安眠小复方对小鼠促眠作用的机制研究

目的探讨中药安眠小复方对小鼠脑神经肽P物质(SP)及睡眠相关细胞因子的影响,以揭示其促眠作用机制。方法60只KM小鼠随机分为6组,安眠小复方高、中、低剂量组分别灌胃给予安眠小复方4.16g/kg,2.08g/kg,1.04g/kg,百乐眠组灌胃给予百乐眠胶囊0.28g/kg,地西泮组灌胃给予地西泮片1.30mg/kg,连续给药7d。末次给药30min后,处死动物,取脑组织,检测小鼠脑内神经肽SP、白介素1β(IL-1β)和肿瘤坏死因子α(TNF-α)含量。结果与空白对照组比较,安眠小复方高、中、低剂量组均能明显降低小鼠脑组织中SP含量(P0.05或P0.01)和IL-1β含量(P0.01);安眠小复方高、中、低剂量组亦能降低小鼠脑组织中TNF-α含量,其中高、低剂量组与空白对照组比较差异有统计学意义(P0.05)。结论中药安眠小复方可能通过降低脑内SP含量、破坏觉醒中枢同时调节睡眠相关细胞因子而发挥促眠作用。     

基于信息化血糖监测系统建立血糖基准报告研究

背景　随着糖尿病患病率的增高，住院患者血糖管理已成为医院关注的焦点，但目前尚缺乏公认的绩效指标定义、指标测算和标准化血糖基准报告，影响了医院血糖管理持续质量改进。目的　基于信息化血糖监测系统（IGMS）构建血糖基准报告，一为同行建立标准化血糖报告提供方法学指导，二为同行提供血糖基准参考。方法　纳入2019年10月至2020年3月遂宁市中心医院安装了IGMS（该系统能自动上传血糖数据和按需求查阅血糖数据）的非重症监护病区（10个内科和7个外科）的糖尿病患者或高血糖患者（无糖尿病病史但随机末梢血糖超过11.1 mmol/L），排除住院第1天的血糖数据。采用群体（population）、患者（patient）和患者日（patient-day）三种模型报告理想血糖、高血糖和低血糖发生率，低血糖报告增加患者低血糖发生天数比、发生频次比和管理及时性比，采用四分位数分析不同病区的血糖数据，并与美国、澳大利亚、重庆和广东医疗机构的血糖数据进行比较。结果　三种模型平均血糖、理想血糖、平均高血糖和任意高血糖（>10.0 mmol/L、≥15.0 mmol/L、≥16.7 mmol/L）、任意低血糖（≤3.9 mmol/L、<3.0 mmol/L、<2.8 mmol/L、<2.2 mmol/L）比较，差异均有统计学意义（P<0.001）。17个病区任意低血糖≤3.9 mmol/L发生>3次者312例（3.9%），发生>3 d者202例（2.5%），复测血糖时间≤15 min者446例（5.6%），>30 min者2 187例（27.5%）。患者日任意高血糖≥15.0 mmol/L、任意低血糖≤3.9 mmol/L、理想血糖下四分位数分别为38.6%、5.5%和38.0%，上四分位数分别为21.5%、2.1%和58.1%。17个病区与美国、澳大利亚、重庆医疗机构的平均高血糖和任意高血糖（>10.0 mmol/L、≥15.0 mmol/L、≥16.7 mmol/L）、任意低血糖（≤3.9 mmol/L、<3.0 mmol/L、<2.8 mmol/L、<2.2 mmol/L）比较，差异均有统计学意义（P<0.05）。本研究内分泌病区和广东省某内分泌病区血糖、理想血糖、任意高血糖≥16.7 mmol/L、任意低血糖≤3.9 mmol/L比较，差异均有统计学意义（P<0.05）。结论　IGMS允许医疗机构建立全方位、标准化血糖报告。因目的不同，其选择模型也不同。群体模型更适用药物管理和风险管理人员，患者模型更适用个体化护理评估，患者日模型适用于某单元或单位进行质量改进方向和目标的制定。     

