Secondary Metabolite Analysis of Phomopsis sp. LGT-5 Based on the Dual Guidance of Whole-Genome Sequencing and HPLC-Q-ToF-MS/MS.

Microorganisms produce a wealth of structurally diverse specialized metabolites with a remarkable range of biological activities. The Phomopsis sp. LGT-5 was obtained through tissue block and repeatedly crossed methods from Tripterygium wilfordii Hook. F. The antibacterial experiments of LGT-5 showed that it has high inhibitory activity against Staphylococcus aureus and Pseudomonas aeruginosa, and moderate inhibitory activity against Candida albicans. To research the generation of the antibacterial phenomenon of LGT-5 and provide support for further research and application, the whole genome sequencing (WGS) of LGT-5 was obtained by single-molecule real-time DNA sequencing platform Pacific Biosciences (PacBio) sequencing and Illumina paired-end sequencing. The final assembled LGT-5 genome is 54.79 Mb with a contig N50 of 290.07 kb; in addition, its secondary metabolites were detected through HPLC-Q-ToF-MS/MS. By comparing its MS/MS data, the secondary metabolites were analyzed based on visual network maps obtained on the Global Natural Products Social Molecular Networking (GNPS). The analysis results showed that the secondary metabolites of LGT-5 were triterpenes and various cyclic dipeptides.

Comparison and fusion prediction model for lung adenocarcinoma with micropapillary and solid pattern using clinicoradiographic, radiomics and deep learning features.

To investigate whether the combination scheme of deep learning score (DL-score) and radiomics can improve preoperative diagnosis in the presence of micropapillary/solid (MPP/SOL) patterns in lung adenocarcinoma (ADC). A retrospective cohort of 514 confirmed pathologically lung ADC in 512 patients after surgery was enrolled. The clinicoradiographic model (model 1) and radiomics model (model 2) were developed with logistic regression. The deep learning model (model 3) was constructed based on the deep learning score (DL-score). The combine model (model 4) was based on DL-score and R-score and clinicoradiographic variables. The performance of these models was evaluated with area under the receiver operating characteristic curve (AUC) and compared using DeLong's test internally and externally. The prediction nomogram was plotted, and clinical utility depicted with decision curve. The performance of model 1, model 2, model 3 and model 4 was supported by AUCs of 0.848, 0.896, 0.906, 0.921 in the Internal validation set, that of 0.700, 0.801, 0.730, 0.827 in external validation set, respectively. These models existed statistical significance in internal validation (model 4 vs model 3, P = 0.016; model 4 vs model 1, P = 0.009, respectively) and external validation (model 4 vs model 2, P = 0.036; model 4 vs model 3, P = 0.047; model 4 vs model 1, P = 0.016, respectively). The decision curve analysis (DCA) demonstrated that model 4 predicting the lung ADC with MPP/SOL structure would be more beneficial than the model 1and model 3 but comparable with the model 2. The combined model can improve preoperative diagnosis in the presence of MPP/SOL pattern in lung ADC in clinical practice.

Quantitative texture analysis based on dynamic contrast enhanced MRI for differential diagnosis between primary thymic lymphoma from thymic carcinoma.

To evaluate the value of texture analysis based on dynamic contrast enhanced MRI (DCE-MRI) in the differential diagnosis of thymic carcinoma and thymic lymphoma. Sixty-nine patients with pathologically confirmed (thymic carcinoma, n = 32; thymic lymphoma, n = 37) were enrolled in this retrospective study. Ktrans, Kep and Ve maps were automatically generated, and texture features were extracted, including mean, median, 5th/95th percentile, skewness, kurtosis, diff-variance, diff-entropy, contrast and entropy. The differences in parameters between the two groups were compared and the diagnostic efficacy was calculated. The Ktrans-related significant features yielded an area under the curve (AUC) of 0.769 (sensitivity 90.6%, specificity 51.4%) for the differentiation between thymic carcinoma and thymic lymphoma. The Kep-related significant features yielded an AUC of 0.780 (sensitivity 87.5%, specificity 62.2%). The Ve-related significant features yielded an AUC of 0.807 (sensitivity 75.0%, specificity 78.4%). The combination of DCE-MRI textural features yielded an AUC of 0.962 (sensitivity 93.8%, specificity 89.2%). Five parameters were screened out, including age, Ktrans-entropy, Kep-entropy, Ve-entropy, and Ve-P95. The combination of these five parameters yielded the best discrimination efficiency (AUC of 0.943, 93.7% sensitivity, 81.1% specificity). Texture analysis of DCE-MRI may be helpful to distinguish thymic carcinoma from thymic lymphoma.

