Prevalence and clinical implications of polypharmacy and potentially inappropriate medication in elderly patients with heart failure: results of six months' follow-up / 老年心脏病学杂志（英文版）

OBJECTIVES@#To investigate the prevalence of polypharmacy and potentially inappropriate medication (PIM) in elderly patients with heart failure (HF) and their impact on readmission and mortality.@*METHODS@#We conducted a study of 274 participants aged 60 years or older with HF. The prevalence of polypharmacy (defined as the use of five or more medications) was calculated, and the 2019 American Geriatrics Society Beers criteria were applied to access PIMs. Medications and PIMs were characterized at admission and discharge, and changes in prescriptions during hospitalization were compared. The impact of polypharmacy and PIM on readmission and mortality were investigated.@*RESULTS@#The median age of this study population was 68 years old. The median number of prescribed drugs was 7 at admission and 10 at discharge. At discharge, 99.27% of all patients were taking five or more drugs. The incidence of composite endpoint and cardiovascular readmission increased with the number of polypharmacy within 6 months. The use of guideline-directed medical therapy reduced the incidence of composite endpoint events and cardiovascular readmission, while the use of non-cardiovascular medications increased the composite endpoint events. The frequency of PIMs was 93.79% at discharge. The incidence of composite endpoint events increased with the number of PIMs. "PIMs in older adults with caution" increased cardiovascular readmission and "PIMs based on kidney function" increased cardiovascular mortality. Several comorbidities were associated with cardiovascular mortality or non-cardiovascular readmission.@*CONCLUSIONS@#Polypharmacy and PIM were highly prevalent in elderly patients with HF, and their use was associated with an increased risk of composite endpoint events, readmission and mortality. Non-cardiovascular medications, "PIMs in older adults with caution", "PIMs based on kidney function" and several comorbidities were important factors associated with hospital readmission and mortality. Our findings highlight the importance of medication optimization in the management of HF in elderly patients.

Report of three death cases of imported falciparum malaria in Wenzhou City / 中国血吸虫病防治杂志

The three death cases of falciparum malaria in Wenzhou City were all imported from Africa. One patient died on 10 January 2007 because of severe clinical symptoms after hospitalization. The second case was initially misdiagnosed as influen-za in primary health and medical institution. The patient's condition quickly worsened and died of Plasmodium falciparum infec-tion on 5 March 2011. The third patient belonged to"non-identity"person,and there were no detailed information and epidemio-logical history on admission,which resulted in the delayed diagnosis,disease exacerbation and death. In conclusion,the health education should be provided to the people who return from Africa and also to medical workers in order to reduce the mortality of falciparum malaria.

Effects of simvastatin on expression of Bcl-2 and Bax in myocardium of rats with renal ischemia-reperfusion injury / 中国病理生理杂志

AIM:To observe the effect of simvastatin on myocardial tissue after renal ischemia-reperfusion in-jury and its mechanism .METHODS:A rat model of renal ischemia-reperfusion injury was prepared by clamping the bilat-eral renal arteries for 45 min.The rats (n=36) were randomly divided into sham operation group , renal ischemia-reperfu-sion (I/R) group and simvastatin group with 12 rats in each group.The content of serum creatinine (SCr), blood urea ni-trogen ( BUN) and myocardial tissue malondialdehyde ( MDA) , the myocardial activity of lactate dehydrogenase ( LDH) , creatine kinase (CK) and superoxide dismutase (SOD), and the myocardial protein expression of Bcl-2 and Bax were de-tected.RESULTS:Compared with sham operation group , the content of SCr , BUN and myocardial MDA , and the myo-cardial activity of LDH and CK in I/R group were significantly increased (P<0.05), and the activity of SOD was signifi-cantly decreased (P<0.05).Compared with I/R group, the content of SCr, BUN and myocardial MDA, and the myocar-dial activity of LDH and CK in simvastatin group were significantly decreased ( P<0.05 ) , while SOD activity was en-hanced (P<0.05).The protein expression of Bcl-2 and Bax in sham operation group was less than that in I/R group (P<0.05), and the protein level of Bax in simvastatin group was significantly lower than that in I /R group (P<0.05), while the protein level of Bcl-2 was increased (P<0.05).CONCLUSION:Simvastatin has a protective effect on the my-ocardium of the rats with renal ischemia-reperfusion injury , and the protective mechanism may be related to the elimination of free radicals by simvastatin , increase in the protein expression of Bcl-2 and decrease in the protein expression of Bax .

Hsp70 Fused with the Envelope Glycoprotein E0 of Classical Swine Fever Virus Enhances Immune Responses in Balb/c Mice / 病毒学报

Heat-shock protein (Hsp) 70 potentiates specific immune responses to some antigenic peptides fused to it. Here, the prokaryotic plasmids harboring the envelope glycoprotein E0 gene of classical swine fever virus (CSFV) and/or the Hsp70 gene of Haemophilus parasuis were constructed and expressed in Escherichia coli Rosseta 2(R2). The fusion proteins were then purified. Groups of Balb/c mice were immunized with these fusion proteins, respectively, and sera collected 7 days after the third immunization. Immune effects were determined via an enzyme-linked immunosorbent assay and flow cytometric analyses. E0-Hsp70 fusion protein and E0+Hsp70 mixture significantly improved the titer of E-specific antibody, levels of CD4+ and CD8+ T cells, and release of interferon-γ. These findings suggested that Hsp70 can significantly enhance the immune effects of the envelope glycoprotein E0 of CSFV, thereby laying the foundation of further application in pigs.

Application of calcium ionophore A23187 in ICSI for globozoospermia: A report of 2 cases and review of the literature / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the pathogenesis of globozoospermia, fertilization ability of round-headed sperm, and the application value of assisted oocyte activation in intracytoplasmic sperm injection (ICSI) for the wives of glohozoospermia men.</p><p><b>METHODS</b>We collected oocytes from the wives of 2 globozoospermia patients and randomly divided them into two groups after ICSI to receive calcium ionophore A23187-activation and conventional treatment, respectively. We reviewed the relevant literature published at home and abroad, and discussed the etiology of globozoospermia, fertilization ability of round-headed sperm, and treatment options for this disease.</p><p><b>RESULTS</b>Quality embryos were obtained in the A23187-activation group while no fertilized oocytes, oocyte cleavage, quality embryos, or blastular formation were found in the conventional treatment group. Both women achieved pregnancy and gave birth to healthy neonates after transfer of the quality embryos from the A23187-activation group.</p><p><b>CONCLUSION</b>Calcium ionophore A23187 can be applied to ICSI for the wives of globozoospermia men and bring about desirable clinical outcomes. Meanwhile, attention should be paid to its safety.</p>