Obesity is positively Associated with Depression in Older Adults: Role of Systemic Inflammation / 生物医学与环境科学（英文）

OBJECTIVE@#We aimed to explore the association between obesity and depression and the role of systemic inflammation in older adults.@*METHODS@#Adults ≥ 65 years old ( n = 1,973) were interviewed at baseline in 2018 and 1,459 were followed up in 2021. General and abdominal obesity were assessed, and serum C-reactive protein (CRP) levels were measured at baseline. Depression status was assessed at baseline and at follow-up. Logistic regression was used to analyze the relationship between obesity and the incidence of depression and worsening of depressive symptoms, as well as the relationship between obesity and CRP levels. The associations of CRP levels with the geriatric depression scale, as well as with its three dimensions, were investigated using multiple linear regressions.@*RESULTS@#General obesity was associated with worsening depression symptoms and incident depression, with an odds ratio ( OR) [95% confidence interval ( CI)] of 1.53 (1.13-2.12) and 1.80 (1.23-2.63), especially among old male subjects, with OR (95% CI) of 2.12 (1.25-3.58) and 2.24 (1.22-4.11), respectively; however, no significant relationship was observed between abdominal obesity and depression. In addition, general obesity was associated with high levels of CRP, with OR (95% CI) of 2.58 (1.75-3.81), especially in subjects free of depression at baseline, with OR (95% CI) of 3.15 (1.97-5.04), and CRP levels were positively correlated with a score of specific dimension (life satisfaction) of depression, P < 0.05.@*CONCLUSION@#General obesity, rather than abdominal obesity, was associated with worsening depressive symptoms and incident depression, which can be partly explained by the systemic inflammatory response, and the impact of obesity on depression should be taken more seriously in the older male population.

Novel strategies for promoting tumor penetration of anticancer nanomedicines / 药学学报

There is a broad and urgent need for the clinical application of anticancer nanomedicine in tumor therapy, but the complex biological barrier in solid tumors has always been the main obstacle to infiltrating nanomedicine into the tumor. The traditional design of nanomedicine based on enhanced permeability and retention (EPR) effect still has some limitations in tumor permeability, it is urgent to find other design theories. Therefore, this review summarizes two novel strategies, active transcytosis and immune cell-mediated tumor penetration, for promoting tumor penetration of anticancer nanomedicine.

Recurrent Bacterial Meningitis Associated with Inflammatory Nasal Polyp

In case of no head trauma history and intact immunity, adultonset recurrent bacterial meningitis is scarce. Parameningeal infection is the crucial latent cause of recurrent bacterial meningitis in adults. Nasal polyp can cause a variety of nasal symptoms, depending on its location and size. Chronic sinusitis with nasal polyp tends to have more severe symptoms than those without nasal polyp. We report a case of adult onset third recurrent bacterial meningitis associated with inflammatory nasal polyp.

Quality control of Prunella vulgaris based on HPLC fingerprints combined with chemical pattern recognition and content determination / 中草药

Objective: The quantitative method for the quality makers screened by a chemical pattern recognition method combined with the HPLC fingerprint was established, so as to provide reference for scientific and comprehensive quality evaluation of Prunella vulgaris. Methods: Fingerprints of 30 batches of P. vulgaris were established by HPLC. Similarity evaluation was performed by using Similarity Evaluation System for Fingerprint Chromatogram of TCM (2004A) to confirm the common peak. Principal component analysis and orthogonal partial least squares discriminant analysis were used to screen out the components that caused the quality differences in the batches. Quantitative method of the screened quality makers was established, and its content in 61 batches of samples was determined. Results: The HPLC fingerprints of P. vulgaris were obtained, and a total of 28 common peaks were marked. The similarity of 30 batches of samples was higher than 0.970, which indicated that the overall quality of P. vulgaris was relatively stable. Caffeic acid (F5), hyperoside (F9), isoquercitrin (F10), salviaflaside (F11), and rosmarinic acid (F12) were recognized as the quality makers using principal component analysis and orthogonal partial least squares discriminant analysis. Five markers, which showed good linear relationship, were used as indicators for content determination. The average recovery was 95.0%-105.0%, with the RSD value less than 3%. Conclusion: The analysis method established was scientific, accurate, and reliable. A more perfect, reasonable, and effective method for quality evaluation of P. vulgaris was constructed using a fingerprint combined with chemical pattern recognition technique.

Klebsiella pneumoniae Brain Abscess and Endophthalmitis after Acute Epiglottitis

Klebsiella pneumoniae is an unusual cause of brain abscess. Among the few cases of Klebsiella pneumoniae brain abscess that have been reported, most were associated with another underlying primary focus of infection. Endogenous endophthalmitis caused by Klebsiella pneumoniae is an infrequent but often devastating septic metastatic infection. We report a rare case of Klebsiella pneumoniae brain abscess and endophthalmitis after acute epiglottitis.

