Severity of COVID-19 reinfection among healthcare workers in a grade A tertiary hospital in Shanghai by the end of 2022 / 上海预防医学

ObjectiveTo describe the epidemic characteristics of COVID-19 after policy adjustment from “Category B notifiable disease with category A management” to “Category B notifiable disease with category B management”， and to explore the protective effect of previous infection with SARS-CoV-2 on common symptoms of reinfection. MethodsHealthcare workers infected with SARS-CoV-2 in a grade A tertiary hospital in Shanghai were included in the study from December 4， 2022 to January 11， 2023. Data on demographic characteristics， clinical symptoms， medical history， and COVID-19 vaccination history were collected. We determined the epidemiological curve and characteristics， and then compared the difference in the severity of clinical symptoms between primary and reinfection subjects. ResultsA total of 2 704 cases were included in the study， of which 45 had reinfection， 605 （22.4%）were males， 608 （22.5%）were doctors， 1 275 （47.2%） were nurses， and 2 351 （86.9%） received ≥3 doses of COVID-19 vaccination. The average age of these healthcare workers was （34.9±9.1） years old. The number of cases with mild/moderate illness， asymptomatic infection， fever， headache， dry cough， expectoration， and chest tightness were 2 704 （100.0%）， 92 （3.4%）， 2 385 （88.2%）， 2 066 （76.4%）， 1 642 （60.7%）， 1 807 （66.8%）， and 439 （16.2%）， respectively. Reinfection was a protective factor for fever （OR=0.161， P<0.001）， headache （OR=0.320， P<0.001）， and peak body temperature （β=-0.446， P<0.001）. ConclusionFollowing the COVID-19 policy adjustment as a category B notifiable disease， healthcare workers at a grade A tertiary hospital in Shanghai predominantly experiences mild to moderate COVID-19 symptoms. Reinfection results in milder clinical manifestations， with a lower proportion of being asymptomatic.

Effect of naringenin regulating RIP1-RIP3-MLKL signaling pathway on apoptosis of ovarian granulosa cells in rats with polycystic ovary syndrome / 中国药理学通报

Aim Based on the apoptotic pathway mediated by receptor interacting protein kinase(RIP)1-RIP3-mixed spectrum kinase domain like protein(MLKL), to explore the effects of naringenin on ovarian granulosa cell apoptosis in rats with polycystic ovary syndrome(PCOS). Methods SD rats were randomly assigned into normal control group, model group, naringenin group, RIP1 inhibitor(Nec-1)group, RIP1-RIP3-MLKL necrosis signal activator(Z-VAD-fmk)group, naringenin+Z-VAD-fmk group, 15 rats per group. ELISA method was performed to measure the levels of IL-1β and TNF-α in ovarian tissue. HE method was performed to observe the shape of the ovary. Granular cells were isolated from ovarian tissue, and flow cytometry was performed to measure apoptosis rate and necrosis rate. Immunohistochemistry was performed to measure the positive expression of p-RIP1 in ovarian tissue. Western blot was employed to detect the expression of RIP1-RIP3-MLKL pathway. Results RIP1 specific inhibitor Nec-1 and naringenin could block the phosphorylation and activation of RIP1, inhibit the RIP1-RIP3-MLKL signaling pathway, reduce the inflammation level in PCOS rats, and alleviate the necrosis and apoptosis of ovarian granulosa cells(P<0.05). Z-VAD-fmk could promote the activation of RIP1-RIP3-MLKL pathway, aggravate the apoptosis of ovarian granulosa cells, and partially weaken the anti-apoptosis effect of naringenin(P<0.05). Conclusions Naringenin may inhibit the apoptosis of ovarian granulosa cells in PCOS rats by blocking the activation of the necrotic apoptotic pathway mediated by RIP1-RIP3-MLKL.