Multiparametric Magnetic Resonance Imaging for Assessing Thymic Epithelial Tumors: Correlation With Pathological Subtypes and Clinical Stages.

BACKGROUND: World Health Organization classification and Masaoka-Koga stage are widely used for thymic epithelial tumors (TETs). Reduced field-of-view (rFOV) diffusion-weighed imaging (DWI) proved to improve the image quality. Dynamic contrast-enhanced (DCE) MRI was commonly used in evaluating tumors. PURPOSE: To investigate the value of multiparametric MRI in evaluating TETs. STUDY TYPE: Retrospective. SUBJECTS: Eighty-seven participants including 38 low risk (52.08 ± 14.19 years), 30 high risk (52.40 ± 11.35 years), and 19 thymic carcinoma patients (59.76 ± 10.78 years). FIELD STRENGTH/SEQUENCE: A 3 T, turbo spin echo imaging, echo planar imaging, volumetric interpolated breath-hold examination with radial acquisition trajectory. ASSESSMENT: DCE-MRI and apparent diffusion coefficient (ADC) variables were compared. Diagnostic performances of single significant factor and combined model were compared. STATISTICAL TESTS: Parameters were compared using one-way ANOVA or independent-samples t test. Logistic regression was employed to investigate the combined model. Receiver operating curves (ROC) and DeLong's test were used to compare the diagnostic efficiency. RESULTS: ADC, Ktrans , and kep values were significantly different among low-risk, high-risk and carcinoma group (ADC, 1.279 ± 0.345 × 10-3  mm2 /sec, 0.978 ± 0.260 × 10-3  mm2 /sec, 0.661 ± 0.134 × 10-3  mm2 /sec; Ktrans 0.167 ± 0.071 min-1 , 0.254 ± 0.136 min-1 , 0.393 ± 0.110 min-1 ; kep 0.345 ± 0.113 min-1 , 0.560 ± 0.269 min-1 , 0.872 ± 0.149 min-1 ). They were significantly different for early stage and advanced stage (ADC, 1.270 ± 0.356 × 10-3  mm2 /sec vs. 0.845 ± 0.251 × 10-3  mm2 /sec; Ktrans 0.179 ± 0.092 min-1 vs. 0.304 ± 0.142 min-1 ; kep 0.370 ± 0.181 min-1 vs. 0.674 ± 0.362 min-1 ). The combination of them had highest diagnostic efficiency for WHO classification (AUC, 0.925; sensitivity, 83.7%; specificity, 89.5%), clinical stage (AUC, 0.879; sensitivity, 80.9%; specificity, 82.5%). DATA CONCLUSION: Multiparametric MRI model may be useful for discriminating WHO classification and clinical stage of TETs. EVIDENCE LEVEL: 4 TECHNICAL EFFICIENCY: Stage 2.

Association of frailty with in-hospital outcomes in elderly patients with heart failure.

BACKGROUND: Frailty is prevalent in elderly patients with cardiovascular diseases. However, the association between frailty and in-hospital outcomes for elderly patients with heart failure and reduced ejection (HFrEF) remains unknown. AIM: To evaluate the predictive efficacy of frailty, compared with pre-frailty, for adverse events in these patients. METHODS: Elderly patients (≥ 60 years) with HFrEF were assessed. Frailty was evaluated with the Fried phenotype criteria, and physical performance was evaluated based on handgrip strength and the short physical performance battery (SPPB). The composite incidence of adverse events, including all-cause death, multiple organ failure, cardiac shock, and malignant arrhythmia, during hospitalization was recorded. RESULTS: Overall, 252 elderly individuals with HFrEF [mean age: 69.4 ± 6.7 years, male: 169 (67.0%)] were included. One hundred and thirty-five (53.6%) patients were frail and 93 (36.9%) were pre-frail. Frail patients were older, more likely to be female, to have a lower blood pressure, and to present with left ventricular thrombosis (P all < 0.05). Frail patients with HFrEF had a higher incidence of in-hospital mortality (11.9% vs 4.3%, P = 0.048). Multivariate analyses showed that female gender (OR = 0.422), aging (OR = 1.090), poor cardiac functional class (OR = 2.167), frailty (OR = 2.379), and lower handgrip strength (OR = 1.106) were independent predictors of in-hospital adverse events (P all < 0.05). CONCLUSION: Frailty may be associated with poor in-hospital outcomes for elderly patients with HFrEF. The influence of frailty on long-term prognosis in these patients deserves further investigation.