Treatment of complex coronary lesions by excimer laser coronary atherectomy: the experiences of single center / 中国实用内科杂志

OBJECTIVE: The aim of this study was to introduce the experience in treatment of acute ST segment elevation myocardial infarction(STEMI), saphenous vein graft(SVG), Chronic total occlusion(CTO),In-stent restenosis(ISR)and diffuse calcification lesions by excimer laser coronary atherectomy(ELCA). METHODS: Twenty-two patients were enrolled through our center from November 2016 to May 2017 and ELCA was performed on 22 lesions.The clinical and procedure endpoints were recorded. RESULTS: All the lesions were successfully crossed with laser catheterand and finally were performed by ELCA. Five cases(22.7%)with STEMI, ten cases(45.5%) with SVG lesions,five cases with ISR and other cases were CTO(4.5%) and Calcification(4.5%) lesions.Seventeen patients underwent balloon dilatation and successful implantation of drug-eluting stents(DES) and one patients was treated with drug-eluting balloon(DEB).the procedual and clinical success rates were 100%. At 6.6±2.7 months follow-up, there were no major adverse cardiac events(MACEs) and ELCA relatedcomplications recorded. Conclution This limited evdiences showed that treatment of complex coronary lesions by excimer laser coronary atherectomy may be a Safe and effective choice.It can be further popularized in complex coronary artery disease.

Protective Effect and Mechanism of Modified Dahuang Zhechong Wan on Renal Interstitial Fibrosis in Rats with Obstructive Nephropathy / 中国实验方剂学杂志

Objective: To explore the protective effect and mechanism of modified Dahuang Zhechong Wan on renal interstitial fibrosis in rats with obstructive nephropathy. Method: The unilateral ureteral ligation (UUO)-induced renal interstitial fibrosis model was adopted, 50 SD rats were randomly divided into 5 groups:sham operation group, model group, enalapril group (0.001 g·kg-1), and high and low-dose modified Dahuang Zhechong Wan group (19, 9.5 g·kg-1). Rats in each group were put to death on the 15th day after operation. The serum levels of serum creatinine (SCr) and urea nitrogen (BUN) were collected by enzyme method. The 24-hour urine was collected for 24-hour urinary protein quantity(24 h-Upro) by pyrogallol red molybdenum end point. The kidney tissue was removed from the ligated side. Hematoxylin-eosin (HE) staining and Masson staining were performed; the expressions of transforming growth factor-β1 (TGF-β1), fibronectin (FN) and α-smooth actin (α-SMA) were determined by immunohistochemistry (IHC). Expressions of TGF-β1, p38 mitogen-activated protein kinase (p38 MAPK) and phosphorylated p38 MAPK (p-p38 MAPK) were detected by Western blot. Result: Compared with Sham group, UUO group showed a significant increase in 24 h-Upro, SCr, and BUN (Pβ1, FN, and α-SMA were increased obviously (Pβ1, p38 MAPK, and p-p38 MAPK were increased obviously (PPβ1, FN and α-SMA decreased obviously (Pβ1 and p-p38 decreased obviously (PConclusion: Modified Dahuang Zhechong Wan may improve renal interstitial fibrosis by reducing the high expressions of FN and α-SMA, down-regulating the expressions of p-p38 MAPK and TGF-β1 in p38 MAPK signaling pathway, and decreasing extracellular matrix over deposition and renal cell damage.

Isolated Trigeminal Neuralgia Presented Due to Cerebellopontine Angle Epidermoid Cyst

Trigeminal neuralgia (TN) is a paroxysmal shock like pain restricted to the innervations of the areas of one or more trigeminal branches. The pathogenesis of TN is uncertain and typically is idiopathic, but it may be due to a structural lesion. Various etiologies such as vascular anomaly, tumor, infectious agents, and multiple sclerosis have been implicated as possible causes. Here we report two young patients diagnosed with trigeminal neuralgia secondary to epidermoid cyst at the cerebellopontine angle.

Cerebral Microbleed Induced Seizure Misdiagnosed with Transient Ischemic Attack

Diagnosis of transient ischemic attack has been entirely dependent on the clinical history due to the absence of brain magnetic resonance imaging lesion. It is challenging to distinguish between transient ischemic attack and transient ischemic attack-mimics. Cerebral microbleeds would be found in 11.1–23.5% of incidental findings in elderly population. However, cerebral microbleeds have been known to lead to cognitive decline, dementia, seizure and even status epilepticus. We report a case of cerebral microbleeds induced epileptic seizure, visiting the emergency room with sudden onset unilateral motor weakness.

Lower Cranial Nerve Palsy Due to Vertebrobasilar Dolichoectasia

No abstract available.

