Objective To investigate whether increasing the concentration of serum potassium facilitates the cardioversion to sinus rhythm during cardiopulmonary resuscitation (CPR) in a rat ventricular fibrillation (VF) model. Methods Sprague-Dawley (SD) rats with sustained VF by electrical induction were randomized into two groups by random number table. Five minutes after onset of electrical induction, 2.5% potassium chloride solution at a dose of 0.8 mL/kg (KCl group, n = 9) or equivalent normal saline (NS group, n = 9) was given respectively via femoral vein followed by traditional CPR. The changes of electrocardiogram (ECG) and the effect of defibrillation were compared between the two groups. Results During the CPR, the number of animals with spontaneous cardioversion (2 vs. 1, P = 1.000) and successful defibrillation (7 vs. 3, P = 0.026) were both increasing in KCl group compare with those in the NS group, which required fewer defibrillation (1.60±0.79 vs. 2.70±0.58, P = 0.064), lower calculative defibrillation energy (J: 4.00±3.00 vs. 8.30±2.89, P = 0.068), more animals restore spontaneous circulation (ROSC, 9 vs. 4, P = 0.029) and shorter ROSC time (s: 265.10±134.58 vs. 421.30±162.06, P = 0.096). At the beginning of CPR, animals in two groups all presented the fine amplitude (amplitude < 0.5 mV). At CPR 3 minutes the KCl group presented significantly larger amplitude compared with NS group (mV: 0.92±0.16 vs. 0.67±0.23, P = 0.030); The amplitude decreased in the animals which did not attain cardioversion to sinus rhythm over time. The animal number of fine amplitude at CPR 7 minutes were 0 and 5, respectively, in the KCl group and the NS group. Conclusion Increasing serum potassium concentration facilitates the VF amplitude enlargement, promotes the spontaneous conversion, increases the successful rate of defibrillation and reduces the energy for defibrillation in a rat VF model.

Objective To study the effect of potassium chloride (KCl) before CPR on successful resuscitation of rats with ventricular fibrillation (VF).Methods Sprague-Dawley (SD) rats with VF induced by alternating electricity current were randomly (ramdam runmber) divided into KCl group and normal saline (NS) group.Rats of two groups were prepared with 0.8 mL/kg of 2.5％ KCl in KCI group and equivalent volume of NS in NS group instead before CPR.The resuscitation was considered to be failure if ROSC was absent for 10 min.The comparisons of time required for ROSC,the average attempt of defibrillation,the average joule used for defibrillation,ROSC rate and 72 h survival rate were carried out between the two groups.Results The length of time required for ROSC in the KCl group (n =10) was shorter than that in NS group (n=10) [(283.89±152.44) svs.(404.38±164.27) s] (t=1.369,P =0.196).The average attempt of defibrillation in KCl group were fewer compared to the NS group [(1.50 ± 0.75) times vs.(2.66 ± 0.57) times,(t =2.701,P =0.022)],the average joule used for defibrillation in KCl group were less compared to NS group [(3.75 ± 2.86) J vs.(8.33 ± 2.88) J,(t =2.78,P =0.019)].The ROSC rate in the KCl group was higher than that in NS group (P =0.011).The 72 h survival rate in KCl group was higher than that in NS group (P =0.001).Conclusions Increasing plasma potassium level before CPR could increase the ROSC rate and survival rate in rats with VF.

With the recognition of antineutrophil cytoplasmic antibodies (ANCA)-related vasculitis and widespread vaccination against viral hepatitis B, the prevalence of polyarteritis nodosa (PAN) varied considerably. In our study, patients diagnosed as polyarteritis nodasa (PAN)based on the 1990 American College of Rheumatology(ACR) criteria were reclassified using 2007 European Medicines Agency(EMA) algorithm modified by 2012 Chapel Hill Consensus Conference(CHCC) definitions, aiming to evaluate the new classification criteria for the diagnosis of PAN. A total of 113 PAN patients admitted to Peking Union Medical College Hospital from January 2002 to December 2018 were retrospectively analyzed, who were classified into three subtypes including 9 patients with cutaneous, 80 with classic and 24 Hepatitis B virus (HBV) associated PAN. All patients were reclassified according to 2007 EMA algorithm using CHCC 2012 definitions. As a result, 7 patients were diagnosed as microscopic polyangiitis(MPA) and 19 patients with unclassified vasculitis based on the new classification criteria. The diagnostic rate of PAN was gradually declined as the classification criteria of vasculitides was update. However, there are quite a few PAN patients in China, whom rheumatologists should pay attention to the early diagnosis and treatment.