Effects of meteorological factors on the incidence of mumps and models for prediction, China.

BACKGROUND: Mumps is an acute respiratory infectious disease with obvious regional and seasonal differences. Exploring the impact of climate factors on the incidence of mumps and predicting its incidence trend on this basis could effectively control the outbreak and epidemic of mumps. METHODS: Considering the great differences of climate in the vast territory of China, this study divided the Chinese mainland into seven regions according to the administrative planning criteria, data of Mumps were collected from the China Disease Prevention and Control Information System, ARIMA model and ARIMAX model with meteorological factors were established to predict the incidence of mumps. RESULTS: In this study, we found that precipitation, air pressure, temperature, and wind speed had an impact on the incidence of mumps in most regions of China and the incidence of mumps in the north and southwest China was more susceptible to climate factors. Considering meteorological factors, the average relative error of ARIMAX model was 10.87%, which was lower than ARIMA model (15.57%). CONCLUSIONS: Meteorology factors were the important factors which can affect the incidence of mumps, ARIMAX model with meteorological factors could better simulate and predict the incidence of mumps in China, which has certain reference value for the prevention and control of mumps.

Effect of continuous use of metformin on kidney function in diabetes patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.

BACKGROUND: Diabetes patients presenting with ST-segment elevation myocardial infarction (STEMI) scheduled for primary percutaneous coronary intervention (PCI) have an increased risk of contrast induced-acute kidney injury (CI-AKI). The effects of continuous use of metformin on kidney function are still controversial in patients submitted to primary PCI. This study aimed to assess continuous metformin therapy on kidney function in diabetic patients undergoing coronary intervention. METHODS: Two hundred eighty-four patients with metformin-treated diabetes, who underwent coronary intervention within 24 h for STEMI, were enrolled in the retrospective study. All the patients had estimated glomerular filtration rate (eGFR) of > 30 mL/min/1.73 m2. According to the physicians' decisions after admission, 119 patients continued metformin treatment after primary PCI, while 165 patients discontinued it > 48 h after the procedure. Serum creatinine was collected at admission and within 48 h post primary PCI to evaluate the incidence of CI-AKI. We performed a multiple logistic regression analysis to examine the determinants of CI-AKI. RESULTS: No statistical difference in CI-AKI incidence between the continuous and the discontinuous metformin group (12.6%vs10.3%, p = 0.545). Multivariable logistic regression analysis indicated eGFR ≤60 ml/min/1.73 m2[p = 0.025, OR: 3.131; 95% CI (1.156-8.482)] and contrast volume [p = 0.002, OR: 1.010; 95% CI (1.004-1.016)] were predictive factors of CI-AKI. Metformin therapy was irrelevant to CI-AKI [p = 0.365, OR: 0.698; 95% CI (0.320-1.521)]. No case of lactic acidosis was found in this study. Besides, the study supported discontinuation of metformin was not beneficial for patients' blood glucose control after admission. CONCLUSIONS: The study indicated that the metformin continuation after primary PCI for STEMI in diabetic patients with eGFR > 30 ml/min / 1.73 m2 did not increase the risk of CI-AKI.

Regioselective Sulfonylation/Acylation of Carbohydrates Catalyzed by FeCl3 Combined with Benzoyltrifluoroacetone and Its Mechanism Study.

