Radiomics model based on CT images for distinguishing invasive lung adenocarcinoma with micropapillary or solid structure / 中国胸心血管外科临床杂志

@#Objective    To investigate the radiomics features to distinguish invasive lung adenocarcinoma with micropapillary or solid structure. Methods    A retrospective analysis was conducted on patients who received surgeries and pathologically confirmed invasive lung adenocarcinoma in our hospital from April 2016 to August 2019. The dataset was randomly divided into a training set [including a micropapillary/solid structure positive group (positive group) and a micropapillary/solid structure negative group (negative group)] and a testing set (including a positive group and a negative group) with a ratio of 7∶3. Two radiologists drew regions of interest on preoperative high-resolution CT images to extract radiomics features. Before analysis, the intraclass correlation coefficient was used to determine the stable features, and the training set data were balanced using synthetic minority oversampling technique. After mean normalization processing, further radiomics features selection was conducted using the least absolute shrinkage and selection operator algorithm, and a 5-fold cross validation was performed. Receiver operating characteristic (ROC) curves were depicted on the training and testing sets to evaluate the diagnostic performance of the radiomics model. Results    A total of 340 patients were enrolled, including 178 males and 162 females with an average age of 60.31±6.69 years. There were 238 patients in the training set, including 120 patients in the positive group and 118 patients in the negative group. There were 102 patients in the testing set, including 52 patients in the positive group and 50 patients in the negative group. The radiomics model contained 107 features, with the final 2 features selected for the radiomics model, that is, Original_ glszm_ SizeZoneNonUniformityNormalized and Original_ shape_ SurfaceVolumeRatio. The areas under the ROC curve of the training and the testing sets of the radiomics model were 0.863 (95%CI 0.815-0.912) and 0.857 (95%CI 0.783-0.932), respectively. The sensitivity was 91.7% and 73.7%, the specificity was 78.8% and 84.0%, and the accuracy was 85.3% and 78.4%, respectively. Conclusion    There are differences in radiomics features between invasive pulmonary adenocarcinoma with or without micropapillary and solid structures, and the radiomics model is demonstrated to be with good diagnostic value.

Adrenal cortical carcinoma in children: a clinicopathological analysis of 25 cases / 中华病理学杂志

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of adrenal cortical carcinoma (ACC) in children. Methods: Twenty-five children with ACC diagnosed in the Department of Pathology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China from March 2014 to August 2022 were retrospectively analyzed. The related literature was reviewed. Results: A total of 25 children with ACC were collected, including 11 males and 14 females, with a male to female ratio of 1.0∶1.3. The patient ages ranged from 8 months to 14 years (median, 4 years). Eighteen cases with clinical data had functional tumors (18/22, 81.8%) presenting with virilization or precocious puberty (15/18), symptoms related to hypercortisolism (8/18) or endocrine symptoms mixed with both (5/18), while 3 cases (3/22, 13.6%) had unknown clinical data. The clinical manifestations of four patients with nonfunctional tumors were an abdominal mass and/or abdominal pain, walking instability and others. Grossly, the average maximum diameter of the tumor was 9.4 cm. Most of the tumors were nodular and partially encapsuled. The cut surfaces were gray or gray brown, soft with hemorrhage. Histologically, the tumor cells were diffusely distributed, separated by a vascular-rich network. The tumor cells were large, with distinct nucleoli, abundant eosinophilic or clear cytoplasm, and round or oval nuclei. The mitotic index was high, and atypical mitoses were common. Necrosis, calcification, capsule invasion or/and venous invasion were present. In some cases, the tumor invaded the surrounding soft tissues or kidneys. Immunohistochemically, the tumor cells were diffusely positive for syn and SF1 and focally positive for α-inhibin, Melan A and Calretinin, but negative for CgA. Ki-67 proliferation index ranged from 2%-90%. TP53 gene status was examined in 7 cases, in which mutations were detected in 4 cases. Follow-up data was obtained in 21 patients, among whom 18 received chemotherapy and 3 received radiotherapy. Distant metastasis occurred in 13 patients. Median progression-free survival (PFS) was 11.2 months and median overall survival (OS) was 54.7 months. Patients aged less than 5 years had a better prognosis for OS (P<0.05) than the older ones (≥5 years), but a similar PFS (P>0.05). Male patients and Ki-67 proliferation index <15% had a better prognosis tendency for OS, but there was no statistically significant difference (P>0.05). Conclusions: ACC in children is a rare, often functional tumor associated with Li-Fraumeni genetic syndrome and has a poor prognosis. Diagnosis and differential diagnosis require a combination of morphological, phenotypic and clinical analysis.

