Correlation between serum lipoprotein (a) and the severity of white matter hyperintensities in middle-aged and elderly people in the community / 国际脑血管病杂志

Objective:To investigate the correlation between serum lipoprotein (a) [LP(a)] and the severity of white matter hyperintensities (WMHs) in the middle-aged and elderly people in the community.Methods:Consecutive middle-aged and elderly residents residing in the community underwent physical examinations in the Affiliated Jiangning Hospital of Nanjing Medical University from June 2016 to August 2021 were retrospectively collected. Fasting venous blood was collected on the next day of admission to detect the level of Lp(a). During hospitalization, cranial MRI examination was performed and the severity of WMHs was graded using the Fazekas visual scoring method. Ordinal multivariate logistic regression analysis was used to determine independent related factors for the severity of WMHs.Results:A total of 1 752 patients were included in the analysis. There were 969 males (55.31%) and 783 females (44.69%). Their age was 66.18±10.32 years old. There were 1 167 patients (66.61%) in the mild WMHs group, 407 (23.23%) in the moderate WMHs group, and 178 (10.16%) in the severe WMHs group. Ordinal multivariable logistic regression analysis showed that after adjusting for confounding factors, a higher serum Lp(a) level was independently related to the severity of WMHs (with the first quartile as a reference, the third quartile: odds ratio 1.441, 95% confidence interval 1.050-1.976, P=0.023; the fourth quartile: odds ratio 1.717, 95% confidence interval 1.252-2.354, P=0.001). Conclusion:Serum Lp(a) is independently correlated with the severity of WMHs.

Thrombospondin-2 Couples Pressure-Promoted Chondrogenesis through NF-jB Signaling

METHODS@#Rat BMSCs were isolated, cultured and identified. The time-dependent expressions of TSP-2 and Sox9 in BMSCs under a dynamic mechanical pressure of 0–120 kPa at 0.1 Hz for 1 h were tested by qPCR and Western blotting. The role of TSP-2 in chondrogenic differentiation of BMSCs under mechanical pressure was validated by using small interfering RNA. The impact of TSP-2 and mechanical pressure on chondrogenesis were detected and the downstream signaling molecules were explored using Western blotting. @*RESULTS@#Mechanical pressure stimulation of 0–120 kPa for 1 h significantly upregulated the expression of TSP-2 in BMSCs. The expression of the chondrogenesis markers Sox9, Aggrecan, and Col-II were all upregulated under dynamic mechanical pressure or TSP-2 stimulation. Additional exogenous TSP-2 may potentiate the chondrogenic effect of mechanical stimulation. After knock down TSP-2, the upregulation of Sox9, Aggrecan and Col-II under mechanical pressure was inhibited. The NF-jB signaling pathway responded to both dynamic pressure and TSP-2 stimulation, and the cartilage-promoting effect was blocked by an NF-jB signaling inhibitor. @*CONCLUSION@#TSP-2 plays an essential role in the chondrogenic differentiation of BMSCs under mechanical pressure. NF-jB signaling is involved in the mechano-chemical coupling of TSP-2 and mechanical pressure for the chondrogenic differentiation of BMSCs.

Research progress on enteral nutrition monotherapy and combination therapy in adults with Crohn's disease / 中华临床营养杂志

Patients with Crohn's disease (CD) are often complicated with malnutrition and enteral nutrition is the preferred option for nutritional support. Enteral nutrition is the first-line therapy to induce remission of CD in children, but its application in adults has not been well established. In recent years, studies have found that enteral nutrition can not only improve the nutritional status in adult CD patients, but also induce and maintain CD remission through various mechanisms. Given its favorable nutritional efficacy and safety, enteral nutrition has been considered as the basic treatment for adult CD patients and often used in combination with other treatment approaches. However, any combination therapy should be assessed in terms of benefit and risk. This review aims to describe the efficacy and safety of enteral nutrition combined with other treatment approaches in adult CD patients and enumerate common applicable clinical settings, so as to better inform clinical treatment.