Recurrent Guillain-Barré Syndrome Following Urinary Tract Infection by Escherichia coli

Recurrent Guillain-Barré syndrome (GBS) is a rare, immune-mediated disease of the peripheral nervous system. It has been reported to occur at intervals ranging from four months to 10 years; published case studies suggest that 1%–6% of patients who have had GBS will experience recurrent attacks. The most commonly identified infections coinciding with GBS are Campylobacter jejuni, Haemophilus influenzae, Mycoplasma pneumonia, and cytomegalovirus, while an antecedent infection with Escherichia coli is very uncommon. In this case report, we present a rare episode of recurrent GBS, which followed a urinary tract infection (UTI) by E. coli, and an accompanying literature review. A 75-year-old woman with a prior history of acute motor axonal neuropathy (AMAN), a subtype of GBS, presented with subsequent weakness of limbs and areflexia following 10 days of fever, frequency, and dysuria. Base on nerve conduction studies, cerebrospinal fluid analysis and other clinical investigation, we diagnosed the patient with recurrent GBS caused by E. coli. The patient recovered with mild subjective weakness following treatment of intravenous immunoglobulin with ceftriaxone. We suggest that E. coli causes UTI could be one of the diverse trigger factors involved in recurrent GBS.

Survival of Cancer Patients in Northeast China: Analysis of Sampled Cancers from Population-Based Cancer Registries / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The cancer survival was characterized by following up sampled subgroups of cancer cases from three population-based cancer registries in Northeast China. MATERIALS AND METHODS: Survival analysis was used to analyze 6,871 patients, who had one of the 21 most common cancers based on sampling from the population-based cancer registries of three cities in Liaoning Province. All patients were diagnosed between 2000 and 2002 and were followed up to the end of 2007 by active and passive methods. The 5-year age standardized relative survival rates (ASRS) were estimated for all cancers combined and each of the 21 individual cancers. RESULTS: The survival status was traced for 80.8% of 8,506 sampled cancer cases. The 5-year ASRS for all 21 cancers combined was 41.5% (95% confidence interval, 40.3 to 42.7), the highest ASRS was observed for thyroid cancer (85.2%), breast cancer (78.9%), uterine corpus cancer (75.9%), and urinary bladder cancer (70.2%); the lowest 5-year ASRS was noted in pancreatic cancer (8.8%), liver cancer (11.0%), esophageal cancer (18.8), and lung cancer (19.6%). The cancer survival rates in Liaoning cities were similar to those of urban areas in mainland China, but significantly lower than those in Hong Kong, Korea, and Japan. CONCLUSION: The strikingly poor cancer survival rates in three cities of Liaoning Province and in other places in China highlight the need for urgent investment in cancer prevention, early detection, and standardized and centralized treatment.

Ig-like domain 6 of VCAM-1 is a potential therapeutic target in TNFα-induced angiogenesis

Tumor necrosis factor alpha (TNFα)-induced angiogenesis plays important roles in the progression of various diseases, including cancer, wet age-related macular degeneration, and rheumatoid arthritis. However, the relevance and role of vascular cell adhesion molecule-1 (VCAM-1) in angiogenesis have not yet been clearly elucidated. In this study, VCAM-1 knockdown shows VCAM-1 involvement in TNFα-induced angiogenesis. Through competitive blocking experiments with VCAM-1 Ig-like domain 6 (VCAM-1-D6) protein, we identified VCAM-1-D6 as a key domain regulating TNFα-induced vascular tube formation. We demonstrated that a monoclonal antibody specific to VCAM-1-D6 suppressed TNFα-induced endothelial cell migration and tube formation and TNFα-induced vessel sprouting in rat aortas. We also found that the antibody insignificantly affected endothelial cell viability, morphology and activation. Finally, the antibody specifically blocked VCAM-1-mediated cell–cell contacts by directly inhibiting VCAM-1-D6-mediated interaction between VCAM-1 molecules. These findings suggest that VCAM-1-D6 may be a potential novel therapeutic target in TNFα-induced angiogenesis and that antibody-based modulation of VCAM-1-D6 may be an effective strategy to suppress TNFα-induced angiogenesis.

Trigeminal Neuralgia Associated with Tentorial Meningioma

No abstract available.

Transient visual loss after lung surgery in a healthy patient: posterior reversible encephalopathy syndrome: A case report

Postoperative visual loss is a rare complication of general anesthesia in patients undergoing lung surgery. If the visual complication is permanent, it can greatly affect the patient's quality of life. Posterior reversible encephalopathy syndrome (PRES) leads to visual disturbances and may be associated with hypertension, renal disease, eclampsia, and chemotherapy. Although PRES is usually reversible, delayed diagnosis and treatment can result in permanent damage. We herein report a case of PRES in a patient with no medical history. The patient's symptoms included somnolence, visual loss, and headache. He was treated with conservative therapy, and his vision abruptly recovered three days after surgery. He was discharged from the hospital without neurologic complications 13 days after surgery.