Cognitive frailty in older patients with chronic heart failure and its influencing factors / 中华老年医学杂志

Objective:To investigate the characteristics of cognitive frailty and its influencing factors in older patients with chronic heart failure.Methods:In this cross-sectional study, 300 older patients hospitalized for chronic heart failure in a tertiary hospital in Shandong Province between September 2021 and September 2022 were selected.A general information questionnaire, the mini-nutritional assessment scale-short form(MNA-SF), the athens insomnia scale(AIS), the ulca loneliness scale, the geriatric depression scale-5 item version(GDS-5), and the social support rating scale(SSRS)were used for assessment and influencing factors were identified by univariate and Logistic regression analysis.Results:Among 300 older patients with chronic heart failure, the prevalence of cognitive frailty was 75.3%(226 cases). Logistic regression analysis showed that age between 70-79 years( OR=0.543, 95% CI: 0.299-0.987), education level( OR=3.644, 95% CI: 1.780-7.461), weekly intellectual activity( OR=2.168, 95% CI: 1.082-4.334)and loneliness( OR=1.101, 95% CI: 1.032-1.175)were factors influencing cognitive frailty in older patients with chronic heart failure. Conclusions:The prevalence of cognitive frailty in older patients with chronic heart failure is high, and age, education level, weekly intellectual activity and loneliness are influencing factors, with education level having the greatest impact on older patients with chronic heart failure.

Analysis of urinary iodine level in Hashimoto thyroiditis patients / 安徽医科大学学报

Objective @#To analyze the difference of urinary iodine level in Hashimoto thyroiditis ( HT) patients， and to explore the possible relationship between urinary iodine level and HT under different iodine nutritional sta- tus，so as to provide some references for reasonable iodine intake in HT patients．@*Methods @#A total of 101 hospi- talized HT patients were selected as HT group and divided into 3 groups according to thyroid function : HT group with hyperthyroidism (41 cases) ．There were 25 cases in HT group with normal thyroid function．There were 35 cases in HT combined with hypothyroidism group．In addition，30 healthy subjects were selected as control group. Serum levels of thyroid stimulating hormone(TSH) ，triiodothyronine(T3 ) ，thyroxine (T4 ) ，thyroid peroxidase an- tibody (TPOAb) and thyroglobulin antibody (ATG) were detected by chemiluminescence assay．The size and mor- phological structure of thyroid organs were examined by ultrasonography．Urinary iodine was determined by catalytic spectrophotometry with arsenic and cerium．The nutritional status of iodine was classified into iodine deficiency ( < 100 μg/ L) ，iodine adequacy( 100 －199 μg/ L) ，iodine adequacy (200 －299 μg/ L) and iodine excess ( ≥ 300 μg/ L) ．Non-parametric test was used to compare urinary iodine level between HT group and control group，one- way ANOVA and t test were used to compare urinary iodine level between HT group and control group ，and Spearman correlation analysis was used to compare the correlation between urinary iodine level and T3 ，T4 ，TSH， ATG and TPOAb under different iodine nutrition status. @*Results @#Compared with control group，ATG and TPOAb levels in HT group increased (P＜0. 001) ，and urinary iodine levels increased (P＜0. 05) ，with statistical signifi- cance．Compared with the control group in different thyroid function states，only the HT group with hypothyroidism increased the urinary iodine level (P＜0. 01) ，and the difference was statistically significant．Spearman correlation analysis showed that urine iodine level was positively correlated with ATG and TPOAb levels in iodine excess condi- tion (P＜0. 05) ，and urine iodine level was positively correlated with TSH level in iodine sufficient condition and iodine excess condition in HT patients (P＜0. 05) ．@*Conclusion @#The urinary iodine level of HT patients was high- er than that of normal people．When the urinary iodine level of residents is ≥ 300 μg/ L，iodine intake is prone to HT．When the urinary iodine level of HT patients is ≥ 200 μg/ L，iodine consumption is prone to hypothyroidism， and iodine intake should be limited.

