It is far from understood why we forget things that are known to us seconds ago. Emerging evidence emphasizes that small G protein Rac could be a key to understanding this type of rapid early memory forgetting. This current perspective article will first review these studies and then discuss their implications for the internal processes underlying forgetting.
Animals ; Drosophila Proteins ; physiology ; Drosophila melanogaster ; physiology ; Humans ; Memory ; physiology ; Oxidation-Reduction ; Retention (Psychology) ; Signal Transduction ; rac GTP-Binding Proteins ; physiology

Background:The prevalence rate of diabetes mellitus ( DM ) associated with gastroesophageal reflux disease ( GERD)is increasing recently,and the relationship between DM and GERD has become a research hotspot. Aims:To study clinical features and influential factors of therapeutic efficacy of reflux esophagitis( RE)in elderly patients with type 2 DM(T2DM). Methods:Two hundred elderly patients with RE diagnosed by gastroscopy from March 2011 to October 2013 were enrolled,and divided into T2DM associated with RE( T2DM)group and RE group. The clinical features, endoscopic findings and therapeutic efficacy of the two groups were analyzed,and the influences of DM course and control of blood glucose on efficacy of RE were also analyzed. Results:The main manifestations of RE were extraesophageal symptoms,typical esophageal symptoms were less common. The overall efficacy rate decreased with the increase of endoscopic grade of RE,however,extraesophageal symptoms improved significantly. With the prolonging of DM course,the endoscopic grade of RE was increased,and the control of blood glucose was worse. The overall therapeutic efficacy was significantly reduced with the prolonging of DM course in patients with well controlled blood glucose. Conclusions:Extraesophageal symptoms are common,endoscopic grade of RE is worse and blood glucose is difficult to control in elderly T2DM patients associated with RE. DM course and status of blood glucose control have influences on the therapeutic efficacy of RE.

OBJECTIVE: To observe the clinical treatment effectiveness of Clarithromycin combined with nasal glucocorticoids for chronic rhinosinusitis (CRS). METHOD: Clarithromycin was 0.25 g a day (the first two weeks was 0.25 g twice a day) and topical Triamcinolone Acetonide Acetate nasal spray was (220 microg/d) once a day. Fifty-six patients were enrolled in our research. Twenty-six patients of CRS without nasal polyps was treated for 12 to 28 weeks (average 16.62 weeks). Thirty patients of CRS with nasal polyps was treated for 12 to 33 weeks (average 20.03 weeks) after polypectomy. The patients' symptom were evaluated through Sino-Nasal Outcome Test 20 (SNOT-20) scale. Meanwhile sinus CT were evaluated by Lund-Mackey system before and after operation. RESULT: The score of CT scan was significantly decreased to 2.83 +/- 1.86 (t = 11.41, P < 0.01) in the CRS with nasal polyps group and to 2.43 +/- 1.91 (t = 12.86, P < 0.01) in the CRS without nasal polyps group after treatment. Recovery rate of CRS with nasal polyps group was 43.3% and of CRS without nasal polyps group was 50.0% with CT images. The self assessments of treatment efficiency was coincident with CT image in the two groups. CONCLUSION The treatment with Long term use of low dosage oral macrolide Clarithromycin combined with nasal steroid on CRS was efficacy. Polypectomy ,large dose antibiotic and steroid used in intraoperative period could significant improve the treatment efficiency of CRS with nasal polyps.
Adolescent ; Adult ; Aged ; Chronic Disease ; Clarithromycin ; administration & dosage ; therapeutic use ; Drug Therapy, Combination ; Female ; Humans ; Male ; Middle Aged ; Nasal Polyps ; drug therapy ; Rhinitis ; drug therapy ; Sinusitis ; drug therapy ; Treatment Outcome ; Triamcinolone Acetonide ; administration & dosage ; therapeutic use ; Young Adult

