A HPLC-ELSD method was developed and validated for simultaneous determination of five Hetisane-type diterpenoid alkaloids in a Tibetan traditional herbal medicine, “Gebu Dilu” (Herba Delphinii), using a Kromasil C18 column (250 mm ? 4.6 mm, 5μm) with the mobile phase consisting of acetonitrile and 0.1% triethylamine in gradient (detected by evaporative light scattering detector). The linear ranges of five compounds were determined and method validation was evaluated completely. The established method is rapid and accurate with high repeatability, and can be applied for the quality control of Herba Delphinii.

Histone deacetylase 1 ( sirtuin 1, SIRT1) is an important member of deacetylase family, and plays an important role in the process of malignant tumor and embryonic development. In this article it was found that overexpression of SIRT1 could accelerate the DNA synthesis in human pancreatic beta cell CRL-1837 and inhibit cell senescence. SIRT1 also could bind to p53 as detected by co-immunoprecipitation and could change the phosphorylation level of p53.

Objective To investigate the relationship between chest radiographic changes and clinical manifestations in patients with scrub typhus in Guangdong area.MethodsA total of 148 cases of scrub typhus admitted to First Affiliated Hospital of Ji′nan University,Guangzhou Eighth People′s Hospital and the Second People′s Hospital of Yuebei between 1999 and 2010 was retrospectively reviewed.The patients were divided into two groups based on the findings of the chest X-rays (with or without radiographic abnormalities).Furthermore,the clinical characteristics and prognosis in two groups were compared.The statistical analysis was done using t test,chi-square test or Fisher′s exact test.ResultsChest X-rays showed abnormalities in 66 (44.6％) cases,and the chest X-ray features were diverse.The incidences of cough,severe thrombocytopenia,hypoalbuminemia,shock,acute respiratory failure,jaundice and acute renal failure were all significantly increased in group of patients with chest X-rays abnormalities compared with the other group of patients without chest X-rays abnormalities (χ2 =18.193,6.872,17.138,5.608,4.318,7.982 and 7.932,respectively; all P＜0.05).The hospitalization day was longer in patients with chest X-rays abnormalities compared with the patients without chest X-rays abnormalities,but there was no statistical difference [(11.7±7.1)d vs (9.9±5.0)d,t=1.717; P=0.088)],while the mortality was higher(6.1 ％ vs 0; Fisher′s exact test,P =0.038).Conclusions The clinical manifestations of the patients with scrub typhus are diverse,and the presence of abnormal chest X-rays is shown to be associated with the disease severity.Physicians should have the awareness of scrub typhus to make the diagnosis and treatment properly.

Objective To investigate the feasibility and accuracy of dual energy CT myocardial iodine maps in detecting acute myocardial infarction in canine model. Methods Myocardial ischemia model was made by ligaturing left anterior descending coronary arteries (LAD) after thoracotomy in six dogs, while another 3 dogs undergoing thoracotomy not ligaturing LAD as control group. Before and three hours after operation, dual-source CT (DSCT) was performed, followed by resting 99Tcm-MIBI single photon emission computed tomography myocardial perfusion imaging. Then, dogs were sacrificed, and the hearts were removed, triphenyltetrazolium chloride staining and conventional HE staining were performed. CT number of non-ischemic and ischemic regions were measured and analyzed. The wall of the left ventricle in the short axis was divided into 17 segments, the segments of myocardial perfusion defect in DSCT myocardial iodine maps, SPECT, and pathology were determined. Student t test was used to analyze the difference of CT number between infarcted and non-infarcted myocardium. Kappa test was used for the accuracy of DSCT myocardial iodine maps and SPECT in detecting myocardial ischemia according to the pathological results. Results No abnormal regions were detected using DSCT myocardial iodine maps in preoperative control and infarction group. After thoracotomy, partial sparse or defective perfusion was consistently noted in six dogs' apical anterior and partition wall in both DSCT myocardial iodine maps and SPECT. In the infarcted group, the attenuation of infarction region (34.75 ± 16.66) HU was significantly decreased compared with preoperative measurements ( 123. 18 ± 15.38 ) HU ( t = 10. 526, P ＜ 0. 01 ); decreased perfusion in the infarcted region was also noted in the DSCT myocardial iodine maps and SPECT. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of DSCT myocardial iodine maps and SPECT were 85.0% (34/40) , 84. 1% (95/113) ,65.4% (34/52) ,94. 0%(95/101) ,and 82. 5% (33/40), 90. 3% ( 102/113 ) ,75.0% (33/44) ,93.6% ( 102/109 ), respectively.Kappa values were 0. 63 and 0. 71 for the agreement of DSCT myocardial iodine maps and SPECT.Conclusion DSCT myocardial iodine maps is comparable diagnostic accuracy with rest SPECT myocardial perfusion imaging in detection of acute myocardial infarction in a canine model.