Dynamic Interactive Reasoning and Intelligent Dialectics of Chinese Medicine Based on Probability Graph / 世界科学技术-中医药现代化

This paper proposes a mathematical model based on probability graphs and an algorithm of iterative reasoning,which is an automatic interactive question-and-answer mathematical model based on the classic TCM syndrome differentiation system and the theory of prescription and syndrome correspondence.It is used for TCM online interactive consultation and automatic syndrome differentiation analysis to improve the effectiveness of remote TCM clinical consultation and help TCM artificial intelligence assist syndrome differentiation.This model can express the clinician's experience in syndrome differentiation,and reflect his ability to accumulate and apply knowledge of ancient Chinese books,which is conducive to the inheritance and development of TCM physicians'personal experience.The model is scalable and configurable,and can continuously accumulate experience in dialectics and knowledge of traditional Chinese medicine.The use of iterative reasoning algorithm can realize the automatic analysis and reasoning of more optimized syndrome analysis results through brief interactive question and answer,providing more efficient and convenient practical assistance for clinical diagnosis and treatment of traditional Chinese medicine,which is conducive to accelerating the inheritance and promotion of traditional Chinese medicine,and is conducive to the expansion of Chinese medicine.The mass basis and market supply of medical diagnosis and treatment services have far-reaching social benefits.

Research progress on the assessment method of carers′ fall concern for the elderly / 中国实用护理杂志

This paper focused on the research progress of the assessment methods of carers′ fall concern for the elderly. The content of this review included the definition of carers′ fall concern, and the advantages and disadvantages of various assessment method of carers′ fall concern for the caregivers to the elderly, such as qualitative interviews, questionnaires, and scales. Through this review, the authors hoped to provide a reference for selecting or developing a localized carers′ fall concern assessment tool.

Secondary type 1 narcolepsy after traumatic brain injury: a case report / 中华神经科杂志

Type 1 narcolepsy is a rare central nervous system disorder that is believed to result from the interaction of environmental and genetic factors. Traumatic brain injury (TBI) is one of the most common causes of secondary narcolepsy. Currently, there are very few reports on post-TBI narcolepsy, and this patient is the first reported case of HLA-DQB1 *06:02-positive type 1 narcolepsy following TBI in China. The clinical data of this patient are retrospectively analyzed to improve the understanding of the diagnosis and pathogenesis of the disease among clinicians.

Correlation between the quartering method of nerve root subsidence sign and the cross-sectional area of the narrow segment thecal sac in patients with lumbar spinal stenosis / 中国医师杂志

Objective:To study the correlation between the quartering of nerve root subsidence sign (NRS) and the cross-sectional area (CSA) of the narrow segment thecal sac in patients with lumbar spinal stenosis (LSS).Methods:The data of 203 LSS patients in the Fourth People′s Hospital of Hengshui from January 2020 to December 2021 were retrospectively analyzed. All patients underwent MRI cross sectional scanning. The patients were divided into positive type a group ( n=62), positive type b group ( n=32), positive type c group ( n=51), and negative group ( n=58) by NRS quartering method. The minimum CSA, median sagittal diameter (PAD), and lateral recess sagittal diameter of each group were compared. The correlation between NRS quartering classification and the minimum CSA and related indicators of lumbar spinal stenosis was analyzed. Results:The minimum CSA, PAD, and sagittal diameter of the lateral recess in the positive a group, positive b group, and positive c group were all smaller than those in the negative group, while the Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI) were higher than those in the negative group; The minimum CSA, PAD, and sagittal diameter of the lateral recess in the positive b type and positive c type groups were smaller than those in the positive a type group, while the VAS score and ODI index were higher than those in the positive a type group; The minimum CSA, PAD, and sagittal diameter of the lateral recess in the positive c type group were smaller than those in the positive b type group; The VAS score and ODI index were higher than those of the positive b type group; The differences were statistically significant (all P<0.05). 203 patients were divided into 54 normal cases, 58 mild stenosis cases, 49 moderate stenosis cases, and 42 severe stenosis cases based on the minimum CSA. The coincidence rate between negative NRS and minimal CSA diagnosis as normal was 94.44%(51/54), the coincidence rate between positive type a and minimal CSA diagnosis as mild stenosis was 84.48%(49/58), the coincidence rate between positive type b and minimal CSA diagnosis as moderate stenosis was 53.06%(26/49), and the coincidence rate between positive type c and minimal CSA diagnosis as severe stenosis was 90.48%(38/42). Using the kappa consistency test, the kappa value for quantitative diagnosis of minimum CSA stenosis in NRS and LSS patients was 0.743, indicating good consistency. The kappa values for quantitative diagnosis of NRS, sagittal diameter of lateral recess, and PAD stenosis were 0.271 and 0.335, with poor consistency. NRS typing was negatively correlated with CSA and PAD ( r=-0.723, -0.581, all P<0.001), and positively correlated with VAS score and ODI index ( r=0.473, 0.640, all P<0.001). Conclusions:The NRS quartering method has a good consistency in diagnosing the severity of LSS patients and the minimum CSA of stenosis segments, suggesting that the NRS quartering method can better reflect the degree of Spinal stenosis, which can not only be used as an auxiliary indicator for qualitative diagnosis of LSS, but also has a high value in quantitative diagnosis.