Objective:To explore the effectiveness, safety and cost between urinary follicle stimulating hormone (uFSH) and recombinant follicle stimulating hormone (rFSH) in controlled ovarian stimulation (COS) in China.Methods:Data were collected from 16 reproductive centers in China covering oocytes collection time from May 1, 2015 to June 30, 2018. Eligible patients were over 18 years old, adopting COS with uFSH (uFSH group) or rFSH (rFSH group) as start gonadotropins (Gn), and using in vitro fertilization (IVF) and (or) intracytoplasmic sperm injection for fertilisation, excluding frozen embryo recovery cycle. Generalised estimating equation was used to address the violation of independency assumption between cycles due to multiple IVF cycles for one person and clustering nature of cycles carried out within one center. Controlling variables included age, body mass index, anti-Müllerian hormone level, cause of infertility, ovulation protocol, type of fertilisation, number of embryos transferred, number of days of Gn use.Results:Totally 102 061 cycles met eligibility criteria and were included in the analyses. In terms of effectiveness, after controlling relevant unbalanced baseline characteristics, compared with rFSH group, the high oocyte retrieval (>15 oocytes was considered high retrieval) rate of uFSH group significantly decreased in gonadotropin-releasing hormone agonist protocol ( OR=0.642, P<0.01) and in gonadotropin-releasing hormone antagonist protocol ( OR=0.556, P=0.001), but the clinical pregnancy rate per transfer cycle and the live birth rate per transfer cycle significantly increased ( OR=1.179, OR=1.169, both P<0.01) in both agonist and antagonist protocols. For safety, multiple analysis result demonstrated that in the agonist protocol, compared with rFSH group, the incidence of moderate to severe ovarian hyperstimulation syndrome of uFSH group significantly decreased ( OR=0.644, P=0.002). The differences in ectopic pregnancy rate and multiple pregnancy rate between the uFSH and rFSH groups were not significant ( P=0.890, P=0.470) in all patients. In terms of cost, compared with rFSH group, the uFSH group had lower total Gn costs for each patient ( P<0.01). Conclusion:For patients who underwent COS, uFSH has better safety, and economic profiles over rFSH in China.

Objective:To observe the changes of relevant clinical indicators and ultrasound pre-sentations in rheumatoid arthritis (RA) patients after being treated with tocilizumab for 3 months and explore the efficacy and safety of tocilizumab in the treatment of RA.Methods:Clinical data, laboratory and ultrasound examinations and medications of RA patients who met inclusion criteria in our hospital from Jan-uary 2017 to September 2020 were included and their data were analyzed retrospectively, and the efficacy and safety of tocilizumab and the ultrasound assessment of disease remission were analyzed. Paired sample t test, Wilcoxon signed-rank test, χ2 test or Fisher's exact probability test were used for comparative analysis. Results:① Compared with baseline data, morning stiffness duration of patients treated with tocilizumab for 3 months [60(30, 120) min vs 0(0, 10) min, Z=-6.19, P<0.001], disease activity score of 28 joints-erythrocyte sedimentation rate (DAS28-ESR) [(4.6±1.5) vs (3.2±1.2), t=6.83, P<0.001], disease activity score of 28 joints-C-reactive protein (DAS28-CRP) [(4.2±1.4) vs (2.8±1.1), t=7.14, P<0.001], swollen joint count (SJC) [2(1, 7) vs 0(0, 2), Z=-4.31, P<0.001], tender joints count (TJC) [6(2, 13.5) vs 2(0,4), Z=-5.16, P<0.001], gray scale score (GS) [4.5(2, 6) vs 1(0, 3), Z=-5.86, P<0.001], intra-synovial blood flow energy Doppler (PD) [2(1, 3) vs 0(0, 0), Z=-5.38, P<0.001], white blood cell (WBC) [6.6(4.9, 8.4)×10 9/L vs 5.7(4.9, 7.3)×10 9/L, Z=-2.83, P=0.005], hemoglobin (Hb) [119(104, 131) g/L vs 123(113, 136) g/L, Z=-2.82, P=0.007], ESR [32(14.5, 50) mm/1 h vs 19 (10, 30) mm/1 h, Z=-3.31, P=0.001], CRP [11.40(3.02, 25.80) mg/L vs 3.49(1.30, 11.82) mg/L, Z=-2.78, P=0.004], D-dimer (D-D) [0.93(0.47, 2.07) mg/L vs 0.43(0.21, 0.80) mg/L, Z=-3.77, P<0.001] were significantly improved, and the difference was statistically significant. ② The serum levels of interleukin (IL)-2 [2.08(1.43, 2.76) pg/ml vs 1.21(0.54, 2.08) pg/ml, Z=-2.67, P=0.008], IL-6 [22.40(5.13, 67.27) pg/ml vs 14.63(5.27, 27.71) pg/ml, Z=-2.81, P=0.005], IL-10 [(2.53±0.68) pg/ml vs (1.74±0.74) pg/ml, t=2.60, P=0.017] were significantly changed, while serum levels of IL-4 [1.63(1.08, 3.38) pg/ml vs 1.33(0.97, 2.59) pg/ml, Z=-0.89, P=0.374], tumor necrosis factor (TNF) -α [4.04(1.41, 10.45) pg/ml vs 1.62(0.84, 3.79) pg/ml, Z=-1.92, P=0.056], IL-17 [4.68(1.67, 6.72) pg/ml vs 3.15(1.81, 5.29) pg/ml, Z=-0.53, P=0.594] were not significantly changed from baseline data. ③ There was poor consistency between ultrasonic response and DAS28-ESR response, simplified disease activity Index (SDAI) response and clinical disease activity index (CDAI) response ( Kappa coefficient: 0.142, 0.142, 0.191), but no consistency between ultrasonic response and DAS28-CRP response (Kappa coefficient: -0.015) were found. Receiver operating characteristic (ROC) curve showed that ultrasound was not statistically significantly different in assessing the remission of RA, indicating subclinical synovitis remained in ultrasound examination even though clinically remission could be reached based on the above scoring indexes in RA patients. ④ In terms of adverse reactions, neutrophils (NEU) of patients after 3 months' tocilizumab treatment [4.47(2.77, 5.39)×10 9/L vs 3.76(2.98, 4.74)×10 9/L, Z=-2.77, P=0.006], platelet count (PLT) [(291±84)×10 9/L vs (254±70)×10 9/L, t=4.76, P<0.001] were significantly decreased, high-density lipoprotein-cholesterol (HDL-C) [(1.22±0.27) mmol/L vs (1.39±0.34) mmol/L, t=3.12, P=0.003], low density lipoprotein-cholesterol (LDL-C) [(1.96±0.66) mmol/L vs (2.19±0.84) mmol/L, t=3.15, P=0.003], triglyceride (TG) [0.85(0.68, 1.08) mmol/L vs 0.93(0.71, 1.25) mmol/L, Z=-2.36, P=0.018] and total cholesterol (TC) [(4.18±1.04) mmol/L vs (4.52±1.16) mmol/L, t=3.33, P=0.002] were significantly different from baseline. Among 65 patients, 5 patients (7.7%) had transaminase abnormality, but returned to normal after symptomatic treatment. Conclusion:Tocilizumab treatment can effectively suppress the inflammatory reactions, improve the clinical symptoms and prognosis of patients, however, patients who judged as clinical remission according to the current clinical commonly scores may still have subclinical active disease, ultrasound results should be included as one criteria for disease remission assessment and take into consideration when adjusting treatrnent.