Objective:To explore the different patterns of brain structural abnormalities in patients with delayed neuromyelitis optica pedigree disease (LO-NMOSD) and its relationship with clinical neuropsychological scale score based on the quantitative analysis of three-dimensional (3D) brain structure MRI.Methods:Patients with neuromyelitis optica pedigree disease in remission (NMOSD group) who received treatment at Jilin University First Hospital from January 2016 to December 2018 were prospectively included and divided into LO-NMOSD subgroup and early-onset NMOSD (EO-NMOSD) subgroup according to whether the age of first onset was>50 years. Another age-and sex-matched healthy volunteers with NMOSD patients were recruited as the control group. 3D brain T 1WI and T 2 fluid-attenuated inversion recovery sequence imaging were acquired, and clinical data, neuropsychological scores of all subjects were analyzed. Total gray matter volume (GMV), cerebral gray matter fraction (GMF), cerebral white matter fraction (WMF), and cerebral white matter high signal fraction (WMHF) were obtained by quantitative analysis of MRI data using voxel-based morphology and lesion segmentation tool techniques. Analysis of covariance was used to compare the differences in brain structure between LO-NMOSD subgroup and EO-NMOSD subgroup, NMOSD group and control group. Partial correlation analysis was used to analyze the correlation between GMF, WMHF and patient clinical data, neuropsychological scale scores, and the correlation between WMHF and GMF, WMF. Results:There were 47 cases in the NMOSD group, including 7 males and 40 females aged 18-66 years. Among them, there were 20 cases in the LO-NMOSD subgroup and 27 cases in the EO-NMODS subgroup. The control group consisted of 50 individuals (13 males and 37 females, aged 18 to 77 years). Compared with the control group, the GMV of the right caudate nucleus in the LO-NMOSD group was reduced ( t=3.33, P<0.05), and the GMV of multiple brain regions in the bilateral frontal and temporal lobes in the EO-NMOSD group was reduced considerably (FDR corrected, P<0.05), which was consistent with the NMOSD group. After adjusting for age, there was no statistically significant difference in WMHF between the LO-NMOSD and EO-NMOSD groups ( F=0.22, P=0.644). The LO-NMOSD subgroup showed a negative correlation between global GMF and the extended disability status scale (EDSS) score ( r=-0.53, P=0.025). WMHF in the NMOSD group was positively correlated with annual recurrence rate and EDSS ( r=0.35 and 0.35, respectively, and P=0.017 and 0.018, respectively), while other indicators were not correlated ( P>0.05). The EO-NMOSD subgroup WMHF showed a negative correlation with GMF and WMF ( r=-0.76, -0.70, respectively, P<0.001). The NMOSD group showed a negative correlation between WMHF and GMF, WMF ( r=-0.38, -0.55, respectively, P<0.05). There was no correlation between WMHF and GMF, WMF in the LO-NMOSD subgroup ( P>0.05). Conclusions:The extent and location of gray matter atrophy in patients with LO-NMOSD are different from those of EO-NMOSD. The correlation between WMHF and brain structural changes and clinical data is different between the two groups of patients. These suggest that LO-NMOSD patients may have different patterns of brain structural damage.

