Purpose: Administering early parenteral amino acids to very low birth weight (VLBW) premature infants (birth body weight [BBW]<1,500 g) is challenging due to factors such as holidays, cost, and access to sterile compounding facilities. Using advance-prepared parenteral nutrition (PN) may address this issue and should be evaluated for its safety and potential benefits. Methods: We extracted data from medical records collected between July 2015 and August 2019. VLBW infants received PN for at least seven days and were split into two groups:the traditional group (n=30), which initially received a glucose solution and then PN on workdays, and the pre-preparation group (n=16), which received advance-prepared PN immediately upon admission to the neonatal intensive care unit. Results: The median BBWs of the traditional and pre-preparation groups were 1,180.0 vs. 1,210.0 g. In the initial two days, the pre-preparation group had a significantly higher amino acid intake (2.23 and 2.24 g/kg/d) than the traditional group (0 and 1.78 g/kg/d). The pre-preparation group exhibited greater head circumference growth ratio relative to birth (7th day: 1.21% vs. −3.57%, p=0.014; 21st day: 7.71% vs. 3.31%, p=0.017). No significant differences in metabolic tolerance were observed. Conclusion Advanced preparation of PN can be safely implemented in VLBW preterm infants, offering advantages such as early, higher amino acid intake and improved head circumference growth within the first 21 days post-birth. This strategy may serve as a viable alternative in settings where immediate provision of sterile compounding facilities is challenging.

OBJECTIVETo investigate the therapeutic effects of Qingre Quyu Granule (QQG) on the patients with severe carotid stenosis, and to explore the mechanism of it.

METHODSNinety-six patients with severe carotid stenosis were enrolled in the study and were classified into a QQG group (n=48) and a control group (n=48) randomly using consecutively numbered envelopes. The patients in the QQG group were given QQG and Western medicine, those in the control group were given Western medicine merely, the course of treatment was 16 weeks. All patients went through endarterectomy after treatment. Plaques were subjected to the analysis of CD3, CD68, soluble intercellular adhesion molecule 1 (ICAM-1), matrix metalloprotease-9 (MMP-9), CD40L, tenascin-C, and collagen content lipid content by immunohistochemistry or polarized light analysis.

RESULTSBy the end of experiment, the expressions of CD3, CD68, ICAM-1, MMP9, CD40L and tenascin-C on the plaques were statistically significant lower in the QQG group compared with the control group(P<0.01). The lipid content of the plaque was also significantly lower in the QQG group compared with the control group (P<0.01). The interstitial collagen in the tissue sections of the plaques was also significantly higher in the QQG group in comparison with the control group (P<0.01).

CONCLUSIONQQG could stabilize carotid artery plaques through inhibiting pro-inflammation factors and restraining the tenascin-C and MMP9 pathway.

Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; CD3 Complex ; metabolism ; CD40 Ligand ; metabolism ; Carotid Arteries ; metabolism ; pathology ; Carotid Stenosis ; blood ; complications ; drug therapy ; Collagen ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Immunohistochemistry ; Inflammation ; complications ; pathology ; Intercellular Adhesion Molecule-1 ; metabolism ; Lipids ; blood ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Plaque, Atherosclerotic ; blood ; complications ; drug therapy ; Tenascin ; metabolism

OBJECTIVETo explore the clinical curative effect and safety of Jiedu Tongluo Lishi decoction on treating active rheumatoid arthritis (RA).

METHOD106 cases of RA in active period were randomly divided into the integrated Chinese and western medicine group (n=54) and western medicine contrast group (n=52). The former group were treated by Jiedu Tongluo Lishi decoction combined with SASP, the latter by MTX combined with SASP. The arthritis morning stiffness time, ache indexes, tumidness indexes, function indexes, hands grip, 20-m walking time and experimental indexes including ESR, RF, CRP, C3, immune globin of both groups were observed and compared.

RESULTThe obviously clinical effective ratio and the total clinical effective ratio in the former group were 77.78% and 90.74% respectively, which are better than those in the latter group (59.62% and 71.15% respectively) (P < 0.01). The arthritis morning stiffness time, ache indexes, tumidness indexes, function indexes, hands grip and 20-m walking time in both groups were obviously released after treatment (P < 0.01). The clinical release in the former group was better than that in the latter group (P < 0.05). ESR, RF and CRP in both groups were markedly improved (P < 0.05). The improvement of ESR, RF, CRP, C3 and IgA in the former group were better than those in the latter group (P < 0.05). The side effect includes gastroenteric tract reaction, decrease of leucocyte, abnormity of liver function, tetter and catamenia maladjustment. The occurent ratio in the former group was 7.41%, which was obviously lower than that in the latter group (15.38%) (P < 0.01).

