Risk factors of paclitaxel-induced peripheral neuropathy in patients with breast cancer: a prospective cohort study.

Objective: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and severe adverse reaction in taxane-based chemotherapy. This study aimed to analyze the risk factors of peripheral neuropathy in patients with breast cancer receiving paclitaxel chemotherapy to provide a reference for the early prevention of CIPN. Methods: We included 350 patients with breast cancer who received chemotherapy for the first time at the Tangshan People's Hospital between August 2022 and June 2023 and were followed for at least 3 months after the end of chemotherapy. The incidence of CIPN in patients with breast cancer was calculated, and risk factors for CIPN were analyzed using logistic regression analysis. Results: The incidence rate of CIPN was 79.1%. Multifactor logistic regression analysis indicated that age ≥45 years [odds ratio (OR)=5.119, 95% confidence interval (CI)=1.395-18.780] and ≥60 years (OR=9.366, 95% CI=1.228-71.421), history of hypertension (OR=3.475, 95% CI=1.073-11.250), cumulative dose of chemotherapy drugs >900 mg (OR=4.842, 95% CI=1.961-5.946), vitamin D deficiency (OR=6.214, 95% CI=2.308-16.729), abnormal alanine aminotransferase (OR=3.154, 95% CI=1.010-9.844), anemia before chemotherapy (OR=2.770, 95% CI=1.093-7.019), infusion duration of chemotherapy drugs >30 min (OR=3.673, 95% CI=1.414-9.539), body mass index ≥24 kg/m2 (OR=8.139, 95% CI=1.157-57.240), mild depression (OR=4.546, 95% CI=1.358-15.223), and major depression (OR=4.455, 95% CI=1.237-16.037) increased the risk of CIPN. Having a regular caregiver (OR=0.223, 95% CI=0.087-0.573), high levels of physical activity (OR=0.071, 95% CI=0.008-0.647), and strong social support (OR=0.048, 95% CI=0.003-0.682) were protective factors against CIPN. Conclusion: Clinical attention should be paid to patients with these risk factors, and active and effective preventive measures should be taken to reduce the occurrence of CIPN and improve the quality of life.

Nuclear factor-Y mediates pancreatic β-cell compensation by repressing reactive oxygen species-induced apoptosis under metabolic stress / 中华医学杂志(英文版)

BACKGROUND@#Pancreatic β-cells elevate insulin production and secretion through a compensatory mechanism to override insulin resistance under metabolic stress conditions. Deficits in β-cell compensatory capacity result in hyperglycemia and type 2 diabetes (T2D). However, the mechanism in the regulation of β-cell compensative capacity remains elusive. Nuclear factor-Y (NF-Y) is critical for pancreatic islets' homeostasis under physiological conditions, but its role in β-cell compensatory response to insulin resistance in obesity is unclear.@*METHODS@#In this study, using obese ( ob/ob ) mice with an absence of NF-Y subunit A (NF-YA) in β-cells ( ob , Nf-ya βKO) as well as rat insulinoma cell line (INS1)-based models, we determined whether NF-Y-mediated apoptosis makes an essential contribution to β-cell compensation upon metabolic stress.@*RESULTS@#Obese animals had markedly augmented NF-Y expression in pancreatic islets. Deletion of β-cell Nf-ya in obese mice worsened glucose intolerance and resulted in β-cell dysfunction, which was attributable to augmented β-cell apoptosis and reactive oxygen species (ROS). Furthermore, primary pancreatic islets from Nf-ya βKO mice were sensitive to palmitate-induced β-cell apoptosis due to mitochondrial impairment and the attenuated antioxidant response, which resulted in the aggravation of phosphorylated c-Jun N-terminal kinase (JNK) and cleaved caspase-3. These detrimental effects were completely relieved by ROS scavenger. Ultimately, forced overexpression of NF-Y in INS1 β-cell line could rescue palmitate-induced β-cell apoptosis, dysfunction, and mitochondrial impairment.@*CONCLUSION@#Pancreatic NF-Y might be an essential regulator of β-cell compensation under metabolic stress.