Anxiety and Depression Related to Inflammatory Bowel Disease and its Intervention / 胃肠病学

Anxiety and depression are common in patients with inflammatory bowel disease (IBD), especially in patients with complex and active disease. IBD promotes the occurrence of anxiety and depression, while anxiety and depression also affect the progression of IBD. However, the pathogenesis has not been fully clarified, which is related mainly to inflammation, immune activation and brain-gut axis. Clinically, psychological disorders could be screened and identified by quantifiable assessment tools. Appropriate psychotherapy and psychiatric drugs can reduce the level of anxiety and depression and improve the quality of life of patients. This article reviewed the anxiety and depression related to IBD and its intervention.

Correlation between white matter lesions and hematoma volume in patients with intracerebral hemorrhage / 国际脑血管病杂志

Objective To investigate the relationship between the severity of white matter lesions (WMLs) and the hematoma volume in patients with spontaneous intracerebral hemorrhage. Methods Patients with intracerebral hemorrhage (age ≥40 years) who were included in the Image Registration Center, Drum Tower Hospital, Nanjing University School of medicine from June 1, 2012 to May 31, 2017 were enrolled retrospectively. The head CT and baseline head MRI data were collected within 12 h after onset. The volume of hematoma on the baseline CT was calculated using ITK-SNAP software. The WMLs volume was semi-automatically segmented and calculated in the WMLs area by MRIcron software and ITK-SNAP software. According to the Fazekas score, the severity of WMLs was divided into mild ( 0-2), moderate (3-4) and severe (5-6). According to the median volume of hematoma, the patients were divided into smaller hematoma volume group and larger hematoma volume group. The baseline data in patients of both groups were compared. Multivariate logistic regression analysis was used to determine the independent related factors of hematoma volume. Results Age, National Institutes of Health Stroke Scale (NIHSS) score, and hematoma volume increased with the severity of WMLs, while the total cholesterol and low-density lipoprotein cholesterol levels decreased with the severity of WMLs. Hematoma volume was significantly associated with the NIHSS scores, apolipoprotein A1, D-dimer, WML volume, and intracerebral hemorrhage site. Multivariate logistic regression analysis showed that high WML score (odds ratio [OR] 1.001, 95% confidence interval [ CI] 1.002-1.008; P=0.049), intracerebral hemorrhage site ( OR 1.441, 95% CI 1.090-1.911; P=0.010), and NIHSS score (OR 1.081, 95% CI 1.011-1.152; P=0.031) were the independent risk factors for larger hematoma volume. Conclusion The severity of WMLs was significantly positively correlated with the baseline hematoma volume in patients with spontaneous intracerebral hemorrhage.

Multi?center studies on the application of Addenbrooke′s cognitive examination revised scale to evaluate cognitive function in patients with chronic kidney disease / 实用医学杂志

Objective To evaluate the application of Addenbrooke′s cognitive examination revised(ACE?R)scale to evaluate cognitive function in patients with chronic kidney disease(CKD). Methods We used ACE?R scale to evaluate the cognitive function on 205 cases of CKD patients received outpatient and inpatient treatment in renal Department of four hospitals in Nanjing. One?way ANOVA analysis ,receiver operating characteristic (ROC)curve and other statistical methods were adopted to compare differences. Results (1)There is significant difference of ACE?R scale scores among group NC?NCDs(89.18 ± 4.80),group Mild?NCDs(77.28 ± 5.80)and group Major?NCDs(55.90 ± 10.90)(F = 292.28,P < 0.01). There is significant difference between any two groups(all P<0.01).(2)(ACE?R)scale(AUC=0.944,P<0.01)showed significantly higher sensitivity than mini?mental state examination(MMSE)scale(AUC = 0.777,P < 0.01)on identifying Mild?NCDs patients with chronic kidney disease(P < 0.01);(3)The optimal cut?off value of total ACE?R score between group NC?NCDs and group Mild?NCDs was 83/84,(sensitivity 88.00%,specificity 85.90%,Youden index 0.739),the optimal cut?off value between group Mild?NCDs and group Major?NCDs was 83/84(sensitivity 89.70%,specificity 96.10%, Youden index 0.858). Conclusion ACE?R possesses a good ability in distinguishing different severity of cognitive impairment in patients with CKD. ACE?R can effectively identify early mild cognitive impairment ,which is suitable for clinical application as a tool to evaluating and studying of cognitive function in patients with CKD.