CONCLUSIONThe compositively clinical curative effect of Jiedu Tongluo Lishi decoction combined with MTX on treating RA is obviously better than that of western medicine only such as MTX and SASP, with less side effect and higher safety, which is worth applying in clinics extensively.

Animals ; Antirheumatic Agents ; isolation & purification ; therapeutic use ; Arthritis, Experimental ; blood ; chemically induced ; drug therapy ; Dinoprostone ; blood ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Female ; Freund's Adjuvant ; Interleukin-1beta ; blood ; Male ; Materia Medica ; isolation & purification ; therapeutic use ; Medicine, Chinese Traditional ; Mice ; Pain Threshold ; drug effects ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Wistar ; Scorpions ; chemistry ; Tumor Necrosis Factor-alpha ; blood

Background Early detection with screening mammography can potentially reduce breast cancer mortality rates.To achieve an efficient screening,a peer review system provides a compensatory double-check reviewing,will hopefully to prevent the omission of detectable lesions and reduce unnecessary recall.Methods In 2009,4643 initial mammographic screenings reported by 74 screening radiologists had negative results with a recall rate of less than 5％.In the same year,2538 initial positives screened by 18 screening radiologists had a recall rate higher than 15％.Those 7181 randomized screenings were evenly distributed for reassessment by 39 reviewing radiologists.The disagreement of assessments between the reviewers and screening radiologists was recorded.The differential rate was defined as the number of the disagreements divided by the number of audited films reviewed by a screening radiologist.The equality of the differential rates for each screening radiologists with negative and positive assessments was compared by a Chi-square test.The performance of the 39 auditors was measured by the Kendall's tau statistic.P values less than 0.05 were considered statistically significant.Results The mean differential rate for screening radiologists of negative assessments was 6.7％ (P=-0.588),while 35.0％ for positive assessments were significant (P ＜0.001).The result indicated that most of the initial negative assessments reported by the screening radiologists were generally accepted by the reviewers but not the positive assessments.With respect to the 39 reviewers,there was no significant evidence for the association of the difference rates between negative and positive assessments.Nine reviewers were found to have their differential rate for negative and positive assessments larger than the average of the population.Eleven reviewers were found to have their differential rates smaller than the average for both.Thirteen reviewers had their differential rates smaller than the average for negative assessments but larger than the average for positive assessments.The opposite condition was found for six reviewers.The Kendall's tau statistic was 0.038 (P=0.735).Conclusions Reviewers usually agreed with the opinion of the initial screening doctors who reported negative findings.Therefore,a 5％ recall rate as the lower range of reviewing negatives may be still too high.The recall rate of more than 15％ was significantly related to improper interpretation,especially when the differential rate is 25％ or higher,a warning to the underperforming screening radiologist is recommended.An ideal reviewer should interpret films independently.Reviewers with tendencies to be followers or contrarians should not be enrolled in the reviewing system.

Mounting evidence indicates that melatonin has possible activity against different tumors. Pazopanib is an anticancer drug used to treat renal cell carcinoma (RCC). This study tested the anticancer activity of melatonin combined with pazopanib on RCC cells and explored the underlying mechanistic pathways of its action. Methods: The 786-O and A-498 human RCC cell lines were used as cell models. Cell viability and tumorigenesis were detected with the MTT and colony formation assays, respectively. Apoptosis and autophagy were assessed using TUNEL, annexin V/propidium iodide, and acridine orange staining with flow cytometry. The expression of cellular signaling proteins was investigated with western blotting. The in vivo growth of tumors derived from RCC cells was evaluated using a xenograft mouse model. Results: Together, melatonin and pazopanib reduced cell viability and colony formation and promoted the apoptosis of RCC cells. Furthermore, the combination of melatonin and pazopanib triggered more mitochondrial, caspase-mediated, and LC3-II-mediated autophagic apoptosis than melatonin or pazopanib alone. The combination also induced higher activation of the p38 mitogen-activated protein kinase (p38MAPK) in the promotion of autophagy and apoptosis by RCC cells than melatonin or pazopanib alone. Finally, tumor xenograft experiments confirmed that melatonin and pazopanib cooperatively inhibited RCC growth in vivo and predicted a possible interaction between melatonin/pazopanib and LC3-II. Conclusion: The combination of melatonin and pazopanib inhibits the growth of RCC cells by inducing p38MAPK-mediated mitochondrial and autophagic apoptosis. Therefore, melatonin might be a potential adjuvant that could act synergistically with pazopanib for RCC treatment.

