Safety of COVID-19 vaccine in patients with myasthenia gravis: a self-controlled case series study.

Background: The safety of COVID-19 vaccines has been clarified in clinical trials; however, some immunocompromised patients, such as myasthenia gravis (MG) patients, are still hesitant to receive vaccines. Whether COVID-19 vaccination increases the risk of disease worsening in these patients remains unknown. This study aims to evaluate the risk of disease exacerbation in COVID-19-vaccinated MG patients. Methods: The data in this study were collected from the MG database at Tangdu Hospital, the Fourth Military Medical University, and the Tertiary Referral Diagnostic Center at Huashan Hospital, Fudan University, from 1 April 2022 to 31 October 2022. A self-controlled case series method was applied, and the incidence rate ratios were calculated in the prespecified risk period using conditional Poisson regression. Results: Inactivated COVID-19 vaccines did not increase the risk of disease exacerbation in MG patients with stable disease status. A few patients experienced transient disease worsening, but the symptoms were mild. It is noted that more attention should be paid to thymoma-related MG, especially within 1 week after COVID-19 vaccination. Conclusion: COVID-19 vaccination has no long-term impact on MG relapse.

Risk of psychiatric events in women treated with isotretinoin: a self-controlled study with SIDIAP database.

BACKGROUND: Since isotretinoin marketing, reports of psychiatric events have been noted. Howeverto date, a relation between these events and acne or isotretinoin treatment has not been clearly established. Our objective was to analyze the incidence of psychiatric events in women receiving isotretinoin. METHODS: Self-controlled study including women treated with isotretinoin from July 2014 to December 2018. Data source was SIDIAP, a primary health care-based database from Catalonia, Spain. Risk of psychiatric events was analyzed during the isotretinoin exposure and during the previous and posterior periods of non-exposure. RESULTS: We included 4,738 women in the study, 25.3% of them had history psychiatric disorders prior to receiving isotretinoin. During the follow-up, 782 (16.5%) patients were diagnosed with new mental disorders and 925 (19.5%) received new psychotropic drug prescriptions. We found a trend to an increase of new events when the previous non-exposure and the isotretinoin exposure periods were compared, with no significant differences. Incident psychiatric events during isotretinoin exposure was significantly higher in those patients with previous psychiatric history. CONCLUSIONS: We cannot conclude any causality between acne and isotretinoin and the appearance of new psychiatric events. However, we contribute to the evidence with a more robust methodological approach, which minimizes the effect of confounding variables.

[A comparative study on effectiveness of patellar resurfacing against non-resurfacing in total knee arthroplasty].

Objective: To investigate the effectiveness of total knee arthroplasty (TKA) with or without patellar resurfacing. Methods: Between March 2013 and August 2015, 30 patients (60 knees) with osteoarthritis who met the inclusion criteria were recruited in the study. Of 30 cases, 24 were male and 6 were female with an average age of 57.2 years (range, 37-65 years). The body mass index ranged from 19.5 to 40.3 kg/m 2 (mean, 28.2 kg/m 2). According to Kellgren-Lawrence grading, there were 8 cases at grand Ⅲ and 22 cases at grand Ⅳ. All patients underwent primary bilateral TKA. The patellar resurfacing was done at the unilateral knee randomly (resurfacing side); the opposite treatment was done at the other side (non-resurfacing side). The indexes of 2 groups were recorded and compared, including the intraoperative blood loss, operation time, knee society score (KSS), "Forgotten Joint" scale (FJS), anterior knee pain, anterior patellar spirant, knee constraint feeling, anterior patellar clunk, muscle power of knee extension, and ability of up and down stairs, weight-bearing flexion, squatting down, cross-legged, knee down, knee extension, and patient satisfaction. Radiographic examination was used to analyze the prosthesis position. Results: The operation time were (126±14) minutes and (112±11) minutes in resurfacing side and non-resurfacing side, respectively, showing significant difference between two sides ( t=5.103, P=0.030); and there was no significant difference in intraoperative blood loss between two sides ( t=3.431, P=0.800). All patients were followed up 2-4 years (mean, 2.6 years). There was no significant difference ( P>0.05) between two sides in KSS clinical and functional scores at preoperation and 6 weeks, 6 months, and 2 years after operation; in visual analogue scale (VAS) score of anterior knee pain at preoperation and 6 weeks after operation; in incidences of anterior patellar spirant, knee constraint feeling, anterior patellar clunk, and muscle power of knee extension at 6 weeks, 6 months, and 2 years after operation; in incidences of disability of up and down stairs, weight-bearing flexion, squatting down, cross-legged, knee down, and knee extension at 6 weeks, 6 months, and 2 years after operation; in ratio of FJS score at 2 years after operation. The VAS scores at 6 months and 2 years after operation in resurfacing group were significantly lower than those in non-resurfacing group ( Z=-1.997, P=0.046; Z=-2.197, P=0.028). Patient satisfaction of resurfacing side was superior to the non-resurfacing side at 6 weeks after operation ( χ2=4.271, P=0.039). Radiographic examination showed no prosthesis loosing occurred. Conclusion: The effectiveness of TKA with patellar resurfacing is better than that with non-resurfacing in patients satisfaction.

A comparative study on effectiveness of patellar resurfacing against non-resurfacing in total knee arthroplasty / 中国修复重建外科杂志

Objective: To investigate the effectiveness of total knee arthroplasty (TKA) with or without patellar resurfacing.