Evaluation of brainstem function using vestibular evoked myogenic potentials in patients with early-stage Parkinson′s disease / 中华神经科杂志

Objective:To investigate whether vestibular-evoked myogenic potentials (VEMP) can be used to assess brainstem and its supplementary diagnostic value in patients with early-stage Parkinson′s disease (PD).Methods:A total of 123 patients with early-stage PD (PD group) diagnosed in the Department of Neurology of the Second Affiliated Hospital of Soochow University from January 2019 to January 2022 were consecutively enrolled, and 122 healthy controls (healthy control group) were included. Cervical VEMP (cVEMP) and ocular VEMP (oVEMP) examinations were performed on all subjects. VEMP parameters between the 2 groups were compared, and receiver operating characteristic curve was used to evaluate the auxiliary diagnostic efficacy of VEMP for early-stage PD. Correlations between VEMP parameters and motor and non-motor symptoms such as autonomic dysfunction were analyzed in the PD group using Spearman correlation analysis.Results:Bilateral latencies of cVEMP [left P1 latency (Lp13): 19.0 (16.4, 20.9) ms vs 13.1(12.0, 14.2) ms, Z=-11.18, left N1 latency (Ln23): 27.4 (24.6, 29.9) ms vs 21.2 (19.8, 23.0) ms, Z=-10.14; right P1 latency (Rp13): 18.8 (16.2, 20.9) ms vs 13.0 (11.7, 14.1) ms, Z=-10.84, right N1 latency (Rn23): 27.7 (24.3, 29.7) ms vs 21.1 (19.6, 22.9) ms, Z=-10.50] and bilateral latencies of oVEMP [left N1 latency (Ln10): 12.7 (10.7, 14.4) ms vs 10.4 (9.7, 11.4) ms, Z=-8.02, left P1 latency (Lp15): 16.5 (15.1, 18.3) ms vs 14.5 (13.4, 15.3) ms, Z=-7.96; right N1 latency (Rn10): 12.8 (11.4, 14.0) ms vs 10.5 (9.7, 11.5) ms, Z=-8.85, right P1 latency (Rp15): 16.7 (15.3, 18.3) ms vs 14.4 (13.3, 15.1) ms, Z=-9.39] of the PD group significantly prolonged compared to the healthy control group (all P<0.001). Compared to the healthy control group, the area under the curve (AUC) values of Lp13, Ln23, Rp13 and Rn23 of cVEMP in the PD group were all greater than 0.7, and the AUC values of Lp13 and Rp13 in the PD group were greater than 0.9 (all P<0.001); the AUC values of Ln10, Lp15, Rn10, and Rp15 of oVEMP in the PD group were all greater than 0.7 (all P<0.001). The Rn10-p15 corrected amplitude in PD patients was positively correlated with levodopa equivalent dose ( r=0.21, P=0.020). The Rn10 in PD patients was positively correlated with the Non-Motor Symptoms Questionnaire scores ( r=0.21, P=0.023). The Lp13-n23 corrected amplitude was negatively correlated with the Scale for Outcomes in Parkinson′s Disease-Autonomic scores ( r=-0.20, P=0.023). There was no significant correlation between VEMP parameters and Unified Parkinson′s Disease Rating Scale part Ⅲ score ( P>0.05). Conclusion:VEMP, especially cVEMP, as a non-invasive neuroelectrophysiological index, is an objective marker for brainstem damage and could be used for screening early-stage PD patients.