Newcastle disease virus-like particles (NDV VLPs) are composed of matrix protein (M) as the skeleton,with the insertion of hemagglutinin-neuraminidase and/or fusion protein.NDV VLPs are reported to be immunogenic and can induce specific humoral and cellular immune responses.However,its relationship with innate immunity remains elusive.Dendritic cells (DCs) are a group of specialized antigen presenting cells,which are crucial in connecting innate immunity and adaptive immunity.In this study,NDV VLPs and murine DCs were used to investigate the connection between NDV VLPs and innate immunity.The DC maturation induced by NDV VLPs (M+ HN) was evaluated.The results showed that NDV VLPs could be effectively taken up by DC and presented to naive T cells.NDV VLPs-induced DC significantly up-regulated the expression of MHC Ⅱ and costimulatory molecules on DC surface,and subsequently promoted the secretion of proinflammatory cytokines.This experiments also showed that different assembled NDV VLPs induced significant stimulating ability in cytokine levels.In summary,NDV VLPs can induce DC maturation,which gives insights to better understanding of VLPs-mediated innate immunity and provide information in selecting preferred NDV VLPs candidate.

OBJECTIVETo analyze the relationship between the ictal onset zone and dominant interictal epileptiform foci in tuberous sclerosis complex (TSC) patients.

METHODClinical data of 20 patients with TSC which had epileptic seizures during Video-EEG monitoring was assessed. Consistency and dominance of focal interictal epileptiform activity and the ictal onset zone were identified. Concordance between interictal and ictal findings was analyzed.

RESULTOf the 20 patients, 7 were female, and 13 were male. The age of epilepsy onset was from 15 d to 6 years. The Video-EEG monitoring age was from 6 months to 11 years. Family history was found in three cases. Abnormality in neuroimaging existed in 17 of 18 patients who were examined. Interictal EEG showed hypsarrhythmia in 3 patients, multifocal epileptiform activity with a dominant focus in 12 patients, both focal and generalized discharges in 2 patients, and only focal discharges in 3 patients. The seizures types during EEG monitoring included epileptic spasms, partial seizure, atypical absence, and generalized or focal myoclonic seizure. The most common seizure type was partial seizure and then epileptic spasms. EEG in 4 patients with epileptic spasms showed ictal generalized discharges and interictal hypsarrhythmia or generalized discharges. Clinical manifestation of epileptic spasms was asymmetric in 3 patients. Lateralization and location of interictal and ictal discharges were consistent in 2 of the 3 patients, while only lateralization consistency in 1 of the 3 patients. Partial seizures as the only seizure type were monitored in 13 patients. Of the 13 patients, lateralization and location of interictal and ictal discharges were inconsistent in 2 patients (15%), consistent in 8 patients (62%), lateralization or location consistent in 2 patients (15%). One case could not be analyzed because of uncertainty of lateralization and location of seizure onset.

CONCLUSIONIn the majority of patients with TSC, multifocal interictal epileptiform activity is present, in which a most dominance of focal epileptiform activity could be found. For some epileptic seizures or the majority of partial seizures, the ictal onset zone is concordant with the dominance of focal interictal epileptiform foci. The concordance might have positioning reference significance for preoperative evaluation of epilepsy surgery.

Brain ; pathology ; physiopathology ; Brain Mapping ; methods ; Cerebral Cortex ; pathology ; physiopathology ; Child ; Child, Preschool ; Electroencephalography ; statistics & numerical data ; Epilepsies, Partial ; diagnosis ; etiology ; physiopathology ; Female ; Humans ; Infant ; Infant, Newborn ; Magnetic Resonance Imaging ; Male ; Predictive Value of Tests ; Retrospective Studies ; Seizures ; diagnosis ; etiology ; physiopathology ; Tuberous Sclerosis ; complications ; diagnosis ; physiopathology

OBJECTIVETo study the effect of chemotherapy assisted with shenqi fuzheng injection (SFI) on senile patients with non-small cell lung cancer (NSCLC).

METHODSOne hundred and twenty old patients with NSCLC were treated with NP chemotherapeutic protocol, to the 60 patients in the treated group among them, additional medication of SFI was started one week before the beginning of chemotherapy. The short-term therapeutic efficacy, long-term survival rate, changes on quality of life (QOL) and immune function of patients, and hematological toxicity of therapy were observed.