Identification and pedigree investigation of B(A) and cisAB blood groups / 中国输血杂志

【Objective】 To investigate the serological and molecular genetic characteristics of B(A) and cisAB blood groups discovered in our laboratory. 【Methods】 ABO blood group serology and genetic tests were used to identify blood groups of 6 blood samples, submitted by blood center and hospitals in Shandong, and pedigree investigation was carried on 2 of them. 【Results】 Among the 6 samples, serological results were B(A) in 5 cases and cisAB in 1 case. The results of genetic tests were consistent with the serological results, as the alleles included B(A)04, B(A)02 and cisAB01, and all genotypes were heterozygous with O. Serological pedigree study was conducted on 2 samples: One cisAB patient with his 4 relatives(cisAB type father and three O type relatives) and one B(A)02/O1 donor with his 3 relatives[ B(A) type father/brother and O type mother). For B(A)02/O1 donor, the results of genetic testing were consistent with the serological results, as the paternal genotype was the same as that of the proband, the younger brother was B(A)02/O2, and the maternal genotype was O1/O2. 【Conclusion】 The cisAB and B(A) blood groups are often indistinguishable by serological phenotypes and require genetic confirmation. CisAB pedigree investigation revealed 2 cases of cisAB blood type and B(A) pedigree investigation revealed 3 cases of B(A). The genotyping of cisAB and B(A) in this region were cisAB01/O2, B(A)02/O1, B(A)02/O2, B(A)04/O1 and B(A)04/O2. B(A)and cisAB subtypes can be accurately identified through genetic testing and pedigree investigation, which can provide a reliable basis for blood transfusion selection and ensure the safety of clinical blood transfusion.

Value of visual analysis and SUVR during 18F-AV45 PET/CT imaging in the diagnosis of mild cognitive impairment and Alzheimer′s disease / 中华核医学与分子影像杂志

Objective:To evaluate the value of visual analysis and standardized uptake value ratio (SUVR) during 18F-florbetapir (AV45) PET/CT brain imaging in diagnosis of β-amyloid (Aβ) deposition in patients with mild cognitive impairment (MCI) and Alzheimer′s disease (AD), and to explore the clinical ancillary value of the two indexes. Methods:From December 2018 to July 2019, a total of 47 subjects, including 5 (3 males, 2 females, age (58±13) years) normal controls (NC), 8 (2 males, 6 females, age (66±10) years) patients with AD and 34 (16 males, 18 females, age (70±7) years) patients with MCI were enrolled. All subjects underwent 18F-AV45 PET/CT scan. All images were evaluated by visual analysis and SUVR were calculated. The diagnostic efficiencies of visual analysis and SUVR were compared by McNemar test and Kappa test. One-way analysis of variance and Welch test were used to compare data differences. The best threshold value of SUVR was obtained by receiver operating characteristic (ROC) curve analysis. Results:The positive rate of Aβ deposition for all subjects was 46.81%(22/47) by SUVR analysis, and 38.30%(18/47) by visual analysis. There was no significant difference between the two methods ( χ2=33.15, P>0.05), and the consistency was good ( Kappa=0.83). Considering the clinical diagnosis as the"gold standard", the Aβ deposition obtained by visual analysis and SUVR analysis can effectively distinguish AD from NC, and the sensitivities were 7/8 vs 8/8, respectively, both specificities were 5/5( χ2=9.48, P>0.05), with good consistency ( Kappa=0.84). SUVR quantitative analysis could distinguish AD from NC, AD from MCI ( F values: 3.99-8.79, all P<0.01), but could not distinguish NC from MCI (all P>0.05). ROC curve analysis showed that the best threshold value of precuneus′ SUVR was 1.08 for the differential diagnosis of AD and NC; for the differential diagnosis of AD and MCI, the best threshold value of lateral temporal′s SUVR was 1.06. Conclusion:Visual analysis was consistent with SUVR′s qualitative determination during 18F-AV45 PET/CT imaging for brain Aβ deposition, while SUVR quantitative analysis could assist in the differential diagnosis of AD and NC, AD and MCI.