Corticosteroids Treatment in Spinal Cord and Neuromuscular Disorders

Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex of the vertebrates, as well as the synthetic analogs of these hormones that are synthesized in the laboratories. Two main classes of corticosteroids, glucocorticoids, and mineralocorticoids, are involved in a wide range of physiologic processes, including stress response, immune response, and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior. Corticosteroids have been used for almost 60 years in medicine and their roles in patients have always been discussed by researchers and clinicians dedicated in the related field. Currently, they are still used in the treatment of patients with neurological disorders. Usually, corticosteroids are used in the treatment of various inflammatory diseases and conditions. In this review, we present five key indications, i.e., neuromyelitis optica, acute spinal cord injury, chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, polymyositis/dermatomyositis for the systemic use of corticosteroids in neurology based on a mix of quality of evidence, prevalence, and impact on disease management.

Morphological and microscopical identification of Genkwa Ramulus and its adulterants / 中国中药杂志

The purpose of this article is to identify Daphne genkwa and its adulterants, Wikstroemia chamaedaphne, according to the morphological and microstructure characteristics of their stem and foliage. The root of D.genkwa was studied simultaneously. The results indicated that the crude drug and processed pieces of Genkwa Ramulus were mainly composed of stems and branches where obvious opposite petiole scars and branch marks were able to be seen on their nodes. Otherwise, foliage or peduncles generally couldn't be found. Moreover, the fine silver flocculent fibers could be observed in the bark of fracture surface. The adulterants were the plant segments which were composed of stems, foliage and peduncles with spikelet-pedicel scars. There existed microstructures differences between Genkwa Ramulus and its adulterants. In the former, single thick lignified phloem fibers were interspersed in the stem phloem of the transverse section with very thick wall and unicellular non-glandular hairs could be observed on the lower epidermis of foliage. Nevertheless, in the latter, there was no thick lignified phloem fibers in cross section of stem phloem, the outer wall of epidermal cells of foliage hadthick cuticles and no non-glandular hairs in lower epidermis of foliage. The results can be used for the identification and the quality standard of the crude drug and processed pieces of D.genkwa.The characteristics of the microstructures and the transverse section can be used to identify the radix D.genkwa.

Phenylephrine Induced Posterior Reversible Encephalopathy Syndrome during Resection of Solitary Pulmonary Nodule

BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a neurological complication caused by cerebral hyperperfusion. CASE REPORT: A 46-year-old male presented with decreased mental status, left facial palsy, and left-sided weakness after video-assisted thoracoscopic surgery for a solitary pulmonary nodule. During the surgery, phenylephrine was infused intravenously for general anesthesia-induced hypotension. High signal intensity at the right parietooccipital lobe was noted on fluid-attenuated inversion recovering imaging and diffusion-weighted imaging. His neurological symptoms improved two days after initial presentation. Follow-up diffusion-weighted imaging showed resolution of the brain lesions 10 days after the surgery. CONCLUSIONS: We report a patient who presented with PRES after administration of phenylephrine during resection of a solitary pulmonary nodule. PRES should be considered for patients presented with acute neurologic symptoms following surgical procedures.

High-dose Sulbactam Treatment for Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Acinetobacter Baumannii / 대한중환자의학회지

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.

High-dose Sulbactam Treatment for Ventilator-Associated Pneumonia Caused by Carbapenem-Resistant Acinetobacter Baumannii / 대한구급학회지

BACKGROUND: Several antibiotics can be used to treat ventilator-associated pneumonia caused by carbapenem-resistant A. baumannii (CRAB-VAP) including high-dose sulbactam. However, the effectiveness of high-dose sulbactam therapy is not well known. We report our experience with high-dose sulbactam for treatment of CRAB-VAP. METHODS: Medical records of patients with CRAB-VAP who were given high-dose sulbactam between May 2013 and June 2015 were reviewed. RESULTS: Fifty-eight patients with CRAB-VAP were treated with high-dose sulbactam. The mean age was 72.0 ± 15.2 years, and the acute physiology and chronic health evaluation II (APACHE II) score was 15.1 ± 5.10 at the time of CRAB-VAP diagnosis. Early clinical improvement was observed in 65.5% of patients, and 30-day mortality was 29.3%. Early clinical failure (odds ratio [OR]: 8.720, confidence interval [CI]: 1.346-56.484; p = 0.023) and APACHE II score ≥ 14 at CRAB-VAP diagnosis (OR: 10.934, CI: 1.047-114.148; p = 0.046) were associated with 30-day mortality. CONCLUSIONS: High-dose sulbactam therapy may be effective for the treatment of CRAB-VAP. However, early clinical failure was observed in 35% of patients and was associated with poor outcome.