Meta-analyses on SARS-CoV-2 Viral Titers in Wastewater and Their Correlations to Epidemiological Indicators

BackgroundRecent applications of wastewater-based epidemiology (WBE) have demonstrated its ability to track the spread and dynamics of COVID-19 at the community level. Despite the growing body of research, quantitative synthesis of SARS-CoV-2 titers in wastewater generated from studies across space and time using diverse methods has not been performed. ObjectiveThe objective of this study is to examine the correlations between SARS-CoV-2 viral titers in wastewater across studies, stratified by key covariates in study methodologies. In addition, we examined the associations of proportions of positive detections (PPD) in wastewater samples and methodological covariates. MethodsWe systematically searched the Web of Science for studies published by February 16th, 2021, performed a reproducible screen, and employed mixed-effects models to estimate the levels of SARS-CoV-2 viral titers in wastewater samples and their correlations to case prevalence, sampling mode (grab or composite sampling), and the fraction of analysis (FOA, i.e., solids, solid-supernatant mixtures, or supernatants/filtrates) ResultsA hundred and one studies were found; twenty studies (1,877 observations) were retained following a reproducible screen. The mean of PPD across all studies was 0.67 (95%-CI, [0.56, 0.79]). The mean titer was 5,244.37 copies/mL (95%-CI, [0; 16,432.65]). The Pearson Correlation coefficients (PCC) between viral titers and case prevalences were 0.28 (95%-CI, [0.01; 0.51) for daily new cases or 0.29 (95%-CI, [-0.15; 0.73]) for cumulative cases. FOA accounted for 12.4% of the variability in PPD, followed by case prevalence (9.3% by daily new cases and 5.9% by cumulative cases) and sampling mode (0.6%). Among observations with positive detections, FOA accounted for 56.0% of the variability in titers, followed by sampling mode (6.9%) and case prevalence (0.9% by daily new cases and 0.8% by cumulative cases). While sampling mode and FOA both significantly correlated with SARS-CoV-2 titers, the magnitudes of increase in PPD associated with FOA were larger. Mixed-effects model treating studies as random effects and case prevalence as fixed effects accounted for over 90% of the variability in SARS-CoV-2 PPD and titers. InterpretationsPositive pooled means and confidence intervals in PCC between SARS-CoV-2 titers and case prevalence indicators provide quantitative evidence reinforcing the value of wastewater-based monitoring of COVID-19. Large heterogeneities among studies in proportions of positive detections, titers, and PCC suggest a strong demand in methods to generate data accounting for cross-study heterogeneities and more detailed metadata reporting. Large variance explained by FOA suggesting FOA as a direction that needs to be prioritized in method standardization. Mixed-effects models accounting for study level variations provide a new perspective to synthesize data from multiple studies.

Meta-analysis of Therapeutic Efficacy of TCM External Treatment for Alopecia Areata and Investigation on the Regularity of Prescription Selection and Medicine Use / 中国药房

OBJECTIVE:To systematically evaluate the therapeutic efficacy and safety of TCM external treatment for alopecia areata,and to investigate the regularity of prescription selection and medicine use. METHODS:Retrieved from PubMed,EMBase, Cochrane Library,CBM and CNKI,RCTs about TCM external treatment(trial group)vs. routine regimen(control group)in the treatment of alopecia areata were included. The qualities of included studies were evaluated with modified Jadad scale after literature screening and data extraction. Meta-analysis was conducted by using Rev Man 5.3 statistical software. Frequency statistics and ingredient analysis were conduced among included prescriptions. RESULTS:A total of 21 RCTs were included,involving 2 510 patients. Meta-analysis showed that total response rate of trial group was significantly higher than that of control group,with statistical significance [OR=4.14,95%CI(3.04,5.65),P<0.001]. There was no statistical difference in the incidence of ADR between 2 groups [OR=1.66,95%CI(3.04,5.65),P=0.48]. A total of 20 prescriptions among included 21 RCTs were included after the repeated prescriptions were deleted. Above prescriptions were analyzed statistically;there were 53 ingredients in 20 prescriptions,and the sum of use frequency for those ingredients was 138.The ingredients with high use frequency were Carthamus tinctorius,Platycladus orientalis,Salvia miltiorrhiza;main types of medicines were restoring vital energy,relieving exterior disorder,invigorating blood circulation and eliminating stasis,etc. CONCLUSIONS:TCM external treatment shows good therapeutic efficacy and safety. Medicines are mainly used for restoring vital energy,invigorating blood circulation and eliminating stasis.