Practice of convergence education of psychological health for overseas students in the perspective of positive psychology: taking Chongqing Medical University as an example / 中华医学教育探索杂志

With the expansion of the overseas students in China,the psychological health education has been paid more and more attention.For the weak ability of conflicts management,prominent communication barrier and inveterate cultural difference,a preliminary study of convergence education of psychological health for overseas students is conducted in the perspective of positive psychology by building students'positive emotional experiences,cultivating students' positive qualities,as well as optimizing ideological education environment,around the theme as well as the virtues underlined in the theory of positive psychology on the basis of the convergence experiences of Chongqing Medical University.

MRI diagnosis of sellar germ cell tumors / 实用放射学杂志

Objective To explore the MRI features of germ cell tumors in sellar regions for better developing clinical treatment plans.Methods The imaging and pathologic findings of 44 sellar germ cell tumors were retrospectively analyzed.Results There were 1 9 germinoma,most of which had clear boundaries,different extents of cystic necrosis and mild peritumoral edema.Lesions were significantly enhanced in contrast-enhanced MRI (CE-MRI).There were 8 cases with mature teratoma,most showed cystic-solid changes,presenting mixed-intensities on T1-weighted images and T2-weighted images.There were 1 1 malignant teratoma(im-mature teratoma and teratoma malformation ),however,there were more parenchymatous tissue in malignant teratoma than mature teratoma.Two yolk sac tumors showed uniform signals on T1-weighted images and T2-weighted images,significant enhancement on CE-MRI,and visibly higher AFP in serum.Two embryonal carcinomas had clear boundary,inhomogeneous intensities,visibly cyst-ic necrosis,median to servere peritumoral edema,the parenchyma showed significant enhancement in CE-MRI.The signals of two mixed germ cell tumors were not typical,which depended on the components within tumors.Conclusion The MRI features of germ cell tumors in sellar region are characteristic.

Therapeutic effect of botulinum toxin type A in the treatment of migraine / 中国医师杂志

Objective To observe the clinical efficacy and safety of local injection of botulinum toxin type A (BTX-A) in the treatment of Migraine.Methods 31 patients in the treatment group were injected BTX-A 25 U at 10 positions at the muscles.30 patients in the control group were given 2％ lidocaine 1 ml plus prednisolone acetate 1 ml at the same muscle sites as in the treatment group.Days,frequency,and intensity of headache were evaluated by visual analogue scale (VAS),migraine disability was evaluated by migraine disability assessment guestionnaire (MIDAS),and adverse reactions were assessed on 1 month before the treatment and 1st,2st,3st months after the treatment.Results The therapeutic effect between the treatment and control groups was significantly different in terms of days,frequency,and intensity of headache and migraine disability.Compared with preinjection,days and frequency of headache and migraine disability were decreased significantly after injection in treatment group,lasting more than 2 months.No patients in two groups reported any serious treatment-related adverse event.Conclusions Botulinum toxin type A in the treatment of Migraine is effective and relative safe,and can decrease migraine disability.

Evaluation of efficacy and safety of ZD1839 as monotherapy in Chinese patients with advanced non-small cell lung cancer / 中华内科杂志

Objective To report the outcome of gefitinib for Chinese patients with advanced nonsmall cell lung cancer(NSCLC) at Peking Union Medical College Hospital. Methods From Oct. 2002 to Apr. 2006,204 patients with advanced NSCLC received oral ZD1839(250 mg/d)treatment. The were 110(59.9%)men and 94(40.1%)women aged between 25 and 85 years. Thirty-two patients had squamous cell carcinoma, 125 adenocarcinoma, 30 bronchoalveolar carcinoma or adenocarcinoma with partial bronchoalveolar carcinoma, 6 adenosquamous carcinoma. and 11 unspecified. Twenty-six patients had no history of chemotherapy, 62 had no disease progression after chemotherapy, and 111 failed to prior one or more regimens. Median survival was calculated using the Kaplan-Meier method and a Cox regression analysis was used to detect differences in median survival between strata. Results The median survival of all patients and of patients failed to prior chemotherapy were 16.3 months(95% confidential interval CI, 14.5-18.2)and 12.5 months(95% CI 9.3-15.7). The rate of 1-year survival was 57%. The obiective tumor response rate and stable disease rate were 31.4% and 41.7% respectively.The median survival were significantly related with ECOG scores,pathology types,disease progression after chemotherapy,objective efficacy of gefitinib and changes of short-breathing. Among 26 patients with no prior chemotherapy,the median survival was not statistically significant compared with that of other patients. Among the enrolled patients,111 had disease progression and 62 had stable disease after prior chemotherapy, and their median survivals was statistically different. At the time of this analysis. 142 patients had disease progression,58 of whom withdrew from taking gefitinib,and 84 continued gefitinib therapy until death. The median survivals for these subgroups were not significantly different. Among 142 patients with disease progression, 40 received other systemic treatment, the median survival was statistically significant compared with that of other patients. Objective response was significantly related with age,smoking status,pathological type,change of short-breathing and rashes induced by gefitinib. Adverse events were generally mild(grade 1 and 2)and reversible. The most frequent adverse events were rash 72.6%(138/190)and diarrhea 33.7%(64/190).Conclusion Our studv suggests that treatment with gefitinib may be well tolerate and beneficial for some Chinese patients after failure of prior chemotherapy.

