《伤寒论》热入血室与妇科疾病的关系浅析

探讨《伤寒论》中热入血室与妇科疾病的关系。通过对《伤寒论》中热入血室定义的分析,引入现代医学对热入血室的认识,探讨不同妇科疾病与热入血室的关系并进行分析归纳,并总结出在经期不同阶段进行热入血室的辨治方法。     

Towards clinical data-driven eligibility criteria optimization for interventional COVID-19 clinical trials

ObjectiveThis research aims to evaluate the impact of eligibility criteria on recruitment and observable clinical outcomes of COVID-19 clinical trials using electronic health record (EHR) data.Materials and MethodsOn June 18, 2020, we identified frequently used eligibility criteria from all the interventional COVID-19 trials in ClinicalTrials.gov (n = 288), including age, pregnancy, oxygen saturation, alanine/aspartate aminotransferase, platelets, and estimated glomerular filtration rate. We applied the frequently used criteria to the EHR data of COVID-19 patients in Columbia University Irving Medical Center (CUIMC) (March 2020–June 2020) and evaluated their impact on patient accrual and the occurrence of a composite endpoint of mechanical ventilation, tracheostomy, and in-hospital death.ResultsThere were 3251 patients diagnosed with COVID-19 from the CUIMC EHR included in the analysis. The median follow-up period was 10 days (interquartile range 4–28 days). The composite events occurred in 18.1% (n = 587) of the COVID-19 cohort during the follow-up. In a hypothetical trial with common eligibility criteria, 33.6% (690/2051) were eligible among patients with evaluable data and 22.2% (153/690) had the composite event.DiscussionBy adjusting the thresholds of common eligibility criteria based on the characteristics of COVID-19 patients, we could observe more composite events from fewer patients.ConclusionsThis research demonstrated the potential of using the EHR data of COVID-19 patients to inform the selection of eligibility criteria and their thresholds, supporting data-driven optimization of participant selection towards improved statistical power of COVID-19 trials.     

The Akkermansia muciniphila is a gut microbiota signature in psoriasis

Psoriasis is an immune‐mediated chronic inflammatory skin disease. Although its pathogenesis is not fully understood, Th17 cells and the cytokines they produce, such as IL‐17, IL‐22 and IL‐23, play critical roles in the pathogenesis of psoriasis. Evidence has demonstrated that psoriasis has some common features, including immune responses (due to Th17 cells) and inflammatory cytokine profiles, with systematic diseases including inflammatory bowel diseases (IBDs) and obesity. Recently, studies have demonstrated that the gut microbiota plays a crucial role in host homoeostasis and immune response, particular in Th17 cells, but the role of the gut microbiota in psoriasis remains unclear. To study the relationship between gut microbiota and psoriasis, we analysed microbiota profiles in psoriasis using a 16S rDNA sequencing platform, and we found that the abundance of Akkermansia muciniphila was significantly reduced in patients with psoriasis. A. muciniphila is believed to have an important function in the pathogenesis of IBD and obesity; therefore, A. muciniphila, which is an indicator of health status, may be a key node for psoriasis as well as IBD and obesity. Taken together, our study identified that gut microbiota signature and function are significantly altered in the gut of patients with psoriasis, which provides a novel angle to understanding the pathogenesis of psoriasis.     

天麻素对过表达APP的APP6952、93SW细胞增殖和Aβ水平的影响

目的探讨天麻素（Gas）治疗阿尔茨海默病（AD）的可行性及机制。方法将N2a细胞（APP695）和293细胞（293SW）均分为两组,实验组分别加入255、0、1002、00μM的Gas,对照组为正常的培养基。用倒置荧光显微镜观察细胞形态,MTT法检测细胞活力,ELISA法检测纤维状β淀粉样蛋白（Aβ）水平。结果与对照组相比,实验组无胞体形态变化、轴突回缩、贴壁不良、细胞悬浮或成簇现象;Gas预处理细胞存活率无明显变化;但Aβ水平明显降低,且随Gas药物浓度增加而降低。结论 Gas治疗AD可能有功效,其机制可能为抑制Aβ表达。     

Biomechanical,metabolic and cardiopulmonary responses of masters recreational runners during running at different speeds

This study tested interactions between age and running speed on biomechanics, metabolic responses and cardiopulmonary responses. Three-hundred participants ran at preferred and standardized speeds. Age group (younger, masters [≥40 years]) by speed (self-selected 8.8 km/h, 11.2 km/h and 13.6 km/h) interactions were tested on main outcomes of sagittal kinematic, temporal spatial, metabolic and cardiopulmonary parameters. At all speeds, angular displacements of the ankle, pelvis and knee were less in masters than younger runners (Hedges g effect size range = 0.30–1.04; all p < 0.05). A significant age group by speed interaction existed for hip angular displacement (Wald χ² = 10.753; p = 0.013). Masters runners ran at higher relative heart rates (p < 0.05) but at similar rates of oxygen use and energy expenditure. Masters runners used hip-dominant motion and step lengthening as running speed increased, but did not change centre of mass vertical displacement. This may increase mechanical stresses on tissues of the lower extremity in masters runners, especially hamstrings, hip joint and Achilles.     

Key changes in denervated muscles and their impact on regeneration and reinnervation

The neuromuscular junction becomes progressively less receptive to regenerating axons if nerve repair is delayed for a long period of time. It is difficult to ascertain the denervated muscle＇s residual receptivity by time alone. Other sensitive markers that closely correlate with the extent of denervation should be found. After a denervated muscle develops a fibrillation potential, muscle fiber conduction velocity, muscle fiber diameter, muscle wet weight, and maximal isometric force all decrease; remodeling increases neuromuscular junction fragmentation and plantar area, and expression of myogenesis-related genes is initially up-regulated and then down-regulated. All these changes correlate with both the time course and degree of denervation. The nature and time course of these denervation changes in muscle are reviewed from the literature to explore their roles in assessing both the degree of detrimental changes and the potential success of a nerve repair. Fibrillation potential amplitude, muscle fiber conduction velocity, muscle fiber diameter, mRNA expression levels of myogenic regulatory factors and nicotinic acetylcholine receptor could all reflect the severity and length of denervation and the receptiveness of denervated muscle to regenerating axons, which could possibly offer an important clue for surgical choices and predict the outcomes of delayed nerve repair.     