Nutritional recovery after discharge in hospitalized children with malnutrition / 中国当代儿科杂志

OBJECTIVE@#To investigate the nutritional recovery status of children with moderate or severe malnutrition during hospitalization after discharge.@*METHODS@#The children with moderate or severe malnutrition were given nutrition support during hospitalization. They received a regular follow-up and nutrition guidance after discharge. The weight-for-age and height-for-age Z-scores reaching above -2 SD were considered the nutrition criterion for ending follow-up.@*RESULTS@#Among the 298 children with moderate or severe malnutrition, 174 (58.4%) reached the criterion for ending follow-up, 100 (33.6%) were lost to follow-up, 18 (6.0%) died, and 6 (2.0%) did not reach the criterion for ending follow-up after 18 months of follow-up. The children with malnutrition in the department of surgery had a significantly higher proportion of children reaching the criterion for ending follow-up than those in the department of internal medicine (P<0.05). The children with severe malnutrition had a significantly higher loss to follow-up rate than those with moderate nutrition (P<0.05). The majority of children with emaciation reached the criterion for ending follow-up at month 3 after discharge, while those with growth retardation reached such the criterion at months 3-6 after discharge. Up to 1 year after discharge, more than 80% of the children with different types of malnutrition reached the nutrition criterion for ending follow-up.@*CONCLUSIONS@#Most of the children with malnutrition who adhere to follow-up can reach the expected nutrition criterion within 1 year after discharge. The children with growth retardation have slower nutritional recovery than those with emaciation.

Effects of light quality on growth and icariin flavonoid content of Epimedium pseudowushanense under different light intensity / 中国中药杂志

In this study, the growth index including plant height, compound leaf area, specific leaf area, leaf water content, number of branches, and leaf biomass per plant and the icariin flavonoids such as epimedin A, epimedin B, epimedin C and icariin of Epimedium pseudowushanense were determined on 30 d and 60 d under light intensity(18.2±2.5) μmol·m~(-2)·s~(-1)(L1) and(90.9 ±2.5) μmol·m~(-2)·s~(-1)(L2), and white light as control, red light, blue light and yellow light were used as three light quality treatments, to study the effect of light quality on the growth and flavonoids accumulation of E. pseudowushanense. The E. pseudowushanense was sui-table for growth under L1 light intensity, the blue light treatment significantly reduced the leaf area, but had little effect on the stem height, the red light treatment and the yellow light treatment had no obvious effect on the stem height and leaf area, but the yellow light treatment significantly increased the germination of new branches, and had a sustained promoting effect, and the biomass was significantly higher than the white light treatment at 60 d. The content of icariin flavonoids in red light, blue light and yellow light treatment was higher than that in white light treatment at 30 d and 60 d under L1 light intensity, while yellow light treatment promoted the synthesis of icariin flavonoids to the largest extent, which was 1.8 and 1.9 times of white light treatment(30 d and 60 d).Under L2 light intensity, the effect of strong light on promoting stem germination became the main factor, while the yellow light treatment showed no significant effect on promoting stem germination, and the red light treatment exhibited a significant effect on reducing leaf area. Icariin flavonoids under red light, blue light and yellow light treatment were all lower than that under white light treatment, that is, the effect of white light treatment on the synthesis of icariin flavonoids is better than red light, blue light and yellow light treatment. When the time of strong light treatment was longer, the degradation range of icariin flavonoids in other light treatment appeared, while red light treatment promotes the synthesis of icariin flavonoids. Therefore, the influence of light quality on E. pseudowushanense is quite different under different light intensity, no matter from growth index or flavonoid content index. The results support that the biomass and icariin flavonoid content can be increased by providing appropriate red and yellow light.

Diagnostic value of serum NSE, S100B protein and myocardial zymogram in premature infants with intrauterine infection / 中国基层医药