The present study carried out a phytochemical investigation of the methanol extract of the branches and leaves of Clausena lansium and afforded nine carbazole alkaloids (compounds 1-9) including two new carbazole alkaloids, claulansiums A and B (compounds 1 and 2). The new compounds were elucidated on the basis of extensive spectroscopic data (MS, NMR, IR, and UV) and the known compounds were identified by comparing spectroscopic data with those reported in literature. All the isolated compounds were tested for their cytotoxic activity against A549 and Hela cancer cell lines. Our results showed that compounds 2-6 exhibited varying degrees of cytotoxicity to cancer cells, with IC values ranging from 8.67 to 98.89 μmol·L.
A549 Cells ; Alkaloids ; chemistry ; isolation & purification ; toxicity ; Antineoplastic Agents ; chemistry ; isolation & purification ; toxicity ; Carbazoles ; chemistry ; isolation & purification ; toxicity ; Cell Line, Tumor ; Cell Survival ; drug effects ; Clausena ; chemistry ; HeLa Cells ; Humans ; Molecular Structure ; Plant Extracts ; chemistry ; toxicity ; Plant Leaves ; chemistry ; Plant Stems ; chemistry ; Plants, Medicinal ; chemistry

In recent years, continuous manufacturing technology has attracted considerable attention in the pharmaceutical industry. This technology is highly sought after for its significant advantages in cost reduction, increased efficiency, and improved productivity, making it a growing trend in the future of the pharmaceutical industry. Compared to traditional batch production methods, continuous manufacturing technology features real-time control and environmentally friendly intelligence, enabling pharmaceutical companies to produce drugs more efficiently. However, the adoption of continuous manufacturing technology has been slow in the field of traditional Chinese medicine(TCM) pharmaceuticals. On the one hand, there is insufficient research on continuous manufacturing equipment and technology that align with the characteristics of TCM preparations. On the other hand, the scarcity of talent with diverse expertise hampers its development. Therefore, in order to promote the modernization and upgrading of the TCM pharmaceutical industry, this article combined the current development status of the TCM industry to outline the development status and regulatory requirements of continuous manufacturing technology. At the same time, it analyzed the problems with existing TCM manufacturing models and explored the prospects and challenges of applying continuous manufacturing technology in the field of TCM pharmaceuticals. The analysis focused on continuous manufacturing control strategies, technical tools, and pharmaceutical equipment, aiming to provide targeted recommendations to drive the development of the TCM pharmaceutical industry.
Medicine, Chinese Traditional ; Quality Control ; Drug Industry ; Technology, Pharmaceutical/methods* ; Drugs, Chinese Herbal ; Pharmaceutical Preparations