Experimental Studies of a Water/gas Separator Using Hydrophilic Micro-filtration Membrane under Simulated Microgravity / 航天医学与医学工程

Objective To study a technology for separating water from gas under microgravity in long-term manned space flight.Methods Several kinds of mixture of water and oxygen were separated by a new water/gas separating matrix and the action of gravity on the process was studied.Results The water/gas separator worked well in the range of gas flow below 2 500 mL/min and water flow below 4～6 L/h.A mixture of gas and water was separated into gas containing no water containing less than 1% gas.The phenomenon of a little oxygen existing in the water flow was explained.It was also found that gravity has nothing to do with the separation.Conclusion Hydrophilic porous membrane can be used to separate water from gas,and further works were continue needed to study the process and to resolve a few problems about water/gas separation under microgravity.

Perspectives on the Improvement of National Essential Medicine List / 中国药房

OBJECTIVE:To provide references for the improvement of National Essential Medicine List.METHODS:The pertinent literature both at home and abroad was reviewed;the status quo and the problems of the National Essential Medicine List of China were expounded.RESULTS & CONCLUSION:It is suggested that its coverage be extended to cover the list of orphan drugs,meanwhile,an urban-rural essential medicine list and an essential medicine list for children should be established to enhance the hierarchy and practicability of National Essential Medicine List.

Ultrasound evaluation of the carotid artery hemodynamics in hypertensive elders / 中国组织工程研究