Objective@#To explore the diagnostic value of serum NSE, S100B protein and myocardial zymogram in premature infants with intrauterine infection.@*Methods@#From January 2016 to December 2017, 60 preterm infants with intrauterine infection in the Integrated Chinese and Western Medicine Hospital of Wenzhou were selected in the study.According to whether brain injury occurred, they were divided into brain injury group (28 cases) and non-brain injury group (32 cases). Serum NSE content was detected by chemiluminescence method, serum S100B protein level was detected by enzyme linked immunosorbent assay (ELISA), and serum CK and HBDH levels were detected by automatic biochemical analyzer.The serum levels of NSE, S100B, CK and HBDH were compared between the two groups, the combined diagnostic efficacy of NSE+ S100B protein+ CK+ HBDH was analyzed, the correlation of serum NSE, S100B protein, CK, HBDH with brain injury wasanalyzed.@*Results@#The levels of serum NSE [(2.43±0.54)μg/L] and S 100B [(14.36±3.21)ng/L] in the brain injury group were higher than those in the non-brain injury group [(0.97±0.27)μg/L and (8.10±1.87)ng/L] (t=13.498, 9.370, all P<0.05). The levels of serum CK [(437.64±54.12)U/L] and HBDH [(387.91±56.45)U/L] in the brain injury group were significantly higher than those in the non-brain injury group [(183.54±32.58)U/L and (174.3±26.63)U/L] (t=22.347, 19.126, all P<0.05). The sensitivity and specificity of the combined diagnosis of NSE+ S100B protein and myocardial zymogram were higher than those of each single index.Serum NSE, S100B protein, CK and HBDH were positively correlated with brain injury.@*Conclusion@#The elevation of serum NSE, S100B protein and myocardial zymogram in preterm infants with intrauterine infection after birth has certain clinical significance in judging whether brain injury occurs or not.

Advancing USP compendial methods for fixed dose combinations: A case study of metoprolol tartrate and hydrochlorothiazide tablets / 药物分析学报

The current United States Pharmacopeia–National Formulary (USP–NF) includes more than 250 mono-graphs of fixed dose combinations (FDCs), and some of them need to be updated due to incompleteness of impurity profiles and obsolescence of analytical methodologies. A case study of metoprolol tartrate and hydrochlorothiazide tablets is presented to summarize challenges encountered during the USP monograph modernization initiative of FDCs and to highlight an "adoption and adaptation" approach employed for method development. To this end, a single stability-indicating HPLC method was devel-oped to separate the two drug substances and eight related compounds with resolution 2.0 or higher between all critical pairs. Chromatographic separations were achieved on a Symmetry column (C18, 100 mm × 4.6 mm, 3.5 μm) using sodium phosphate buffer (pH 3.0; 34 mM) and acetonitrile as mobile phase in a gradient elution mode. The stability-indicating capability of this method has been demon-strated by analyzing stressed samples of the two drug substances. The developed HPLC method was validated for simultaneous determination of metoprolol tartrate and hydrochlorothiazide and relevant impurities in the tablets. Moreover, the developed method was successfully applied to the analysis of commercial tablet dosage forms and proved to be suitable for routine quality control use. The case study could be used to streamline USP's monograph modernization process of FDCs and strengthen compendial procedures.

Anticancer Effects of Constituents of Herbs Targeting Osteosarcoma / 中国结合医学杂志

Osteosarcoma is a rare primary malignancy of bone that is prone to early metastasis. Resection surgery and chemotherapeutic regimens are current standard treatments for osteosarcoma. However, the long-term survival rate of patients with osteosarcoma is low due to a high risk of metastasis. Hence, a new approach is urgently needed to improve the treatment of osteosarcoma. Compared with chemotherapy, natural active constituents isolated from herbs exhibit less adverse effects and better anti-tumor effects. This study aimed to summarize the anticancer effects of constituents of herbs on the progression and metastasis of osteosarcoma cells. It showed that many constituents of herbs inhibited osteosarcoma by targeting proliferation, matrix metalloproteinases, integrin and cadherin, and angiogenesis. The findings might be beneficial for the development of new drugs and treatment strategies.

Quantitative analysis of 3-isopropylamino-1,2-propanediol as a degradation product of metoprolol in pharmaceutical dosage forms by HILIC-CAD / 药物分析学报

