seizure medications.

Transformation of epilepsy treatment model: anti-epileptogenesis and disease-modifying therapy / 中华神经科杂志

Most anti-seizure medications do not change the course of epilepsy and are basically "symptomatic treatment". Even if a variety of new anti-seizure medications continue to come out, there are still more than 30% of patients develop drug-resistant epilepsy. Therefore, investigating new therapeutic targets and developing effective drugs to prevent or reverse the onset and progression of epilepsy are important goals of clinical and preclinical researches. Based on the current studies, to realize the transformation from anti-seizure to anti-epileptogenesis and disease-modifying therapy, it not only needs standardized animal models and biomarkers that can predict the epileptogenesis or progression but also needs sufficient patients, rigorous design schemes, and cutting-edge analysis methods to successfully transform preclinical research into clinical practice. There is no doubt that in the future, targeting various nerve injury pathways to achieve anti-epileptogenesis and disease-modifying therapy probably becomes a truly effective means of treating and preventing epilepsy.

Research advances in drug preconditioning for hepatic ischemia-reperfusion injury / 中国药理学通报

Hepatic ischemia-reperfusion injury (H I R I) is the major reason of liver dysfunction and even failure after liver resection and transplantation, which can seriously affect the postoperative recovery of patients. In recent years, according to the further research on the mechanism of hepatic ischemia reperfusion injury, a number of HIRI treatments have been proposed, such as drug preconditioning, ischemic preconditioning and remote ischemic preconditioning. Among these methods, drug preconditioning has already attracted extensive clinical attention. The intervention mechanism of HIRI preconditioning is to prevent the main pathophysiological responses that occur in HIRI, such as calcium overload, reactive oxygen species production, aseptic inflammation response and cell apoptosis and autophagy. Currently, a variety of drugs, such as mitochondrial protector, ROS scavenger, anti-inflammatory drugs have been proved to alleviate HIRI via the above mechanisms, and these studies are reviewed in this article.

A 14-year multi-institutional collaborative study of Chinese pelvic floor surgical procedures related to pelvic organ prolapse / 中华医学杂志(英文版)

BACKGROUND@#It has been a global trend that increasing complications related to pelvic floor surgeries have been reported over time. The current study aimed to outline the development of Chinese pelvic floor surgeries related to pelvic organ prolapse (POP) over the past 14 years and investigate the potential influence of enhanced monitoring conducted by the Chinese Association of Urogynecology since 2011.@*METHODS@#A total of 44,594 women with POP who underwent pelvic floor surgeries between October 1, 2004 and September 30, 2018 were included from 22 tertiary academic medical centers. The data were reported voluntarily and obtained from a database. We compared the proportion of each procedure in the 7 years before and 7 years after September 30, 2011. The data were analyzed by performing Z test (one-sided).@*RESULTS@#The number of different procedures during October 1, 2011-September 30, 2018 was more than twice that during October 1, 2004-September 30, 2011. Regarding pelvic floor surgeries related to POP, the rate of synthetic mesh procedures increased from 38.1% (5298/13,906) during October 1, 2004-September 30, 2011 to 46.0% (14,107/30,688) during October 1, 2011-September 30, 2018, whereas the rate of non-mesh procedures decreased from 61.9% (8608/13,906) to 54.0% (16,581/30,688) (Z = 15.53, P < 0.001). Regarding synthetic mesh surgeries related to POP, the rates of transvaginal placement of surgical mesh (TVM) procedures decreased from 94.1% (4983/5298) to 82.2% (11,603/14,107) (Z = 20.79, P < 0.001), but the rate of laparoscopic sacrocolpopexy (LSC) procedures increased from 5.9% (315/5298) to 17.8% (2504/14,107).@*CONCLUSIONS@#The rate of synthetic mesh procedures increased while that of non-mesh procedures decreased significantly. The rate of TVM procedures decreased while the rate of LSC procedures increased significantly.@*TRIAL REGISTRATION NUMBER@#NCT03620565, https://register.clinicaltrials.gov.

Optimization ratio between Coptis chinensis and cinnamo of Jiaotai pill plus benzodiazepines for insomnia in China:a network meta-analysis / 中国药理学与毒理学杂志

OBJECTIVE To explore the efficacy of Jiaotai pill (JTW) and JTW modified prescriptions (JTW+) plus benzodiazepines (BDZ) for insomnia in China by systematic review and network meta-analysis, especially optimization ratio (m:n) between Coptis chinensis and Cinnamo. METHODS Randomized controlled trials (RCTs) regarding JTW and JTW++BDZ for insomina were comprehensively searched in CNKI, VIP, Wanfang, and PubMed, Cochrane Library, OVID, Embase databases from their inception to December 2017. The risk of bias was assessed by the Cochrane collab?oration's tool and Jadad scale. Systematic review and network meta-analysis were performed to evaluate the relative risk (RR) plus 95％confidence interval (95％CI) or prediction interval (95％PrI), and draw surface under the cumulative rank?ing curves (SUCRA) by Stata 14.0 and RevMan 5.0 software. RESULTS A total of 13 RCTs (1 RCT was omitted by sen?sitivity analysis) with 1040 patients were included. Overall heterogeneity was acceptable, except publication bias. Based on classical meta-analysis, JTW and JTWm:n++BDZ, such as JTW2:1++BDZ, JTW5:1++BDZ, JTW6:1++BDZ, JTW10:1++BDZ, had more efficacy than BDZ. Based on network meta-analysis, JTW and JTWm:n++BDZ, such as JTW2:1++BDZ, JTW6:1++BDZ, JTW10:1++BDZ, had more efficacy than BDZ; meanwhile, SUCRA showed the best rank of JTW/JTW+ (BDZ<JTWm:n++BDZ<JTW) for insomina, as same as that of JTWm:n+(BDZ<JTW5:1++BDZ<JTW10:1++BDZ<JTW2:1++BDZ<JTW6:1++BDZ). CONCLUSION Based on the existing clinical evidence, JTW has efficacy for insomnia, but the optimization ratio between Coptis chinensis and cinnamo of JTWm:n++BDZ for insomnia needs more supports.

Opinions on the reclassification of pulmonary adenocarcinoma in situ in the fifth edition of WHO classification of thoracic tumours / 中国胸心血管外科临床杂志

@#Pulmonary adenocarcinoma in situ is reclassified as precursor glandular lesions in the fifth edition of WHO classification of thoracic tumours, causing widespread attention and heated debate among domestic thoracic oncologists, radiologists, pathologists and surgeons. We would like to comment on the topic and make a few suggestions on the management of pulmonary nodule during lung cancer screening. We are open to all suggestion and welcome debates.