Education of professional postgraduate medical students is an important way for the cultivation of high-level medical and health talents in China.This article discusses the current status and problems in the training of professional postgraduate medical students,with thoughts on how to train qualified professional postgraduate medical students majoring in urology in the context of the expansion of enrollment scale.This article also puts forward the following detailed suggestions:pay attention to the quality of students and formulate corresponding training strategies;continuously improve the teaching level of postgraduate tutors and teachers and attach importance to the quality of teaching;improve the rotation and assessment system for postgraduates;actively apply new training methods.

Objective To explore the immune response of T helper cells 17 in patients with hepatitis B virus (HBV) and the relation with Th1,Th2 and Treg cells.Methods The percentages of Th17 cells were detected by intracellular cytokine staining with flow cytometry.Using Realtime PCR method,we assayed the mRNA expression of IL-17,T-bet,GATA-3 and FoxP3 in 58 HBV patients and 40 healthy controls in our research.Results Compared with control group (3.56％ ± 1.26％),the percentage of Th17 cells in the peripheral blood of HBV group (4.72％ ± 1.80％) was higher (P ＜0.001).The mRNA of IL-17 expression of the HBV group (4 ±0.49) was higher than in healthy control group (1.19 ±0.19,P ＜ 0.0001).The mRNA of T-bet expression of the HBV group (2.27 ± 0.24) was higher than in healthy control group (1.10 ± 0.13,P ＜ 0.05).The mRNA of GATA-3 expression of the HBV group (2.29 ± 0.16) was higher than in healthy control group (1.10 ± 0.10,P ＜ 0.0001).The mRNA of FoxP3 expression of the HBV group (2.03 ±0.15) was higher than in healthy control group ((1.05 ±0.10,P ＜ 0.0001).Conclusions The Th17 cells participated in immune response of the hepatitis B virus infection patients,and there has certain adjustment relations among Th1,Th2 and Treg cells.

Objective:To conduct a visual analysis of domestic and international research on kinesiophobia to explore recent advancements and trending topics within the field and to provide references for future research in China.Methods:Literature published from 2015 to 2022 retrieved from Chinese databases such as China National Knowledge Infrastructure, Wanfang data, and VIP, and those published from 2009 to 2022 from the Web of Science, was analyzed using CiteSpace software. This analysis summarized and examined the number of publications, authors, collaborating institutions, and keywords, etc.Results:Both domestic and international publications on kinesiophobia showed an increasing trend in recent years, with international publications consistently outnumbering domestic ones. The most prolific authors were Cai Libai and Vlaeyen, and the leading institutions were the First Affiliated Hospital of Zhengzhou University and Maastricht University. Domestic research primarily involved intra-team collaborations with less inter-institutional cooperation, whereas international collaborations were more extensive. Key research topics identified through keyword analysis included kinesiophobia, pain, and movement, with frontiers in risk factors, clinical outcomes, and psychological health.Conclusions:There is a noticeable gap between domestic and international research on kinesiophobia. China should further focus on the emerging hotspots and trends in this field to enhance the prevention and intervention strategies for kinesiophobia research.

