Butanedioic acid was isolated from the ethyl alcohol extract of Hedysarum polybotrys. The methylated carboxylic acid was identified by GC-MS method.
Carboxylic Acids ; chemistry ; isolation & purification ; Drugs, Chinese Herbal ; chemistry ; Succinates ; chemistry ; isolation & purification

INTRODUCTIONWe aimed to create a definition of neurophobia, and determine its prevalence and educational risk factors amongst medical students and junior doctors in Singapore.

MATERIALS AND METHODSWe surveyed medical students and junior doctors in a general hospital using electronic and paper questionnaires. We asked about knowledge, interest, perceived difficulty in neurology, and confidence in managing neurology patients compared to 7 other internal medicine specialties; quality and quantity of undergraduate and postgraduate neuroscience teaching, clinical neurology exposure, and postgraduate qualifications. Neurophobia was defined as ≤4 composite score of difficulty and confidence with neurology.

RESULTSOne hundred and fifty-eight medical students (63.5%) and 131 junior doctors (73.2%) responded to the questionnaire. Neurophobia prevalence was 47.5% in medical students, highest amongst all medical subspecialties, and 36.6% in junior doctors. Multivariate analysis revealed that for medical students, female gender (OR 3.0, 95% CI, 1.3 to 6.7), low interest (OR 2.5, 95% CI, 1.0 to 6.2), low knowledge (OR 10.1, 95% CI, 4.5 to 22.8), and lack of clinical teaching by a neurologist (OR 2.8, 95% CI, 1.2 to 6.6) independently increased the risk of neurophobia. For doctors, low interest (OR 3.0, 95% CI, 1.3 to 7.0) and low knowledge (OR 2.7, 95% CI, 1.2 to 6.2) independently increased the risk of neurophobia, and female gender was of borderline significance (OR 2.0, 95% CI, 0.9 to 4.6).

CONCLUSIONNeurophobia is highly prevalent amongst Singapore medical students and junior doctors. Low interest and knowledge are independent risk factors shared by both groups; female gender may also be a shared risk factor. The mnemonic GIK (Gender, Interest, Knowledge) identifies the risk factors to mitigate when planning teaching strategies to reduce neurophobia.

Attitude of Health Personnel ; Humans ; Medical Staff, Hospital ; Neurology ; Physicians ; Students, Medical ; Surveys and Questionnaires

The purpose of this study is to evaluate the interaction effects of In-Chen-How (Artemisia capillaries Thunb.) on the pharmacokinetics of acetaminophen and on liver microsomal cytochrome P450 enzyme activity in rats. The rats were divided into control group (n = 8) without In-Chen-How and the pretreated group (n = 8) administered with In-Chen-How (approximately 1.0 mL x kg(-1), according to weight) for 5 consecutive days. Rats in the control group received water simultaneously. Each rat was then given acetaminophen. The pharmacokinetic parameters of acetaminophen of the two groups were significantly different. In the In-Chen-How pretreated group, the maximum concentration of acetaminophen and the area under the plasma concentration-time curve were reduced about 58.4%, 56.7% and 55.4%. To further explain the results, liver microsomal suspensions were obtained from rats that were randomly divided into control and In-Chen-How pretreated group. The levels of CYP1A2 and CYP2E1 in hepatic microsomal protein from pretreated group were increased as compared to that from the control group. It indicated that In-Chen-How can stimulate the activity of CYP isozymes. The changes in the pharmacokinetics of acetaminophen resulting from the administration of In-Chen-How are related to an increase in metabolic activity of CYP1A2 and CYP2E1.
Acetaminophen ; administration & dosage ; blood ; pharmacokinetics ; Administration, Oral ; Analgesics, Non-Narcotic ; administration & dosage ; blood ; pharmacokinetics ; Animals ; Area Under Curve ; Artemisia ; chemistry ; Aryl Hydrocarbon Hydroxylases ; metabolism ; Cytochrome P-450 CYP1A2 ; metabolism ; Cytochrome P-450 CYP2E1 ; metabolism ; Drug Interactions ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Immunoblotting ; Male ; Metabolic Clearance Rate ; drug effects ; Microsomes, Liver ; drug effects ; enzymology ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Wistar