A catalytic amount of FeCl3 combined with benzoyl trifluoroacetone (Hbtfa) (FeCl3/Hbtfa = 1/2) was used to catalyze sulfonylation/acylation of diols and polyols using diisopropylethylamine (DIPEA) or potassium carbonate (K2CO3) as a base. The catalytic system exhibited high catalytic activity, leading to excellent isolated yields of sulfonylation/acylation products with high regioselectivities. Mechanism studies indicated that FeCl3 initially formed [Fe(btfa)3] (btfa = benzoyl trifluoroacetonate) with twice the amount of Hbtfa under basic conditions in the solvent acetonitrile at room temperature. Then, Fe(btfa)3 and two hydroxyl groups of the substrates formed a five- or six-membered ring intermediate in the presence of the base. The subsequent reaction between the cyclic intermediate and a sulfonylation reagent led to the selective sulfonylation of the substrate. All key intermediates were captured in the high-resolution mass spectrometry assay, therefore demonstrating this mechanism for the first time.

Stroke Dysbiosis Index (SDI) in Gut Microbiome Are Associated With Brain Injury and Prognosis of Stroke.

Background: Significant dysbiosis occurs in the gut microbiome of stroke patients. Condensing these broad, complex changes into one index would greatly facilitate the clinical usage of gut microbiome data. Here, we formulated a gut microbiota index in patients with acute ischemic stroke based on their gut microbiota dysbiosis patterns and tested whether the index was correlated with brain injury and early outcome. Methods: A total of 104 patients with acute ischemic stroke and 90 healthy individuals were recruited, and their gut microbiotas were compared and to model a Stroke Dysbiosis Index (SDI), which representing stroke-associated dysbiosis patterns overall. Another 83 patients and 70 controls were recruited for validation. The association of SDI with stroke severity (National Institutes of Health Stroke Scale [NIHSS] score) and outcome (modified Rankin scale [mRS] score: favorable, 0-2; unfavorable, >2) at discharge was also assessed. A middle cerebral artery occlusion (MCAO) model was used in human flora-associated (HFA) animals to explore the causal relationship between gut dysbiosis and stroke outcome. Results: Eighteen genera were significantly different between stroke patients and healthy individuals. The SDI formula was devised based on these microbiome differences; SDI was significantly higher in stroke patients than in healthy controls. SDI alone discriminated stroke patients from controls with AUCs of 74.9% in the training cohort and 84.3% in the validation cohort. SDI was significantly and positively correlated with NIHSS score on admission and mRS score at discharge. Logistic regression analysis showed that SDI was an independent predictor of severe stroke (NIHSS ≥8) and early unfavorable outcome (mRS >2). Mice receiving fecal transplants from high-SDI patients developed severe brain injury with elevated IL-17+ γδ T cells in gut compared to mice receiving transplants from low-SDI patients (all P < 0.05). Conclusions: We developed an index to measure gut microbiota dysbiosis in stroke patients; this index was significantly correlated with patients' outcome and was causally related to outcome in a mouse model of stroke. Our model facilitates the potential clinical application of gut microbiota data in stroke and adds quantitative evidence linking the gut microbiota to stroke.

Luteolin decreases atherosclerosis in LDL receptor-deficient mice via a mechanism including decreasing AMPK-SIRT1 signaling in macrophages.

Lipid metabolism dysfunction and inflammatory infiltration into arterial walls are associated with the initiation and progression of atherosclerosis. Luteolin has been reported to possess anti-inflammatory actions and protect against tumor necrosis factor-α (TNF-α)-induced vascular inflammation, monocyte adhesion to endothelial cells and the formation of lipid-laden macrophages in vitro. However, the role of luteolin in atherosclerosis and the associated vascular inflammatory remains to be elucidated. The aim of the present study was to investigate the effects of luteolin on plaque development, lipid accumulation and macrophage inflammation low-density lipoprotein receptor-deficient (LDLR-/-) mice with atherosclerosis, as well as the underlying mechanisms in ox-induced THP-1-derived macrophages. Firstly, 9-week-old male C57BL/6 mice were fed a standard chow diet, western diet or western diet supplemented with 100 mg/kg luteolin for 14 weeks. The results of histological staining revealed that 100 mg/kg dietary luteolin ameliorated western diet-induced atherosclerotic plaque development and lipid accumulation in the abdominal aorta. Furthermore, total cholesterol, triglyceride and LDL-cholesterol levels were decreased in the plasma of western diet + luteolin mice compared with those fed with a western diet alone. Quantitative polymerase chain reaction analysis revealed that dietary luteolin inhibited the expression of cluster of differentiation 68, macrophage chemoattractant protein 2 and inflammatory cytokines, including interleukin-6 (IL-6) and TNF-α. Mechanistically, luteolin decreased the total cholesterol level as well as macrophage chemokine and inflammatory cytokine expression in THP-1-derived macrophages via AMP-activated protein kinase (AMPK)-Sirtuin (SIRT)1 signaling following induction with oxidized low-density lipoprotein. The results of the present study suggest that luteolin prevents plaque development and lipid accumulation in the abdominal aorta by decreasing macrophage inflammation during atherosclerosis, which is mediated by mechanisms including AMPK-SIRT1 signaling.