RESULTSDifference between the two groups on short-term therapeutic effect, 1- and 2-year survival rate showed no significance (P>0.05), but the 3-year survival rate in the treated group was 26.6%, while that in the control group was 11.7%, showed that the former was higher than the latter. After treatment QOL of the treated group was better than that of the control (P<0.05). Besides, the hematological toxicity and affection on immune function of chemotherapy after treatment in the treated group were all lower than those in the control group showing significant difference (P<0.05).

CONCLUSIONSFI has definite toxicity relieving effect on chemotherapy in treating senile NSCLC.

Adenocarcinoma ; drug therapy ; immunology ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; immunology ; Carcinoma, Squamous Cell ; drug therapy ; immunology ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Injections ; Lung Neoplasms ; drug therapy ; immunology ; Male ; Middle Aged ; Phytotherapy ; Quality of Life

OBJECTIVE:To provide reference for improving rational drug use in undergraduates from non-medical college. METHODS:By questionnaire survey,9 non-medical colleges were collected according to college entrance examination admission batches and school types stratification sampling. The questionnaires were issued among 860 college students by encounter sampling. The survey included medication knowledge,medication behavior,personal basic information three aspects. Single factor analysis and Logistic regression analysis were conducted for their influential factors. RESULTS:A total of 860 questionnaires were sent out, and 812 valid questionnaires were collected with effective recovery rate of 94.4%. In respect of medication knowledge,4.2% of college students answered all of the five questions correctly,the correlation of correct rate with monthly disposable income was maximal(P=0.007);correct rate of the minority students with monthly disposable income more than 6 000 yuan was higher. In respect of medication behavior,14.4% of college students answered all of the seven questions correctly,the correlation of correct rate with whether the family had long-term(more than half a year)medication experience was maximal(P=0.035);the students whose family had no long-term(more than half a year)medication experience member and had medical personnel used drugs more standardly. CONCLUSIONS:The non-medical college students in Beijing lack of medication knowledge and have poor compliance;medication behavior is also unreasonable. Society,universities and families should strengthen the health education of students,and guide students to standardize the self-medicine therapy.

Objective:To investigate the effects of long non-coding RNA (lncRNA) Gm13568 on the activation of A1 astrocytes and the progress of experimental autoimmune encephalomyelitis (EAE) in mice.Methods:A recombinant lentiviral vector (LV-Inhibit-Gm13568) carrying astrocyte-specific promoter of glial fibrillary acidic protein (GFAP) was established to inhibit the function of endogenous Gm13568. A control vector (LV-ctrl) was established as well. The recombinant vectors were packaged. C57BL/6 mice were injected with 1×10 7 transforming units of viral suspension via the tail vein and 7 d after the injection, myelin oligodendrocyte glycoprotein 35-55 (MOG 35-55) was used to establish the mouse model of EAE. Four groups, PBS group, EAE group, LV-ctrl+ EAE group and LV-Inhibit-Gm13568+ EAE group, were included in this study. Clinical signs of the mice were monitored daily in a double-blinded manner. The mice were sacrificed 23 d after the EAE model was established and the spinal cord tissues were collected. The expression of Serping 1, C3, Srgn and H2-T23 at mRNA level was detected by real-time PCR. Changes in the expression of IL-6, TNF-α, macrophage chemotactic protein-1 (MCP-1) and interferon-inducible protein-10 (IP-10) were measured. Western blot was used to investigate the expression of GFAP and Notch1 in spinal cord tissues and the phosphorylation of signal transduction and transcription activator 3 (STAT3). The expression of Notch1 intracellular domain (NICD) and GFAP in spinal cord tissues was detected by immunofluorescence. Furthermore, the infiltration of inflammatory cells and the demyelination of spinal cord were observed using HE and Luxol fast blue (LFB) staining methods. Results:Compared with PBS group, A1 astrocytes were activated and Notch1 expression was significantly up-regulated in EAE group and LV-ctrl+ EAE group. The clinical score of mice in LV-Inhibit-Gm13568+ EAE group was decreased from an average score of 3.5 to less than 1 on 23 d after antigen induction and the clinical symptoms were alleviated as compared with the mice in LV-ctrl+ EAE group. Meanwhile, the activation of A1 astrocytes was down-regulated, and the production of inflammatory cytokines and chemokines was also reduced. The expression of Notch1, GFAP and NICD at protein level and the phosphorylation of STAT3 were significantly reduced. Moreover, the infiltration of inflammatory cells and demyelination of spinal cord tissues were alleviated significantly.Conclusions:LncRNA Gm13568 might regulate the activation of A1 astrocytes via the Notch1/STAT3 pathway, thus affecting the production of inflammatory cytokines and chemokines and participating in the process of EAE.