Study on preventive and therapeutic effect of Tongbu-fangchan prescription on Ach-CaCl / 中国药理学通报

Aim To explore he preventive and therapeutic effects of Tongbu-fangchan prescription on aceylcholine-calcium chloride (Ach-CaCl

Research progress of endothelial-mesenchymal transdifferentiation in fibrotic diseases / 中国药理学通报

Fibrosis is a repair response initiated by tissues and organs after injury, and is a self-protection mechanism of the body. It has been found that endothelium-to-interstitial transdifferentiation (EndMT) is involved in the physiological and pathological processes of various organ fibrosis, which has become a focus of the research on fibrotic diseases. In recent years, the study has found that EndMT plays an important role in many pathological processes in cardiovascular system, lungs, kidneys, liver, pancreas fibrosis, and so on. This article summarizes EndMT regulatory mechanism and its role in each organ fibrosis, as well as the related treatment progress of EndMT targets, so as to provide new targets for prevention and control of organ fibrosis.

Novel STING-targeted PET radiotracer for alert and therapeutic evaluation of acute lung injury

Acute lung injury (ALI), as a common clinical emergency, is pulmonary edema and diffuse lung infiltration caused by inflammation. The lack of non-invasive alert strategy, resulting in failure to carry out preventive treatment, means high mortality and poor prognosis. Stimulator of interferon genes (STING) is a key molecular biomarker of innate immunity in response to inflammation, but there is still a lack of STING-targeted strategy. In this study, a novel STING-targeted PET tracer, [18F]FBTA, was labeled with high radiochemical yield (79.7 ± 4.3%) and molar activity (32.5 ± 2.9 GBq/μmol). We confirmed that [18F]FBTA has a strong STING binding affinity (Kd = 26.86 ± 6.79 nmol/L) and can be used for PET imaging in ALI mice to alert early lung inflammation and to assess the efficacy of drug therapy. Our STING-targeted strategy also reveals that [18F]FBTA can trace ALI before reaching the computed tomography (CT) diagnostic criteria, and demonstrates its better specificity and distribution than [18F]fluorodeoxyglucose ([18F]FDG).

Research progress on the influencing factors of health literacy in patients with coronary heart disease based on the perspective of health ecology / 中国实用护理杂志

The self-health management level of patients with coronary heart disease depends largely on their health literacy level. The theory of health ecology believes that the factors affecting individual health are multi-level. Based on the perspective of health ecology, this paper analyzed the influencing factors of health literacy of patients with coronary heart disease from five aspects: personal characteristics, behavior, interpersonal network, living and working conditions, environmental policies, so as to provide a basis for formulating targeted and systematic strategies for improving the health literacy of patients with coronary heart disease in the future.

Analysis of risk factors and construction of risk prediction model of cognitive dysfunction in patients with atrial fibrillation / 中国实用护理杂志

Objective:To identify the risk factors of cognitive dysfunction in patients with atrial fibrillation and to establish a risk prediction model.Methods:The convenience sampling method was used to evaluate 260 patients with atrial fibrillation who were hospitalized in the Department of Cardiology of the Affiliated Hospital of Jining Medical College from January to December 2020. The cognitive function of the patients was evaluated with the Montreal Cognitive Function Assessment Scale (MoCA). Univariate analysis was used to screen the independent variables that had influence on the occurrence of cognitive dysfunction, and the statistically significant variables were included in the multivariate Logistic regression model. According to the regression coefficients of statistically significant variables, a line map was drawn to construct the risk prediction model of cognitive dysfunction in patients with atrial fibrillation.Results:There were 209 cases with cognitive impairment and 51 cases without cognitive impairment. Univariate analysis showed that sex, age, smoking history, drinking history, education level, free thyroxine, hemoglobin, D-dimer and BMI ( χ2 values were 4.08-18.83, t values were -6.04-2.94, Z=-2.76) were significantly different between the patients with or without cognitive dysfunction. The results of multivariate Logistic regression analysis showed that age ( OR values were 1.13), education level ( OR=0.01-0.05), quit smoking history ( OR=0.36), drinking history ( OR=0.35) and free thyroxine( OR=1.14) had significantly statistical significance ( P<0.05). The area under ROC curve (AUC) = 0.878 and AUC>0.8, this model had good clinical prediction ability. Conclusions:The construction of cognitive dysfunction risk prediction model for patients with atrial fibrillation can prevent or intervene high risk factors in advance, facilitate clinical use, and provide data support for the improvement of cognitive function in patients with atrial fibrillation.