Changes in bacterial diversity and composition in the faeces and colon of weaned piglets after feeding fermented soybean meal.

PURPOSE: The microbiota composition of faeces and colonic contents were analysed to investigate the mechaninsm by which fermented soybean meal improves intestinal microbial communities, growth and immunity in weaning piglets. METHODOLOGY: Microbiota were investigated using16S rRNA gene sequencing and systematical bio-information Operational Taxonomic Units; α-diversity analyses indicated that fermented soybean meal increased bacterial species diversity. RESULTS: The levels of Actinobacteria and Proteobacteia in faeces, and Firmicutes and Tenericutes in the colon, increased significantly in piglets fed fermented soybean meal (P<0.05). The relative abundance of Clostridium sensu stricto1, Lachnospira and Bacteoides had positive correlations with diarrhoea in the piglets. Lactobacillus, Blautia and Clostridium sensu stricto1 levels were correlated with increases in the average daily feed intake of piglets. Lactobacillus and Lachnospira also had positive relationships with IgM levels, and lymphocytes levels were increased relative to Clostridium sensu stricto1. Lymphocyte numbers also increased with higher levels of Blautia and decreased with Clostridium sensu stricto1. Increased levels of Blautia were also correlated with significant increases in white blood cells. CONCLUSION: The significant differences in faecal and colonic bacteria were correlated with enhanced immunity and overall improved health in the weaning piglets.

Aldosterone is involved in the pathogenesis of obesity-related glomerulopathy through activation of Wnt/ß-catenin signaling in podocytes.

Obesity-related glomerulopathy (ORG) is morphologically characterized by glomerulomegaly with or without observable focal segmental glomerulosclerosis under light microscope, with decreased podocyte density and number, and with increased foot­process width observed under electron microscope. The severity of podocyte injury is correlated with the degree of proteinuria and renal dysfunction. However, the pathogenesis of ORG is not well understood. The aim of the present study was to explore the possible pathogenic role of aldosterone (ALDO) in ORG. In the in vivo animal experiments, body weight, Lee's obesity index, abdominal fat index, urinary protein excretion, average glomerular diameter were significantly increased, the mRNA and protein expression of podocyte­associated molecules including nephrin, podocin, podoplanin and podocalyxin were significantly reduced, and the Wnt/ß­catenin signaling pathway was activated in ORG model mice compared with the Control mice, whereas the administration of spironolactone significantly ameliorated these effects. In the in vitro experiments on cultured podocytes, the mRNA and protein expression levels of the aforementioned podocyte­associated molecules were significantly downregulated and the Wnt/ß­catenin signaling pathway was activated following ALDO stimulation, whereas eplerenone significantly attenuated all the above effects. Dickkopf­related protein 1 (DKK1), an inhibitor of Wnt/ß­catenin signaling pathway, also reduced the effects of ALDO exposure on the expression of podocyte­associated molecules. The present study hypothesized that ALDO may be involved in the pathogenesis of ORG through the activation of Wnt/ß­catenin signaling pathway in podocytes.

Increased Local Spontaneous Neural Activity in the Left Precuneus Specific to Auditory Verbal Hallucinations of Schizophrenia.