Objective:To investigate the serotype features of group B Streptococcus (GBS) vaginal colonization in late pregnancies and their relationship with early-onset neonatal GBS disease (GBS-EOD). Methods:Thirty-two strains were isolated from neonates delivered by GBS-positive mothers and hospitalized for GBS-EOD in Xiamen Maternal and Child Care Hospital from June 2016 to June 2018. Another 266 strains were isolated from vaginal samples from randomly selected late pregnant women who received antenatal screening and delivered in the same hospital during the same period with an allocation ratio of 12∶1. A total of 298 strains from mothers and 32 strains from neonates were involved. Every isolate was serotyped with latex agglutination assay. GBS infection caused by eleven serotypes and the correlation between GBS serotypes in late pregnant women and neonatal GBS-EOD were analyzed. Qualitative variables were compared using Chi-square or Fisher's exact test. A correlation analysis was presented by the column contact number C. Multiple analysis of multiple sample rates was performed with Post hoc testing. Differences between groups were analyzed according to the adjusted standardized residual. Results:A total of nine serotypes were identified among the 298 strains isolated from the mothers. The most prevalent serotype wasⅢ [55.0% (164/298)], followed byⅠb [16.4% (49/298)], Ⅰa [11.1% (33/298)], Ⅴ [9.4% (28/298)], Ⅱ [5.0% (15/298)], non-typable [NT, 1.0% (3/298)], and Ⅵ, Ⅷ and Ⅸ [0.7% (2/298) in each]. Neither Ⅳ nor Ⅶ serotype was identified. The 32 strains isolated from neonates with GBS-EOD belonged to five serotypes, which were Ⅲ [18/32 (56.3%)], Ⅰa [8/32 (25.0%)], Ⅰb [3/32 (9.4%)], Ⅱ [2/32 (6.2%)] and Ⅴ [1/32 (3.1%)]. The positive rates of GBS Ⅲ serotype in neonates with pneumonia, sepsis, and meningitis were 6/13, 7/14, and 5/5. However, no statistically significant difference was observed in the distribution of the five serotypes in GBS-EOD neonates ( P=0.654). Thirty neonates (93.7%) were cured, while two (6.3%) died. There were statistically significant differences among neonatal GBS-EOD caused by vertical transmission with Ⅰa, Ⅰb, Ⅱ, Ⅲ and Ⅴ, Ⅵ, Ⅷ, Ⅸ and NT serotypes ( P=0.046, contingency coefficient: 0.183). Further analysis showed that the adjusted absolute value of the standardized residual of serotype Ⅰa was 2.7 (>2), and the difference was statistically significant. However, the adjusted absolute value of the standardized residual of serotype Ⅲ was only 0.1, which was not statistically significant. Conclusions:Serotype Ⅲ is the most prevalent GBS serotype in late pregnant women and GBS-EOD neonates, and also the predominant serotype in infants with early-onset meningitis. Serotype Ⅰa could be highly vertically transmitted, while the virulence of serotypes Ⅲ and Ⅰa strains of GBS are the strongest.

The study aimed to analyze the efficacy and safety of rituximab in the treatment of 23 cases of lupus nephritis and explore the prospect of half-dose rituximab in lupus nephritis treatment. Twenty-three patients with lupus nephritis hospitalized in the Department of Rheumatology and Immunology at the First Medical Center of the PLA General Hospital from May 2013 to December 2021 were selected. Eighteen patients received rituximab 375 mg/m 2 on the first and 14th days, 5 patients received 500 mg of rituximab on the first and 14th days, and rituximab was used as needed 6 months later. Methylprednisolone (80-120 mg) was given together with rituximab. Afterward, 1 mg/kg prednisone was used for 4 weeks, which was progressively tapered to maintenance doses or discontinued. B lymphocyte level, renal function, 24-h urine protein level, and systemic lupus erythematosus (SLE) disease activity index 2000 (SLEDAI2K) score before and after treatment were recorded. The efficacy and adverse reactions were analyzed. The results showed that 11 patients suffered from renal insufficiency [creatinine (162.7±58.6) μmol/L ] at baseline, while the creatinine level of 9 patients returned to normal 12 months after the treatment [ (66.3±10.1)μmol/L ]. Normal renal function of the other 12 patients was maintained during treatment. After 12 months, the 24-h urine protein level decreased from 4.00 (2.00,6.80) g in the baseline period to 0.10 (0.08,0.40) g. SLEDAI2K score decreased from 22 (18,26) in the baseline period to 3 (0,6) 12 months after the treatment. The B lymphocyte level reached 0.00 (0.00,0.01)% at 3 months. Of 23 patients, 13 patients achieved complete remission, and 7 patients achieved partial remission after 6 months of rituximab treatment. Five patients experienced adverse reactions related to rituximab, including 1 case of transfusion reaction, 1 case of perioral herpes with pulmonary infection, and 3 cases of decreased IgG levels. Therefore, rituximab regimen used in this study can be an effective treatment strategy for lupus nephritis.