Lipid accumulation product as useful predictors of stroke: A correlation analysis between lipid accumulation index/cerebral vascular hemodynamics indexes and risk factors of stroke in 3264 people undergoing physical examination in Xinjiang

Objective:To investigate the relationship between lipid accumulation index and cerebral hemodynamic integral value in 3264 people undergoing physical examination, so as to analyze the correlation between different lipid accumulation product index (LAP) levels and stroke risk factors.Methods:This cross-sectional study was conducted from January to December 2019 on 3264 adults at the age of 19 to 85 living in Urumqi, Xinjiang. The stroke related risk factors were evaluated by the questionnaire survey. The enrolled subjects were divided into Q1 group (n = 817), Q2 group (n = 815), Q3 group (n = 816) and Q4 group (n = 816) according to the quartile site at a low-to-high-score manner.Results:The proportion of males was significantly higher than that of females in Q2, Q3, and Q4 groups. The proportion of middle-aged people and the elderly in Q2, Q3, and Q4 groups was significantly higher than that of youths (P < .05). The proportion of patients with history of hypertension, hyperlipidemia, physical inactivity, and smoking, and the levels of systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, high-density cholesterol, low-density cholesterol, triglyceride, body mass index, waist circumference increased with the increase of LAP level in different groups (P < .05). On both sides of the cerebral hemodynamic integral value (CVHI) index, Vmean, Vmax, Vmin showed a decreasing trend whereas peripheral resistance, pulse velocity, Zcv, dynamic resistance, critical pressure level, difference between diastolic and critical pressure showed an increase trend with the increase of LAP level. The normal rate of CVHI in 4 groups (>75 points) was 97.4%, 89.7%, 87.0, and 80.8%, respectively, showing a decreasing trend. Logistic regression results showed that the higher the LAP, the higher the abnormal risk of CVHI.Conclusion:There is a positive correlation between LAP and CVHI, the higher the LAP, the higher the risk of CVHI abnormality, which should be concerned seriously.     

Long-term survival in a patient with advanced non-smoking lung adenocarcinoma and no EGFR mutation after comprehensive therapy with EGFR-TKI-based therapy: A case report

Rationale:This is the first known report to describe a case of advanced non-smoking lung adenocarcinoma with no epidermal growth factor receptor mutation after comprehensive epidermal growth factor receptor-tyrosine kinase inhibitor-based therapy that survived for nearly 12 years.Patient concerns:A 48-year-old Chinese woman that came to our hospital with a left supraclavicular mass.Diagnosis:The final diagnosis was left lung adenocarcinoma with left supraclavicular lymph node metastasis, cT1N3M0 IIIB (International association for the Study of lung cancer 6th version).Interventions:After 4 months of 4 cycles of chemotherapy, gefitinib was administered alone for 5.5 years. Local radiotherapy (40GY/20F) was administered for 1 month, and osimertinib alone was followed for 4.5 years. A combination of pemetrexed with oxaliplatin and hyperthermia at the same time was administered for 4 cycles. Toripalimab and anlotinib were administered for 3 months. Since then, the patient had been taking a double dose of icotinib herself.Outcomes:The patient has survived for nearly 12 years since diagnosis of lung cancer.Lessons:Our case is of significant importance to clinicians involved in the treatment of patients with advanced nonsmoking lung adenocarcinoma and no epidermal growth factor receptor mutations.     

Quercetin protects against cisplatin‐induced acute kidney injury by inhibiting Mincle/Syk/NF‐κB signaling maintained macrophage inflammation

Acute kidney injury (AKI) with high incidence and mortality is the main cause of chronic kidney disease. Previous studies have indicated that quercetin, an abundant flavonoid in plants, exhibited renoprotective role in AKI. However, the underlying mechanism is largely unknown. In this study, we try to explore whether quercetin protects against AKI by inhibiting macrophage inflammation via regulation of Mincle/Syk/NF‐κB signaling. The results demonstrated that quercetin can significantly inhibit expression and secretion of IL‐1β, IL‐6, and TNF‐α in LPS‐induced bone marrow‐derived macrophages (BMDMs) and reduce activity of Mincle/Syk/NF‐κB signaling in vitro. We also found that quercetin can strongly reduce the concentration of serum creatinine, BUN, IL‐1β, IL‐6, and TNF‐α in cisplatin‐induced AKI model. Furthermore, quercetin down‐regulated protein levels of Mincle, phosphorylated Syk and NF‐κB in kidney macrophages of AKI, as well as inhibited M1, up‐regulated M2 macrophage activity. Notably, the down‐regulation of LPS‐induced inflammation by quercetin was reversed after adding TDB (an agonist of Mincle) in BMDMs, suggesting that quercetin suppresses macrophage inflammation may mainly through inhibiting Mincle and its downstream signaling. In summary, these findings clarified a new mechanism of quercetin improving AKI‐induced kidney inflammation and injury, which provides a new drug option for the clinical treatment of AKI.     