Aryloxypropanolamine is an essential structural scaffold for a variety of β-adrenergic receptor antago-nists such as metoprolol. Molecules with such a structural motif tend to degrade into α, β-hydroxypropanolamine impurities via a radical-initiated oxidation pathway. These impurities are typically polar and nonchromophoric, and are thus often overlooked using traditional reversed phase chromatography and UV detection. In this work, stress testing of metoprolol confirmed the generation of 3-isopropylamino-1,2-propanediol as a degradation product, which is a specified impurity of metoprolol in the European Pharmacopoeia (impurity N). To ensure the safety and quality of metoprolol drug products, hydrophilic interaction chromatography (HILIC) methods using Halo Penta HILIC column (150 mm×4.6 mm, 5 μm) coupled with charged aerosol detection (CAD) were developed and optimized for the separation and quantitation of metoprolol impurity N in metoprolol drug products including metoprolol tartrate injection, metoprolol tartrate tablets, and metoprolol succinate extended-release tablets. These HILIC-CAD methods were validated per USP validation guidelines with respect to speci-ficity, linearity, accuracy, and precision, and have been successfully applied to determine impurity N in metoprolol drug products.

Ultrasound characteristics of testicular Leydig cell tumors , , , 1 / 中华男科学杂志

Objective@#To explore the color Doppler ultrasonic characteristics of testicular Leydig cell tumors (LCT) and improve the clinical diagnosis of the disease.@*METHODS@#We retrospectively analyzed 4 cases of testicular LCT diagnosed and treated in our hospital and summarized the experience in the ultrasonic diagnosis of LCT with a review of the relevant literature.@*RESULTS@#All the 4 testicular LCTs were solitary and quasi-round, 1 in the left and 3 in the right. The smallest mass was 1.8 × 1.5 cm and the largest 3.1 × 2.5 cm, and 2 were complicated by hydrocele of tunica vaginalis. The margins of tumors were distinct in 2 cases and indistinct in 1, and changed from distinct to indistinct in another during the follow-up. Hypoechoes were revealed in all the 4 cases in ultrasonography, 2 with abundant internal blood flow, 1 with abundant peripheral blood flow, and the other with abundant internal blood flow changed from circular blood flow surrounding the mass.@*CONCLUSIONS@#A typical sporadic LCT was ultrasonically manifested as an isolated hypoechoic infracentimetric mass with a clear demarcation from the adjacent pulp. It exhibited intrinsic hypervascularization associated with a typical peripheral rim pattern. Larger lesions more often presented a lobulated shape and intense hypervascularization. Although these ultrasonic characteristics do not reveal the nature of LCT with certainty, they can help the surgeon with the decision on testis-sparing surgery or perhaps even on the active monitoring for the smallest lesions in a population with impaired fertility.

PGL3 is required for chlorophyll synthesis and impacts leaf senescence in rice / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Rice leaf color mutants play a great role in research about the formation and development of chloroplasts and the genetic mechanism of the chlorophyll (Chl) metabolism pathway. pgl3 is a rice leaf color mutant derived from Xiushui11 (Oryza sativa L. spp. japonica), treated with ethyl methane sulfonate (EMS). The mutant exhibited a pale-green leaf (pgl) phenotype throughout the whole development as well as reduced grain quality. Map-based cloning of PGL3 revealed that it encodes the chloroplast signal recognition particle 43 kDa protein (cpSRP43). PGL3 affected the Chl synthesis by regulating the expression levels of the Chl synthesis-associated genes. Considerable reactive oxygen species were accumulated in the leaves of pgl3, and the transcription levels of its scavenging genes were down-regulated, indicating that pgl3 can accelerate senescence. In addition, high temperatures could inhibit the plant's growth and facilitate the process of senescence in pgl3.

Therapeutic effect of pingyangmycin injection combined with hypercator resection under suspension laryngoscope on laryngopharyngeal hemangioma / 第二军医大学学报