【Objective】 To investigate the clinical efficacy and safety of low-dose rituximab combined with dexamethasone in the treatment of refractory ITP (RITP) in children. 【Methods】 A total of 31 RITP children, admitted to the Hematology Department of Kunming Children′s Hospital from January 2016 to December 2019 and agreed to receive low-dose rituximab (100 mg/ time, once a week, for 4 successive weeks) combined with dexamethasone (0.6 mg/kg, once a day, for 4 successive days) were enrolled and studied. Blood routine was monitored every other day during treatment, and adverse drug reactions were recorded. The influence of gender, disease course and age on prognosis was compared by χ² test. 【Results】 1) Among the 31 cases, 11 (35.5%) had platelets >100×10⁹/L after 4 weeks and had no recurrence in 6 months; 9 (29%) had platelets >30×10⁹/L but <100×10⁹/L and had no recurrence in 6 months; 11 (35.5%) showed no recovery of platelets, which were consistently lower than 30×10⁹/L. 2) Rituximab was used in 4 cases (12.9%), 1 case (3.2%) presented with severe drug-induced rashes; Headache, vomiting and elevated blood pressure occurred in 2 cases (6.4%). 1 case (3.2%) presented with laryngeal edema. 3) There was no difference in the total effective rate among different gender, age and disease course (P >0.05). 【Conclusion】 The total effective rate of low-dose rituximab combined with dexamethasone for children with refractory ITP in 6 months is 64.5%, and the adverse reactions are tolerable, so it can be used as a treatment option for children with refractory ITP.

Objective:To evaluate the differences in clinical characteristics between different genders of Chinese patients with systemic sclerosis(SSc).Methods:The data of SSc patients registered in Chinese Rheumatism Data Center between August 2008 and June 2020 were retrospectively analyzed.Results:A total of 1 844 patients with SSc were enrolled in the study. The ratio of males to females was 289 to 1 555. The onset age was (48.6±13.7) years in males and (45.5±13.1) years in females( P<0.001). Male patients represented shorter disease duration [2.0(0.0, 4.0)years vs.3.0(1.0, 7.0) years, P<0.001],higher proportion of diffuse cutaneous SSc (dcSSc) [63.0% (182/289)vs.44.2%(688/1 555), P<0.001]. Although more man patients experienced smoking [47.4%(137/289) vs. 1.7%(27/1 555), P<0.001] and exposure to harmful environments [7.6%(22/289) vs. 2.1%(33/1 555), P<0.001], there was no statistically significant difference in interstitial lung disease between male and female patients [69.3%(181/261) vs. 74.5%(1 085/1 457), P=0.084].Otherwise, Raynaud′s phenomenon [87.7% (1 364/1 555) vs.75.4%(218/289), P<0.001], arthritis [11.1%(173/1 555) vs.6.9%(20/289), P=0.032], gastroesophageal reflux disease [22.0%(342/ 1 555) vs.13.1%(38/289), P=0.001], and leucopoenia [10.7(161/1 511)% vs. 6.1%(17/279), P=0.019] were more common in female patients, but finger ulcer was less common [22.5%(350/1 555) vs. 30.4%(88/289), P=0.004]. Antinuclear antibody(ANA) positivity rate [85.6%(1 310/1 531) vs. 78.6%(221/281), P=0.003], anti-RNP antibody positivity rate [23.1%(342/1 479) vs.14.0%(38/271), P=0.001], anti-SSA antibody positivity rate [28.2%(419/1 487) vs.13.9%(38/274), P<0.001] were higher in female patients. Physician′s global assessment(PGA) scores [1.4 (1.0, 2.0) vs. 1.0 (0.3, 1.6), P<0.001] and modified Rodnan Skin Score(mRSS) [18.0 (9.5, 28.0) vs. 14.0 (5.0, 28.0), P=0.003] were higher in males. Conclusion:Even though male SSc patients account for a small proportion, more extensive skin involvement, finger ulcers and higher PGA are manifested in males. Physicians need pay attention to these clinical disparities between different genders in SSc.