Objective:To understand the current situation of clinical application and management of food for special medical purpose (FSMP) in China's medical institutions.Methods:A questionnaire was developed based on literature review, consultation with experts and multiple discussions to investigate the application and management of FSMP in hospitals. The survey was conducted in secondary and tertiary general or specialized hospitals in China. The accountable person of Clinical Nutrition Department in each hospital filled in the questionnaire with the guidance from provincial quality control center.Results:A total of 592 hospitals across 30 provinces/municipalities participated in the survey. The majority (40.5%) of prescription for FSMP with approved batch number was given by clinical nutrition departments, nutritional risk screening was conducted before using FSMP as enteral nutrition in 64.0% of the hospitals, consent from patients or their families prior to initial FSMP use was required in 94.8% of the hospitals, follow-up after FSMP use was carried out in 86.5% of the hospitals, 79.2% of the hospitals maintained electronic or paper documentation of the clinical application of enteral nutrition preparations, 41.6% of the hospitals had no organization or institution to supervise the standardized application of FSMP.Conclusion:In the future, we should strengthen the construction of FSMP professional team, establish convenient and efficient nutrition diagnosis and treatment information module, and set up special institutions to implement FSMP standardized management.

Objective:To discuss the clinical and electrophysiological characteristics of familial cortical myoclonic tremor with epilepsy (FCMTE) with fixation-off sensitivity (FOS).Methods:The clinical and electrophysiological characteristics of four patients diagnosed as FCMTE with FOS in the Electroencephalography (EEG) Monitoring Center of Xijing Hospital from May 2016 to December 2017 were studied and followed up.Results:The four patients were all female. The age was ranged from 29 to 67 years. The course was from six to 30 years, and the follow-up time was at least two years. The tremors and jerks occurred to the four patients frequently when the eyes were closed, which prevented their falling a sleep, and three of them had generalized tonic-clonic seizure occasionally. The FOS was monitored in the all four patients, and the photosensitivity occured to the three of them.Conclusions:The fixation-off sensitive trail during EEG monitoring is helpful to find the FCMTE with FOS. It is necessary to determine the potential clinical significance of FOS and photosensitivity coexisting in patients with FCMTE.

OBJECTIVE: To investigate the effect of calmodulin (CaM) and its mutants on binding to voltage-gated Na channel isoleucine-glutamine domain (Na1.2 IQ). METHODS: The cDNA of Na1.2 IQ was constructed by PCR technique, CaM mutants CaM, CaM and CaM were constructed with Quickchange site-directed mutagenesis kit (QIAGEN). The binding of Na1.2 IQ to CaM and CaM mutants under calcium and calcium free conditions were detected by pull-down assay. RESULTS: Na1.2 IQ and CaM were bound to each other at different calcium concentrations, while GST alone did not bind to CaM. The binding affinity of CaM and Na1.2 IQ at [Ca]-free was greater than that at 100 nmol/L [Ca] ( < 0.05). In the absence of calcium, the binding amount of CaM wild-type to Na1.2 IQ was greater than that of its mutant, and the binding affinity of CaM to Na1.2 IQ was the weakest among the three mutants ( < 0.05). CONCLUSIONS The binding ability of CaM and CaM mutants to Na1.2 IQ is Ca-dependent. This study has revealed a new mechanism of Na1.2 regulated by CaM, which would be useful for the study of ion channel related diseases.
Calcium ; metabolism ; Calmodulin ; genetics ; metabolism ; Mutation ; NAV1.2 Voltage-Gated Sodium Channel ; metabolism ; Protein Binding ; genetics

Objective To investigate the difference of niacin skin flush response between patients with major depressive disorder (MDD) and healthy controls (HCs), and its sensitivity and specificity for the diagnosis of MDD. Methods Twenty-one untreated patients with MDD and 28 age- and gender-matched HCs were enrolled in this study. The severity of depressive symptoms was assessed mainly by using the 17-item Hamilton Depression Rating Scale (HDRS-17). Methyl Nicotinate (MN) solution at 8 different concentrations (10-5 mol/L, 10-4 mol/L, 10-3.5 mol/L, 10-3 mol/L, 10-2.5 mol/L, 10-2 mol/L, 10-1.5 mol/L, 10-1 mol/L) were applied on subjects' forearms. Signals of blood flow were collected using the Doppler Laser Flowmetry to detect the skin flushing of the test. Results Under the concentrations of 10-2.5 mol/L, 10-2 mol/L, 10-1.5 mol/L and 10-1 mol/L MN solution, the blood flow was significantly higher in depressive patients than in HCs (P<0.01). The MN sensitivity (logEC50) was inversely correlated to the severity of depressive symptoms (r=-0.57, P<0.05). ROC curve analysis implied that the maximum blood flow (MBF) caused by the niacin skin flush response, could efficiently discriminate MDD from HCs (AUC=0.90, P<0.01). Conclusion The presence of enhanced niacin skin flush response may be helpful in the diagnosis of MDD.