Effect of molar ligation and local Porphyromonas gingivalis inoculation on alveolar bone loss in the mouse / 北京大学学报(医学版)

Objective:To compare the extent and time course of alveolar bone loss and osteoclast activation in two murine models of periodontal disease:molar ligation and Porphyromonas gingivalis (P.gingivalis) oral inoculation.Methods:A split-mouth design was applied to two groups of mice (C57BL6,6-8 weeks old,n =24 in both groups),resulting in four treatment groups:(1) Control group:unligated upper right 2nd molars receiving CMC only,(2)Ligature group:ligation of a 9-0 suture around the upper left 2nd molar,(3) P.gingivalis group:unligated upper right 2nd molar receiving P.gingivalis challenge only,(4)Ligature ± P.gingivalis group:ligation of the upper left 2nd molar in combination with oral inoculation with 109 colony-forming units(CFU) P.gingivalis.Alveolar bone loss was measured as the cementoenamel junction and alveolar bone crest (CEJ-ABC) distance.In the study,48 C57BL6 mice were designed and treated as described above,and osteoclasts were counted on histological sections following tartrate-resistant acid phosphatase (TRAP) staining and counts were normalized to alveolar bone surface distance.Then 36 C57BL6 mice were investigated,of which 30 were ligated a 940 silk ligature around the 2nd molar in the left maxillary quadrant and 6 were not ligated.After ligation for 1 week,the ligatures in 12 mice were taken off for either 1 week or 2 weeks.The CEJ-ABC distance of the 6 mice without ligation was baseline.The CEJ-ABC distances were measured and analyzed.The data were analyzed with one-way ANOVA.Results:Molar ligation induced marked alveolar bone loss after 3,6,9 and 12 weeks [(0.16 ±0.04) mm,(0.16 ±0.02) mm,(0.18 ±0.03) mm,(0.17 ±0.02) mm],vs.corresponding controls [(0.09 ± 0.03) mm,(0.10 ± 0.01) mm,(0.12 ± 0.04) mm,(0.12 ± 0.01) mm] andP.gingivalisgroup [(0.09±0.03)mm、(0.12±0.01)mm,(0.12±0.02)mm,(0.10± 0.01) mm],P ＜ 0.05.Combined treatment with molar ligation and P.gingivalis did not further increase the CEJ-ABC distance.Evidence for osteoclast activation was found one day after molar ligation,and TRAP-positive cell numbers peaked on day 3 (12 ±4 vs.control 2 ±2,P ＜0.01).After taking off ligature following ligation for 2 weeks,it showed significantly regrowth of alveolar bone compared with that before removal of the ligature on day 7 [(0.07 ±0.02) mm vs.(0.13 ± 0.01) mm,P ＜ 0.01].Conclusion:Molar ligation is a rapid and effective way to induce periodontal bone loss in mice.Osteoclast activation occurs within 24 hours of ligature placement,and the extent of bone loss well exceeds that of the P.gingivalis-induced bone loss.Removing ligature after periodontal disease might help bone regeneration by regrowth of the alveolar bone.