BACKGROUNDEarly detection with screening mammography can potentially reduce breast cancer mortality rates. To achieve an efficient screening, a peer review system provides a compensatory double-check reviewing, will hopefully to prevent the omission of detectable lesions and reduce unnecessary recall.

METHODSIn 2009, 4643 initial mammographic screenings reported by 74 screening radiologists had negative results with a recall rate of less than 5%. In the same year, 2538 initial positives screened by 18 screening radiologists had a recall rate higher than 15%. Those 7181 randomized screenings were evenly distributed for reassessment by 39 reviewing radiologists. The disagreement of assessments between the reviewers and screening radiologists was recorded. The differential rate was defined as the number of the disagreements divided by the number of audited films reviewed by a screening radiologist. The equality of the differential rates for each screening radiologists with negative and positive assessments was compared by a Chi-square test. The performance of the 39 auditors was measured by the Kendall's tau statistic. P values less than 0.05 were considered statistically significant.

RESULTSThe mean differential rate for screening radiologists of negative assessments was 6.7% (P = 0.588), while 35.0% for positive assessments were significant (P < 0.001). The result indicated that most of the initial negative assessments reported by the screening radiologists were generally accepted by the reviewers but not the positive assessments. With respect to the 39 reviewers, there was no significant evidence for the association of the difference rates between negative and positive assessments. Nine reviewers were found to have their differential rate for negative and positive assessments larger than the average of the population. Eleven reviewers were found to have their differential rates smaller than the average for both. Thirteen reviewers had their differential rates smaller than the average for negative assessments but larger than the average for positive assessments. The opposite condition was found for six reviewers. The Kendall's tau statistic was 0.038 (P = 0.735).

CONCLUSIONSReviewers usually agreed with the opinion of the initial screening doctors who reported negative findings. Therefore, a 5% recall rate as the lower range of reviewing negatives may be still too high. The recall rate of more than 15% was significantly related to improper interpretation, especially when the differential rate is 25% or higher, a warning to the underperforming screening radiologist is recommended. An ideal reviewer should interpret films independently. Reviewers with tendencies to be followers or contrarians should not be enrolled in the reviewing system.

Breast Neoplasms ; diagnostic imaging ; Early Detection of Cancer ; Female ; Humans ; Mammography ; Peer Review ; Reproducibility of Results ; Taiwan

OBJECTIVETo explore the relationship between the polymorphisms of DNA repair gene (XRCC1 194, 280 and 399) and the chromosomal damage induced by benzene.

METHODSThe chromosomal damage of the peripheral lymphocytes in 459 workers occupationally exposed to benzene and 88 non-exposed controls were detected with cytokinesis-block micronucleus (CBMN) assay. PCR-RFLP technique was used to measure polymorphisms in XRCC1 194, 280 and 399.

RESULTSIt was found that the MN frequency (2.12‰ ± 1.88‰) of the exposed group was significantly higher than that (1.19‰ ± 1.68‰) of the control group (P < 0.05), in the exposed group, the MN frequency (3.00‰ ± 2.76‰) of older workers (> 35 years) was significantly higher than that (2.02‰ ± 1.71‰) of younger workers (≤ 35 years) (P < 0.05). The effect of genetic polymorphisms of XRCC1 on CBMN was not found. The haplotypes AAA/BAA, AAB/AAB, ABA/ABA, ABB/ABB could associated with the increased frequencies of total micronucleus (P < 0.05).

CONCLUSIONBenzene exposure could result in chromosome damage. Age of workers and diplotypes of XRCC1 could associated with chromosomal damage induced by benzene.

Adult ; Benzene ; adverse effects ; DNA Damage ; drug effects ; genetics ; DNA-Binding Proteins ; genetics ; Humans ; Micronuclei, Chromosome-Defective ; Micronucleus Tests ; Occupational Exposure ; Polymorphism, Single Nucleotide ; X-ray Repair Cross Complementing Protein 1 ; Young Adult

OBJECTIVETo evaluate the efficacy and safety of nausea oral, disintegrating buccal tablet (DBT) in the prevention of gastrointestinal reaction induced by anticancer drugs (cisplatin DDP 30 - 50 mg/m(2) or adramycin ADM >/= 40 mg/m(2)), as compared with those of kytril tablets.