Objective To observe the therapeutic effect of hoop circumference drug,Hongzhongxiao tincture,on the treatment of skin abscess in rats under the guidance of defended field theory.Methods Forty SpragueDawley (SD) rats were randomly divided into normal control group,model group,western medicine control group,Hongzhongxiao pretreatment group and Hongzhongxiao treatment group according to the computer generated random number.Subcutaneous abscesses models were reproduced by subcutaneous injection of 1 mL (3-5 × 109 cfu/mL) of staphylococcus aureus,and the normal control group was subcutaneously injected with the same amount of normal saline.After molding,the rats in the model group were treated with normal saline for change of dressing;the western medicine control group was treated with mupirocin ointment for external use;Hongzhongxiao pretreatment group was treated with 2 mL of Hongzhongxiao for dressing 4 hours after the modeling;in Hongzhongxiao treatment group,2 mL dressing was given after the emergence of hard swelling,and the Hongzhongxiao drug range applied was 1 cm over the swelling range.Each group was dressed once daily.The changes of mental state,body weight,skin temperature,range and time of abscess formation,wound ulceration and healing time,transcutaneous oxygen pressure (TcPO2) at the periphery of abscess were observed in each group.Results ① After modeling,the activity of the rats was decreased,the appetite became worse,and the food intake less.Except the normal control group,the rats in other groups had different degrees of mental listlessness.② After 3 days of treatment,the body weight gain of the model group was significantly lower than that of the normal control group (g:8.75 ± 9.85 vs.31.67 ± 7.92,P ＜ 0.01),and continued to 18 days after treatment (g:27.13± 11.70 vs.98.00 ± 8.94);after treatment for 18 days,the body weight gain in the western medicine control group,Hongzhongxiao pretreatment group and Hongzhongxiao treatment group was significantlyhigher than those of model group (g:53.28 ± 19.69,49.12 ± 7.23,44.71 ± 12.42 vs.27.13 ± 11.70,all P ＜ 0.05).③ After 3 days of treatment,the body temperature of the model group was obviously lower than that of the normal control group (℃:33.75 ± 0.68 vs.35.03 ± 0.41,P ＜ 0.01) and continued to 10 days (℃:34.30 ± 0.35 vs.35.03 ± 0.41,P ＜ 0.01).The body temperature of the rats in Hongzhongxiao pretreatment group was significantly lower than that in the normal control group,the model group and the western medicine control group on the 14th day after treatment (℃:33.97 ± 0.83 vs.35.10 ± 0.57,35.01 ± 0.68,35.25 ± 0.23,all P ＜ 0.05).The body temperature of Hongzhongxiao treatment group was significantly higher than that of the Hongzhongxiao pretreatment group (℃:34.87 ± 0.94 vs.33.97 ± 0.83,P ＜0.05).④ After treatment for 13,15,17 days,the contraction rates of swollen area in western medicine control group,hongzhongxiao pretreatment group and hongzhongxiao treatment group were greater than the rate in model group,and the change was most significant on the 17th day after treatment [(96.37 ± 5.09)％,(92.76 ± 13.56)％,(98.41 ± 3.85)％ vs.(77.46 ± 19.07)％,all P ＜ 0.05].⑤ Compared with the model group,the times of abscess localization in the western medicine control group,the Hongzhongxiao pretreatment group and the Hongzhongxiao treatment group was shorter than that in the model group (days:9.28 ± 1.38,7.33 ± 1.97,7.67 ± 1.63 vs.12.63 ± 1.99,all P ＜ 0.05);the time of wound healing in Hongzhongxiao pretreatment group aud Hongzhongxiao treatment group were significantly shorter than those of the model group (days:17.67 ± 1.03,16.83 ± 1.51 vs.19.92 ± 2.33,P ＜ 0.05).⑥ TcPO2 in the Hongzhongxiao pretreatment group was significantly higher than that in the model group on the 7th day after treatment [mmHg (1 mmHg =0.133 kPa):63.33 ± 9.77 vs.39.51 ± 8.42],and the Hongzhongxiao treatment group (44.25 ± 6.41) was significantly lower than that of the Hongzhongxiao pretreatment group,and the Hongzhongxiao treatment group was significantly higher than that of the model group (59.50 ± 7.34 vs.49.52 ± 10.17) on the 14th day after drug application,and the western medicine control group was significantly lower than that of the model group (37.71 ± 5.63 vs.54.33 ± 7.74),the Hongzhongxiao pretreatment group and Hongzhongxiao treatment group were significantly higher than those of the western medicine control group,the difference being statistically significant (all P ＜ 0.05).Conclusions The Hongzhongxiao tincture applied on top and circumferentially around the periphery of the abscess can reduce the local inflammatory response,improve the body weight and mental state,increase the blood supply around wound periphery for anti-infection and anti-inflammation in order to promote the formation of defending field of nursing.Although the early application of Hongzhongxiao tincture cannot reduce the local infectious symptoms and kill the Staphylococcus aureus,it can make skin abscess localization as soon as possible and shorten the wound healing time.