BACKGROUND: Non-invasive vascular ultrasound is used to assess in tima-media thickness (IMT) and atheromatous plaque, of which the result is better correlated to that of pathological examination. OBJECTIVE: Non-invasive vascular ultrasound was used to assess the hemodynamical changes of external and internal carotid in hypertensive elders, so as to investigate the relationship between pulse pressures, left ventricular mass index (LVMI), vascular resistance index (VRI) and shearing ratio. DESIGN: Randomized, controlled, correlative analyzedstudy. SETTING: Ultrasound Department of Affiliated Hospital of Jiangshu University. PARTICIPANTS: Totally 54 hypertensive elders, including 33 males and 21 females, were recruited from the Ultrasound Department of Affiliated Hospital of Jiangshu University, from September 30th 2000 to March 30th 2002. Meanwhile 26 normotensive elders (systolic pressure ＜ 130 mm Hg and/or diastolic pressure ＜ 85 mm Hg), including 16 males and 10 females, were selected as controls, METHODS: Color duplex blood flow imaging technique was used to assess the left ventricular end-diastolic diameter (LVEDD) and the interventricular septum thickness (IVST), so as to calculate the LVMI. The insiddiameter of bilateral common carotid artery (CCA) and internal carotid,IMT, the systolic peak flow velocity and resistance index were measured in order to calculate the vascular shearing ratio and atheromatous plaque index,moreover arterial pressure, LVMI, as well as resistance index and shearing ratio were subjected to linear correlative analysis,of which the results were compared with that of control group. MAIN OUTCOME MEASURES: ① Pulse pressure, LVMI and atheromatous plaque index of CCA. ② The inside diameter of bilateral CCA and internal carotid, IMT and the systolic peak flow velocity and resistance index were measured in order to calculate the atheromatous plaque index and maximum vascular shearing ratio. RESULTS: According to the experimental objective,data of all 80 cases were analyzed without loss. ① The pulse pressure and LVMI, the incidence of atheromatous plaque and plaque index of CCA in hypertensive elder group were obviously higher than that of control group [(64.36±7.44) mm Hg,(45.78±8.72) mm Hg; (131.47±18.73) g/m2, (83.28±12.34) g/m2; 5.62 ±1.78,3.44±1.10; 66.7％, 23.1％, (x2=13.37, t=5.730-13.234, P ＜ 0.01)]. ② The inside diameter of bilateral CCA and internal carotid, IMT and resistance index in hypertensive elders were significantly higher than that of control group [CCA: (8.96±1.20) mm, (8.08±0.96) mm; (1.28±0.88) mm, (0.91±0.17) mm;0.75±0.05, 0.69±0.06; ICA: (6.82±1.12) mm, (5.72±0.92) mm; (1.06±0.17) mm,(0.76±0.15) mm; 0.70±0.07, 0.64±0.06, t=2.872-10.850, P ＜ 0.01], but the systolic peak flow velocity and shearing ratio were markedly lower than that of control group [CCA: (47.44±12.85) cm/s, (60.20±14.32) cm/s;(225.78 ±95.76)/s, (300.26 ±110.42)/s. ICA: (41.22 ±10.18) cm/s,(48.64±11.58) cm/s; (268.54±112.56)/s, (324.52±121.42)/s, t=2.872-10.850, P ＜ 0.01]. ③ The pulse pressure, LVMI, the resistance index of CCA and ICA and shearing ratio were linearly correlated (r=0.30-0.36, P ＜ 0.05). CONCLUSION: Pulse pressure and LVMI were found increased in hypertensive elders, together with carotid vessels dilated, IMT and resistance index increased, as well as shearing ratio decreased, atheromatous plaque formed, vascular stiffness increased, which resulted in consequently decrease of vascular compliance.

Individual educative instruction and its effect in children with learning disorder: 8 case analysis / 中国组织工程研究

BACKGROUND: Educative instruction is good for the improvement of learning and behavior disorder in children with learning disorder. If this educative instruction were individualized, i. e. different education is provided for different individual, it would receive even better effects.OBJECTIVE: To explore the method and effect of educative instruction for children with learning disorder to accumulate experiences for the development of their learning potentials.DESIGN: A paired(pairing the subjects with similar age and learning disorder) case analysis based on the suffers .SETTING: A medical college of some university.PARTICIPANTS: Eight children with learning disorder were selected from Zhenjiang City Dongwu Kindergarten or Zhenjiang City Dagang Central Primary School. These 8 cases suffered from 4 types of disorders including clumsiness, seclusive personality, language disorder, and poor learning ability. Eight cases were randomly divided into education group and control group.METHODS: Cases of control group received normal educations without specific interventions. Cases of education group received individual customized educative instructions. The educative effects were observed after 3 months.MAIN OUTCOME MEASURES: The improvement of clumsiness, seclusive personality, language disorder or poor learning ability in children with learning disorder.RESULTS: Cases of education group had better psychological and behavior improvements than that of control group after individual educative instruction.CONCLUSION: Individual educative instruction for children with learning disorder is an effective approach for the development of their learning potentials.

Observation of curative effect of stent angioplasty for treatment vertebral basilar artery stenosis / 临床神经病学杂志

Objective To evaluate the curative effect of stent angioplasty for treatment vertebral basilar artery stenosis. Methods 34 patients with vertebral basilar artery stenosis diagnosed by DSA were treated with cerebral angioplasty and stenting(CAS ) operation by flexible balloon expandable stents. Results 36 stents were placed in 34 patients. The achievement ratio of operation was 100%. All stenosis showed by DSA were successfully improved without complications.The mean stenosis rate of preoperation and postoperation were (78.3?6.2)% and (3.6?4.2)% respectively. During the further follow up period of 6～38 months, clinical symptoms were disappeared in 31 patients, relieved in 2 patients, recurred in 1 patient.There were no vertebro-basilar system transient ischemic attack and brain infarction onset in those patients.Conclusion Stent angioplasty is safe and effective in the treatment of symptomatic vertebral artery stenosis.