Metabolic Characterization of Myocardial Infarction Using GC-MS-Based Tissue Metabolomics.

Understanding the metabolic features of myocardial infarction (MI) is critical to its prevention and treatment. Here, we aimed to characterize the metabolic features of early MI using a tissue metabolomics method based on gas chromatography-mass spectrometry (GC-MS). Thirty-four pairs of infarcted myocardia and their matched non-infarcted myocardia were collected from 34 rats that underwent coronary artery ligation (CAL); their metabolic profiles were compared by GC-MS-based tissue metabolomics to characterize the metabolic features of MI. On the basis of differential metabolites, their diagnostic potential for MI was analyzed, and MI-related metabolic pathways were investigated. Serum samples before and post MI were used to validate the results obtained in myocardia. The metabolic profile of the infarcted myocardia was obviously different from that of the non-infarcted myocardia, as indicated by partial least squares discriminate analysis (PLS-DA) plots. Twenty-two metabolites were identified to be different between the infarcted myocardia and non-infarcted myocardia. These metabolic alterations reflect energy deficit, acidosis, oxidative stress, ionic imbalance, and cardiac injury post MI. Glutamine, glutamate, and lactate were confirmed to jointly confer a favorable potential for diagnosing MI, which can be well validated in serum.

Observations on the Efficacy of Fire Needling Therapy for Vitiligo / 上海针灸杂志

Objective To assess the clinical efficacy and safety of fire needling therapy for vitiligo. Method A self-control study was carried out. Fifty-six vitiligo patients with 124 skin lesions were allocated by long-axis random to two groups. The treatment group received fire needling therapy weekly for 12 times or until cure and the control group, no treatment as a blank control. The clinical efficacy and safety were assessed after the completion of treatment. Result The total efficacy rate of local fire needling therapy for vitiligo skin lesions was 79.8% and there was a statistically significant difference as compared with the control group (P<0.05). The therapeutic effect was better in patients with faciocervical skin lesions or short course of disease. The therapeutic effect increased with an increase in the course of treatment at the early stage of treatment but did not significantly increase after 8 weeks of treatment. Main adverse reactions were mild pain and skin infection. Conclusion Local fire needling has a definite therapeutic effect on vitiligo with high safety.

Self-control study on reduced-dose depot versus daily administration of gonadotrophin-releasing hormone agonists for pituitary desensitization in in vitro fertilization cycles.

AIM: Our aim was to analyze the effect of reducing the dose of depot gonadotrophin-regulating hormone-agonist (GnRH-a) to 1.0 mg on pituitary desensitization and clinical outcome of in vitro fertilization and embryo transfer cycles. MATERIAL AND METHODS: This retrospective self-control study was conducted on 143 patients who underwent repeated long-protocol treatment from 1 January 2011 to 31 May 2012 at our hospital. Of the 143 patients, 64 received reduced-dose depot (1.0 mg diphereline depot) GnRH-a for the first cycle and short-acting GnRH-a (0.05 mg diphereline) for the second cycle, while 79 patients received short-acting GnRH-a for the first cycle and reduced-dose depot GnRH-a for the second cycle. RESULTS: The serum follicle-stimulating hormone, luteinizing hormone and estradiol levels on the day of gonadotrophin initiation were significantly higher in the short-acting group compared with the long-acting group. Both number of days of gonadotrophin stimulation and gonadotrophin doses were significantly higher in the short-acting group. On the day of human chorionic gonadotrophin administration, the serum estradiol level was significantly higher while the progesterone level was significantly lower in the short-acting group. There were no significant differences with regard to the number of retrieved oocytes, fertilization rate, number of transferred embryos, clinical pregnancy rate, implantation rate, and early pregnancy loss rate between the two groups. However, the oocyte maturation rate was significantly higher in the long-acting group. CONCLUSION: Reduced-dose depot GnRH-a can be successfully used for pituitary desensitization in in vitro fertilization and embryo transfer. Deeper downregulation with reduced-dose depot GnRH-a indicates that the optimal dose of GnRH-a warrants future study.

Clinical Self-Control Comparative Study on Treatment Effect of Compound Yisui Shengxue Keli for ?-Thalassemia Cases / 中国中医药信息杂志

Objective To study the clinical effect of compound Yisui Shengxue Keli(YSSXKL) on treating ?-thalassemia. Methods By using self-control study method,30 cases of major and intermediate ?-thalassemia had been first treated with placebo for three months,then were treated with YSSXKL in the followed three months in Guangxi province,the high incidence area of the disease. The clinical symptoms,traditional Chinese medicine symptoms and dynamic changes of the blood levels of Hb,RBC,Ret and HbF were observed before and after each treatment. The CRF tables were filled in according to the traditional Chinese medicine symptoms of the patients and the side effects recorded. Results During period of placebo treatment,the main curtive effective indexes Hb and RBC were not obviously raised,while the RBC levels were inversely degraded after the first month of taking placebo orally(P

The Effect of Sleep Deprivation on Executive Control Function:an fMRI Study / 中国心理卫生杂志

Objective:To explore the impact of total sleep deprivation (TSD) on executive control function.Methods:Thirteen healthy young men completed visual Go/No-go task before and after the 36 hour sleep deprivation.Functional magnetic resonance imaging (fMRI) was carried out in these subjects 3 weeks apart.Results: The hit rate of Co/No-go task decreased (P