Objective To investigate the risk difference of early neurological deterioration (END) in minor stroke patients with large artery atherosclerosis (LAA) and small vessel occlusion (SVO). Methods From January 2012 to August 2016, consecutive patients with first-ever acute ischemic stroke registered in the Nanjing Stroke Registration System were enrolled. The patients with minor stroke whose National Institutes of Health Stroke Scale (NIHSS) ≤3 on admission were screened. Propensity score matching analysis and McNemar's test were used to analyze the risk difference of END in minor stroke patients with LAA and SVO. Results A total of 778 patients with minor stroke were included, including 249 with LAA, 183 with SAO, and 145 matched pairs with propensity score matching method. The proportion of patients with END in the LAA group was significantly higher than that in the SVO group (6.2% vs. 1.4%; P<0.001). Conclusion Minor stroke due to LAA is more prone to have END than that due to SVO.

Objective To investigate the relationship between the times of thrombectomy and the prognosis of acute ischemic stroke. Methods From June 2014 to June 2016,the clinical data of 61 consecutive patients with ischemic stroke treated with emergency endovascular thrombectomy in Jinling Hospital,Medical School of Nanjing University were collected retrospectively. According to the times of thrombectomy,they were divided into either a routine thrombectomy group ( <3, n =48 ) or a multiple thrombectomy group (≥3,n=13). The modified Rankin scale (mRS) was used to evaluate the neurological function prognosis at 90 d in both groups of patients. The mRS score 0-2 was defined as good prognosis,3-6 were defined as poor prognosis,and 6 was death. Univariate analysis was used to compare the differences between the groups (excluding the patients whose DSA data missing or of poor quality). Spearman correlation analysis was used to evaluate the relationship between the times of thrombectomy and prognosis and fatality rate. Results Univariate analysis showed that the recanalization rate of the patients in the routine thrombectomy group (73. 9%[34/46] vs. 25. 0%[3/12],P =0. 005) and the rate of good collateral compensatory (55. 6%[25/45] vs. 8. 3%[1/12],P =0. 004) were higher than those in the multiple thrombectomy group. The incidence of symptomatic intracranial hemorrhage in the routine thrombectomy group was lower than that in the multiple thrombectomy group (14. 6%[7/48] vs. 53. 8%[7/13],P =0. 003). The mortality rate at 90 days was 18. 0%(n=11). Further Spearman correlation analysis showed that the times of thrombectomy were moderately positive correlated with the mortality rate ( r=0. 517,P=0. 000). There was no significant correlation between the times of thrombectomy and the good function prognosis (r=0. 076,P=0. 560). However,the effects of the differences between recanalization rate,collateral compensation and symptomatic intracranial hemorrhage could not be ruled out. Conclusion Emergency intravascular interventional therapy of multiple thrombectomy is positively related to the mortality rate at 90 d in patients with acute ischemic stroke,however,a study with larger sample is needed to confirm it.

MicroRNAs (miRNAs) play critical roles in the development and progression in various cancers.Dysfunctional miR-9 expression remains ambiguous,and no consensus on the metastatic progression of ovarian cancer has been reached.In this study,results from the bioinformatics analysis show that the 3'-UTR of the E-cadherin mRNA was directly regulated by miR-9.Luciferase reporter assay results confirmed that miR-9 could directly target this 3'-UTR.miR-9 and E-cadherin expression in ovarian cancer tissue was quantified by qRTPCR.Migration and invasion were detected by wound healing and Transwell system assay in SKOV3 and A2780.qRT-PCR and Western blot were performed to detect the epithelial-mesenchymal transition-associated mRNA and proteins.Immunofluorescence technique was used to analyze the expression and subcellular localization of Ecadherin,N-cadherin,and vimentin.The results showed that miR-9 was frequently upregulated in metastatic serous ovarian cancer tissue compared with paired primary ones.Upregulation of miR-9 could downregulate the expression of E-cadherin but upregulate the expression of mesenchymal markers (N-cadherin and vimentin).Overexpression of miR-9 could promote the cell migration and invasion in ovarian cancer,and these processes could be effectively inhibited via miR-9 inhibitor.Thus,our study demonstrates that miR-9 may promote ovarian cancer metastasis via targeting E-cadherin and a novel potential therapeutic approach to control metastasis of ovarian cancer.