OBJECTIVE: To investigate the efficacy and safety of polysaccharide nucleic acid-fraction (BCG-PSN) in the treatment of vasomotor rhinitis. METHOD: Sixty patients were randomly divided into BCG-PSN group (n = 30) and control group (n = 30). The patients in BCG-PSN group were administered with BCG-PSN 1.0 mg twice a week for two months, and intranasal azelastine was used if needed. The patients in control group were administered with intranasal azelastine solely twice a day, which could be decreased with the symptom relief. Follow-up was 6 months. Symptom and medication scores were recorded. Side effects were registered. RESULT: The symptom and medication scores of BCG-PSN group were significantly lower than that of control group (P < 0.01) after BCG-PSN treatment. There was no significant difference in symptom score between the two groups at 6 months after BCG-PSN treatment (P > 0.05), while the medication score of BCG-PSN group was still much lower than that of control group (P < 0.01). No serious adverse events were reported in BCG-PSN group except for local pain on the injection place in one patient. CONCLUSION BCG-PSN is effective and safe in the treatment of vasomotor rhinitis.
Adolescent ; Adult ; BCG Vaccine ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Vasomotor ; drug therapy ; Single-Blind Method ; Young Adult

OBJECTIVE: To investigate the distribution of positive allergens in patients with allergic rhinitis and the discrepancy among different age group. METHOD: Skin prick tests were done to 2 808 allergic rhinitis patients, the major allergens of local area were tested with standard allergens. Data was analyzed with age and allergens. RESULT: Dermatophagoides pteronyssinus and dermatophagoides farinae had the highest positivity among all allergens (91.03%, 86.47%). Other important allergens were cockroach (19.55%), ragweed (15.63%) and mugwort (14.13%) subsequently. The distribution of major allergens was variable among different age group. The positivity of mold mixture I was much higher in 3-9 years old group than other age group. Positive percentage of ragweed and mugwort allergens were increased with age growing. Positive ratio of cockroach which was higher in the elder than that in the younger, was highest in 30-39 years old group. Ratio in patients with single allergen positive decreased with age growing. CONCLUSION House dust mite was the most important allergen of the local area, the distribution of positive allergens was variable in different age group.
Adolescent ; Adult ; Age Distribution ; Aged ; Allergens ; analysis ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic, Perennial ; epidemiology ; Rhinitis, Allergic, Seasonal ; epidemiology ; Young Adult

Although HIV is a significant problem in Africa, HIV infection rates are rising rapidly in other regions such as Asia and South America. International health organizations have recognized the need to develop effective strategies to check the worldwide transmission of HIV. Studies have demonstrated the significant reduction of HIV, HPV, HSV-2 and other STD infection rates with male circumcision (MC). Although numerous MC techniques are available, there are no standardized protocols and surgical training programs. Studies have shown that the standardization of MC techniques coupled with training programs can significantly reduce complication rates. High complication rates have been a primary obstacle to the implementation of MC services. We recommend the establishment of surgical standards and training protocols prior to the promotion of MC services in China.
China ; Circumcision, Male ; standards ; HIV Infections ; prevention & control ; Humans ; Male

OBJECTIVEStandardization of and training in adult male circumcision can significantly reduce its complication rate. Currently no such program exists for its standardization and training, making it difficult to guarantee the quality of male circumcision services. We therefore established a standardized surgical protocol for adult male circumcision in China using the Shang Ring, and applied it to a clinical study examining the performance of the Shang Ring in adult male circumcision.

METHODSA total of 328 adult men aged 18-58 (mean 27.8) years, 25 with phimosis and 303 with redundant prepuce, underwent circumcision with the Shang Ring, and evaluation of the operation time, pain scores (using the visual analog scale), postoperative complications, time for wound healing, and their satisfaction with the postoperative appearance.

RESULTSThe operation time was 4.7 +/- 1.3 minutes. The pain scores were 0. 2 +/- 0.6 during the surgery, 1.6 +/- 1.0 twenty hours postoperatively, 1.7 +/- 1.1 twenty hours prior to the ring removal, and 2.7 +/- 1.4 during the ring removal. Complications included infection in 2 (0.6%), bleeding in 2 (0.6%), and wound dehiscence in 2 (0.6%) of the patients. None of the patients with wound dehiscence required postoperative suturing and all were managed conservatively instead. Sixteen of the patients (4.9%) experienced penile edema. The time for complete wound healing after circumcision was 20.3 +/- 6.7 days. The rate of the patients'satisfaction was 99.7% (327/328).

CONCLUSIONThe standard protocol of adult male circumcision with the Shang Ring has the advantages of short operation time, slight pain, low rate of complications, and high satisfaction and acceptance of the patients. Strict standardization of the surgical protocol can maximize its clinical advantages for adult male circumcision.