Objective To observe the clinical effect of pingyangmycin injection combined with hypercator resection on laryngopharyngeal and laryngeal hemangioma under suspension laryngoscope. Methods Twenty-seven patients with laryngopharyngeal or laryngeal hemangioma were included. After trachea cannula via mouth and general anesthesia, the suspension laryngoscope was used to completely uncover the hemangioma, and 8 mg pingyangmycin (diluted with 6 mL saline injection) was locally injected into the tumor. And then the tumor was completely resected along its root by polypus forceps-like hypercator or was completely coagulated by electric coagulation. The intra-operative and post-operative bleeding were recorded, and the patients were given liquid diets after surgery for two weeks. The fibrolaryngoscope was reviewed to judge the curative effect at 1 month, 3 months, 1 year, 2 years, and 3 years after surgery. Results The pink or prunosus tumor turned into pinkish-white tumor after injection of pingyangmycin. When the root pedicle of the tumor was revealed by forceps holder, the polypus forceps-like hypercator could completely resect the tumor along the base of root, nearly without bleeding in the operation; when the root pedicle was big or could not be revealed, the tumor could be completely coagulated by electric coagulation. After surgery, no patients had dyspnea or wound bleeding. One month later, fibrolaryngoscope showed that the wound was repaired with pink normal mucosa. No recurrence was found in all cases after follow-up for 1 year. After 2 years of follow-up, one case had flaky purple uplift of the pharyngeal wall mucosa, and the tumor was completely resected by the above treatment. No recurrence was found after 3 years of follow-up. Conclusion Hypercator resection after local injection of pingyangmycin under suspension laryngoscope can completely resect the lesions, with less surgery trauma and quick recovery, suggesting that the treatment has affirmative efficacy and is worth popularizing.

Influencing factors of treatment compliance to automatic continuous positive airway pressure for obstructive sleep apnea-hypopnea syndrome / 第二军医大学学报

Objective To explore the factors influencing patient compliance to automatic continuous positive airway pressure (auto-CPAP) treatment in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Retrospective analysis was done on 102 patients diagnosed as OSAHS by polysomnography (PSG), who were treated for sleep snoring symptoms between Oct. 2016 and Dec. 2017. All patients received auto-CPAP treatment. The age, gender, body mass index (BMI), Epworth sleepiness scale (ESS) score, nasal obstruction symptom evaluation (NOSE) score and Mallampati score were recorded and analyzed. The patients were divided into compliance group and non-compliance group by the Kribbs standard, and χ2 test and two sample t test were used to analyze the differences of the above indicators between the two groups. Logistic regression model was used to evaluate the risk factors of treatment compliance of OSAHS by auto-CPAP. Results The 102 patients, aged (42.2±10.0) years (ranging from 31 to 83 years), included 89 males and 13 females. Sixty-five (63.7%) patients had good compliance and were assigned to the compliance group, and 37 (36.3%) patients had poor compliance and were assigned to the non-compliance group. The ESS score, NOSE score and Mallampati score were significantly different between the two groups (all P0.05). Logistic regression analysis showed that the ESS score (OR=1.183, 95% CI 1.046-1.338; P= 0.008) and Mallampati score (OR=2.075, 95% CI 1.121-3.839; P=0.020) were independent risk factors of compliance. Conclusion ESS score, NOSE score, and Mallampati score are the influencing factors of treatment compliance to auto- CPAP in the OSAHS patients. ESS score and Mallampati score are the independent risk factors for treatment compliance.

Measurement Uncertainty Assessment for Determination of Allura Red in Puffed Food by HPLC / 华中科技大学学报（医学）（英德文版）

This study aimed to assess the measurement uncertainty of a new method for determination of allura redin food by high performance liquid chromatography (HPLC).The uncertainty of mathematical model of allura red is based on Europe for Analytical Chemistry(EURACHEM) guidelines.The sources and components of uncertainty were calculated,including recovery,working solution,sample mass,final volume,response of standard solution,response of sample solution.The expanded uncertainty was 0.0024 (k=2).Uncertainty of working solution was the most significant factor contributing to the total uncertainty,accounting for 86.2％.The uncertainty of volume accounted for the minimum at 0.025％.The developed method is simple and accurate,which can be used for the determination of allura redin puffed samples.

Measurement Uncertainty Assessment for Determination of Allura Red in Puffed Food by HPLC / 华中科技大学学报（医学）（英德文版）

This study aimed to assess the measurement uncertainty of a new method for determination of allura redin food by high performance liquid chromatography (HPLC).The uncertainty of mathematical model of allura red is based on Europe for Analytical Chemistry(EURACHEM) guidelines.The sources and components of uncertainty were calculated,including recovery,working solution,sample mass,final volume,response of standard solution,response of sample solution.The expanded uncertainty was 0.0024 (k=2).Uncertainty of working solution was the most significant factor contributing to the total uncertainty,accounting for 86.2％.The uncertainty of volume accounted for the minimum at 0.025％.The developed method is simple and accurate,which can be used for the determination of allura redin puffed samples.