METHODSA multicenter, open and randomized self-crossover control trial was carried out with all the eligible patients randomized into AB or BA group. Patients in AB group were given nausea 0.1 mg as buccal tablet one hour before chemotherapy in the first cycle and kytril tablet 2 mg in the second cycle, those in BA group were given these drugs in the reverse order.

RESULTSSeventy-three patients were allotted to this study, including 44 patients in DDP-arm and 29 in ADM-arm. Sixty-two patients were evaluable for response and 70 patients for safety. Nausea DBT was as effective as kytril tablet in the control of anorexia, nausea and vomiting during the first 24 hours after chemotherapy, with response rates of 74.2%, 77.4%, 83.9% in nausea DBT and 74.2%, 71.0%, 88.7% DBT in kytril tablets. A high efficacy in the control of vommitting induced by cisplatin was observed in both nausea DBT and kytril tablets. The complete control rates and overall control rates were 83.3%, 91.7% in nausea DBT and 86.1%, 97.2% in kytril tablets, respectively. The side effects of nausea DBT were head heaviness, dry mouth and somnolence, which were mild and comparable with kytril in their frequencies.

CONCLUSIONNausea disintegrating buccal tablet is able to effectively prevent gastrointestinal reaction induced by anticancer drugs, with efficacy and side effects similar to kytril tablets. Nausea DB tablet, an intraoral disintegrator, is very convenient for patients who can not swallow tablets for various reasons.

Adolescent ; Adult ; Aged ; Antiemetics ; therapeutic use ; Antineoplastic Agents ; adverse effects ; Cisplatin ; adverse effects ; Digestive System ; drug effects ; Doxorubicin ; adverse effects ; Female ; Granisetron ; therapeutic use ; Humans ; Male ; Middle Aged ; Nausea ; chemically induced ; drug therapy ; Ondansetron ; Tablets ; Treatment Outcome ; Vomiting ; chemically induced ; drug therapy

Non-neonatal tetanus is an acute, specific, toxic disease in patients over 28 days of age, characterized by continuous rigidity and paroxysmal spasms of the skeletal muscles throughout the body caused by the intrusion of Clostridium tetani through skin or mucosal membrane into the body and reproducing in anaerobic environments to produce exotoxins. The mortality rate of severe patients is close to 100% without medical intervention. Even with aggressive comprehensive treatment, the global mortality rate remains at 30%-50%, making it a potentially fatal disease. In order to standardize the diagnosis, treatment and prevention of non-neonatal tetanus, based on "Regulation for Diagnosis and Treatment of Non-neonatal Tetanus (2019 Edition)", experts have revised this regulation according to clinical practice and recent research progress in this field to guide medical institutions in the prevention and control of non-neonatal tetanus. This article interprets the key points and basis for updating the 2024 edition regulation to guide clinical implementation and application.

BACKGROUND: Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD) has become a global epidemic, and air pollution has been identified as a potential risk factor. This study aims to investigate the non-linear relationship between ambient air pollution and MASLD prevalence. METHOD: In this cross-sectional study, participants undergoing health checkups were assessed for three-year average air pollution exposure. MASLD diagnosis required hepatic steatosis with at least 1 out of 5 cardiometabolic criteria. A stepwise approach combining data visualization and regression modeling was used to determine the most appropriate link function between each of the six air pollutants and MASLD. A covariate-adjusted six-pollutant model was constructed accordingly. RESULTS: A total of 131,592 participants were included, with 40.6% met the criteria of MASLD. "Threshold link function," "interaction link function," and "restricted cubic spline (RCS) link functions" best-fitted associations between MASLD and PM_2.5, PM₁₀/CO, and O₃ /SO₂/NO₂, respectively. In the six-pollutant model, significant positive associations were observed when pollutant concentrations were over: 34.64 µg/m³ for PM_2.5, 57.93 µg/m³ for PM₁₀, 56 µg/m³ for O₃, below 643.6 µg/m³ for CO, and within 33 and 48 µg/m³ for NO₂. The six-pollutant model using these best-fitted link functions demonstrated superior model fitting compared to exposure-categorized model or linear link function model assuming proportionality of odds. CONCLUSION Non-linear associations were found between air pollutants and MASLD prevalence. PM_2.5, PM₁₀, O₃, CO, and NO₂ exhibited positive associations with MASLD in specific concentration ranges, highlighting the need to consider non-linear relationships in assessing the impact of air pollution on MASLD.
Humans ; Nitrogen Dioxide ; Cross-Sectional Studies ; Air Pollution/analysis* ; Air Pollutants/analysis* ; Particulate Matter/analysis* ; Liver Diseases ; Environmental Exposure/analysis*