Cross-cultural adaptation, preliminary validity and reliability and modification of the Chinese Version of the KING′s Parkinson′s Disease Pain Scale / 中华神经科杂志

Objective:To perform cross-cultural adaption of the KING′s Parkinson′s Disease Pain Scale (KPPS), explore its reliability and validity in Chinese Parkinson′s disease (PD) patients, and to create the new version of the pain scale which adapts to the Chinese PD patients.Methods:This study enrolled 225 patients, including 121 men and 104 women who were selected from the Outpatient Center of Movement Disorders Clinic of the Second Affiliated Hospital of Soochow University from July 2018 to July 2020. All patients completed the evaluation of the Chinese Version of KPPS (KPPS-CV). According to the preliminary evaluation results, the expert group modified KPPS-CV after discussion, and developed a Modified KPPS-CV (MKPPS-CV). These patients then completed the MKPPS-CV evaluation during the 3-month follow-up. Cross-cultural adaptation was performed according to published international guidelines that include translation, back-translation, expert review, and pretesting. The following psychometric properties were evaluated: basic item analysis; floor and ceiling effects; construct validity; content validity; criterion validity (Spearman′s rho between the KPPS-CV and Numeric Rating Scale); internal consistency reliability (Cronbach′s alpha); test-retest reliability (intra-class correlation coefficient, ICC).Results:In item analysis, 50% of the items had poor discrimination (critical ratio<3.0), and floor effect was found in all domains (proportion of 0 point>15%). The items were reclassified after exploratory factor analysis. The content validity of item 3, item 10 and item 11 was low (item-level content validity index<0.78). Criterion validity showed the highest correlations (Spearman′s rho>0.88) between the KPPS-CV and Numeric Rating Scale. While overall scale reliability was minimally acceptable at 0.46, which showed a poor reliability of this scale. Test-retest reliability was excellent for each item (Spearman's rho>0.85). The Cronbach′s alpha of MKPPS-CV (0.76) was higher than that of KPPS-CV (0.46). It showed a great improvement after the modifying.Conclusions:When using scales that are not developed for local populations, differences in culture and clinical practices should be taken into account. MKPPS-CV is an acceptable, valid measure to evaluate pain in Chinese PD patients, which is more suitable for Chinese people.

Immunomodulatory and Antioxidant Activity of Gouqi Chewable Tablets / 中国实验方剂学杂志

ObjectiveTo explore the regulatory effect of Gouqi chewable tablets on innate and adaptive immunity in normal mice and its antioxidant activity in vitro and in vivo. MethodThe effects of low-， medium-， and high-dose groups （0.25， 0.5， 1.5 g·kg-1） on the immune function of normal mice were observed by carbon clearance test， immune organ index test， serum hemolysin test， ConA-induced splenic lymphocyte proliferation test， and natural killer cell （NK cell） activity test. The effects of Gouqi chewable tablets on the antioxidant capacity in vivo were determined by detecting the content of superoxide dismutase （SOD）， glutathione peroxidase （GSH-Px）， and malondialdehyde （MDA） in mice serum. The in vitro antioxidant activity of Gouqi chewable tablets was detected by 2，2'-azino-bis（3-ethylbenzothiazoline-6-sulfonic acid） diammonium salt （ABTS）， 2，2-diphenyl-1-picrylhydrazyl （DPPH）， and hydroxyl radical scavenging tests. ResultCompared with the blank control group， the low-， medium-， and high-dose groups of Gouqi chewable tablets improved the viability of NK cells， the proliferation of splenic lymphocytes， and the level of serum hemolysin antibody in mice （P<0.05）. The high-dose group increased the thymus index， spleen index， and phagocytic function of macrophages （P<0.05， P<0.01）. As compared with the blank control group， the activity of GSH-Px in mice serum in the medium-dose group was increased （P<0.05）， and the content of MDA in mice serum in the high-dose group was decreased （P<0.05）. In in vitro antioxidant tests， the median inhibitory concentration （IC50） values of Gouqi chewable tablets were 1.64±0.20， 2.04±0.03， and 10.27±0.03 g·L-1 by the DPPH， ABTS， and OH- free radical method， respectively. Those results indicated that Gouqi chewable tablets have good antioxidant effects in vitro. ConclusionGouqi chewable tablets can enhance the immune function of mice with good antioxidant effects.