Pulsed electromagnetic fields improve bone mineral density and bone metabolism after stroke / 中华物理医学与康复杂志

Objective To investigate the effect of a pulsed electromagnetic field ( PEMFS) on bone mineral density and bone metabolism in males with osteoporosis after a stroke. Methods Fifty male stroke survivors with os-teoporosis were randomly divided into a control group and a treatment group, both of 25. Both groups were treated with routine rehabilitation, oral calcium carbonate and vitamin D3 tablets, while the treatment group was additionally pro-vided with PEMFS treatment. The subjects′bone mineral density ( BMD) and their blood levels of bone-specific alka-line phosphatase (B-ALP), type I procollagen amino-terminal peptide (PINP) and type β-I collagen cross-linked carboxy-terminal peptide (β-CTx) were measured before and after the 12 weeks of treatment. Results After the treatment the BMD values of the lumbar spine, femoral neck, trochanter and Ward′s triangle had increased signifi-cantly in both groups, but the average BMD values of the lumbar spine and femoral neck in the treatment group were significantly higher than those of the control group. After the treatment, the average B-ALP, PINP andβ-CTx levels of both groups had also improved significantly compared with before the treatment, but the average improvement in all three among the treatment group was significantly greater than among the controls. Conclusion PEMFS treatment supplementing routine rehabilitation, oral calcium carbonate and vitamin D3 tablets can improve bone formation, re-duce bone resorption and increase bone mineral density in men after a stroke.

Diagnostic efficacy of inflammatory markers in maternal and umbilical cord blood in histologic chorioamnionitis / 中华围产医学杂志

Objective To explore the clinical value of maternal and umbilical blood inflammatory markers,interleukin-6 (IL-6),neutrophil-to-lymphocyte ratio (NLR),C-reactive protein (CRP) and procalcitonin (PCT),in the diagnosis of histologic chorioamnionitis (HCA).Methods A total of 102 suspected chorioamnionitic cases were enrolled from January 2014 to July 2017.They were assigned into two groups based upon postpartum histopathological examination of placenta:HCA group (48 cases) and control group (54 cases).Maternal and umbilical blood samples were collected for routine blood test and tested for IL-6,NLR,CRP and PCT levels.T,Mann-Whitney U or Chi-square (or Fisher's exact) test was used for data comparison.Meaningful indicators in maternal and umbilical cord blood were analyzed by logistic regression analysis and correlation analysis.At the same time,receiver operating characteristic (ROC) curve was drawn to evaluate their diagnostic values.Results (1) IL-6 level and NLR in maternal blood in HCA group were higher than those in control group [6.95 (2.40-13.50) vs 3.90 (2.30-9.20) pg/ml,Z=-5.147;5.03 (1.92-9.20) vs 3.94 (1.85-11.17),Z=-3.097;both P＜0.05],and the levels of white blood cells,neutrophile granulocytes,CRP and IL-6 as well as NLR in umbilical cord blood were also higher [(9.4± 2.0)× 109/L vs (8.6 ± 1.4)× 109/L,t=-2.522;(6.87t1.62)× 109/L vs (5.99± 1.26)× 109/L,t=-3.071;12.30 (0.50-89.04) vs 3.18 (0.50-88.93) mg/L,Z=-4.519;(8.78±2.56) vs (4.78±1.45) pg/ml,t=-7.025;(4.45±1.36) vs (3.78±1.22),t=-3.020;all P＜0.05].(2) Logistic regression analysis showed that elevated levels of IL-6 and NLR in maternal blood and CRP and IL-6 in umbilical cord blood were independent risk factors for HCA [OR (95％CI):1.65 (1.32-2.06),1.34 (1.02-1.77),1.05 (1.00-1.11) and 2.39 (1.72-3.32),all P＜0.05].Positive correlations were found between the levels of IL-6 in maternal and umbilical cord blood,and between NLR in maternal blood and CRP level in umbilical cord blood (correlation coefficient:0.680 and 0.230,both P＜0.05).(3) IL-6 level in umbilical blood was of the greatest value in the diagnosis of HCA among all single markers,followed by IL 6 in maternal blood,CRP in umbilical blood and NLR in maternal blood [area under the ROC curve (AUC):0.904,0.796,0.760 and 0.678].When two indexes were combined,NLR in maternal blood+IL 6 in umbilical cord blood showed the highest diagnostic value,followed by,IL 6 in maternal blood+CRP in umbilical cord blood,IL-6+NLR in maternal blood and NLR in maternal blood+CRP in umbilical cord blood (AUC:0.917,0.870,0.823 and 0.791).When three indexes was used in combination,the diagnostic value of IL-6 in maternal and umbilical cord blood+NLR in maternal blood was higher than that of IL-6 and NLR in maternal blood+CRP in umbilical cord blood (AUC:0.919 and 0.836).(4) There were 13 cases (27.1％) with neonatal complications in HCA group and two (3.7％) in control group (P＜0.05).Conclusions Changes in NLR and IL-6 levels in maternal blood and NLR,IL-6 and CRP levels,and white blood cells and neutrophile granulocytes counts in umbilical cord blood are associated with HCA.The diagnostic efficacy of two indexes combined is superior to that of single index,while the combination of three indexes can significantly improve the diagnostic accuracy and authenticity.