【Objective】 To analyze the hepatitis B virus (HBV) infection data of blood donors from 18 domestic blood stations, so as to investigate the HBV infection situation of blood donors. 【Methods】 The positive rate of HBV and its distribution characteristics of regions, the percentage of HBsAg+ ELISA in first-time vs repeated blood donors, and the percentage of HBsAg-/HBV DNA+ blood donors of 18 domestic blood stations during 2017 to 2020 were collected from the Working Platform for Practice Comparison of Blood Centers, and the HBV infection among blood donors were statistically analyzed. 【Results】 From 2017 to 2020, the positive rate of HBV in blood donors among 18 domestic blood stations was 13.48/10 000-144.02/10 000, with the average HBV positive rate in eastern, central and western region at 26.14/10 000, 51.98/10 000 and 41.00/10 000, respectively. The HBsAg+ rate by ELISA among first-time and repeated blood donors was 14.55/10 000-305.39/10 000 vs 1.04/10 000-87.43/10 000 The HBsAg-/HBV DNA+ yield was 1.80/10 000-35.31/10 000. 【Conclusion】 The distribution of HBV infection in blood donors has regional characteristics, and HBV prevalence was low in repeated blood donors. HBsAg ELISA combined with HBV DNA detection can better ensure blood safety.

To detect the concentration of triptolide in skin and joint after percutaneous administration,an HPLC-MS/MS method and skin and joint micro-dialysis( MD) method of triptolide were established in this study. The separation was achieved on triple quadrupole( AB QTRAP4500) and phenomenex-C18( 4. 6 mm×150 mm,5 μm,luna) column with acetonitrile-water with 0. 1% formic acid( 65 ∶35) as the mobile phase at a flow rate of 0. 7 m L·min-1. An electrospray ionization( ESI) source was applied and operated in the positive multiple reaction monitoring( MRM) mode. The fragment ion for triptolide was m/z 361. 1→145. 0. The effects of different perfusion [Ringer's,PBS( p H 7. 4),30% ethanol saline]drug concentrations and flow rates on the recovery rate,as well as the relationship between the recovery rate and the loss rate were determined by incremental( dialysis) and reduction( retrodialysis) methods.The reduction method was applied in the in vivo study to investigate and determine the stability of the probe recovery rate in 10 h. The results of HPLC-MS/MS detection method conformed to the requirements of biological samples. The perfusion fluid was 30% ethanol saline. The recovery rate of skin and joint probes in vitro of triptolide increased within the flow rate of 0. 5-2. 5 μL·min-1. In order to increase the timeliness of data and the accuracy,the flow rate was determined to be 1 μL·min-1,and the sample interval was determined to be 0. 5 h. The recovery rate of triptolide in skin and joint probes in vitro and the loss rate were stable and equal despite of change of triptolide concentration within 10-200 μg·L-1. This indicated that the effect of drug concentration on the MD probe recovery rate was small,and the recovery rate could be replaced by the loss rate. The loss rate in vivo using MD method was measured at 10 h,indicating that the transfer rate of triptolide was stable within 10 h. The established method of triptolide in MD and HPLC-MS/MS can be applied to investigate the kinetic in skin and joint after percutaneous administration of triptolide.
Chromatography, High Pressure Liquid ; Diterpenes ; pharmacokinetics ; Epoxy Compounds ; pharmacokinetics ; Humans ; Joints ; metabolism ; Phenanthrenes ; pharmacokinetics ; Reproducibility of Results ; Skin ; metabolism ; Tandem Mass Spectrometry

Trauma is the leading cause of death for people under 40 years old in the world. At present, the rescue and treatment system of trauma patients in China is not yet well established, and the mortality of trauma patients is higher than those in the developed countries. Improving the treatment system is the key to reducing the trauma mortality. In order to innovate the service mode of trauma first aid, further promote the establishment of regional trauma first aid system, improve the ability of trauma treatment, reduce the mortality and disability rate of trauma patients in Jiangxi Province, recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center. In order to provide reference for the construction of trauma treatment system, the author analyzes the following aspects including functional positioning, basic requirements, organization management, and evaluation of core indicators.