Effect of Gegen Qinliantang on TLR4/IKKβ/NF-κB Pathway in KKAy Mice with Diabetes / 中国实验方剂学杂志

ObjectiveTo observe the effect of classical prescription Gegen Qinliantang（GGQLT） on inflammatory factors and key targets in the inflammatory pathways mediated by lipopolysaccharide in KKAy mice and explore its mechanism in improving spontaneous type 2 diabetes mellitus （T2DM）. MethodSixty-five SPF KKAy mice with spontaneous T2DM and 13 C57BL/6J mice （control） were selected in the barrier system and fed on a high-fat diet. The model was properly induced in 44 mice in the context of random blood glucose exceeding or equal to 13.9 mmol·L-1. Then the mice were assigned into a normal group （20 mL∙kg-1 normal saline）， a model group （20 mL∙kg-1 normal saline）， an acarbose group （3.9 mg∙kg-1）， and high- and low-dose GGQLT groups （1.82 and 0.45 g∙kg-1）， with 11 mice in each group. The mice in each group were treated correspondingly by gavage for eight weeks， once per day. Blood glucose and body weight were systematically evaluated. Twelve hours after the last administration， blood samples were collected from the eyes， and the serum and muscle and liver tissues were extracted. The levels of tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， and glucose transporter type 4 （GluT4） were detected by semi-quantitative enzyme-linked immunosorbent assay （ELISA）. The protein expression of IκB kinase β （IKKβ） and nuclear factor-κB （NF-κB） in muscle tissues and Toll-like receptor 4 （TLR4） in liver tissues was detected by Western blot. ResultCompared with the normal group， the model group showed increased body weight and blood glucose （P<0.01）. Compared with the model group， the acarbose group and the GGQLT groups showed reduced body weight and blood glucose （P<0.05， P<0.01）. As revealed by ELISA results， compared with the normal group， the model group showed increased levels of TNF-α and IL-6 （P<0.01） and deceased GluT4 level （P<0.05）. Compared with the model group， the groups with drug treatment showed reduced levels of TNF-α and IL-6 （P<0.05， P<0.01）， and the acarbose group and the high-dose GGQLT group showed increased GluT4 level （P<0.05， P<0.01）. As displayed by Western blot results， compared with the normal group， the model group showed increased protein expression of IKKβ， NF-κB， and TLR4 （P<0.01）. Compared with the model group， the acarbose group and the GGQLT groups showed reduced protein expression of IKKβ， NF-κB， and TLR4 （P<0.05， P<0.01）. ConclusionGGQLT can inhibit the inflammatory cascade effect and improve T2DM by down-regulating the levels of key inflammatory factors in the TLR4 pathway， inhibiting their activation， and increasing the translocation and activity of GluT4 on the basis of the regulation of intestinal flora.

Correlation between nutritional status and unplanned readmission in elderly patients with chronic heart failure / 中国实用护理杂志

Objective:To evaluate nutritional status in elderly patients with chronic heart failure and to investigate its association with unplanned readmission.Methods:From July 2020 to August 2021, 220 elderly patients hospitalized for chronic heart failure in Qilu Hospital of Shandong University were enrolled in a prospective cohort study. Basic information, laboratory tests and other data of the patients were collected. Nutritional status of the patients was assessed by geriatric nutritional risk index and the patients were divided into groups. Data were analyzed by R4.1.1 and SPSS26.0, survival curves were drawn by Kaplan-Meier method, and the relationship between nutritional status and unplanned readmission in elderly patients with chronic heart failure was analyzed by univariate and multivariate Cox regression.Results:Among 220 elderly patients with chronic heart failure, 59.5%(131/220) were in normal nutrition. There were 40.5%(89/220) in the malnutrition, including 26.8%(59/220) in the mild malnutrition and 13.6%(30/220) in the moderate and severe malnutrition. During the follow-up period of 3 months, 25.9% (57/220) had unplanned readmission. Kaplan-Meier survival curve showed that the incidence of unplanned readmissions was higher in the moderate and severe malnutrition than in the normal and mild malnutrition, and the difference among them was statistically significant ( P<0.05). Multivariate Cox regression analysis showed that moderate and severe malnutrition was an independent predictor of unplanned readmission in elderly patients with chronic heart failure ( HR=2.064, 95% CI 1.029-4.138, P<0.05). Conclusions:The prevalence of malnutrition in elderly patients with chronic heart failure is high. Moderate and severe malnutrition is an independent predictor of unplanned readmission in elderly patients with chronic heart failure. The geriatric nutritional risk index is an effective screening tool and can provide a reference for clinical evaluation of nutritional risk in patients.