BACKGROUND: Auditory verbal hallucinations (AVHs) of schizophrenia have been associated with structural and functional alterations of some brain regions. However, the brain regional homogeneity (ReHo) alterations specific to AVHs of schizophrenia remain unclear. In the current study, we aimed to investigate ReHo alterations specific to schizophrenic AVHs. METHODS: Thirty-five schizophrenic patients with AVH, 41 schizophrenic patients without AVHs, and fifty healthy subjects underwent resting-state functional magnetic resonance imaging. ReHo differences across the three groups were tested using a voxel-wise analysis. RESULTS: Compared with the healthy control group, the two schizophrenia groups showed significantly increased ReHo in the right caudate and inferior temporal gyrus and decreased ReHo in the bilateral postcentral gyrus and thalamus and the right inferior occipital gyrus (false discovery rate corrected, P < 0.05). More importantly, the AVH group exhibited significantly increased ReHo in the left precuneus compared with the non-AVH group. However, using correlation analysis, we did not find any correlation between the auditory hallucination rating scale score and the ReHo of brain regions. CONCLUSIONS: Our results suggest that increased ReHo in the left precuneus may be a pathological feature exclusive to schizophrenic AVHs.

Dysbiosis of Gut Microbiota With Reduced Trimethylamine-N-Oxide Level in Patients With Large-Artery Atherosclerotic Stroke or Transient Ischemic Attack.

BACKGROUND: Gut microbiota has been suggested to play a role in almost all major diseases including cardio- and cerebrovascular diseases. A possible mechanism is the transformation of dietary choline and l-carnitine into trimethylamine by gut bacteria. This metabolite is further oxidized into trimethylamine-N-oxide (TMAO) in liver and promotes atherogenesis. Nevertheless, little is known about gut microbial diversity and blood TMAO levels in stroke patients. METHODS AND RESULTS: We performed a case-control study of patients with large-artery atherosclerotic ischemic stroke and transient ischemic attack. TMAO was determined with liquid chromatography tandem mass spectrometry. Gut microbiome was profiled using Illumina sequencing of the 16S rRNA V4 tag. Within the asymptomatic control group, participants with and without carotid atherosclerotic plaques showed similar levels of TMAO without a significant difference in gut microbiota; however, the gut microbiome of stroke and transient ischemic attack patients was clearly different from that of the asymptomatic group. Stroke and transient ischemic attack patients had more opportunistic pathogens, such as Enterobacter, Megasphaera, Oscillibacter, and Desulfovibrio, and fewer commensal or beneficial genera including Bacteroides, Prevotella, and Faecalibacterium. This dysbiosis was correlated with the severity of the disease. The TMAO level in the stroke and transient ischemic attack patients was significantly lower, rather than higher, than that of the asymptomatic group. CONCLUSIONS: Participants with asymptomatic atherosclerosis did not exhibit an obvious change in gut microbiota and blood TMAO levels; however, stroke and transient ischemic attack patients showed significant dysbiosis of the gut microbiota, and their blood TMAO levels were decreased.

Resveratrol increases nephrin and podocin expression and alleviates renal damage in rats fed a high-fat diet.

Resveratrol is well known for its anti-inflammation and anti-oxidant properties, and has been shown to be effective in alleviating the development of obesity. The purpose of this investigation was to analyze the effect of resveratrol on renal damage in obese rats induced by a high-fat diet (HFD) and its possible mechanisms. Male Sprague-Dawley rats were divided into three groups: control, HFD, and HFD plus resveratrol (treated with 100 mg/kg/day resveratrol). Body weight, serum and urine metabolic parameters, and kidney histology were measured. Meanwhile, the activities of nuclear factor-κB (NF-κB) and superoxide dismutase (SOD), the content of malondialdehyde (MDA), and the protein levels of tumor necrosis factor (TNF-α), monocyte chemotactic protein-1 (MCP-1), nephrin and podocin in kidney were detected. Our work showed that resveratrol alleviated dyslipidemia and renal damage induced by HFD, decreased MDA level and increased SOD activity. Furthermore, the elevated NF-κB activity, increased TNF-α and MCP-1 levels, and reduced expressions of nephrin and podocin induced by HFD were significantly reversed by resveratrol. These results suggest resveratrol could ameliorate renal injury in rats fed a HFD, and the mechanisms are associated with suppressing oxidative stress and NF-κB signaling pathway that in turn up-regulate nephrin and podocin protein expression.