Clinical study of 3g/L sodium hyaluronate eye drops with bromhexine hydrochloride tablets for dry eye / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To investigate the clinical efficacy of 3g/L sodium hyaluronate eye drops combined with bromhexine hydrochloride tablets on the treatment of dry eye. ·METHODS: Totally 200 patients with dry eye were randomly divided into the control group (n= 100) and observation group (n=100). Patients in two groups were given 3g/L sodium hyaluronate eye drops and physiotherapy. On the basis of this, the observation group were treated with bromhexine hydrochloride tablets. The inflammatory factors (IL-6, IL-10, TNF-α and IL-1β) levels and ocular symptom scores (OSDI, BUT, S Ⅰ t, FL) in the two groups were compared between before and after treatment. And the clinical efficacy and adverse reactions were evaluated. ·RESULTS: After treatment, the IL-6, IL-10, TNF-α, IL-1β, OSDI and FL scores in two groups were significantly lower than those before treatment, and BUT and SⅠt were significantly higher than those before treatment. Moreover, the improvement degree of the above indexes in the observation group were better than those in the control group, showing statistically significant difference (P<0.05). The total effective rate of the observation group was higher than that of the control group (χ2=5.531,P=0.019), but there was no significant difference in the incidence of adverse reactions between the two groups (χ2=0.307,P=0.579). ·CONCLUSION:As for the patients with dry eye, the combination of 3g/L sodium hyaluronate eye drops with bromhexine hydrochloride tablets can significantly decrease the level of inflammatory factors, improve the eye symptoms and the clinical total efficiency, without increasing treatment-related adverse effects.

Efficacy and Safety of Tacrolimus versus Cyclosporine A for Idiopathic Membranous Nephropathy:A Network Meta-analysis / 中国医学科学院学报

Objective To compare the efficacy and safety of tacrolimus with those of cyclosporine in treating idiopathic membranous nephropathy (IMN) via network meta-analysis. Methods Databases including PubMed,Embase,CENTRAL (Cochrane),Wanfang Database,CNKI,and VIP citation database were searched for relevant studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Package Meta 4.5.0 and Gemtc 0.8.1 in R 3.3.1 were used to analyze the included studies. Results In this network meta-analysis,the complete remission rate (RR=0.98,95% CI:0.70-1.40)and the total remission rate (RR=1.00,95% CI:0.90-1.20)of idiopathic membranous nephropathy did not differ significantly between IMN patients treated with cyclosporine A or tacrolimusand,nor did the incidences of hepatic dysfunction(RR=1.40,95% CI:0.52-4.00),infection(RR=0.75,95% CI:0.18-3.10),or gastrointestinal syndrome(RR=2.1,95% CI:0.36-28.00). Conclusion Cyclosporine A seems to have similar effectiveness and safety to tacrolimus in treating IMN.