Refractive error analysis of phacoemulsification combined with intraocular lens implantation after vitrectomy / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the refractive errors after phacoemulsification combined with intraocular lens(IOL)implantation in previously vitrectomized eyes.<p>METHODS: Thirty-eight patients(40 eyes)with cataract who had undergone vitrectomy were divided into two groups: vitrectomy alone as group A(22 eyes), vitrectomy combined with inert gas(C₃F₈)tamponade as group B(18 eyes). In addition, normal eyes(20 eyes)without vitrectomy history who required cataract surgery were included as a control group C. Axial length(AL), keratometric value(K), anterior chamber depth(ACD), and white-to-white(W-W)were measured with IOL Master 500 before the surgery. The power of IOL was calculated with the online Barrett Universal Ⅱ formula. Phacoemulsification combined with IOL implantation by an iris hook assistance technique was used to treat groups A and B, group C was treated only with phacoemulsification and IOL implantation. There were no complications, such as posterior capsule rupture. The postoperative refraction was obtained three months after surgery. The prediction error(PE), absolute prediction error(AE), and median absolute error(MedAE)among the three groups were compared.<p>RESULTS: There was no significant difference among the three groups in AL, K value, and IOL power. A significantly deep ACD was noted in groups A and B compared with group C(<i>P</i><0.01). There was a significant difference in the prediction error among the three groups(<i>P</i>=0.042). Group B showed a significant hyperopic shift compared with group C. AE and MedAE among groups showed no significant difference.<p>CONCLUSION: There was no significant difference in the refractive results of patients with phacoemulsification sequential to vitrectomy alone compared with the normal control group. However, a hyperopic shift was found in patients with phacoemulsification sequential to vitrectomy with inert gas tamponade comparing with the normal eyes. Undercorrection should be avoided when selecting IOL power.

Effect of Electroacupuncture at Fengchi on Astrocytes and Neurons in Rats with Acute Cerebral Infarction / 中国康复理论与实践

Objective:To investigate the effect of electroacupuncture at Fengchi (GB20) on astrocytes and neurons in rats with acute cerebral infarction. Methods:A total of 64 male Sprague-Dawley rats were randomly divided into sham group (n = 16), model group (n = 16), non-acupoint group (n = 16) and Fengchi group (n = 16). The latter three groups were modeled with middle cerebral artery occlusion (MCAO), and the latter two groups were treated with electroacupuncture after modeling, at the point near Fengchi and Fengchi, respectively, for seven days. All the rats were assessed with neurological deficit score after treatment, while the cerebral infarction area and water content were measured, the histopathology of hippocampus was observed by HE staining, the expression levels of brain-derived neurotrophic factor (BDNF), glial fibrillary acidic protein (GFAP) and neuron-specific enolase (NSE) in hippocampus were detected with ELISA, the apoptosis of brain neurons were measured with TUNEL, and the expression levels of caspase-3 and Bcl-2 in brain homogenate were detected with Western blotting and reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR). Results:Compared with the sham group, the neurological deficit score, cerebral infarction area and water content increased significantly (P < 0.05) in the other groups; while the the expression of GFAP and NSE in hippocampus increased (P < 0.05) and the expression of BDNF decreased (P < 0.05); the number of apoptosis in hippocampus increased (P < 0.05), and the expression of caspase-3 increased (P < 0.05) and the expression of Bcl-2 decreased (P < 0.05). Compared with the model group and non-acupoint group, the neurological deficit score, cerebral infarction area and water content decreased in the Fengchi group (P < 0.05); while the the expression of GFAP and NSE in hippocampus decreased (P < 0.05) and the expression of BDNF increased (P < 0.05); the number of apoptosis in hippocampus decreased (P < 0.05), and the expression of caspase-3 decreased (P < 0.05) and the expression of Bcl-2 increased (P < 0.05). Conclusion:Electroacupuncture at Fengchi can protect the brain from acute cerebral infarction, adjust the expression of GFAP, NSE and BDNF, and reduce the neuronal apoptosis.