Guillain-Barré syndrome following sepsis after stereotactic aspiration for spontaneous pontine hemorrhage.

A 52-year-old female was treated with CT-guided stereotactic aspiration for acute spontaneous pontine hemorrhage. On postoperative day 7, the patient was complicated by Acinetobacter baumannii sepsis. As sepsis was stabilized, she developed flaccid weakness and autonomic dysfunction on postoperative day 21. Investigations including neurophysiological studies and cerebral spinal fluid analysis prompted the diagnosis of acute motor axonal neuropathy, a variant of Guillain-Barré syndrome. Intravenous administration of immunoglobulin resolved her potentially life-threatening autonomic instability. At 1-year follow-up, she was able to stand with significant assistance. Although Guillain-Barré syndrome rarely occurs, clinicians should be alert to the possibility of this potentially life-threatening consequence after cranial surgery with severe respiratory infection.

Multi-central clinical research into treating 80 cases of chronic thrombocytopenia with qi-supplementing and yin-nourishing therapy and western medicine.

OBJECTIVE: To probe the effects of qi-supplementing and yin-nourishing therapy (blood-increasing decoction and blood generating powder) on chronic thrombocytopenia. METHODS: Two hundred patients with chronic thrombocytopenia were randomly divided into control (n = 100) and test groups (n = 100) with Amino-polypeptide as a basic treatment for both. Test group patients consumed a blood-increasing decoction and blood-generating powder for 1-3 months. Improvements in platelet counts and TCM syndrome were observed. RESULTS: One hundred and sixty-four (80 in the test group and 84 in the control group) of 189 total participants were treated for 3 months. The total effective rate in improving TCM syndrome was 95.00% in the test group and 79.76% in the control group (P < 0.05). There was significant difference (P < 0.05) in the accumulated score of TCM syndrome between the two groups treated at different time points. The total effective rate of platelet counts was 86.25% in the test group and 59.52% in the control group (P < 0.05). There was a significant difference in platelet counts before and after treatment in the two groups (P < 0.05). There was no significant differences in platelet count between the two groups treated for 1-2 months; however, a significant difference was found between the two groups after treatment for 3 months (P < 0.05). CONCLUSIONS: After a 3-month treatment of chronic thrombocytopenia patients with qi-supplementing and yin-nourishing therapy, TCM syndrome was improved and platelet counts increased with no obvious side effects, and the quality of life of the participants was enhanced with noticeable long-term curative effects.

[Etiological diagnosis and specific treatment of chronic cough in 106 patients].

OBJECTIVE: To analyze the etiological diagnosis and efficacy of specific therapy of chronic cough. METHODS: Totally 106 patients with chronic cough were diagnosed using a diagnostic protocol based on the Guideline on Diagnosis and Treatment of Chronic Cough established by China Medical Association, which included history inquiry, physical examination, pulmonary function tests, X-ray or CT of paranasal sinuses or chest, 24-hour esophageal pH monitoring, and sputum cell differentials. The etiological diagnosis was made according to clinical manifestations, examination results, and response to specific therapy. RESULTS: The cause of chronic cough was confirmed in 101 patients (95.3%). Cough due to a single cause was found in 81 patients (80.2%), and due to multiple causes in 20 patients (19.8%). The causes included cough variant asthma (CVA) in 66 patients (62.3%), postnasal drip syndrome (PNDs) in 15 patients (14.1%), gastroesophageal reflux (GERC) in 11 patients (10.4%), post-infection cough (PIC) in 4 patients (3.8%), angiotensin converting enzyme inhibitor (ACEI) induction in 3 patients (2.8%), and eosinophilic bronchitis (EB) in 2 patients (1.9%). Five patients (4.7%) had not been definitely diagnosed. After specific therapy based on diagnosis, cough disappeared in 92 patients (91.1%) and alleviated in 9 patients (8.9%). CONCLUSIONS: CVA, PNDs, and GERC are the most common causes of chronic cough. Specific therapy based on definite cause can result in good outcome.