Objective To investigate the correlation between the arterial compliance and insulin resistance in the prehypertensive people.Methods 30 healthy persons,36 prehypertensive persons and 46 hypertensive patients were measured Cl and C2 using CVProfilor DO-2020 and determined insulin sensitivity with HOMA-IR.Results Adjusted for the age and the course of disease,C1 and C2 decreased in hypertensive patients compared with that of the healthy and prehypertensive people(P<0.05);C2 decreased in prehypertensive people compared with the healthy groups(P<0.05).HOMA-IR increased in hypertensive patients and prehypertensive people compared with the healthy groups(P<0.05).There was significant correlation between HOMA-IR and C2 in prehypertensive people.Conclusion Small arterial compliance decrease and insulin resistance can be found with negatively correlation in prehypertensive people.

BACKGROUND: Left ventricular hypertrophy (LVH) is an important ring-joint of congestive heart failure (CHF). It is also considered to be independent risk factor of cardiovascular disease, so how to reverse or relieve LVH is valuable to cure CHF.OBJECTIVE: To observe the effect of Lujiao prescription on degree of LVH in patients with CHF.DESIGN: A random-control observation on CHF patients.SETTING: Department of Cardiovasology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine.PARTICIPANTS: A total of 20 patients with CHF were selected from the Special Clinic and Department of Cardiovasology in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 1996 to December 1998. All of them were consistent with the Framirham diagnostic criteria and following standardizations: ①above Ⅲ degree of cardiac functional grading by New York Heart Association (NYHA);②over 3 months case history;③accepted basic treatment of quantity sufficient diuretic and vasodilating agent excluding angiotensin converting enzyme inhibitor (ACEI);LVH was proved by echocardiogram or chest X-ray. They were informed of treatment items and consented.METHODS: According to random lot, the patients were divided into Lujiao prescription group and Digoxin group, each containing 10 patients.①Oral administrations of Lujiao prescription (35 mL, two times per day, produced by Shanghai Shuguang Hospital) and Digoxin (0.125-0.25 mg per tablet, batch number: 970757, once daily) were given in the corresponding groups, and the treatment duration was 3 months. After treatment, all the patients were detected in①NYHA cardiac functional grading; ②interventricular septal thickness (IVST) and posterior wall thickness (PWT) in diastolic phase through echocardiogram, myocardium weight of left ventricular by Devereux formula, left ventricular mass index (LVMI) corrected by bodysurface area, and degree of LVH;③the level of plasma angiotensin Ⅱ (Ang Ⅱ ) by radioactive immunoassay.MAIN OUTCOME MEASURES: NYHA cardiac functional grading, e-chocardiogram (IVST, PWT, LVMI, degree of LVH), the level of plasma Ang Ⅱ.RFSULTS: All 20 adopted patients entered the result analysis.①The classification of NYHA cardiac functional grading ( Ⅰ , Ⅱ ,Ⅲ,Ⅳ) were respectively 2, 5, 3, 0 case in Lujiao prescription group and 2, 4, 4, 0 case in Digoxin group after treatment, and difference was significant compared with those before treatment (0, 0, 7, 3, P ＜ 0.05).②IVST, PWT and LVMI of Lujiao prescription group were obviously decreased after treatment [(11.20±0.42), (12.10±0.32) mm, P ＜ 0.01; (10.60±0.84), (11.40±1.10) mm,P ＜ 0.01; (139.4±12.4), (155.3±15.4) g/m2, P ＜ 0.01], while those of the Digoxin group were untouched (P ＞ 0.05). The degree of LVH of Lujiao prescription group after treatment was obviously decreased [normal, mild,moderate, sever: 2, 6, 2, 0; 0, 3, 4, 3, P ＜ 0.01], while that of the Digoxin group was not obviously decreased (P ＞ 0.05).③)The level of plasma Ang Ⅱin the Lujiao prescription group was obviously decreased [(97.7±19.5),(144.0±18.5) ng/L, P ＜ 0.01], while that of the Digoxin group was not obviously increased (P ＞ 0.05).CONCLUSION: Lujiao prescription can reverse or relieve the degree of LVH in patients with CHF.