Adolescent ; Adult ; China ; Circumcision, Male ; methods ; standards ; Humans ; Male ; Middle Aged ; Phimosis ; surgery ; Reference Standards ; Young Adult

Non-small cell lung cancer is a prevalent and rapidly-expanding challenge to modern medicine. While generalized medicine with traditional chemotherapy yielded comparatively poor response rates and treatment results, the cornerstone of personalized medicine using genetic profiling to direct treatment has exalted the successes seen in the field and raised the standard for patient treatment in lung and other cancers. Here, we discuss the current state and advances in the field of personalized medicine for lung cancer, reviewing several of the mutation-targeting strategies that are approved for clinical use and how they are guided by patient genetic information. These classes include inhibitors of tyrosine kinase (TKI), anaplastic lymphoma kinase (ALK), and monoclonal antibodies. Selecting from these treatment plans and determining the optimal dosage requires in-depth genetic guidance with consideration towards not only the underlying target genes but also other factors such as individual metabolic capability and presence of resistance-conferring mutations both directly on the target gene and along its cascade(s). Finally, we provide our viewpoints on the future of personalized medicine in lung cancer, including target-based drug combination, mutation-guided drug design and the necessity for data of population genetics, to provide rough guidance on treating patients who are unable to get genetic testing.

[摘 要] 目的：探讨碱性核蛋白1（BNC1）对食管鳞状细胞癌（ESCC）细胞增殖、迁移、侵袭、细胞周期和凋亡的影响及其作用机制。方法：通过qPCR法检测ESCC细胞和正常食管上皮细胞中BNC1 mRNA的表达水平，免疫组织化学染色法检测10例ESCC患者癌及癌旁组织中BNC1的蛋白表达水平。利用siRNA敲低BNC1在KYSE-150和KYSE-30细胞中的表达，CCK-8法、划痕愈合实验、Transwell实验和流式细胞术检测BNC1对细胞增殖、迁移、侵袭、细胞周期和凋亡等的影响。通过CHIP-seq实验和GEPIA在线网站数据分析并结合敲低BNC1后的转录组测序数据分析筛选BNC1调控的下游靶基因，qPCR法验证BNC1敲低后靶基因的表达变化，并用双荧光素酶报告基因实验验证BNC1对靶基因的调控作用。结果：BNC1 mRNA和蛋白水平在ESCC组织中较癌旁组织高表达（均P<0.01）。敲低BNC1可明显抑制KYSE-150、KYSE-30细胞的增殖、迁移和侵袭能力（P<0.05或P<0.01），将细胞阻滞于G1期并促进细胞的凋亡（均P<0.01）。CHIP-seq实验结果和在线网站GEPIA数据分析结合敲低BNC1后的转录组测序数据显示，G蛋白通路抑制因子1（GPS1）可能为BNC1正向调控的致癌靶基因。qPCR法和双荧光素酶报告基因实验结果显示，BNC1对GPS1有调控作用（P<0.01）。结论：BNC1在ESCC组织和细胞中高表达，干扰BNC1可显著抑制ESCC细胞的增殖、迁移和侵袭能力，阻滞细胞于G1期并促进细胞凋亡，其机制可能是BNC1通过靶向GPS1调控ESCC细胞的恶性生物学行为。

Back pain is a worldwide health problem, adding a tremendous burden to modern societies. However, little information on back health is available in China, even though a quarter of the world's population is Chinese. To enhance knowledge in this area, we designed and initiated the Hangzhou Lumbar Spine Study, which is a cross-sectional study of a general sample of mainland Chinese with focusing on disc degeneration, Modic changes, endplate lesions, and back pain. The study consists of a structured questionnaire to measure back pain history and lifetime exposure to suspected risk factors, magnetic resonance imaging of the lumbar spine, bone mineral density study of the spine and hip, and DNA sample analysis. Here we briefly introduce the study methodology, report the test-retest reliability of the questionnaire, and describe the cohort profile to date. Since May 2014, 301 randomly selected subjects (male/female, 122/179; mean age, 51.0 years; range, 20-87 years) have been recruited. Tests-retests of the questionnaire, completed by 40 participants, revealed good reliability. To our knowledge, the Hangzhou Lumbar Spine Study is the first population-based epidemiological study conducted to characterize lumbar spinal phenotypes and back pain, their interaction, and their associations with lifetime environmental exposure, in mainland Chinese. Epidemiological information obtained from a reliable questionnaire, magnetic resonance (MR) imaging data, dual energy X-ray absorptiometry (DXA) measurements, and DNA analysis may serve as a valuable reference for future studies on back health, particularly for mainland Chinese.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Cohort Studies ; Cross-Sectional Studies ; Female ; Health Status ; Humans ; Low Back Pain ; diagnostic imaging ; epidemiology ; Lumbar Vertebrae ; diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Reproducibility of Results ; Surveys and Questionnaires ; Young Adult