Deep learning applied to two-dimensional color Doppler flow imaging ultrasound images significantly improves diagnostic performance in the classification of breast masses: a multicenter study

BackgroundThe current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions. In China, breast masses are divided into four categories according to the treatment method: inflammatory masses, adenosis, benign tumors, and malignant tumors. These categorizations are important for guiding clinical treatment. In this study, we aimed to develop a convolutional neural network (CNN) for classification of these four breast mass types using ultrasound (US) images.MethodsTaking breast biopsy or pathological examinations as the reference standard, CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers. The patients were randomly divided into training and test groups (n = 1810 vs. n = 1813). Separate models were created for two-dimensional (2D) images only, 2D and color Doppler flow imaging (2D-CDFI), and 2D-CDFI and pulsed wave Doppler (2D-CDFI-PW) images. The performance of these three models was compared using sensitivity, specificity, area under receiver operating characteristic curve (AUC), positive (PPV) and negative predictive values (NPV), positive (LR+) and negative likelihood ratios (LR−), and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators, between images from different hospitals with AUC, and with the performance of 37 radiologists.ResultsThe accuracies of the 2D, 2D-CDFI, and 2D-CDFI-PW models on the test set were 87.9%, 89.2%, and 88.7%, respectively. The AUCs for classification of benign tumors, malignant tumors, inflammatory masses, and adenosis were 0.90, 0.91, 0.90, and 0.89, respectively (95% confidence intervals [CIs], 0.87–0.91, 0.89–0.92, 0.87–0.91, and 0.86–0.90). The 2D-CDFI model showed better accuracy (89.2%) on the test set than the 2D (87.9%) and 2D-CDFI-PW (88.7%) models. The 2D model showed accuracy of 81.7% on breast masses ≤1 cm and 82.3% on breast masses >1 cm; there was a significant difference between the two groups (P < 0.001). The accuracy of the CNN classifications for the test set (89.2%) was significantly higher than that of all the radiologists (30%).ConclusionsThe CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists.Trial registrationChictr.org, ChiCTR1900021375; http://www.chictr.org.cn/showproj.aspx?proj=33139.     

CyclinB1 deubiquitination by USP14 regulates cell cycle progression in breast cancer

Breast cancer is the most common malignant tumor among women in China, which seriously threatens women's physical and mental health. Tumorigenesis is closely related to the dysregulation of cell cycle. The cell cycle progression includes interphase and mitotic phase (M phase). Cyclin B1 is a key protein in regulating M phase, which is essential for the whole cell cycle progression. CyclinB1 can be degraded through ubiquitination mediated by the anaphase promoting complex/cyclosome (APC/C). However, the mechanism of how CyclinB1 is deubiquitinated in breast cancer still remains unclear. In this study, we discovered that CyclinB1 interacted with ubiquitin-specific peptidase 14 (USP14). Based on the deubiquitinating function of USP14, we detected the effect of USP14 on the ubiquitination of CyclinB1. Inhibiting the activity of USP14 or USP14 knockdown significantly increased the ubiquitination of CyclinB1. In accordance with this, knocking down USP14 arrested cell cycle at G2/M phase. Knocking down USP14 with siRNAs significantly inhibited the proliferation and migration of breast cancer cells. In conclusion, our study demonstrated that USP14 regulated the cell cycle of breast cancer cells by regulating the ubiquitination of CyclinB1, which will provide a solid theoretical basis for the development of anti-cancer drugs targeting USP14.     