姜黄素对脑缺血再灌注自发性高血压大鼠认知功能的影响

目的：探讨姜黄素对脑缺血再灌注自发性高血压（SH）大鼠认知功能的影响。方法:选取75只大鼠随机分为假手术组、模型组和实验组,每组25只;模型组和实验组构建脑中动脉栓塞（MCAO）模型,假手术组不阻塞大脑中动脉血供;实验组于术前30 min及再灌注后6 h腹腔注射姜黄素100 mg/kg,假手术组和模型组注射等量生理盐水。检测大鼠认知功能、缺血侧海马区神经元凋亡及相关蛋白的表达。结果：缺血再灌注2~72 h,与假手术组比,模型组神经元凋亡细胞数量增多,而实验组较模型组减少;模型组穿台次数减少,实验组多于模型组;模型组逃避潜伏期延长,实验组短于模型组;模型组缺血侧海马区磷脂酰肌醇3激酶（PI3K）、磷酸化蛋白激酶B（p-AKT）、半胱氨酸天冬氨酸蛋白酶-3（Caspase-3）蛋白含量高于假手术组,实验组PI3K、p-AKT蛋白含量高于模型组,Caspase-3蛋白低于模型组（均P<0.05）。结论:姜黄素可减轻脑缺血再灌注SH大鼠神经元凋亡程度,改善认知功能,其机制与上调PI3K、p-AKT蛋白表达及下调Caspase-3蛋白表达相关。     

彩色超声引导下针刀治疗肩胛上神经卡压综合征临床疗效观察

目的:观察彩色超声引导下针刀治疗肩胛上神经卡压综合征的临床疗效。方法:选择本院治疗的肩胛上神经卡压综合征患者60例,随机分为观察组和对照组,每组30例。对照组给予小针刀松解治疗,观察组在彩色超声引导下给予小针刀松解治疗。结果:观察组有效率96.7%,对照组有效率86.7%,观察组高于对照组,差异有统计学意义(P<0.05);治疗1周后、1个月后随访,两组VAS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗1周后、1个月后随访,两组Constant-Murley肩关节评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:彩超引导下针刀局部松解治疗肩胛上神经卡压综合征,可减轻患者的疼痛,缩短肩关节活动功能恢复的时间。     

A three-dimensional printing navigational template combined with mixed reality technique for localizing pulmonary nodules

OBJECTIVESLocalizing non-palpable pulmonary nodules is challenging for thoracic surgeons. Here, we investigated the accuracy of three-dimensional (3D) printing technology combined with mixed reality (MR) for localizing ground glass opacity-dominant pulmonary nodules.Open in a separate windowMETHODSIn this single-arm study, we prospectively enrolled patients with small pulmonary nodules (<2 cm) that required accurate localization. A 3D-printing physical navigational template was designed based on the reconstruction of computed tomography images, and a 3D model was generated through the MR glasses. We set the deviation distance as the primary end point for efficacy evaluation. Clinicopathological and surgical data were obtained for further analysis.RESULTSSixteen patients with 17 non-palpable pulmonary nodules were enrolled in this study. Sixteen nodules were localized successfully (16/17; 94.1%) using this novel approach with a median deviation of 9 mm. The mean time required for localization was 25 ± 5.2 min. For the nodules in the upper/middle and lower lobes, the median deviation was 6 mm (range, 0–12.0) and 16 mm (range, 15.0–20.0), respectively. The deviation difference between the groups was significant (Z = −2.957, P = 0.003). The pathological evaluation of resection margins was negative.CONCLUSIONSThe 3D printing navigational template combined with MR can be a feasible approach for localizing pulmonary nodules.     

Which of the acupuncture treatment regimen for lumbar disc herniation is more effective and safer: A protocol for systematic review and network meta-analysis

Introduction:Lumbar disc herniation (LDH) is the most common cause of low back pain and severely affects people''s quality of life and ability to work. Although many clinical trials and medical reports conducted over the years have shown that acupuncture treatments are effective for LDH, the comparative effectiveness of these different acupuncture therapies is still unclear. This protocol of a network meta-analysis was designed to compare the effects and safety of acupuncture treatment regimens on LDH using both direct and indirect evidence.Methods and analysis:This protocol is reported according to the 2015 PRISMA-P and PRISMA guidelines for acupuncture. Eight databases and two platforms will be searched for articles published from their establishment to 1 December 2020 with medical subject heading terms and keywords. Three reviewers will verify the eligible randomized controlled trials independently. NoteExpress (3.2.0) software will be utilized to manage the literature. The overall quality of evidence will be evaluated by Confidence In Network Meta-Analysis (CINeMA). Additionally, we will conduct a meta-analysis of the effectiveness, recurrence rate, and symptom score of acupuncture in treating LDH using Review Manager (RevManV.5.4.1) and R4.0.2 software (The R Foundation for Statistical Computing).Results:The results of the study will be published in journals or relevant conferences.Conclusion:This proposed systematic review will evaluate the comparative efficacy and safety of various acupuncture methods and combination protocols for LDH.     

血清胆红素与血管性痴呆的相关性探讨

目的:探讨血清胆红素与血管性痴呆(VD)是否存在相关性关系.方法:采用比色法对45例血管性痴呆患者、50例老年多发性脑梗死非痴呆患者(MCI)、50例健康老年对照组进行血清胆红素检测,并进行统计学处理.结果:VD组血清胆红素水平低于MCI组及正常对照组,经统计VD组与MCI组差异无显著性,但VD及MCI与正常对照组差异有显著性(P＜0.05).结论:血清胆红素水平的下降可能是脑梗死血管性痴呆的一个危险因素.     

2008—2021年国家药品抽检中成药质量分析

国家药品抽检（以下简称国抽）作为我国对上市后药品监管的重要手段,在药品质量评价与监管等方面发挥了重要作用。2008—2021年,全国共抽检中成药品种672种、共计101 715批样品,抽检品种与剂型多样,覆盖范围广。综合分析显示,历年标准检验合格率高,整体呈现稳中向好的趋势;探索性研究揭示存在一些质量问题,梳理并归纳这些问题与安全性、真实性、有效性、均一性相关;同时,分析、总结了国抽在中成药质量标准与评价体系建设方面取得的成果,并在此基础上提出了一些思考与建议,以期能为今后国抽工作提供借鉴。