产β 内酰胺酶葡萄球菌在临床标本中的检出及耐药性

目的了解某院产β 内酰胺酶葡萄球菌在临床标本中的检出及耐药现状，为防治葡萄球菌感染提供依据。方法回顾性分析该院2005-2010年临床各科送检标本分离的1 725株产β 内酰胺酶葡萄球菌的临床和实验室资料。结果近6年产β 内酰胺酶葡萄球菌总检出率为94.83%（1 725/1 819），各年度（2005-2010年）检出率分别为88.68%（94/106）、89.69%（174/194）、91.72%（155/169）、97.58%（242/248）、96.10%（591/615）、96.30%（469/487），有逐年上升趋势（χ2=51.11, P<0.01）；各菌种以松鼠葡萄球菌β 内酰胺酶阳性率最高（99.50%，198/199），耳葡萄球菌最低（80.37%，86/107），种间差异有统计学意义（χ2＝58.08，P<0.01）。药敏结果显示，除万古霉素、利奈唑烷、呋喃妥因和利福平外，产β 内酰胺酶葡萄球菌对青霉素、氨苄西林、氨苄西林/舒巴坦、苯唑西林、头孢唑林、环丙沙星、四环素、克林霉素、红霉素、庆大霉素和复方磺胺甲口恶唑呈高度耐药（耐药率51.74%～100.00%）和多重耐药，且产酶菌的耐药性均高于非产酶菌（χ2在7.00～485.39之间，P<0.01）。苯唑西林耐药菌株占产β 内酰胺酶金黄色葡萄球菌和凝固酶阴性葡萄球菌的72.86%和78.30%，是产酶葡萄球菌的主要组成菌群。结论产β 内酰胺酶葡萄球菌的高检出率和对临床常用抗菌药物的高耐药率形势严峻，加强对产酶细菌的监测，遏制其快速增长非常必要。     

The diagnostic and prognostic value of MRP8/MRP14 in intrahepatic cholangiocarcinoma

Myeloid-related protein 8 (MRP8) and 14 (MRP14) are abundantly expressed in several kinds of benign and malignant tumors. However, little is known about their clinicopathological significance in intrahepatic cholangiocarcinoma (ICC), biliary intraepithelial neoplasia (BilIN), intraductal papillary neoplasm of bile duct (IPNB), or inflammatory hepatic biliary ducts epithelium (IHBD). This study aimed to investigate the diagnostic and prognostic values of MRP8 and MRP14 as new biomarkers for ICC. We examined MRP8 and MRP14 expression levels by immunohistochemistry in IHBD (n = 15), BilIN (BilIN1 = 24, BilIN2 = 9, BilIN3 = 5), IPNB (n = 18) and ICC (n = 416). The differential diagnostic and prognosis values were also evaluated. The results showed that the ratio of tumor-infiltrating MRP8 and MRP14 positive immune cells, relative to biliary epithelial cells, was significantly increased in ICC tissues compared with nonmalignant tissues, including IHBD, BilIN1, BilIN2, BilIN3, and IPNB (P value < 0.05). In addition, over-expression levels of MRP8 and MRP14 were correlated with overall survival (OS) and time to recurrence (TTR) by univariate analysis; MRP8/MRP14 combination was an independent prognostic factor for OS and TTR. MRP8 and MRP14 expression might help to identify the benign bile duct diseases from ICC, as high expression of MRP8 and MRP14 suggests a poor prognosis after surgical resection.     

Identification of potential drugs for Parkinson's disease based on a sub-pathway method

Parkinson's disease (PD) is the second most prevalent neurodegenerative disease in ageing individuals. Current therapeutic regimen suffers from general side effects and a poor efficiency for PD symptoms. The need for development new therapeutic agents for PD is urgent. Here, we aimed to explore the metabolic mechanism of PD and identified potential novel agents for PD by a sub-pathway-based method. By using the GSE7621 microarray data from the GEO database, we first identified the 1226 differentially expressed genes (DEGs) between PD and normal samples. Then we identified 19 significant enriched metabolic sub-pathways, which may involve in development of PD. Finally, by an integrated analysis of PD-involved sub-pathways and drug-affected sub-pathways, we identified 49 novel small molecular drugs capable to target the PD-involved sub-pathways. Our method could not only identify existing drug (apomorphine) for PD, but also predict potentially novel agents (ketoconazole and astemizole), which might have therapeutic effects via targeting some key enzymes in arachidonic acid metabolism. These candidate agents identified by our approach may provide insights into a novel therapy approach for PD.     

Exploring predictors of medication adherence among inpatients with schizophrenia in Singapore's mental health settings: A non-experimental study

Schizophrenia is a mental disorder, which is marked by frequent relapses. The main reason for relapse is nonadherence to antipsychotics. A cross-sectional, correlational research study was conducted with a convenience sample of 92 participants. The primary aim of this study was to explore the predictors of medication adherence among inpatients with schizophrenia hospitalised at tertiary hospitals in Singapore. Post-hoc analysis revealed that insight, religion, side effects, types of antipsychotics, social support from significant others, nurse-client relationship, were significant predictive factors. Results from this study added knowledge to the nursing literature about medication adherence of schizophrenia patients and in Singapore setting.