Acute effects of alcohol on brain perfusion monitored with arterial spin labeling magnetic resonance imaging in young adults

While a number of studies have established that moderate doses of alcohol increase brain perfusion, the time course of such an increase as a function of breath alcohol concentration (BrAC) has not yet been investigated, and studies differ about regional effects. Using arterial spin labeling (ASL) magnetic resonance imaging, we investigated (1) the time course of the perfusion increase during a 15-minute linear increase of BrAC up to 0.6 g/kg followed by a steady exposure of 100 minutes, (2) the regional distribution, (3) a potential gender effect, and (4) the temporal stability of perfusion effects. In 48 young adults who participated in the Dresden longitudinal study on alcohol effects in young adults, we observed (1) a 7% increase of global perfusion as compared with placebo and that perfusion and BrAC are tightly coupled in time, (2) that the increase reaches significance in most regions of the brain, (3) that the effect is stronger in women than in men, and (4) that an acute tolerance effect is not observable on the time scale of 2 hours. Larger studies are needed to investigate the origin and the consequences of the effect, as well as the correlates of inter-subject variations.     

Preventing preeclampsia and its fetal complications with low-dose aspirin in East Asians and non-East Asians:A systematic review and meta-analysis

Background: Low-dose aspirin can reduce the incidence of preeclampsia and intrauterine growth restriction (IUGR). However, the effects of ethnicity upon low-dose aspirin’s efficacy has not been analyzed. Here, we comparatively evaluated the efficacy of low-dose aspirin in preventing preeclampsia and related fetal complications in East Asian and non-East Asian pregnant women at risk for preeclampsia. Methods: Several databases were searched for randomized controlled trials (RCTs) comparing low-dose aspirin with either placebo or no treatment in pregnant women at risk for preeclampsia. Odds ratios (ORs) and associated 95% confidence intervals (CIs) for preeclampsia and related fetal outcomes were tabulated. Results: Low-dose aspirin significantly reduced preeclampsia risk in both East Asians (OR = 0.20, 95% CI: 0.11–0.35) and non-East Asians (OR = 0.84, 95% CI: 0.77–0.92). Low-dose aspirin significantly reduced IUGR risk in East Asians (OR = 0.36, 95% CI: 0.20–0.67) but not in non-East Asians (OR = 0.85, 95% CI: 0.41–1.77). Low-dose aspirin did not significantly reduce the risk of cesarean section in either East Asians (OR = 0.67, 95% CI: 0.14–3.22) or non-East Asians (OR = 1.01, 95% CI: 0.86–1.19). Conclusions: Low-dose aspirin is effective in reducing preeclampsia risk in both East Asians and non-East Asians and has differential effects in East Asians and non-East Asians with respect to IUGR.     

HSP47 siRNA对体外培养HTCF细胞生物学行为及TGF-β1表达水平的影响

目的:探究热休克蛋白47(HSP47)siRNA对体外培养人眼Tenon囊成纤维(HTCF)细胞生物学行为及转化生长因子-β1(TGF-β1)表达水平影响。方法:体外培养HTCF细胞,并分为:空白对照组、空载体组和转染组;转染组根据HSP47基因序列设计并合成干扰siRNA序列,构建载体并导入HTCF细胞中;空载体组导入空白载体。采用RT-PCR和蛋白质印迹实验检测细胞中HSP47 mRNA和蛋白的表达情况,采用克隆形成实验、流式细胞术、Transwell法及划痕实验检测细胞增殖、凋亡、侵袭及迁移,蛋白质印迹实验检测增殖、凋亡、侵袭、迁移蛋白和TGF-β1的表达情况。结果:相比空载体组,转染组HSP47 mRNA和蛋白的表达、克隆形成率、细胞愈合率、侵袭细胞数目、Ki67、N-cadherin、TGF-β1蛋白相对表达水平显著降低(P<0.05),E-cadherin蛋白相对表达水平显著升高(P<0.05),但细胞凋亡率、Bcl-2和Bax蛋白相对表达水平均无差异(P>0.05)。结论:HSP47 siRNA可以通过抑制TGF-β1蛋白的表达降低HTCF细胞的增殖、侵袭及迁移能力,但对HTCF细胞的凋亡无明显影响。