Nursing care of spinal muscular atrophy complicated with pneumonia / 中国实用护理杂志

Objective We summarized the nursing care experience of spinal muscular atrophy complicated with pneumonia.Methods The measures of nursing care to the 9 children patients were comprised of preventing sputum blockage; preventing suffocating due to milk choking; paying special attention to the time being when the sputum blockage and milk choking occurred; early detection of paralysis of respiratory muscle; and training nursing skills to the families,and so on.Results All 9 children patients were cured and discharged from hospital.Conclusions The measure of targeting nursing intervention to the children with infantile spinal muscular atrophy and pneumonia could improve therapeutic effect and reduce mortality rate.

Experience of minimally invasive treatment in 520 patients with intracranial aneurysms / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To summarize the experience of minimally invasive treatment in 520 patients with intracranial aneurysms on a retrospective study.</p><p><b>METHODS</b>The measures used in the treatment of 520 patients were reviewed in terms of timing of surgery, induced-hypotensive anesthesia, brain protection combined with temporal occlusion of the feeding artery, external drainage of CSF, dynamic monitoring of intracranial pressure, blood flow velocity, serum osmolality and CT scanning, anti-vasospasm therapy as well as selected interventional endovascular embolization of aneurysms.</p><p><b>RESULTS</b>Of the 520 patients, 485 were treated with either direct clipping or endovascular embolization and 35 patients were treated non-surgically. In 449 patients undergoing direct clipping and 36 undergoing endovascular embolization, intraoperative rupture of aneurysm occurred in 27 (6.0%) and 0%, respectively. Death occurred in 13 (2.6%), hemiplegia in 8 (1.6%), and vegetative state in 2 (0.4%). The operative mortality of direct clipping was 3.8% in 210 patients before 1990 and 1.8% in 275 patients after 1990 (36 patients undergoing endovascular embolization, the operative mortality was 0%).</p><p><b>CONCLUSION</b>The outcome of patients with intacranial aneurysms can be markedly improved and the operative mortality can be lowered by minimally invasive treatment.</p>

The new resuscitation strategy for hemorrhagic shock / 解放军医学杂志

For uncontrolled hemorrhagic shock the traditional method and target of resuscitation may be harmful. The existing data supported a strategy of less aggressive interventions to those shock with uncontrolled hemorrhage until a decisive surgery begin. The choice of liquor for resuscitation remains in controversy. A combined application of crystalloid and colloid liquor seems to be reasonable and may be accepted by most physicians. It should be noted that the new resuscitation strategy may not be suitable to some kinds of trauma, such as traumatic brain injury, and its long-term effects on to the prognosis should be further evaluated.

The expression of receptor for advanced glycation end product in gingival tissues of type 2 diabetic patients with periodontitis / 实用口腔医学杂志

Objective:To detect the distribution of the receptor for advanced glycation end products(RAGE) in gingival tissues of patients with non-insulin dependent diabetes mellitus(NIDDM) accompanying periodontitis.Methods:5 patients with chronic periodontitits(CP) and 4 patients with NIDDM accompanying periodontitis were included. Immunohistochemical staining was performed to detect RAGE and tumor necrosis factor ?(TNF-?) expression in gingival tissues.Interleukin 6(IL-6) and TNF-? levels in gingival crevicular fluid and serum of these patients were examined by ELISA.Results:More RAGE cells were observed in the gingival tissus in the patients of NIDDM with CP than in those of CP(P0.05).Conclusion:RAGE may play a role in the destruction of periodontal tissues in NIDDM patients with CP.

Calcium homeostasis deregulation in glutamate-induced excitotoxicity and its role in neurodegenerative diseases / 中国药理学通报

Excitotoxicity refers to a process of neuronal death caused by excessive or prolonged activation of receptors for the excitatory amino acids, which is related to the overload of intracellular calcium ([Ca2+]i) and mitochondrial depolarization. The well accepted hypothesis that Ca2+ plays a central role in neurotoxicity, and it mediated excitotoxicity is deeply involved in both acute and chronic neurodegeneration suggests that inhibitors of Ca2+ transduction, such as NMDA antagonists, might block the pathological process at an early stage and provide more effective protections.